Sample records for assess functional outcome

  1. Assessing Function and Functional Outcome in Schizophrenia

    Microsoft Academic Search

    Elizabeth Bromley; John S. Brekke

    \\u000a The diagnosis of schizophrenia can only be made in the presence of a loss of functioning in domains such as employment, independent\\u000a living, and social functioning. Accurately measuring functioning is central to research on the course of the disorder, treatment\\u000a and rehabilitation outcomes, and biosocial factors in schizophrenia. Assessments of functional disability have described three\\u000a dimensions of functioning: functional capacity,

  2. Measuring Assistive Technology Outcomes in Schools Using Functional Assessment.

    ERIC Educational Resources Information Center

    Silverman, Michelle Kaye; Stratman, Kristine Freiberg; Smith, Roger O.

    2000-01-01

    Activities of Project OATS (Outcomes of Assistive Technology in the Schools) are described, including identification and piloting of existing assessment instruments for use as an outcome measure, examining the validity of the School Function Assessment, and field testing the School Function Assessment-Assistive Technology Version, an adaptation of…

  3. Brief cognitive assessment and prediction of functional outcome in stroke.

    PubMed

    Larson, Eric B; Kirschner, Kristi; Bode, Rita K; Heinemann, Allen W; Clorfene, Jeremy; Goodman, Rebecca

    2003-01-01

    To evaluate the ability to predict outcome with a brief measure of cognitive ability, we tested consecutive admissions who received inpatient rehabilitation for stroke with the Repeatable Battery for Assessment of Neuropsychological Symptoms (RBANS). Six months later, 34 discharged patients were contacted by telephone and were interviewed using a battery of functional outcome and quality of life measures. Multiple regression analysis showed that inpatient RBANS indexes predicted cognitive disability 6 months later. The present findings support the use of cognitive evaluations of patients with acute stroke to assist with prediction of outcome to be used in treatment planning. PMID:14523696

  4. Objective Integrated Assessment of Functional Outcomes in Reduction Mammaplasty

    PubMed Central

    Passaro, Ilaria; Malovini, Alberto; Faga, Angela; Toffola, Elena Dalla

    2013-01-01

    Background: The aim of our study was an objective integrated assessment of the functional outcomes of reduction mammaplasty. Methods: The study involved 17 women undergoing reduction mammaplasty from March 2009 to June 2011. Each patient was assessed before surgery and 2 months postoperatively with the original association of 4 subjective and objective assessment methods: a physiatric clinical examination, the Roland Morris Disability Questionnaire, the Berg Balance Scale, and a static force platform analysis. Results: All of the tests proved multiple statistically significant associated outcomes demonstrating a significant improvement in the functional status following reduction mammaplasty. Surgical correction of breast hypertrophy could achieve both spinal pain relief and recovery of performance status in everyday life tasks, owing to a muscular postural functional rearrangement with a consistent antigravity muscle activity sparing. Pain reduction in turn could reduce the antalgic stiffness and improved the spinal range of motion. In our sample, the improvement of the spinal range of motion in flexion matched a similar improvement in extension. Recovery of a more favorable postural pattern with reduction of the anterior imbalance was demonstrated by the static force stabilometry. Therefore, postoperatively, all of our patients narrowed the gap between the actual body barycenter and the ideal one. The static force platform assessment also consistently confirmed the effectiveness of an accurate clinical examination of functional impairment from breast hypertrophy. Conclusions: The static force platform assessment might help the clinician to support the diagnosis of functional impairment from a breast hypertrophy with objectively based data. PMID:25289256

  5. Myocardial Infarction and Functional Outcome Assessment in Pigs

    PubMed Central

    Koudstaal, Stefan; Jansen of Lorkeers, Sanne J.; Gho, Johannes M.I.H.; van Hout, Gerardus P.J; Jansen, Marlijn S.; Gründeman, Paul F.; Pasterkamp, Gerard; Doevendans, Pieter A.

    2014-01-01

    Introduction of newly discovered cardiovascular therapeutics into first-in-man trials depends on a strictly regulated ethical and legal roadmap. One important prerequisite is a good understanding of all safety and efficacy aspects obtained in a large animal model that validly reflect the human scenario of myocardial infarction (MI). Pigs are widely used in this regard since their cardiac size, hemodynamics, and coronary anatomy are close to that of humans. Here, we present an effective protocol for using the porcine MI model using a closed-chest coronary balloon occlusion of the left anterior descending artery (LAD), followed by reperfusion. This approach is based on 90 min of myocardial ischemia, inducing large left ventricle infarction of the anterior, septal and inferoseptal walls. Furthermore, we present protocols for various measures of outcome that provide a wide range of information on the heart, such as cardiac systolic and diastolic function, hemodynamics, coronary flow velocity, microvascular resistance, and infarct size. This protocol can be easily tailored to meet study specific requirements for the validation of novel cardioregenerative biologics at different stages (i.e. directly after the acute ischemic insult, in the subacute setting or even in the chronic MI once scar formation has been completed). This model therefore provides a useful translational tool to study MI, subsequent adverse remodeling, and the potential of novel cardioregenerative agents. PMID:24796715

  6. Assessment of outcomes.

    PubMed

    Blanchette, V S; O'Mahony, B; McJames, L; Mahlangu, J N

    2014-05-01

    Effective healthcare delivery necessitates evaluation of the effect of interventions in the form of outcome assessment. Treatment effect includes measurement of how the patient feels, functions and survives following healthcare interventions. In haemophilia, which is a rare bleeding disorder, outcome assessment was characterized by a lack of validated outcome measurement tools and the challenges of hemophilia study design to collect outcome data. The aim of this communication is to share current thinking and, through practical examples, provide a state of the art practice in the assessment of hemophilia outcomes from a healthcare provider, patient/family and funder perspective. This discussion is timely and particularly relevant to the care of people with hemophilia on the eve of a number of novel hemophilia treatment products which are about to be licensed for use, specifically the long-acting factor VIII and factor IX concentrates. The first section by Dr Blanchet gives an overview of the tools currently available for assessment of structure/function, patient activities and patient participation in hemophilia healthcare delivery, pointing out the challenge of developing new tools and appropriate validation of currently available tools. The second section by Mr Brian O'Mahony emphasizes the essential collaboration and partnership between healthcare providers and people with hemophilia in collating the outcome data. In the third and final section, Mr Leigh McJames, gives a funder's perspective of the desirable outcomes of hemophilia care. PMID:24762286

  7. Personal Functional Goals: A New Approach to Assessing Patient-Centered Outcomes

    Microsoft Academic Search

    Lucille B. Bearon; Gail M. Crowley; Julie Chandler; Michael S. Robbins; Stephanie Studenski

    2000-01-01

    One dilemma in outcomes research is finding measures that show the impact of an intervention on participants' quality of life, especially in areas most salient to participants. The authors describe the development and testing of a method for eliciting information about personal functional goals from older adults entering an exercise program and assessing progress after completion of the program. The

  8. The Behavioural Assessment of the Dysexecutive Syndrome (BADS) in schizophrenia and its relation to functional outcomes.

    PubMed

    Katz, Noomi; Tadmor, Inbal; Felzen, Batya; Hartman-Maeir, Adina

    2007-04-01

    The purpose of this study was to establish further the validity of the Behavioural Assessment of the Dysexecutive Syndrome (BADS) in a population with schizophrenia. Specific objectives were: to examine the construct validity and sensitivity of the BADS in differentiating between adult inpatients during an acute episode of illness, adult outpatients in the chronic stages of illness, and healthy controls; and to examine the predictive validity of the BADS regarding functional outcomes within the chronic group. Participants were 30 inpatients during an acute episode of their illness; 31 outpatients in the chronic stage; and 93 healthy controls. Instruments included the BADS, the Neurobehavioral Cognitive Status Examination (Cognistat) and the Routine Task Inventory (RTI). Significant differences in BADS scores were found between participants with schizophrenia and healthy controls, and between both groups of patients, showing the chronic group to have more deficits in executive functions. In addition, within the chronic group the BADS was found to be a significant predictor of two of the RTI outcome areas, instrumental activities of daily living (IADL) and communication, beyond that accounted for by basic cognitive skills. These results support the validity of the BADS within the schizophrenic population, and highlight the importance of measuring executive functions for rehabilitation. PMID:17454693

  9. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 2: assessment of functional outcome following lumbar fusion.

    PubMed

    Ghogawala, Zoher; Resnick, Daniel K; Watters, William C; Mummaneni, Praveen V; Dailey, Andrew T; Choudhri, Tanvir F; Eck, Jason C; Sharan, Alok; Groff, Michael W; Wang, Jeffrey C; Dhall, Sanjay S; Kaiser, Michael G

    2014-07-01

    Assessment of functional patient-reported outcome following lumbar spinal fusion continues to be essential for comparing the effectiveness of different treatments for patients presenting with degenerative disease of the lumbar spine. When assessing functional outcome in patients being treated with lumbar spinal fusion, a reliable, valid, and responsive outcomes instrument such as the Oswestry Disability Index should be used. The SF-36 and the SF-12 have emerged as dominant measures of general health-related quality of life. Research has established the minimum clinically important difference for major functional outcomes measures, and this should be considered when assessing clinical outcome. The results of recent studies suggest that a patient's pretreatment psychological state is a major independent variable that affects the ability to detect change in functional outcome. PMID:24980579

  10. Selecting Career Outcome Assessments: An Organizational Scheme.

    ERIC Educational Resources Information Center

    Whiston, Susan C.

    2001-01-01

    Presents a framework for selecting assessments of career outcomes: content (career knowledge and skills, career behaviors, feelings and beliefs, role functioning); information source (client, counselor, observer, relevant other, institution/archive); focus (general, specific); and time orientation (macro-outcome, micro-outcome). (Contains 42…

  11. Mini-Mental State Examination, cognitive FIM instrument, and the Loewenstein Occupational Therapy Cognitive Assessment: Relation to functional outcome of stroke patients

    Microsoft Academic Search

    Manuel Zwecker; Shalom Levenkrohn; Yudit Fleisig; Gabi Zeilig; Avi Ohry; Abraham Adunsky

    2002-01-01

    Zwecker M, Levenkrohn S, Fleisig Y, Zeilig G, Ohry A, Adunsky A. Mini-Mental State Examination, cognitive FIM instrument, and the Loewenstein Occupational Therapy Cognitive Assessment: relation to functional outcome of stroke patients. Arch Phys Med Rehabil 2002;83:342-5. Objectives: To compare 3 cognitive tests, used on admission, for predicting discharge functional outcome and to assess the efficacy of these tests in

  12. The power of outcomes: FOTO Industrial Outcomes Tool -- Initial assessment.

    PubMed

    Hart, D.L.

    2001-01-01

    OBJECTIVE: To demonstrate how outcomes assessment can assist in describing clients receiving rehabilitation in occupational health rehabilitation clinics and to describe the preliminary assessment of internal consistency reliability and construct validity of the FOTO Industrial Outcomes Tool. METHODS: 266 adults referred for acute work rehabilitation (AWR), work conditioning/hardening (WC/WH) or a Functional Capacity Evaluation (FCE) comprised the data set. Clients were treated between July 1998 and January 1999 in 15 clinics from 6 states by 46 clinicians participating in the Focus on Therapeutic Outcomes (FOTO) national rehabilitation database beta test. For AWR and WC/WH, clients completed a health status questionnaire on intake and discharge, and health status was assessed prior to the FCE. Comprehensive demographic data were collected describing the clinics, clinicians, clients and work status collected 2 weeks following discharge. RESULTS: Internal consistency reliability coefficients for the health status scores ranged from 0.57 to 0.89. Construct validity was supported. CONCLUSION: Results demonstrate the power of collecting outcomes from a variety of constructs for clients receiving industrial rehabilitation services. Initial reliability and construct validity findings were adequate and support continuing data analyses. PMID:12441480

  13. Measuring Treatment Outcome for Children with Serious Emotional Disturbances: Discriminant Validity and Clinical Significance of the Child and Adolescent Functioning Assessment Scale

    Microsoft Academic Search

    Kimberlee M. Roy; Michael C. Roberts; Eric M. Vernberg; Camille J. Randall

    2008-01-01

    We investigated the use of a popular measure, the Children and Adolescent Functional Assessment Scale (CAFAS), in treatment\\u000a outcome research. The sample included 70 children who had been discharged from an elementary therapeutic classroom (Intensive\\u000a Mental Health Program). Significant relationships were found between decreases in CAFAS scores and optimal educational placement,\\u000a contributing to evidence of the scale’s discriminant validity. Clinically

  14. Assessment of outcome in hypospadias surgery - a review.

    PubMed

    Springer, Alexander

    2014-01-01

    Hypospadias is a challenging field of urogenital reconstructive surgery with different techniques being currently used. Modern surgery claims that it is possible to create a functionally and cosmetically normal penis. Continuous re-evaluation and assessment of outcome may have a major impact on future clinical practice. Assessment of outcome includes: complication rate, cosmetic appearance of the penis, functional outcome (micturition, sexuality), and psychological factors such as quality of life and psychosexual life. This article briefly reviews current strategies of outcome assessment. Somehow in the future, we will be able to give an accurate estimation of the long-term consequences of being born with hypospadias. PMID:24479107

  15. Assessment of Outcome in Hypospadias Surgery – A Review

    PubMed Central

    Springer, Alexander

    2014-01-01

    Hypospadias is a challenging field of urogenital reconstructive surgery with different techniques being currently used. Modern surgery claims that it is possible to create a functionally and cosmetically normal penis. Continuous re-evaluation and assessment of outcome may have a major impact on future clinical practice. Assessment of outcome includes: complication rate, cosmetic appearance of the penis, functional outcome (micturition, sexuality), and psychological factors such as quality of life and psychosexual life. This article briefly reviews current strategies of outcome assessment. Somehow in the future, we will be able to give an accurate estimation of the long-term consequences of being born with hypospadias. PMID:24479107

  16. Clinical application of optical coherence tomography in combination with functional diagnostics: advantages and limitations for diagnosis and assessment of therapy outcome in central serous chorioretinopathy

    PubMed Central

    Schliesser, Joshua A; Gallimore, Gary; Kunjukunju, Nancy; Sabates, Nelson R; Koulen, Peter; Sabates, Felix N

    2014-01-01

    Purpose While identifying functional and structural parameters of the retina in central serous chorioretinopathy (CSCR) patients, this study investigated how an optical coherence tomography (OCT)-based diagnosis can be significantly supplemented with functional diagnostic tools and to what degree the determination of disease severity and therapy outcome can benefit from diagnostics complementary to OCT. Methods CSCR patients were evaluated prospectively with microperimetry (MP) and spectral domain optical coherence tomography (SD-OCT) to determine retinal sensitivity function and retinal thickness as outcome measures along with measures of visual acuity (VA). Patients received clinical care that involved focal laser photocoagulation or pharmacotherapy targeting inflammation and neovascularization. Results Correlation of clinical parameters with a focus on functional parameters, VA, and mean retinal sensitivity, as well as on the structural parameter mean retinal thickness, showed that functional measures were similar in diagnostic power. A moderate correlation was found between OCT data and the standard functional assessment of VA; however, a strong correlation between OCT and MP data showed that diagnostic measures cannot always be used interchangeably, but that complementary use is of higher clinical value. Conclusion The study indicates that integrating SD-OCT with MP provides a more complete diagnosis with high clinical relevance for complex, difficult to quantify diseases such as CSCR. PMID:25473259

  17. Outcomes Assessment Plan This document describes the program outcomes for the undergraduate program in computer science and

    E-print Network

    Mayfield, John

    a computer-based system, process, component or program to meet desired needs. D. An ability to functionOutcomes Assessment Plan This document describes the program outcomes for the undergraduate program in computer science and an assessment plan to evaluate these outcomes. The primary purpose of the assessment

  18. Linguistics Department Student Outcomes Assessment June 4, 2008 Plans for Student Outcomes Assessment

    E-print Network

    Liberzon, Daniel

    Linguistics Department Student Outcomes Assessment June 4, 2008 Plans for Student Outcomes Assessment Department of Linguistics Submitted by Jennifer Cole Associate Professor and Director of Graduate, speech and hearing science, psychology, cognitive science, artificial intelligence, computer science

  19. Outcomes Assessment in Dental Hygiene Programs.

    ERIC Educational Resources Information Center

    Grimes, Ellen B.

    1999-01-01

    A survey of 22 dental-hygiene-program directors found that programs routinely and effectively assess student outcomes and use the information for program improvements and to demonstrate accountability. Both policy and faculty/administrative support were deemed important to implementation. Time constraints were a major barrier. Outcomes-assessment

  20. Defining, constructing and assessing learning outcomes.

    PubMed

    Taylor, R M

    2009-08-01

    Learning outcomes define the veterinary curriculum and inform students about what they must be able to demonstrate to succeed. Stakeholder consultation during their development ensures that programme learning outcomes equip graduates to contribute to the veterinary profession. Effective learning outcomes form a hierarchy linking the programme, its courses and tasks. Clear outcomes direct students towards higher quality learning by indicating the achievements intended, but leave scope for emergent learning outcomes. Defined technical competencies fit within this overarching framework, complementing higher order learning. Mapping is used to align learning outcomes horizontally and vertically so students are systematically guided towards entry-level competence and professional independence. Constructively aligned learning and assessment tasks ensure learners spend the focused time required to sequentially develop programme outcomes. Assessment by staff, peers and other stakeholders certifies achievement of intended outcomes. Effective assessment also empowers students to define and achieve their own learning outcomes, so they develop the habits of autonomous life-long learning. Evaluation of the quality and consistency of achieved outcomes informs ongoing programme improvement. If we are going to achieve the objectives of this set of papers, i.e. to improve public health education globally (Rev. sci. tech. Off. int. Epiz. 28 [2] 2009), then it is essential that they be well defined in the learning outcomes statement of all veterinary schools. PMID:20128490

  1. Assessing Outcomes in Optometric Education: A Commentary by the Council on Optometric Education.

    ERIC Educational Resources Information Center

    Optometric Education, 1998

    1998-01-01

    A statement of the Council for Optometric Education (COE) defines and characterizes educational outcomes, outcomes assessment, and outcomes data, and explains the reasons for outcomes assessment, its relationship to curricular design, and its function in accreditation of optometry programs. Stated COE standards and expectations of optometry…

  2. Oral Assessment in Mathematics: Implementation and Outcomes

    ERIC Educational Resources Information Center

    Iannone, P.; Simpson, A.

    2012-01-01

    In this article, we report the planning and implementation of an oral assessment component in a first-year pure mathematics module of a degree course in mathematics. Our aim was to examine potential barriers to using oral assessments, explore the advantages and disadvantages compared to existing common assessment methods and document the outcomes

  3. Department of Religion Outcomes Assessment Plan

    E-print Network

    Liberzon, Daniel

    Department of Religion Outcomes Assessment Plan Desired Outcomes: We expect all of our majors such as Buddhism, Christianity, Confucianism, Daoism, Hinduism, Judaism (and the religion of the ancient Hebrews) to identify changes that might increase the number of majors in Religion; 2) to improve the balance between

  4. Neurocognition: Clinical and Functional Outcomes in Schizophrenia

    PubMed Central

    Lepage, Martin; Bodnar, Michael; Bowie, Christopher R

    2014-01-01

    Schizophrenia is characterized by significant heterogeneity in outcome. The last decades have witnessed a significant interest in identifying factors that can moderate or influence clinical and functional outcomes in people with schizophrenia. One factor of particular interest is neurocognition, as performance on various measures of cognitive abilities, such as memory, attention, and executive functions, have been consistently related to functional outcome and, to a lesser extent, clinical outcome. This review aims to provide an up-to-date description of recent studies examining the association between neurocognition and clinical and (or) functional outcomes. In the first section, studies examining neurocognitive performance in relation to clinical outcome are examined. When clinical outcome is defined dichotomously (for example, comparing remitted and nonremitted), verbal memory performance consistently exhibits a strong association with clinical status, with the poor outcome group showing the largest deficits. In the second section, studies exploring the relation between neurocognition and various dimensions of functional outcome are reviewed. These dimensions include independent living, social functioning, and vocational functioning, among others. Again, a strong link between neurocognitive deficits and impairments in several aspects of functioning clearly emerges from this review. Finally, several measurement issues are discussed that pertain to the need to standardize definitions of clinical and (or) functional outcomes, the importance of defining cognitive domains consistently across studies, and distinguishing between one’s competence to perform tasks and what one actually does in everyday life. Addressing these measurement issues will be key to studies examining the development of effective interventions targeting neurocognitive functions and their impact on clinical and functional outcomes. PMID:24444318

  5. Patient-important outcome for the assessment of fracture repair.

    PubMed

    Hoang-Kim, A; Miclau, T; Goldhahn, J; Nijman, T H; Poolman, R W

    2014-06-01

    Current evidence indicates that fracture healing assessment is limited to the use of one or two domains (such as pain, range of motion or mobility) in any single study. Functional outcome measures, which include physician-rated or observer-based impairment ratings and patient self-reported or observer-based activity limitation measures, better position the effectiveness of a given intervention towards patient-important outcomes. Health status measures, for example, cover a wide-range of physical, emotional, and social health dimensions. In this paper, we will examine the utility of metrics to assess fracture healing that are important to both the patient and provider, with selected examples from the recent literature. We recommend outcome measures with established and verified reliability and validity. Policy-makers and other stakeholders need to have an accurate assessment of treatment outcome that includes changes in function over time-adequate measures, should be re-applied at periodic intervals. PMID:24857028

  6. Authentic Assessment for Restorative Outcomes

    ERIC Educational Resources Information Center

    Doerr, Allison

    2008-01-01

    The Developmental Audit[R] is a comprehensive means of assessment and treatment planning that identifies the coping strategies underlying a youth's maladaptive and self-defeating behavior. This is a strength-based assessment that engages youth in conflict in the process of generating solutions rather than focusing on deficits. This process…

  7. Assessment Faculty Guide: The Rationale and Process for Outcomes Assessment.

    ERIC Educational Resources Information Center

    Baker, Richard

    The Assessment Faculty Guide from St. Louis Community College provides guidance for faculty members about how to implement outcomes assessment. The handbook is divided into five areas: (1) assessment rationale, including history, definition, principles, and questions and answers; (2) the structure of assessment, providing a description,…

  8. [Improving functional outcome of schizophrenia with cognitive remediation].

    PubMed

    Franck, Nicolas; Demily, Caroline

    2015-03-01

    The functional outcome of schizophrenia is partly conditioned by cognitive disorders associated with this disease. The functional outcome of schizophrenia depends not only on psychotropic medications, but also on non-pharmacological measures and in particular on cognitive remediation. All patients suffering from schizophrenia should benefit from a multidisciplinary functional evaluation including neuropsychological assessment. The restitution of the functional evaluation's results values preserved skills rather than deficits. Cognitive remediation should be considered when cognitive disorders have a functional impact. It reduces the impact of the patient's cognitive disorders and improves the success of his/her concrete projects. PMID:25544348

  9. Assessing Higher Education Learning Outcomes in Brazil

    ERIC Educational Resources Information Center

    Pedrosa, Renato H. L.; Amaral, Eliana; Knobel, Marcelo

    2013-01-01

    Brazil has developed an encompassing system for quality assessment of higher education, the National System of Higher Education Evaluation (SINAES), which includes a test for assessing learning outcomes at the undergraduate level, the National Exam of Student Performance (ENADE). The present system has been running since 2004, and also serves as…

  10. Outcome Assessment of the Tibetan Scholarship Program

    ERIC Educational Resources Information Center

    US Department of State, 2004

    2004-01-01

    The Office of Policy and Evaluation of the U.S. Department of State's Bureau of Educational and Cultural Affairs (ECA) contracted with SRI International to conduct an outcome assessment of the Tibetan Scholarship Program (TSP). The purpose of this evaluation is to determine if the program has been successful in meeting these goals. The assessment

  11. Academic Outcome Assessment Northwest Commission on Colleges and Universities

    E-print Network

    O'Laughlin, Jay

    and Assessment Educational program planning is based on regular and continuous assessment of programs in lightAcademic Outcome Assessment Northwest Commission on Colleges and Universities NASC statements and Standards (2003 Accreditation Handbook) dealing with academic outcomes assessment: Institutional Self

  12. Biofeedback improves functional outcome after sphincteroplasty

    Microsoft Academic Search

    L. L. Jensen; A. C. Lowry

    1997-01-01

    The primary treatment for obstetric sphincter injury is overlapping sphincteroplasty. However, despite restoration of the anatomy, only 65 percent of patients are fully continent. PURPOSE: This study was undertaken to determine if postoperative biofeedback improved continence in patients with poor functional outcomes after sphincteroplasty. METHOD: Outcomes of 28 patients who underwent electromyographic biofeedback training after sphincteroplasty for obstetric sphincter injury

  13. Multiple-Respondent Anecdotal Assessments: An Analysis of Interrater Agreement and Correspondence with Analogue Assessment Outcomes

    ERIC Educational Resources Information Center

    Smith, Carla M.; Smith, Richard G.; Dracobly, Joseph D.; Pace, Amy Peterson

    2012-01-01

    We evaluated interrater agreement across multiple respondents on anecdotal assessments and compared cases in which agreement was obtained with outcomes of functional analyses. Experiment 1 evaluated agreement among multiple respondents on the function of problem behavior for 27 individuals across 42 target behaviors using the Motivation Assessment

  14. Assessment of Outcomes of Free Expression Courses.

    ERIC Educational Resources Information Center

    Andsager, Julie; Ross, Susan Dente

    1999-01-01

    Assesses outcomes of instruction in three college-senior-level courses on freedom of expression. Suggests that increased attention to freedom-of-expression issues may have resulted in broader understanding of First Amendment issues, and individual and media rights. Notes that students seem to develop an appreciation of the reflexive nature of…

  15. DEPARTMENT OF MATHEMATICAL SCIENCES OUTCOMES ASSESSMENT SURVEY

    E-print Network

    White, Donald L.

    DEPARTMENT OF MATHEMATICAL SCIENCES OUTCOMES ASSESSMENT SURVEY SPRING 2007 Please reflect on your extra sheets if you need additional space. Do not put your name on the survey itself. Put the survey in the enclosed envelope and put your name on the envelope. After all surveys are received, they will be opened

  16. Using Outcomes Assessment to Change Classroom Instruction

    ERIC Educational Resources Information Center

    Cook, Michelle D.; Wiedenhoeft, Mary H.; Polito, Thomas A.; Gibson, Lance R.; Pogranichniy, Sherry; Mullen, Russ E.

    2006-01-01

    How can student outcomes assessment (SOA) be incorporated into ones courses and teaching? The purposes of this article are to explore a process enacted in the Department of Agronomy at Iowa State University using SOA to: (i) develop a clearer understanding of what students should learn in a course, (ii) determine how a course or courses fit within…

  17. Outcomes Assessment: From Knowledge to Practice.

    ERIC Educational Resources Information Center

    Brooks, Kent

    A strategic planning model for planning and conducting outcomes assessment was developed and implemented at Wayland Baptist University in Lubbock, Texas. First, the Secretary's Commission on Achieving Necessary Skills (SCANS) model was used to survey 100 undergraduate students regarding their perceptions of skills they would need after graduation.…

  18. Functional Health Literacy and Smoking Cessation Outcomes

    ERIC Educational Resources Information Center

    Varekojis, Sarah M.; Miller, Larry; Schiller, M. Rosita; Stein, David

    2011-01-01

    Purpose: This paper aims to describe the relationship between functional health literacy level and smoking cessation outcomes. Design/methodology/approach: Participants in an inpatient smoking cessation program in a mid-western city in the USA were enrolled and the Short Test of Functional Health Literacy in Adults was administered while the…

  19. Aligning assessment with learning outcomes in outcome-based education

    Microsoft Academic Search

    Raquel M. Crespo; Jad Najjar; Michael Derntl; Derick Leony; Susanne Neumann; Petra Oberhuemer; Michael Totschnig; Bernd Simon; Israel Gutierrez Rojas; Carlos Delgado Kloos

    2010-01-01

    In outcome based learning, learning outcomes (knowledge, skills and competences) to be achieved by learners are in the focal point of the learning process. All educational activities and resources need to be related to the intended learning outcomes of a learning module or course, in order to assist the learners in successfully achieving the intended learning outcomes at the end

  20. AMEE Guide No. 14. Outcome-Based Education: Part 3--Assessment in Outcome-Based Education.

    ERIC Educational Resources Information Center

    Ben-David, Miriam Friedman

    1999-01-01

    Discusses the role of performance assessment in outcome-based education. Compares the relationship and interplay between the two related paradigms and presents guidelines of assessment programs in outcome-based education. (Author/CCM)

  1. Functional outcomes and quality of life in patients with brain tumors: A preliminary report

    Microsoft Academic Search

    Mark E. Huang; Jennifer E. Wartella; Jeffery S. Kreutzer

    2001-01-01

    Huang ME, Wartella JE, Kreutzer JS. Functional outcomes and quality of life in patients with brain tumors: a preliminary report. Arch Phys Med Rehabil 2001;82:1540-6. Objectives: To determine the relationship between functional outcome and quality of life (QOL) in patients with brain tumors receiving inpatient rehabilitation, and to assess the sensitivity of 4 assessment tools in measuring changes in that

  2. Brain natriuretic peptide predicts functional outcome in ischemic stroke

    PubMed Central

    Rost, Natalia S; Biffi, Alessandro; Cloonan, Lisa; Chorba, John; Kelly, Peter; Greer, David; Ellinor, Patrick; Furie, Karen L

    2011-01-01

    Background Elevated serum levels of brain natriuretic peptide (BNP) have been associated with cardioembolic (CE) stroke and increased post-stroke mortality. We sought to determine whether BNP levels were associated with functional outcome after ischemic stroke. Methods We measured BNP in consecutive patients aged ?18 years admitted to our Stroke Unit between 2002–2005. BNP quintiles were used for analysis. Stroke subtypes were assigned using TOAST criteria. Outcomes were measured as 6-month modified Rankin Scale score (“good outcome” = 0–2 vs. “poor”) as well as mortality. Multivariate logistic regression was used to assess association between the quintiles of BNP and outcomes. Predictive performance of BNP as compared to clinical model alone was assessed by comparing ROC curves. Results Of 569 ischemic stroke patients, 46% were female; mean age was 67.9 ± 15 years. In age- and gender-adjusted analysis, elevated BNP was associated with lower ejection fraction (p<0.0001) and left atrial dilatation (p<0.001). In multivariate analysis, elevated BNP decreased the odds of good functional outcome (OR 0.64, 95%CI 0.41–0.98) and increased the odds of death (OR 1.75, 95%CI 1.36–2.24) in these patients. Addition of BNP to multivariate models increased their predictive performance for functional outcome (p=0.013) and mortality (p<0.03) after CE stroke. Conclusions Serum BNP levels are strongly associated with CE stroke and functional outcome at 6 months after ischemic stroke. Inclusion of BNP improved prediction of mortality in patients with CE stroke. PMID:22116811

  3. Technology and outcomes assessment in lung transplantation.

    PubMed

    Yusen, Roger D

    2009-01-15

    Lung transplantation offers the hope of prolonged survival and significant improvement in quality of life to patients that have advanced lung diseases. However, the medical literature lacks strong positive evidence and shows conflicting information regarding survival and quality of life outcomes related to lung transplantation. Decisions about the use of lung transplantation require an assessment of trade-offs: do the potential health and quality of life benefits outweigh the potential risks and harms? No amount of theoretical reasoning can resolve this question; empiric data are needed. Rational analyses of these trade-offs require valid measurements of the benefits and harms to the patients in all relevant domains that affect survival and quality of life. Lung transplant systems and registries mainly focus outcomes assessment on patient survival on the waiting list and after transplantation. Improved analytic approaches allow comparisons of the survival effects of lung transplantation versus continued waiting. Lung transplant entities do not routinely collect quality of life data. However, the medical community and the public want to know how lung transplantation affects quality of life. Given the huge stakes for the patients, the providers, and the healthcare systems, key stakeholders need to further support quality of life assessment in patients with advanced lung disease that enter into the lung transplant systems. Studies of lung transplantation and its related technologies should assess patients with tools that integrate both survival and quality of life information. Higher quality information obtained will lead to improved knowledge and more informed decision making. PMID:19131538

  4. Clinical Outcomes Assessment of Three Similar Hip Arthroplasty Bearing Surfaces

    PubMed Central

    Parsons, Christopher; Batson, Ryan; Reighard, Shane; Tanner, Stephanie; Snider, Becky; Pace, Thomas B.

    2014-01-01

    This report examines the clinical performance of three very similar total hip arthroplasty designs with distinctly different bearing surfaces used over the course 10-17 years. Clinical outcomes assessments for each group are compared in the context of varying implant related costs related to the latest technology at the time of surgery. Eighty-one surgeries were studied and differ by bearing surface. In this study, 36 hips are ceramic on polyethylene, 27 are metal on polyethylene and 18 are metal on metal. All polyethylene components are nonhighly cross-linked. The ceramic on polyethylene group has younger patients, on average, and higher percentage of patients with significant polyethylene wear. These groups have an average follow-up time of 8.6 years when assessing functional hip scores, thigh pain, groin pain, revision surgeries and radiographic osteolysis. The implant purchasing cost at the time of surgery was assessed to determine if a correlation exists between outcomes and the more technologically advanced implants use at the time of surgery. Based on midterm clinical outcome assessment, no correlation between initial hospital cost and clinical outcomes of one bearing surface over another can be found. PMID:25002938

  5. Meniscal allograft transplantation: preoperative assessment, surgical considerations, and clinical outcomes.

    PubMed

    Mascarenhas, Randy; Yanke, Adam B; Frank, Rachel M; Butty, Davietta C; Cole, Brian J

    2014-12-01

    The purpose of this review is to characterize the preoperative assessment of meniscal allograft transplantation (MAT) candidates, to detail MAT surgical techniques, and to evaluate current clinical outcome data on MAT. The MAT candidate is typically less than 50 years old and has a history of knee injury, previous meniscus surgery, and persistent pain. Physical exam generally reveals knee pain with joint line tenderness with normal radiographs and magnetic resonance imaging demonstrating the postmeniscectomized state. There are several common surgical techniques used for transplantation, with fixation achieved through sutures, bony fixation, or a combination of the two. Concomitant procedures such as anterior cruciate ligament reconstruction, osteotomy, and other cartilage procedures are commonly performed. The available short- and long-term studies of clinical outcomes of MAT are variable and difficult to effectively compare due to heterogeneity of the study population and available treatment techniques. In addition, there are no published randomized controlled trials. However, recent reviews and cohort studies of clinical outcomes following MAT have shown that whether performed in isolation or performed with concomitant articular cartilage, realignment, or soft tissue reconstruction procedures MAT outcomes have been acceptable with the majority of studies reporting improved clinical outcomes regardless of the scoring system employed. MAT has proven to be a safe and effective technique in reducing knee pain and improving function in the symptomatic meniscal deficient knee. Evaluation of long-term clinical outcomes is necessary as is evaluation of meniscal replacement alternatives. PMID:24951950

  6. Assessment of endothelial function.

    PubMed

    Higashi, Yukihito

    2015-03-20

    In 1986, endothelial function was measured for the first time in patients with atherosclerotic coronary arteries. Since then, several methods for assessment of endothelial function, such as endothelium-dependent vasodilation induced by intra-arterial infusion of vasoactive agents using coronary angiography, Doppler flow guide wire, mercury-filled Silastic strain-gauge plethysmography, flow-mediated vasodilation, reactive hyperemia-peripheral arterial tonometry, and vascular response using an oscillometric method have been performed in humans. This review focuses on the assessment of endothelial function, including measurement history, methodological issues, and clinical perspectives. PMID:25740586

  7. Effects of idiosyncratic stimulus variables on functional analysis outcomes.

    PubMed Central

    Carr, E G; Yarbrough, S C; Langdon, N A

    1997-01-01

    As the methods for the functional analysis of problem behavior have continued to develop, there has been a greater focus on the specificity of controlling variables, both antecedents and consequences. Accelerating research interest in the role of antecedents reveals that a large array of stimulus variables can influence the rate of problem behavior. Indeed, the variety of these stimuli is so great that it is sometimes possible to overlook specific stimulus variables during initial assessment. The present study shows that a failure to identify these very specific (idiosyncratic) stimulus variables is serious because their presence can systematically alter the outcomes of functional analyses that are designed to assess the motivation of problem behavior. Guidelines are therefore discussed concerning when to suspect that idiosyncratic stimuli might be acting to influence assessment data, thereby promoting a search for additional stimulus variables whose identification can aid in improving the design of functional analysis conditions. PMID:9433791

  8. FUNCTIONAL NEURORADIOLOGY Functional reorganization associated with outcome in hand

    E-print Network

    ] that significantly impair the quality of daily life for these patients. Previous studies have indicated, for the first time, investigate subgroups of stroke patients with different outcomes in hand function using a resting-state fMRI approach. Methods We selected 24 patients with subcortical stroke and divided them

  9. A Perspective on Student Learning Outcome Assessment at Qatar University

    ERIC Educational Resources Information Center

    Al-Thani, Shaikha Jabor; Abdelmoneim, Ali; Daoud, Khaled; Cherif, Adel; Moukarzel, Dalal

    2014-01-01

    This paper provides a unique perspective on the student learning outcome assessment process as adopted and implemented at Qatar University from 2006 to 2012. The progress of the student learning outcome assessment and continuous improvement efforts at the university and the initiatives taken to establish a culture of assessment and evidence-based…

  10. Implementing Assessment in an Outcome-Based Marketing Curriculum

    ERIC Educational Resources Information Center

    Borin, Norm; Metcalf, Lynn E.; Tietje, Brian C.

    2008-01-01

    This article describes the development and implementation of assessment in a new outcome-based marketing curriculum that was developed using a zero-based approach. Outcomes for the marketing curriculum were specified at the program, department, course, and lesson levels. Direct embedded assessments as well as indirect assessment methods were used…

  11. Pancreatic function assessment.

    PubMed

    Laterza, L; Scaldaferri, F; Bruno, G; Agnes, A; Boškoski, I; Ianiro, G; Gerardi, V; Ojetti, V; Alfieri, S; Gasbarrini, A

    2013-01-01

    Several non invasive tests are available to assess pancreatic function, but no one is routinely used in clinical practice to diagnose chronic pancreatitis, due to their poor sensitivity in diagnosing mild pancreatic insufficiency. (13)C breath tests share the same limits of the other non invasive functional tests, but the mixed triglyceride breath test seems to be useful in finding the correct dosage of enzyme substitutive therapy to prevent malnutrition in patients with known pancreatic insufficiency. PMID:24443071

  12. Assessment of splenic function

    Microsoft Academic Search

    A. P. N. A. de Porto; A. J. J. Lammers; R. J. Bennink; I. J. M. ten Berge; P. Speelman; J. B. L. Hoekstra

    2010-01-01

    Hyposplenic patients are at risk of overwhelming post-splenectomy infection (OPSI), which carries mortality of up to 70%.\\u000a Therefore, preventive measures are warranted. However, patients with diminished splenic function are difficult to identify.\\u000a In this review we discuss immunological, haematological and scintigraphic parameters that can be used to measure splenic function.\\u000a IgM memory B cells are a potential parameter for assessing

  13. Glasgow Head Injury Outcome Prediction Program: an independent assessment

    Microsoft Academic Search

    Justin J Nissen; Patricia A Jones; David F Signorini; Lilian S Murray; Graham M Teasdale; J Douglas Miller

    1999-01-01

    Using an independent data set, the utility of the Glasgow Head Injury Outcome Prediction Program was investigated in terms of possible frequency of use and reliability of outcome prediction in patients with severe head injury, or haematoma requiring evacuation, or coma lasting 6 hours or more, in whom outcome had been reliably assessed at 6 to 24 months after injury.

  14. Functional outcome after acetabular revision with roof reinforcement rings

    PubMed Central

    Jain, Rina; Schemitsch, Emil H.; Waddell, James P.

    2000-01-01

    Objective To evaluate the role for potential predictors of functional outcome after acetabular arthroplasty and to assess the results of revision with the use of a roof reinforcement ring. Design A retrospective case series. Setting A tertiary-care referral centre. Patients Twenty-four patients (average age 72.7 years) who had undergone acetabular revision with a roof reinforcement ring were followed up for an average of 2.8 years. Interventions Revision acetabular arthroplasty was performed using either the Mueller or Burch–Schneider roof reinforcement ring, bone grafting and a cemented polyethylene cup. Outcome measures A modified Harris hip score (range of motion omitted), the SF-36 health survey and the Western Ontario McMaster (WOMAC) osteoarthritis index measured outcome. Multivariate analysis was used to determine the effects of certain clinical factors (age, sex, time to revision from previous hip operation and number of previous revisions) on outcome. Results Patients reported disability both on hip-specific and general health measures. The time to revision from previous operation positively correlated with SF-36 mental component scores (p = 0.003), WOMAC function (p = 0.04) and WOMAC pain (p = 0.03). Age, gender and number of past revisions did not affect outcome. Conclusions Patients who undergo acetabular revision with a roof ring will continue to have some disability in the first 3 years after the procedure. A greater time between the previous operation and the revision operation is associated with a better outcome. Patients’ expectations of postoperative results should be realistic in the face of a challenging reconstructive procedure. PMID:10948688

  15. Predictors of excellent functional outcome in aneurysmal subarachnoid hemorrhage.

    PubMed

    Pegoli, Marianna; Mandrekar, Jay; Rabinstein, Alejandro A; Lanzino, Giuseppe

    2015-02-01

    OBJECT Case fatality rates after aneurysmal subarachnoid hemorrhage (aSAH) have decreased over time, and many patients treated with modern paradigms return to a normal life. However, there is little information on predictors of excellent functional outcome after aSAH. In this study, the authors investigated predictors of excellent outcome in a modern consecutive series of patients with aSAH. METHODS A retrospective review was conducted of patients with aSAH admitted between 2001 and 2013. The primary outcome measure was excellent functional outcome, defined as modified Rankin Scale (mRS) score of 0 or 1 at last follow-up within 1 year of aSAH. RESULTS Three hundred seventy-three patients were identified with posthospital follow-up. Excellent outcome was noted in 236 patients (63.3%), including an mRS score of 0 in 122 (32.7%) and an mRS score of 1 in 114 (30.6%). On univariate analysis, the following factors were associated with an excellent outcome: indicators of less severe bleeding, such as better World Federation of Neurosurgical Societies grade at any of the times of assessment, better modified Fisher grade, and absence of intracerebral hemorrhage (ICH), intraventricular hemorrhage (IVH), and symptomatic hydrocephalus; aneurysm treatment with coil embolization; absence of symptomatic vasospasm, delayed cerebral ischemia, and radiological infarction; absence of in-hospital seizures; lack of need for CSF diversion; fewer hours with fever; less severe anemia; and absence of transfusion. On multivariable analysis, the 4 variables that were most strongly associated with excellent outcome were presence of good clinical grade after neurological resuscitation, absence of ICH on initial CT scan, blood transfusion during the hospitalization, and radiological infarctions on final brain imaging. CONCLUSIONS Excellent outcomes (mRS score 0-1) can be achieved in the majority of patients with aSAH. The likelihood of excellent outcome is predicted by good clinical condition after resuscitation, absence of ICH on presentation, no evidence of infarction on brain imaging, and absence of blood transfusion during hospitalization. PMID:25495745

  16. Assessing the Social and Affective Outcomes of Inclusion

    ERIC Educational Resources Information Center

    Frederickson, Norah; Simmonds, Elizabeth; Evans, Lynda; Soulsby, Chris

    2007-01-01

    The systematic assessment of the social and affective outcomes of inclusion has been lagging behind the assessment of academic outcomes. This is particularly problematic in view of research evidence supporting concerns about peer rejection and bullying. In this article, Norah Frederickson and Elizabeth Simmonds, of University College London, and…

  17. Outcomes Assessment in Accredited Health Information Management Programs

    ERIC Educational Resources Information Center

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  18. Obstacles in Outcomes Assessment: Identifying and Overcoming Them.

    ERIC Educational Resources Information Center

    Woldt, Janet L.

    The obstacles encountered in an outcomes assessment process were studied, focusing on the specific obstacles that prevent program administration from successfully completing the outcomes assessment process and the degree to which these obstacles operate. Of 135 dental hygiene education program directors surveyed, 107 responded, completing a…

  19. Measuring Outcomes in Alzheimer's Disease Research: Assessment of the Effectiveness of Interventions

    Microsoft Academic Search

    Stacey Wood; Jeffrey L. Cummings

    1999-01-01

    Alzheimer's disease is a common disorder in the elderly, and a cure is not currently available. This article summarises the intervention studies that have been done in Alzheimer's disease research and discusses assessment tools and outcome measures used in these studies. Current approaches are broadening their definition of positive outcome beyond improvement or maintenance of cognitive functioning. These new areas

  20. Assessment Strategy for an Outcome Based Education

    Microsoft Academic Search

    M. S. Jaafar; N. K. Nordin; R. Wagiran; A. Aziz; M. J. M. M. Noor; M. R. Osman; J. Noorzaei; F. N. A. Abdulaziz

    Malaysian engineering education is now embracing an Outcome Based Education (OBE) approach. This approach emphasizes on the outcomes, as opposed to the process in an educational strategy. The approach now becomes one of the important for an engineering degree to obtain accreditation from the Malaysian Engineering Accreditation Council (EAC). The approach is relatively new in the country, and it requires

  1. Students' Conceptions of Assessment: Links to Outcomes

    ERIC Educational Resources Information Center

    Brown, Gavin T. L.; Hirschfeld, Gerrit H. F.

    2008-01-01

    Students conceive of assessment in at least four major ways (i.e., assessment makes students accountable; assessment is irrelevant because it is bad or unfair; assessment improves the quality of learning; and assessment is enjoyable). A study in New Zealand of 3469 secondary school students' conceptions of assessment used a self-report inventory…

  2. Alternative Approaches to Outcomes Assessment for Postsecondary Vocational Education.

    ERIC Educational Resources Information Center

    Bragg, Debra D., Ed.

    This document describes six different approaches to outcomes assessments, approaches that are named in the titles of chapters 2 through 7. The chapters and authors are as follows: "Perspectives on Assessment Policy and Practice" (Bragg, Harmon); "Total Quality Management" (Bragg); "Assessing Student Success" (Harmon); "Value-Added Assessment"…

  3. Executive Function Processes Predict Mobility Outcomes in Older Adults

    PubMed Central

    Gothe, Neha P.; Fanning, Jason; Awick, Elizabeth; Chung, David; Wójcicki, Thomas R.; Olson, Erin A.; Mullen, Sean P.; Voss, Michelle; Erickson, Kirk I.; Kramer, Arthur F.; McAuley, Edward

    2013-01-01

    BACKGROUND: There is growing evidence suggesting an association between cognitive function and physical performance in late life. This study examined the relationship between performance on executive function measures and subsequent mobility outcomes among community dwelling older adults across a 12-month randomized controlled exercise trial. DESIGN: Randomized controlled clinical trial SETTING: Champaign-Urbana, Illinois PARTICIPANTS: Community dwelling older adults (N = 179; Mage = 66.4) INTERVENTION: A 12-month exercise trial with two arms: an aerobic exercise group and a stretching and strengthening group MEASUREMENTS: Established cognitive tests of executive function including the flanker task, task switching and a dual task paradigm, and the Wisconsin card sort test. Mobility was assessed using the timed 8-foot up and go test and times to climb up and down a flight of stairs. METHODS: Participants completed the cognitive measures at baseline and the mobility measures at baseline and after 12 months of the intervention. Multiple regression analyses were conducted to determine whether baseline executive function predicted post-intervention functional performance after controlling for age, sex, education, cardiorespiratory fitness and baseline mobility levels. RESULTS: Our analyses revealed that selective baseline executive function measures, particularly performance on the flanker task (?’s =.15 to .17) and the Wisconsin card sort test (?’s =.11 to .16) consistently predicted mobility outcomes at month 12. The estimates were in the expected direction, such that better baseline performance on the executive function measures predicted better performance on the timed mobility tests independent of the intervention group. CONCLUSION: Executive functions of inhibitory control, mental set shifting and attentional flexibility were predictive of functional mobility. Given the literature associating mobility limitations with disability, morbidity, and mortality, these results are important for understanding the antecedents to poor mobility function that can be attenuated by well-designed interventions to improve cognitive performance. PMID:24521364

  4. Mental Health and Functional Outcomes of Maternal and Adolescent Reports of Adolescent Depressive Symptoms

    ERIC Educational Resources Information Center

    Rice, Frances; Lifford, Kate J.; Thomas, Hollie V.; Thapar, Anita

    2007-01-01

    Objective: To assess the value of maternal and self-ratings of adolescent depression by investigating the extent to which these reports predicted a range of mental health and functional outcomes 4 years later. The potential influence of mother's own depressed mood on her ratings of adolescent depression and suicidal ideation on adolescent outcome

  5. Neurologic, Functional and Cognitive Stroke Outcomes in Mexican Americans

    PubMed Central

    Lisabeth, Lynda D; Sánchez, Brisa N; Baek, Jonggyu; Skolarus, Lesli E; Smith, Melinda A; Garcia, Nelda; Brown, Devin L; Morgenstern, Lewis B

    2014-01-01

    Background and Purpose: Our objective was to compare neurologic, functional, and cognitive stroke outcomes in Mexican Americans (MAs) and non-Hispanic whites (NHWs) using data from a population-based study. Methods: Ischemic strokes (2008-2012) were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) Project. Data were collected from patient or proxy interviews (conducted at baseline and 90 days post-stroke) and medical records. Ethnic differences in neurologic (National Institutes of Health Stroke Scale (NIHSS), range 0-44, higher scores worse), functional (activities of daily living (ADL)/instrumental activities of daily living (IADL) score, range 1-4, higher scores worse), and cognitive (Modified Mini-Mental State Examination (3MSE), range 0-100, lower scores worse) outcomes were assessed with Tobit or linear regression adjusted for demographics and clinical factors. Results: 513, 510, and 415 subjects had complete data for neurologic, functional and cognitive outcomes and covariates, respectively. Median age was 66 (IQR: 57-78); 64% were MA. In MAs, median NIHSS, ADL/IADL and 3MSE score were 3 (IQR: 1-6), 2.5 (IQR: 1.6-3.5) and 88 (IQR: 76-94), respectively. MAs scored 48% worse (95% CI: 23%-78%) on NIHSS, 0.36 points worse (95% CI: 0.16-0.57) on ADL/IADL score, and 3.39 points worse (95% CI: 0.35-6.43) on 3MSE than NHWs after multivariable adjustment. Conclusions: MAs scored worse than NHWs on all outcomes after adjustment for confounding factors; differences were only partially explained by ethnic differences in survival. These findings in combination with the increased stroke risk in MAs suggest that the public health burden of stroke in this growing population is substantial. PMID:24627112

  6. Air ions and respiratory function outcomes: a comprehensive review

    PubMed Central

    2013-01-01

    Background From a mechanistic or physical perspective there is no basis to suspect that electric charges on clusters of air molecules (air ions) would have beneficial or deleterious effects on respiratory function. Yet, there is a large lay and scientific literature spanning 80 years that asserts exposure to air ions affects the respiratory system and has other biological effects. Aims This review evaluates the scientific evidence in published human experimental studies regarding the effects of exposure to air ions on respiratory performance and symptoms. Methods We identified 23 studies (published 1933–1993) that met our inclusion criteria. Relevant data pertaining to study population characteristics, study design, experimental methods, statistical techniques, and study results were assessed. Where relevant, random effects meta-analysis models were utilized to quantify similar exposure and outcome groupings. Results The included studies examined the therapeutic benefits of exposure to negative air ions on respiratory outcomes, such as ventilatory function and asthmatic symptoms. Study specific sample sizes ranged between 7 and 23, and studies varied considerably by subject characteristics (e.g., infants with asthma, adults with emphysema), experimental method, outcomes measured (e.g., subjective symptoms, sensitivity, clinical pulmonary function), analytical design, and statistical reporting. Conclusions Despite numerous experimental and analytical differences across studies, the literature does not clearly support a beneficial role in exposure to negative air ions and respiratory function or asthmatic symptom alleviation. Further, collectively, the human experimental studies do not indicate a significant detrimental effect of exposure to positive air ions on respiratory measures. Exposure to negative or positive air ions does not appear to play an appreciable role in respiratory function. PMID:24016271

  7. Assessment of Student Learning Outcomes: Workplace, Family, and Community Roles

    ERIC Educational Resources Information Center

    Johnson, Cheryl A.; Heath, Claudia J.

    2011-01-01

    A project was conducted to assess Family Studies bachelor's degree graduates' use of learning outcomes from course competencies in personal finance, family lifespan development, intervention, and advocacy and policy, and to determine how they apply these learning outcomes to their workplace, family, and community roles. Alumni surveys completed by…

  8. Assessment of Student Professional Outcomes for Continuous Improvement

    ERIC Educational Resources Information Center

    Keshavarz, Mohsen; Baghdarnia, Mostafa

    2013-01-01

    This article describes a method for the assessment of professional student outcomes (performance-type outcomes or soft skills). The method is based upon group activities, research on modern electrical engineering topics by individual students, classroom presentations on chosen research topics, final presentations, and technical report writing.…

  9. ASSESSING THE UTILITY OF A DEMAND ASSESSMENT FOR FUNCTIONAL ANALYSIS

    PubMed Central

    Roscoe, Eileen M; Rooker, Griffin W; Pence, Sacha T; Longworth, Lynlea J

    2009-01-01

    We evaluated the utility of an assessment for identifying tasks for the functional analysis demand condition with 4 individuals who had been diagnosed with autism. During the demand assessment, a therapist presented a variety of tasks, and observers measured problem behavior and compliance to identify demands associated with low levels of compliance or high levels of problem behavior (low-probability demands) and demands associated with high levels of compliance or low levels of problem behavior (high-probability demands). Results showed that clearer functional analysis outcomes were obtained for 3 of the 4 participants when low-probability rather than high-probability demands were used. PMID:20514188

  10. A Conceptual Scheme for Assessing Treatment Outcome in Suicidality

    Microsoft Academic Search

    M. David Rudd

    This chapter provides a simpIe framework for conceptualizing treatment outcome, distinguishing between direct and indirect\\u000a markers of treatment success. Additionally, normative comparisons and the need for a core assessment battery are discussed.

  11. Functional Impairment and Occupational Outcome in Adults with ADHD

    ERIC Educational Resources Information Center

    Gjervan, Bjorn; Torgersen, Terje; Nordahl, Hans M.; Rasmussen, Kirsten

    2012-01-01

    Objective: ADHD is associated with poor functional outcomes. The objectives were to investigate the prevalence of functional impairment and occupational status in a clinically referred sample of adults with ADHD and explore factors predicting occupational outcome. Method: A sample of 149 adults with a confirmed diagnosis of ADHD participated in…

  12. Contribution of Functional Parameters to Patient-rated Outcomes after Surgical Treatment of Distal Radius Fractures

    PubMed Central

    Shauver, Melissa J.; Chang, Kate Wan-Chu; Chung, Kevin C.

    2014-01-01

    Purpose Outcomes of distal radius fractures can be measured radiographically, functionally, or via patient-rated questionnaires; but previous studies report conflicting results regarding the relationship between these outcomes. Our specific aim was to explore the role that functional outcomes play in the score of the Michigan Hand Outcomes Questionnaire (MHQ), a patient-rated hand instrument. Methods Data were obtained for 207 patients. Demographic information was collected as part of the MHQ. Function (wrist motion and grip and pinch strength) was assessed 3 and 6 months following fracture fixation. Linear regression analysis was applied to determine each item’s contribution to total MHQ score. Results After linear regression analysis was applied, it was determined that 3 months following fixation all included factors contributed 37% of MHQ score. Only grip strength difference between the injured and uninjured hands was significantly associated, contributing 22% of MHQ score. Six weeks and 6 months after fixation all included factors contributed 43% and 34% of MHQ score, respectively. No individual factors were significant contributors. Conclusions Measured functional outcomes variables account for less than 40% of total MHQ score. Identifying the unmeasured factors that make-up the additional 60% of total MHQ score would be beneficial in the continued examination of patient-rated outcomes. Furthermore the use of multiple outcomes assessment modalities should be considered in any study measuring patient-rated outcomes. Level of Evidence II, Prognostic PMID:24447846

  13. Direct Measures for Course Outcomes Assessment for ABET Accreditation

    NSDL National Science Digital Library

    Gurocak, Hakan

    Direct measures provide for the direct examination or observation of student knowledge or skills against measurable learning outcomes. ABET has been putting increasing emphasis on direct measures for a program to demonstrate its achievement of program outcomes and educational objectives. In this paper, an approach for assessment of course outcomes using direct measures is presented. The knowledge and skills described by the course outcomes are mapped to specific problems on homework and exams. Throughout the semester the instructor keeps track of the performance of each student on each course outcome. At the end of the semester students receive letter grades as usual. But in addition each student receives a score on the scale of 1-to-5 for every course outcome indicating how well he/she achieved each outcome. The data (scores) coming from each course are used at the program level to assess the program outcomes. The paper provides an example and concludes with recommendations for other institutions that may choose to adapt a similar approach.

  14. Determinants of the subjective functional outcome of total joint arthroplasty

    Microsoft Academic Search

    B. Caracciolo; S. Giaquinto

    2005-01-01

    The aim of the study is three-fold: (i) to analyze association between early subjective functional outcome of total joint arthroplasty (TJA) and patient-related risk factors; (ii) to evaluate the six-month subjective functional outcome of TJA as compared with subjective functional status of non-operated outpatients; (iii) to evaluate TJA self-perceived amelioration rates compared to the status of an age-matched sample from

  15. The State of Learning Outcomes Assessment in the United States

    ERIC Educational Resources Information Center

    Kuh, George D.; Ewell, Peter T.

    2010-01-01

    Worldwide, economic and other factors are pressing institutions of higher education to assess student learning to insure that graduates acquire the skills and competencies demanded in the 21st century. This paper summarises the status of undergraduate student learning outcomes assessment at accredited colleges and universities in the United…

  16. Investigating ESL Students' Performance on Outcomes Assessments in Higher Education

    ERIC Educational Resources Information Center

    Lakin, Joni M.; Elliott, Diane Cardenas; Liu, Ou Lydia

    2012-01-01

    Outcomes assessments are gaining great attention in higher education because of increased demand for accountability. These assessments are widely used by U.S. higher education institutions to measure students' college-level knowledge and skills, including students who speak English as a second language (ESL). For the past decade, the increasing…

  17. Student Learning Outcome Assessment Plan: Continuous Quality Improvement

    E-print Network

    Fernandez, Eduardo

    Student Learning Outcome Assessment Plan: Continuous Quality Improvement Florida Atlantic University A Report to the Team for Assurance of Student Learning and the Associate Provost for Assessment and Instruction By the TASL Best Practices Subcommittee Sharon Dormire, PhD, RN, College of Nursing Diane Green

  18. Assessing Outcomes: Practical Methods and Evidence

    ERIC Educational Resources Information Center

    Moore, Jon; Owen, Jesse

    2014-01-01

    University counseling center clients' (N = 52) perceptions of precounseling functioning were highly correlated with their actual well-being scores at intake. The magnitude of change based on perceptions of precounseling functioning to current well-being was approximately double of what is found from the difference of actual precounseling…

  19. Assessing traumatic brain injury outcome measures for long-term follow-up of community-based individuals

    Microsoft Academic Search

    Karyl M. Hall; Tamara Bushnik; Bajazeda Lakisic-Kazazic; Jerry Wright; Anna Cantagallo

    2001-01-01

    Hall KM, Bushnik T, Lakisic-Kazazic B, Wright J, Cantagallo A. Assessing traumatic brain injury outcome measures for long-term follow-up of community-based individuals. Arch Phys Med Rehabil 2001;82:367-74. Objectives: To determine which outcome measures are best and least suited for assessing long-term functional outcome of individuals with traumatic brain injury (TBI) in the community. Design: Survey of participants in the community

  20. Functional Outcomes in a Postacute Brain Injury Rehabilitation Program

    Microsoft Academic Search

    Esther Brahmstadt

    2012-01-01

    The purpose of this study was to evaluate functional outcomes among individuals with acquired brain injury who received treatment at a postacute brain injury rehabilitation program over a 3-year period (2008 to 2010). Participation in community and\\/or social roles, supervision required, and adaptive functioning outcomes were evaluated in a sample of 109 adults (71% male, 29% female; 88.1% White, 11.9%

  1. Social cognition and its relationship to functional outcomes in patients with sustained acquired brain injury

    PubMed Central

    Ubukata, Shiho; Tanemura, Rumi; Yoshizumi, Miho; Sugihara, Genichi; Murai, Toshiya; Ueda, Keita

    2014-01-01

    Deficits in social cognition are common after traumatic brain injury (TBI). However, little is known about how such deficits affect functional outcomes. The purpose of this study was to investigate the relationship between social cognition and functional outcomes in patients with TBI. We studied this relationship in 20 patients with TBI over the course of 1 year post-injury. Patients completed neurocognitive assessments and social cognition tasks. The social cognition tasks included an emotion-perception task and three theory of mind tasks: the Faux Pas test, Reading the Mind in the Eyes (Eyes) test, and the Moving-Shapes paradigm. The Craig Handicap Assessment and Reporting Technique was used to assess functional outcomes. Compared with our database of normal subjects, patients showed impairments in all social cognition tasks. Multiple regression analysis revealed that theory of mind ability as measured by the Eyes test was the best predictor of the cognitive aspects of functional outcomes. The findings of this pilot study suggest that the degree to which a patient can predict what others are thinking is an important measure that can estimate functional outcomes over 1 year following TBI. PMID:25395854

  2. From Perception to Functional Outcome in Schizophrenia: Modeling the Role of Ability and Motivation

    PubMed Central

    Green, Michael F.; Hellemann, Gerhard; Horan, William P.; Lee, Junghee; Wynn, Jonathan K.

    2014-01-01

    Context Schizophrenia remains a highly disabling disorder, but the specific determinants and pathways that lead to functional impairment are not well understood. It is not known whether these key determinants of outcome lie on one or multiple pathways. Objective This study evaluated theoretically-based models of pathways to functional outcome starting with early visual perception. The intervening variables were previously established determinants of outcome drawn from two general categories: ability (i.e., social cognition and functional capacity) and beliefs / motivation (i.e., defeatist beliefs, expressive and experiential negative symptoms). We evaluated an integrative model in which these intervening variables formed a single pathway to poor outcome. Design This was a cross-sectional study that applied structural equation modeling to evaluate the relationships among determinants of functional outcome in schizophrenia. Setting Assessments were conducted at a Veterans Administration (VA) Medical Center. Participants One hundred ninety one clinically-stable outpatients with schizophrenia or schizoaffective disorder were recruited from the community. Results A measurement model showed that the latent variables of perception, social cognition, and functional outcome were well-reflected by their indicators. An initial untrimmed structural model with functional capacity, defeatist beliefs, and expressive and experiential negative symptoms had good model fit. A final trimmed model was a single path running from perception to ability to motivational variables to outcome. It was more parsimonious and had better fit indices than the untrimmed model. Further, it could not be improved by adding or dropping connections that would change the single path to multiple paths. The indirect effect from perception to outcome was significant. Conclusions The final structural model was a single pathway running from perception to ability to beliefs / motivation to outcome. Hence, both ability and motivation appear to be needed for community functioning, and can be modeled effectively on the same pathway. PMID:23026889

  3. Outcome Assessment Process in a Manufacturing Engineering Program

    NSDL National Science Digital Library

    Ansari, Jahangir

    To achieve the goals and objectives of program educational objectives, our Manufacturing Engineering (MANE) program at Virginia State University developed a curriculum that provides students with balanced coverage of ABET and the University core requirements. The program outcomes have been adopted considering the University and school mission, program objectives, (a) through (k) defined by Accreditation Board for Engineering and Technology (ABET), and specific outcomes for manufacturing engineering as defined by the Society of Manufacturing Engineering (SME). Our MANE program focuses on the areas of automation, quality, manufacturing process, engineering analysis and manufacturing design to prepare students for successful careers in manufacturing engineering and allied professions. This paper presents a brief description of the major components of our assessment that fulfill the ABET criteria for continuous improvement requirements. The assessment process and evaluation of the program outcomes are discussed along with the results as well.

  4. Outcome Assessment of the Visiting Fulbright Scholar Program

    ERIC Educational Resources Information Center

    US Department of State, 2005

    2005-01-01

    The Office of Policy and Evaluation of the Bureau of Educational and Cultural Affairs of the U.S. Department of State contracted with SRI International to conduct a series of assessments of outcomes and impacts of various specialized exchange programs under the overall umbrella of the Fulbright Educational Exchange Program, the U.S. government's…

  5. Pastureland Conservation Effects Assessment Project: Status and expected outcomes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Conservation Effects Assessment Project (CEAP) is a multiagency scientific effort to quantify environmental outcomes of conservation practices applied to private agricultural lands. A CEAP effort on pastureland, primarily in the eastern and central United States, began in 2008. In this paper we ...

  6. Choosing Assessment Instruments for Bulimia Practice and Outcome Research

    ERIC Educational Resources Information Center

    Sandberg, Katie; Erford, Bradley T.

    2013-01-01

    Six commonly used instruments for assessment of eating disorders were analyzed. Effect size results from Erford et al.'s (2013) meta-analysis for the treatment of bulimia nervosa were used to compare each scale's ability to measure treatment outcomes for bulimia nervosa. Effect size comparisons indicated higher overall effect sizes using…

  7. Functional Outcomes in the Treatment of Adults with ADHD

    ERIC Educational Resources Information Center

    Adler, Lenard A.; Spencer, Thomas J.; Levine, Louise R.; Ramsey, Janet L.; Tamura, Roy; Kelsey, Douglas; Ball, Susan G.; Allen, Albert J.; Biederman, Joseph

    2008-01-01

    Objective: ADHD is associated with significant functional impairment in adults. The present study examined functional outcomes following 6-month double-blind treatment with either atomoxetine or placebo. Method: Patients were 410 adults (58.5% male) with "DSM-IV"--defined ADHD. They were randomly assigned to receive either atomoxetine 40 mg/day to…

  8. Functional MRI and Outcome in Traumatic Coma

    PubMed Central

    Giacino, Joseph T.; Wu, Ona

    2013-01-01

    Advances in task-based functional MRI (fMRI), resting-state fMRI (rs-fMRI), and arterial-spin labeled (ASL) perfusion MRI have occurred at a rapid pace in recent years. These techniques for measuring brain function have great potential to improve the accuracy of prognostication for civilian and military patients with traumatic coma. In addition, fMRI, rs-fMRI, and ASL have provided novel insights into the pathophysiology of traumatic disorders of consciousness, as well as mechanisms of recovery from coma. However, functional neuroimaging techniques have yet to achieve widespread clinical use as prognostic tests for patients with traumatic coma. Rather, a broad spectrum of methodological hurdles currently limits the feasibility of clinical implementation. In this review, we discuss the basic principles of fMRI, rs-fMRI and ASL and their potential applications as prognostic tools for patients with traumatic coma. We also discuss future strategies for overcoming the current barriers to clinical implementation. PMID:23881623

  9. Poststroke Shoulder Pain in Turkish Stroke Patients: Relationship with Clinical Factors and Functional Outcomes

    ERIC Educational Resources Information Center

    Barlak, Aysegul; Unsal, Sibel; Kaya, Kurtulus; Sahin-Onat, Sule; Ozel, Sumru

    2009-01-01

    The objective of this study was to assess the possible causes of hemiplegic shoulder pain (HSP) in Turkish patients with stroke, to identify the correlation between HSP and clinical factors, and to review the effects of HSP on functional outcomes. A total of 187 consecutive patients with stroke were evaluated for the presence of HSP and for the…

  10. Critical analysis of outcome measures used in the assessment of carpal tunnel syndrome

    PubMed Central

    Priyanka, P.; Gul, Arif; Ilango, Balakrishnan

    2007-01-01

    Clinicians and researchers are confounded by the various outcome measures used for the assessment of carpal tunnel syndrome (CTS). In this study, we critically analysed the conceptual framework, validity, reliability, responsiveness and appropriateness of some of the commonly used CTS outcome measures. Initially, we conducted an extensive literature search to identify all of the outcome measures used in the assessment of CTS patients, which revealed six different carpal tunnel outcome measures [Boston Carpal Tunnel Questionnaire (BCTQ), Michigan Hand Outcome Questionnaire (MHQ), Disability of Arm, Shoulder and Hand (DASH), Patient Evaluation Measure (PEM), clinical rating scale (Historical-Objective (Hi-Ob) scale) and Upper Extremity Functional Scale (UEFS)]. We analysed the construction framework, development process, validation process, reliability, internal consistency (IC), responsiveness and limitations of each of these outcome measures. Our analysis reveals that BCTQ, MHQ and PEM have comprehensive frameworks, good validity, reliability and responsiveness both in the hands of the developers, as well as independent researchers. The UEFS and Hi-Ob scale need validation and reliability testing by independent researchers. Region-specific measures like DASH have good frameworks and, hence, a potential role in the assessment of CTS but they require more validation in exclusive carpal tunnel patients. PMID:17370071

  11. Functional limitations and survival following stroke: Psychological and clinical predictors of 3-year outcome

    Microsoft Academic Search

    Marie Johnston; Beth Pollard; Val Morrison; Ron MacWalter

    2004-01-01

    Previous studies predicting functional outcomes of stroke have mainly used clinical and demographic measures. This study examines\\u000a the additional predictive value of psychological predictors. A cohort of patients were assessed on 6 occasions between admission\\u000a to hospital and 3 years post-stroke, with 40 of the original sample of 101 being available at the final assessment. Demographic\\u000a variables, clinical indexes, and

  12. The Impact of Functional Dependency on Outcomes After Complex General and Vascular Surgery

    PubMed Central

    Scarborough, John E.; Bennett, Kyla M.; Englum, Brian R.; Pappas, Theodore N.; Lagoo-Deenadayalan, Sandhya A.

    2015-01-01

    Objective To describe the outcomes of functionally dependent patients who undergo major general or vascular surgery and to determine the relationship between functional health status and early postoperative outcomes. Background In contrast to frailty, functional health status is a relatively easy entity to define and to measure and therefore may be a more practical variable to assess in patients who are being considered for major surgery. To date, few studies have assessed the impact of functional health status on surgical outcomes. Methods Patients undergoing 1 of 10 complex general or vascular operations were extracted from the 2005 to 2010 America College of Surgeons National Surgical Quality Improvement Program database. Propensity score techniques were used to match patients with and without preoperative functional dependency on known patient- and procedure-related factors. The postoperative outcomes of this matched cohort were then compared. Results A total of 10,246 functionally dependent surgical patients were included for analysis. These patients were more acutely and chronically ill than functionally independent patients, and they had higher rates of mortality and morbidity for each of the 10 procedures analyzed. Propensity-matching techniques resulted in the creation of a cohort of functionally independent and dependent patients who were well matched for known patient- and procedure-related variables. Dependent patients from the matched cohort had a 1.75-fold greater odds of postoperative death (95% confidence interval: 1.54–1.98, P < 0.0001) than functionally independent patients. Conclusions Preoperative functional dependency is an independent risk factor for mortality after major operation. Functional health status should be routinely assessed in patients who are being considered for complex surgery. PMID:24887971

  13. High Plasma Glutamate Levels are Associated with Poor Functional Outcome in Acute Ischemic Stroke.

    PubMed

    Meng, Xiang-En; Li, Na; Guo, Da-Zhi; Pan, Shu-Yi; Li, Hang; Yang, Chen

    2015-03-01

    The aim of the present study was to investigate the relationship between acute ischemic stroke and glutamate levels and to determine the prognosis value of plasma glutamate levels to predict the functional outcome. Two hundred and forty-two patients with acute ischemic stroke and 100 sex- and age-matched controls were included in the study. Plasma glutamate levels were determined by HPLC at admission in both groups. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). The modified Rankin Scale (mRS) scores at 3 months was determined to outcomes, and unfavorable outcomes were defined as mRS at 3-6. The prognostic value analyzed by logistic regression analysis, after adjusting for the possible confounders. In the 94 patients with an unfavorable functional outcome, plasma glutamate levels were higher compared with those in patients with a favorable outcome [221(IQR, 152-321) ?M; 176(IQR, 112-226) ?M, respectively; P < 0.0001). In multivariate logistic regression analysis, glutamate was an independent predictor of functional outcome, with an adjusted OR of 6.99 (95 % confidence interval [CI] 2.21-21.23). Receiver operating characteristics to predict functional outcome demonstrated areas under the curve of glutamate of 0.821 (95 % CI 0.733-0.878; P < 0.0001) and combined model (glutamate and NIHSS) improved the NIHSS score alone. Plasma glutamate levels can be seen as an independent short-term prognostic marker of functional outcome in Chinese patients with acute ischemic stroke even after correcting for possible confounding factors. PMID:25190005

  14. Functional Outcome Analysis: Do the Costs Outweigh the Benefits?

    ERIC Educational Resources Information Center

    Sheridan, Susan M.

    1993-01-01

    Responds to previous article (Noell and Gresham, this issue) on Functional Outcome Analysis (FOA) as important construct for evaluation of consultation and prereferral interventions. Notes that, practically speaking, one must wonder if information gleaned from FOA is worth costs. Addresses perceived scientific and practical merits of FOA. (NB)

  15. Emotion Responsivity, Social Cognition, and Functional Outcome in Schizophrenia

    E-print Network

    Emotion Responsivity, Social Cognition, and Functional Outcome in Schizophrenia Jennifer R. Mathews been a defining feature in schizophrenia, but relatively little research has examined how emotion in schizophrenia. Participants were 40 outpatients with DSM-IV schizophrenia or schizoaffective disorder and 40

  16. The effectiveness of modified cottle maneuver in predicting outcomes in functional rhinoplasty.

    PubMed

    Fung, Elaine; Hong, Paul; Moore, Corey; Taylor, S Mark

    2014-01-01

    Objective. To assess the outcomes of functional rhinoplasty for nasal valve incompetence and to evaluate an in-office test used to select appropriate surgical techniques. Methods. Patients with nasal obstruction due to nasal valve incompetence were enrolled. The modified Cottle maneuver was used to assess the internal and external nasal valves to help select the appropriate surgical method. The rhinoplasty outcomes evaluation (ROE) form and a 10-point visual analog scale (VAS) of nasal breathing were used to compare preoperative and postoperative symptoms. Results. Forty-nine patients underwent functional rhinoplasty evaluation. Of those, 35 isolated batten or spreader grafts were inserted without additional procedures. Overall mean ROE score increased significantly (P < 0.0001) from 41.9 ± 2.4 to 81.7 ± 2.5 after surgery. Subjective improvement in nasal breathing was also observed with the VAS (mean improvement of 4.5 (95% CI 3.8-5.2) from baseline (P = 0.000)). Spearman rank correlation between predicted outcomes using the modified Cottle maneuver and postoperative outcomes was strong for the internal nasal valve (Rho = 0.80; P = 0.0029) and moderate for the external nasal valve (Rho = 0.50; P = 0.013). Conclusion. Functional rhinoplasty improved subjective nasal airflow in our population. The modified Cottle maneuver was effective in predicting positive surgical outcomes. PMID:25243085

  17. The Effectiveness of Modified Cottle Maneuver in Predicting Outcomes in Functional Rhinoplasty

    PubMed Central

    Moore, Corey; Taylor, S. Mark

    2014-01-01

    Objective. To assess the outcomes of functional rhinoplasty for nasal valve incompetence and to evaluate an in-office test used to select appropriate surgical techniques. Methods. Patients with nasal obstruction due to nasal valve incompetence were enrolled. The modified Cottle maneuver was used to assess the internal and external nasal valves to help select the appropriate surgical method. The rhinoplasty outcomes evaluation (ROE) form and a 10-point visual analog scale (VAS) of nasal breathing were used to compare preoperative and postoperative symptoms. Results. Forty-nine patients underwent functional rhinoplasty evaluation. Of those, 35 isolated batten or spreader grafts were inserted without additional procedures. Overall mean ROE score increased significantly (P < 0.0001) from 41.9 ± 2.4 to 81.7 ± 2.5 after surgery. Subjective improvement in nasal breathing was also observed with the VAS (mean improvement of 4.5 (95% CI 3.8–5.2) from baseline (P = 0.000)). Spearman rank correlation between predicted outcomes using the modified Cottle maneuver and postoperative outcomes was strong for the internal nasal valve (Rho = 0.80; P = 0.0029) and moderate for the external nasal valve (Rho = 0.50; P = 0.013). Conclusion. Functional rhinoplasty improved subjective nasal airflow in our population. The modified Cottle maneuver was effective in predicting positive surgical outcomes. PMID:25243085

  18. Cost-Optimal Assessment Scheduling for Outcome Management in Psychotherapy

    E-print Network

    Percevic Robert

    The random walk model for psychological distress justify the following outcome management strategy: consider prolonging psychotherapy as long as an acceptable distress level is not reached and terminating the therapy if this level is reached. This strategy promises to increase the efficiency of psychotherapy provision by guiding the allocation of therapeutic resources. As the strategy rely on frequent assessments, the question of cost-optimal assessment scheduling arises. In this study the cost effects of two scheduling modes were explored by computer simulations. With fixed schedule the assessments were carried out each S sessions. With adaptive schedule the assessments were carried out at the percentile P of the distribution of predicted time till reaching acceptable distress whereby the prediction were updated at each assessment. S and P influence the sensitivity/specificity ratio of the schedule. To find the costoptimal values, they were varied. The model parameters were based on SCL-90-R GSI courses from an inpatient sample (N=2046). With therapy/assessment cost ratio set to 5 and acceptable distress set to ?0.58, the cost-optimal fixed solution yields a mean therapy length of 52 days and a mean number of 11 assessments. The cost-optimal adaptive solution yields a mean therapy length of 51 days and a mean number of 4 assessments.

  19. Serum Levels of 25-Hydroxyvitamin D and Functional Outcome among Postmenopausal Women with Hip Fracture

    PubMed Central

    Liu, Lan-Mei; Wang, Shuai-Hua; Fu, Chuan-Sheng; Han, Xiang-Zhen; Wei, Bao-Fu

    2015-01-01

    Objective The main objective of the current study was to assess the distribution and its prognostic value of serum 25-hydroxyvitamin D (25[OH] D) levels assessed at admission in Chinese postmenopausal women with hip fracture. Methods From January 1, 2012 to December 31, 2013, all postmenopausal women with first-ever hip fracture were recruited to participate in the study. Serum 25[OH] D levels were measured at admission. The functional evaluation at the time of discharge was performed by the Barthel Index (BI). The prognostic value of 25[OH] D to predict the functional outcome within discharge was analyzed by logistic regression analysis, after adjusting for the possible confounders. Results In our study, 261 patients were included and assessed. In the 76 patients with an unfavorable functional outcome, serum 25(OH) D levels were lower compared with those in patients with a favorable outcome [11.8(IQR, 9.9–16.1)ng/ml; 16.8(IQR, 13.6–21.4)ng/ml, respectively; P<0.0001]. In multivariate analysis, there was an increased risk of unfavorable outcome associated with serum 25(OH) D levels ? 20ng/ml (OR 5.24, 95%CI: 3.11–8.15; P<0.0001) after adjusting for possible confounders. Conclusions Our data support an association between serum 25[OH] D levels and prognosis in Chinese postmenopausal women with hip fracture. PMID:25635882

  20. Social cognition in psychosis: multidimensional structure, clinical correlates, and relationship with functional outcome.

    PubMed

    Mancuso, Francesco; Horan, William P; Kern, Robert S; Green, Michael F

    2011-02-01

    Social cognitive impairments are common, detectable across a wide range of tasks, and appear to play a key role in explaining poor outcome in schizophrenia and related psychotic disorders. However, little is known about the underlying factor structure of social cognition in people with psychotic disorders due to a lack of exploratory factor analyses using a relatively comprehensive social cognitive assessment battery. In a sample of 85 outpatients with psychosis, we examined the factor structure and clinical/functional correlates of eight indexes derived from five social cognition tasks that span the domains of emotional processing, social perception, attributional style, and Theory of Mind. Exploratory factor analysis revealed three factors with relatively low inter-correlations that explained a total of 54% of the variance: (1) Hostile attributional style, (2) Lower-level social cue detection, and (3) Higher-level inferential and regulatory processes. None of the factors showed significant correlations with negative symptoms. Factor 1 significantly correlated with clinical symptoms (positive, depression-anxiety, agitation) but not functional outcome, whereas Factors 2 and 3 significantly correlated with functional outcome (functional capacity and real-world social and work functioning) but not clinical symptoms. Furthermore, Factor 2 accounted for unique incremental variance in functional capacity, above and beyond non-social neurocognition (measured with MATRICS Consensus Cognitive Battery) and negative symptoms. Results suggest that multiple separable dimensions of social cognition can be identified in psychosis, and these factors show distinct patterns of correlation with clinical features and functional outcome. PMID:21112743

  1. Hearing and facial function outcomes for neurofibromatosis 2 clinical trials

    PubMed Central

    Ardern-Holmes, Simone L.; Barker, Fred G.; Blakeley, Jaishri O.; Evans, D. Gareth; Ferner, Rosalie E.; Hadlock, Tessa A.; Halpin, Chris

    2013-01-01

    Objectives: Vestibular schwannomas are the hallmark of neurofibromatosis 2 (NF2), occurring in >95% of patients. These tumors develop on the vestibulocochlear nerve and are associated with significant morbidity due to hearing loss, tinnitus, imbalance, facial weakness, and risk of early mortality from brainstem compression. Although hearing loss and facial weakness have been identified as important functional outcomes for patients with NF2, there is a lack of consensus regarding appropriate endpoints in clinical trials. Methods: The functional outcomes group reviewed existing endpoints for hearing and facial function and developed consensus recommendations for response evaluation in NF2 clinical trials. Results: For hearing endpoints, the functional group endorsed the use of maximum word recognition score as a primary endpoint, with the 95% critical difference as primary hearing outcomes. The group recommended use of the scaled measurement of improvement in lip excursion (SMILE) system for studies of facial function. Conclusions: These recommendations are intended to provide researchers with a common set of endpoints for use in clinical trials of patients with NF2. The use of common endpoints should improve the quality of clinical trials and foster comparison among studies for hearing loss and facial weakness. PMID:24249803

  2. Predictors of Improvements in Daytime Function Outcomes with CPAP Therapy

    Microsoft Academic Search

    RUTH N. KINGSHOTT; MARJORIE VENNELLE; CAROL J. HOY; HEATHER M. ENGLEMAN; IAN J. DEARY; NEIL J. DOUGLAS

    2000-01-01

    Continuous positive airway pressure (CPAP) therapy improves daytime function in the sleep apnea\\/ hypopnea syndrome (SAHS) but it is unclear which patients benefit and what factors predict this im- provement. To test the hypothesis that brief arousals from sleep predict improvements in daytime functioning with CPAP therapy, we prospectively studied 62 patients with polysomnography-defined SAHS. Each underwent daytime function assessments

  3. To Assess the Effect of Maternal BMI on Obstetrical Outcome

    NASA Astrophysics Data System (ADS)

    Lakhanpal, Shuchi; Aggarwal, Asha; Kaur, Gurcharan

    2012-06-01

    AIMS: To assess the effect of maternal BMI on complications in pregnancy, mode of delivery, complications of labour and delivery.METHODS:A crossectional study was carried out in the Obst and Gynae department, Kasturba Hospital, Delhi. The study enrolled 100 pregnant women. They were divided into 2 groups based on their BMI, more than or equal to 30.0 kg/m2 were categorized as obese and less than 30 kg/m2 as non obese respectively. Maternal complications in both types of patients were studied.RESULTS:CONCLUSION: As the obstetrical outcome is significantly altered due to obesity, we can improve maternal outcome by overcoming obesity. As obesity is a modifiable risk factor, preconception counseling creating awareness regarding health risk associated with obesity should be encouraged and obstetrical complications reduced.

  4. Assessment of Global Functioning in Adolescents with Autism Spectrum Disorders: Utility of the Developmental Disability-Child Global Assessment Scale

    ERIC Educational Resources Information Center

    White, Susan W.; Smith, Laura A.; Schry, Amie R.

    2014-01-01

    Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment

  5. Routine outcome measurement in mental health service consumers: Who should provide support for the self-assessments?

    PubMed

    Gelkopf, Marc; Pagorek-Eshel, Shira; Trauer, Tom; Roe, David

    2015-06-01

    This study examined whether mental health community service users completed outcome self-reports differently when assessments were supervised by internal vs. external staff. The examination of potential differences between the two has useful implications for mental health systems that take upon themselves the challenge of Routine Outcome Measurement (ROM), as it might impact allocation of public resources and managed care program planning. 73 consumers completed the Manchester Short Assessment of Quality of Life (MANSA), a shortened version of the Recovery Assessment Scale (RAS), and a functioning questionnaire. Questionnaires were administered, once using support provided by internal staff and once using support provided by external professional staff, with a one-month time interval and in random order. A MANOVA Repeated Measures showed no differences in outcomes of quality of life and recovery between internal and external support. Functioning scores were higher for the internal support when the internal assessments were performed first. Overall, except for the differences in functioning assessment, outcome scores were not determined by the supporting agency. This might indicate that when measuring quality of life and recovery, different supporting methods can be used to gather outcome measures and internal staff might be a good default agency to do this. Differences found in functioning assessment are discussed. PMID:25748604

  6. Renal function and oncologic outcomes in nephron sparing surgery for renal masses in solitary kidneys

    Microsoft Academic Search

    Daniel J. Lee; Greg Hruby; Mitchell C. Benson; James M. McKiernan

    2011-01-01

    Introduction  With low life expectancy rates in hemodialysis patients, the preservation of renal parenchyma must be weighed against the\\u000a oncological outcomes in considering partial nephrectomy (PN) in solitary kidneys. The main objective of this study was to\\u000a assess the oncologic and functional outcomes after PN in patients with solitary kidneys.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective analysis of the Columbia University Medical Center Urologic Oncology

  7. Cognitive and functional assessments of stroke patients: An analysis of their relation

    Microsoft Academic Search

    Vlasta E. Hajek; Sylvain Gagnon; James E. Ruderman

    1997-01-01

    Objectives: To improve the assessment of stroke patients for the purpose of designing rehabilitation treatments and predicting rehabilitation outcomes. Specific objectives included the evaluation of the power of functional scales to properly assess both physical and cognitive disabilities, and the evaluation of the relations between functional, neurological, physical, and cognitive assessments. The hypothesis was that the relations between different assessment

  8. Strategies for Assessing Learning Outcomes in an Online Oceanography Course

    NASA Astrophysics Data System (ADS)

    Reed, D. L.

    2003-12-01

    All general education courses at the San Jose State University, including those in the sciences, must present a detailed assessment plan of student learning, prior to certification for offering. The assessment plan must state a clear methodology for acquiring data on student achievement of the learning outcomes for the specific course category, as well as demonstrate how students fulfill a strong writing requirement. For example, an online course in oceanography falls into the Area R category, the Earth and Environment, through which a student should be able to demonstrate an understanding of the methods and limits of scientific investigation; distinguish science from pseudo-science; and apply a scientific approach to answer questions about the Earth and environment. The desired learning outcomes are shared with students at the beginning of the course and subsequent assessments on achieving each outcome are embedded in the graded assignments, which include a critical thinking essay, mid-term exam, poster presentation in a symposium-style format, portfolio of web-based work, weekly discussions on an electronic bulletin board, and a take-home final exam, consisting of an original research grant proposal. The diverse nature of the graded assignments assures a comprehensive assessment of student learning from a variety of perspectives, such as quantitative, qualitative, and analytical. Formative assessment is also leveraged into learning opportunities, which students use to identify the acquisition of knowledge. For example, pre-tests are used to highlight preconceptions at the beginning of specific field studies and post-testing encourages students to present the results of small research projects. On a broader scale, the assessment results contradict common misperceptions of online and hybrid courses. Student demand for online courses is very high due to the self-paced nature of learning. Rates of enrollment attrition match those of classroom sections, if students are informed of the instructor's expectations at the beginning of the course. The level of faculty-student and student-student communication is very high, both in terms of quantity and quality, and exceeds that experienced in classroom sections. Student scores on graded assignments compare favorably to classroom sections. Overall, online courses offer a cost-effective means of addressing top priority issues, including increasing student access to learning, accelerating rates of graduation, and improving outreach to K-12 educators, especially those working on credential requirements.

  9. A Comparison of Functional Outcomes After Metallic and Bioabsorbable Interference Screw Fixations in Arthroscopic ACL Reconstructions

    PubMed Central

    Rai, Deepak K; Kannampilly, Antony J

    2014-01-01

    Introduction: Anterior Cruciate Ligament (ACL) is as one of the most frequently injured ligaments in the modern contact sports scenario. Graft fixations can be achieved during anterior cruciate ligament (ACL) reconstructions by using either bioabsorbable screws or metal screws. The objective of this study was to compare the functional outcomes after bioabsorbable and metallic interference screw fixations in arthroscopic anterior cruciate ligament reconstructions done by using hamstring grafts. Materials and Methods: This was a prospective, randomized study. Patients in Group 1 received bioabsorbable interference screws and patients in Group 2 received metallic interference screws. Arthroscopic assisted, anterior cruciate ligament reconstructions with the use of hamstring grafts which were fixed proximally with endobuttons and distally with bioabsorbable or metallic interference screws, were undertaken. Progress in functional outcomes was assessed by using Mann Whitney U- test. Functional outcomes in the two groups were compared by using independent t-test. Observation and Results: In each group, there were statistically significant improvements in functional outcomes over successive follow-ups, which were seen on basis on Mann-Whitney U-test. The comparison of functional outcomes between the two groups, done by using independent t-test, showed no statistically significant differences between the two groups at 3 months, 6 months and 1 year of follow-up. p-value <0.05 was considered to be significant in our study. Conclusion: In our prospective study of comparison of functional outcomes between bioabsorbable and metallic interference screws in arthroscopic anterior cruciate ligament reconstuctions, which were evaluated by using Tegner activity scale and Lysholm knee scoring scale for a period of 1 year, no statistically significant difference was found. However, further authentication is required by doing long term studies. PMID:24959468

  10. Assessing outcome in psychoanalysis and long-term dynamic psychotherapy.

    PubMed

    Marshall, R D; Vaughan, S C; MacKinnon, R A; Mellman, L A; Roose, S P

    1996-01-01

    The efficacy of psychoanalysis and long-term psychotherapy remains a fundamentally unresolved issue for lack of methodologically sound studies. This article reviews the shortcomings of prior long-term treatment research, and presents a rationale and justification of the importance of more rigorous outcome studies. An emphasis on process research is premature when efficacy remains uncertain. The modern reconceptualization of psychotherapy in terms of hermeneutic theory is discussed in relation to the empirical model. Although historically the hermeneutic perspective has served to repudiate positivism, the hermeneutic and empirical (but not positivistic) approaches to understanding information actually share common priorities. The clearest of these is that the process is ultimately evaluated and validated by the produced effect. It is argued that the recasting of psychoanalytic technique and theory according to aesthetic and pragmatic principles is not inconsistent with contemporary outcome research paradigms so long as the professed treatment objective is clearly specified in verifiable terms. The specific methodologic problems involved in extending the successful short-term psychotherapy research model to psychoanalysis are discussed. An overview of the major components of the Columbia feasibility study currently underway is presented. Finally, a number of assessment domains-for which reliable and validated instruments exist-that are thought to be relevant to outcome are reviewed. PMID:9220374

  11. State Special Education Outcomes, 1993: A Report on State Activities in the Assessment of Educational Outcomes for Students with Disabilities.

    ERIC Educational Resources Information Center

    Shriner, James G.; And Others

    This report presents the results of the third national survey of state activities in the assessment of educational outcomes for students with disabilities. The report does not contain actual outcomes data on students with disabilities. Twenty-three tables present data on: number of students in general education and special education in each state;…

  12. Ambulatory and admitted laparoscopic cholecystectomy patients have comparable outcomes but different functional health status

    Microsoft Academic Search

    R. E. Burney; K. R. Jones

    2002-01-01

    Background  Laparoscopic cholecystectomy is frequently an ambulatory procedure, but some patients are best admitted for a brief hospital\\u000a stay. In this study, we compared the functional health status, symptoms, and outcomes of patients undergoing ambulatory elective\\u000a laparoscopic cholecystectomy to those with brief hospital admission. The purpose was to assess patient satisfaction and to\\u000a identify factors that might assist in selecting patients

  13. Air pollutants and health outcomes: Assessment of confounding by influenza

    NASA Astrophysics Data System (ADS)

    Thach, Thuan-Quoc; Wong, Chit-Ming; Chan, King-Pan; Chau, Yuen-Kwan; Neil Thomas, G.; Ou, Chun-Quan; Yang, Lin; Peiris, Joseph S. M.; Lam, Tai-Hing; Hedley, Anthony J.

    2010-04-01

    We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996-2002. Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ?4% of the annual number for ?2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus <2% of the annual positive isolates for ?2 consecutive weeks. We examined effects of influenza on associations between nitrogen dioxide (NO 2), sulfur dioxide (SO 2), particulate matter with aerodynamic diameter ?10 ?m (PM 10) and ozone (O 3) and health outcomes including all natural causes mortality, cardiorespiratory mortality and hospitalization. Generalized additive Poisson regression model with natural cubic splines was fitted to control for time-varying covariates to estimate air pollution health effects. Confounding with influenza was assessed using an absolute difference of >0.1% between unadjusted and adjusted excess risks (ER%). Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO 2 and stroke hospitalization with O 3. Following adjustment, changes in ER% for all pollutants were <0.1% for all natural causes mortality, but >0.1% for mortality from stroke with NO 2 and SO 2, cardiac or heart disease with NO 2, PM 10 and O 3, lower respiratory infections with NO 2 and O 3 and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO 2, SO 2 and O 3 and acute lower respiratory infections hospitalization with PM 10. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants and subgroups of cardiorespiratory mortality and respiratory hospitalization there was evidence to suggest confounding by influenza.

  14. Introduction to Outcomes Assessment of Graduate Programs at NC State The Graduate School, NC State University

    E-print Network

    Buckel, Jeffrey A.

    University Outcomes assessment is a part of a broader shift in higher education. Traditionally, we have taken, and other attributes we expect of them. An outcomes-based perspective reverses that relationship. Instead #12;of what faculty have learned about their programs based on outcomes assessment and what changes

  15. Outcome assessment for spasticity management in the patient with traumatic brain injury: the state of the art.

    PubMed

    Elovic, Elie P; Simone, Lisa K; Zafonte, Ross

    2004-01-01

    The objective of this article was to (1) review the engineering and medical literature to structure the available information concerning the assessment of spasticity in the neurological population; (2) to discuss the strengths and weaknesses of the different methods currently in use in spasticity assessment; and (3) make recommendations for future efforts in spasticity outcome assessment. Spasticity textbooks, Web sites, and OVID, IEEE, and Medline searches from 1966 through 2003 of spasticity, quantitative measure, or outcome assessment in the rehabilitation population were used as data sources. Over 500 articles were reviewed. Articles that discussed outcome measures used to assess interventions and evaluation of spasticity were included. Authors reviewed the articles looking at inclusion criteria, data collection, methodology, assessment methods, and conclusions for validity and relevance to this article. Issues such as clinical relevance, real-world function and lack of objectivity, and time consumed during performance are important issues for spasticity assessment. Some measures such as the Ashworth Scale remain in common use secondary to ease of use despite their obvious functional limitations. More functional outcome goals are plagued by being more time consuming and a general inability to demonstrate changes after an intervention. This may be secondary to the other factors that combine with spasticity to cause dysfunction at that level. Quantitative metrics can provide more objective measurements but their clinical relevance is sometimes problematic. The assessment of spasticity outcome is still somewhat problematic. Further work is necessary to develop measures that have real-world functional significance to both the individuals being treated and the clinicians. A lack of objectivity is still a problem. In the future it is important for clinicians and the engineers to work together in the development of better outcome measures. PMID:15247825

  16. Curriculum Assessment as a Direct Tool in ABET Outcomes Assessment in a Chemical Engineering Programme

    ERIC Educational Resources Information Center

    Abu-Jdayil, Basim; Al-Attar, Hazim

    2010-01-01

    The chemical engineering programme at the United Arab Emirates University is designed to fulfil the Accreditation Board for Engineering and Technology (ABET) (A-K) EC2000 criteria. The Department of Chemical & Petroleum Engineering has established a well-defined process for outcomes assessment for the chemical engineering programme in order to…

  17. Results From a Prospective Acute Inpatient Rehabilitation Database: Clinical Characteristics and Functional Outcomes using the Functional Independence Measure

    Microsoft Academic Search

    Yee Sien Ng; Chek Wai Bok; Yi Chiong

    2007-01-01

    Introduction: Rehabilitation improves functional outcomes, but there is little data on the profiles and outcomes of patients undergoing inpatient rehabilitation in Singapore. The aims of this paper were to document the clinical characteristics and functional outcomes, using the Functional Independence Measure (FIM), of all patients admitted to an inpatient rehabilitation unit in a tertiary teaching hospital, and to identify and

  18. Functional outcome and depression in the elderly with or without fatigue.

    PubMed

    Soyuer, Ferhan; ?enol, Vesile

    2011-01-01

    We evaluated the influence of fatigue on functional outcomes and depression in older people. Fatigue was measured using the fatigue severity scale (FSS). Activity of daily living function was assessed using the functional independence measurement (FIM), the geriatric depression inventory (GDI) was used to assess depression. The average FSS score was 5.66 ± 1.03 for subjects in the fatigue group, with 50 patients (40.3%) having FSS scores ? 4 points. Significant relationships were found between fatigue and GDI (p<0.001, r = 0.363) and FIM (p<0.04, r = -0.183). Binary logistic regression analysis identified GDI as a significant predictor of fatigue (p < 0.001). We found that 40.3% of older people had fatigue. Fatigue showed a significant correlation with depression and functional status. These findings emphasize the need for careful clinical screening of both fatigue and depression in older individuals. PMID:20850877

  19. Trauma Outcome Process Assessment (TOPA) Model: An Ecological Paradigm for Treating Traumatized Sexually Abusive Youth

    Microsoft Academic Search

    Lucinda A. Rasmussen

    2012-01-01

    Discussed is a comprehensive, ecologically based paradigm applicable across cultures and created to assess the effects of abusive traumatic experiences, the Trauma Outcome Process Assessment (TOPA) model (Rasmussen, 1999, 2004, 2007; Rasmussen, Burton, & Christopherson, 1992). The TOPA model comprehensively assesses the risk and protective factors and trauma outcomes that contribute to self-destructive and\\/or abusive behavior in youth. TOPA interventions

  20. Functional and oncological outcomes after limb-salvage surgery for primary sarcomas of the upper limb.

    PubMed

    Wright, E H C; Gwilym, S; Gibbons, C L M H; Critchley, P; Giele, H P

    2008-01-01

    The surgical treatment of upper limb sarcoma poses an oncological and reconstructive challenge. Limb-salvage surgery aims to balance adequate excision margins for disease control and preservation of all important structures to retain maximum function. Reported here is an assessment of the functional and oncological outcomes of limb salvage surgery for primary sarcoma of the upper limb and limb girdle in 72 patients referred to a specialist musculoskeletal tumour unit over 9 years. All patients underwent excision of the sarcoma with reconstruction and adjuvant treatment as needed. Functional outcome was assessed using the Toronto Extremity Salvage Score (TESS) after discharge from hospital. The upper limb sarcomas treated by limb-salvage surgery achieved planned margins of excision in 85% of cases with primary surgery. This increased to 100% with re-excision, resulting in local recurrence in 15% and survival of 75% among those at 5 years or more after surgery, while retaining good to excellent function (TESS mean of 87 out of 100). A total of 38 patients completed TESS questionnaires and, as a single group, had a mean TESS of 87. Patient age, anatomical site of tumour and adjuvant treatment made no significant difference to TESS. Liposarcomas had a significantly better TESS than leiomyosarcomas, chondrosarcomas and malignant peripheral nerve sheath tumours. Oncological outcome was assessed in terms of excision margins achieved, local recurrence, re-excision and disease-free survival. Eight patients died of disease, all with high-grade primary tumours. Fourteen had local recurrence, four low-grade disease and the remaining high-grade disease. All four low-grade recurrences were successfully re-excised, as were five of the high-grade recurrences. The remaining five died of disease, with or without further recurrences. Consistently good functional results as measured by TESS were reported by responders, but high-grade disease and early recurrence were identified as predictors of recurrence and death from disease, respectively. PMID:17889633

  1. Reporting outcome measures of functional constipation in children from 0 to 4 years of age.

    PubMed

    Kuizenga-Wessel, Sophie; Benninga, Marc A; Tabbers, Merit M

    2015-04-01

    Functional constipation (FC) often begins in the first year of life. Although standard definitions and criteria have been formulated to describe FC, these are rarely used in research and clinical practice. The aim of the study is to systematically assess how definitions and outcome measures are defined in therapeutic randomized controlled trials (RCTs) of infants with FC. PubMed, EMBASE, and Cochrane databases were searched. Studies were included if it was a (systematic review of) therapeutic RCT, children ?4 years old, they had FC, a clear definition of constipation was provided, and were written in English. Quality was assessed using the Delphi list. A total of 1115 articles were found; only 5 studies fulfilled the inclusion criteria. Four different definitions were used, of which only 2 used the internationally accepted Rome III criteria. Defecation frequency was used as primary outcome in all included trials and stool consistency in 3 trials. Two trials involving infants investigated new infant formulas, whereas the third RCT evaluated the efficacy of a probiotic strain. The 2 trials including infants up to 4 years of age compared polyethylene glycol without electrolytes (PEG4000) with lactulose and milk of magnesia. All of the trials used nonvalidated parental diaries. Different definitions and outcome measures for FC in infants are used in RCTs. Disappointingly, there is a lack of well-designed therapeutic trials in infants with constipation. To make comparison between future trials possible, standard definitions, core outcomes, and validated instruments are needed. PMID:25406527

  2. N-terminal probrain natriuretic peptide levels as a predictor of functional outcomes in patients with ischemic stroke.

    PubMed

    Chang, Li; Yan, Haiqing; Li, Hehua; Song, Zhixiu; Gui, Yongkun; Yan, Zhixin; Li, Tong; Duan, Dongyin

    2014-09-10

    The prognostic value of the N-amino terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP) in acute ischemic stroke (AIS) is uncertain. We sought to determine whether NT-proBNP levels were associated with functional outcomes after AIS. From August 2012 to October 2013, consecutive first-ever AIS patients admitted to the Department of Emergency of the First Affiliated Hospital of Xinxiang Medical University, China, were included in this study. Plasma NT-proBNP levels were measured from admission. Outcomes were measured as 90-day modified Rankin Scale score ('good outcome'=0-2 vs. 'poor'). Multivariate logistic regression was used to assess associations between NT-proBNP levels and outcomes. Predictive performance of NT-proBNP as compared with the clinical model was assessed by comparing receiver-operating characteristic curves. During this study period, 217 consecutive patients with AIS were included and completed 90 days of follow-up. There was a strong positive correlation between the plasma level of NT-proBNP and the National Institutes of Health Stroke Scale score (r=0.415, P=0.000). Plasma levels of NT-proBNP in patients with an unfavorable outcome were significantly higher than those in patients with a favorable outcome [3432 (interquartile range, 1100-54991) vs. 978 (interquartile range, 123-1705) pg/ml; P=0.000]. In multivariate analyses, after adjusting for all other significant outcome predictors, the NT-proBNP level that remained can be seen as an independent unfavorable outcome predictor, with an adjusted odds ratios of 4.14 (95% confidence interval, 2.72-7.99; P=0.000). Our results show that plasma NT-proBNP levels were significantly elevated in patients with an unfavorable outcome and might be of clinical importance as a supplementary tool for the assessment of functional outcomes in patients with AIS. PMID:25102374

  3. Does Childhood Executive Function Predict Adolescent Functional Outcomes in Girls with ADHD?

    Microsoft Academic Search

    Meghan Miller; Stephen P. Hinshaw

    2010-01-01

    We prospectively followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n?=?140) and matched comparison girls (n?=?88) over a period of 5 years, from middle childhood through early\\/mid-adolescence. Our aim was to examine the ability of\\u000a measures of childhood executive function (EF) to predict functional outcomes in adolescence. Measures of neuropsychological\\u000a functioning comprised the childhood predictors, with academic,

  4. Functional Analysis Outcomes and Comparison of Direct Observations and Informant Rating Scales in the Assessment of Severe Behavior Problems of Infants and Toddlers At-Risk for Developmental Delays.

    PubMed

    Schroeder, Stephen R; Richman, David M; Abby, Layla; Courtemanche, Andrea B; Oyama-Ganiko, Rosa

    2014-06-01

    Severe problem behaviors, like aggression, self-injury, and repetitive behaviors, in people with intellectual and developmental disabilities often appear during early development and may persist without early intervention. The frequencies of self-injurious behavior, aggression, tantrums, property destruction and stereotyped behavior among 17 infants and toddlers at risk for developmental delays and severe behavior problems were assessed using two methods: 1) direct observation of responses during 10 s partial interval recording during analogue functional analysis and 2) the Behavior Problem Inventory-01 (BPI-01; Rojahn et al, 2001), an informant rating scale. Analogue functional analysis results suggested that the most common function for problem behavior was automatic reinforcement, followed by negative reinforcement in the form of escape from demands. Agreement across the two types of measurement systems as to occurrence of the behaviors reported on the BPI-01 and direct observations during analogue functional analyses was greater than 75% across aggression, self-injury, and stereotyped behavior. Agreement at a more molecular level of the ranking of the most commonly occurring specific behaviors was considerably lower. Results are discussed in terms of future research on identifying conditions that set the occasion for high levels of agreement between indirect and direct measurement systems for severe behavior problems. PMID:24778543

  5. Neuropeptide Y, social function and long-term outcome in schizophrenia.

    PubMed

    Stålberg, Gabriella; Ekselius, Lisa; Lindström, Leif H; Larhammar, Dan; Bodén, Robert

    2014-07-01

    There is a lack of biomarkers in schizophrenia and the mechanisms underlying the observed deficits in social functioning are poorly understood. This cohort study aimed to explore whether neurotransmitter neuropeptide Y (NPY) in cerebrospinal fluid (CSF) from patients with schizophrenia is correlated to social function and clinical variables. A further aim was to determine whether baseline levels of NPY were associated with subsequent 3-year outcome. Fifty-six consecutively admitted patients with schizophrenia were included and underwent lumbar puncture and symptom ratings before antipsychotic treatment. NPY levels in CSF were determined by radioimmunoassay. Social function (Social Competence and Social Interest) was assessed by Nurses' Observation Scale for Inpatient Evaluation while psychiatric symptoms were rated using the Comprehensive Psychopathological Rating Scale. Three-year outcome was assessed with the Strauss-Carpenter Outcome Scale. Cross-sectional analysis showed a correlation between level of NPY and Social Competence at index admission (r(s)=0.37, p<0.05). The longitudinal analysis (i.e., at the 3-year follow-up) indicated that, for each standard deviation increase in baseline NPY, there was an increased risk of being unemployed (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.07-3.82), having moderate or severe symptoms (OR 3.09, CI 1.30-7.32) or being hospitalized at least 6 months the previous year (OR 3.24, CI 1.09-9.64). However, NPY was not correlated to Social Interest or clinical variables at index admission. In conclusion, NPY levels in CSF are correlated to Social Competence and seem to predict some aspects of longitudinal outcome in schizophrenia. PMID:24799298

  6. Functional Assessment for Individuals with Problem Behaviors.

    ERIC Educational Resources Information Center

    Kim, Ui-Jung; Choi, Hye-Sung

    1998-01-01

    This article summarizes articles related to functional assessment and its applications for individuals with problem behaviors. The research indicates functional assessment procedures have been established as a standard assessment tool that identifies environmental variables related to problem behaviors with links to the development of effective…

  7. Early Post-Stroke Cognition in Stroke Rehabilitation Patients Predicts Functional Outcome at 13 Months

    Microsoft Academic Search

    Jørgen Wagle; Lasse Farner; Kjell Flekkøy; Torgeir Bruun Wyller; Leiv Sandvik; Brynjar Fure; Brynhild Stensrød; Knut Engedal

    2011-01-01

    Objective: To identify prognostic factors associated with functional outcome at 13 months in a sample of stroke rehabilitation patients. Specifically, we hypothesized that cognitive functioning early after stroke would predict long-term functional outcome independently of other factors. Methods: 163 stroke rehabilitation patients underwent a structured neuropsychological examination 2–3 weeks after hospital admittance, and their functional status was subsequently evaluated 13

  8. Quality of life measurement: bibliographic study of patient assessed health outcome measures

    Microsoft Academic Search

    Andrew Garratt; Louise Schmidt; Anne Mackintosh; Ray Fitzpatrick

    2002-01-01

    Objectives To assess the growth of quality of life measures and to examine the availability of measures across specialties. Design Systematic searches of electronic databases to identify developmental and evaluative work relating to health outcome measures assessed by patients. Main outcome measures Types of measures: disease or population specific, dimension specific, generic, individualised, and utility. Specialties in which measures have

  9. Assessment Choices to Target Higher Order Learning Outcomes: The Power of Academic Empowerment

    ERIC Educational Resources Information Center

    McNeill, Margot; Gosper, Maree; Xu, Jing

    2012-01-01

    Assessment of higher order learning outcomes such as critical thinking, problem solving and creativity has remained a challenge for universities. While newer technologies such as social networking tools have the potential to support these intended outcomes, academics' assessment practice is slow to change. University mission statements and unit…

  10. The Trauma Outcome Process Assessment Model: A Structural Equation Model Examination of Adjustment

    ERIC Educational Resources Information Center

    Borja, Susan E.; Callahan, Jennifer L.

    2009-01-01

    This investigation sought to operationalize a comprehensive theoretical model, the Trauma Outcome Process Assessment, and test it empirically with structural equation modeling. The Trauma Outcome Process Assessment reflects a robust body of research and incorporates known ecological factors (e.g., family dynamics, social support) to explain…

  11. Use of Adverse Outcome Pathways for Assessing Effects of the Fungicide Propiconazole on Fish Reproduction

    EPA Science Inventory

    Adverse outcome pathways (AOP) are used to describe the linkage of biological events from a molecular initiating point, to individual-level-endpoints relevant to risk assessment. This study was done to assess toxicity outcomes for the conazole fungicide propiconazole based on a p...

  12. Implementing ABET outcomes, assessment and remedial techniques in a basic circuits course

    Microsoft Academic Search

    L. P. Huelsman; R. N. Strickland

    2001-01-01

    In this paper the authors describe a project undertaken to implement ABET protocols of defining educational outcomes, making definitive assessment of the outcomes, and providing remedial improvement based on the results of the assessment. The project incorporates the results obtained from teaching a basic introductory course in circuit theory over the past three years at the Department of Electrical and

  13. The Status of Student Outcomes Assessment at NASULGC Member Institutions. AIR 1991 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Muffo, John A.

    A survey was conducted of the member institutions of the National Association of State Universities and Land Grant Colleges (NASULGC) to determine the status of outcomes assessment on their campuses, as well as the usefulness of the NASULGC "Statement of Principles on Outcomes Assessment." Seventy-three institutions (response rate = 49 percent)…

  14. The Trauma Outcome Process Assessment Model: A Structural Equation Model Examination of Adjustment

    Microsoft Academic Search

    Susan E. Borja; Jennifer L. Callahan

    2009-01-01

    This investigation sought to operationalize a comprehensive theoretical model, the Trauma Outcome Process Assessment, and test it empirically with structural equation modeling. The Trauma Outcome Process Assessment reflects a robust body of research and incorporates known ecological factors (e.g., family dynamics, social support) to explain internalizing distress (e.g., anxiety, depression), externalizing distress (e.g., aggression), and recovery outcomes following traumatic events.

  15. Correlates of functional outcome among stroke survivors in a developing country--a prospective community-based study from India.

    PubMed

    Ghosal, Malay Kumar; Burman, Prabir; Singh, Vineeta; Das, Sujata; Paul, Neelanjana; Ray, Biman Kanti; Hazra, Avijit; Banerjee, Tapas Kumar; Basu, Arindam; Chaudhuri, Arijit; Das, Shyamal Kumar

    2014-01-01

    Stroke survivors (SS) are rising with higher incidence of stroke in developing countries. In addition to physical impairment, other factors such as cognition, social interaction, and depression determine the functional outcome after stroke. Considering the paucity of data from developing countries, we planned to determine the change in various functional parameters among SS. This community-based prospective study was carried out in Kolkata, India among 283 SS between 2006 and 2010. Functional outcome was assessed at baseline and at 3 annual follow-up visits using validated tools. A stepwise regression analysis was performed with demographic and stroke-related covariates against various measures of functional outcome. Result showed that mean Barthel Index score at baseline was 76.4 ± 30.8. Bengali version of mental status examination and Geriatric Depression Scale scores trended down over time with a negative regression coefficient of -.2061 (standard error [SE], .0937) and -.4488 (SE, .2145). Other outcomes did not change. Female gender, depression, and cognitive dysfunction had an unfavorable impact, whereas education correlated positively. In conclusions female gender and neuropsychiatric disturbances showed poor functional outcome compared with education, which correlates with better outcome. This information will be helpful for patients in developing countries for planning stroke rehabilitation. PMID:25238928

  16. Identification of Vocational Education Outcomes in Illinois. Identification and Assessment of Vocational Education Outcomes.

    ERIC Educational Resources Information Center

    Wentling, Tim L.; Barnard, Wynette S.

    A statewide survey determined perceptions of the state staff and vocational administrators and teachers regarding time given to categories of vocational education outcomes and the educational level at which outcomes are appropriate. Differences existed between the secondary and postsecondary level regarding classroom time spent on identified…

  17. Inpatient Rehabilitation Volume and Functional Outcomes in Stroke, Lower Extremity Fracture, and Lower Extremity Joint Replacement

    PubMed Central

    Graham, James E.; Deutsch, Anne; O’Connell, Ann A.; Karmarkar, Amol M.; Granger, Carl V.; Ottenbacher, Kenneth J.

    2013-01-01

    Background It is unclear if volume-outcome relationships exist in inpatient rehabilitation. Objectives Assess associations between facility volumes and two patient-centered outcomes in the three most common diagnostic groups in inpatient rehabilitation. Research Design We used hierarchical linear and generalized linear models to analyze administrative assessment data from patients receiving inpatient rehabilitation services for stroke (n=202,423), lower extremity fracture (n=132,194), or lower extremity joint replacement (n=148,068) between 2006 and 2008 in 717 rehabilitation facilities across the U.S. Facilities were assigned to quintiles based on average annual diagnosis-specific patient volumes. Measures Discharge functional status (FIM instrument) and probability of home discharge. Results Facility-level factors accounted for 6–15% of the variance in discharge FIM total scores and 3–5% of the variance in home discharge probability across the 3 diagnostic groups. We used the middle volume quintile (Q3) as the reference group for all analyses and detected small, but statistically significant (p < .01) associations with discharge functional status in all three diagnosis groups. Only the highest volume quintile (Q5) reached statistical significance, displaying higher functional status ratings than Q3 each time. The largest effect was observed in FIM total scores among fracture patients, with only a 3.6-point difference in Q5 and Q3 group means. Volume was not independently related to home discharge. Conclusions Outcome-specific volume effects ranged from small (functional status) to none (home discharge) in all three diagnostic groups. Patients with these conditions can be treated locally rather than at higher-volume regional centers. Further regionalization of inpatient rehabilitation services is not needed for these conditions. PMID:23579350

  18. Stereotype threat and executive functions: which functions mediate different threat-related outcomes?

    PubMed

    Rydell, Robert J; Van Loo, Katie J; Boucher, Kathryn L

    2014-03-01

    Stereotype threat research shows that women's math performance can be reduced by activating gender-based math stereotypes. Models of stereotype threat assert that threat reduces cognitive functioning, thereby accounting for its negative effects. This work provides a more detailed understanding of the cognitive processes through which stereotype threat leads women to underperform at math and to take risks, by examining which basic executive functions (inhibition, shifting, and updating) account for these outcomes. In Experiments 1 and 2, women under threat showed reduced inhibition, reduced updating, and reduced math performance compared with women in a control condition (or men); however, only updating accounted for women's poor math performance under threat. In Experiment 3, only updating accounted for stereotype threat's effect on women's math performance, whereas only inhibition accounted for the effect of threat on risk-taking, suggesting that distinct executive functions can account for different stereotype threat-related outcomes. PMID:24345711

  19. Integrating Outcomes Assessment into Optometry Education: A Strategic Guide for Enhancing Student Learning.

    ERIC Educational Resources Information Center

    Beck, Diane E.; Daum, Kent M.

    2003-01-01

    Outlines eight steps that will help optometry schools transition a faculty from "denial" of the need for assessment to "institutionalization": establish a collaborative environment, establish an infrastructure that makes assessment an integral activity, recruit a leader for full implementation of outcomes assessment, conduct a needs assessment,…

  20. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ) Implant Arthroplasty

    PubMed Central

    Kachooei, Amir Reza; Chase, Samantha M; Jupiter, Jesse B

    2014-01-01

    Background: Conventional treatments after complicated injuries of the distal radioulnar joint (DRUJ) such as Darrach and Kapandji-Sauvé procedures have many drawbacks, which may eventually lead to a painful unstable distal ulna. The development of DRUJ prosthesis has significantly evolved over the past years. In this study, we assessed the outcome results of patients after DRUJ implant arthroplasty using the Aptis (Scheker) prosthesis. Methods: We identified 13 patients with 14 prosthesis during the past 10 years. Patients underwent DRUJ arthroplasty due to persistent symptoms of instability, chronic pain, and stiffness. Records and follow-up visits were reviewed to find the final post-operative symptoms, pain, range of motion, and grip strength with a mean follow-up of 12 months (range: 2-25 months). Also, patients were contacted prospectively by phone in order to administer the disabilities of the arm shoulder and hand (DASH), patient rated wrist evaluation (PRWE), and visual analogue scale (VAS), and to interview regarding satisfaction and progress in daily activities. Eleven patients out of 13 could be reached with a median follow-up time of 60 months (range: 2 to 102 months). Results: No patient required removal of the prosthesis. Only two patients underwent secondary surgeries in which both required debridement of the screw tip over the radius. The median DASH score, PRWE score, VAS, and satisfaction were 1.3, 2.5, 0, and 10, respectively. The mean range of flexion, extension, supination, and pronation was 62, 54, 51, and 64, respectively. Conclusions: Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation. PMID:25386579

  1. Mind your hand during the energy crunch: Functional Outcome of Circular Saw Hand Injuries

    PubMed Central

    2010-01-01

    Background Although injuries due to circular saws are very common all over the world, there is surprisingly little information available about their functional outcomes. As the socioeconomic impact of these injuries is immense and determined by the casualties' disability and impairment, it is the objective of this study to present data on the functional outcome, disability, and impairment of hand injuries due to electric circular saws. Methods Patients treated from 1999 through 2007 for circular saw-related hand injuries were contacted and asked for clinical follow-up assessment. The clinical follow-up protocol consisted of a physical examination and an assessment of static muscle power (grip and pinch strength). For assessment of the subjective experience of the patients regarding their injury-related disability and impairment, the DASH follow-up questionnaire was used. The occupational impact of these injuries was measured by number of lost working days. Finally, safety-related behaviour of the patients was investigated. Results 114 Patients were followed-up on average 52 months after the injury. Average in-house treatment was 8.8 days. Average time lost from work was 14.8 weeks. A significant reduction of static muscle testing parameters compared with the uninjured hand was revealed for grip strength, tip pinch, key pinch, and palmar pinch. Average DASH score was 17.4 (DASH work 15.8, DASH sports/music 17.7). Most patients had more than ten years experience in using these power tools. Conclusion The everyday occurrence of circular saw-related hand injuries followed by relatively short periods of in-house treatment might distort the real dimension of the patients' remaining disability and impairment. While the trauma surgeon's view is generally confined to the patients' clinical course, the outcome parameters in this follow-up investigation, with loss of working time as the key factor, confirm that the whole socioeconomic burden is much greater than the direct cost of treatment. PMID:20819215

  2. Level of kidney function as a risk factor for cardiovascular outcomes in the elderly

    Microsoft Academic Search

    Guruprasad Manjunath; Hocine Tighiouart; Josef Coresh; Bonnie Macleod; Deeb N. Salem; John L. Griffith; Andrew S. Levey; Mark J. Sarnak

    2003-01-01

    Level of kidney function as a risk factor for cardiovascular outcomes in the elderly.BackgroundThere is a high prevalence of both reduced kidney function as well as cardiovascular disease (CVD) in the elderly. We evaluated whether the level of kidney function is an independent risk factor for CVD outcomes in the Cardiovascular Health Study (CHS), a cohort of subjects whose age

  3. Assessing Outcome Criteria in Rehabilitation: A Multi-Component Approach.

    ERIC Educational Resources Information Center

    Livneh, Hanoch

    1988-01-01

    Reviews approaches for categorizing outcome criterion measures in the human services. Suggests a multidimensional paradigm based on conceptualizations advocated in the literature. Discusses paradigm's implications for rehabilitation practice. (Author/ABL)

  4. Valuing preferences over stormwater management outcomes including improved hydrologic function

    NASA Astrophysics Data System (ADS)

    LondoñO Cadavid, Catalina; Ando, Amy W.

    2013-07-01

    Stormwater runoff causes environmental problems such as flooding, soil erosion, and water pollution. Conventional stormwater management has focused primarily on flood reduction, while a new generation of decentralized stormwater solutions yields ancillary benefits such as healthier aquatic habitat, improved surface water quality, and increased water table recharge. Previous research has estimated values for flood reduction from stormwater management, but no estimates exist for the willingness to pay (WTP) for some of the other environmental benefits of alternative approaches to stormwater control. This paper uses a choice experiment survey of households in Champaign-Urbana, Illinois, to estimate the values of several attributes of stormwater management outcomes. We analyzed data from 131 surveyed households in randomly selected neighborhoods. We find that people value reduced basement flooding more than reductions in yard or street flooding, but WTP for basement flood reduction in the area only exists if individuals are currently experiencing significant flooding themselves. Citizens value both improved water quality and improved hydrologic function and aquatic habitat from runoff reduction. Thus, widespread investment in low impact development stormwater solutions could have very large total benefits, and stormwater managers should be wary of policies and infrastructure plans that reduce flooding at the expense of water quality and aquatic habitat.

  5. Development of Performance Criteria for Assessing Program Outcomes in Engineering, Engineering Technology and Computer Science Programs

    NSDL National Science Digital Library

    This paper presents the development and the use of performance criteria that could be used for detailed assessment of specific students performance in the program outcomes listed for Engineering programs (EAC Criterion 3, a-k outcomes), Engineering Technology programs (TAC Criterion 2, a-k outcomes) and Computer Science programs (CAC criterion 1, a-i outcomes). Performance criteria have been used to break down each program outcome into concrete measurable actions students are expected to be able to perform to demonstrate proficiency in the outcome. For each of the listed outcomes for the ABET Accreditation bodies, detailed performance criteria are presented in this paper. Suggestions on how the performance criteria can be used in a program are described in detail to allow selective adoption of the performance criteria for different programs and for different courses. The methodology for defining and using the performance criteria enables faculty to (1) fully understand the outcomes, (2) understand a range of performance criteria that need to be measured for each outcome, and (3) remove any ambiguity in the interpretation of the outcomes. In addition, it makes it possible to identify the critical skill-sets to measure for each outcome and makes assessment meaningful to the various programs.

  6. The long-term functional outcome of type II odontoid fractures managed non-operatively

    PubMed Central

    Dolan, R. T.; Burbridge, M.; Hurson, C. J.; O’Byrne, J. M.; McCormack, D.; Synnott, K.; Poynton, A. R.

    2010-01-01

    Odontoid fractures currently account for 9–15% of all adult cervical spine fractures, with type II fractures accounting for the majority of these injuries. Despite recent advances in internal fixation techniques, the management of type II fractures still remains controversial with advocates still supporting non-rigid immobilization as the definitive treatment of these injuries. At the NSIU, over an 11-year period between 1 July 1996 and 30 June 2006, 66 patients (n = 66) were treated by external immobilization for type II odontoid fractures. The medical records, radiographs and CT scans of all patients identified were reviewed. Clinical follow-up evaluation was performed using the Cervical Spine Outcomes Questionnaire (CSOQ). The objectives of this study were to evaluate the long-term functional outcome of patients suffering isolated type II odontoid fractures managed non-operatively and to correlate patient age and device type with clinical and functional outcome. Of the 66 patients, there were 42 males and 24 females (M:F = 1.75:1) managed non-operatively for type II odontoid fractures. The mean follow-up time was 66 months. Advancing age was highly correlated with poorer long-term functional outcomes when assessing neck pain (r = 0.19, P = 0.1219), shoulder and arm pain (r = 0.41, P = 0.0007), physical symptoms (r = 0.25, P = 0.472), functional disability (r = 0.24, P = 0.0476) and psychological distress (r = 0.41, P = 0.0007). Patients >65 years displayed a higher rate of pseudoarthrosis (21.43 vs. 1.92%) and established non-union (7.14 vs. 0%) than patients <65 years. The non-operative management of type II odontoid fractures is an effective and satisfactory method of treating type II odontoid fractures, particularly those of a stable nature. However, patients of advancing age have been demonstrated to have significantly poorer functional outcomes in the long term. This may be linked to higher rates of non-union. PMID:20364276

  7. Functional Area Assessments Project Charter Workstream Name Functional Area Assessments

    E-print Network

    Sheridan, Jennifer

    -level diagnostic will be completed for each of the following functions: - Facilities/Space Management - Purchasing and Payables - Auxiliary Operations - Research Administration - Business Services - Enrollment Management - Internal Budgeting - Human Resources These diagnostics will be performed using interviews, surveys, data

  8. Assessment of ?-cell function in human patients.

    PubMed

    Choi, Cheol Soo; Kim, Mi Yeon; Han, Kyungreem; Lee, Myung-Shik

    2012-01-01

    This review focuses on the methods accessing ?-cell function. ?-cell failure is the critical step in the development of type 2 diabetes. Therefore, assessment of ?-cell function is an important part of the evaluation and treatment of diabetic patients. However, it is not easy because of complex interaction between multiple tissues. Several parameters should be considered, such as glucose level and insulin sensitivity of diverse insulin target tissues to assess ?-cell function. To overcome these difficulties, several invasive or non-invasive methods have been developed to assess ?-cell function for clinical or research purposes. PMID:22627463

  9. Dorsolateral prefrontal lobe volume and neurological soft signs as predictors of clinical social and functional outcome in schizophrenia: A longitudinal study

    PubMed Central

    Behere, Rishikesh V.

    2013-01-01

    Schizophrenia is a disorder with variable outcome and the ability to predict the outcome has important clinical utility. Neurological soft signs (NSS) and dorsolateral prefrontal cortex volumes have been described as trait markers for schizophrenia and their relation to long-term outcome in schizophrenia has not been well studied. The aim of this study was to examine the correlation between baseline dorsolateral prefrontal lobe (DLPFL) volume and NSS scores to clinical and functional outcome variables in a cohort of schizophrenia patients who were anti-psychotic naïve at baseline. Fourteen anti-psychotic naive schizophrenia patients whose baseline magnetic resonance imaging scans, NSS scores and positive and negative signs and symptoms scale (PANSS) scores (assessed in drug naïve state) were available were reevaluated after a mean follow-up period of 74.2±24.2 months. The clinical outcome variables measured was PANSS. The social and functional outcome was assessed comprehensively by the socio occupational functioning scale and the Strauss Carpenter outcome scale. The DLPFL, volume was measured from the baseline scans using the region of interest method. Statistical analysis was done using the paired samples t-test and the Pearson's correlation co-efficient. The results showed that smaller left DLPFL volume and greater primitive reflexes at baseline predicted greater negative symptoms and poorer functional outcome on follow-up. This study also demonstrates the clinical utility of NSS as a simple bedside tool in assessing schizophrenia patients. PMID:23825842

  10. Prediction of Rat Behavior Outcomes in Memory Tasks Using Functional Connections among Neurons

    PubMed Central

    Lu, Hu; Yang, Shengtao; Lin, Longnian; Li, Baoming; Wei, Hui

    2013-01-01

    Background Analyzing the neuronal organizational structures and studying the changes in the behavior of the organism is key to understanding cognitive functions of the brain. Although some studies have indicated that spatiotemporal firing patterns of neuronal populations have a certain relationship with the behavioral responses, the issues of whether there are any relationships between the functional networks comprised of these cortical neurons and behavioral tasks and whether it is possible to take advantage of these networks to predict correct and incorrect outcomes of single trials of animals are still unresolved. Methodology/Principal Findings This paper presents a new method of analyzing the structures of whole-recorded neuronal functional networks (WNFNs) and local neuronal circuit groups (LNCGs). The activity of these neurons was recorded in several rats. The rats performed two different behavioral tasks, the Y-maze task and the U-maze task. Using the results of the assessment of the WNFNs and LNCGs, this paper describes a realization procedure for predicting the behavioral outcomes of single trials. The methodology consists of four main parts: construction of WNFNs from recorded neuronal spike trains, partitioning the WNFNs into the optimal LNCGs using social community analysis, unsupervised clustering of all trials from each dataset into two different clusters, and predicting the behavioral outcomes of single trials. The results show that WNFNs and LNCGs correlate with the behavior of the animal. The U-maze datasets show higher accuracy for unsupervised clustering results than those from the Y-maze task, and these datasets can be used to predict behavioral responses effectively. Conclusions/Significance The results of the present study suggest that a methodology proposed in this paper is suitable for analysis of the characteristics of neuronal functional networks and the prediction of rat behavior. These types of structures in cortical ensemble activity may be critical to information representation during the execution of behavior. PMID:24098641

  11. Structural Equation Modeling of Motor Impairment, Gross Motor Function, and the Functional Outcome in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Park, Eun-Young; Kim, Won-Ho

    2013-01-01

    Physical therapy intervention for children with cerebral palsy (CP) is focused on reducing neurological impairments, improving strength, and preventing the development of secondary impairments in order to improve functional outcomes. However, relationship between motor impairments and functional outcome has not been proved definitely. This study…

  12. The feasibility of using electronic clinical outcome assessments in people with schizophrenia and their informal caregivers

    PubMed Central

    Tolley, Chloe; Rofail, Diana; Gater, Adam; Lalonde, Justine K

    2015-01-01

    Many clinical outcome assessments (COAs) were originally developed for completion via pen and paper. However, in recent years there have been movements toward electronic capture of such data in an effort to reduce missing data, provide time-stamped records, minimize administrative burden, and avoid secondary data entry errors. Although established in many patient populations, the implications of using electronic COAs in schizophrenia are unknown. In accordance with International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force recommendations, in-depth cognitive debriefing and usability interviews were conducted with people with schizophrenia (n=12), their informal (unpaid) caregivers (n=12), and research support staff (n=6) to assess the suitability of administration of various electronic COA measures using an electronic tablet device. Minimal issues were encountered by participants when completing or administering the COAs in electronic format, with many finding it easier to complete instruments in this mode than by pen and paper. The majority of issues reported were specific to the device functionality rather than the electronic mode of administration. Findings support data collection via electronic tablet in people with schizophrenia and their caregivers. The appropriateness of other forms of electronic data capture (eg, smartphones, interactive voice response systems, etc) is a topic for future investigation. PMID:25870518

  13. Type 2 diabetes is associated with a worse functional outcome of ischemic stroke

    PubMed Central

    Tziomalos, Konstantinos; Spanou, Marianna; Bouziana, Stella D; Papadopoulou, Maria; Giampatzis, Vasilios; Kostaki, Stavroula; Dourliou, Vasiliki; Tsopozidi, Maria; Savopoulos, Christos; Hatzitolios, Apostolos I

    2014-01-01

    AIM: To assess whether ischemic stroke severity and outcome is more adverse in patients with type 2 diabetes mellitus (T2DM). METHODS: Consecutive patients hospitalized for acute ischemic stroke between September 2010 and June 2013 were studied prospectively (n = 482; 40.2% males, age 78.8 ± 6.7 years). T2DM was defined as self-reported T2DM or antidiabetic treatment. Stroke severity was evaluated with the National Institutes of Health Stroke Scale (NIHSS) score at admission. The outcome was assessed with the modified Rankin scale (mRS) score at discharge and with in-hospital mortality. Adverse outcome was defined as mRS score at discharge ? 2 or in-hospital death. The length of hospitalization was also recorded. RESULTS: T2DM was present in 32.2% of the study population. Patients with T2DM had a larger waist circumference, higher serum triglyceride and glucose levels and lower serum high-density lipoprotein cholesterol levels as well as higher prevalence of hypertension, coronary heart disease and congestive heart failure than patients without T2DM. On the other hand, diabetic patients had lower low-density lipoprotein cholesterol levels and reported smaller consumption of alcohol than non-diabetic patients. At admission, the NIHSS score did not differ between patients with and without T2DM (8.7 ± 8.8 and 8.6 ± 9.2, respectively; P = NS). At discharge, the mRS score also did not differ between the two groups (2.7 ± 2.1 and 2.7 ± 2.2 in patients with and without T2DM, respectively; P = NS). Rates of adverse outcome were also similar in patients with and without T2DM (62.3% and 58.5%, respectively; P = NS). However, when we adjusted for the differences between patients with T2DM and those without T2DM in cardiovascular risk factors, T2DM was independently associated with adverse outcome [relative risk (RR) = 2.39; 95%CI: 1.21-4.72, P = 0.012]. In-hospital mortality rates did not differ between patients with T2DM and those without T2DM (9.0% and 9.8%, respectively; P = NS). In multivariate analysis adjusting for the difference in cardiovascular risk factors between the two groups, T2DM was again not associated with in-hospital death. CONCLUSION: T2DM does not appear to affect ischemic stroke severity but is independently associated with a worse functional outcome at discharge. PMID:25512800

  14. Evaluation of oral glucose tolerance test, ?-cell function and adverse obstetric outcomes

    PubMed Central

    ZHANG, HONGXIU; ZHAO, DONGMEI; SHEN, JIE; ZHOU, XIAOPING; CHEN, WENWEI; JIANG, SHIWEN

    2013-01-01

    This study was conducted in order to investigate the prevalence of impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM), their effect on pregnancy and their association with adverse obstetric outcomes. A cross-sectional study was performed on 345 pregnant women, who were screened between the 24th and 28th gestational week with a 75-g oral glucose tolerance test following abnormal results at 1 h after a 50-g oral glucose challenge test. The obstetric outcomes were recorded along with plasma glucose and insulin levels, homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of ?-cell function index (HOMA-?CFI) and 50 subjects were excluded due to incomplete data recovery. Of the 295 pregnant women, 18.6% (55/295) were diagnosed with GDM and 32% (95/295) with IGT. The GDM group exhibited significantly higher fasting and 1-h blood glucose concentrations compared to the normal glucose tolerance (NGT) and IGT groups (P<0.01). The 2- and 3-h insulin values of the NGT group were significantly lower compared to those of the GDM group (P<0.05, P<0.01). In the IGT group, the 2-h insulin values were higher compared to the NGT group and the 3-h values were significantly higher (P<0.01), similar to the GDM group. There was a tendency for progressively decreased ?-cell function and increased HOMA-IR from the NGT to the IGT to the GDM group. The adverse outcomes of pregnancy-induced hypertension, fetal distress, neonatal hyperbilirubinemia, preterm delivery, macrosomia and cesarean delivery indicated an association with HOMA-?CFI and HOMA-IR. In conclusion, these findings suggest a clinical significance of ?-cell dysfunction in women with gestational IGT. PMID:24649033

  15. Evaluation of oral glucose tolerance test, ?-cell function and adverse obstetric outcomes.

    PubMed

    Zhang, Hongxiu; Zhao, Dongmei; Shen, Jie; Zhou, Xiaoping; Chen, Wenwei; Jiang, Shiwen

    2013-09-01

    This study was conducted in order to investigate the prevalence of impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM), their effect on pregnancy and their association with adverse obstetric outcomes. A cross-sectional study was performed on 345 pregnant women, who were screened between the 24th and 28th gestational week with a 75-g oral glucose tolerance test following abnormal results at 1 h after a 50-g oral glucose challenge test. The obstetric outcomes were recorded along with plasma glucose and insulin levels, homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of ?-cell function index (HOMA-?CFI) and 50 subjects were excluded due to incomplete data recovery. Of the 295 pregnant women, 18.6% (55/295) were diagnosed with GDM and 32% (95/295) with IGT. The GDM group exhibited significantly higher fasting and 1-h blood glucose concentrations compared to the normal glucose tolerance (NGT) and IGT groups (P<0.01). The 2- and 3-h insulin values of the NGT group were significantly lower compared to those of the GDM group (P<0.05, P<0.01). In the IGT group, the 2-h insulin values were higher compared to the NGT group and the 3-h values were significantly higher (P<0.01), similar to the GDM group. There was a tendency for progressively decreased ?-cell function and increased HOMA-IR from the NGT to the IGT to the GDM group. The adverse outcomes of pregnancy-induced hypertension, fetal distress, neonatal hyperbilirubinemia, preterm delivery, macrosomia and cesarean delivery indicated an association with HOMA-?CFI and HOMA-IR. In conclusion, these findings suggest a clinical significance of ?-cell dysfunction in women with gestational IGT. PMID:24649033

  16. Functional Outcomes of Mpfl Reconstruction VS. Graft Tissue Placement

    PubMed Central

    Larson, Evan; Edwards, Alan; Albright, John

    2014-01-01

    Background The medial patellofemoral ligament (MPFL) is essential for the maintenance of correct biomechanical function of the knee. Reconstruction of the MPFL is commonly used in the restoration of patellofemoral stability after traumatic lateral subluxation of the patella. Although a method to accurately determine the MPFL's insertion point has been described, it remains unclear if anatomic placement of MPFL graft tissue is essential for preservation of knee function after MPFL reconstruction. Thus, the purpose of this study was to determine the importance of anatomic placement of MPFL graft tissue for the preservation of knee function following MPFL reconstruction operations. Methods Twenty-seven subjects who underwent MPFL reconstruction operations were retrospectively analyzed. Postoperative radiographs were reviewed. Measurements were taken, and the placement of each patient's MPFL graft tissue was determined to be anatomic or non-anatomic based on radiographic methods previously described in the literature. Each subject's electronic medical record was then reviewed, and clinical data was recorded. Finally, the clinical outcomes of each patient were compared to placement location of the MPFL graft tissue in their procedure. Results Thirteen patients were found to have anatomic MPFL graft tissue placement, and 14 non-anatomic. A significant post-operative difference was found between groups in the following parameters: WOMAC pain (anatomic mean = 85.71 ± 11.34, non-anatomic mean = 75.00 ± 26.35 p = 0.018), function (anatomic mean = 85.85 ± 9.96, non-anatomic mean = 79.09 ± 24.45, p = 0.017) and in KOOS symptom (anatomic mean = 75.63 ± 11.79, non-anatomic mean = 67.83 ± 22.40, p = 0.024), pain (anatomic mean = 77.54 ± 8.61, non-anatomic mean = 71.39 ± 25.18, p = 0.01), ADL (anatomic mean = 85.85 ± 9.97, non-anatomic mean = 79.09 ± 24.45, p = 0.017) and overall (anatomic mean = 74.61 ± 10.33, non-anatomic mean = 69.41 ± 24.25, p = 0.01) scores. No significant difference was observed for post-op instability (p = 0.290) or apprehension (p = 0.496), improvement in WOMAC or KOOS, 2-week, 6-week, or final 1-year range of motion, WOMAC stiffness, or KOOS sport/recreation or QOL. Conclusion Within the range of graft placement values considered by this study, while no reduction in range of motion was seen, non-anatomic placement of MPFL graft tissue in MPFL reconstruction operations caused increased pain and decreased function, evidenced by post-operative KOOS and WOMAC scores. Clinical Relevance It seems that the pivotal step in MPFL reconstruction operations is ensuring correct patellofemoral tracking via intraoperative electrical femoral nerve stimulation. If this step of the procedure is performed correctly, non-anatomic placement will not limit range of motion, lead to continued apprehension, or affect the overall biomechanical functioning of the knee. PMID:25328457

  17. How to Tackle the Shift of Educational Assessment from Learning Outcomes to Competencies: One Program's Transition

    ERIC Educational Resources Information Center

    Meyer-Adams, Nancy; Potts, Marilyn K.; Koob, Jeffrey J.; Dorsey, Catherine J.; Rosales, Anna M.

    2011-01-01

    Although the new Educational Policy and Accreditation Standards (EPAS) represent a shift from measuring learning outcomes to core competencies, results from assessments conducted prior to this shift continue to provide useful information for program-level assessment and can serve as a baseline as programs redesign assessments for reaffirmation.…

  18. Beyond Student Learning Outcomes: Developing Comprehensive, Strategic Assessment Plans for Advising Programmes

    ERIC Educational Resources Information Center

    McClellan, Jeffrey L.

    2011-01-01

    This article argues that while the importance of assessment in academic advising is clear and the current emphasis on defining and measuring student learning outcomes represents an essential component of any comprehensive advising assessment plan, an even more comprehensive understanding of programme assessment is needed. Drawing upon business…

  19. Utility of Two PANSS 5-Factor Models for Assessing Psychosocial Outcomes in Clinical Programs for Persons with Schizophrenia

    PubMed Central

    Jerrell, Jeanette M.

    2013-01-01

    Using symptom factors derived from two models of the Positive and Negative Syndrome Scale (PANSS) as covariates, change over time in consumer psychosocial functioning, medication adherence/compliance, and treatment satisfaction outcomes are compared based on a randomized, controlled trial assessing the effectiveness of antipsychotic medications for 108 individuals diagnosed with schizophrenia. Random effects regression analysis was used to determine the relative performance of these two 5-factor models as covariates in estimating change over time and the goodness of fit of the regression equations for each outcome. Self-reported psychosocial functioning was significantly associated with the relief of positive and negative syndromes, whereas patient satisfaction was more closely and significantly associated with control of excited/activation symptoms. Interviewer-rated psychosocial functioning was significantly associated with relief of positive and negative symptoms, as well as excited/activation and disoriented/autistic preoccupation symptoms. The VDG 5-factor model of the PANSS represents the best “goodness of fit” model for assessing symptom-related change associated with improved psychosocial outcomes and functional recovery. Five-factor models of the syndromes of schizophrenia, as assessed using the PANSS, are differentially valuable in determining the predictors of psychosocial and satisfaction changes over time, but not of improved medication adherence/compliance. PMID:24381761

  20. Undergraduate Student Ethics Outcomes 4/28/14 draft developed by the CSM Assessment Committee

    E-print Network

    will demonstrate ethical knowledge: Students will describe professional norms, principles, and ideals related of the Mines Graduate both reference ethical outcomes/behaviors. In response, the Assessment Committee has demonstrate in fulfillment of the numbered outcomes. Departments may also add discipline-specific skills

  1. 2013-2015 Student Life Assessment Plan Report Tier III: Learning Outcomes

    E-print Network

    Missouri-Rolla, University of

    and improve the quality of one's work and one's organization Demonstrate self-initiative and self2013-2015 Student Life Assessment Plan Report Tier III: Learning Outcomes Student Life Outcomes Through participation in Student Life programs, students are expected to be able to do the following

  2. Using a University-Wide Syllabus Study to Examine Learning Outcomes and Assessment

    ERIC Educational Resources Information Center

    Willingham-McLain, Laurel

    2011-01-01

    This cross-disciplinary study examined syllabus quality (n = 280) and the connection of learning outcomes to the Dimensions of a Duquesne Education for two purposes: informing instructional development and writing an accreditation self-study. Three researchers coded the syllabi for learning outcomes, assessment, and the presence of these…

  3. The Process/Outcome Evaluation Model: A Conceptual Framework for Assessment.

    ERIC Educational Resources Information Center

    Kovalik, Cindy L.; Dalton, David W.

    1999-01-01

    The Process/Outcome Evaluation Model (POEM) is proposed to guide in the development of more holistic evaluations of both the learning process and the resultant outcomes of that process. POEM consists of four major components that employ multiple evaluation techniques and strategies resulting in a composite assessment of the totality of a learning…

  4. Longitudinal Assessment of Comprehensive School Reform Program Implementation and Outcomes: First-Year Report

    ERIC Educational Resources Information Center

    Tushnet, Naida C., Flaherty, John, Jr., Smith, And

    2004-01-01

    The Longitudinal Assessment of Comprehensive School Reform Implementation and Outcomes (LACIO) responds to the No Child Left Behind Act's requirement for an evaluation of the federal Comprehensive School Reform (CSR) program. The legislation stipulates two broad goals for the evaluation: (1) to evaluate the implementation and outcomes achieved by…

  5. Assessing Outcomes in an English Authority (The Royal Borough of Kensington and Chelsea).

    ERIC Educational Resources Information Center

    Murphy, Imelda; Phillips, Malcolm

    1998-01-01

    Used the "Assessment and Action Record" from the "Looking After Children" materials to identify needs and desired outcomes for youth leaving out-of-home care in 1995 in an English local authority. Found that desired outcomes included providing information and knowledge, providing the means to acquire financial-related skills and to deal with…

  6. Outcomes-Based Education Reexamined: From Structural Functionalism to Poststructuralism

    Microsoft Academic Search

    Colleen A. Capper; Michael T. Jamison

    1993-01-01

    Outcomes-Based Education (OBE) views itself as a drastic break from current educational practices and a means of providing educational success for all students. Though not stated in overt terms, OBE also positions it self as a means of \\

  7. 76 FR 45271 - Review and Qualification of Clinical Outcome Assessments; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-28

    ...workshop to discuss measurement principles for clinical outcome assessments...is separate from the drug marketing application process, qualification...workshop will focus on FDA review principles specific to all type of COAs...evaluation: COA measurement principles; COA...

  8. Mind your hand during the energy crunch: Functional Outcome of Circular Saw Hand Injuries

    Microsoft Academic Search

    Matthias Frank; Juliane Hecht; Matthias Napp; Joern Lange; Rico Grossjohann; Dirk Stengel; Uli Schmucker; Axel Ekkernkamp; Peter Hinz

    2010-01-01

    BACKGROUND: Although injuries due to circular saws are very common all over the world, there is surprisingly little information available about their functional outcomes. As the socioeconomic impact of these injuries is immense and determined by the casualties' disability and impairment, it is the objective of this study to present data on the functional outcome, disability, and impairment of hand

  9. Radiological and functional outcome after anterior lumbar interbody spinal fusion

    Microsoft Academic Search

    F. B. Christensen; B. Karlsmose; E. S. Hansen; C. E. Bringer

    1996-01-01

    Outcome after anterior spinal fusion has mainly been studied radiologically and reported fusion rates vary greatly. The aim of this study was to investigate radiological and long-term clinical outcome. The study comprised 120 consecutive patients, operated on during the period 1979–1987, with single-or two-level anterior interbody spinal fusion due to disc degeneration or isthmic spondylolisthesis with lumbar instability. In 64

  10. Assessment of Functional Status and Quality of Life in Claudication

    PubMed Central

    Mays, Ryan J.; Casserly, Ivan P.; Kohrt, Wendy M.; Ho, P. Michael; Hiatt, William R.; Nehler, Mark R.; Regensteiner, Judith G.

    2012-01-01

    Background Treadmill walking is commonly used to evaluate walking impairment and efficacy of treatment for intermittent claudication (IC) in clinical and research settings. Although this is an important measure, it does not provide information about how patients perceive the effects of their treatments on more global measures of health-related quality of life (HRQOL). Methods PubMed/Medline was searched to find publications about the most commonly used questionnaires to assess functional status and/or general and disease-specific HRQOL in patients with PAD who experience IC. Inclusion criteria for questionnaires were based on existence of a body of literature in symptomatic PAD. Results Six general questionnaires and 7 disease-specific questionnaires are included with details about the number of domains covered and how each tool is scored. The Medical Outcomes Study Short Form 36 item questionnaire and Walking Impairment Questionnaire are currently the most used general and disease-specific questionnaires at baseline and following treatment for IC, respectively. Conclusions The use of tools which assess functional status and HRQOL has importance in both the clinical and research areas to assess treatment efficacy from the patient perspective. Therefore, assessing HRQOL in addition to treadmill-measured walking ability provides insight as to effects of treatments on patient outcomes and may help guide therapy. PMID:21334172

  11. Assessing performance outcomes of new graduates utilizing simulation in a military transition program.

    PubMed

    Hughes, Robie V; Smith, Sherrill J; Sheffield, Clair M; Wier, Grady

    2013-01-01

    This multi-site, quasi-experimental study examined the performance outcomes of nurses (n = 152) in a military nurse transition program. A modified-performance instrument was used to assess participants in two high-fidelity simulation scenarios. Although results indicated a significant increase in scores posttraining, only moderate interrater reliability results were found for the new instrument. These findings have implications for nurse educators assessing performance-based outcomes of new nurses completing transition programs. PMID:23703274

  12. Examinable course assessment tool based on outcome based education

    Microsoft Academic Search

    Hadzli Hashim Mohd Fuad Latip

    2009-01-01

    Engineering program offered in Malaysia nowadays, has to be accredited by the Engineering Accreditation Council (EAC) which represents the Board of Engineers Malaysia (BEM) in order to be recognized by Washington Accord signatories' country. Such accreditation would benefit the graduates to look for jobs globally. Outcome-based education (OBE) has become a critical aspect of accreditation requirement and Faculty of Electrical

  13. Assessing Individual Support Needs to Enhance Personal Outcomes

    ERIC Educational Resources Information Center

    van Loon, Jos; Claes, Claudia; Vandevelde, Stijn; Van Hove, Geert; Schalock, Robert L.

    2010-01-01

    Education and human service organizations providing services to people with intellectual and closely related developmental disabilities are increasingly being impacted by the supports paradigm, the quality of life concept, and the evaluation of personal outcomes. In this article the authors discuss the relationship among these three areas,…

  14. Assessment of Student Outcomes Using a Theoretical Framework.

    ERIC Educational Resources Information Center

    Levins, Lesley

    1997-01-01

    Examines the scientific concept of evaporation. Attempts to show how students develop their understanding through the levels of the Structure of the Observed Learning Outcome (SOLO) taxonomy. Shows how designing learning experiences to suit the learners' developmental stages in understanding a concept is paramount to the overall growth of the…

  15. Assessing Medication Effects in the MTA Study Using Neuropsychological Outcomes

    ERIC Educational Resources Information Center

    Epstein, Jeffery N.; Conners, C. Keith; Hervey, Aaron S.; Tonev, Simon T.; Arnold, L. Eugene; Abikoff, Howard B.; Elliott, Glen; Greenhill, Laurence L.; Hechtman, Lily; Hoagwood, Kimberly; Hinshaw, Stephen P.; Hoza, Betsy; Jensen, Peter S.; March, John S.; Newcorn, Jeffrey H.; Pelham, William E.; Severe, Joanne B.; Swanson, James M.; Wells, Karen; Vitiello, Benedetto; Wigal, Timothy

    2006-01-01

    Background: While studies have increasingly investigated deficits in reaction time (RT) and RT variability in children with attention deficit/hyperactivity disorder (ADHD), few studies have examined the effects of stimulant medication on these important neuropsychological outcome measures. Methods: 316 children who participated in the Multimodal…

  16. Social Cognition as a Mediator between Neurocognition and Functional Outcome in Individuals at Clinical High Risk for Psychosis

    PubMed Central

    Barbato, Mariapaola; Liu, Lu; Penn, David L.; Keefe, Richard S.E.; Perkins, Diana O.; Woods, Scott W.; Addington, Jean

    2013-01-01

    In schizophrenia, neurocognition, social cognition and functional outcome are all inter-related, with social cognition mediating the impact that impaired neurocognition has on functional outcome. Less clear is the nature of the relationship between neurocognition, social cognition and functional outcome in individuals at clinical high risk (CHR) for psychosis. 137 CHR participants completed a neurocognitive test battery, a battery of social cognition tasks and the Social Functioning Scale. Confirmatory factor analysis showed that all social cognition tasks were reliable and valid measures of the latent variable. The path from neurocognition to functioning was statistically significant (standardized coefficient ? = 0.22, p <0.01). The path from social cognition to functioning was also statistically significant (?= 0.27, p<0.05). In the mediation model the bootstrapping estimate revealed a nonsignificant indirect effect that was the association of social cognition with neurocognition and with functional outcome (? =0.20, 95% CI =?0.07 to 0.52, p=0.11). However, social cognition was significantly associated with neurocognition (? = 0.80, p < 0.001) and the path from neurocognition to functioning was no longer significant as soon as the mediator (social cognition) was entered into the mediation model (? = 0.02, p = 0.92). All of the model fit indices were very good. Unlike what has been observed with psychotic patients, social cognition does not seem to mediate the pathway from neurocognition to functional outcome when assessed with a measure of social attainment in individuals at CHR for psychosis. PMID:24012459

  17. Effect of retaining a patellar prosthesis on pain, functional, and satisfaction outcomes after revision total knee arthroplasty.

    PubMed

    Masri, Bassam A; Meek, R M Dominic; Greidanus, Nelson V; Garbuz, Donald S

    2006-12-01

    It remains controversial whether patients' pain, function, and satisfaction are affected in revision total knee arthroplasty by patellar prosthetic resurfacing. This is a retrospective, comparative cohort study to evaluate this. One hundred twenty-six patients who underwent total knee arthroplasty revision were identified. After revision, the presence or absence of a patellar prosthesis was ascertained. At a minimum of 2 years' follow-up, pain and function were assessed by Western Ontario and McMaster Universities Osteoarthritis Index, Oxford-12, Short-Form 12, and patient satisfaction questionnaires in 110 patients (58 with patellar component, 52 bony shell). Univariate and multivariate analyses demonstrated no significant difference between the 2 cohorts for Western Ontario and McMaster Universities Osteoarthritis Index pain, function, Oxford-12, and satisfaction outcomes. The absence of a patellar prosthesis does not appear to significantly affect pain, function, or satisfaction outcomes after revision total knee arthroplasty. PMID:17162177

  18. Neurocognitive and Social Cognitive Approaches for Improving Functional Outcome in Early Psychosis: Theoretical Considerations and Current State of Evidence

    PubMed Central

    Bartholomeusz, Cali F.; Allott, Kelly

    2012-01-01

    Improving functional outcome, in addition to alleviating psychotic symptoms, is now a major treatment objective in schizophrenia research. Given the large body of evidence suggesting pharmacological treatments generally have minimal effects on indices of functioning, research has turned to psychosocial rehabilitation programs. Among these, neurocognitive and social cognitive interventions are at the forefront of this field and are argued to target core deficits inherent to the schizophrenia illness. However, to date, research trials have primarily focused on chronic schizophrenia populations, neglecting the early psychosis groups who are often as severely impaired in social and occupational functioning. This theoretical paper will outline the rationale for investigating adjunctive cognitive-based interventions in the early phases of psychotic illness, critically examine the current approach strategies used in these interventions, and assess the evidence supporting certain training programs for improving functional outcome in early psychosis. Potential pathways for future research will be discussed. PMID:22966447

  19. Grade 3 open tibial shaft fractures treated with a circular frame, functional outcome and systematic review of literature.

    PubMed

    Dickson, D R; Moulder, E; Hadland, Y; Giannoudis, P V; Sharma, H K

    2015-04-01

    We report on the surgical and functional outcome of 22 patients with Grade 3 open tibial fractures treated with circular frame. All cases united and there were no re-fractures or amputations. All patients were assessed at a minimum of 1-year post frame removal. Assessment included clinical examination, IOWA ankle and knee scores, Olerud and Molander ankle score and EuroQol EQ-5D. Clinical scores were either good or excellent in over half of the patients in all knee and ankle scores. There was a significant positive correlation between functional outcomes and the EQ-5D score. The EQ-5D mean health state visual analogue score was comparable to the general UK population despite patients scoring less than the average UK population in three of the five domains. 36% reported some difficulties in walking and 41% had problems with pain. 14% had difficulties with self-care and 46% had difficulties with their usual activities. 14% had problems with anxiety or depression. Systematic review of the literature suggests, in the management of open tibial fractures, circular frames provide equivalent or superior surgical outcomes in comparison with other techniques. Our study finds the application of a circular frame also results in a good functional outcome in the majority of cases. PMID:25648287

  20. Brain immune cell composition and functional outcome after cerebral ischemia: comparison of two mouse strains

    PubMed Central

    Kim, Hyun Ah; Whittle, Stephanie C.; Lee, Seyoung; Chu, Hannah X.; Zhang, Shenpeng R.; Wei, Zihui; Arumugam, Thiruma V.; Vinh, Anthony; Drummond, Grant R.; Sobey, Christopher G.

    2014-01-01

    Inflammatory cells may contribute to secondary brain injury following cerebral ischemia. The C57Bl/6 mouse strain is known to exhibit a T helper 1-prone, pro-inflammatory type response to injury, whereas the FVB strain is relatively T helper 2-prone, or anti-inflammatory, in its immune response. We tested whether stroke outcome is more severe in C57Bl/6 than FVB mice. Male mice of each strain underwent sham surgery or 1 h occlusion of the middle cerebral artery followed by 23 h of reperfusion. Despite no difference in infarct size, C57Bl/6 mice displayed markedly greater functional deficits than FVB mice after stroke, as assessed by neurological scoring and hanging wire test. Total numbers of CD45+ leukocytes tended to be larger in the brains of C57Bl/6 than FVB mice after stroke, but there were marked differences in leukocyte composition between the two mouse strains. The inflammatory response in C57Bl/6 mice primarily involved T and B lymphocytes, whereas neutrophils, monocytes and macrophages were more prominent in FVB mice. Our data are consistent with the concept that functional outcome after stroke is dependent on the immune cell composition which develops following ischemic brain injury. PMID:25477780

  1. Long-term functional outcomes in the elderly after burn injury.

    PubMed

    Palmieri, Tina L; Molitor, Fred; Chan, Grace; Phelan, Elizabeth; Shier, Brian J; Sen, Soman; Greenhalgh, David G

    2012-01-01

    Although the elderly represent a substantial proportion of the population, limited information exists on postdischarge long-term outcomes of elderly burn survivors. The purpose of this study was to assess elderly burn patient outcomes 2 to 10 years after discharge. This study was a prospective cross-sectional survey assessment of quality of life and retrospective trauma registry for the American College of Surgeons review of patients ? 60 years of age discharged alive after acute burn from 1997 to 2007. In-hospital treatment and burn demographic information were obtained from database and chart review. Surviving patients or their families were contacted, and the Short-Form-12 and Functional Independence Measure (FIM) administered. Of the 344 patients discharged, 232 participated. Mean age was 72.3 (60-85.8) years, TBSA burn was 7.8% (1-79), and length of stay was 11.2 ± 0.9 days (1-51). Most patients were discharged home (71%) or to a skilled nursing facility (SNF; 20%). Mean interval between discharge and survey administration was 46.1 months. In all, 24% of patients sent home died after discharge and prior to interview compared with 58% of patients sent to an SNF. On multivariate analysis, mortality increased with age (confidence interval [CI] 1.04-1.09), and government insurance (CI 0.34-0.94), but decreased with discharge to home (CI 1.68-4.47). There were no differences in FIM or Short-Form-12 scores between groups. Long-term mortality after discharge in elderly burn survivors is substantial. Patients sent to an SNF or with government insurance had increased mortality postdischarge. These data suggest that issues that may influence disposition status of elderly burn patients should be optimized prior to discharge to mitigate adverse outcomes associated with SNF placement. PMID:22777398

  2. Facial dog bite injuries in children: treatment and outcome assessment.

    PubMed

    Eppley, Barry L; Schleich, Arno Rene

    2013-03-01

    Dog bite injuries to a child's face are not an infrequent occurrence. They may require primary and revisional surgery. All result in permanent facial scars. This report describes the treatment and outcomes of dog bites of the face, scalp, and neck based on a case series of 107 children over a 10-year period.The average children's age was 5.9 years. In cases where the dog was identified (95%), it was known to the victim and their family. The events leading to the dog bite were categorized as provoked (77%) in the majority of the cases.The majority of wounds could be closed primarily without a significant risk of wound infection. Complex reconstructions were required in more severe cases. The majority of families (77%) opted for scar revision between 9 and 18 months after initial treatment to improve the aesthetic outcome.Lawsuit actions resulted in 39 of the cases making good documentation an essential part of treatment. Dogbite injuries to the face in children frequently require multiple scar revisions to obtain the best possible aesthetic outcome, and the family should be so counseled at the onset of treatment. PMID:23524699

  3. Student Learning Outcomes Assessment and Institutional Effectiveness Activities at Bellevue Community College. Report of the 1996-97 Assessment Inventory.

    ERIC Educational Resources Information Center

    Hodge, Valerie

    In response to recommendations from an accreditation visit regarding improvements in the utilization of research findings, Washington's Bellevue Community College (BCC) developed this assessment inventory to give faculty and staff a more complete understanding of student outcomes and assessment efforts at the college. Following an executive…

  4. Assessing the Dimensions and Outcomes of an Effective Teammate

    ERIC Educational Resources Information Center

    Crutchfield, Tammy N.; Klamon, Kimberly

    2014-01-01

    Though teamwork is a mainstay of corporate America and business academia, individual assessment and compensation are problematic in disciplining and removing teammates who are free-riders and rewarding high performing team members who bear a disproportionate burden of the project. Therefore, the authors set out to develop and test an assessment

  5. Exploring Alternative Approaches to Child Outcome Assessments in Children's Centres

    ERIC Educational Resources Information Center

    Campbell-Barr, Verity; Lavelle, Marie; Wickett, Karen

    2012-01-01

    In England, early years education services and the children and who attend them are the subject of increasing scrutiny and assessment. While these assessments offer a number of benefits in terms of tracking child development and ensuring the efficient use of public monies, they also impose restrictions to practice, limits to understandings of…

  6. The Outcomes of Statewide Assessment: Implications for Curriculum Evaluation.

    ERIC Educational Resources Information Center

    Rubinstein, Sherry Ann; Nassif-Royer, Paula

    State Departments of Education are turning to the use of criterion referenced, as opposed to norm referenced, models for statewide assessment. The underlying assumption in this turn of events is that results generated by criterion referenced tests within the statewide assessment context permit the drawing of value inferences about the…

  7. The Case for Assessing Complex General Education Student Learning Outcomes

    ERIC Educational Resources Information Center

    Penn, Jeremy D.

    2011-01-01

    Assessment of general education has a long history, although relative to the age of liberal education and educational evaluation it is a very recent development. One of the first recorded efforts to comprehensively assess student achievement in higher education in the United States occurred in the late 1920s and early 1930s, when many institutions…

  8. Outcomes of Synergetic Peer Assessment: First-Year Experience

    ERIC Educational Resources Information Center

    Hodgson, Paula; Chan, Kitty; Liu, Justina

    2014-01-01

    Active participation in learning activities and reviewing assessment activity can facilitate learners engaged in these processes. This case study reports student experiences of the process of peer assessment with teacher guidance in a group project for a first-year nursing course with 153 students. Twenty groups of students were assigned roles in…

  9. Three-Year Outcomes of Cultured Limbal Epithelial Allografts in Aniridia and Stevens-Johnson Syndrome Evaluated Using the Clinical Outcome Assessment in Surgical Trials Assessment Tool

    PubMed Central

    Bunce, Catey; Levis, Hannah J.; Blows, Peter; Doré, Caroline J.; Vernon, Amanda; Secker, Genevieve A.; Tuft, Stephen J.; Daniels, Julie T.

    2014-01-01

    Limbal stem cell deficiency (LSCD) is an eye disorder in which the stem cells responsible for forming the surface skin of the cornea are destroyed by disease. This results in pain, loss of vision, and a cosmetically unpleasant appearance. Many new treatments, including stem cell therapies, are emerging for the treatment of this condition, but assessment of these new technologies is severely hampered by the lack of biomarkers for this disease or validated tools for assessing its severity. The aims of this study were to design and test the reliability of a tool for grading LSCD, to define a set of core outcome measures for use in evaluating treatments for this condition, and to demonstrate their utility. This was achieved by using our defined outcome set (which included the Clinical Outcome Assessment in Surgical Trials of Limbal stem cell deficiency [COASTL] tool) to evaluate the 3-year outcomes for allogeneic ex vivo cultivated limbal epithelial transplantation (allo-CLET) in patients who had bilateral total LSCD secondary to aniridia or Stevens-Johnson syndrome. The results demonstrate that our new grading tool for LSCD, the COASTL tool, is reliable and repeatable, and that improvements in the biomarkers used in this tool correlate positively with improvements in visual acuity. The COASTL tool showed that following allo-CLET there was a decrease in LSCD severity and an increase in visual acuity up to 12 months post-treatment, but thereafter LSCD severity and visual acuity progressively deteriorated. PMID:24443006

  10. Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later.

    PubMed

    Klein, Rachel G; Mannuzza, Salvatore; Olazagasti, María A Ramos; Roizen, Erica; Hutchison, Jesse A; Lashua, Erin C; Castellanos, F Xavier

    2012-12-01

    CONTEXT Prospective studies of childhood attention-deficit/hyperactivity disorder (ADHD) have not extended beyond early adulthood. OBJECTIVE To examine whether children diagnosed as having ADHD at a mean age of 8 years (probands) have worse educational, occupational, economic, social, and marital outcomes and higher rates of ongoing ADHD, antisocial personality disorder (ASPD), substance use disorders (SUDs), adult-onset psychiatric disorders, psychiatric hospitalizations, and incarcerations than non-ADHD comparison participants at a mean age of 41 years. DESIGN Prospective, 33-year follow-up study, with masked clinical assessments. SETTING Research clinic. PARTICIPANTS A total of 135 white men with ADHD in childhood, free of conduct disorder, and 136 men without childhood ADHD (65.2% and 76.4% of original cohort, respectively). MAIN OUTCOME MEASURES Occupational, economic, and educational attainment; marital history; occupational and social functioning; ongoing and lifetime psychiatric disorders; psychiatric hospitalizations; and incarcerations. RESULTS Probands had significantly worse educational, occupational, economic, and social outcomes; more divorces; and higher rates of ongoing ADHD (22.2% vs 5.1%, P < .001), ASPD (16.3% vs 0%, P < .001), and SUDs (14.1% vs 5.1%, P = .01) but not more mood or anxiety disorders (P = .36 and .33) than did comparison participants. Ongoing ADHD was weakly related to ongoing SUDs (? = 0.19, P = .04), as well as ASPD with SUDs (? = 0.20, P = .04). During their lifetime, probands had significantly more ASPD and SUDs but not mood or anxiety disorders and more psychiatric hospitalizations and incarcerations than comparison participants. Relative to comparisons, psychiatric disorders with onsets at 21 years or older were not significantly elevated in probands. Probands without ongoing psychiatric disorders had worse social, but not occupational, functioning. CONCLUSIONS The multiple disadvantages predicted by childhood ADHD well into adulthood began in adolescence, without increased onsets of new disorders after 20 years of age. Findings highlight the importance of extended monitoring and treatment of children with ADHD. PMID:23070149

  11. Morbidity and functional mid-term outcomes using Prolift pelvic floor repair systems

    PubMed Central

    Kozal, Sébastien; Ripert, Thomas; Bayoud, Younes; Menard, Johan; Nicolacopoulos, Ioannis; Bednarzyck, Laurence; Staerman, Frederic; Larré, Stéphane

    2014-01-01

    Introduction: We assess midterm morbidity and functional outcomes using the Prolift (Gynecare/Ethicon, Somerville, NJ) system and identify potential related risk factors. The Prolift mesh system to treat genital prolapse was introduced in 2005. It was withdrawn from the market in early 2013 after rising doubts about safety. Methods: Over a 7-year period, we retrospectively analyzed a cohort of 112 consecutive patients who underwent the Prolift procedure since 2006. Intraoperative and postoperative complications, anatomical and functional outcomes were recorded. Results: The median follow-up was 49.5 months (range: 16–85). The mean age was 64.7 ± 10.9 years (range: 40–86). Of the 112 patients, 74 patients had stage 3 (66.1%) and 8 patients had stage 4 (7.14%) vaginal prolapse. Prolift surgery was performed for pro-lapse recurrence for 26 patients (23.2%). Total mesh was used in 32 patients (29%), an isolated anterior mesh in 57 patients (51%) and an isolated posterior mesh in 23 patients (21%). Concomitant surgical procedures were performed for 44 patients (39.3%). Overall, 72% (18/25) of the complications were managed medically. We reported a failure rate of 8% (n = 9) occurring after a median follow-up of 9.5 months (range: 1–45). Among the 64 patients who had preoperative sexual activity (57.1%), de novo dyspareunia occurred in 9 patients (16.07%). We extracted predictive factors concerning failure, complications and sexuality. Conclusion: Despite its market withdrawal, the Prolift system was associated with good midterm anatomic outcomes and few severe complications. Long-term follow-up data are still lacking, but surgeons and patients may be reassured. PMID:25295130

  12. A physiotherapy triage assessment service for people with low back disorders: evaluation of short-term outcomes

    PubMed Central

    Bath, Brenna; Pahwa, Punam

    2012-01-01

    Purpose: To determine the short-term effects of physiotherapy triage assessments on self-reported pain, functioning, and general well-being and quality of life in people with low back-related disorders. Methods: Participants with low back–related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists (PTs). Before undergoing the triage assessment, the participants completed a battery of questionnaires covering a range of sociodemographic, clinical, and psychosocial features. The study used the Numeric Pain Rating Scale (NPRS), the Oswestry Disability Index (ODI), and the Medical Outcomes Survey 36-item short-form version 2 (SF-36v2) to assess self-reported pain, function, and quality of life. Baseline measures and variables were analyzed using a descriptive analysis method (ie, proportions, means, medians). Paired samples t-tests or Wilcoxon matched-pair signed-rank tests were used to analyze the overall group differences between the pretest and posttest outcome measures where appropriate. Results: A total of 108 out of 115 (93.9%) participants completed the posttest survey. The Physical Component Summary of the SF36v2 was the only measure that demonstrated significant improvement (P < 0.001). Conclusion: A spinal triage assessment program delivered by PTs can be viewed as a complex intervention that may have the potential to affect a wide range of patient-related outcomes. Further research is needed to examine the long-term outcomes and explore potential mechanisms of improvement using a biopsychosocial framework. PMID:22915980

  13. Behaviors and Corresponding Functions Addressed via Functional Assessment

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Sipes, Megan; Horovitz, Max; Worley, Julie A.; Shoemaker, Mary E.; Kozlowski, Alison M.

    2011-01-01

    One-hundred seventy-three studies that employed functional assessment were evaluated with respect to types of challenging behaviors studied and the functions identified that maintained those behaviors. For most studies, two to three behaviors were targeted. Of the 38 different challenging behaviors identified, self-injurious behavior (SIB) and…

  14. Outcomes-Based Education Reexamined: From Structural Functionalism to Poststructuralism.

    ERIC Educational Resources Information Center

    Capper, Colleen A.; Jamison, Michael T.

    1993-01-01

    Outcomes-based education (OBE) views itself as drastic break from current inequitable educational practices and means of providing educational success for all students. Reexamines OBE from a multiparadigm perspective of organizations and educational administration. Although certain OBE facets may be empowering to students and teachers, much of the…

  15. Exploring Posttraumatic Outcomes as a Function of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Shakespeare-Finch, Jane; de Dassel, Therese

    2009-01-01

    There is sparse systematic examination of the potential for growth as well as distress that may occur for some adult survivors of childhood sexual abuse. The presented study explored posttraumatic growth and its relationship with negative posttrauma outcomes within the specific population of survivors of childhood sexual abuse (N = 40). Results…

  16. The importance of team functioning to natural resource planning outcomes.

    PubMed

    Stern, Marc J; Predmore, S Andrew

    2012-09-15

    In its recent history, the U.S. Forest Service is among many federal land management agencies struggling with questions concerning why its planning procedures are sometimes inefficient, perform poorly in the eyes of the public, and fail to deliver outputs that advance agency mission. By examining a representative sample of National Environmental Policy Act (NEPA) processes conducted by the agency between 2007 and 2009, we provide new insights into what drives outcomes in these planning processes. We examined team leaders' perceptions of the following outcomes: achievement of agency goals and NEPA mandates, process efficiency, public relations, and team outcomes. The most consistently important predictors of positive outcomes were team harmony and a clearly empowered team leader. Other factors, such as perceptions of the use of best science, a clear and unambiguous purpose and need, team turnover (personnel changes during the process), extra-agency engagement, and intra-agency relations, were also important, but played a less consistent role. The findings suggest the importance of empowering team leaders and team members through enhancing elements of discretion, responsibility, clear role definition, collaborative interdisciplinary deliberation, and perceived self-efficacy. The results also suggest the importance of genuine concern and respect for participating publics and effective inter-agency coordination. PMID:22562009

  17. Functional Mentoring: A Practical Approach with Multilevel Outcomes

    ERIC Educational Resources Information Center

    Thorndyke, Luanne E.; Gusic, Maryellen E.; Milner, Robert J.

    2008-01-01

    Introduction: Mentoring is a central component of professional development. Evaluation of "successful" mentoring programs, however, has been limited and mainly focused on measures of satisfaction with the relationship. In today's environment, mentoring programs must produce tangible outcomes to demonstrate success. To address this issue, the…

  18. MANUAL FOR ASSESSMENT OF BOTTOMLAND HARDWOOD FUNCTIONS

    EPA Science Inventory

    This manual outlines a procedure for qualitatively assessing the functions and values of bottomland hardwoods (BLH). he procedure is based on the Wetland Evaluation Technique (WET) and for this reason is referred to as WET-BLH. etland functions are the physical, chemical, and bio...

  19. Core outcome measures for opioid abuse liability laboratory assessment studies in humans: IMMPACT recommendations

    PubMed Central

    Comer, Sandra D.; Zacny, James P.; Dworkin, Robert H.; Turk, Dennis C.; Bigelow, George E.; Foltin, Richard W.; Jasinski, Donald R.; Sellers, Edward M.; Adams, Edgar H.; Balster, Robert; Burke, Laurie B.; Cerny, Igor; Colucci, Robert D.; Cone, Edward; Cowan, Penney; Farrar, John T.; Haddox, J. David; Haythornthwaite, Jennifer A.; Hertz, Sharon; Jay, Gary W.; Johanson, Chris-Ellyn; Junor, Roderick; Katz, Nathaniel P.; Klein, Michael; Kopecky, Ernest A.; Leiderman, Deborah B.; McDermott, Michael P.; O’Brien, Charles; O’Connor, Alec B.; Palmer, Pamela P.; Raja, Srinivasa N.; Rappaport, Bob A.; Rauschkolb, Christine; Rowbotham, Michael C.; Sampaio, Cristina; Setnik, Beatrice; Sokolowska, Marta; Stauffer, Joseph W.; Walsh, Sharon L.

    2012-01-01

    A critical component in development of opioid analgesics is assessment of their abuse liability (AL). Standardization of approaches and measures used in assessing AL has the potential to facilitate comparisons across studies, research laboratories, and drugs. The goal of this report is to provide consensus recommendations regarding core outcome measures for assessing abuse potential of opioid medications in humans in a controlled laboratory setting. Although many of the recommended measures are appropriate for assessing the AL of medications from other drug classes, the focus here is on opioid medications because they present unique risks from both physiological (e.g., respiratory depression, physical dependence) and public health (e.g., individuals in pain) perspectives. A brief historical perspective on AL testing is provided and then those measures that can be considered primary and secondary outcomes and possible additional outcomes in AL assessment are discussed. These outcome measures include: (1) subjective effects (some of which comprise the primary outcome measures, including drug liking); (2) physiological responses; (3) drug self-administration behavior; and (4) cognitive and psychomotor performance. Prior to presenting recommendations for standardized approaches and measures to be used in AL assessments, the appropriateness of using these measures in clinical trials with patients in pain is discussed. PMID:22998781

  20. The echocardiographic assessment of functional mitral regurgitation.

    PubMed

    Ray, Simon

    2010-12-01

    Functional mitral regurgitation (MR) is common, clinically important, and mechanistically complex. Its assessment by echocardiography can be challenging, and particular care is needed in the quantification of severity. Echocardiographers need to be aware of the potential limitations of flow convergence and vena contracta methods in assessing severity and alert to the prognostic importance of even moderate functional MR. Three-dimensional echocardiography has the potential to improve both the understanding of the mechanisms of functional MR and the accuracy of its quantification. PMID:21078834

  1. Combining the Tasks of Grading Individual Assignments and Assessing Student Outcomes in Project-Based Courses

    ERIC Educational Resources Information Center

    Dahm, Kevin

    2014-01-01

    ABET requires that engineering programs demonstrate continuous assessment and continuous improvement in order to be accredited. Central to the process is establishing and assessing measurable "student outcomes" that reflect whether the goals and objectives of the program are being met. This paper examines effective strategies for…

  2. Using Mobile Technologies for Assessment and Learning in Practice Settings: Outcomes of Five Case Studies

    ERIC Educational Resources Information Center

    Dearnley, Christine; Taylor, Jill; Hennessy, Scott; Parks, Maria; Coates, Catherine; Haigh, Jackie; Fairhall, John; Riley, Kevin; Dransfield, Mark

    2009-01-01

    This article presents the outcomes of the Mobile Technologies Pilot Project for the Assessment and Learning in Practice Settings (ALPS) Centre for Excellence in Teaching and Learning (CETL). ALPS is a partnership of five Higher Education Institutions (HEI) that aims to develop and improve assessment, and thereby learning, in practice settings for…

  3. Can Assessment Reactivity Predict Treatment Outcome among Adolescents with Alcohol and Other Substance Use Disorders?

    ERIC Educational Resources Information Center

    Kaminer, Yifrah; Burleson, Joseph A.; Burke, Rebecca H.

    2008-01-01

    The objectives of this paper are two-fold: to examine first, if the change from positive to negative alcohol and any other substance use status from baseline assessment to the onset of the first session (i.e., pre-treatment phase) occurs in adolescents, that is, Assessment Reactivity (AR); second, whether AR predicts treatment outcome.…

  4. Towards a Model and Methodology for Assessing Student Learning Outcomes and Satisfaction

    ERIC Educational Resources Information Center

    Duque, Lola C.; Weeks, John R.

    2010-01-01

    Purpose: The purpose of this paper is threefold: first, to introduce a conceptual model for assessing undergraduate student learning outcomes and satisfaction that involves concepts drawn from the services marketing and assessment literatures; second, to illustrate the utility of the model as implemented in an academic department (geography)…

  5. ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read, analyze and critique written discourse

    E-print Network

    Barrash, Warren

    written discourse in Spanish at the intermediate level Exams and/or Quizzes (These will assess reading discourse in Spanish at the intermediate level ; Analyze underlying assumptions affect- ing the demographicSPANISH202 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read, analyze and critique

  6. ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read and understand written discourse in

    E-print Network

    Barrash, Warren

    discourse in Spanish at the elementary level Exams and/or Quizzes (These will assess reading skills- mation sources in both written and spoken discourse in Spanish at the elementary level. PresentationsSPANISH101 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read and understand written

  7. ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read, analyze and critique written discourse

    E-print Network

    Barrash, Warren

    written discourse in Spanish at the intermediate level Exams and/or Quizzes (These will assess reading discourse in Spanish at the intermediate level ; Analyze underlying assumptions affect- ing the demographicSPANISH203 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read, analyze and critique

  8. ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read and understand written discourse in

    E-print Network

    Barrash, Warren

    discourse in Spanish at the elementary level Exams and/or Quizzes (These will assess reading skills Spanish in both written and spoken discourse in Spanish at the elementary level. Presentations ; Exams. PortionsSPANISH102 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read and understand written

  9. SPANISH111-112 ULO Course Learning Outcome Assessment Method Pedagogy

    E-print Network

    Barrash, Warren

    written discourse in Spanish at the elementary level Exams and/or Quizzes (These will assess reading appropriate infor- mation sources in both written and spoken discourse in Spanish at the elementary levelSPANISH111-112 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read and understand

  10. ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read, analyze and critique written discourse

    E-print Network

    Barrash, Warren

    written discourse in Spanish at the intermediate level Exams and/or Quizzes (These will assess reading culturally appropriate infor- mation sources in both written and spoken discourse in SpanishSPANISH201 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read, analyze and critique

  11. Perspectives to performance of environment and health assessments and models--from outputs to outcomes?

    PubMed

    Pohjola, Mikko V; Pohjola, Pasi; Tainio, Marko; Tuomisto, Jouni T

    2013-07-01

    The calls for knowledge-based policy and policy-relevant research invoke a need to evaluate and manage environment and health assessments and models according to their societal outcomes. This review explores how well the existing approaches to assessment and model performance serve this need. The perspectives to assessment and model performance in the scientific literature can be called: (1) quality assurance/control, (2) uncertainty analysis, (3) technical assessment of models, (4) effectiveness and (5) other perspectives, according to what is primarily seen to constitute the goodness of assessments and models. The categorization is not strict and methods, tools and frameworks in different perspectives may overlap. However, altogether it seems that most approaches to assessment and model performance are relatively narrow in their scope. The focus in most approaches is on the outputs and making of assessments and models. Practical application of the outputs and the consequential outcomes are often left unaddressed. It appears that more comprehensive approaches that combine the essential characteristics of different perspectives are needed. This necessitates a better account of the mechanisms of collective knowledge creation and the relations between knowledge and practical action. Some new approaches to assessment, modeling and their evaluation and management span the chain from knowledge creation to societal outcomes, but the complexity of evaluating societal outcomes remains a challenge. PMID:23803642

  12. Perspectives to Performance of Environment and Health Assessments and Models—From Outputs to Outcomes?

    PubMed Central

    Pohjola, Mikko V.; Pohjola, Pasi; Tainio, Marko; Tuomisto, Jouni T.

    2013-01-01

    The calls for knowledge-based policy and policy-relevant research invoke a need to evaluate and manage environment and health assessments and models according to their societal outcomes. This review explores how well the existing approaches to assessment and model performance serve this need. The perspectives to assessment and model performance in the scientific literature can be called: (1) quality assurance/control, (2) uncertainty analysis, (3) technical assessment of models, (4) effectiveness and (5) other perspectives, according to what is primarily seen to constitute the goodness of assessments and models. The categorization is not strict and methods, tools and frameworks in different perspectives may overlap. However, altogether it seems that most approaches to assessment and model performance are relatively narrow in their scope. The focus in most approaches is on the outputs and making of assessments and models. Practical application of the outputs and the consequential outcomes are often left unaddressed. It appears that more comprehensive approaches that combine the essential characteristics of different perspectives are needed. This necessitates a better account of the mechanisms of collective knowledge creation and the relations between knowledge and practical action. Some new approaches to assessment, modeling and their evaluation and management span the chain from knowledge creation to societal outcomes, but the complexity of evaluating societal outcomes remains a challenge. PMID:23803642

  13. Assessing Adult Learning within a Doctor of Physical Therapy Program: Student Outcomes and Satisfaction

    ERIC Educational Resources Information Center

    Greiner, Ann W. B.

    2011-01-01

    This applied dissertation was a program evaluation study, which was conducted to assess the educational outcomes of the adult learners compared to the traditional learners, as well as the satisfaction with learning while enrolled in the program. The level of satisfaction of all graduates was assessed for comparison between the traditional learners…

  14. Self-Assessment as a Tool for the Evaluation of Learning Outcomes.

    ERIC Educational Resources Information Center

    Von der Kamp, Max

    1984-01-01

    An evaluation study of learning outcomes for secondary art education in The Netherlands is described. A student self-assessment questionnaire (learner report), based on De Groot's Self-Assessment Theories, was sent to 1150 students after final exams. Students wrote learning effect sentences, ranked 30 possible learning effects, and answered…

  15. Learning in a comfort zone: cultural and social capital inside an outcome?based assessment regime

    Microsoft Academic Search

    Kathryn Ecclestone

    2004-01-01

    Despite numerous problems with outcome?based assessment systems, claims that they enhance learners' motivation and autonomy resonate with research interest in how young people develop cultural and social capital. However, research has not yet explored the ways in which assessment systems affect the forms of capital embedded within them. This paper applies concepts from a growing body of work on social

  16. Student Outcomes Assessment, 2000-01: A Progress Report to the Virginia Community College System.

    ERIC Educational Resources Information Center

    Germanna Community Coll., Locust Grove, VA.

    This report details the activities, findings, and actions that have made up Germanna Community College's (Virginia) student outcomes assessment program in specific reporting areas for 2000-2001. The following sections comprise the report: (1) an executive summary; (2) a report on assessment activities in five general education areas, including…

  17. Outcomes Assessment at Tufts University School of Veterinary Medicine.

    ERIC Educational Resources Information Center

    Kleine, Lawrence J.; Terkla, Dawn Geronimo; Kimball, Grayson

    2002-01-01

    Using a survey, compared relative values assigned by Tufts veterinary alumni to questions about skills, training, attitudes, and behaviors with those of veterinary employers and faculty. Also assessed their perceptions of future employment opportunities. (EV)

  18. Determinants of revision and functional outcome following unicompartmental knee replacement

    PubMed Central

    Liddle, A.D.; Judge, A.; Pandit, H.; Murray, D.W.

    2014-01-01

    Summary Objective Unicompartmental Knee Replacement (UKR) has important advantages over total knee replacement (TKR) but has a higher revision rate. Outcomes vary between centres, suggesting that risk factors for revision may be modifiable with changes to patient selection or operative technique. The objective of this study was to determine factors affecting revision, patient-reported outcome and satisfaction following UKR. Method 25,982 cases from three national databases were analysed. Multilevel multivariable regression models were used to examine the effect of patient and surgical factors on implant survival, patient-reported outcome and satisfaction at 6 months and 8 years following UKR. Results Of the 25,982 cases, 3862 (14.9%) had pre-operative and 6-month Oxford Knee Scores (OKS). Eight-year survival was 89.1% (95% confidence intervals (CI) 88.3–89.9). OKS increased from 21.9 (SD 7.6) to 37.5 (SD 9.5). Age (Hazard ratio (HR) 0.96 (95% CI 0.96–0.97) per year), male gender (HR 0.86 (95% CI 0.76–0.96)), unit size (HR 0.92 (95% CI 0.86–0.97) per case up to 40 cases/year) and operating surgeon grade (HR 0.78 (95% CI 0.67–0.91) if consultant) predicted improved implant survival. Older patients (?75 years), and those with lower deprivation levels had superior OKS and satisfaction (adjusted mean difference 0.14 (95% CI 0.09–0.20) points per year of age and 0.93 (95% CI 0.60–1.27) per quintile of deprivation). Ethnicity, anxiety and co-morbidities also affected patient-reported outcome. Conclusions This study has identified important predictors of revision and patient-reported outcome following UKR. Older patients, who are least likely to be offered UKR, may derive the greatest benefits. Improved understanding of these factors may improve the long-term outcomes of UKR. PMID:25042552

  19. Long-Term Intellectual Functioning and School-Related Behavioural Outcomes in Children and Adolescents after Invasive Treatment for Congenital Heart Disease

    ERIC Educational Resources Information Center

    Spijkerboer, A. W.; Utens, E. M. W. J.; Bogers, A. J. J. C.; Verhulst, F. C.; Helbing, W. A.

    2008-01-01

    In this study, long-term intellectual functioning and school-related behavioural outcomes were assessed in a patient sample that underwent invasive treatment for congenital heart disease (ConHD) between 1990 and 1995. The Wechsler Intelligence Scale for Children-Revised was used to measure intellectual functioning and the Teacher's Report Form to…

  20. Outcomes Research Branch | Assessing Patients' Experiences of Cancer Care

    Cancer.gov

    Two ORB studies have addressed the need for comprehensive, psychometrically sound, cancer-specific measures of patients' experience of and satisfaction with the care they receive during the post-treatment, survivorship phase of the cancer care continuum. The Assessment of Patients' Experience of Cancer Care (APECC) Study, funded as a SEER Rapid Response Surveillance Study (RRSS), developed and pilot tested a survey instrument to assess patients' experiences and satisfaction with care for colorectal cancer, bladder cancer, and leukemia.

  1. Renal tumour anatomical characteristics and functional outcome after partial nephrectomy.

    PubMed

    Nisen, Harry; Heimonen, Petri; Kenttä, Lauri; Visapää, Harri; Nisen, Jessica; Taari, Kimmo

    2014-11-11

    Abstract Objective. Anatomical features of renal tumours may be useful in predicting glomerular filtration rate (GFR) after partial nephrectomy. In this study, anatomical classification systems (ACSs) were compared to predict changes in renal function after surgery. Materials and methods. A group of 294 patients with T1 renal tumours receiving partial nephrectomy between January 2006 and June 2013 were identified from the institutional kidney tumour database. Preoperative images from computed tomography or magnetic resonance imaging were reviewed to assess diameter, PADUA (preoperative aspects and dimensions used for an anatomical) classification score, RENAL (radius, exophytic/endophytic properties of the tumour, nearness of tumour deepest portion to the collecting system or sinus, anterior/posterior descriptor and location relative to polar lines) nephrometry score, centrality index (C index) and renal tumour invasion index (RTII). GFR was estimated using the Modification of Diet in Renal Disease equation preoperatively and 3 months after operation. Linear and logistic regression were applied as statistical methods. Results. Mean tumour diameter was 3.0 ± 2.2 cm (range 1.0-7.0 cm). GFR was 85 ± 22?ml/min/1.73?m² before the operation and 77 ± 21 ml/min/1.73 m² (-8% change) 3 months after the operation. In univariate linear regression, the percentage change in GFR was weakly but statistically significantly associated with surgical approach (p = 0.04), indication for nephron sparing (p = 0.02), preoperative GFR (p < 0.001), PADUA (p = 0.02), RENAL (p = 0.01) and RTII (p = 0.003). In multivariate logistic regression analysis among patients with tumours 3?cm or larger, PADUA (odds ratio 1.55, p = 0.021) and RTII (odds ratio 3.87, p = 0.037) predicted at least a 20% reduction in GFR. Conclusions. Renal tumour ACSs may be clinically useful in predicting changes in renal function after partial nephrectomy in patients with larger tumours. The performance of RTII is equal to that of other ACSs in predicting changes in GFR. PMID:25385687

  2. The measurement properties of modified Rivermead mobility index and modified functional ambulation classification as outcome measures for Chinese stroke patients.

    PubMed

    Tsang, Raymond Chi-Chung; Chau, Rosanna Mei-Wa; Cheuk, Terence Hau-Wai; Cheung, Benny Shu-Pui; Fung, Donna Mei-Yee; Ho, Ester Yuk-Lai; Ip, Ellen Mei-Lun; Ko, Betty Pik-Ha; Lee, Jimson Yuk-Lam; Liu, Alan Kin-Lun; Ng, Vivien Pui-Ling; Tang, Robert Shun-Keung; To, Karen Wing-Sau; Tsang, Claudia Pui-Ling

    2014-07-01

    Valid, reliable, responsive and practical outcome measures are essential for treatment planning and outcome assessment. This study aimed to examine the measurement properties of Modified Rivermead Mobility Index (MRMI) and Modified Functional Ambulation Classification (MFAC) in Chinese stroke patients. The content validity, responsiveness, predictive validity, test-retest reliability, internal consistency and factor structure of the MRMI were examined. The content validity, discriminative power and inter-rater agreement of the MFAC were investigated. A total of 456 Chinese stroke patients were recruited. Evidence of good content validity, high responsiveness, adequate predictive validity, excellent test-retest reliability with 1.3-point as minimum detectable change in 95% confidence interval, high internal consistency and unidimensionality was obtained for the MRMI. Good content validity, sufficient discriminative power and excellent inter-rater agreement were demonstrated for the MFAC. Both the MRMI and MFAC have good to excellent measurement properties and are recommended as routine outcome measures for Chinese stroke patients. PMID:24400683

  3. Anatomical and functional outcomes in contusion injuries of posterior segment

    Microsoft Academic Search

    F Cuneyt Erdurman; G Sobaci; C H Acikel; M O Ceylan; A H Durukan; V Hurmeric

    2011-01-01

    PurposeTo evaluate the clinical features, and anatomical and visual outcomes in patients with closed-globe contusion injury involving the posterior segment.MethodsRetrospective review of posterior segment contusion injuries admitted to our tertiary referral center.ResultsIn all, 115 patients (115 eyes) with complete data were reviewed. Surgery had been performed in 79 (69%) patients. The mean follow-up period was 6 months (range, 2–34 months).

  4. Executive Function Following Focal Frontal Lobe Lesions: Impact of Timing of Lesion on Outcome

    Microsoft Academic Search

    Rani Jacobs; A. Simon Harvey; Vicki Anderson

    2007-01-01

    While it is generally agreed that outcome following cerebral insult during childhood differs from that seen following similar pathology in adulthood, the specific relationship between timing of cerebral lesion and outcome, and the mechanism associated with observed neurobehavioral changes, remains controversial. Data from children with focal lesions suggests a non-linear relationship between age at injury and language function (e.g., Bates

  5. Mentor functions and outcomes: A comparison of men and women in formal and informal mentoring relationships

    Microsoft Academic Search

    Belle Rose Ragins; John L. Cotton

    1999-01-01

    The authors examined the effects of the type of mentoring relationship and the gender composition of the relationship on mentoring functions and career outcomes reported by 352 female and 257 male proteges. Proteges of informal mentors viewed their mentors as more effective and received greater compensation than proteges of formal mentors. Proteges with informal mentors also received more career outcomes

  6. Effects of "Right" and "Wrong" as a Function of Recalling Either the Response or the Outcome

    ERIC Educational Resources Information Center

    d'Ydewalle, Gery; Buchwald, Alexander M.

    1976-01-01

    The effects of the outcomes "right" and "wrong" upon subsequent correct responding in paired-associate learning have recently been interpreted as a function of subject's memory of previous responses and their outcomes. Tests that interpretation in two experiments of recall procedures. (Editor/RK)

  7. Some implications of the technology assessment function for the effective public decision-making process

    NASA Technical Reports Server (NTRS)

    Mayo, L. H.

    1971-01-01

    A preliminary provisional assessment of the prospects for the establishment of an adequate technology assessment function and the implications of the assessment function for the public decision process are presented. Effects of the technology assessment function on each phase of the public decision process and briefly explored. Significant implications during the next decade are projected with respect to the following phases: invention and development of alternative means (technological configurations); evaluation, selection and promotion of preferred courses of action; and modification of statutory scheme or social action program as an outcome of continuing monitoring and appraisal.

  8. Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians.

    PubMed

    Cadore, Eduardo L; Casas-Herrero, Alvaro; Zambom-Ferraresi, Fabricio; Idoate, Fernando; Millor, Nora; Gómez, Marisol; Rodriguez-Mañas, Leocadio; Izquierdo, Mikel

    2014-04-01

    This randomized controlled trial examined the effects of multicomponent training on muscle power output, muscle mass, and muscle tissue attenuation; the risk of falls; and functional outcomes in frail nonagenarians. Twenty-four elderly (91.9?±?4.1 years old) were randomized into intervention or control group. The intervention group performed a twice-weekly, 12-week multicomponent exercise program composed of muscle power training (8-10 repetitions, 40-60 % of the one-repetition maximum) combined with balance and gait retraining. Strength and power tests were performed on the upper and lower limbs. Gait velocity was assessed using the 5-m habitual gait and the time-up-and-go (TUG) tests with and without dual-task performance. Balance was assessed using the FICSIT-4 tests. The ability to rise from a chair test was assessed, and data on the incidence and risk of falls were assessed using questionnaires. Functional status was assessed before measurements with the Barthel Index. Midthigh lower extremity muscle mass and muscle fat infiltration were assessed using computed tomography. The intervention group showed significantly improved TUG with single and dual tasks, rise from a chair and balance performance (P?functional outcomes. Routine multicomponent exercise intervention should be prescribed to nonagenarians because overall physical outcomes are improved in this population. PMID:24030238

  9. The outcome at ten years of lateral closing-wedge high tibial osteotomy: determinants of survival and functional outcome.

    PubMed

    Howells, N R; Salmon, L; Waller, A; Scanelli, J; Pinczewski, L A

    2014-11-01

    The aim of this study was to examine the functional outcome at ten years following lateral closing wedge high tibial osteotomy for medial compartment osteoarthritis of the knee and to define pre-operative predictors of survival and determinants of functional outcome. 164 consecutive patients underwent high tibial osteotomy between 2000 and 2002. A total of 100 patients (100 knees) met the inclusion criteria and 95 were available for review at ten years. Data were collected prospectively and included patient demographics, surgical details, long leg alignment radiographs, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and Knee Society scores (KSS) pre-operatively and at five and ten years follow-up. At ten years, 21 patients had been revised at a mean of five years. Overall Kaplan-Meier survival was 87% (95% confidence interval (CI) 81 to 94) and 79% (95% CI 71 to 87) at five and ten years, respectively. When compared with unrevised patients, those who had been revised had significantly lower mean pre-operative WOMAC Scores (47 (21 to 85) vs 65 (32 to 99), p < 0.001), higher mean age (54 yrs (42 to 61) vs 49 yrs (26 to 66), p = 0.006) and a higher mean BMI (30.2; 25 to 39 vs 27.9; 21 to 36, p = 0.005). Each were found to be risk factors for revision, with hazard ratios of 10.7 (95% CI 4 to 28.6; pre-operative WOMAC < 45), 6.5 (95% CI 2.4 to 17.7; age > 55) and 3.0 (95%CI 1.2 to 7.6; BMI > 30). Survival of patients with pre-operative WOMAC > 45, age < 55 and BMI < 30 was 97% at five and ten years. WOMAC and KSS in surviving patients improved significantly between pre-operative (mean 61; 32 to 99) and five (mean 88; 35 to 100, p = 0.001) and ten years (mean 84; 38 to 100, p = 0.001). Older patients had better functional outcomes overall, despite their higher revision rate. This study has shown that improved survival is associated with age < 55 years, pre-operative WOMAC scores > 45 and, a BMI < 30. In patients over 55 years of age with adequate pre-operative functional scores, survival can be good and functional outcomes can be significantly better than their younger counterparts. We recommend the routine use of pre-operative functional outcome scores to guide decision-making when considering suitability for high tibial osteotomy. PMID:25371462

  10. Major adverse events, pretransplant assessment and outcome prediction.

    PubMed

    Huang, Hui-Chun; Lee, Fa-Yauh; Huo, Teh-Ia

    2009-11-01

    Liver cirrhosis and portal hypertension pose enormous loss of lives and resources throughout the world, especially in endemic areas of chronic viral hepatitis. Although the pathophysiology of cirrhosis is not completely understood, the accumulating evidence has paved the way for better control of the complications, including gastroesophageal variceal bleeding, hepatic encephalopathy, ascites, hepatorenal syndrome, hepatopulmonary syndrome and portopulmonary hypertension. Modern pharmacological and interventional therapies have been designed to treat these complications. However, liver transplantation (LT) is the only definite treatment for patients with preterminal end-stage liver disease. To pursue successful LT, the meticulous evaluation of potential recipients and donors is pivotal, especially for living donor transplantation. The critical shortage of cadaveric donor livers is another concern. In many Asian countries, cultural and religious concerns further limit the number of the donors, which lags far behind that of the recipients. The model for end-stage liver disease (MELD) scoring system has recently become the prevailing criterion for organ allocation. Initial results showed clear benefits of moving from the Child-Turcotte-Pugh-based system toward the MELD-based organ allocation system. In addition to the MELD, serum sodium is another important prognostic predictor in patients with advanced cirrhosis. The incorporation of serum sodium into the MELD could enhance the performance of the MELD and could become an indispensable strategy in refining the priority for LT. However, the feasibility of the MELD in combination with sodium in predicting the outcome for patients on transplant waiting list awaits actual outcome data before this becomes standard practice in the Asia-Pacific region. PMID:20136958

  11. Assessment of coronary hemodynamics and vascular function.

    PubMed

    Drenjancevic, Ines; Koller, Akos; Selthofer-Relatic, Kristina; Grizelj, Ivana; Cavka, Ana

    2015-01-01

    Coronary blood flow closely matches to metabolic demands of heart and myocardial oxygen consumption and is conditioned by function of coronary resistance vessels. The microvascular endothelium of coronary resistance vessels is exposed to a spatially and temporally regulated input from cardiomyocytes and the haemodynamic forces of the cardiac cycle. Functional measurements of coronary pressure and flow are important approaches that provide complementary information on the function of coronary vessel function that could not be assessed by the methods utilized for the anatomic characterization of coronary disease, such as coronary angiography. The goal of this paper is to review the methodologies for assessment of coronary vascular function and haemodynamics which are utilized in research and to discuss their potential applicability in the clinical settings. PMID:25460847

  12. Optimising outcome in congenital hypothyroidism; current opinions on best practice in initial assessment and subsequent management.

    PubMed

    Donaldson, Malcolm; Jones, Jeremy

    2013-01-01

    Congenital hypothyroidism (CH), usually of the primary and permanent variety, is an eminently preventable cause of growth retardation and mental handicap whose outlook has been transformed by newborn screening, usually involving the measurement of capillary thyroid stimulating hormone (TSH). Severe primary CH, due for example to athyreosis, may result in subtle cognitive, behavioural and sensori-motor deficits, but the extent to which these can be offset by optimal postnatal diagnosis and management remains uncertain. This is because the available adult follow-up data reflect the outcome of previous management in the 1970's and 1980's, and also because the accurate neuro-psychological assessment of children is difficult, particularly in the preschool population. There is an urgent need to develop new consensus guidelines and to ensure that the children managed according to such guidelines are systematically and prospectively assessed so that good quality outcome data become available. In this review, key recommendations in the management of CH include: screening at day 3 so that severely affected infants can begin treatment within the first 10 days of life; setting the TSH referral cut-off at 8-10 mU/L; adopting a disciplined diagnostic algorithm to evaluate referred cases, with measurement of venous free thyroxine (T4), TSH and thyroglobulin combined with dual ultrasound and radioisotope imaging; initial treatment with a T4 dose of 50 ?g daily in infants weighing ? 2.5 kg and 15 ?g/kg/day in infants weighing < 2.5 kg followed by weekly review until thyroid function is normalised; and maintenance of free T4 levels between 15-26 pmol/L and TSH between 0.5-5 mU/L thereafter to avoid both under- and overtreatment. PMID:23154163

  13. Mouse models of osteoarthritis: modelling risk factors and assessing outcomes.

    PubMed

    Fang, Hang; Beier, Frank

    2014-07-01

    Osteoarthritis (OA) is a prevalent musculoskeletal disease that results in pain and low quality of life for patients, as well as enormous medical and socioeconomic burdens. The molecular mechanisms responsible for the initiation and progression of OA are still poorly understood. As such, mouse models of the disease are having increasingly important roles in OA research owing to the advancements of microsurgical techniques and the use of genetically modified mice, as well as the development of novel assessment tools. In this Review, we discuss available mouse models of OA and applicable assessment tools in studies of experimental OA. PMID:24662645

  14. ULO Course Learning Outcome Assessment Method Pedagogy Process of Inqui-

    E-print Network

    Barrash, Warren

    to bicycle system. Example: Introduce web-based bicycle design software and computer-aid- ed-design. Emphasis on course) Develop engineering intuition in four diverse engineering areas; Statics, Computer Aided Design of the ideas of design, statics, material science and data acquisition. Assessment :4: Excellent: Student

  15. Research on AT Outcomes and Large Scale Assessments

    ERIC Educational Resources Information Center

    Thurlow, Martha; Tindal, Gerald; Powers, Richard; Lewis, Preston; Laitusis, Cara Cahalan; Breslin-Larson, Joan

    2007-01-01

    Current educational policies require the participation of students with disabilities in state assessments. Their participation has raised a number of issues, among them the need for accommodations. In this article we consider the role that assistive technology (AT) can play to alleviate current accommodations demands, and highlight research and…

  16. DISTORTIONS IN STATE LEVEL PERFORMANCE OUTCOMES ON HIGH STAKES ASSESSMENTS

    E-print Network

    Hornback, Joseph Edward

    2013-05-31

    growth equation that subtracts the two scores and divides that by the maximum score on that test in that year, from the first score. This calculation produces a Practical Normed Growth (PNG) for the state assessment as well as the NAEP. To determine...

  17. ULO Course Learning Outcome Assessment Method Pedagogy Understanding

    E-print Network

    Barrash, Warren

    . American national government. 11-02 Understanding of historical and/or cultural forces Demonstrates demonstrate such under- standing within the context of. American national government. Instructors will assess an understanding of the historical and / or social forces that shape individuals and institutions. Analyzes

  18. Distortions in State Level Performance Outcomes on High Stakes Assessments

    ERIC Educational Resources Information Center

    Hornback, Joseph E.

    2013-01-01

    This dissertation addresses two research questions: 1. Do states misrepresent their progress on their own state assessments? 2. If states do distort their progress, are their predictors to suggest why this distortion occurs? The first research question requires that distortion be defined. For the purposes of this dissertation I calculated the…

  19. Biochemical Visual Literacy with Constructive Alignment: Outcomes, Assessment, and Activities

    ERIC Educational Resources Information Center

    Herraez, Angel; Costa, Manuel Joao

    2013-01-01

    Several contributions in "Biochemistry and Molecular Biology Education" have highlighted the role of visualization tools and the importance of developing students' visual literacy in biochemistry education. In this forum, the authors suggest that more focus is needed on the assessment of student learning, and they advance…

  20. ULO Course Learning Outcome Assessment Method Pedagogy Process of Inqui-

    E-print Network

    Barrash, Warren

    -03 Communication of Scientific and/ or Technological Understandings Develop a terminology and fact base so and Technology with Humans and Environment Identify and assess the impact of mod- ern technology on humans lectures on biotechnology and human impact on the environment Laboratory presentations and proce- dures

  1. Functional outcome following a large head total hip arthroplasty: A retrospective analysis of mid term results

    PubMed Central

    Agarwala, Sanjay; Mohrir, Ganesh; Moonot, Pradeep

    2014-01-01

    Background: One of the reasons that hip resurfacing and large head metal on metal (MOM) total hip arthroplasty (THA) became popular in Asia was the possible increased range of movement and thereby improved function of the hip joint. Due to concerns of MOM articulation an alternative bearing was sought. Hence, a shift from large head MOM to large head ceramic on ceramic (COC) was made. The aim of this study was to compare the functional outcome including range of motion (ROM) and dislocation rates following large head MOM and large head COC THA. Materials and Methods: Retrospectively, 39 primary THA with large head MOM with a mean age of 56 years (range 36-72 years) and average followup of 54 months (range 38-70 months) were compared with 23 primary THA with large head COC bearing with a mean age of 48 years (range 36-68 years) and an average followup of 18 months (range 12-26 months). Functional outcome was assessed using the Modified Harris Hip Score. Dislocation rate and ROM were compared. Results: Global ROM averaged 248 degrees with MOM group and 252 degrees with the COC group. One patient with metal bearing had dislocation at an average 3 year followup which required revision THA while there were no complications in the COC group. MHHS averaged 89 points in MOM and 94 in COC THR. Conclusion: This study has shown that large head ceramic on ceramic THA is a good alternative to large head metal on metal THA with comparable dislocation rates and range of movements and without complications of metallosis in Asian patients. PMID:25143647

  2. The assessment of outcome after total knee arthroplasty: are we there yet?

    PubMed

    Hossain, F S; Konan, S; Patel, S; Rodriguez-Merchan, E C; Haddad, F S

    2015-01-01

    The routine use of patient reported outcome measures (PROMs) in evaluating the outcome after arthroplasty by healthcare organisations reflects a growing recognition of the importance of patients' perspectives in improving treatment. Although widely embraced in the NHS, there are concerns that PROMs are being used beyond their means due to a poor understanding of their limitations. This paper reviews some of the current challenges in using PROMs to evaluate total knee arthroplasty. It highlights alternative methods that have been used to improve the assessment of outcome. PMID:25568406

  3. Brain lesion size and location: Effects on motor recovery and functional outcome in stroke patients

    Microsoft Academic Search

    Chia-Ling Chen; Fuk-Tan Tang; Hsieh-Ching Chen; Chia-Ying Chung; May-Kuen Wong

    2000-01-01

    Chen C-L, Tang F-T, Chen H-C, Chung C-Y, Wong M-K. Brain lesion size and location: effects on motor recovery and functional outcome in stroke patients. Arch Phys Med Rehabil 2000;81:447-52. Objective: To investigate effects of brain lesion profiles that combined sizes and locations on motor recovery and functional outcome after stroke in hemiplegic patients. Design: Delimiting sizes (a threshold lesion

  4. Are Outcomes of Extremely Preterm Infants Improving? Impact of Bayley Assessment on Outcomes

    PubMed Central

    Vohr, Betty R.; Stephens, Bonnie E.; Higgins, Rosemary D.; Bann, Carla M.; Hintz, Susan R.; Epi, MS; Das, Abhik; Newman, Jamie E.; Peralta-Carcelen, Myriam; Yolton, Kimberly; Dusick, Anna M.; Evans, Patricia W.; Goldstein, Ricki F.; Ehrenkranz, Richard A.; Pappas, Athina; Adams-Chapman, Ira; Wilson-Costello, Deanne E.; Bauer, Charles R.; Bodnar, Anna; Heyne, Roy J.; Vaucher, Yvonne E.; Dillard, Robert G.; Acarregui, Michael J.; McGowan, Elisabeth C.; Myers, Gary J.; Fuller, Janell

    2013-01-01

    Objectives To compare 18- to 22-month cognitive scores and neurodevelopmental impairment (NDI) in 2 time periods using the National Institute of Child Health and Human Development’s Neonatal Research Network assessment of extremely low birth weight infants with the Bayley Scales of Infant Development, Second Edition (Bayley II) in 2006–2007 (period 1) and using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), with separate cognitive and language scores, in 2008–2011 (period 2). Study design Scores were compared with bivariate analysis, and regression analyses were run to identify differences in NDI rates. Results Mean Bayley III cognitive scores were 11 points higher than mean Bayley II cognitive scores. The NDI rate was reduced by 70% (from 43% in period 1 to 13% in period 2; P < .0001). Multivariate analyses revealed that Bayley III contributed to a decreased risk of NDI by 5 definitions: cognitive score <70 and <85, cognitive or language score <70; cognitive or motor score <70, and cognitive, language, or motor score <70 (P < .001). Conclusion Whether the Bayley III is overestimating cognitive performance or whether it is a more valid assessment of emerging cognitive skills than the Bayley II is uncertain. Because the Bayley III identifies significantly fewer children with disability, it is recommended that all extremely low birth weight infants be offered early intervention services at the time of discharge from the neonatal intensive care unit, and that Bayley scores be interpreted with caution. PMID:22421261

  5. Functional outcome following an ankle or subtalar arthrodesis in adults.

    PubMed

    Faraj, Adnan A; Loveday, David T

    2014-06-01

    Arthrodesis surgery aims to give pain relief by abolishing the movement of the joint concerned. Few studies describe the outcome as appreciated by the patient. This was the major concern of the authors, when they set up this retrospective study about the outcome after ankle fusion or subtalar fusion. Inclusion criteria were: pre-existing idiopathic and posttraumatic osteoarthritis, leading to joint pain unresponsive to conservative treatment, clinically and radiologically fused with an open approach between 2007 and 2011. Exclusion criteria were: preexisting joint infection, diabetes, rheumatoid arthritis, nonunion, age below 18 years, decease, and arthroscopic fusion. Fifteen ankle fusions and 18 subtalar fusions fulfilled the criteria. The mean age of the patients was 77 and 69 years, respectively; the average follow-up period was 3 and 4 years. A telephone questionnaire showed that the average patients' satisfaction was 7.86/10 in the ankle group and 7.94/10 in the subtalar group. All patients driving a car prior to surgery were able to do so afterwards. Forty percent walked unaided and without problems (excellent). Fifty-one percent were able to mobilise, but their walking distance was limited and a stick was required (good or fair). Nine percent were unable to mobilise out of their homes (poor), however it was generalized osteoarthritis which limited their mobility. Forty-five percent were involved in sports including judo, swimming, cycling, jogging, gardening, bowling, golf, and boules. PMID:25090803

  6. Calibrated peer reviewTM and assessing learning outcomes

    Microsoft Academic Search

    Patricia A. Carlson; Frederick C. Berry

    2003-01-01

    The need for more focused and less-labor intensive assessment practices has brought new challenges, both for institutions and for individual educators. We elaborate on Calibrated Peer Review™ (CPR™) - an end- to-end computer-mediated learning environment that seamlessly integrates writing as a vehicle for critical thinking into a technical or content course. Developed as a tool to help incorporate writing into

  7. Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism.

    PubMed

    MacDonald, Rebecca; Parry-Cruwys, Diana; Dupere, Sally; Ahearn, William

    2014-12-01

    Intensive behavioral intervention for young children diagnosed with autism can produce large gains in social, cognitive, and language development. Although several studies have identified behaviors that are possible indicators of best outcome, changes in performance are typically measured using norm-referenced standardized scores referencing overall functioning level rather than via repeated observational measures of autism-specific deficits (i.e., social behavior). In the current study, 83 children with autism (CWA), aged 1, 2 and 3 years, and 58 same-aged typically developing children (TDC) were directly observed in the areas of cognitive skills, joint attention (JA), play, and stereotypic behavior using a measure called the Early Skills Assessment Tool (ESAT; MacDonald et al., 2006). CWA were assessed at entry into an EIBI program and again after 1 year of treatment. Changes in performance were compared pre- and post-treatment as well as to the normative data by age. Results indicate significant gains on the ESAT across all age groups with the greatest gains seen in the children who entered treatment prior to their second birthday. Increases were seen on direct measures of JA, play, imitation and language while decreases were seen in stereotypy regardless of level of performance at entry into EIBI. The ESAT, a direct measurement tool, served as a sensitive tool to measure changes in autism symptomatology following EIBI treatment. PMID:25241118

  8. Functional and Aesthetic Outcome Enhancement of Head and Neck Reconstruction through Secondary Procedures

    PubMed Central

    Hofer, Stefan O.P.; Payne, Caroline E.

    2010-01-01

    The foundation of head and neck reconstruction is based on two pillars: the restoration of function and the restoration of aesthetics. The objective of this article is to provide insight into how to prevent undesirable functional and aesthetic outcome after the initial procedure and also to provide solutions for enhancement of functional and aesthetic outcome with secondary procedures. Functional and aesthetic outcome enhancement is discussed in relation to the individual structures within the oral cavity, for the mandible, and for facial reconstruction. Normal prerequisites for all individual structures are described, and key points for restoration of these functional and aesthetic issues are proposed. In addition, further suggestions to improve suboptimal results after initial reconstructive surgery are presented. Understanding the function and aesthetics of the area to be reconstructed will allow appropriate planning and management of the initial reconstruction. Secondary enhancement should be attainable by minor procedures rather than a requirement to redo the initial reconstruction. PMID:22550452

  9. Real-time functional mapping: potential tool for improving language outcome in pediatric epilepsy surgery.

    PubMed

    Korostenskaja, Milena; Chen, Po-Ching; Salinas, Christine M; Westerveld, Michael; Brunner, Peter; Schalk, Gerwin; Cook, Jane C; Baumgartner, James; Lee, Ki H

    2014-09-01

    Accurate language localization expands surgical treatment options for epilepsy patients and reduces the risk of postsurgery language deficits. Electrical cortical stimulation mapping (ESM) is considered to be the clinical gold standard for language localization. While ESM affords clinically valuable results, it can be poorly tolerated by children, requires active participation and compliance, carries a risk of inducing seizures, is highly time consuming, and is labor intensive. Given these limitations, alternative and/or complementary functional localization methods such as analysis of electrocorticographic (ECoG) activity in high gamma frequency band in real time are needed to precisely identify eloquent cortex in children. In this case report, the authors examined 1) the use of real-time functional mapping (RTFM) for language localization in a high gamma frequency band derived from ECoG to guide surgery in an epileptic pediatric patient and 2) the relationship of RTFM mapping results to postsurgical language outcomes. The authors found that RTFM demonstrated relatively high sensitivity (75%) and high specificity (90%) when compared with ESM in a "next-neighbor" analysis. While overlapping with ESM in the superior temporal region, RTFM showed a few other areas of activation related to expressive language function, areas that were eventually resected during the surgery. The authors speculate that this resection may be associated with observed postsurgical expressive language deficits. With additional validation in more subjects, this finding would suggest that surgical planning and associated assessment of the risk/benefit ratio would benefit from information provided by RTFM mapping. PMID:24995815

  10. Real-time functional mapping: potential tool for improving language outcome in pediatric epilepsy surgery

    PubMed Central

    Korostenskaja, Milena; Chen, Po-Ching; Salinas, Christine M.; Westerveld, Michael; Brunner, Peter; Schalk, Gerwin; Cook, Jane C.; Baumgartner, James; Lee, Ki H.

    2015-01-01

    Accurate language localization expands surgical treatment options for epilepsy patients and reduces the risk of postsurgery language deficits. Electrical cortical stimulation mapping (ESM) is considered to be the clinical gold standard for language localization. While ESM affords clinically valuable results, it can be poorly tolerated by children, requires active participation and compliance, carries a risk of inducing seizures, is highly time consuming, and is labor intensive. Given these limitations, alternative and/or complementary functional localization methods such as analysis of electrocorticographic (ECoG) activity in high gamma frequency band in real time are needed to precisely identify eloquent cortex in children. In this case report, the authors examined 1) the use of real-time functional mapping (RTFM) for language localization in a high gamma frequency band derived from ECoG to guide surgery in an epileptic pediatric patient and 2) the relationship of RTFM mapping results to postsurgical language outcomes. The authors found that RTFM demonstrated relatively high sensitivity (75%) and high specificity (90%) when compared with ESM in a “next-neighbor” analysis. While overlapping with ESM in the superior temporal region, RTFM showed a few other areas of activation related to expressive language function, areas that were eventually resected during the surgery. The authors speculate that this resection may be associated with observed postsurgical expressive language deficits. With additional validation in more subjects, this finding would suggest that surgical planning and associated assessment of the risk/benefit ratio would benefit from information provided by RTFM mapping. PMID:24995815

  11. ULO Course Learning Outcome Assessment Method Pedagogy Process of Inqui-

    E-print Network

    Barrash, Warren

    . Describe the structure of the cells, tissues, organs, and organ systems in the human body and explain how health and well-being. Describe how physiological mecha- nisms work in the functioning of the human body. Analyze the roles that var- ious organ systems of the body play in establishing and maintaining homeosta

  12. Histological, cellular and behavioral assessments of stroke outcomes after photothrombosis-induced ischemia in adult mice

    PubMed Central

    2014-01-01

    Background Following the onset of focal ischemic stroke, the brain experiences a series of alterations including infarct evolvement, cellular proliferation in the penumbra, and behavioral deficits. However, systematic study on the temporal and spatial dependence of these alterations has not been provided. Results Using multiple approaches, we assessed stroke outcomes by measuring brain injury, dynamic cellular and glial proliferation, and functional deficits at different times up to two weeks after photothrombosis (PT)-induced ischemic stroke in adult mice. Results from magnetic resonance imaging (MRI) and Nissl staining showed a maximal infarction, and brain edema and swelling 1–3 days after PT. The rate of Bromodeoxyuridine (Brdu)-labeled proliferating cell generation is spatiotemporal dependent in the penumbra, with the highest rate in post ischemic days 3–4, and higher rate of proliferation in the region immediate to the ischemic core than in the distant region. Similar time-dependent generation of proliferating GFAP+ astrocytes and Iba1+ microglia/macrophage were observed in the penumbra. Using behavioral tests, we showed that PT resulted in the largest functional deficits during post ischemic days 2–4. Conclusion Our study demonstrated that first a few days is a critical period that causes brain expansion, cellular proliferation and behavioral deficits in photothrombosis-induced ischemic model, and proliferating astrocytes only have a small contribution to the pools of proliferating cells and reactive astrocytes. PMID:24886391

  13. Assessing Student Outcomes of Undergraduate Research with URSSA, the Undergraduate Student Self-Assessment Instrument

    NASA Astrophysics Data System (ADS)

    Laursen, S. L.; Weston, T. J.; Thiry, H.

    2012-12-01

    URSSA is the Undergraduate Research Student Self-Assessment, an online survey instrument for programs and departments to use in assessing the student outcomes of undergraduate research (UR). URSSA focuses on what students learn from their UR experience, rather than whether they liked it. The online questionnaire includes both multiple-choice and open-ended items that focus on students' gains from undergraduate research. These gains include skills, knowledge, deeper understanding of the intellectual and practical work of science, growth in confidence, changes in identity, and career preparation. Other items probe students' participation in important research-related activities that lead to these gains (e.g. giving presentations, having responsibility for a project). These activities, and the gains themselves, are based in research and thus constitute a core set of items. Using these items as a group helps to align a particular program assessment with research-demonstrated outcomes. Optional items may be used to probe particular features that are augment the research experience (e.g. field trips, career seminars, housing arrangements). The URSSA items are based on extensive, interview-based research and evaluation work on undergraduate research by our group and others. This grounding in research means that URSSA measures what we know to be important about the UR experience The items were tested with students, revised and re-tested. Data from a large pilot sample of over 500 students enabled statistical testing of the items' validity and reliability. Optional items about UR program elements were developed in consultation with UR program developers and leaders. The resulting instrument is flexible. Users begin with a set of core items, then customize their survey with optional items to probe students' experiences of specific program elements. The online instrument is free and easy to use, with numeric results available as raw data, summary statistics, cross-tabs, and graphs, and as raw, downloadable data. Finally, URSSA has high content validity based on its research grounding and rigorous development. We will present examples of how URSSA has been used in evaluations of UR programs. A multi-year evaluation of a university-based UR program shows that URSSA items are sensitive to differences in students' prior level of experience with research. For example, experienced student researchers reported greater gains than did their peers new to UR in understanding the process of research and in coming to see themselves as scientists. These differences are consistent with interview data that suggest a developmental progression of gains as students pursue research and gain confidence in their ability to contribute meaningfully. A second example comes from a multi-site evaluation of sites funded by the National Science Foundation's Research Experience for Undergraduates (REU) program in Biology. This study acquired data from nearly 800 students at some 60 Bio REU sites in 2010 and 2011. Results reveal differences in gains among demographic groups, and the general strength of these well-planned programs relative to a comparison sample of UR programs that are not part of REU. Our presentation will demonstrate the evaluative use of URSSA and its potential applications to undergraduate research in the geosciences.

  14. Anorectal functional outcome after repeated transanal endoscopic microsurgery

    PubMed Central

    Zhang, Hong-Wei; Han, Xiao-Dong; Wang, Yu; Zhang, Pin; Jin, Zhi-Ming

    2012-01-01

    AIM: To evaluate the status of anorectal function after repeated transanal endoscopic microsurgery (TEM). METHODS: Twenty-one patients undergoing subtotal colectomy with ileorectal anastomosis were included. There were more than 5 large (> 1 cm) polyps in the remaining rectum (range: 6-20 cm from the anal edge). All patients, 19 with villous adenomas and 2 with low-grade adenocarcinomas, underwent TEM with submucosal endoscopic excision at least twice between 2005 and 2011. Anorectal manometry and a questionnaire about incontinence were carried out at week 1 before operation, and at weeks 2 and 3 and 6 mo after the last operation. Anal resting pressure, maximum squeeze pressure, maximum tolerable volume (MTV) and rectoanal inhibitory reflexes (RAIR) were recorded. The integrity and thickness of the internal anal sphincter (IAS) and external anal sphincter (EAS) were also evaluated by endoanal ultrasonography. We determined the physical and mental health status with SF-36 score to assess the effect of multiple TEM on patient quality of life (QoL). RESULTS: All patients answered the questionnaire. Apart from negative RAIR in 4 patients, all of the anorectal manometric values in the 21 patients were normal before operation. Mean anal resting pressure decreased from 38 ± 5 mmHg to 19 ± 3 mmHg (38 ± 5 mmHg vs 19 ± 3 mmHg, P = 0.000) and MTV from 165 ± 19 mL to 60 ± 11 mL (165 ± 19 mL vs 60 ± 11 mL, P = 0.000) at month 3 after surgery. Anal resting pressure and MTV were 37 ± 5 mmHg (38 ± 5 mmHg vs 37 ± 5 mmHg, P = 0.057) and 159 ± 19 mL (165 ± 19 mL vs 159 ± 19 mL, P = 0.071), respectively, at month 6 after TEM. Maximal squeeze pressure decreased from 171 ± 19 mmHg to 62 ± 12 mmHg (171 ± 19 mmHg vs 62 ± 12 mmHg, P = 0.000) at week 2 after operation, and returned to normal values by postoperative month 3 (171 ± 19 vs 166 ± 18, P = 0.051). RAIR were absent in 4 patients preoperatively and in 12 (?2 = 4.947, P = 0.026) patients at month 3 after surgery. RAIR was absent only in 5 patients at postoperative month 6 (?2 = 0.141, P = 0.707). Endosonography demonstrated that IAS disruption occurred in 8 patients, and 6 patients had temporary incontinence to flatus that was normalized by postoperative month 3. IAS thickness decreased from 1.9 ± 0.6 mm preoperatively to 1.3 ± 0.4 mm (1.9 ± 0.6 mm vs 1.3 ± 0.4 mm, P = 0.000) at postoperative month 3 and increased to 1.8 ± 0.5 mm (1.9 ± 0.6 mm vs 1.8 ± 0.5 mm, P = 0.239) at postoperative month 6. EAS thickness decreased from 3.7 ± 0.6 mm preoperatively to 3.5 ± 0.3 mm (3.7 ± 0.6 mm vs 3.5 ± 0.3 mm, P = 0.510) at month 3 and then increased to 3.6 ± 0.4 mm (3.7 ± 0.6 mm vs 3.6 ± 0.4 mm, P = 0.123) at month 6 after operation. Most patients had frequent stools per day and relatively high Wexner scores in a short time period. While actual fecal incontinence was exceptional, episodes of soiling were reported by 3 patients. With regard to the QoL, the physical and mental health status scores (SF-36) were 56.1 and 46.2 (50 in the general population), respectively. CONCLUSION: The anorectal function after repeated TEM is preserved. Multiple TEM procedures are useful for resection of multi-polyps in the remaining rectum. PMID:23155324

  15. A Multilevel Assessment of Differential Item Functioning.

    ERIC Educational Resources Information Center

    Shen, Linjun

    A multilevel approach was proposed for the assessment of differential item functioning and compared with the traditional logistic regression approach. Data from the Comprehensive Osteopathic Medical Licensing Examination for 2,300 freshman osteopathic medical students were analyzed. The multilevel approach used three-level hierarchical generalized…

  16. Relationship between procalcitonin serum levels and functional outcome in stroke patients.

    PubMed

    Deng, Wen-Jing; Shen, Rui-Le; Li, Meng; Teng, Jun-Fang

    2015-04-01

    To determine whether serum procalcitonin (PCT) levels at admission were associated with short-term functional outcome after acute ischemic stroke (AIS) in a cohort Chinese sample. We prospectively studied 378 patients with AIS who were admitted within 24 h after the onset of symptoms. PCT and NIH stroke scale (NIHSS) were measured at the time of admission. Short-term functional outcome was measured by modified Rankin scale (mRS) 90 days after admission. The results indicated that the serum PCT levels were significantly higher in AIS patients as compared to normal controls (P < 0.0001). In the 114 patients with an unfavorable functional outcome, serum PCT levels were higher compared with those in patients with a favorable outcome (2.40 (IQR, 1.10-3.69) ng/mL and 0.42 (IQR, 0.10-1.05) ng/mL, respectively, P < 0.001). PCT was an independent prognostic marker of functional outcome [odds ratio (OR) 3.45 (2.29-4.77), adjusted for the NIHSS and other possible confounders] in patients with ischemic stroke, added significant additional predictive value to the clinical NIHSS score. In receiver operating characteristic curve analysis, the prognostic accuracy of PCT was higher compared to Hs-CRP and NIHSS score. PCT is an independent predictor of short-term functional outcome after ischemic stroke in Chinese sample even after correcting for possible confounding factors. PMID:25370803

  17. Laryngeal transplantation in minipigs: vascular, myologic and functional outcomes

    Microsoft Academic Search

    M. A. Birchall; P. J. Kingham; P. J. Murison; S. M. Ayling; R. Burt; L. Mitchard; A. Jones; P. Lear; C. R. Stokes; G. Terenghi; M. Bailey; P. Macchiarini

    2011-01-01

    There is no effective way of replacing all the functions of the larynx in those requiring laryngectomy. Regenerative medicine\\u000a offers promise, but cannot presently deliver implants with functioning neuromuscular units. A single well-documented laryngeal\\u000a transplant in man was a qualified success, but more information is required before clinical trials may be proposed. We studied\\u000a the early response of the larynx

  18. Functional Assessment for Congenital Heart Disease

    PubMed Central

    2014-01-01

    Significant improvement in survival of children with congenital cardiac malformations has resulted in an increasing population of adolescent and adult patients with congenital heart disease. Of the long-term cardiac problems, ventricular dysfunction remains an important issue of concern. Despite corrective or palliative repair of congenital heart lesions, the right ventricle, which may be the subpulmonary or systemic ventricular chamber, and the functional single ventricle are particularly vulnerable to functional impairment. Regular assessment of cardiac function constitutes an important aspect in the long-term follow up of patients with congenital heart disease. Echocardiography remains the most useful imaging modality for longitudinal monitoring of cardiac function. Conventional echocardiographic assessment has focused primarily on quantification of changes in ventricular size and blood flow velocities during the cardiac cycles. Advances in echocardiographic technologies including tissue Doppler imaging and speckle tracking echocardiography have enabled direct interrogation of myocardial deformation. In this review, the issues of ventricular dysfunction in congenital heart disease, conventional echocardiographic and novel myocardial deformation imaging techniques, and clinical applications of these techniques in the functional assessment of congenital heart disease are discussed. PMID:24653734

  19. Functional outcome of nerve transfer for restoration of shoulder and elbow function in upper brachial plexus injury

    Microsoft Academic Search

    Hari Venkatramani; Praveen Bhardwaj; Sajedur Reza Faruquee; S Raja Sabapathy

    2008-01-01

    BACKGROUND: Purpose of this study was to evaluate the functional outcome of spinal accessory to suprascapular nerve transfer (XI-SSN) done for restoration of shoulder function and partial transfer of ulnar nerve to the motor branch to the biceps muscle for the recovery of elbow flexion (Oberlin transfer). METHODS: This is a prospective study involving 15 consecutive cases of upper plexus

  20. Assessing English literacy as a predictor of postschool outcomes in the lives of deaf individuals.

    PubMed

    Garberoglio, Carrie Lou; Cawthon, Stephanie W; Bond, Mark

    2014-01-01

    Lower English literacy achievement of deaf students is often hypothesized to be an impediment for successful adult life experiences. Yet, literacy practices that individuals engage in throughout their daily lives are much more complex than what school-based measures of English can capture and particularly so for deaf individuals. A national large-scale data set with a sample of over 1,000 deaf youths was used to assess what, precisely, standardized measures of literacy may predict in terms of postschool outcomes in three domains: life, employment, and education. Regression analyses indicate that these measures predicted some postschool outcomes, but not all, and if significant, only a small amount of variation in the outcomes was explained. Findings suggest that English literacy, particularly the narrow conceptualization of English literacy skills that are measured through school-based assessments, may not play a significant role in the lives of deaf individuals, contrary to expectations. PMID:24077877

  1. Evaluating Cognitive Training Outcomes: Validity and Utility of Structural Knowledge Assessment

    Microsoft Academic Search

    Mark A. Davis; Mary B. Curtis; Jeffrey D. Tschetter

    2003-01-01

    Conventional approaches to evaluating cognitive outcomes of training typically use paper-and-pencil tests that emphasize gains or differences in declarative knowledge. Yet a key factor in differentiating expert and novice performance is the way individuals organize their knowledge. Accordingly, the acquisition of meaningful knowledge structures and methods of assessing structural knowledge are potentially important issues for designing and evaluating training programs.

  2. Transitioning into Cohabitation Early in a Relationship: Associations With Family of Origin Assessments and Couple Outcomes

    Microsoft Academic Search

    Brian J. Willoughby; Eunicia Jones

    2012-01-01

    The present authors used data from 1,920 heterosexual, never-married individuals to assess the differences on couple outcomes and family of origin evaluations between early cohabiters and early daters. Early cohabiters were individuals who were living with their romantic partner in relationships that were less than 1 year old. Results suggested that once common demographic controls were factored in, the dating

  3. Motivating Learning and Assessing Outcomes in Continuing Medical Education Using a Personal Learning Plan

    ERIC Educational Resources Information Center

    Reed, Virginia A.; Schifferdecker, Karen E.; Turco, Mary G.

    2012-01-01

    Introduction: Although there is increasing focus on provider behavior change as an outcome of continuing medical education (CME), it has long been known that an increase in knowledge alone is rarely sufficient to induce such change. The Personal Learning Plan (PLP), designed to motivate and assess CME learning, was partly derived from SMART goals…

  4. Assessing the Relationship between Prosody and Reading Outcomes in Children Using the PEPS-C

    ERIC Educational Resources Information Center

    Lochrin, Margaret; Arciuli, Joanne; Sharma, Mridula

    2015-01-01

    This study investigated the relationship between both receptive and expressive prosody and each of three reading outcomes: accuracy of reading aloud words, accuracy of reading aloud nonwords, and comprehension. Participants were 63 children aged 7 to 12 years. To assess prosody, we used the Profiling Elements of Prosody in Speech Communication…

  5. Designing a Student Assessment Study: The CIRP Surveys and the Input-Environment-Outcome Model.

    ERIC Educational Resources Information Center

    Higher Education Research Inst., Inc., Los Angeles, CA.

    This paper describes how the Input-Environment-Outcome (IEO) model of A. Astin can be used with the Cooperative Institutional Research Program (CIRP) Freshman Survey and the College Student Survey (CSS) to assess student change during college. The CIRP Freshman Survey, given to entering students, provides pretest data. The CSS, given to continuing…

  6. Assessment Plan for M.S. students in the Field of Plant Breeding 1. Learning outcomes

    E-print Network

    Walter, M.Todd

    Assessment Plan for M.S. students in the Field of Plant Breeding 1. Learning outcomes When students breeding/genetics 2. Demonstrate broad understanding about plant breeding/genetics 3. Write and speak complete the M.S. they should be able to: 1. Assist in conducting original, publishable research in plant

  7. Assessment Plan for Ph.D, students in the Field of Plant Breeding 1. Learning outcomes

    E-print Network

    Walter, M.Todd

    Assessment Plan for Ph.D, students in the Field of Plant Breeding 1. Learning outcomes When breeding/genetics 2. Demonstrate in-depth knowledge about plant breeding/genetics and at least one other students complete the Ph.D., they should be able to: 1. Conduct original, publishable research in plant

  8. Assessing Extreme Outcomes: The Strategic Treatment of Low Probability Impacts of Climate Change

    Microsoft Academic Search

    A. Patt

    1997-01-01

    Many assessments of climate change fail to consider the possibility of low probability, yet catastrophic, outcomes of greenhouse warming. A noteworthy example is the potential rapid deterioration of the West Antarctic ice sheet. If the ice sheet were to melt, as a minority of scientists believe it may, sea levels could rise by five meters or more in the next

  9. ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Use written communication to summarize

    E-print Network

    Barrash, Warren

    -01 Use oral communication to effectively and succinctly present key aspects of a scientific findingBIOL323 ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Use written communication of sources. Discussion and examples of effective writ- ing for scientific communication Students prepare

  10. BUSINESS ADMINISTRATION ASSESSMENT REPORT 2005-2006 Student Learning Outcomes Committee

    E-print Network

    Gallo, Linda C.

    and Critical Thinking Skills - Demonstrate effective analytical and critical thinking skills to make and Critical Thinking Skills) 2006-2007 (To be discussed in 4-1-08 Assessment Re Goal #3 (Ethical Reasoning an appropriate decision in a complex situation. Learning Outcomes: · Collect and organize critical data

  11. USE OF CASE REPORTS IN ASSESSING ADVERSE OUTCOMES OF HUMAN PRENATAL DRUG EXPOSURES: AN APPROACH

    EPA Science Inventory

    The use of case reports for assessing the developmental consequences of prenatal drug exposure is limited by the inability to determine the incidence of adverse outcomes and by the high likelihood for bias. Yet, because it is impossible to conduct clinical trials for the assessme...

  12. Learning Outcomes Assessment Step-By-Step: Enhancing Evidence-Based Practice in Career Services

    ERIC Educational Resources Information Center

    Makela, Julia Panke; Rooney, Gail S.

    2012-01-01

    What difference do your career programs and services make in clients' lives? How do you know? Answer these questions and more. Learn a practical approach to learning outcomes assessment that helps you tell the story of your career programs and services, celebrate your successes, and continuously improve your practice. Within this monograph, you…

  13. An Outcome Evaluation of an Inpatient Crisis Stabilization and Assessment Program for Youth

    ERIC Educational Resources Information Center

    Greenham, Stephanie L.; Bisnaire, Lise

    2008-01-01

    Objective: To describe characteristics and outcomes of youth aged 7 to 17 who received inpatient psychiatric and mental health services along different clinical pathways of a new service delivery model. Method: Participants included 211 admissions to an inpatient crisis stabilization and assessment program over a one-year period. Standardized…

  14. Developing a Rubric to Assess Student Learning Outcomes Using a Class Assignment

    ERIC Educational Resources Information Center

    Thaler, Nicholas; Kazemi, Ellie; Huscher, Crystal

    2009-01-01

    We developed a rubric to assess several of our department's undergraduate student learning outcomes (SLOs). Target SLOs include applications of principles of research methodology, using appropriate statistics, adherence to the Publication Manual of the American Psychological Association, and written communication skills. We randomly sampled 20…

  15. Applying Social Cognitive Theory to Academic Advising to Assess Student Learning Outcomes

    ERIC Educational Resources Information Center

    Erlich, Richard J.; Russ-Eft, Darlene

    2011-01-01

    Review of social cognitive theory constructs of self-efficacy and self-regulated learning is applied to academic advising for the purposes of assessing student learning. A brief overview of the history of student learning outcomes in higher education is followed by an explanation of self-efficacy and self-regulated learning constructs and how they…

  16. Factors affecting cosmetic outcome in breast-conserving cancer treatment — objective quantitative assessment

    Microsoft Academic Search

    Richard D. Pezner; Mary P. Patterson; James A. Lipsett; Tamara Odom-Maryon; Nayana L. Vora; Jeffrey Y. C. Wong; Kenneth H. Luk

    1991-01-01

    Summary A battery of objective measurements of cosmetic outcome was performed on 114 patients who had been treated by breast-preservation techniques for breast cancer. Cosmetic breast retraction, as determined by Breast Retraction Assessment (BRA) measurements, was significantly greater in patients who underwent extensive primary tumor resection, were more than 60 years old, weighed more than 150 lbs, or had a

  17. Wave of the Future?: Integrating IR, Outcomes Assessment, Planning, Program Review, and Accreditation

    ERIC Educational Resources Information Center

    Leimer, Christina

    2010-01-01

    Integrating institutional research, outcomes assessment, program review, strategic planning, and accreditation can be a powerful means of creating a culture of evidence-based decision making and continuous improvement. This study examined how this "integrated" model is organized in practice, how such offices began, why this approach was chosen,…

  18. Career Preparedness Survey Outcomes of Food Science Graduates--A Follow-Up Assessment

    ERIC Educational Resources Information Center

    Bohlscheid, Jeffri; Clark, Stephanie

    2012-01-01

    Fifty-eight recent graduates (1998-2008) from the joint Washington State University (WSU) and University of Idaho (UI) BiState School of Food Science program and 27 of their employers participated in a survey assessing learning outcomes based on the 2001 Institute of Food Technologists (IFT) core competencies for undergraduate food science…

  19. Program Assessment Report for MS-EC, 2012/2013 Program Outcomes

    E-print Network

    Kamberov, George

    version of the course remains. The material on hypervisor security may haveProgram Assessment Report for MS-EC, 2012/2013 Program Outcomes 1 of CS 594 Enterprise and Cloud Security as a new core course in the program

  20. An Outcomes-Based Assessment of Quality of Life in Social Services

    ERIC Educational Resources Information Center

    Gomez, Laura Elisabet; Arias, Benito; Verdugo, Miguel Angel; Navas, Patricia

    2012-01-01

    The goal of this article consists of describing the calibration of an instrument to assess quality of life-related personal outcomes using Rasch analysis. The sample was composed of 3.029 recipients of social services from Catalonia (Spain) and was selected using a probabilistic polietapic sample design. Results related to unidimensionality, item…

  1. Assessment of Student Learning Outcomes The Department of Modern Languages & Cultures

    E-print Network

    Cantlon, Jessica F.

    Assessment of Student Learning Outcomes The Department of Modern Languages & Cultures The Department of Modern Languages and Cultures offers students a carefully integrated approach to the study of language, literature, and culture. Students acquire linguistic knowledge in the context of living cultures

  2. Institutionalizing Student Outcomes Assessment: The Need for Better Research to Inform Practice

    ERIC Educational Resources Information Center

    Kezar, Adrianna

    2013-01-01

    This article explores the organizational impediments and facilitators that influence the implementation of student learning outcomes assessment (SLOA). This review points to the importance of culture, leadership, and organizational policies to the implementation of SLOA. However, we need to approach research differently, both conceptually and…

  3. Assessing outcome after a modified vaginal wall sling for stress incontinence with intrinsic sphincter deficiency

    Microsoft Academic Search

    Elisabetta Costantini; Luigi Mearini; Ettore Mearini; Cinzia Pajoncini; Federico Guercini; Vittorio Bini; Massimo Porena

    2005-01-01

    Forty women with stress incontinence, intrinsic sphincter deficiency (ISD), associated or not with urethral hypermobility, a Valsalva leak point pressure (VLLP) 20 and a maximum urethral closure pressure 20 underwent in situ vaginal wall sling. The main modification to the technique was the use of two small Marlex meshes placed at the lateral edges of the sling. Outcome was assessed

  4. From Process to Outcome: The Effect of Portfolio Assessment on Student Learning.

    ERIC Educational Resources Information Center

    Tiwari, Agnes; Tang, Catherine

    2003-01-01

    Three findings emerged from 12 Hong Kong student nurses' descriptions of their experiences of portfolio assessment: (1) despite initial anxiety, all favored portfolio use; (2) portfolios had positive academic and affective outcomes; and (3) unexpectedly, spontaneous collaborative learning and increased motivation resulted. (Contains 35…

  5. Identifying Low-Effort Examinees on Student Learning Outcomes Assessment: A Comparison of Two Approaches

    ERIC Educational Resources Information Center

    Rios, Joseph A.; Liu, Ou Lydia; Bridgeman, Brent

    2014-01-01

    This chapter describes a study that compares two approaches (self-reported effort [SRE] and response time effort [RTE]) for identifying low-effort examinees in student learning outcomes assessment. Although both approaches equally discriminated from measures of ability (e.g., SAT scores), RTE was found to have a stronger relationship with test…

  6. Assessment of risk factors for culling dairy cows using logistic regression. Definition of outcome

    E-print Network

    Boyer, Edmond

    / réforme / trouble de santé / risque INTRODUCTION Health disorders of dairy cows may have a significantAssessment of risk factors for culling dairy cows using logistic regression. Definition of outcome; The culling of dairy cows can occur either early or late during lactation. Furthermore, the farmers decision

  7. Program Evaluation and Outcome Assessment Documenting the Worth of Educational Programs.

    ERIC Educational Resources Information Center

    Erford, Bradley T.; Moore-Thomas, Cheryl

    National concerns regarding quality education make program evaluation and outcomes assessment more important than ever. Traditionally, however, educators have failed to hold their programs and services accountable, or to provide evidence that selected activities were achieving intended results. The purpose of this chapter is to give educators the…

  8. ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Plan lessons and instructional units that

    E-print Network

    Barrash, Warren

    MATH400 ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Plan lessons and instructional of and proficiency with mathematics ; Articulate a personal philosophy for teaching Lesson plans ; Philosophy strategies ; Short lecture 04-01 Plan lessons and instructional units that address appropriate learning goals

  9. Assessing Intermediate Outcomes of a Faith-Based Residential Prisoner Reentry Program

    ERIC Educational Resources Information Center

    Roman, Caterina G.; Wolff, Ashley; Correa, Vanessa; Buck, Janeen

    2007-01-01

    Objective: This study examined intermediate outcomes of a faith-based prisoner reentry program by assessing how client spirituality related to client- and program-level characteristics, investigating differences between completers and terminators, and examining how religious preference, religiosity/spirituality, religious salience, and…

  10. Clinical outcomes and safety assessment in elderly patients undergoing decompressive laminectomy for lumbar spinal stenosis: a prospective study

    PubMed Central

    2010-01-01

    Background To assess safety, risk factors and clinical outcomes in elderly patients with spinal stenosis after decompressive laminectomy. Methods A prospective cohort of patients 70 years and older with spinal stenosis undergoing conventional laminectomy without fusion (n = 101) were consecutively enrolled from regular clinical practice and reassessed at 3 and 12 months. Primary outcome was change in health related quality of life measured (HRQL) with EuroQol-5 D (EQ-5D). Secondary outcomes were safety assessment, changes in Oswestry disability index (ODI), Visual Analogue Scale (EQ-VAS) score for self reported health, VAS score for leg and back pain and patient satisfaction. We used regression analyses to evaluate risk factors for less improvement. Results The mean EQ-5 D total score were 0.32, 0.63 and 0.60 at baseline, 3 months and 12 months respectively, and represents a statistically significant (P < 0.001) improvement. Effect size was > 0.8. Mean ODI score at baseline was 44.2, at 3 months 25.6 and at 27.9. This represents an improvement for all post-operative scores. A total of 18 (18.0%) complications were registered with 6 (6.0%) classified as major, including one perioperative death. Patients stating that the surgery had been beneficial at 3 months was 82 (89.1%) and at 12 months 73 (86.9%). The only predictor found was patients with longer duration of leg pain had less improvement in ODI (P < 0.001). Increased age or having complications did not predict a worse outcome in any of the outcome variables. Conclusions Properly selected patients of 70 years and older can expect a clinical meaningful improvement of HRQL, functional status and pain after open laminectomy without fusion. The treatment seems to be safe. However, patients with longstanding leg-pain prior to operation are less likely to improve one year after surgery. PMID:21092227

  11. Mnk kinase pathway: Cellular functions and biological outcomes

    PubMed Central

    Joshi, Sonali; Platanias, Leonidas C

    2014-01-01

    The mitogen-activated protein kinase (MAPK) interacting protein kinases 1 and 2 (Mnk1 and Mnk2) play important roles in controlling signals involved in mRNA translation. In addition to the MAPKs (p38 or Erk), multiple studies suggest that the Mnk kinases can be regulated by other known kinases such as Pak2 and/or other unidentified kinases by phosphorylation of residues distinct from the sites phosphorylated by the MAPKs. Several studies have established multiple Mnk protein targets, including PSF, heterogenous nuclear ribonucleoprotein A1, Sprouty 2 and have lead to the identification of distinct biological functions and substrate specificity for the Mnk kinases. In this review we discuss the pathways regulating the Mnk kinases, their known substrates as well as the functional consequences of engagement of pathways controlled by Mnk kinases. These kinases play an important role in mRNA translation via their regulation of eukaryotic initiation factor 4E (eIF4E) and their functions have important implications in tumor biology as well as the regulation of drug resistance to anti-oncogenic therapies. Other studies have identified a role for the Mnk kinases in cap-independent mRNA translation, suggesting that the Mnk kinases can exert important functional effects independently of the phosphorylation of eIF4E. The role of Mnk kinases in inflammation and inflammation-induced malignancies is also discussed. PMID:25225600

  12. Magnetic resonance volumetric assessments of brains in fetuses with ventriculomegaly correlated to outcome

    PubMed Central

    Pier, Danielle B; Levine, Deborah; Kataoka, Miliam L; Estroff, Judy A.; Werdich, Xiang Q.; Ware, Janice; Beeghly, Marjorie; Poussaint, Tina Y; DuPlessis A, Adre; Li, Y; Feldman, Henry A.

    2013-01-01

    Objective To correlate MR 2D measurements of lateral ventricular width and 3D measures of lateral ventricular and supratentorial parenchymal volumes to postnatal outcomes in fetuses with ventriculomegaly (VM). Methods 307 fetuses (mean gestational age 26.0 weeks, range 15.7-39.4 weeks) had MR volumetry after referral for VM. Fetuses were grouped into those with (N=114) or without (N=193) other CNS anomalies. Pregnancy outcome and postnatal neurodevelopmental outcomes up to age 3 were obtained. A subgroup analysis was performed excluding fetuses with other CNS anomalies. Logistic regression analysis was performed to assess which measure was most predictive of outcome. Results There were 50 terminations and 2 stillbirths. There were 255 live births. 75 were lost to follow-up. Among 180 liveborn infants with follow-up, 140 had an abnormal and 40 had normal outcome. Atrial diameter (p<0.0001), frontal horn diameter (p<0.0001), and ventricular volume (p=0.04) were each predictive of live-birth, with each having 92% specificity at 60% sensitivity. Among fetuses without other CNS anomalies, 180/193 (93%) pregnancies resulted in live deliveries, with atrial diameter (p<0.0001), frontal horn diameter (p=0.003), and ventricular volume (p=0.008) associated with live birth, and with atrial diameter having highest specificity of >99% at 60% sensitivity. Parenchymal volume was not associated with normal or abnormal outcome (either livebirth vs. demise or normal vs. abnormal neurodevelopmental outcome). Among live-borns, there was no age-adjusted threshold for any of the measures that reliably distinguished between normal and abnormal neurodevelopmental outcome. Conclusions Ventricular volume and diameter, but not parenchymal volume, correlate with live birth in fetuses with VM. However, once live-born, neither 2D nor 3D measurements can distinguish a fetus that will go on to have a normal outcome. PMID:21527607

  13. Age of seizure onset, functional reorganization, and neuropsychological outcome in temporal lobectomy

    Microsoft Academic Search

    Stefanie Griffin; Daniel Tranel

    2007-01-01

    Patients with early onset seizure disorder tend to have less cognitive decline following surgical resection than patients with late onset seizure disorder. Differential opportunity for presurgical cerebral functional reorganization has been proposed to account for this “age of onset” effect. However, the relationships between age of seizure onset, functional organization, and neuropsychological outcome remain incompletely understood. To shed additional light

  14. In it for the long haul: the integration of outcomes assessment, clinical services, and management decision-making.

    PubMed

    Hoffmann, F L; Leckman, E; Russo, N; Knauf, L

    1999-05-01

    Behavioral health providers are increasingly called upon to develop outcomes strategies that highlight opportunities for performance improvement and assess in turn the impact of applying total quality management (TQM) principles to treatment outcomes. This article describes the evolution of an outcomes assessment program at a private psychiatric facility, and presents two case studies of the integration of outcomes data into clinical decision-making. In Study I, outcomes data were used to identify patterns in the responsiveness to treatment of child/adolescent patients with behavioral disorders and document changes in improvement rates following the application of continuous quality improvement (CQI) principles within the inpatient services. In Study II, improvements sought in the outcomes methodology resulted in improved response rates, improved data quality, and new opportunities for both clinical intervention and staff development. Benefits of committing to outcomes assessment over the long haul to facilitate empirically driven planning processes are described. PMID:24011414

  15. Heart Failure and Preserved Left Ventricular Function: Long Term Clinical Outcome

    Microsoft Academic Search

    Israel Gotsman; Donna Zwas; Chaim Lotan; Andre Keren

    2012-01-01

    BackgroundPatients with heart failure (HF) have a poor prognosis. The proportion of patients with HF and preserved left ventricular function (LVF) is increasing. Long term prognosis of HF with preserved LVF may not be so benign.ObjectivesTo evaluate the long term clinical outcome of patients with HF and preserved LVF and predictors of outcome.MethodsWe prospectively evaluated 309 patients hospitalized with a

  16. Patients’ Expectations of Functional Outcomes Following Rectal Cancer Surgery: a Qualitative Study

    PubMed Central

    Park, Jason; Neuman, Heather B.; Bennett, Antonia V.; Polskin, Lily; Phang, P. Terry; Wong, W. Douglas; Temple, Larissa K.

    2014-01-01

    Background Rectal cancer patients’ expectations of health and function may affect their disease- and treatment-related experience, but how patients form expectations of post-surgery function has received little study. Objective We used a qualitative approach to explore patients’ expectations of outcomes related to bowel function following sphincter-preserving surgery (SPS) for rectal cancer. Design and Setting Individual telephone interviews with patients who were about to undergo SPS for rectal cancer. Patients 26 patients (14 men, 12 women) with clinical stage (cTNM) I to III disease. Main Outcome Measures The semi-structured interview script contained open-ended questions on patients’ expectations of post-operative bowel function and its perceived impact on daily function and life. Two researchers analyzed the interview transcripts for emergent themes using a grounded theory approach. Results Participants’ expectations of bowel function reflected three major themes: (1) information sources, (2) personal attitudes, and (3) expected outcomes. The expected outcomes theme contained references to specific symptoms and participants’ descriptions of the certainty, importance and imminence of expected outcomes. Despite multiple information sources and attempts at maintaining a positive personal attitude, participants expressed much uncertainty about their long term bowel function. They were more focused on what they considered more important and imminent concerns about being cancer-free and getting through surgery. Limitations This study is limited by context in terms of the timing of interviews (relative to the treatment course). The transferability to other contexts requires further study. Conclusions Patients’ expectations of long term functional outcomes cannot be considered outside of the overall context of the cancer-experience and the relative importance and imminence of cancer- and treatment-related events. Recognizing the complexities of the expectation formation process offers opportunities to develop strategies to enhance patient education and appropriately manage expectations, attend to immediate and long term concerns, and support patients through the treatment and recovery process. PMID:24401875

  17. Clinimetrics & determinants of outcome after stroke

    Microsoft Academic Search

    V. P. M. Schepers

    2006-01-01

    This thesis is based on findings of the Functional Prognostication and disability study on stroke, which had two main objectives: (1) to examine which outcome measures are most appropriate, and especially most responsive, for the assessment of functional outcome in stroke patients and (2) to study prognostic determinants of functional outcome and recovery after stroke. A total of 308 patients

  18. Vascular function assessed with cardiovascular magnetic resonance predicts survival in patients with advanced chronic kidney disease

    Microsoft Academic Search

    Patrick B Mark; Arthur Doyle; Kevin G Blyth; Rajan K Patel; Robin AP Weir; Tracey Steedman; John E Foster; Henry J Dargie; Alan G Jardine

    2008-01-01

    BACKGROUND: Increased arterial stiffness is associated with mortality in patients with chronic kidney disease. Cardiovascular magnetic resonance (CMR) permits assessment of the central arteries to measure aortic function. METHODS: We studied the relationship between central haemodynamics and outcome using CMR in 144 chronic kidney disease patients with estimated glomerular filtration rate <15 ml\\/min (110 on dialysis). Aortic distensibilty and volumetric

  19. Evaluation of a pre-treatment assessment to select mand topographies for functional communication training

    Microsoft Academic Search

    Joel E. Ringdahl; Terry S. Falcomata; Tory J. Christensen; Sandie M. Bass-Ringdahl; Alison Lentz; Anuradha Dutt; Jessica Schuh-Claus

    2009-01-01

    Recent research has suggested that variables related to specific mand topographies targeted during functional communication training (FCT) can affect treatment outcomes. These include effort, novelty of mands, previous relationships with problem behavior, and preference. However, there is little extant research on procedures for identifying which mand topographies to incorporate into FCT. In the current study, a mand topography assessment was

  20. Self-Reported versus Professionally Assessed Functional Limitations in Community-Dwelling Very Old Individuals

    ERIC Educational Resources Information Center

    Carlsson, Gunilla; Haak, Maria; Nygren, Carita; Iwarsson, Susanne

    2012-01-01

    The objective of this study was to examine the relationship between self-reported and professionally assessed functional limitations in community-dwelling very old individuals. In total, 306 single-living adults aged 81-90 years were included in this cross-sectional study. The main outcome measure was the presence and absence of self-reported and…

  1. CMR for Assessment of Diastolic Function

    Microsoft Academic Search

    Jos J. M. Westenberg

    2011-01-01

    Prevalence of heart failure with preserved left ventricular ejection fraction amounts to 50% of all cases with heart failure.\\u000a Diagnosis assessment requires evidence of left ventricular diastolic dysfunction. Currently, echocardiography is the method\\u000a of choice for diastolic function testing in clinical practice. Various applications are in use and recommended criteria are\\u000a followed for classifying the severity of dysfunction. Cardiovascular magnetic

  2. COMT Val158Met and cognitive and functional outcomes after traumatic brain injury.

    PubMed

    Willmott, Catherine; Withiel, Toni; Ponsford, Jennie; Burke, Richard

    2014-09-01

    There is significant variability in long-term outcomes after traumatic brain injury (TBI), making accurate prognosis difficult. In seeking to enhance understanding of outcomes, this study aimed to investigate whether COMT Val(158)Met allele status was associated with performance on neuropsychological measures of attention and working memory, executive functioning, learning and memory, and speed of information processing in the early rehabilitation phase. The study also aimed to examine whether the COMT polymorphism was associated with longer-term functional outcomes. A total of 223 participants (71.3% male) with moderate-to-severe TBI were recruited as rehabilitation inpatients to participate in a prospective, longitudinal head injury outcome study. The three COMT genotype groups (Val/Val, Val/Met, and Met/Met) were well matched for estimated full-scale IQ, years of education, age at injury, and injury severity. Results showed no significant difference between genotypes on neuropsychological measures (all p>0.05) or functional outcome, as measured by the Glasgow Outcome Scale-Extended (GOS-E), after controlling for age, education, and severity of injury. The presence of frontal lobe pathology was also not associated with cognitive performance. Those with greater injury severity (i.e., longer duration of post-traumatic amnesia) performed more poorly on measures of processing speed and verbal new learning and recall. It was concluded that there was little support for the influence of COMT Val(158)Met on cognitive function, or functional outcome measures, in the acute rehabilitation phase after TBI. PMID:24786534

  3. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty.

    PubMed

    Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

    2015-03-18

    To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

  4. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

    PubMed Central

    Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

    2015-01-01

    To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

  5. ABET Criterion 3: Outcomes Met By Course Content This brief content assessment should be consistent with the updated Course Syllabet

    E-print Network

    Walter, M.Todd

    solutions in the context of a complex natural environment #12;(C) COURSE OUTCOMES ASSESSMENT MATRIX Dept and impacts of wastes in an environmental medium. a,b,e,k Assigned problems Class quizzes Problems 2, 5, 6, 7ABET Criterion 3: Outcomes Met By Course Content This brief content assessment should be consistent

  6. Assessing cognitive function and capacity in older adults with cancer.

    PubMed

    McKoy, June M; Burhenn, Peggy S; Browner, Ilene S; Loeser, Kari L; Tulas, Katrina M; Oden, Megan R; Rupper, Randall W

    2014-01-01

    The number of older individuals with cancer is increasing exponentially, mandating that oncologists contemplate more comprehensive and multidisciplinary approaches to treatment of this cohort. Recruitment of assessment instruments validated in older patients can be invaluable for guiding treatment and decision-making by both patients and providers, and can arguably contribute to improving outcomes and health-related quality of life. The Comprehensive Geriatric Assessment is one such validated instrument that can be used by oncologists to assess patient readiness and appropriateness for prescribed cancer therapy. As a multidisciplinary diagnostic and treatment process, it comprises functional status, cognitive status, social support, and advance care preferences, and is an ideal instrument for evaluating complex older individuals. It is well established that many older individuals with cancer travel with multiple comorbid illnesses, including cognitive impairment, and when presented with a cancer diagnosis struggle to choose from multiple treatment options. In addition to the complete medical history, the ability of patients to decide on a course of therapy in concert with their oncologist is critically important. Alternatively, many oncologists are conflicted as to whether true informed consent for treatment can be obtained from many older patients. Having a roadmap to decision-making capacity is therefore an inescapable imperative in geriatric oncology, because careful attention must be directed at identifying older patients with cancer who might benefit from these assessments and the individualized treatment plans that emerge. PMID:24453297

  7. Long-term functional outcomes and patient perspective following altered fractionation radiotherapy with concomitant boost for oropharyngeal cancer.

    PubMed

    Cartmill, Bena; Cornwell, Petrea; Ward, Elizabeth; Davidson, Wendy; Porceddu, Sandro

    2012-12-01

    With no long-term data available in published research to date, this study presents details of the swallowing outcomes as well as barriers to and facilitators of oral intake and weight maintenance at 2 years after altered fractionation radiotherapy with concomitant boost (AFRT-CB). Twelve patients with T1-T3 oropharyngeal cancer who received AFRT-CB were assessed at baseline, 6 months, and 2 years post-treatment for levels of dysphagia and salivary toxicity, food and fluid tolerance, functional swallowing outcomes, patient-reported function, and weight. At 2 years, participants were also interviewed to explore barriers and facilitators of oral intake. Outcomes were significantly worse at 2 years when compared to baseline for late toxicity, functional swallowing, and patient-rated physical aspects of swallowing. Most patients (83%) tolerated a full diet pretreatment, but the rate fell to 42% (remainder tolerated soft diets) at 2 years. Multiple barriers to oral intake that impacted on activity and participation levels were identified. Participants lost 11 kg from baseline to 2 years, which was not regained between 6 months and 2 years. Global, social, and emotional domains of patient-reported function returned to pretreatment levels. At 2 years post AFRT-CB, worsening salivary and dysphagia toxicity, declining functional swallowing, and multiple reported ongoing barriers to oral intake had a negative impact on participants' activity and participation levels relating to eating. These ongoing deficits contributed to significant deterioration in physical swallowing functioning determined by the MDADI. In contrast, patients perceived their broader functioning had improved at 2 years, suggesting long-term adjustment to ongoing swallowing deficits. PMID:22362547

  8. Determinants of Adult Functional Outcome in Adolescents Receiving Special Educational Assistance

    ERIC Educational Resources Information Center

    McGeown, H. R.; Johnstone, E. C.; McKirdy, J.; Owens, D. C.; Stanfield, A. C.

    2013-01-01

    Background: This study investigates the role of IQ, autistic traits and challenging behaviours in affecting adult outcomes among adolescents who receive special educational assistance. Methods: A total of 58 participants were recruited from an ongoing longitudinal study. All received assessments of IQ, behavioural patterns (using the Childhood…

  9. Functional outcome of arthroscopic assisted fixation of distal radius fractures

    PubMed Central

    Khanchandani, Prakash; Badia, Alejandro

    2013-01-01

    Background: Many studies in literature have supported the role of wrist arthroscopy as an adjunct to the stable fixation of unstable intraarticular distal radial fractures. This article focuses on the surgical technique, indications, advantages, and results using wrist arthroscopy to assess articular reduction and evaluates the treatment of carpal ligament injuries and triangular fibrocartilage complex (TFCC) injuries in conjunction with the stable fixation of distal radial fractures. Materials and Methods: We retrospectively evaluated 27 patients (16 males and 11 females), who underwent stable fixation of intraarticular distal radial fractures with arthroscopic evaluation of the articular reduction and repair of associated carpal injuries. As per the AO classification, they were 9 C 1, 12 C2, 2 C3, 3 B 1, and 1 B2 fractures. The final results were evaluated by modified Mayo wrist scoring system. The average age was 41 years (range: 18-68 years). The average followup was of 26 months (range 24-52 months). Results: Five patients needed modification of the reduction and fixation after arthroscopic joint evaluation. Associated ligament lesions found during the wrist arthroscopy were TFCC tears (n=17), scapholunate ligament injury (n=8), and luno-triquetral ligament injury (n=1). Five patients had combined injuries i.e. included TFCC tear, scapholunate and/or lunotriquetral ligament tear. There were 20 excellent, 3 good, and 4 fair results using this score. Conclusion: The radiocarpal and mid carpal arthroscopy is a useful adjunct to stable fixation of distal radial fractures. PMID:23798761

  10. Methods for Assessing Mitochondrial Function in Diabetes

    PubMed Central

    Kane, Daniel A.; Lanza, Ian R.; Neufer, P. Darrell

    2013-01-01

    A growing body of research is investigating the potential contribution of mitochondrial function to the etiology of type 2 diabetes. Numerous in vitro, in situ, and in vivo methodologies are available to examine various aspects of mitochondrial function, each requiring an understanding of their principles, advantages, and limitations. This review provides investigators with a critical overview of the strengths, limitations and critical experimental parameters to consider when selecting and conducting studies on mitochondrial function. In vitro (isolated mitochondria) and in situ (permeabilized cells/tissue) approaches provide direct access to the mitochondria, allowing for study of mitochondrial bioenergetics and redox function under defined substrate conditions. Several experimental parameters must be tightly controlled, including assay media, temperature, oxygen concentration, and in the case of permeabilized skeletal muscle, the contractile state of the fibers. Recently developed technology now offers the opportunity to measure oxygen consumption in intact cultured cells. Magnetic resonance spectroscopy provides the most direct way of assessing mitochondrial function in vivo with interpretations based on specific modeling approaches. The continuing rapid evolution of these technologies offers new and exciting opportunities for deciphering the potential role of mitochondrial function in the etiology and treatment of diabetes. PMID:23520284

  11. Assessment of adrenal function in liver diseases

    PubMed Central

    Kharb, Sandeep; Garg, M. K.; Puri, Pankaj; Nandi, Bhaskar; Brar, Karninder S.; Gundgurthi, Abhay; Pandit, Aditi

    2013-01-01

    Background: In recent times, there are reports of adrenal dysfunction in whole spectrum of liver disease. Adrenal insufficiency (AI) has been shown to correlate with progression of liver disease. Hence this study was conducted to assess adrenal function in subjects with acute liver disease (ALD), chronic liver disease (CLD) and post liver transplantation (LT). Material and Methods: This study included 25 healthy controls, 25 patients of ALD, 20 subjects of CLD with Child-Pugh stage A (CLD-1) and 30 with Child-Pugh stage B or C (CLD-2), and 10 subjects with LT. All subjects were assessed clinically, biochemically and for adrenal functions. Results: AI was present in 9 (34.6%) patients with ALD, 20 (40%) patients with CLD and 4 (40%) in subjects with LT. AI was more common in CLD-2 (18 patients – 60%) than CLD-1 (2 patients – 10%). All patients with chronic liver disease had significantly lower basal cortisol (8.8±4.8, P=0.01), stimulated cortisol (18.2±6.3, P <0.00001) and incremental cortisol (9.4±4.6, P <0.00001) as compared to controls. There was increase in percentage of subjects with adrenal dysfunction with progression of liver disease as assessed by Child-Pugh staging. AI was predicted by lower levels of serum protein, serum albumin, total cholesterol and HDL cholesterol and higher levels of serum bilirubin and INR. Adrenal functions showed recovery following liver transplantation. Conclusions: AI forms important part of spectrum of acute and chronic liver disease. Deterioration of synthetic functions of liver disease predicts presence of AI, and these patients should be evaluated for adrenal dysfunction periodically. PMID:23869304

  12. Uncertainty and the decision maker: assessing and managing the risk of undesirable outcomes.

    PubMed

    Gafni, Amiram; Walter, Stephen; Birch, Stephen

    2013-11-01

    We present an approach to rank order new programs in ways that accommodate uncertainty of different outcomes occurring, on the basis of the size and nature ('bad' or 'good') of those outcomes. This represents an improvement on the way uncertainty has been accommodated in existing approaches (e.g., threshold approach to cost-effectiveness analysis). We illustrate the approach using the decision making plane, which explicitly incorporates opportunity costs and relaxes the assumptions of perfect divisibility and constant returns to scale of the cost-effectiveness plane. The nature of the bad (or good) outcome is determined by the quadrant that it falls into (i.e., a 'quadrant effect') and its magnitude by its location within the quadrant (i.e., 'within quadrant effect'). By explicitly defining the loss function, the process of accepting (or rejecting) a new program becomes transparent. We illustrate the approach using a loss function and a net gain function. We show that by recognizing that, not all bad (or good) outcomes are equal and the choice of a loss or a net gain function can result in different ranking of resource allocation options. Further implications of the proposed approach are discussed. PMID:23280702

  13. Does percutaneous nephrolithotomy and its outcomes have an impact on renal function? Quantitative analysis using SPECT-CT DMSA.

    PubMed

    Pérez-Fentes, Daniel; Cortés, Julia; Gude, Francisco; García, Camilo; Ruibal, Alvaro; Aguiar, Pablo

    2014-10-01

    To assess the functional effects of percutaneous nephrolithotomy (PCNL) and its outcomes in the operated kidney, we prospectively studied 30 consecutive cases undergoing PCNL. Kidney function was evaluated preoperatively and 3 months after surgery with serum creatinine, glomerular filtration rate (GFR), and with (99m)Tc-DMSA SPECT-CT scans to determine the differential renal function (DRF). PCNL effects in the operated kidney DRF were considered globally (DRFPLANAR, DRFSPECT) and in the region of percutaneous access (DRFACCESS). PCNL functional impact was also assessed depending on its outcomes, namely success (stone-free status) and the development of perioperative complications. PCNL has rendered 73 % of the cases completely stone free with a 33 % complication rate. After PCNL, serum creatinine and GFR did not change significantly, whereas DRFPLANAR and DRFSPECT dropped 1.2 % (p = 0.014) and 1.0 % (p = 0.041), respectively. The highest decrease was observed in DRFACCESS (1.8 %, p = 0.012). Stone-free status after PCNL did not show any impact on kidney function. Conversely, cases that suffered from a complication showed impairment in serum creatinine (0.1 mg/dL, p = 0.028), in GFR (11.1 mL/min, p = 0.036) as well as in DRFPLANAR (2.7 %, p = 0.018), DRFSPECT (2.2 %, p = 0.023) and DRFACCESS (2.7 %, p = 0.049). We conclude that PCNL has a minimal impact on global kidney function, which is mainly located in the region of percutaneous access. The advent of perioperative complications increased PCNL functional damage, whereas the stone-free status did not show any meaningful effect. PMID:25074714

  14. Assessment of murine lung mechanics outcome measures: alignment with those made in asthmatics

    PubMed Central

    Walker, Julia K. L.; Kraft, Monica; Fisher, John T.

    2013-01-01

    Although asthma is characterized as an inflammatory disease, recent reports highlight the importance of pulmonary physiology outcome measures to the clinical assessment of asthma control and risk of asthma exacerbation. Murine models of allergic inflammatory airway disease have been widely used to gain mechanistic insight into the pathogenesis of asthma; however, several aspects of murine models could benefit from improvement. This review focuses on aligning lung mechanics measures made in mice with those made in humans, with an eye toward improving the translational utility of these measures. A brief description of techniques available to measure murine lung mechanics is provided along with a methodological consideration of their utilization. How murine lung mechanics outcome measures relate to pulmonary physiology measures conducted in humans is discussed and we recommend that, like human studies, outcome measures be standardized for murine models of asthma. PMID:23408785

  15. Functional outcome following colon interposition in total pharyngoesophagectomy with or without laryngectomy.

    PubMed

    Moerman, Mieke; Fahimi, Hossein; Ceelen, Wim; Pattyn, Piet; Vermeersch, Hubert

    2003-01-01

    Our study compares deglutition between a group who had undergone total esophagopharyngolaryngectomy and a group who had esophagectomy and partial pharyngectomy with preserved larynx, after reconstruction of the upper digestive tract with pedicled colon interposition. In four patients the laryngeal structures could be preserved (three caustic burns and one proximal esophageal tumor). Six patients underwent a total laryngopharyngectomy for large pharyngeal tumors. Swallowing was assessed by a questionnaire, clinical examination, and videofluoroscopy. All patients had normal intake of semisolid foods and fluids. All patients but three experienced some feeling of "narrowing" of the tract: four at the level of the hypopharynx, two at the oropharyngeal level, one at the oral level. In the laryngectomy group, solid food caused some degree of delayed swallowing in three patients. Dumping occurred in one case out of the nonlaryngectomy group. On clinical examination a tense motility in all laryngectomy patients appeared, food remnants in five and repeated swallowing movements in four. The videofluoroscopy confirmed repeated swallowing movements and presence of residual food in the oral cavity. Temporal stagnation occurred at the anastomosis site in all patients and in two patients at a place of colon redundancy. Colon interposition is a reliable reconstruction and gives the possibility of a good functional outcome. Although preservation of the larynx facilitates swallowing even in this reconstructive procedure, it may be better to perform a total laryngopharyngectomy and colon interposition in oncological cases where the pharyngeal remnant is borderline for primary closure. PMID:12825900

  16. Retrospective agreement and consent to neurocritical care is influenced by functional outcome

    PubMed Central

    2010-01-01

    Introduction Only limited data are available on consent and satisfaction of patients receiving specialized neurocritical care. In this study we (i) analyzed the extent of retrospective consent to neurocritical care--given by patients or their relatives--depending on functional outcome one year after hospital stay, and (ii) identified predisposing factors for retrospective agreement to neurocritical care. Methods We investigated 704 consecutive patients admitted to a nonsurgical neurocritical care unit over a period of 2 years (2006 through 2007). Demographic and clinical parameters were analyzed, and the patients were grouped according to their diagnosis. Functional outcome, retrospective consent to neurocritical care, and satisfaction with hospital stay was obtained by mailed standardized questionnaires. Logistic regression analyses were calculated to determine independent predictors for consent. Results High consent and satisfaction after neurointensive care (91% and 90%, respectively) was observed by those patients who reached an independent life one year after neurointensive care unit (ICU) stay. However, only 19% of surviving patients who were functionally dependent retrospectively agreed to neurocritical care. Unfavorable functional outcome and the diagnosis of stroke were independent predictors for missing retrospective consent. Conclusions Retrospective agreement to neurocritical care is influenced by functional outcome. Especially in severely affected stroke patients who cannot communicate their preferences regarding life-sustaining therapy, neurocritical care physicians should balance the expected burdens and benefits of treatment to meet the patients' putative wishes. Efforts should be undertaken to identify predictors for severe disability after neurocritical care. PMID:20673358

  17. Paper tools for assessing visual function.

    PubMed

    Powers, Maureen K

    2009-06-01

    Instruments for assessing visual function are valuable tools for optometry, ophthalmology, vision science, education, and public health. Inspired by my observations in the Teller lab, with Dobson, on the process of developing a useful clinical tool from laboratory work, I present four examples of functional vision tests that are made of paper and currently used in the field: the Amsler Grid, the Pelli-Robson Contrast Sensitivity Chart, the Teller Acuity Cards, and the Developmental Eye Movement Test. All are characterized by ease of use and rigorous design. All are either being used with children or have the potential to be so. Each tool is reviewed in terms of its development, with a view toward similarities in the steps or process taken. The goal is to encourage the further development of the functional vision assessments already in existence, and to urge scientists and clinicians alike to consider ways in which their own work can be translated into clinically useful, simple paper tools. PMID:19483511

  18. Evidence for the validity of grouped self-assessments in measuring the outcomes of educational programs.

    PubMed

    D'Eon, Marcel F; Trinder, Krista

    2014-12-01

    There is compelling empirical evidence in support of the use of grouped self-assessment data to measure program outcomes. However, other credible research has clearly shown that self-assessments are poor predictors of individual achievement such that the validity of self-assessments has been called into question. Based on the reanalysis of two previously published studies and an analysis of two original studies, we show that grouped self-assessments may be good predictors of and hence valid measures of performance at the group level, an outcome commonly used in program evaluation studies. We found statistically significant correlation coefficients (between 0.56 and 0.87), when comparing across performance items using the group means of self-assessments with the group means of individual achievement on criterion tests. We call for further research into the conditions and circumstances in which grouped self-assessments are used, so that they can be employed more effectively and confidently by program evaluators, decision makers, and researchers. PMID:23396128

  19. Risk Assessment of Adverse Birth Outcomes in Relation to Maternal Age

    PubMed Central

    Weng, Yi-Hao; Yang, Chun-Yuh; Chiu, Ya-Wen

    2014-01-01

    Background Although a number of studies have investigated correlations of maternal age with birth outcomes, an extensive assessment using age as a continuous variable is lacking. In the current study, we estimated age-specific risks of adverse birth outcomes in childbearing women. Method National population-based data containing maternal and neonatal information were derived from the Health Promotion Administration, Taiwan. A composite adverse birth outcome was defined as at least anyone of stillbirth, preterm birth, low birth weight, macrosomia, neonatal death, congenital anomaly, and small for gestational age (SGA). Singletons were further analyzed for outcomes of live birth in relation to each year of maternal age. A log-binomial model was used to adjust for possible confounders of maternal and neonatal factors. Results In total, 2,123,751 births between 2001 and 2010 were utilized in the analysis. The risk of a composite adverse birth outcome was significantly higher at extreme maternal ages. In specific, risks of stillbirth, neonatal death, preterm birth, congenital anomaly, and low birth weight were higher at the extremes of maternal age. Furthermore, risk of macrosomia rose proportionally with an increasing maternal age. In contrast, risk of SGA declined proportionally with an increasing maternal age. The log-binomial model showed greater risks at the maternal ages of <26 and > 30 years for a composite adverse birth outcome. Conclusions Infants born to teenagers and women at advanced age possess greater risks for stillbirth, preterm birth, neonatal death, congenital anomaly, and low birth weight. Pregnancies at advanced age carry an additional risk for macrosomia, while teenage pregnancies carry an additional risk for SGA. The data suggest that the optimal maternal ages to minimize adverse birth outcomes are 26?30 years. PMID:25494176

  20. Assessing health care needs and clinical outcome with urological case complexity: a study using INTERMED.

    PubMed

    Di Gangi Herms, Alida M R; Pinggera, Germar M; De Jonge, Peter; Strasser, Hannes; Söllner, Wolfgang

    2003-01-01

    Urinary tract symptoms and, particularly, urinary incontinence are often chronic and complex conditions that cause diagnosis, treatment, and management problems. In many cases, psychosocial factors contribute to the development of a chronic condition. The authors investigated whether INTERMED, an instrument for assessing case complexity and health care needs, was able to identify such complex cases, to estimate the amount of comorbidity, and to predict clinical outcome for 31 consecutive patients suffering from urinary tract symptoms. To assess clinical outcome, the authors used the American Urologic Association Symptom Score, the Brief Symptom Inventory, and the Hospital Anxiety and Depression Scale. On the basis of the patients' INTERMED scores, the authors distinguished between low-complexity patients (INTERMED score <21, N=25, 80.6%) and high-complexity patients (INTERMED score >or=21, N=6; 19.4%). Low-complexity patients had fewer depressive and anxiety symptoms, less distress, and better clinical outcome at their 3-month follow-up than high-complexity patients. The data confirmed the ability of the instrument to detect patients at risk of complex urinary tract symptoms and to predict clinical outcome. PMID:12724500

  1. Gait analysis at multiple speeds reveals differential functional and structural outcomes in response to graded spinal cord injury.

    PubMed

    Krizsan-Agbas, Dora; Winter, Michelle K; Eggimann, Linda S; Meriwether, Judith; Berman, Nancy E; Smith, Peter G; McCarson, Kenneth E

    2014-05-01

    Open-field behavioral scoring is widely used to assess spinal cord injury (SCI) outcomes, but has limited usefulness in describing subtle changes important for posture and locomotion. Additional quantitative methods are needed to increase the resolution of locomotor outcome assessment. This study used gait analysis at multiple speeds (GAMS) across a range of mild-to-severe intensities of thoracic SCI in the rat. Overall, Basso, Beattie, and Bresnahan (BBB) scores and subscores were assessed, and detailed automated gait analysis was performed at three fixed walking speeds (3.5, 6.0, and 8.5?cm/sec). Variability in hindpaw brake, propel, and stance times were analyzed further by integrating across the stance phase of stepping cycles. Myelin staining of spinal cord sections was used to quantify white matter loss at the injury site. Varied SCI intensity produced graded deficits in BBB score, BBB subscores, and spinal cord white matter and total volume loss. GAMS measures of posture revealed decreased paw area, increased limb extension, altered stance width, and decreased values for integrated brake, propel, and stance. Measures of coordination revealed increased stride frequency concomitant with decreased stride length, resulting in deviation from consistent forelimb/hindlimb coordination. Alterations in posture and coordination were correlated to impact severity. GAMS results correlated highly with functional and histological measures and revealed differential relationships between sets of GAMS dynamics and cord total volume loss versus epicenter myelin loss. Automated gait analysis at multiple speeds is therefore a useful tool for quantifying nuanced changes in gait as an extension of histological and observational methods in assessing SCI outcomes. PMID:24405378

  2. Functional Outcomes and Efficiency of Rehabilitation in a National Cohort of Patients with Guillain - Barré Syndrome and Other Inflammatory Polyneuropathies

    PubMed Central

    Alexandrescu, Roxana; Siegert, Richard John; Turner-Stokes, Lynne

    2014-01-01

    Objectives To describe functional outcomes, care needs and cost-efficiency of hospital rehabilitation for a UK cohort of inpatients with complex rehabilitation needs arising from inflammatory polyneuropathies. Subjects and Setting 186 patients consecutively admitted to specialist neurorehabilitation centres in England with Guillain-Barré Syndrome (n?=?118 (63.4%)) or other inflammatory polyneuropathies, including chronic inflammatory demyelinating polyneuropathy (n?=?15 (8.1%) or critical illness neuropathy (n?=?32 (17.2%)). Methods Cohort analysis of data from the UK Rehabilitation Outcomes Collaborative national clinical dataset. Outcome measures include the UK Functional Assessment Measure, Northwick Park Dependency Score (NPDS) and Care Needs Assessment (NPCNA). Patients were analysed in three groups of dependency based on their admission NPDS score: ‘low’ (NPDS<10), ‘medium’ (NPDS 10–24) and ‘high’ (NPDS ?25). Cost-efficiency was measured as the time taken to offset the cost of rehabilitation by savings in NPCNA-estimated costs of on-going care in the community. Results The mean rehabilitation length of stay was 72.2 (sd?=?66.6) days. Significant differences were seen between the diagnostic groups on admission, but all showed significant improvements between admission and discharge, in both motor and cognitive function (p<0.0001). Patients who were highly dependent on admission had the longest lengths of stay (mean 97.0 (SD 79.0) days), but also showed the greatest reduction in on-going care costs (£1049 per week (SD £994)), so that overall they were the most cost-efficient to treat. Conclusions Patients with polyneuropathies have both physical and cognitive disabilities that are amenable to change with rehabilitation, resulting in significant reduction in on-going care-costs, especially for highly dependent patients. PMID:25402491

  3. Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance

    Microsoft Academic Search

    Peter B. DeOreo

    1997-01-01

    We asked patients to assess their functional health status by completing the SF-36. Over 2 years, we studied 1,000 patients (average age, 58 years; 50% male; 25% white; 36% diabetic) in three outpatient, staff-assisted hemodialysis units. We used both the eight-scale scores and two-component summary scores to study the relationship between baseline functional health status and clinical outcomes. The physical

  4. Modern Control Systems in Electrical Engineering course assessment using the Outcome Based Education approach

    Microsoft Academic Search

    A. A. Ab Rahim; N. M. Thamrin; N. E. Abdullah; H. Hashim

    2010-01-01

    Ahstract-In the year 2004, Outcome-Based Education (OBE) has been adopted by the Engineering Accreditation Council (EAC) in accrediting Electrical Engineering Programmes for universities in Malaysia. To fulfill the requirement, Faculty of Electrical Engineering (FEE), Universiti Teknologi MARA (UiTM) has taken necessary steps to implement OBE in each programme offered. An OBE measurement tool known as Summative Assessment Dynamic Model with

  5. Using Qualitative Research to Inform the Development of a Comprehensive Outcomes Assessment for Asthma

    Microsoft Academic Search

    Diane M. Turner-Bowker; Renee N. Saris-Baglama; Michael A. DeRosa; Christine A. Paulsen; Christopher P. Bransfield

    2009-01-01

    Background: Qualitative research can inform the development of asthma patient-reported outcome (PRO) measures and user-friendly technologies through defining measurement constructs, identifying potential limitations in measurement and sources of response error, and evaluating usability. Abstract: Objective: To inform the development of a comprehensive asthma PRO assessment with input from patients and clinical experts. Abstract: Methods: Self-reported adult asthma patients recruited from

  6. Outcomes of a 5-day physiotherapy programme for functional (psychogenic) motor disorders.

    PubMed

    Nielsen, G; Ricciardi, L; Demartini, B; Hunter, R; Joyce, E; Edwards, M J

    2015-03-01

    Patients with functional motor disorder (FMD) are commonly seen by physiotherapists and there is growing evidence to support a physical rehabilitation approach. There are, however, few descriptions in the literature of the content of successful physiotherapy treatment. This prospective cohort study reports the practicalities and outcomes of a pilot 5-day physiotherapy programme. Patients were referred from a specialist movement disorders clinic. The treatment consisted of education and movement retraining, with a long-term self-management focus. Education and movement retraining was based on a pathophysiological model for FMD that stresses the importance of self-focussed attention and illness belief. Patients were assessed at baseline, end of treatment and 3-month follow-up. 47 patients completed the programme, mean symptom duration was 5.5 years, 64 % were unemployed due to ill health. At the end of treatment, 65 % rated their symptoms as "very much improved" or "much improved", this reduced to 55 % at 3 months. At follow-up, there was a significant improvement in physical domains of the SF-36, Berg Balance Scale and 10 Metre Timed Walk. Measures of mental health did not change. This prospective cohort study adds to the growing evidence that supports the use of specialist physiotherapy treatment for FMD. Improvements here were made despite the cohort having characteristics associated with poor prognosis. We argue that specific treatment techniques are important and have the potential to improve physical function, quality of life and may prove to be a cost-effective treatment for selected patients with FMD. PMID:25557282

  7. Complications and functional outcomes of restorative proctocolectomy for ulcerative colitis in the elderly

    PubMed Central

    2013-01-01

    Background Restorative proctocolectomy with ileopouch-anal anastomosis (IPAA) is the treatment of choice for intractable or complicated ulcerative colitis (UC). Debate exists concerning outcomes of IPAA in the elderly and literature data are scarce. We report our experience of IPAA in older population. Methods We gathered data on a prospective database of patients undergoing IPAA for UC over 70 years of age in our Unit from January 1990 through January 2010. Patients were compared with randomly selected younger controls on a 1:3 ratio. Patients underwent IPAA in 2 or 3 stages. Demographical data, disease characteristics, comorbidities, concomitant medications, peri-operative management, intra- and post-operative complications were analyzed. Function and quality of life were assessed by clinical visit and Inflammatory Bowel Disease Questionnaire 1 and 3 years after ileostomy takedown. Results Twenty-seven elderly patients underwent IPAA for UC in the study period; these were compared with 81 younger controls. The former had more comorbidities and higher ASA score. All patients underwent loop-ileostomy closure. There were no differences between groups concerning the rate of major complications, but elderly patients more frequently had nuisances due to stoma output. Younger patients experienced significantly more episodes of small bowel obstruction. No significant differences in bowel control and health-related quality of life was observed, except for an higher rate of elderly patients taking antidiarrhoeals at 1-year follow-up; this observation was not confirmed at 3-year follow-up. A minimal decrease in continence was observed, but this did not affect overall satisfaction. Conclusions IPAA can be safely offered to selected elderly UC patients who are strongly motivated and with no clinical disturbances of continence. In experienced hands no differences are likely to be expected concerning complications, quality of life and function. Results are stable with time and comparable to those of younger patients. PMID:24267006

  8. Anterior Temporal Lobe Connectivity Correlates with Functional Outcome after Aphasic Stroke

    ERIC Educational Resources Information Center

    Warren, Jane E.; Crinion, Jennifer T.; Ralph, Matthew A. Lambon; Wise, Richard J. S.

    2009-01-01

    Focal brain lesions are assumed to produce language deficits by two basic mechanisms: local cortical dysfunction at the lesion site, and remote cortical dysfunction due to disruption of the transfer and integration of information between connected brain regions. However, functional imaging studies investigating language outcome after aphasic…

  9. Level of kidney function as a risk factor for atherosclerotic cardiovascular outcomes in the community

    Microsoft Academic Search

    Guruprasad Manjunath; Hocine Tighiouart; Hassan Ibrahim; Bonnie MacLeod; Deeb N Salem; John L Griffith; Josef Coresh; Andrew S Levey; Mark J Sarnak

    2003-01-01

    ObjectivesThe goal of this study was to determine whether the level of kidney function is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) outcomes in the Atherosclerosis Risk in Communities (ARIC) study, a prospective cohort study of subjects aged 45 to 64 years.

  10. Functional Outcome Analysis: A Good Heuristic That Went a Bridge Too Far.

    ERIC Educational Resources Information Center

    Barnett, David; Lentz, Francis E., Jr.

    1993-01-01

    Responds to previous article (Noell and Gresham, this issue) on Functional Outcome Analysis (FOA) as important construct for evaluation of consultation and prereferral interventions. Sees core question being utility of most prominent alternative service delivery model for school psychologists, that of prereferral interventions/problem-solving…

  11. The impact of physical therapy on functional outcomes after stroke: what's the evidence?

    Microsoft Academic Search

    R PS Van Peppen; G Kwakkel; S Wood-Dauphinee; H JM Hendriks; Ph J Van der Wees; J Dekker

    2004-01-01

    Objective: To determine the evidence for physical therapy interventions aimed at improving functional outcome after stroke.Methods: MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, DARE, PEDro, EMBASE and DocOnline were searched for controlled studies. Physical therapy was divided into 10 intervention categories, which were analysed separately. If statistical pooling (weighted summary effect sizes) was not

  12. Effects of a summer treatment program on functional sports outcomes in young children with ADHD

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Participation in youth sports can be very beneficial, but children with Attention Deficit Hyperactivity Disorder (ADHD) may participate less often and less successfully. The current study evaluated functional sports outcomes for children with ADHD who attended an intensive behavioral treatment that...

  13. Functional Outcomes of Child and Adolescent Oppositional Defiant Disorder Symptoms in Young Adult Men

    ERIC Educational Resources Information Center

    Burke, Jeffrey D.; Rowe, Richard; Boylan, Khrista

    2014-01-01

    Background: Oppositional defiant disorder (ODD) is considered to be a disorder of childhood, yet evidence suggests that prevalence rates of the disorder are stable into late adolescence and trajectories of symptoms persist into young adulthood. Functional outcomes associated with ODD through childhood and adolescence include conflict within…

  14. Patterns in Cortical Connectivity for Determining Outcomes in Hand Function after Subcortical Stroke

    E-print Network

    recovery. Moreover, subgroups of stroke patients with different outcomes in hand function have rarely been studied. Materials and Methods: We selected 24 patients who had a subcortical stroke in the left motor. Although a full recovery may occur after a stroke, more than 50% of the patients are left with residual

  15. The online measurement of hemodialysis dose (Kt): Clinical outcome as a function of body surface area

    Microsoft Academic Search

    Edmund G. Lowrie; ZHENSHENG LI; NORMA OFSTHUN; J. Michael Lazarus

    2005-01-01

    The online measurement of hemodialysis dose (Kt): Clinical outcome as a function of body surface area.BackgroundRecent advances enable the direct measurement of small molecule clearance, Kecn, during each dialysis. Average Kecn and treatment length, t, are multiplied giving total clearance, Kt. The body surface area (BSA) is a fixed transformation of height and weight and is a well recognized measure

  16. Health, Functioning, and Participation of Adolescents and Adults with Cerebral Palsy: A Review of Outcomes Research

    ERIC Educational Resources Information Center

    Frisch, Dana; Msall, Michael E.

    2013-01-01

    With medical advances, more individuals with cerebral palsy (CP) syndromes who reside in developed countries are surviving to adolescence and adulthood. However, there continues to be a paucity of research examining long-term health, functional activities, and participatory outcomes over their life-course. This article reviews the current…

  17. Mid-term functional outcome after the internal fixation of distal radius fractures

    E-print Network

    Phadnis, Joideep; Trompeter, Alex; Gallagher, Kieran; Bradshaw, Lucy; Elliott, David S; Newman, Kevin J

    2012-01-26

    locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to report the functional outcome of a large number of patients at a significant follow up time after fixation of their distal radius...

  18. Prognosis and outcome in a cohort of patients with non-affective functional psychosis

    Microsoft Academic Search

    Robert Giel; Durk Wiersmal; Peter A. de Jong; Cees Slooff

    1984-01-01

    Summary Over a period of 3 years since the first in a lifetime onset of an episode of non-affective functional psychosis a cohort of 82 Dutch patients was studied at set intervals with regard to prognosis and outcome. Prognostic statements on remission, relapse, duration of episode, length of stay in hospital, and occupational, family and overall social adjustment were checked

  19. Does Surgical Management of the Hand in Children with Spastic Unilateral Cerebral Palsy Affect Functional Outcome?

    ERIC Educational Resources Information Center

    van Munster, Judith C.; Maathuis, Karel G. B.; Haga, Nienke; Verheij, Nienke P.; Nicolai, Jean-Philippe A.; Hadders-Algra, Mijna

    2007-01-01

    The aim of this review was to examine the literature on the effects of surgery of the spastic hand in children with cerebral palsy on functional outcome and muscle coordination. We performed a search of the relevant literature in Medline, Embase, and Biological Abstracts from 1966 to June 2006. The search resulted in eight studies on the effect of…

  20. Evaluating social outcomes of HIV/AIDS interventions: a critical assessment of contemporary indicator frameworks

    PubMed Central

    Mannell, Jenevieve; Cornish, Flora; Russell, Jill

    2014-01-01

    Introduction Contemporary HIV-related theory and policy emphasize the importance of addressing the social drivers of HIV risk and vulnerability for a long-term response. Consequently, increasing attention is being given to social and structural interventions, and to social outcomes of HIV interventions. Appropriate indicators for social outcomes are needed in order to institutionalize the commitment to addressing social outcomes. This paper critically assesses the current state of social indicators within international HIV/AIDS monitoring and evaluation frameworks. Methods We analyzed the indicator frameworks of six international organizations involved in efforts to improve and synchronize the monitoring and evaluation of the HIV/AIDS response. Our analysis classifies the 328 unique indicators according to what they measure and assesses the degree to which they offer comprehensive measurement across three dimensions: domains of the social context, levels of change and organizational capacity. Results and discussion The majority of indicators focus on individual-level (clinical and behavioural) interventions and outcomes, neglecting structural interventions, community interventions and social outcomes (e.g. stigma reduction; community capacity building; policy-maker sensitization). The main tool used to address social aspects of HIV/AIDS is the disaggregation of data by social group. This raises three main limitations. Indicator frameworks do not provide comprehensive coverage of the diverse social drivers of the epidemic, particularly neglecting criminalization, stigma, discrimination and gender norms. There is a dearth of indicators for evaluating the social impacts of HIV interventions. Indicators of organizational capacity focus on capacity to effectively deliver and manage clinical services, neglecting capacity to respond appropriately and sustainably to complex social contexts. Conclusions Current indicator frameworks cannot adequately assess the social outcomes of HIV interventions. This limits knowledge about social drivers and inhibits the institutionalization of social approaches within the HIV/AIDS response. We conclude that indicator frameworks should expand to offer a more comprehensive range of social indicators for monitoring and evaluation and to include indicators of organizational capacity to tackle social drivers. While such expansion poses challenges for standardization and coordination, we argue that the complexity of interventions producing social outcomes necessitates capacity for flexibility and local tailoring in monitoring and evaluation. PMID:25160645

  1. Methodological aspects in the assessment of treatment effects in observational health outcomes studies.

    PubMed

    Haro, Josep Maria; Kontodimas, Stathis; Negrin, Miguel Angel; Ratcliffe, Mark; Suarez, David; Windmeijer, Frank

    2006-01-01

    Prospective observational studies, which provide information on the effectiveness of interventions in natural settings, may complement results from randomised clinical trials in the evaluation of health technologies. However, observational studies are subject to a number of potential methodological weaknesses, mainly selection and observer bias. This paper reviews and applies various methods to control for selection bias in the estimation of treatment effects and proposes novel ways to assess the presence of observer bias. We also address the issues of estimation and inference in a multilevel setting. We describe and compare the use of regression methods, propensity score matching, fixed-effects models incorporating investigator characteristics, and a multilevel, hierarchical model using Bayesian estimation techniques in the control of selection bias. We also propose to assess the existence of observer bias in observational studies by comparing patient- and investigator-reported outcomes. To illustrate these methods, we have used data from the SOHO (Schizophrenia Outpatient Health Outcomes) study, a large, prospective, observational study of health outcomes associated with the treatment of schizophrenia. The methods used to adjust for differences between treatment groups that could cause selection bias yielded comparable results, reinforcing the validity of the findings. Also, the assessment of observer bias did not show that it existed in the SOHO study. Observational studies, when properly conducted and when using adequate statistical methods, can provide valid information on the evaluation of health technologies. PMID:16774289

  2. Programmatic Curricular Outcomes Assessment at Colleges and Schools of Pharmacy in the United States and Puerto Rico

    PubMed Central

    Kirschenbaum, Harold L.; Brown, Martin E.; Kalis, Michelle M.

    2006-01-01

    Objectives To categorize the manner in which programmatic curricular outcomes assessment is accomplished, identify the types of assessment methodologies used, and identify the persons or groups responsible for assessment. Methods A self-administered questionnaire was mailed to 89 institutions throughout the United States and Puerto Rico. Results Sixty-eight of 89 surveys (76%) were returned. Forty-one respondents (60%) had a written and approved plan for programmatic curricular outcomes assessment, 18% assessed the entire curriculum, and 57% had partial activities in place. Various standardized and institution-specific assessment instruments were employed. Institutions differed as to whether an individual or a committee had overall responsibility for assessment. Conclusion To move the assessment process forward, each college and school should identify a person or group to lead the effort. Additional validated assessment instruments might aid programmatic assessment. Future studies should identify the reasons for selecting certain assessment instruments and should attempt to identify the most useful ones. PMID:17136151

  3. Cardiac Function and Outcome in Patients with Cardio-Embolic Stroke

    PubMed Central

    Byun, Jung-Ick; Jung, Keun-Hwa; Kim, Young-Dae; Kim, Jeong-Min; Roh, Jae-Kyu

    2014-01-01

    Background The relationship between whole spectrum of Ejection fraction (EF) and cardioembolic stroke (CES) outcome has not been fully described yet. Notably, it remains unclear whether borderline EF (41?49%) is related with poor outcome after CES. We sought to evaluate whether lower ejection fraction and borderline EF could predict the outcome in patients with CES. Method and Results We evaluated the relationship between EF and functional outcome in 437 consecutive patients with CES. EF was introduced as continuous and categorical (EF?40%, EF 41?49%, EF?50%) variable. Patients with CES and the subgroup with AF were evaluated separately. Poor short-term outcome (modified Rankin Score?3at discharge or death within 90 days after stroke onset) and long-term mortality were evaluated. A total of 165 patients (37.8%) had poor short-term outcomes. EF tends to be lower in patients with poor short-term outcome (56.8±11.0 vs. 54.8±12.0, p-value 0.086). Overall cumulative death was136 (31.1%) in all CES patients and 106 (31.7%) in the AF subgroup. In a multivariable model adjusted for possible covariates, the hazard ratio for mortality significantly decreased by 3% for every 1% increase in ejection fraction in CES patients and 2% for every 1% increase in the AF subgroup. Reduced EF (EF?40%) showed higher mortality (HR 2.61), and those with borderline EF (41?49%) had a tendency of higher mortality (HR 1.65, p-value 0.067)compared with those with normal EF. Conclusion We found a strong association between lower EF and CES outcome. Echocardiographic evaluation helps to better determine the prognosis in CES patients, even in subgroup of patients with AF. PMID:24760037

  4. Developing an assessment tool for intended learning outcomes in clinical practice for nursing students.

    PubMed

    Ulfvarson, Johanna; Oxelmark, Lena

    2012-08-01

    This report describes the development of a new criterion based reference tool to assess nursing knowledge and competence in clinical practice. Nursing education has changed from educating a profession, based on tested experience, to being based on a scientific approach and research based knowledge. Assessment should be capable of measuring whether intended learning outcomes have been reached or not, and if the aims of a course have been fulfilled in order to ensure safe and competent nursing care. The intended learning outcomes from a first year course syllabus were integrated and formed into a three-graded criterion-referenced assessment tool, Assessment of Clinical Education, (AClEd). The AClEd is to be seen as a template, and may be tailor-made in accordance to the objectives, level and criteria of a specific course. The tool showed validity in assessing nursing skills not only the nursing student's ability to perform a task but also, most importantly, the quality of nursing care. PMID:22051102

  5. Correlates of subjective and functional outcomes in outpatient clinic attendees with schizophrenia and schizoaffective disorder

    Microsoft Academic Search

    Alex Hofer; Maria A. Rettenbacher; Christian G. Widschwendter; Georg Kemmler; Martina Hummer; W. Wolfgang Fleischhacker

    2006-01-01

    Outcome in schizophrenia is multidimensional and, thus, consists of clinical,humanitarian, rehabilitative and cost domains.\\u000a Accordingly, recovery is conceptualized as the ability to function in the community, socially and vocationally, as well as\\u000a being relatively free of disease–related psychopathology. The present cross–sectional study examined the relationship of premorbid\\u000a functioning, psychopathology, insight, attitudes toward medication and side–effects, as well as sociodemographic factors

  6. Coronary microvascular dysfunction: mechanisms and functional assessment.

    PubMed

    Camici, Paolo G; d'Amati, Giulia; Rimoldi, Ornella

    2015-01-01

    Obstructive disease of the epicardial coronary arteries was recognized as the cause of angina pectoris >2 centuries ago, and sudden thrombotic occlusion of an epicardial coronary artery has been established as the cause of acute myocardial infarction for >100 years. In the past 2 decades, dysfunction of the coronary microvasculature emerged as an additional mechanism of myocardial ischaemia that bears important prognostic implications. The coronary microvasculature (vessels <300 ?m in diameter) cannot be directly imaged in vivo, but a number of invasive and noninvasive techniques, each with relative advantages and pitfalls, can be used to assess parameters that depend directly on coronary microvascular function. These methods include invasive or noninvasive measurement of Doppler-derived coronary blood flow velocity reserve, assessment of myocardial blood flow and flow reserve using noninvasive imaging, and calculation of microcirculatory resistance indexes during coronary catheterization. These advanced techniques for assessment of the coronary microvasculature have provided novel insights into the pathophysiological role of coronary microvascular dysfunction in the development of myocardial ischaemia in different clinical conditions. PMID:25311229

  7. In Support of Prior Learning Assessment and Outcomes Assessment of Prior Learning Assessment Programs. Proceedings of the National Institute on the Assessment of Experiential Learning (Princeton, New Jersey, June 12-15, 1993).

    ERIC Educational Resources Information Center

    Dagavarian, Debra A., Ed.

    This publication contains two papers from the 1993 National Institute on the Assessment of Experiential Learning. "In Support of Prior Learning Assessment" (Rebecca C. Hull) highlights arguments in opposition to the acceptance of prior learning assessment and the responses that might best counter these arguments. "Outcomes Assessment of Prior…

  8. MRI Default Mode Network Connectivity is Associated with Functional Outcome after Cardiopulmonary Arrest

    PubMed Central

    Koenig, Matthew A.; Holt, John L.; Ernst, Thomas; Buchthal, Steven D.; Nakagawa, Kazuma; Stenger, Victor A.; Chang, Linda

    2014-01-01

    Introduction We hypothesized that the degree of preserved functional connectivity within the DMN during the first week after cardiopulmonary arrest (CPA) would be associated with functional outcome at hospital discharge. Methods Initially comatose CPA survivors with indeterminate prognosis at 72 hours were enrolled. Seventeen CPA subjects between 4–7 days after CPA and 17 matched controls were studied with task-free fMRI. Independent component analysis was performed to delineate the DMN. Connectivity strength in the DMN was compared between CPA subjects and controls, as well as between CPA subjects with good outcome (discharge Cerebral Performance Category or CPC 1–2) and those with bad outcome (CPC 3–5). The relationship between connectivity strength in the posterior cingulate cortex (PCC) and precuneus (PC) within the DMN with discharge CPC was evaluated using linear regression. Results Compared to controls, CPA subjects had significantly lower connectivity strength in subregions of the DMN, the PCC and PC (p <0.0001). Furthermore, connectivity strength in the PCC and PC was greater in CPA subjects with good outcome (n=8) than those with bad outcome (n=9) (p <0.003). Among CPA subjects, the connectivity strength in the PCC and PC showed strong linear correlations with the discharge CPC (p <0.005). Conclusion Among initially comatose CPA survivors with indeterminate prognosis, task-free fMRI demonstrated graded disruption of DMN connectivity, especially in those with bad outcomes. If confirmed, connectivity strength in the PC/PCC may provide a clinically useful prognostic marker for functional recovery after CPA. PMID:24464830

  9. The Promise of mHealth: Daily Activity Monitoring and Outcome Assessments by Wearable Sensors

    PubMed Central

    Dobkin, Bruce H.; Dorsch, Andrew

    2014-01-01

    Mobile health tools that enable clinicians and researchers to monitor the type, quantity, and quality of everyday activities of patients and trial participants have long been needed to improve daily care, design more clinically meaningful randomized trials of interventions, and establish cost-effective, evidence-based practices. Inexpensive, unobtrusive wireless sensors, including accelerometers, gyroscopes, and pressure-sensitive textiles, combined with Internet-based communications and machine-learning algorithms trained to recognize upper- and lower-extremity movements, have begun to fulfill this need. Continuous data from ankle triaxial accelerometers, for example, can be transmitted from the home and community via WiFi or a smartphone to a remote data analysis server. Reports can include the walking speed and duration of every bout of ambulation, spatiotemporal symmetries between the legs, and the type, duration, and energy used during exercise. For daily care, this readily accessible flow of real-world information allows clinicians to monitor the amount and quality of exercise for risk factor management and compliance in the practice of skills. Feedback may motivate better self-management as well as serve home-based rehabilitation efforts. Monitoring patients with chronic diseases and after hospitalization or the start of new medications for a decline in daily activity may help detect medical complications before rehospitalization becomes necessary. For clinical trials, repeated laboratory-quality assessments of key activities in the community, rather than by clinic testing, self-report, and ordinal scales, may reduce the cost and burden of travel, improve recruitment and retention, and capture more reliable, valid, and responsive ratio-scaled outcome measures that are not mere surrogates for changes in daily impairment, disability, and functioning. PMID:21989632

  10. The promise of mHealth: daily activity monitoring and outcome assessments by wearable sensors.

    PubMed

    Dobkin, Bruce H; Dorsch, Andrew

    2011-01-01

    Mobile health tools that enable clinicians and researchers to monitor the type, quantity, and quality of everyday activities of patients and trial participants have long been needed to improve daily care, design more clinically meaningful randomized trials of interventions, and establish cost-effective, evidence-based practices. Inexpensive, unobtrusive wireless sensors, including accelerometers, gyroscopes, and pressure-sensitive textiles, combined with Internet-based communications and machine-learning algorithms trained to recognize upper- and lower-extremity movements, have begun to fulfill this need. Continuous data from ankle triaxial accelerometers, for example, can be transmitted from the home and community via WiFi or a smartphone to a remote data analysis server. Reports can include the walking speed and duration of every bout of ambulation, spatiotemporal symmetries between the legs, and the type, duration, and energy used during exercise. For daily care, this readily accessible flow of real-world information allows clinicians to monitor the amount and quality of exercise for risk factor management and compliance in the practice of skills. Feedback may motivate better self-management as well as serve home-based rehabilitation efforts. Monitoring patients with chronic diseases and after hospitalization or the start of new medications for a decline in daily activity may help detect medical complications before rehospitalization becomes necessary. For clinical trials, repeated laboratory-quality assessments of key activities in the community, rather than by clinic testing, self-report, and ordinal scales, may reduce the cost and burden of travel, improve recruitment and retention, and capture more reliable, valid, and responsive ratio-scaled outcome measures that are not mere surrogates for changes in daily impairment, disability, and functioning. PMID:21989632

  11. URSSA, the Undergraduate Research Student Self-Assessment: A Tool for Assessing Student Outcomes of Undergraduate Research

    NASA Astrophysics Data System (ADS)

    Laursen, S. L.; Hunter, A.; Weston, T.; Thiry, H.

    2009-12-01

    Evidence-based thinking is essential both to science and to the development of effective educational programs. Thus assessment of student learning—gathering evidence about the nature and depth of students’ learning gains, and about how they arise—is a centerpiece of any effective undergraduate research (UR) program. Assessment data can be used to monitor progress, to diagnose problems, to strengthen program designs, and to report both good outcomes and strategies to improve them to institutional and financial stakeholders in UR programs. While the positive impact of UR on students’ educational, personal and professional development has long been a matter of faith, only recently have researchers and evaluators developed an empirical basis by which to identify and explain these outcomes. Based on this growing body of evidence, URSSA, the Undergraduate Research Student Self-Assessment, is a survey tool that departments and programs can use to assess student outcomes of UR. URSSA focuses on what students learn from their UR experience, rather than whether they liked it. Both multiple-choice and open-ended items focus on students’ gains from UR, including: (1) skills such as lab work and communication; (2) conceptual knowledge and linkages among ideas in their field and with other fields; (3) deepened understanding of the intellectual and practical work of science; (4) growth in confidence and adoption of the identity of scientist; (5) preparation for a career or graduate school in science; and (6) greater clarity in understanding what career or educational path they might wish to pursue. Other items probe students’ participation in important activities that have been shown to lead to these gains; and a set of optional items can be included to probe specific program features that may supplement UR (e.g. field trips, career seminars, housing arrangements). The poster will describe URSSA's content, development, validation, and use. For more information about URSSA and how to use it, visit our web site.

  12. Functional assessment of communication: Merging public policy with clinical views

    Microsoft Academic Search

    Carol M. Frattali

    1992-01-01

    Functional assessment—the measurement of an individual's ability to perforni daily life activities despite disease, disorder, or impairment-is becoming a vital supplement to traditional clinical assessment batteries in rehabilitation. From a clinical perspective, functional assessment seems to bridge the gap between identifying specific behaviours, and evaluating how those behaviours affect an individual's ability to function in natural contexts (Holland 1980; Sarno

  13. Assessment of cardiovascular function by digital angiocardiography.

    PubMed

    Heintzen, P H; Bürsch, H J; Hahne, H J; Brennecke, R; Budach, W; Lange, P

    1985-01-01

    A methodology for computerized digital videoangiocardiography is briefly described. Single or biplane projection image series from the cardiovascular system are combined with the corresponding physiologic (electrocardiogram, blood pressure, etc.) reference data, digitized and stored as a block of simultaneously available information representing anatomic and functional aspects of the cardiovascular system. Simple mask mode and more complex modes of digital subtraction, image combination and manipulation techniques, as developed during the last decade, are mentioned. These techniques are primarily useful to separate the contrast bolus from the background, thereby allowing contrast enhancement with less contrast medium injected selectively, or so-called noninvasive intravenous angiocardiography. Ventricular function can be assessed by these simple digital image processing techniques. This has been proved for determining right ventricular volumes and ejection fraction with respect to reproducibility and accuracy using conventional biplane angiocardiography as reference. More complex techniques for the assessment of function, in particular blood flow distributions in the systemic circulation, are described using information from the whole digitized angiocardiographic image series by extracting time and volume parameters from the complete matrix of pixel densograms. Various modes of extraction and display of time parameters allow a generation of parametric images that display heretofore unavailable flow patterns reflecting the progress of the contrast bolus within the arterial tree. Based on an adequate temporal segmentation (for example, time segments of one cardiac cycle) and simultaneous volume determination of the circulatory structure from the area of the densogram, relative and absolute flow as well as regional flow distribution in a branching arterial system can be determined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3965530

  14. The Incremental Value of Self-Reported Mental Health Measures in Predicting Functional Outcomes of Veterans

    Microsoft Academic Search

    Susan V. Eisen; Kathryn A. Bottonari; Mark E. Glickman; Avron Spiro; Mark R. Schultz; Lawrence Herz; Robert Rosenheck; Ethan S. Rofman

    2011-01-01

    Research on patient-centered care supports use of patient\\/consumer self-report measures in monitoring health outcomes. This\\u000a study examined the incremental value of self-report mental health measures relative to a clinician-rated measure in predicting\\u000a functional outcomes among mental health service recipients. Participants (n?=?446) completed the Behavior and Symptom Identification Scale, the Brief Symptom Inventory, and the Veterans\\/Rand Short\\u000a Form-36 at enrollment in

  15. Usefulness of induced sputum eosinophil count to assess severity and treatment outcome in asthma patients

    PubMed Central

    Bandyopadhyay, Ankan; Roy, Partha P.; Saha, Kaushik; Chakraborty, Semanti; Jash, Debraj; Saha, Debabrata

    2013-01-01

    Context: Currently treatment decisions in asthma are governed by clinical assessment and spirometry. Sputum eosinophil, being a marker of airway inflammation, can serve as a tool for assessing severity and response to treatment in asthma patients. Aims: To establish correlation between change in sputum eosinophil count and forced expiratory volume in one second (FEV1)% predicted value of asthma patients in response to treatment. In this study, we also predicted prognosis and treatment outcome of asthma patients from baseline sputum eosinophil count. Settings and Design: A longitudinal study was conducted to determine the treatment outcome among newly diagnosed asthma patients who were classified into A (n = 80) and B (n = 80) groups on the basis of initial sputum eosinophil count (A ? 3% and B < 3%). Materials and Methods: After starting treatment according to Global Initiative for Asthma Guideline, both A and B groups were evaluated every 15 days interval for the 1st month and monthly thereafter for a total duration of 12 months. In each follow-up visit detailed history, induced sputum eosinophil count and spirometry were done to evaluate severity and treatment outcome. Results: FEV1% predicted of group A asthma patients gradually increased and sputum eosinophil count gradually decreased on treatment. Longer time was required to achieve satisfactory improvement (FEV1% predicted) in asthma patients with sputum eosinophil count ?3%. There was statistically significant negative correlation between FEV1% predicted and sputum eosinophil count (%) in of group A patients in each follow-up visit, with most significant negative correlation found in 8th visit (r = ?0.9237 and P = < 0.001). Change in mean FEV1% (predicted) from baseline showed strong positive correlation (r = 0.976) with change in reduction of mean sputum eosinophil count at each follow-up visits in group A patients. Conclusions: Sputum eosinophil count, being an excellent biomarker of airway inflammation, can serve as a useful marker to assess disease severity, treatment outcome, and prognosis in asthma patients. PMID:23741092

  16. Management and functional outcome of intramedullary spinal cord tumors: A prospective clinical study

    PubMed Central

    Kumar, Raj; Banerjee, Sumit

    2014-01-01

    Aim: Intramedullary spinal cord tumors (IMSCT) are rare neoplasms of central nervous system but require proper evaluation and management to ensure a good outcome. This study was carried out to evaluate the functional outcome of IMSCT following surgery and to decipher the factors affecting optimal outcome of these cases. Materials and Methods: A prospective clinical study was carried out at a tertiary care center from 2003 to 2012. Forty three patients with intramedullary tumors diagnosed on magnetic resonance imaging were included. Their clinical details, neurological findings and demographic data were recorded. The patients were then subjected to surgery and adjuvant radiotherapy. The patients were followedup clinically and radiologically, and all parameters examined and recorded. Results: Sensory and motor impairment was present preoperatively in majority of patients (n = 39 and n = 38, 90.7% and 88.4%, respectively). Gross total excision was performed in 30 cases (69.76%). The most common histological diagnosis was ependymoma (n = 21, 48.8%). Postoperatively 32 patients (74.4%) were in McCormick functional Grade I or II improving from 13 cases (30.2%) in Grade I or II preoperatively. Fifteen of 17 patients in Medical Research Council (MRC) Grade III and 10 out of 12 patients in Grade MRC IV improved. No mortality was recorded during the entire period of follow-up (mean: 22, range: 3-96 months). Eight patients (18.6%) had recurrence till the last follow-up visit. Conclusions: Preoperative neurological grade was the most important predictor of functional outcome. Gross tumor excision was the best surgical modality to improve event free survival. High-grade tumors had higher rates of recurrence but no effect on functional outcome. PMID:25685212

  17. Functional outcomes in children with abusive head trauma receiving inpatient rehabilitation compared with children with non-abusive head trauma

    PubMed Central

    Risen, Sarah R; Suskauer, Stacy J; DeMatt, Ellen J; Slomine, Beth S; Salorio, Cynthia F

    2013-01-01

    Objective To compare clinical features and functional outcomes of age and sex matched children with abusive and non-abusive head trauma receiving inpatient rehabilitation. Study design Children with abusive head trauma (n = 28) and age, sex matched children with non-abusive head trauma (n = 20) admitted to one inpatient pediatric rehabilitation unit from 1995–2012 were studied. Acute hospitalization and inpatient rehabilitation records were retrospectively reviewed for pertinent clinical data: initial GCS score, signs of increased intracranial pressure, neuroimaging findings, and presence of associated injuries. Functional status at admission to and discharge from inpatient rehabilitation was assessed using the Functional Independence Measure for Children (WeeFIM). Outcome at discharge and outpatient follow-up was described based on attainment of independent ambulation and expressive language. Results Children with abusive and non-abusive head trauma had similar levels of injury severity although associated injuries were greater in abusive head trauma. Functional impairment upon admission to inpatient rehabilitation was comparable and functional gains during inpatient rehabilitation were similar between groups. More children with non-abusive than abusive head trauma attained independent ambulation and expressive language after discharge from rehabilitation; the difference was no longer significant when only children greater than 12 months of age at injury were examined. There was variability in delay to obtain these skills and quality of gained skills in both groups. Conclusions Despite more associated injuries, children with abusive head trauma make significant functional gains during inpatient rehabilitation comparable with an age and sex matched sample with non-abusive head trauma. Key functional skills may be gained by children in both groups following discharge from inpatient rehabilitation. PMID:24321537

  18. Assessing Outcomes and Perceived Benefits of a Professional Development Seminar Series

    PubMed Central

    Zueger, Patrick M.; Katz, Norman L.

    2014-01-01

    Objective. To evaluate the outcomes of alumni who were enrolled in a professional development seminar series during their doctor of pharmacy program. Design. A weekly development seminar series was administered over 5 semesters with the goal of bringing academic advisees together to help develop performance-based abilities, prepare them for entry into the profession after graduation, and provide exposure to different career opportunities. Assessment. A survey instrument containing 39 Likert-type scale items, 2 open-ended questions, and a 10-item demographic survey was created and content-validated to assess the effect of the seminar series on alumni advisees’ perceived outcomes and professional development since their graduation. The survey was electronically forwarded to advisees from the graduating classes of 2005 to 2012, and response data was collected with Qualtrics, a web-based survey service. A total of 36 percent of alumni responded to the survey. Respondents cited exposure to career alternatives and opportunities, development of presentation and communication skills, networking, and the importance of advisor/mentor relationships as benefits of the seminar series. Conclusion. The professional development seminar series has demonstrated a positive impact on alumni advisees’ career development and professional outcomes, most notably relating to career path exposure, communication skills, and advisor/mentor relationships. PMID:25386015

  19. Outcome Based Education Performance Measurement: A Rasch-based Longitudinal Assessment Model to measure Information Management Courses LO's

    Microsoft Academic Search

    AZLINAH MOHAMED; ISO QMS

    Malaysia Qualification Framework, 2005 (MQF) promotes outcome based education (OBE) learning process. OBE calls for the evaluation of the course's Learning Outcomes (CLO) as specified in the Program Specification. This good practice is implemented in the Faculty of Information Technology and Quantitative Science, Universiti Teknologi MARA (FTMSK) teaching and learning processes which was duly certified to ISO 9001:2000. Assessment methods

  20. Clinical outcomes and safety assessment in elderly patients undergoing decompressive laminectomy for lumbar spinal stenosis: a prospective study

    Microsoft Academic Search

    Asgeir S Jakola; Andreas Sørlie; Sasha Gulati; Øystein P Nygaard; Stian Lydersen; Tore Solberg

    2010-01-01

    BACKGROUND: To assess safety, risk factors and clinical outcomes in elderly patients with spinal stenosis after decompressive laminectomy. METHODS: A prospective cohort of patients 70 years and older with spinal stenosis undergoing conventional laminectomy without fusion (n = 101) were consecutively enrolled from regular clinical practice and reassessed at 3 and 12 months. Primary outcome was change in health related

  1. Respondent-driven sampling to assess outcomes of sexual violence: a methodological assessment.

    PubMed

    Greiner, Ashley L; Albutt, Katherine; Rouhani, Shada A; Scott, Jennifer; Dombrowski, Kirk; VanRooyen, Michael J; Bartels, Susan A

    2014-09-01

    Sexual violence is pervasive in eastern Democratic Republic of Congo (DRC). Survivors of sexual violence encounter numerous challenges, and women with a sexual violence-related pregnancy (SVRP) face even more complex sequelae. Because of the stigma associated with SVRP, there is no conventional sampling frame and, therefore, a paucity of research on SVRP outcomes. Respondent-driven sampling (RDS), used to study this "hidden" population, uses a peer recruitment sampling system that maintains strict participant privacy and controls and tracks recruitment. If RDS assumptions are met and the sample attains equilibrium, sample weights to correct for biases associated with traditional chain referral sampling can be calculated. Questionnaires were administered to female participants who were raising a child from a SVRP and/or who terminated a SVRP. A total of 852 participants were recruited from October 9, 2012, to November 7, 2012. There was rapid recruitment, and there were long referral chains. The majority of the variables reached equilibrium; thus, trends established in the sample population reflected the target population's trends. To our knowledge, this is the first study to use RDS to study outcomes of sexual violence. RDS was successfully applied to this population and context and should be considered as a sampling methodology in future sexual violence research. PMID:25073471

  2. The Early Functional Outcome of Mau Osteotomy for the Correction of Moderate-Severe Hallux Valgus

    PubMed Central

    Thangarajah, Tanujan; Ahmed, Usman; Malik, Shahbaz; Tillu, Abhay

    2013-01-01

    Hallux valgus is one of the commonest conditions of the foot and has been reported to affect nearly half of the adult population. It is most effectively treated by a corrective osteotomy of which there a numerous subtypes. The Mau osteotomy confers the greatest structural stability but is not thought to provide adequate correction of moderate-severe deformities. Accordingly, complications such as under correction and non-union are common. The aim of this study was to determine the functional outcome in patients with moderate-severe hallux valgus following a Mau osteotomy. A retrospective review of 23 patients with moderate-severe hallux valgus treated by Mau osteotomy was conducted. Patients were assessed clinically by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system and radiologically by measuring the first intermetatarsal (IM) and hallux abductovalgus angles (HAV). The mean AOFAS score had improved from 47 preoperatively to 92 postoperatively (P<0.01). Additionally, preoperative HAV and IM angles improved from 39o and 15o respectively to 15o and 9o respectively (P<0.01). There were no cases of undercorrection or non-union. In this series, the Mau osteotomy was able to achieve good correction of the IM and HAV angles in patients with moderate-severe hallux valgus. This was reflected in a significantly higher postoperative AOFAS score. Contrary to other studies there were no cases of undercorrection and despite allowing patients to fully weight-bear postoperatively there were no cases of non-union. PMID:24416481

  3. Distal Radial Fractures in the Superelderly: Does Malunion Affect Functional Outcome?

    PubMed Central

    Clement, N. D.; Duckworth, A. D.; Court-Brown, C. M.; McQueen, M. M.

    2014-01-01

    Purpose. The management of unstable distal radial fractures in the superelderly (?80 years old) remains controversial. The aim of this study was to compare the functional outcome of super-elderly patients with and without malunion after a distal radial fracture. Methods. We identified 51 superelderly patients living independently with displaced fractures from a prospective database of 4024 patients with distal radial fractures. Activities of daily living, presence of wrist pain, whether the wrist had returned to its normal level function, grip strength and ROM were recorded. The dorsal angulation was measured radiographically. Results. There were 17 (33.3%) patients defined to have a malunion. The outcomes of the independent patients with and without malunion were compared at a mean follow-up of 15 months. No difference was observed in activities of daily living (P = 0.28), wrist pain (P = 0.14), whether the wrist had returned to its normal level function (P = 0.25), grip strength (P = 0.31), or ROM (P = 0.41). An increasing degree of dorsal angulation correlated with diminished ROM (P = 0.038), but did not correlate with activities of daily living (P = 0.10). Conclusions. Malunion of the distal radius does not influence the functional outcome of independent superelderly patients. PMID:24967123

  4. Relationship between peripheral airway function and patient-reported outcomes in COPD: a cross-sectional study

    PubMed Central

    2010-01-01

    Background Health status, dyspnea and psychological status are important clinical outcomes in chronic obstructive pulmonary disease (COPD). However, forced expiratory volume in one second (FEV1) measured by spirometry, the standard measurement of airflow limitation, has only a weak relationship with these outcomes in COPD. Recently, in addition to spirometry, impulse oscillometry (IOS) measuring lung resistance (R) and reactance (X) is increasingly being used to assess pulmonary functional impairment. Methods We aimed to identify relationships between IOS measurements and patient-reported outcomes in 65 outpatients with stable COPD. We performed pulmonary function testing, IOS, high-resolution computed tomography (CT), and assessment of health status using the St. George's Respiratory Questionnaire (SGRQ), dyspnea using the Medical Research Council (MRC) scale and psychological status using the Hospital Anxiety and Depression Scale (HADS). We then investigated the relationships between these parameters. For the IOS measurements, we used lung resistance at 5 and 20 Hz (R5 and R20, respectively) and reactance at 5 Hz (X5). Because R5 and R20 are regarded as reflecting total and proximal airway resistance, respectively, the fall in resistance from R5 to R20 (R5-R20) was used as a surrogate for the resistance of peripheral airways. X5 was also considered to represent peripheral airway abnormalities. Results R5-R20 and X5 were significantly correlated with the SGRQ and the MRC. These correlation coefficients were greater than when using other objective measurements of pulmonary function, R20 on the IOS and CT instead of R5-R20 and X5. Multiple regression analyses showed that R5-R20 or X5 most significantly accounted for the SGRQ and MRC scores. Conclusions IOS measurements, especially indices of peripheral airway function, are significantly correlated with health status and dyspnea in patients with COPD. Therefore, in addition to its simplicity and non-invasiveness, IOS may be a useful clinical tool not only for detecting pulmonary functional impairment, but also to some extent at least estimating the patient's quality of daily life and well-being. PMID:20205936

  5. Serum albumin at admission for prediction of functional outcome in ischaemic stroke patients

    Microsoft Academic Search

    Yoon-Mi Cho; In-Sung Choi; Ren-Xiu Bian; Jae-Hyung Kim; Jae-Young Han; Sam-Gyu Lee

    2008-01-01

    This study aimed to investigate the effect of serum albumin at admission, measured within 24 h after stroke onset, on the\\u000a functional outcome in ischaemic stroke patients. The medical records of 76 first-ever hemiplegic ischaemic stroke patients\\u000a were reviewed. Collected data included age, sex, initial stroke severity, cerebrovascular risk factors, lesion-related variables,\\u000a aetiologic subtype of stroke and serum albumin at

  6. Long-Term Outcome from Tricyclic Antidepressant Treatment of Functional Chest Pain

    Microsoft Academic Search

    Chandra Prakash; Ray E. Clouse

    1999-01-01

    Antidepressants are of demonstrated value inshort-term treatment of functional chest pain, butlong-term outcome data are unavailable. Follow-upinformation over a median of 2.7 years (0.8-8.6 years)was systematically obtained from 21 outpatientstreated with tricyclic antidepressants after incompleteresponse to antireflux therapy. Initial treatmentproduced at least moderate symptom reduction orremission in 17 subjects (81.0%). Of these, 7 (41.2%)were successfully treated continuously or for symptomrelapses

  7. Effect of Intravenous Thrombolysis on MRI Parameters and Functional Outcome in Acute Stroke <6 Hours

    Microsoft Academic Search

    J. Röther; P. D. Schellinger; A. Gass; M. Siebler; A. Villringer; J. B. Fiebach; J. Fiehler; O. Jansen; T. Kucinski; V. Schoder; K. Szabo; G. J. Junge-Hülsing; M. Hennerici; H. Zeumer; K. Sartor; C. Weiller; W. Hacke

    2002-01-01

    Background and Purpose—The goals of this study were to examine MRI baseline characteristics of patients with acute ischemic stroke (AIS) and to study the influence of intravenous tissue plasminogen activator (tPA) on MR parameters and functional outcome using a multicenter approach. Methods—In this open-label, nonrandomized study of AIS patients with suspected anterior circulation stroke, subjects received a multiparametric stroke MRI

  8. Bladder evisceration in a child with antenatally detected gastroschisis: outcome of bladder function.

    PubMed

    Matsumoto, Fumi; Matsui, Futoshi; Kawagoe, Mari; Shimada, Kenji; Kawahara, Hisayoshi; Kubota, Akio

    2007-12-01

    In patients with gastroschisis, evisceration of the bladder is rare. To date, little is known about functional outcome of the antenatally eviscerated bladder. We present a case of antenatally detected gastroschisis associated with entire bladder evisceration and fetal hydronephrosis. Full urological evaluation was carried out after primary closure of the abdominal wall defect. The postoperative period was uneventful and there were no abnormal findings in the kidney or urinary tract. This indicated good prognosis of the antenatally eviscerated bladder. PMID:18036052

  9. Functional outcome and discharge destination in elderly patients with spinal cord injuries

    Microsoft Academic Search

    A Gulati; C J Yeo; A D Cooney; A N McLean; M H Fraser; D B Allan

    2011-01-01

    Study design:Retrospective cohort study.Objective:To describe functional outcome and discharge destination of elderly patients with traumatic spinal cord injuries.Setting:National Spinal Injuries Unit, Glasgow, UK.Methods:We collected data for 5 years on all patients >65 years old with a traumatic spinal cord injury treated at the National Spinal Injuries Unit.Results:We identified 39 patients. Of these, nine patients died during admission; all had cervical

  10. Reverse shoulder arthroplasty. Part 1: Systematic review of clinical and functional outcomes

    PubMed Central

    Samitier, Gonzalo; Alentorn-Geli, Eduard; Torrens, Carlos; Wright, Thomas W.

    2015-01-01

    Many factors influence the outcomes of reverse shoulder arthroplasty (RSA). The purpose of this study was to compare the clinical and functional outcomes of RSA depending on the surgical approach, type of prosthesis, and indication for surgery through a comprehensive, systematic review. A literature search was conducted (1985 to June 2012) using PubMed, CINAHL, EBSCO–SPORTDiscus, and Cochrane Central Register of Controlled Trials. Levels I–IV evidence, in-vivo human studies (written in English with minimum of 2 years of follow-up and sample size of 10 patients) reporting clinical and/or functional outcomes after RSA were included. The outcomes were analyzed depending on the surgical approach, type of prosthesis (with medialized or lateralized center of rotation), or indication for surgery. A total of 35 studies were included involving 2049 patients (mean [SD] percentage of females, age, and follow-up of 71.6% [13.4], 71.5 years [3.7], and 43.1 months [18.8], respectively). Studies using deltopectoral approach with lateralized prostheses demonstrated greater improvement in external rotation compared with medialized prostheses with the same approach (mean 22.9° and 5°, respectively). In general, RSA for cuff tear arthropathy demonstrated higher improvements in Constant and American Shoulder and Elbow Society scores, and range of motion compared with revision of anatomic prosthesis, failed rotator cuff repair, and fracture sequelae. Lateralized prostheses provided more improvement in external rotation compared to medialized prostheses. Indications of RSA for cuff tear arthropathy demonstrated higher improvements in the outcomes compared with other indications. RSA demonstrated high patient's satisfaction regardless of the type of prosthesis or indication for surgery. Level of Evidence: Level IV. PMID:25709242

  11. Mechanomyogram for Muscle Function Assessment: A Review

    PubMed Central

    Islam, Md. Anamul; Sundaraj, Kenneth; Ahmad, R. Badlishah; Ahamed, Nizam Uddin

    2013-01-01

    Background Mechanomyography (MMG) has been extensively applied in clinical and experimental practice to examine muscle characteristics including muscle function (MF), prosthesis and/or switch control, signal processing, physiological exercise, and medical rehabilitation. Despite several existing MMG studies of MF, there has not yet been a review of these. This study aimed to determine the current status on the use of MMG in measuring the conditions of MFs. Methodology/Principal Findings Five electronic databases were extensively searched for potentially eligible studies published between 2003 and 2012. Two authors independently assessed selected articles using an MS-Word based form created for this review. Several domains (name of muscle, study type, sensor type, subject's types, muscle contraction, measured parameters, frequency range, hardware and software, signal processing and statistical analysis, results, applications, authors' conclusions and recommendations for future work) were extracted for further analysis. From a total of 2184 citations 119 were selected for full-text evaluation and 36 studies of MFs were identified. The systematic results find sufficient evidence that MMG may be used for assessing muscle fatigue, strength, and balance. This review also provides reason to believe that MMG may be used to examine muscle actions during movements and for monitoring muscle activities under various types of exercise paradigms. Conclusions/Significance Overall judging from the increasing number of articles in recent years, this review reports sufficient evidence that MMG is increasingly being used in different aspects of MF. Thus, MMG may be applied as a useful tool to examine diverse conditions of muscle activity. However, the existing studies which examined MMG for MFs were confined to a small sample size of healthy population. Therefore, future work is needed to investigate MMG, in examining MFs between a sufficient number of healthy subjects and neuromuscular patients. PMID:23536834

  12. Effects of a summer treatment program on functional sports outcomes in young children with ADHD.

    PubMed

    O'Connor, Briannon C; Fabiano, Gregory A; Waschbusch, Daniel A; Belin, Peter J; Gnagy, Elizabeth M; Pelham, William E; Greiner, Andrew R; Roemmich, James N

    2014-08-01

    Participation in youth sports can be very beneficial, but children with Attention Deficit Hyperactivity Disorder (ADHD) may participate less often and less successfully. The current study evaluated functional sports outcomes for children with ADHD who attended an intensive behavioral treatment program that included a sports training component, and it compared outcomes to children with ADHD who did not attend the program. Results suggest that treatment resulted in significant improvements in many aspects of children's sports functioning, including knowledge of game rules, in vivo game performance, and fundamental skill tasks (motor proficiency, ability to trap a soccer ball appropriately, reduced handball penalties in soccer, and improved ability to catch a baseball). Parents also reported improved sports skills and good sportsmanship in the treatment group. No differences between groups were evident on additional skill tasks evaluating accurately kicking a soccer ball, throwing a baseball, or hitting a baseball off a tee. These results suggest intensive behavioral intervention that includes sports training can significantly improve functional sports outcomes for young children with ADHD. PMID:24362766

  13. Effects of a Summer Treatment Program on Functional Sports Outcomes in Young Children with ADHD

    PubMed Central

    Fabiano, Gregory A.; Waschbusch, Daniel A.; Belin, Peter J.; Gnagy, Elizabeth M.; Pelham, William E.; Greiner, Andrew R.; Roemmich, James N.

    2015-01-01

    Participation in youth sports can be very beneficial, but children with Attention Deficit Hyperactivity Disorder (ADHD) may participate less often and less successfully. The current study evaluated functional sports outcomes for children with ADHD who attended an intensive behavioral treatment program that included a sports training component, and it compared outcomes to children with ADHD who did not attend the program. Results suggest that treatment resulted in significant improvements in many aspects of children’s sports functioning, including knowledge of game rules, in vivo game performance, and fundamental skill tasks (motor proficiency, ability to trap a soccer ball appropriately, reduced handball penalties in soccer, and improved ability to catch a baseball). Parents also reported improved sports skills and good sportsmanship in the treatment group. No differences between groups were evident on additional skill tasks evaluating accurately kicking a soccer ball, throwing a baseball, or hitting a baseball off a tee. These results suggest intensive behavioral intervention that includes sports training can significantly improve functional sports outcomes for young children with ADHD. PMID:24362766

  14. Impact of outcome-based assessment on student learning and faculty instructional practices.

    PubMed

    Dawson, Susan D; Miller, Tess; Goddard, Sally F; Miller, Lisa Maag

    2013-01-01

    Increased accountability has been a catalyst for the reformation of curriculum and assessment practices in postsecondary schools throughout North America, including veterinary schools. There is a call for a shift in assessment practices in clinical rotations, from a focus on content to a focus on assessing student performance. Learning is subsequently articulated in terms of observable outcomes and indicators that describe what the learner can do after engaging in a learning experience. The purpose of this study was to examine the ways in which a competency-based program in an early phase of implementation impacted student learning and faculty instructional practices. Findings revealed that negative student perceptions of the assessment instrument's reliability had a detrimental effect on the face validity of the instrument and, subsequently, on students' engagement with competency-based assessment and promotion of student-centered learning. While the examination of faculty practices echoed findings from other studies that cited the need for faculty development to improve rater reliability and for a better data management system, our study found that faculty members' instructional practices improved through the alignment of instruction and curriculum. This snap-shot of the early stages of implementing a competency-based program has been instrumental in refining and advancing the program. PMID:23709109

  15. Environmental justice, impact assessment and the politics of knowledge: The implications of assessing the social distribution of environmental outcomes

    SciTech Connect

    Walker, Gordon, E-mail: g.p.walker@lancaster.ac.u [Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ (United Kingdom)

    2010-09-15

    Claims of environmental injustice have increasingly become part of environmental conflicts, both explicitly through the work of environmental justice campaigning groups and implicitly through the arguments deployed about the rights and wrongs of a given situation. Such claims can centre on different notions of justice, including those concerned with questions of distribution and procedure. This paper focuses on distributional or outcome justice and explores what implications follow when the distributional concerns of environmental justice are included in the practice of impact assessment processes, including through social impact assessment (SIA). The current use of impact assessment methods in the UK is reviewed showing that although practices are evolving there is a little routine assessment of distributional inequalities. It is argued that whilst this should become part of established practice to ensure that inequalities are revealed and matters of justice are given a higher profile, the implications for conflict within decision making processes are not straightforward. On the one hand, there could be scope for conflict to be ameliorated by analysis of inequalities informing the debate between stakeholders, and facilitating the implementation of mitigation and compensation measures for disadvantaged groups. On the other hand, contestation over how evidence is produced and therefore what it shows, and disagreement as to the basis on which justice and injustice are to be determined, means that conflict may also be generated and sustained within what are essentially political and strategic settings.

  16. Improving functional outcomes for schizophrenia patients in the Netherlands using Cognitive Adaptation Training as a nursing intervention - A pilot study.

    PubMed

    Quee, Piotr J; Stiekema, Annemarie P M; Wigman, Johanna T W; Schneider, Harald; van der Meer, Lisette; Maples, Natalie J; van den Heuvel, Edwin R; Velligan, Dawn I; Bruggeman, Richard

    2014-09-01

    Cognitive Adaptation Training (CAT) improves functional outcomes in schizophrenia outpatients living in the United States. The effectiveness of CAT for patients living outside the US as well as for long-term hospitalized patients remains to be determined. In addition, it has not yet been studied whether CAT can be successful if patients receive the treatment from psychiatric nurses. This pilot study investigated the effectiveness and feasibility of CAT as a nursing intervention in the Netherlands. Thirty schizophrenia patients (long-term hospitalized patients: 63%) participated in this study. Sixteen patients received treatment as usual (TAU)+CAT, and fourteen patients received TAU. Patients in CAT participated in the treatment for eight months, consisting of weekly home-visits by a psychiatric nurse, supervised by a psychologist. After eight months, CAT interventions were integrated in the usual treatment. Outcome measures were the Multnomah Community Ability Scale (MCAS), the Social and Occupational Functioning Scale (SOFAS), and the Negative Symptom Assessment-Motivation subscale (NSA-M). For inpatients, work-related activities were also tracked for 16 months after baseline. Patients receiving TAU+CAT had better scores on the MCAS (trend), compared to TAU patients. Moreover, inpatients' work-related activities increased in TAU+CAT, relative to TAU inpatients, reaching significance after ten months. Improvements on the SOFAS and NSA-M were not significant. These results indicate that CAT as a nursing intervention may improve outcomes in patients with schizophrenia living in the Netherlands, including long-term hospitalized patients. However, since the current study was designed for exploratory purposes, larger randomized controlled studies are needed to confirm our results and to investigate the long-term effects of CAT as a nursing intervention systematically. PMID:25000912

  17. Characterizing Tumor Heterogeneity With Functional Imaging and Quantifying High-Risk Tumor Volume for Early Prediction of Treatment Outcome: Cervical Cancer as a Model

    PubMed Central

    Mayr, Nina A.; Huang, Zhibin; Wang, Jian Z.; Lo, Simon S.; Fan, Joline M.; Grecula, John C.; Sammet, Steffen; Sammet, Christina L.; Jia, Guang; Zhang, Jun; Knopp, Michael V.; Yuh, William T.C.

    2015-01-01

    Purpose Treatment response in cancer has been monitored by measuring anatomic tumor volume (ATV) at various times without considering the inherent functional tumor heterogeneity known to critically influence ultimate treatment outcome: primary tumor control and survival. This study applied dynamic contrast-enhanced (DCE) functional MRI to characterize tumors’ heterogeneous subregions with low DCE values, at risk for treatment failure, and to quantify the functional risk volume (FRV) for personalized early prediction of treatment outcome. Methods and Materials DCE-MRI was performed in 102 stage IB2–IVA cervical cancer patients to assess tumor perfusion heterogeneity before and during radiation/chemotherapy. FRV represents the total volume of tumor voxels with critically low DCE signal intensity (<2.1 compared with precontrast image, determined by previous receiver operator characteristic analysis). FRVs were correlated with treatment outcome (follow-up: 0.2–9.4, mean 6.8 years) and compared with ATVs (Mann-Whitney, Kaplan-Meier, and multivariate analyses). Results Before and during therapy at 2–2.5 and 4–5 weeks of RT, FRVs >20, >13, and >5 cm3, respectively, significantly predicted unfavorable 6-year primary tumor control (p = 0.003, 7.3 × 10?8, 2.0 × 10?8) and disease-specific survival (p = 1.9 × 10?4, 2.1 × 10?6, 2.5 × 10?7, respectively). The FRVs were superior to the ATVs as early predictors of outcome, and the differentiating power of FRVs increased during treatment. Discussion Our preliminary results suggest that functional tumor heterogeneity can be characterized by DCE-MRI to quantify FRV for predicting ultimate long-term treatment outcome. FRV is a novel functional imaging heterogeneity parameter, superior to ATV, and can be clinically translated for personalized early outcome prediction before or as early as 2–5 weeks into treatment. PMID:22208967

  18. Quantitative Liver Function Tests Improve the Prediction of Clinical Outcomes in Chronic Hepatitis C: Results from the HALT-C Trial

    PubMed Central

    Everson, Gregory T.; Shiffman, Mitchell L.; Hoefs, John C.; Morgan, Timothy R.; Sterling, Richard K.; Wagner, David A.; Lauriski, Shannon; Curto, Teresa M.; Stoddard, Anne; Wright, Elizabeth C.

    2011-01-01

    Risk for future clinical outcomes is proportional to the severity of liver disease in patients with chronic hepatitis C. We measured disease severity by quantitative liver function tests (QLFTs) to determine cutoffs for QLFTs that identified patients who were at low and high risk for a clinical outcome. Two hundred twenty seven participants in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial underwent baseline QLFTs and were followed for a median of 5.5 years for clinical outcomes. QLFTs were repeated in 196 patients at month 24 and in 165 patients at month 48. Caffeine elimination rate (k), antipyrine (AP) clearance (Cl), MEGX concentration, methionine breath test (MBT), galactose elimination capacity (GEC), dual cholate (CA) clearances and shunt, and perfused hepatic mass (PHM) and liver and spleen volumes (SPECT) were measured. Baseline QLFTs were significantly worse (p=0.0017 to <0.0001) and spleen volumes larger (p<0.0001) in the 54 patients who subsequently experienced clinical outcomes. QLFT cutoffs that characterized patients as “low” and “high risk” for clinical outcome yielded hazard ratios ranging from 2.21 (95%CI 1.29–3.78) for GEC to 6.52 (95%CI 3.63–11.71) for CA Cloral. QLFTs independently predicted outcome in models with Ishak fibrosis score, platelet count, and standard laboratory tests. In serial studies, patients with “high risk” results for CA Cloral or PHM had a nearly 15-fold increase in risk for clinical outcome. Less than 5% of patients with “low risk” QLFTs experienced a clinical outcome. Conclusion QLFTs independently predict risk for future clinical outcomes. By improving risk assessment, QLFTs could enhance noninvasive monitoring, counseling, and management of patients with chronic hepatitis C. PMID:22030902

  19. APPROACHES TO LUNG FUNCTION ASSESSMENT IN SMALL MAMMALS

    EPA Science Inventory

    The review chapter of pulmonary function assessment in small mammals first discusses basic principles and methods such as assessment of various pressures, volumes and flows. The three types of plethysmographs (pressure, flow and barometric) used by animal physiologists are evalua...

  20. Validation of a patient reported outcome questionnaire for assessing success of endoscopic prostatectomy

    PubMed Central

    Hossack, Tania; Woo, Henry

    2014-01-01

    Purpose Several international committees involved in establishing standards of care have recommended that patients undergoing surgery for bladder outlet obstruction should be assessed with patient reported outcomes (PRO). The Patient Global Impression of Improvement (PGI-I) is an instrument designed to measure a patients interpretation of symptom changes following intervention. The objective of this study was to validate the PGI-I as a PRO assessment following surgery for bladder outflow obstruction (BOO) in men with benign prostatic hyperplasia (BPH). Methods Men undergoing photoselective vaporisation of the prostate were followed prospectively. Pre- and postoperative International Prostate Symptom Score (IPSS), Quality of life (QoL) index, peak urinary flow (Qmax), and postvoid residual (PVR) assessments were done. The PGI-I was conducted and correlated at 3 months postoperatively to changes in IPSS, QoL, Qmax, and PVR. Results One hundred and sixty-six consecutive patients were included. Following surgery, IPSS and QoL improved by 11 and 2.4 points (P<0.0001). PGI-I was found to correlate with postoperative changes in IPSS and QoL (Pearson correlation, 0.47 and 0.58, respectively; P<0.0001). Conclusions This is the first study to validate the PGI-I as a PRO measure to surgery for BOO. This suggests a potential for the PGI-I to be used to assess surgical therapies for BPH and may be a valuable addition for measuring outcomes in clinical trials evaluating surgical interventions for BPH. PMID:25599074

  1. An Exploratory Investigation of the Assessment Practices of Selected Association to Advance Collegiate Schools of Business--Accredited Business Programs and Linkages with General Education Outcomes

    ERIC Educational Resources Information Center

    Vitullo, Elizabeth; Jones, Elizabeth A.

    2010-01-01

    This research study investigated the assessment practices of five different undergraduate business programs. It examines the learning outcomes required for the business programs and their linkages with general education outcomes. Specific assessment methods, the results from assessments, and how business program faculty use assessment findings to…

  2. Effect of Inpatient Quality of Care on Functional Outcomes in Patients With Hip Fracture

    PubMed Central

    Boockvar, Kenneth S.; Penrod, Joan D.; Morrison, R. Sean; Halm, Ethan A.; Litke, Ann; Silberzweig, Stacey B.; Teresi, Jeanne; Ocepek-Welikson, Katja; Magaziner, Jay

    2006-01-01

    Objectives We sought to examine the relationship between functional outcome and process of care for patients with hip fracture. Research Design and Participants We undertook a prospective cohort study in 4 hospitals of 554 patients treated with surgery for hip fracture. Measurements Information on patient characteristics and processes of hospital care collected from the medical record, interviews, and bedside observations. Follow-up information obtained at 6 months on function (using the Functional Independence Measure [FIM]), survival, and readmission. Results Individual processes of care were generally not associated with adjusted outcomes. A scale of 9 processes related to mobilization was associated with improved adjusted locomotion (P = 0.006), self care (P = 0.022), and transferring (P = 0.007) at 2 months, but the benefits were smaller and not significant by 6 months. These processes were not associated with mortality. The predicted value for the FIM locomotion measure (range, 2–14) at 2 months was 5.9 (95% confidence interval 5.4–6.4) for patients at the 10th percentile of performance on these processes compared with 7.1 (95% confidence interval 6.6, 7.6) at the 90th percentile. Patients who experienced no hospital complications and no readmissions retained the benefits in locomotion at 6 months. Anticoagulation processes were associated with improved transferring at 2 months (P = 0.046) but anticoagulation and other processes of care were not otherwise associated with improved function. Discussion Our findings indicate the need to attend to all steps in the care of patients with hip fracture. Additionally, functional outcomes were more sensitive markers of improved process of care, compared with 6-month mortality, in the case of hip fracture. PMID:16932138

  3. Interhemispheric functional connectivity following prenatal or perinatal brain injury predicts receptive language outcome.

    PubMed

    Dick, Anthony Steven; Raja Beharelle, Anjali; Solodkin, Ana; Small, Steven L

    2013-03-27

    Early brain injury alters both structural and functional connectivity between the cerebral hemispheres. Despite increasing knowledge on the individual hemispheric contributions to recovery from such injury, we know very little about how their interactions affect this process. In the present study, we related interhemispheric structural and functional connectivity to receptive language outcome following early left hemisphere stroke. We used functional magnetic resonance imaging to study 14 people with neonatal brain injury, and 25 age-matched controls during passive story comprehension. With respect to structural connectivity, we found that increased volume of the corpus callosum predicted good receptive language outcome, but that this is not specific to people with injury. In contrast, we found that increased posterior superior temporal gyrus interhemispheric functional connectivity during story comprehension predicted better receptive language performance in people with early brain injury, but worse performance in typical controls. This suggests that interhemispheric functional connectivity is one potential compensatory mechanism following early injury. Further, this pattern of results suggests refinement of the prevailing notion that better language outcome following early left hemisphere injury relies on the contribution of the contralesional hemisphere (i.e., the "right-hemisphere-take-over" theory). This pattern of results was also regionally specific; connectivity of the angular gyrus predicted poorer performance in both groups, independent of brain injury. These results present a complex picture of recovery, and in some cases, such recovery relies on increased cooperation between the injured hemisphere and homologous regions in the contralesional hemisphere, but in other cases, the opposite appears to hold. PMID:23536076

  4. Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood

    PubMed Central

    Hoag, Chris C; Gotto, Geoff T; Morrison, Kevin B; Coleman, Gerald U; MacNeily, Andrew E

    2008-01-01

    Introduction Potential long-term sequelae of hypospadias and its surgical correction include difficulties in voiding, sexual function, psychosexual adjustment and self-appraisal. These difficulties often evolve long after surgical repair as children grow to adulthood. Despite this, patient-driven data on long-term functional outcomes and satisfaction are limited, leaving the true success of hypospadias surgery essentially unknown. The aim of this study was to address these deficiencies. Methods We conducted a chart review for all patients operated on by a single urologist from 1981 to 1988. Extensive efforts were made to obtain accurate current address information for patients. A database of patient demographics and pathology, operative details and complications was created. A 22-item questionnaire was mailed to study subjects. Telephone follow-up by an independent research nurse bolstered response rates. Responses from returned questionnaires were pooled and analyzed. Results The chart review included 115 patients. Of 100 patients (with address information) who were sent questionnaires, 28 ultimately responded. The chart review group was comparable to groups in other published studies. Despite a slightly higher initial major complication rate (57.2%), respondents reported few long-term complications (11% fistula, 29% persistent chordee and 10% stricture) and excellent urinary and sexual functional results. The most common functional complaints were spraying and hesitancy during micturition. Overall, 86% of patients were satisfied with their surgical result, and 52% wished they had been provided longer follow-up. Conclusion Long-term outcomes data are critical to an honest account of success rates for hypospadias surgery. Obtaining these data remains challenging. In this series, despite high initial complication rates, most patients reported excellent long-term functional results and were quite satisfied with their overall outcome. PMID:18542723

  5. Applying Adverse Outcome Pathways (AOPs) to support Integrated Approaches to Testing and Assessment (IATA).

    PubMed

    Tollefsen, Knut Erik; Scholz, Stefan; Cronin, Mark T; Edwards, Stephen W; de Knecht, Joop; Crofton, Kevin; Garcia-Reyero, Natalia; Hartung, Thomas; Worth, Andrew; Patlewicz, Grace

    2014-12-01

    Chemical regulation is challenged by the large number of chemicals requiring assessment for potential human health and environmental impacts. Current approaches are too resource intensive in terms of time, money and animal use to evaluate all chemicals under development or already on the market. The need for timely and robust decision making demands that regulatory toxicity testing becomes more cost-effective and efficient. One way to realize this goal is by being more strategic in directing testing resources; focusing on chemicals of highest concern, limiting testing to the most probable hazards, or targeting the most vulnerable species. Hypothesis driven Integrated Approaches to Testing and Assessment (IATA) have been proposed as practical solutions to such strategic testing. In parallel, the development of the Adverse Outcome Pathway (AOP) framework, which provides information on the causal links between a molecular initiating event (MIE), intermediate key events (KEs) and an adverse outcome (AO) of regulatory concern, offers the biological context to facilitate development of IATA for regulatory decision making. This manuscript summarizes discussions at the Workshop entitled "Advancing AOPs for Integrated Toxicology and Regulatory Applications" with particular focus on the role AOPs play in informing the development of IATA for different regulatory purposes. PMID:25261300

  6. Patient-reported outcomes assessment in cancer trials: taking stock, moving forward.

    PubMed

    Lipscomb, Joseph; Reeve, Bryce B; Clauser, Steven B; Abrams, Jeffrey S; Bruner, Deborah Watkins; Burke, Laurie B; Denicoff, Andrea M; Ganz, Patricia A; Gondek, Kathleen; Minasian, Lori M; O'Mara, Ann M; Revicki, Dennis A; Rock, Edwin P; Rowland, Julia H; Sgambati, Maria; Trimble, Edward L

    2007-11-10

    To evaluate and improve the use of cancer trial end points that reflect the patient's own perspective, the National Cancer Institute organized an international conference, Patient-Reported Outcomes Assessment in Cancer Trials (PROACT), in 2006. The 13 preceding articles in this special issue of the Journal were commissioned in preparation for or in response to the PROACT conference, which was cosponsored by the American Cancer Society. Drawing from these articles and also commentary from the conference itself, this concluding report takes stock of what has been learned to date about the successes and challenges in patient-reported outcome (PRO) assessment in phase III, phase II, and symptom management trials in cancer and identifies ways to improve the scientific soundness, feasibility, and policy relevance of PROs in trials. Building on this synthesis of lessons learned, this article discusses specific administrative policies and management procedures to improve PRO data collection, analysis, and dissemination of findings; opportunities afforded by recent methodologic and technologic advances in PRO data collection and analysis to enhance the scientific soundness and cost efficiency of PRO use in trials; and the importance of better understanding the usefulness of PRO data to the full spectrum of cancer decision makers, including patients and families, health providers, public and private payers, regulatory agencies, and standards-setting organizations. PMID:17991933

  7. Assessing Spatial Relationships between Axonal Integrity, Regional Brain Volumes, and Neuropsychological Outcomes after Traumatic Axonal Injury

    PubMed Central

    Warner, Matthew A.; de la Plata, Carlos Marquez; Spence, Jeffrey; Wang, Jun Yi; Harper, Caryn; Moore, Carol; Devous, Michael

    2010-01-01

    Abstract Diffuse traumatic axonal injury (TAI) is a type of traumatic brain injury (TBI) characterized predominantly by white matter damage. While TAI is associated with cerebral atrophy, the relationship between gray matter volumes and TAI of afferent or efferent axonal pathways remains unknown. Moreover, it is unclear if deficits in cognition are associated with post-traumatic brain volumes in particular regions. The goal of this study was to determine the relationship between markers of TAI and volumes of cortical and subcortical structures, while also assessing the relationship between cognitive outcomes and regional brain volumes. High-resolution magnetic resonance imaging scans were performed in 24 patients with TAI within 1 week of injury and were repeated 8 months later. Diffusion tensor imaging (DTI) tractography was used to reconstruct prominent white matter tracts and calculate their fractional anisotropy (FA) and mean diffusivity (MD) values. Regional brain volumes were computed using semi-automated morphometric analysis. Pearson's correlation coefficients were used to assess associations between brain volumes, white matter integrity (i.e., FA and MD), and neuropsychological outcomes. Post-traumatic volumes of many gray matter structures were associated with chronic damage to related white matter tracts, and less strongly associated with measures of white matter integrity in the acute scans. For example, left and right hippocampal volumes correlated with FA in the fornix body (r?=?0.600, p?=?0.001; r?=?0.714, p?outcome after injury. PMID:20874032

  8. Oil Red O-assessed macrosteatosis in liver transplant donor biopsies predicts ischemia-reperfusion injury and clinical outcome.

    PubMed

    Reis, Henning; Peterek, Patricia T; Wohlschlaeger, Jeremias; Kaiser, Gernot M; Mathe, Zoltan; Juntermanns, Benjamin; Sotiropoulos, Georgios C; Beckhove, Ulrich; Canbay, Ali; Wirges, Ulrike; Scherag, Andre; Treckmann, Juergen-Walter; Paul, Andreas; Baba, Hideo Andreas

    2014-02-01

    Steatosis in donor livers is an accepted adverse prognostic factor after liver transplantation. While its semiquantitative assessment shows varying reproducibility, it is questioned as a standard method. Additionally, the influence of hepatic steatosis on ischemia/reperfusion injury (I/R injury) has not been evaluated in biopsies after reperfusion. We compared different staining and analyzing methods for the assessment of donor liver steatosis in order to predict I/R injury and clinical outcome after transplantation. To do this, 56 paired pre- and post-reperfusion liver biopsies were analyzed for macro- (MaS)/micro- (MiS) and total steatosis in cryo and permanent sections by special fat (Oil Red O or ORO) and standard stains. Computerized morphometrical analyses were compared to the semiquantitative assessment by a pathologist. I/R injury was determined histopathologically and by M30 immunohistochemistry. We found ORO to be more sensitive in detecting hepatic steatosis with higher reproducibility for MaS. Semiquantitative analyses were highly reproducible and not inferior to computerized morphometry. Categorized MaS as determined by ORO correlated with the extent of I/R injury, initial poor function, liver enzymes, and survival. Therefore fat stains like ORO are a reliable and easy method comprising significant advantages in the evaluation of hepatic steatosis and are thereby of prognostic value. Computerized analysis is a precise tool though not superior to semiquantitative analyses. PMID:24297629

  9. Factors that Influence Functional Outcome after Total or Subtotal Scapulectomy: Japanese Musculoskeletal Oncology Group (JMOG) Study

    PubMed Central

    Hayashi, Katsuhiro; Iwata, Shintaro; Ogose, Akira; Kawai, Akira; Ueda, Takafumi; Otsuka, Takanobu; Tsuchiya, Hiroyuki

    2014-01-01

    Background Scapulectomy requires not only joint resection but also wide resection of the shoulder girdle muscles. Even the significance of reconstruction has not yet been determined because of the difficulties in comparing the different conditions. The purpose of this study was to investigate factors that influence functional outcomes after scapulectomy in a multicenter study. Methods This retrospective study comprised 48 patients who underwent total or subtotal scapulectomy and were followed for at least one year after surgery. Patients were registered at the Japanese Musculoskeletal Oncology Group affiliated hospitals. Soft tissue reconstruction for joint stabilization was performed when there was enough remaining tissue for reconstruction of the rotator cuff and tendons. In 23 cases, humeral suspension was performed. The average follow-up period was 61.9 months. Multivariate analysis was performed using the patient’s background to determine which factors influence the Enneking functional score or active range of motion. Results The average functional score was 21.1 out of 30. Active shoulder range of motion was 42.7 degree in flexion, 39.7 degree in abduction, 49.6 degree of internal rotation and 16.8 degree of external rotation. The amount of remaining bone influenced functional outcome, which means that preserving the glenoid or the acromion lead to better function compared to total scapulectomy (p<0.01). Factors that influenced each functional measure include the amount of remaining bone, soft tissue reconstruction, the length of the resected humerus and nerve resection (p<0.05). Conclusion Although shoulder function was almost eliminated following total or subtotal scapulectomy, minimal resection of bone, and soft tissue reconstruction should lead to better function. PMID:24937254

  10. Deconstructing Negative Symptoms of Schizophrenia: Avolition-Apathy and Diminished Expression Clusters Predict Clinical Presentation and Functional Outcome

    PubMed Central

    Strauss, Gregory P.; Horan, William P.; Kirkpatrick, Brian; Fischer, Bernard A.; Keller, William R.; Miski, Pinar; Buchanan, Robert W.; Green, Michael F.; Carpenter, William T.

    2013-01-01

    Background Previous studies indicate that negative symptoms reflect a separable domain of pathology from other symptoms of schizophrenia. However, it is currently unclear whether negative symptoms themselves are multi-faceted, and whether sub-groups of patients who display unique negative symptom profiles can be identified. Methods A data-driven approach was used to examine the heterogeneity of negative symptom presentations in two samples: Study 1 included 199 individuals with schizophrenia assessed with a standard measure of negative symptoms and Study 2 included 169 individuals meeting criteria for deficit schizophrenia (i.e., primary and enduring negative symptoms) assessed with a specialized measure of deficit symptoms. Cluster analysis was used to determine whether different groups of patients with distinct negative symptoms profiles could be identified. Results Across both studies, we found evidence for two distinctive negative symptom sub-groups: one group with predominantly Avolition-Apathy (AA) symptoms and another with a predominantly Diminished Expression (DE) profile. Follow-up discriminant function analyses confirmed the validity of these groups. AA and DE negative symptom sub-groups significantly differed on clinically relevant external validators, including measures of functional outcome, premorbid adjustment, clinical course, disorganized symptoms, social cognition, sex, and ethnicity. Conclusions These results suggest that distinct subgroups of patients with elevated AA or DE can be identified within the broader diagnosis of schizophrenia and that these subgroups show clinically meaningful differences in presentation. Additionally, AA tends to be associated with poorer outcomes than DE, suggesting that it may be a more severe aspect of psychopathology. PMID:23453820

  11. Physical therapy clinical management recommendations for children with cerebral palsy - spastic diplegia: achieving functional mobility outcomes.

    PubMed

    O'Neil, Margaret E; Fragala-Pinkham, Maria A; Westcott, Sarah L; Martin, Karen; Chiarello, Lisa A; Valvano, Joanne; Rose, Rachel Unanue

    2006-01-01

    The purpose of this special report is to present recommendations for the clinical management of children with cerebral palsy, spastic diplegia when increased functional mobility is the identified outcome. These recommendations provide a framework that allows physical therapists to increase their accountability and promote effective interventions for improved patient outcomes. The key components of this special report on clinical management are: a) the Major Recommendations that provide the background and evidence for clinical management; b) a flow chart to assist in clinical decision-making; and c) a Table of Tests and Measures for information on useful tools in the management of children with spastic diplegia. These recommendations are suggestions for clinical management, not an all-inclusive document on physical therapy for children with cerebral palsy. These recommendations may help therapists develop systematic approaches to service delivery and documentation. PMID:16508534

  12. The Adult Respiratory Distress Syndrome Cognitive Outcomes Study: long-term neuropsychological function in survivors of acute lung injury

    PubMed Central

    2013-01-01

    Expanded abstract Citation Mikkelsen ME, Christie JD, Lanken PN, Biester RC, Thompson BT, Bellamy SL, Localio AR, Demissie E, Hopkins RO, Angus DC: The adult respiratory distress syndrome cognitive outcomes study: long-term neuropsychological function in survivors of acute lung injury. Am J Respir Crit Care Med 2012, 185:1307-1315. Background Cognitive and psychiatric morbidity is common and potentially modifiable after acute lung injury (ALI). However, practical measures of neuropsychological function for use in multicenter trials are lacking. Methods Objective The objectives were to determine whether a validated telephone-based neuropsychological test battery is feasible in a multicenter trial and to determine the frequency and risk factors for long-term neuropsychological impairment. Design A prospective, multicenter cohort study of a subset of survivors from the Fluid and Catheter Treatment Trial (FACTT) was conducted. Setting The FACTT enrolled patients from 38 North American hospitals between June 2000 and October 2005. Subjects To be eligible for the ALI Cognitive Outcomes Study (ACOS), subjects had to be enrolled in the FACTT and the EA-PAC (Economic Assessment of the Pulmonary Artery Catheter) trial. The FACTT enrolled mechanically ventilated adults who met the American-European Consensus Conference criteria for ALI. Intervention In an adjunct study to the Acute Respiratory Distress Syndrome Clinical Trials Network Fluid and Catheter Treatment Trial, neuropsychological function at 2 and 12 months after hospital discharge was assessed. Outcomes The primary outcome was the result of a validated telephone battery of standardized neuropsychological tests administered to consenting, English-speaking subjects at 2 and 12 months after hospital discharge. Results Of 406 eligible survivors, 261 patients were approached to participate and 213 consented. One hundred twenty-two subjects, including 102 subjects at 12 months, were tested at least once. Memory, verbal fluency, and executive function were impaired in 13% (12 of 92), 16% (15 of 96), and 49% (37 of 76) of long-term survivors, respectively. Long-term cognitive impairment was present in 41 (55%) of the 75 survivors who completed cognitive testing. Depression, post-traumatic stress disorder, and anxiety were present in 36% (37 of 102), 39% (40 of 102), and 62% (63 of 102) of long-term survivors, respectively. Enrollment in a conservative fluid management strategy (P <0.005) was associated with cognitive impairment, and lower partial pressure of arterial oxygen during the trial was associated with cognitive (P <0.02) and psychiatric (P <0.02) impairment. Conclusions Neuropsychological function can be assessed by telephone in a multicenter trial. Long-term neuropsychological impairment is common in survivors of ALI. Hypoxemia is a risk factor for long-term neuropsychological impairment. A fluid management strategy is a potential risk factor for long-term cognitive impairment; however, given the select population studied and an unclear mechanism, this finding requires confirmation. PMID:23714655

  13. Development of Items that Assess Physical Function in Children who Use Wheelchairs

    PubMed Central

    Kerfeld, Cheryl I; Dudgeon, Brian J; Engel, Joyce M; Kartin, Deborah

    2013-01-01

    Purpose To assess the content, format, and comprehension of the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric physical function related to mobility items for children who use wheelchairs (WCs). Methods During a cognitive interview, 14 children, ages 8 to 12 years, who use WCs, verbalized their thoughts when answering PROMIS items. Questionnaire Appraisal System was used to code summarized text from the interviews. Results The children requested items be more specific and include options for reporting adaptive ways of performing and participating. How they would answer the item depended on the situation and specific environmental supports and constraints they may have experienced. Conclusions As rehabilitation professionals develop and use self-reported outcome measures, they should explore what is important to children who use WCs regarding their views on physical functioning, the influences of the environment, and variability in the use of devices to assist with functional mobility. PMID:23542193

  14. Data Collection Strategies and Measurement Tools for Assessing Academic and Therapeutic Outcomes in Recovery Schools

    PubMed Central

    Botzet, Andria M.; McIlvaine, Patrick W.; Winters, Ken C.; Fahnhorst, Tamara; Dittel, Christine

    2014-01-01

    Accurate evaluation and documentation of the efficacy of recovery schools can be vital to the continuation and expansion of these beneficial resources. A very limited data set currently exists that examines the value of specific schools established to support adolescents and young adults in recovery; additional research is necessary. The following article outlines the methodology utilized in a current quasi-experimental study evaluating both academic and therapeutic outcomes of adolescents attending recovery high schools as compared to traditional (non-recovery-based) high schools. The developmental considerations in assessing adolescents in recovery and their parents is delineated in this article, which underscores the need for extensive knowledge of adolescent substance abuse and other mental health issues. In addition, sensitivity around privacy among adolescents, parents, schools, and health providers is highlighted, as well as the validity of assessment. Key assessment strategies, including protocol of recruitment and interviewing techniques, are also presented along with a list of parent and adolescent assessment instruments and their corresponding interpretive variables. Protocol recommendations for future research are also outlined. PMID:25018573

  15. [ Comparison of BESA and RAI: evaluating the outcomes of two assessment instruments for long-term residential care needs].

    PubMed

    Gattinger, Heidrun; Ott, Stefan; Saxer, Susi

    2014-02-01

    In Switzerland, the level of nursing care required for residents in nursing homes is either assessed by the BESA Catalogue 2010 or by the Minimum Data Set (MDS) of the Resident Assessment Instrument (RAI). Within both instruments the nursing care need is represented in minutes. According to these minutes, the resident is allocated to a tariff level. The aim of the study was to compare the outcomes of the two assessment instruments BESA Catalogue 2010 and MDS. For this purpose data were collected in two nursing homes. At each facility 60 nursing home residents were assessed with the BESA Catalogue 2010 and the MDS. The assessments were independently performed by nurses of the facility (internal assessment) and by system experts (external assessment). Descriptive data analysis and a comparison of the outcome in minutes and with regard to tariff level were carried out. In average, internal assessments were higher than external assessments. In both nursing homes, half or 54 % of residents were allocated into a higher tariff level by means of internal assessment. Comparing the outcomes in total and within tariff level, significant differences were found. Different classifications may occur, especially for residents with high nursing care needs. As a result, higher or lower costs of nursing care may arise. PMID:24571846

  16. Functional outcome in older adults with joint pain and comorbidity: design of a prospective cohort study

    PubMed Central

    2011-01-01

    Background Joint pain is a highly prevalent condition in the older population. Only a minority of the older adults consult the general practitioner for joint pain, and during consultation joint pain is often poorly recognized and treated, especially when other co-existing chronic conditions are involved. Therefore, older adults with joint pain and comorbidity may have a higher risk of poor functional outcome and decreased quality of life (QoL), and possibly need more attention in primary care. The main purpose of the study is to explore functioning in older adults with joint pain and comorbidity, in terms of mobility, functional independence and participation and to identify possible predictors of poor functional outcome. The study will also identify predictors of decreased QoL. The results will be used to develop prediction models for the early identification of subgroups at high risk of poor functional outcome and decreased QoL. This may contribute to better targeting of treatment and to more effective health care in this population. Methods/Design The study has been designed as a prospective cohort study, with measurements at baseline and after 6, 12 and 18 months. For the recruitment of 450 patients, 25 general practices will be approached. Patients are eligible for participation if they are 65 years or older, have at least two chronic conditions and report joint pain on most days. Data will be collected using various methods (i.e. questionnaires, physical tests, patient interviews and focus groups). We will measure different aspects of functioning (e.g. mobility, functional independence and participation) and QoL. Other measurements concern possible predictors of functioning and QoL (e.g. pain, co-existing chronic conditions, markers for frailty, physical performance, psychological factors, environmental factors and individual factors). Furthermore, health care utilization, health care needs and the meaning and impact of joint pain will be investigated from an older person's perspective. Discussion In this paper, we describe the protocol of a prospective cohort study in Dutch older adults with joint pain and comorbidity and discuss the potential strengths and limitations of the study. PMID:22024146

  17. Using Qualitative Research to Inform the Development of a Comprehensive Outcomes Assessment for Asthma

    PubMed Central

    Turner-Bowker, Diane M.; Saris-Baglama, Renee N.; DeRosa, Michael A.; Paulsen, Christine A.; Bransfield, Christopher P.

    2009-01-01

    Background Qualitative research can inform the development of asthma patient-reported outcome (PRO) measures and user-friendly technologies through defining measurement constructs, identifying potential limitations in measurement and sources of response error, and evaluating usability. Objective The goal of the current study was to inform the development of a comprehensive asthma PRO assessment with input from patients and clinical experts. Method Self-reported adult asthma sufferers recruited from a 3,000 member New England-area research panel participated in either one of three focus groups (N=21) or individual cognitive item debriefing interviews (N=20) to discuss how asthma impacts their health-related quality of life (HRQOL), and provide feedback on a preliminary set of asthma impact survey items and prototype patient report. Focus groups and cognitive interviews were conducted using traditional research principles (e.g., semi-structured interview guide, probing, and think aloud techniques). An Expert Advisory Panel (N=12) including asthma clinical specialists and measurement professionals was convened to review results from the focus group and cognitive interview studies and make recommendations for final survey and report development. Results Domains of health impacted by asthma included physical (recreation, play, competitive sports, and exercise), social (activities, family relationships), emotional (anger, upset, frustration, anxiety, worry), sleep, role (recreational/leisure activities; work), and sexual functioning. Most items in the impact survey were easily understood, covered important content, and included relevant response options. Items with contradictory examples and multiple concepts were difficult to comprehend. Suggestions were made to expand survey content by including additional items on physical and sexual functioning, sleep, self-consciousness, stigma, and finances. Reports were considered useful and participants saw value in sharing the results with their doctor. Graphic presentation of scores was not always understood; participants preferred tabular presentation of score levels with associated interpretative text. Display of inverse scores for different measures (higher scores equaling better health on one scale and worse health on another) shown on a single page was confusing. The score history section of the report was seen as helpful for monitoring progress over time, particularly for those recently diagnosed with asthma. Expert panelists agreed that displaying inverse scores in a single summary report may be confusing to patients and providers. They also stressed the importance of comprehensive interpretation guidelines for patients, with an emphasis on what they should do next based on scores. Panelists made recommendations for provider and aggregate-level reports (e.g., “red flags” to indicate significant score changes or cut-points of significance; identification of subgroups that have scored poorly or recently gotten worse). Conclusion Incorporating input from patients, clinicians, and measurement experts in the early stages of product development should improve the construct validity of this PRO measure and enhance its practical application in healthcare. PMID:20508735

  18. Integrating real-time feedback of outcome assessment for individual patients in an inpatient psychiatric setting: a case study of personalized psychiatric medicine.

    PubMed

    Confer, Jacob R; White, Melissa; Groat, Michael M; Madan, Alok; Allen, Jon G; Fowler, J Christopher; Kahn, David A

    2015-01-01

    Routine assessment of psychiatric patient outcomes is rare, despite growing evidence that feedback to clinicians and patients concerning patient progress improves treatment outcomes. The authors present a case in which real-time feedback proved beneficial in the treatment of a woman with a personality disorder admitted for inpatient treatment due to worsening depression, anxiety, severe suicide risk, and decline in functioning. During the course of her 10-week hospitalization, she completed standardized assessments of symptoms/functioning at admission, at 2 week intervals, and at discharge. The distinctive feature of this case is the way in which real-time feedback to the treatment team, psychiatrist, and patient exposed hidden treatment barriers. In the midst of an improving profile with decreasing symptom severity, the patient experienced a spike in distress and symptoms, prompting her treatment team to examine the treatment plan and to engage the patient around understanding the decline in functioning. This intervention revealed a replay of a familiar pattern in the patient's life that led to the identification and repair of a rupture in the therapeutic alliance and to an improvement in the patient's functioning. This case expands on previous research concerning the integration of individualized assessments into outpatient treatment and it illustrates the need to extend outpatient research to inpatient settings. PMID:25603454

  19. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the "right stuff"?

    PubMed

    Green, M F; Kern, R S; Braff, D L; Mintz, J

    2000-01-01

    There has been a surge of interest in the functional consequences of neurocognitive deficits in schizophrenia. The published literature in this area has doubled in the last few years. In this paper, we will attempt to confirm the conclusions from a previous review that certain neurocognitive domains (secondary verbal memory, immediate memory, executive functioning as measured by card sorting, and vigilance) are associated with functional outcome. In addition to surveying the number of replicated findings and tallying box scores of results, we will approach the review of the studies in a more thorough and empirical manner by applying a meta-analysis. Lastly, we will discuss what we see as a key limitation of this literature, specifically, the relatively narrow selection of predictor measures. This limitation has constrained identification of mediating variables that may explain the mechanisms for these relationships. PMID:10755673

  20. A Community Assessment of Functional Literacy.

    ERIC Educational Resources Information Center

    Holian, Barbara L.

    A community assessment for literacy action was conducted in Salinas, California. Service agencies were surveyed to assess literacy programs and materials. The agencies were asked questions regarding awareness of the illiteracy problem, knowledge of existing or retired programs, and agency commitment to support of a community-wide program. Research…

  1. Alternative and traditional assessments: Their comparative impact on students' attitudes and science learning outcomes. An exploratory study

    NASA Astrophysics Data System (ADS)

    Century, Daisy Nelson

    This probing study focused on alternative and traditional assessments, their comparative impacts on students' attitudes and science learning outcomes. Four basic questions were asked: What type of science learning stemming from the instruction can best be assessed by the use of traditional paper-and pencil test? What type of science learning stemming from the instruction can best be assessed by the use of alternative assessment? What are the differences in the types of learning outcomes that can be assessed by the use of paper-pencil test and alternative assessment test? Is there a difference in students' attitude towards learning science when assessment of outcomes is by alternative assessment means compared to traditional means compared to traditional means? A mixed methodology involving quantitative and qualitative techniques was utilized. However, the study was essentially a case study. Quantitative data analysis included content achievement and attitude results, to which non-parametric statistics were applied. Analysis of qualitative data was done as a case study utilizing pre-set protocols resulting in a narrative summary style of report. These outcomes were combined in order to produce conclusions. This study revealed that the traditional method yielded more concrete cognitive content learning than did the alternative assessment. The alternative assessment yielded more psychomotor, cooperative learning and critical thinking skills. In both the alternative and the traditional methods the student's attitudes toward science were positive. There was no significant differences favoring either group. The quantitative findings of no statistically significant differences suggest that at a minimum there is no loss in the use of alternative assessment methods, in this instance, performance testing. Adding the results from the qualitative analysis to this suggests (1) that class groups were more satisfied when alternative methods were employed, and (2) that the two assessment methodologies are complementary to each other, and thus should probably be used together to produce maximum benefit.

  2. Post-injury baicalein improves histological and functional outcomes and reduces inflammatory cytokines after experimental traumatic brain injury

    PubMed Central

    Chen, S-F; Hsu, C-W; Huang, W-H; Wang, J-Y

    2008-01-01

    Background and purpose: Traumatic brain injury (TBI) triggers a complex series of inflammatory responses that contribute to secondary tissue damage. The aim of this study was to investigate the effect of baicalein, a flavonoid possessing potent anti-inflammatory properties, on functional and histological outcomes and inflammatory cytokine expression, following TBI in rats. Experimental approach: Rats subjected to controlled cortical impact injury were injected with baicalein (30?mg?kg?1) or vehicle immediately after injury or daily for 4 days. Neurological status was evaluated using the rotarod, adhesive removal, modified neurological severity scores and beam walk tests. Contusion volume and neuronal degeneration were measured using cresyl violet and FluoroJade B (FJB) histochemistry. Levels of tumour necrosis factor-? (TNF-?), interleukin-1? (IL-1?) and interleukin-6 (IL-6) mRNA and protein were assessed by real-time quantitative reverse transcriptase-PCR, enzyme-linked immunosorbent assay and immunohistochemistry. Key results: Single-dose and multiple-dose treatment with baicalein significantly improved functional recovery and reduced contusion volumes up to day 28 post-injury, although multiple-dose baicalein was the more effective treatment. Single-dose baicalein also significantly reduced the number of degenerating neurons (31%) on post-injury day 1 as indicated by FJB staining. These changes were associated with significantly decreased levels, at the contusion site, of TNF-?, IL-1? and IL-6 mRNA at 6?h, and cytokine protein on day 1 post-injury. Conclusions and implications: Post-injury treatment with baicalein improved functional and histological outcomes and reduced induction of proinflammatory cytokines in rat TBI. The neuroprotective effect of baicalein may be related to a decreased inflammatory response following the injury. PMID:18776918

  3. Resection of gliomas in the cingulate gyrus: functional outcome and survival.

    PubMed

    Oszvald, Ági; Quick, Johanna; Franz, Kea; Güresir, Erdem; Szelényi, Andrea; Vatter, Hartmut; Seifert, Volker

    2012-09-01

    Functional outcome after resection of tumors arising from the gyrus cinguli (GC), part of the limbic system, is not well analyzed. The purpose of this study was to evaluate the feasibility and functional outcome of surgical treatment for a series of 65 patients with gliomas involving the GC. Preoperative data, extent of resection, functional outcome (Karnofsky performance index, KPI, and the National Institute of Health Stroke Scale, NIHSS), and survival of 65 patients with gliomas arising from the GC were analyzed on the basis of a prospectively conducted database of gliomas between 06/1999 and 07/2010. Extent of resection (complete, subtotal, or partial) was based on early postoperative MRI. Eighty-six percent of the gliomas were located in the anterior part of the GC and 14 % in the posterior part. Fifty-five percent of the patients presented with seizures and 17 % with hemiparesis (mean preoperative KPI = 86 ± 17, NIHSS = 1.4 ± 1.7). Histologically, the tumors were WHO Grade II in 25 %, Grade III in 26 %, and Grade IV in 49 %. Complete resection was achieved for 59 %, subtotal resection for 32%, and partial resection for 9 %. Postoperative transient deficits included SMA lesion (14 %) and new or worsened hemiparesis (8 %), which resolved within 30 days (NIHSS early postoperatively 1.7 ± 1.4, late postoperatively 0.8 ± 1.4, and after 6 months 0.6 ± 1.4). According to histopathological grading, median survival was 67 months (WHO°II), 87 months (WHO°III), and 16.5 months (WHO°IV), and overall survival was 34 months. Microsurgical resection of gliomas arising from the GC is feasible; gross total resection can be achieved for 90 % of gliomas arising from the GC with 5 % long-term morbidity. PMID:22660921

  4. Implications of Apathy for Everyday Functioning Outcomes in Persons Living with HIV Infection†

    PubMed Central

    Kamat, Rujvi; Woods, Steven Paul; Marcotte, Thomas D.; Ellis, Ronald J.; Grant, Igor

    2012-01-01

    Apathy is a relatively common clinical feature of HIV-Associated Neurocognitive Disorders, but little is known about its implications for everyday functioning outcomes. In the present study, we examined the associations between apathy and self-reported instrumental activities of daily living (IADL) and neurocognitive complaints in 75 participants with HIV infection and 52 demographically comparable seronegative comparison subjects. All volunteers completed the apathy subscale of the Frontal Systems Behavioral Scale as part of a comprehensive neuromedical, psychiatric, and neurocognitive research evaluation. When compared with the seronegative comparison participants, the HIV+ group reported significantly higher current levels of apathy, but did not differ in self-report of prior (i.e., pre-seroconversion) apathy. Higher current apathy self-ratings were associated with greater severity of IADL declines and more numerous cognitive complaints in the HIV+ sample, even after adjusting for potential psychiatric (e.g., depression), medical (e.g., hepatitis C co-infection), and neurocognitive predictors. Cognitive complaints, but not IADLs, were also uniquely associated with ratings of executive dysfunction and disinhibition. All told, these findings suggest that apathy may make a unique contribution to important everyday functioning outcomes among persons living with HIV infection. The clinical detection of apathy may help identify HIV-infected individuals at particular risk for functional impairments who may require additional support to maintain independence. PMID:22705481

  5. Assessing Executive Functioning: A Pragmatic Review

    ERIC Educational Resources Information Center

    Hass, Michael R.; Patterson, Ashlea; Sukraw, Jocelyn; Sullivan, Brianna M.

    2014-01-01

    Despite the common usage of the term "executive functioning" in neuropsychology, several aspects of this concept remain unsettled. In this paper, we will address some of the issues surrounding the notion of executive functioning and how an understanding of executive functioning and its components might assist school-based practitioners…

  6. Assessment of Electrode Placement and Audiologic Outcomes in Bilateral Cochlear Implantation

    PubMed Central

    Noble, Jack H.; McRrackan, Theodore R.; Dawant, Benoit M.; Dietrich, Mary S.; Watkins, Linsey; Rivas, Alejandro; Schuman, Theodore A.; Labadie, Robert F.

    2011-01-01

    Objective The goal of this study was to use highly accurate, non-rigid algorithms to locate the position of cochlear implant electrodes and correlate this with audiological performance. Patients After obtaining IRB approval, adult, bilateral CI patients were identified and those with pre-operative temporal bone CT scans were asked to return for a post-intervention CT. Sixteen adult patients agreed. Demographics, etiology of deafness, length of auditory deprivation and audiological performance were recorded. Intervention Using a non-rigid model of the shape variations of intracochlear anatomy, the location of the basilar membrane was specified in relationship to the electrode array. Number of electrodes within each compartment of the cochlea was correlated with HINT and CNC scores for the known confounding variable, length of deafness. Main Outcomes Mann-Whitney tests of differences were used to compare the hearing performance resulting from implants completely in the ST versus those not completely in the ST. Results 62.5% implants were fully inserted in ST; 34.4% were partially inserted into the ST and 3.1% was fully inserted in SV. Controlling for the known contributing variable of length of auditory deprivation our results show that location of electrodes in relationship to the scala is not predictive of audiological performance. Conclusions We have assessed electrode placement and correlated it with audiological outcome. Presence of the electrodes solely in ST was not predictive of outcome. We estimate that is would take analysis of thousands of CI patients data before any valid correlations could be made. PMID:21283037

  7. Assessing the effectiveness of mental health care in routine clinical practice. Characteristics, development, and uses of patient outcomes modules.

    PubMed

    Smith, G R; Rost, K M; Fischer, E P; Burnam, M A; Burns, B J

    1997-03-01

    The health care delivery system faces continually increasing pressure to be accountable for the historically unparalleled amount of resources it utilizes. This article discusses one set of recently developed tools known as outcomes modules that are used to assess how treatment affects outcomes in patients with a given disorder. These tools currently are being used to inform administrative decisions about how to improve the quality of care, and can potentially influence decisions by patients, providers, and payers of care as well. The critical components of outcomes modules, as well as their administration and applications are described, using modules for psychiatric conditions as examples. PMID:10183313

  8. A functional outcomes survey of elderly patients who sustained distal radius fractures

    Microsoft Academic Search

    Louis F. Amorosa; Mark A. Vitale; Shervondalonn Brown; Robert A. Kaufmann

    Purpose  This study aims to examine the subjective functional outcomes of patients 70 years or older who sustained distal radius fractures\\u000a through the use of the Disability of the Arm, Shoulder, and Hand (DASH) and Short Form-8 Health (SF-8) surveys.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Patients at least 70 years old with a distal radius fracture between 2000 and 2004 were identified and their charts reviewed.\\u000a They were

  9. Stapled transanal rectal resection for symptomatic intussusception: morphological and functional outcome

    Microsoft Academic Search

    Reinhold A. Lang; Sonja Buhmann; Christine Lautenschlager; Mario H. Müller; Andreas Lienemann; Karl-Walter Jauch; Martin E. Kreis

    2010-01-01

    Introduction  Stapled transanal rectal resection (STARR) was developed to correct intussusception causing obstructed defecation. Some patients,\\u000a however, do not profit from this operation as anticipated. We aimed to study the relationship between functional outcome and\\u000a rectal morphology after STARR.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Fifteen consecutive female patients with median age of 64 years [interquartile range (IQR) 58–71 years] were studied before\\u000a and after STARR. All patients had

  10. Daily Automated Telephone Assessment and Intervention Improved 1-Month Outcome in Paroled Offenders.

    PubMed

    Andersson, Claes; Vasiljevic, Zoran; Höglund, Peter; Ojehagen, Agneta; Berglund, Mats

    2014-03-13

    This randomized trial evaluates whether automated telephony could be used to perform daily assessments in paroled offenders (N = 108) during their first 30 days after leaving prison. All subjects were called daily and answered assessment questions. Based on the content of their daily assessments, subjects in the intervention group received immediate feedback and a recommendation by automated telephony, and their probation officers also received a daily report by email. The outcome variables were analyzed using linear mixed models. The intervention group showed greater improvement than the control group in the summary scores (M = 9.6, 95% confidence interval [CI] = [0.5, 18.7], p = .038), in mental symptoms (M = 4.6, CI = [0.2, 9.0], p = .042), in alcohol drinking (M = 0.8, CI = [0.1, 1.4], p = .031), in drug use (M = 1.0, CI = [0.5, 1.6], p = .000), and in most stressful daily event (M = 1.9, CI = [1.1, 2.7], p = .000). In conclusion, automated telephony may be used to follow up and to give interventions, resulting in reduced stress and drug use, in paroled offenders. PMID:24626145

  11. Assessing the quality of studies supporting genetic susceptibility and outcomes of ARDS

    PubMed Central

    Acosta-Herrera, Marialbert; Pino-Yanes, Maria; Perez-Mendez, Lina; Villar, Jesús; Flores, Carlos

    2014-01-01

    The acute respiratory distress syndrome (ARDS) is a severe inflammatory disease manifested as a result of pulmonary and systemic responses to several insults. It is now well accepted that genetic variation influences these responses. However, little is known about the genes that are responsible for patient susceptibility and outcome of ARDS. Methodological flaws are still abundant among genetic association studies with ARDS and here, we aimed to highlight the quality criteria where the standards have not been reached, to expose the associated genes to facilitate replication attempts, and to provide quick-reference guidance for future studies. We conducted a PubMed search from January 2008 to September 2012 for original articles. Studies were considered if a statistically significant association was declared with either susceptibility or outcomes of all-cause ARDS. Fourteen criteria were used for evaluation and results were compared to those from a previous quality assessment report. Significant improvements affecting study design and statistical analysis were detected. However, major issues such as adjustments for the underlying population stratification and replication studies remain poorly addressed. PMID:24567738

  12. Progress since OMERACT 6 on including patient perspective in rheumatoid arthritis outcome assessment.

    PubMed

    Kirwan, John R; Ahlmén, Monica; de Wit, Maarten; Heiberg, Turid; Hehir, Maggie; Hewlett, Sarah; Katz, Patricia P; Minnock, Patricia; Quest, Enid M; Richards, Pam

    2005-11-01

    The first OMERACT Patient Perspective Workshop took place at OMERACT 6 in 2002. Through a series of meetings and discussion sessions a research agenda emerged and this report outlines progress made on this agenda. Work on identifying novel outcomes, instruments, and methods has shown similarities across European countries in the importance patients with rheumatoid arthritis (RA) attach to specific outcomes, in particular fatigue. Validation of an appropriate instrument to measure fatigue in patients with RA is currently being investigated. Frequent or repeated real-time assessment of symptoms such as pain and fatigue is becoming possible using electronic systems. An OMERACT Patient Panel has been established, and has produced a glossary for patients involved in supporting clinical research. In some centers, efforts are being made to provide Patient Research Partners with knowledge and skills that will enhance their contribution, and some of these approaches will be incorporated into OMERACT 7. The research agenda that was developed during the first Patient Perspective Workshop has stimulated new work in several areas. In addition, international attention has been drawn to the need to make sure that the patient's perspective is not lost among the technical expertise of rheumatology. PMID:16265711

  13. Statistical issues in risk assessment of reproductive outcomes with chemical mixtures

    SciTech Connect

    Hertzber, V.S.; Lemasters, G.K.; Hansen, K. (Univ. of Cincinnati, OH (United States)); Zenick, H.M. (Environmental Protection Agency, Research Triangle Park, NC (United States))

    1991-01-01

    Establishing the relationship between a given chemical exposure and human reproductive health risk is complicated by exposures or other concomitant factors that may vary from pregnancy to pregnancy. Moreover, when exposures are to complex mixtures of chemicals, varying with time in number of components, doses of individual components, and constancy of exposure, the picture becomes even more complicated. A pilot study of risk of adverse reproductive outcomes among male wastewater treatment workers and their wives is described here. The wives of 231 workers were interviewed to evaluate retrospectively the outcomes of spontaneous early fetal loss and infertility. In addition, 87 workers participated in a cross-sectional evaluation of sperm/semen parameters. Due to the ever-changing nature of the exposure and the lack of quantification of specific exposures, six dichotomous variables were used for each specific job description to give a surrogate measure of exposure. Hence, no quantitative exposure-response relationships could be modeled. These six variables were independently assigned by two environmental hygienists, and their interrater reliability was assessed. Results are presented and further innovations in statistical methodology are proposed for further applications.

  14. Effect of platelet reactivity, endothelial function, and inflammatory status on outcomes in patients with stable angina pectoris on clopidogrel therapy.

    PubMed

    Woo, Jong Shin; Kim, Weon; Jang, Hyun Hee; Kim, Jin Bae; Kim, Woo-Shik; Kim, Kwon Sam

    2014-03-01

    Although high on-treatment platelet reactivity (HTPR) is an important predictor of clinical outcomes in patients undergoing coronary stenting, it is unknown whether endothelial dysfunction and HTPR are associated. We examined the platelet function, peripheral vascular function, endothelial progenitor cell (EPC) number, platelet activation markers, high-sensitivity C-reactive protein (hs-CRP) level, and clinical outcomes in patients receiving chronic clopidogrel therapy. We consecutively enrolled 91 patients who underwent follow-up angiography because of chest discomfort. All patients took aspirin and clopidogrel for an average of 498 ± 138 days. Platelet reactivity was assessed by light transmittance aggregometry (maximal platelet aggregation by 5 ?mol/L of adenosine diphosphate ?50% in group 1 [optimal response] and >50% as group 2 [HTPR]). Flow-mediated dilation of the brachial artery and brachial-ankle pulse wave velocity (PWV), numbers of EPCs isolated from peripheral blood, platelet activation markers (soluble CD40 ligand and soluble P-selectin), and hs-CRP levels were assessed before follow-up angiography. There were no significant differences in baseline characteristics and previous percutaneous coronary intervention (PCI) data between groups 1 (n = 59) and 2 (n = 32). Group 2 showed poorer flow-mediated dilation (6.1 ± 4.1% vs 12.9 ± 6.2%, p <0.001), pulse wave velocity (1925.4 ± 362.2 vs 1571.0 ± 306.5 ms, p <0.001), and lower circulating EPCs by flow cytometry (21.9 ± 14.7 vs 65.2 ± 30.1 per 10 fields, p <0.001) compared with group 1. Significantly higher levels of soluble CD40 ligand, soluble P-selectin, and hs-CRP were observed in group 2. In multivariate analysis, elevated hs-CRP level, but not HTPR, was independently associated with repeated PCI. In patients with angina, HTPR was associated endothelial dysfunction and elevated hs-CRP, although elevated hs-CRP level was significantly associated with poorer outcomes. PMID:24388620

  15. High-Functioning Autism/Asperger Syndrome in Schools: Assessment and Intervention. Practical Intervention in the Schools Series

    ERIC Educational Resources Information Center

    Sansosti, Frank J.; Powell-Smith, Kelly A.; Cowan, Richard J.

    2010-01-01

    Meeting a growing need for school-based practitioners, this book provides vital tools for improving the academic, behavioral, and social outcomes of students with high-functioning autism or Asperger syndrome (HFA/AS). Research-based best practices are presented for conducting meaningful assessments; collaborating with teachers, students, and…

  16. A Dirichlet process mixture model for survival outcome data: assessing nationwide kidney transplant centers.

    PubMed

    Zhao, Lili; Shi, Jingchunzi; Shearon, Tempie H; Li, Yi

    2015-04-15

    Mortality rates are probably the most important indicator for the performance of kidney transplant centers. Motivated by the national evaluation of mortality rates at kidney transplant centers in the USA, we seek to categorize the transplant centers based on the mortality outcome. We describe a Dirichlet process model and a Dirichlet process mixture model with a half-cauchy prior for the estimation of the risk-adjusted effects of the transplant centers, with strategies for improving the model performance, interpretability, and classification ability. We derive statistical measures and create graphical tools to rate transplant centers and identify outlying groups of centers with exceptionally good or poor performance. The proposed method was evaluated through simulation and then applied to assess kidney transplant centers from a national organ failure registry. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25620744

  17. Defining and assessing quality improvement outcomes: a framework for public health.

    PubMed

    McLees, Anita W; Nawaz, Saira; Thomas, Craig; Young, Andrea

    2015-04-01

    We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention's National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI's impact on the practice of public health. PMID:25689185

  18. Impact of Executive Function Deficits and Attention-Deficit\\/Hyperactivity Disorder (ADHD) on Academic Outcomes in Children

    Microsoft Academic Search

    Joseph Biederman; Michael C. Monuteaux; Alysa E. Doyle; Larry J. Seidman; Timothy E. Wilens; Frances Ferrero; Christie L. Morgan; Stephen V. Faraone

    2004-01-01

    The association between executive function deficits (EFDs) and functional outcomes were examined among children and adolescents with attention-deficit\\/hyperactivity disorder (ADHD). Participants were children and adolescents with (n = 259) and without (n = 222) ADHD, as ascertained from pediatric and psychiatric clinics. The authors defined EFD as at least 2 executive function measures impaired. Significantly more children and adolescents with

  19. Use of Standardized Mastery Content Assessments Given during the First Year of a Baccalaureate Nursing Program for Predicting NCLEX-RN Outcomes

    ERIC Educational Resources Information Center

    Emory, DeAnna Jan

    2012-01-01

    The purpose of this study was to evaluate the relationship between standardized content specific mastery assessments and NCLEX-RN outcomes. Three content-specific standardized assessments testing Fundamentals, Pharmacology and Mental Health concepts were used to explain the dichotomous NCLEX-RN outcome of pass or fail. The three assessments were…

  20. Assessing severity of illness and outcomes of treatment in children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME): a systematic review of patient-reported outcome measures (PROMs).

    PubMed

    Haywood, K L; Collin, S M; Crawley, E

    2014-11-01

    Chronic Fatigue Syndrome or Myalgic Encephalomyelitis (CFS/ME) in children is characterized by persistent or recurrent debilitating fatigue which results in a substantial reduction in activity. There is a growing interest in the use of questionnaires, or patient-reported outcome measures (PROMs), to assess how patients function and feel in relation to their health and associated healthcare. However, guidance for PROM selection for children with CFS/ME does not exist. We reviewed the quality and acceptability of PROMs used with children with CFS/ME to inform recommendations for practice. We conducted a systematic review of PROMs completed by children with CFS/ME. The quality of the evaluative studies and the reviewed measures were assessed against recommended criteria using an appraisal framework and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. We sought evidence of measurement (reliability, validity, responsiveness, interpretability, data quality) and practical properties (acceptability, relevance, feasibility). Sixteen articles were included in the review, providing evidence of reliability and/or validity for 13 PROMs. Of these, five were child-specific (one health-related quality-of-life; four emotional well-being) and eight were not (four emotional well-being, three fatigue-specific; and one generic). All measures had limited evidence of measurement properties and no evidence of practical properties. Recommendations for patient-reported assessment are difficult to make because of limited evidence of the quality and acceptability of PROMs for children with CFS/ME. The appraisal method highlighted significant methodological and quality issues which must be addressed in future research. There is a lack of qualitative evidence describing the outcomes of healthcare that are important to children with CFS/ME, and the relevance or appropriateness of available measures. Future PROM development and evaluation in this group must seek to involve children collaboratively to ensure that the outcomes that children care about are assessed in an acceptable way. PMID:24661148

  1. Perioperative, Functional, and Oncologic Outcomes of Partial Adrenalectomy for Multiple Ipsilateral Pheochromocytomas

    PubMed Central

    Benson, Jonas S.; Ross, Michael J.; Sundaram, Vani S.; Lin, Kelly Y.; Pinto, Peter A.; Linehan, W. Marston; Bratslavsky, Gennady

    2014-01-01

    Abstract Objective: Managing patients with multiple adrenal masses is technically challenging. We present our experience with minimally invasive partial adrenalectomy (PA) performed for synchronous multiple ipsilateral pheochromocytomas in a single setting. Materials and Methods: We reviewed records of patients undergoing PA for pheochromocytoma at the National Cancer Institute between 1994 and 2010. Patients were included if multiple tumors were excised from the ipsilateral adrenal gland in the same operative setting. Perioperative, functional, and oncologic outcomes of PA for multiple pheochromocytomas are shown. Results: Of 121 partial adrenalectomies performed, 10 procedures performed in eight patients for synchronous multiple ipsilateral pheochromocytomas were identified. All eight patients were symptomatic at presentation. The mean patient age was 30.6 years, median follow up was 12 months. The average surgical time was 228 minutes, average blood loss of 125?mL, and average number of tumors removed was 2.6 per adrenal. In total, 26 tumors were removed, 24 were pathologically confirmed pheochromocytomas, while two were adrenal cortical hyperplasia. After surgery, all patients had resolution of their symptoms, one patient required steroid replacement postoperatively. On postoperative imaging, one patient had evidence of ipsilateral adrenal nodule at the prior resection site 2 months postoperatively, which was consistent with incomplete resection. Conclusions: Minimally invasive surgical resection of synchronous multiple pheochromocytomas is feasible with acceptable perioperative, functional, and short-term oncologic outcomes. PMID:23998199

  2. Prenatal infarction of the left middle cerebral artery: A case report of excellent functional outcome.

    PubMed

    Kuhtz-Buschbeck, Johann P.; Dreesmann, Mona; Gölge, Mukaddes; Stephani, Ulrich

    2000-01-01

    Extensive cortical-subcortical damage of the left hemisphere, most likely due to prenatal infarction of the left middle cerebral artery, was accidentally detected in a 12-year-old left-handed girl. Since clinical symptoms were minimal, the lesion had not been discovered for more than a decade. Meticulous examination revealed some slowness and somatosensory deficits of the right hand. Yet, independent finger movements were preserved, and functional skills such as reaching and grasping were unimpaired, as documented with optoelectronic motion analysis. There were no mirror movements. Transcranial magnetic stimulation indicated that the right hand was controlled by spared cortical areas of the damaged hemisphere. Gait was normal. Neuropsychological examination confirmed regular development of language, intellect, and visuospatial abilities. This case report demonstrates exceptionally good functional outcome after early brain damage. PMID:11455093

  3. Fluorescently Labeled Peptide Increases Identification of Degenerated Facial Nerve Branches during Surgery and Improves Functional Outcome

    PubMed Central

    Hussain, Timon; Mastrodimos, Melina B.; Raju, Sharat C.; Glasgow, Heather L.; Whitney, Michael; Friedman, Beth; Moore, Jeffrey D.; Kleinfeld, David; Steinbach, Paul; Messer, Karen; Pu, Minya; Tsien, Roger Y.; Nguyen, Quyen T.

    2015-01-01

    Nerve degeneration after transection injury decreases intraoperative visibility under white light (WL), complicating surgical repair. We show here that the use of fluorescently labeled nerve binding probe (F-NP41) can improve intraoperative visualization of chronically (up to 9 months) denervated nerves. In a mouse model for the repair of chronically denervated facial nerves, the intraoperative use of fluorescent labeling decreased time to nerve identification by 40% compared to surgeries performed under WL alone. Cumulative functional post-operative recovery was also significantly improved in the fluorescence guided group as determined by quantitatively tracking of the recovery of whisker movement at time intervals for 6 weeks post-repair. To our knowledge, this is the first description of an injectable probe that increases visibility of chronically denervated nerves during surgical repair in live animals. Future translation of this probe may improve functional outcome for patients with chronic denervation undergoing surgical repair. PMID:25751149

  4. Functional variants in TNFAIP8 associated with cervical cancer susceptibility and clinical outcomes.

    PubMed

    Shi, Ting-Yan; Cheng, Xi; Yu, Ke-Da; Sun, Meng-Hong; Shao, Zhi-Ming; Wang, Meng-Yun; Zhu, Mei-Ling; He, Jing; Li, Qiao-Xin; Chen, Xiao-Jun; Zhou, Xiao-Yan; Wu, Xiaohua; Wei, Qingyi

    2013-04-01

    Tumor necrosis factor-?-induced protein 8 (TNFAIP8) is an anti apoptotic and pro-oncogenic signaling molecule involved in the process of immunity, carcinogenesis and tumor progression. Single nucleotide polymorphisms (SNPs) at microRNA-binding sites may change messenger RNA target gene function, thus leading to cancer susceptibility and tumor progression. In this study of 1584 cervical cancer cases and 1394 cancer-free female controls, we investigated associations between three potentially functional SNPs in TNFAIP8 family genes and cervical cancer risk as well as platinum resistance and clinical outcomes in Eastern Chinese women. We found that the TNFAIP8-rs11064 variant GG genotype was associated with an increased risk of cervical cancer compared with AA/AG genotypes (adjusted odds ratio = 2.16, 95% confidence interval = 1.16-4.03, P = 0.015). Further in vitro and ex vivo functional experiments demonstrated that the TNFAIP8-rs11064 variant G allele weakened the binding affinity of miR-22 to the TNFAIP8 3'-untranslated region (UTR) in four cancer cell lines, resulting in increased production of the TNFAIP8 protein in the patients' cervical tissues. In the survival subset, the high TNFAIP8 protein expression was significantly associated with both resistance to cisplatin and nedaplatin, recurrence and death from cervical cancer. Taken together, in the absence of information on human papillomavirus (HPV) infection, the TNFAIP8-rs11064 SNP may function by affecting the affinity of miR-22 binding to the 3'-UTR of TNFAIP8 and regulating TNFAIP8 expression, thus contributing to cervical cancer risk. Additionally, the increased TNFAIP8 protein expression may predict platinum resistance and clinical outcomes in cervical cancer patients. Larger, prospective studies with detailed HPV infection data are warranted to validate our findings. PMID:23299407

  5. Treatment Outcomes, Growth Height, and Neuroendocrine Functions in Patients With Intracranial Germ Cell Tumors Treated With Chemoradiation Therapy

    SciTech Connect

    Odagiri, Kazumasa, E-mail: t086016a@yokohama-cu.ac.jp [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama (Japan) [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Department of Radiology, Kanagawa Children's Medical Center, Yokohama (Japan); Omura, Motoko [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama (Japan) [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Department of Radiology, Kanagawa Children's Medical Center, Yokohama (Japan); Hata, Masaharu [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama (Japan)] [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Aida, Noriko; Niwa, Tetsu [Department of Radiology, Kanagawa Children's Medical Center, Yokohama (Japan)] [Department of Radiology, Kanagawa Children's Medical Center, Yokohama (Japan); Ogino, Ichiro [Department of Radiology, Yokohama City University Medical Center, Yokohama (Japan)] [Department of Radiology, Yokohama City University Medical Center, Yokohama (Japan); Kigasawa, Hisato [Division of Hemato-oncology/Regeneration Medicine, Kanagawa Children's Medical Center, Yokohama (Japan)] [Division of Hemato-oncology/Regeneration Medicine, Kanagawa Children's Medical Center, Yokohama (Japan); Ito, Susumu [Department of Neurosurgery, Kanagawa Children's Medical Center, Yokohama (Japan)] [Department of Neurosurgery, Kanagawa Children's Medical Center, Yokohama (Japan); Adachi, Masataka [Department of Endocrinology, Kanagawa Children's Medical Center, Yokohama (Japan)] [Department of Endocrinology, Kanagawa Children's Medical Center, Yokohama (Japan); Inoue, Tomio [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama (Japan)] [Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama (Japan)

    2012-11-01

    Purpose: We carried out a retrospective review of patients receiving chemoradiation therapy (CRT) for intracranial germ cell tumor (GCT) using a lower dose than those previously reported. To identify an optimal GCT treatment strategy, we evaluated treatment outcomes, growth height, and neuroendocrine functions. Methods and Materials: Twenty-two patients with GCT, including 4 patients with nongerminomatous GCT (NGGCT) were treated with CRT. The median age at initial diagnosis was 11.5 years (range, 6-19 years). Seventeen patients initially received whole brain irradiation (median dose, 19.8 Gy), and 5 patients, including 4 with NGGCT, received craniospinal irradiation (median dose, 30.6 Gy). The median radiation doses delivered to the primary site were 36 Gy for pure germinoma and 45 Gy for NGGCT. Seventeen patients had tumors adjacent to the hypothalamic-pituitary axis (HPA), and 5 had tumors away from the HPA. Results: The median follow-up time was 72 months (range, 18-203 months). The rates of both disease-free survival and overall survival were 100%. The standard deviation scores (SDSs) of final heights recorded at the last assessment tended to be lower than those at initial diagnosis. Even in all 5 patients with tumors located away from the HPA, final height SDSs decreased (p = 0.018). In 16 patients with tumors adjacent to the HPA, 8 showed metabolic changes suggestive of hypothalamic obesity and/or growth hormone deficiency, and 13 had other pituitary hormone deficiencies. In contrast, 4 of 5 patients with tumors away from the HPA did not show any neuroendocrine dysfunctions except for a tendency to short stature. Conclusions: CRT for GCT using limited radiation doses resulted in excellent treatment outcomes. Even after limited radiation doses, insufficient growth height was often observed that was independent of tumor location. Our study suggests that close follow-up of neuroendocrine functions, including growth hormone, is essential for all patients with GCT.

  6. Positive aspects of patients’ state: A measure for assessing outcome and predicting follow-up of treatment for depression

    Microsoft Academic Search

    Irene Elkin; Alisa Ainbinder; Sun-Young Park; Jane Yamaguchi

    2006-01-01

    Most psychotherapy outcome studies in the field of depression focus on changes in depressive symptoms and impairment of functioning. The present article reports on the General Life Functioning Scale (GLF), a measure of more positive aspects of a patient's experience, specifically the patient's sense of well-being and feeling that he or she can cope with problems that arise. The development

  7. Electrocortical features of depression and their clinical utility in assessing antidepressant treatment outcome.

    PubMed

    Jaworska, Natalia; Protzner, Andrea

    2013-09-01

    Major depressive disorder (MDD) is primarily characterized by decreased affect and accompanying behavioural consequences, but it is also associated with cognitive dysfunction. Assessment of electroencephalographic (EEG) activity and associated event-related potentials (ERPs; derived from averaged EEG activity in response to a stimulus) in the context of MDD has provided insights into the electrocortical abnormalities associated with the disorder. Importantly, EEG and ERPs also have emerged as candidates for predicting and optimizing antidepressant (AD) treatment outcome. This is critical in light of relatively low remission rates or a limited response to initial AD interventions. In contrast to other neuroimaging approaches, EEG and ERPs may be superior for predicting and monitoring AD response, as electrocortical measures are relatively inexpensive, easy to use, and have excellent temporal (that is, millisecond) resolution, enabling fine-grained assessment of basic cognitive and emotive processes. This review aims to highlight the most consistently noted EEG and ERP features in MDD, which may one day assist with diagnostic confirmation, as well as the potential clinical utility of specific electrocortical measures in aiding with response prediction. PMID:24099498

  8. Outcome assessment of 603 cases of concomitant inferior turbinectomy and Le Fort I osteotomy

    PubMed Central

    Movahed, Reza; Morales-Ryan, Carlos; Allen, Will R.; Warren, Scott

    2013-01-01

    This retrospective study assessed the outcome of 603 patients undergoing partial inferior turbinectomies (PIT) in association with Lefort I osteotomy. The study included 1234 patients from a single private practice; these patients had dentofacial deformities and underwent Lefort I osteotomy procedures. For the full patient group, 888 patients (72%) were women; in the turbinectomy group, 403 (67%) were women. The anteroposterior, transverse, and vertical dimensions of the mandible, maxilla, and occlusal plane of each subject were assessed, in addition to cephalometric analysis and determination of the presence or absence of temporomandibular joint disorders. PIT, when indicated, was performed after downfracture of the maxilla, providing access to the turbinates where approximately two thirds of the total turbinate volume was removed and septoplasty was completed if indicated. Hypertrophied turbinates causing significant nasal airway obstruction were present in 603 (49%) of the 1234 patients undergoing Le Fort I osteotomy. The results of this study showed that PIT performed simultaneously with Le Fort I osteotomy is a safe method of managing nasal airway obstruction related to hypertrophied turbinates with minimal complications. PMID:24082413

  9. The impact of medical comorbidity on mental health and functional health outcomes among children with anxiety disorders

    PubMed Central

    Chavira, Denise A.; Garland, Ann F.; Daley, Sandra; Hough, Richard

    2009-01-01

    Objective Medical comorbidity is common among children with anxiety disorders; however, little is known about the impact of such comorbidity on mental and functional health outcomes. Even less is known about these problems in high-risk samples of youth. Method Participants in this study were youth with at least one DSM-IV anxiety disorder with a physical illness (N=77) and without a physical illness (N=73), as well as youth with at least one physical illness (but no anxiety disorder) (N = 438). These youth were recruited as part of the Patterns of Care study in which the original set of participants (N = 1715) were randomly sampled from one of five public sectors of care (e.g., juvenile justice, child welfare, mental health, alcohol and substance use services, school services for children with serious emotional disturbance) in San Diego County. Psychiatric diagnoses were assessed with a structured interview and three standardized measures were used to assess child health, emotional, and behavior functioning. Results At least half of children with anxiety disorders had a comorbid physical illness. Allergies and asthma were the most common comorbid physical illnesses. Children with anxiety disorders who had a comorbid physical illness exhibited greater levels of emotional problems, more somatic complaints, and more functional impairment than anxious children without a physical illness as well as than children with physical illness alone. Parents of children in the comorbid group also reported greater caregiver strain than the other two groups. Conclusions Children with anxiety disorders have high rates of chronic illnesses such as asthma and allergies. These children experience considerable impairment and likely have unique needs that may complicate usual care. PMID:18714205

  10. Functional Outcomes of Patients with Sternectomy after Cardiothoracic Surgery: A Case Series

    PubMed Central

    Irons, Sonya L.; Hoffman, Julie E.; Elliott, Shannon; Linnaus, Melanie

    2012-01-01

    Purpose One potential complication after cardiothoracic surgery involves mediastinitis, which may lead to a sternectomy. A sternectomy involves partial or total debridement of the sternum to remove infected bone. Little evidence regarding functional outcomes following sternectomy exists in literature. The purpose of this case series is to report the demographics of 6 patients admitted to a long term acute care hospital (LTACH) treated for sternectomy after open heart surgery, along with presenting length of stay (LOS) data, analyzing functional outcomes, and describing the physical therapy (PT) interventions used with these patients to obtain the reported functional outcomes. Methods Medical charts were reviewed retrospectively. Information in four main areas were extrapolated from the chart and further analyzed: patient demographics, length of hospital stay (acute care and LTACH), admission and discharge FIM scores, and information about the PT interventions (both numerical and descriptive). Results Patients included 5 males and 1 female with an age range of 65-78 years old (mean 70 years old, SD 4.8 years). Patients had a total mean acute care LOS of 26.33 (12.26) days and total mean LTACH LOS of 27.67 (11.74) days. Median total FIM score at admission was 80.00 [range 58.00-94.00], while the median total FIM score at discharge increased significantly to 106.50 [range 86.00-116.00] (p = 0.031). Total mean FIM score change during LTACH stay (efficiency) was 25.17 (3.25), and FIM score change per day (efficacy) was 1.23 (0.46). Median motor score had a significant increase from admission to discharge (p = 0.031). Median cognitive score did not significantly change from admission to discharge (p = 0.125). PT interventions used with this patient population were presented and described, with a mean number of PT sessions in LTACH of 27.33 (15.38) (range = 10-46). Conclusion Although patients required an increased acute care LOS and an additional stay on LTACH, all 6 patients were discharged home following a course of multi-disciplinary inpatient rehabilitation on a LTACH unit. Patients are able to make significant functional gains during rehabilitation following sternectomy, as evidenced by increases in FIM score. PMID:23304094

  11. Severe ulnar nerve entrapment at the elbow: functional outcome after minimally invasive in situ decompression.

    PubMed

    Karthik, K; Nanda, R; Storey, S; Stothard, J

    2012-02-01

    The role of in situ decompression in patients with severe ulnar nerve compression is still controversial. Thirty patients with severe ulnar nerve compression confirmed clinically and electrophysiologically underwent simple decompression. The mean age of the patients was 58 (range 26-87) years. Through incisions ?4?cm the nerves were fully visualized and decompressed. Outcome was measured prospectively using Modified Bishop's score (BS), grip and pinch strengths and two-point discrimination (2PD). Significant improvement in power (p?=?0.01) and pinch grip (p?=?0.001) was noted at 1 year. The grip strength continued to improve up to 1 year. According to the BS, 24 patients (80%) had good to excellent results at 1 year. Minimally invasive in situ decompression is technically simple, safe and gives good results in patients with severe nerve compression. The BS and 2PD were more reliable than grip strength in assessing these patients at follow-up. PMID:21914694

  12. Early Clinical Outcomes Demonstrate Preserved Cognitive Function in Children With Average-Risk Medulloblastoma When Treated With Hyperfractionated Radiation Therapy

    SciTech Connect

    Gupta, Tejpal, E-mail: tejpalgupta@rediffmail.com [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India)] [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India); Jalali, Rakesh [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India)] [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India); Goswami, Savita [Department of Clinical Psychology and Psychiatry Unit, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India)] [Department of Clinical Psychology and Psychiatry Unit, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India); Nair, Vimoj [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India)] [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India); Moiyadi, Aliasgar [Division of Neuro-Surgery, Department of Surgical Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India)] [Division of Neuro-Surgery, Department of Surgical Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India); Epari, Sridhar [Department of Pathology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India)] [Department of Pathology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India); Sarin, Rajiv [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India)] [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer and Tata Memorial Hospital, Mumbai (India)

    2012-08-01

    Purpose: To report on acute toxicity, longitudinal cognitive function, and early clinical outcomes in children with average-risk medulloblastoma. Methods and Materials: Twenty children {>=}5 years of age classified as having average-risk medulloblastoma were accrued on a prospective protocol of hyperfractionated radiation therapy (HFRT) alone. Radiotherapy was delivered with two daily fractions (1 Gy/fraction, 6 to 8 hours apart, 5 days/week), initially to the neuraxis (36 Gy/36 fractions), followed by conformal tumor bed boost (32 Gy/32 fractions) for a total tumor bed dose of 68 Gy/68 fractions over 6 to 7 weeks. Cognitive function was prospectively assessed longitudinally (pretreatment and at specified posttreatment follow-up visits) with the Wechsler Intelligence Scale for Children to give verbal quotient, performance quotient, and full-scale intelligence quotient (FSIQ). Results: The median age of the study cohort was 8 years (range, 5-14 years), representing a slightly older cohort. Acute hematologic toxicity was mild and self-limiting. Eight (40%) children had subnormal intelligence (FSIQ <85), including 3 (15%) with mild mental retardation (FSIQ 56-70) even before radiotherapy. Cognitive functioning for all tested domains was preserved in children evaluable at 3 months, 1 year, and 2 years after completion of HFRT, with no significant decline over time. Age at diagnosis or baseline FSIQ did not have a significant impact on longitudinal cognitive function. At a median follow-up time of 33 months (range, 16-58 months), 3 patients had died (2 of relapse and 1 of accidental burns), resulting in 3-year relapse-free survival and overall survival of 83.5% and 83.2%, respectively. Conclusion: HFRT without upfront chemotherapy has an acceptable acute toxicity profile, without an unduly increased risk of relapse, with preserved cognitive functioning in children with average-risk medulloblastoma.

  13. Risk assessment and predicting outcomes in patients with depressive symptoms: a review of potential role of peripheral blood based biomarkers

    PubMed Central

    Jani, Bhautesh D.; McLean, Gary; Nicholl, Barbara I.; Barry, Sarah J. E.; Sattar, Naveed; Mair, Frances S.; Cavanagh, Jonathan

    2015-01-01

    Depression is one of the major global health challenges and a leading contributor of health related disability and costs. Depression is a heterogeneous disorder and current methods for assessing its severity in clinical practice rely on symptom count, however this approach is unreliable and inconsistent. The clinical evaluation of depressive symptoms is particularly challenging in primary care, where the majority of patients with depression are managed, due to the presence of co-morbidities. Current methods for risk assessment of depression do not accurately predict treatment response or clinical outcomes. Several biological pathways have been implicated in the pathophysiology of depression; however, accurate and predictive biomarkers remain elusive. We conducted a systematic review of the published evidence supporting the use of peripheral biomarkers to predict outcomes in depression, using Medline and Embase. Peripheral biomarkers in depression were found to be statistically significant predictors of mental health outcomes such as treatment response, poor outcome and symptom remission; and physical health outcomes such as increased incidence of cardiovascular events and deaths, and all-cause mortality. However, the available evidence has multiple methodological limitations which must be overcome to make any real clinical progress. Despite extensive research on the relationship of depression with peripheral biomarkers, its translational application in practice remains uncertain. In future, peripheral biomarkers identified with novel techniques and combining multiple biomarkers may have a potential role in depression risk assessment but further research is needed in this area. PMID:25698954

  14. Competency Outcomes for Learning and Performance Assessment. Redesigning a BSN Curriculum.

    ERIC Educational Resources Information Center

    Luttrell, Marjorie F.; Lenburg, Carrie B.; Scherubel, Janet C.; Jacob, Susan R.; Koch, Robert W.

    1999-01-01

    A baccalaureate nursing curriculum was redesigned around eight core competencies with measurable indicators for each performance-based competency outcome. Effective learning strategies to achieve outcomes and methods to document achievement were also outlined. (SK)

  15. The social function of technology assessment

    NASA Technical Reports Server (NTRS)

    Huddle, F. P.

    1972-01-01

    The problem of preserving the uneasy balance between a dynamic society and the equilibrium of man-environment society is discussed. Four sets of activities involved in technology assessment are considered: (1) Technology forecasting is necessary to warn of future dangers and opportunities, for effective timing, and to identify tradeoffs and alternatives. But forecasting is also chancy at best. (2) Social indicators need to be developed for the characterization of social status and measurement of social progress, as well as a better understanding of social needs. (3) With respect to technology assessment, the conflict between profitable directions of innovations and socially desirable directions is described, and a systematic way is needed to determine in advance what is technologically feasible to meet social needs. (4) National goals with respect to scientific and technological developments are also required.

  16. Using soil functional indices to assess wildfire impact

    NASA Astrophysics Data System (ADS)

    López-Poma, Rosario; Mayor, Ángeles G.; Bautista, Susana

    2014-05-01

    Disturbance impact on ecosystem are often based on functional indicators, which provide integrated and yet simple and affordable measures of key ecosystem functions. In this work, we studied the amount of change (resistance) and the recovery (resilience) of soil functions after fire as a function of vegetation type for a variety of Mediterranean shrublands. We used the Landscape Functional Analysis methodology to assess soil stability, water infiltration, and nutrient cycling functions for different types of vegetation patches and for bare-soil interpatches in repeatedly burned shrubland communities two weeks before, and two and nine months after experimental fires. We assessed the impact of fire on soil functions using resistance and resilience indices. The resistance and resilience of soil surface functions to fire was mediated by vegetation traits associated to the fuel structure and the post-fire regenerative strategy of the species. Resistance was higher in vegetation patches that accumulated low contents of fine dead fuel, whereas resilience was higher in patches of resprouter species. The variation in resistance and resilience of soil functions to fire in Mediterranean shrublands depends greatly on variation in fire-related plant structural and functional traits. Although originally designed for the assessment of dryland ecosystems LFA has proved to have great potential for the assessment of the soil functional status of recently burned areas.

  17. Personalized Risk Assessment of Drug-Related Harm Is Associated with Health Outcomes

    PubMed Central

    Jones, Andrea A.; Vila-Rodriguez, Fidel; Panenka, William J.; Leonova, Olga; Strehlau, Verena; Lang, Donna J.; Thornton, Allen E.; Wong, Hubert; Barr, Alasdair M.; Procyshyn, Ric M.; Smith, Geoffrey N.; Buchanan, Tari; Krajden, Mel; Krausz, Michael; Montaner, Julio S.; MacEwan, G. William; Nutt, David J.; Honer, William G.

    2013-01-01

    Background The Independent Scientific Committee on Drugs (ISCD) assigned quantitative scores for harm to 20 drugs. We hypothesized that a personalized, ISCD-based Composite Harm Score (CHS) would be associated with poor health outcomes in polysubstance users. Methods A prospective community sample (n=293) of adults living in marginal housing was assessed for substance use. The CHS was calculated based on the ISCD index, and the personal substance use characteristics over four weeks. Regression models estimated the association between CHS and physical, psychological, and social health outcomes. Results Polysubstance use was pervasive (95.8%), as was multimorbid illness (median 3, possible range 0–12). The median CHS was 2845 (interquartile range 1865–3977). Adjusting for age and sex, every 1000-unit CHS increase was associated with greater mortality (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.07–2.01, p = 0.02), and persistent hepatitis C infection (OR 1.29, 95% CI 1.02–1.67, p = 0.04). The likelihood of substance-induced psychosis increased 1.39-fold (95% CI 1.13–1.67, p = 0.001). The amount spent on drugs increased 1.51-fold (1.40–1.62, p < 0.001) and the odds of having committed a crime increased 1.74-fold (1.46–2.10, p < 0.001). Multimorbid illness increased 1.43-fold (95% CI 1.26–1.63, p < 0.001). Conclusions Greater CHS predicts poorer physical, psychological, and social health, and may be a useful quantitative, personalized measure of risk for drug-related harm. PMID:24223192

  18. Modeling Clinical Outcome Using Multiple Correlated Functional Biomarkers: A Bayesian Approach

    PubMed Central

    Long, Qi; Zhang, Xiaoxi; Zhao, Yize; Johnson, Brent A.; Bostick, Roberd M.

    2012-01-01

    In some biomedical studies, biomarkers are measured repeatedly along some spatial structure or over time and are subject to measurement error. In these studies, it is often of interest to evaluate associations between a clinical endpoint and these biomarkers (also known as functional biomarkers). There are potentially two levels of correlation in such data, namely, between repeated measurements of a biomarker from the same subject and between multiple biomarkers from the same subject; none of the existing methods accounts for correlation between multiple functional biomarkers. We propose a Bayesian approach to model a clinical outcome of interest (e.g., risk for colorectal cancer) in the presence of multiple functional biomarkers while accounting for potential correlation. Our simulations show that the proposed approach achieves good performance in finite samples under various settings. In the presence of substantial or moderate correlation, the proposed approach outperforms an existing approach that does not account for correlation. The proposed approach is applied to a study of biomarkers of risk for colorectal neoplasms and our results show that the risk for colorectal cancer is associated with two functional biomarkers, APC and TGF-?, in particular, with their values in the region between the proliferating zone and the differentiating zone of colorectal crypts. PMID:23070593

  19. Changes of Functional Outcomes According to the Degree of Completeness of Spinal Cord Injury

    PubMed Central

    Kim, Hyo Sang; Jeong, Hyung Jun

    2014-01-01

    Objective To evaluate whether an initial complete impairment of spinal cord injury (SCI) contributes to the functional outcome prediction, we analyzed the relationship between the degree of complete impairment according to the American Spinal Injury Association impairment scale (AIS), the posterior tibial nerve somatosensory evoked potential (PTSEP) and the changes of functional indices. Methods Sixty subjects with SCI were studied who received rehabilitative management for over 2 months. The degree of completeness on basis of the initial AIS and PTSEP were evaluated at the beginning of rehabilitation. Following treatment, several functional indices, such as walking index for spinal cord injury version II (WISCI II), spinal cord independence measure version III (SCIM III), Berg Balance Scale (BBS), and Modified Barthel Index (MBI), were evaluated until the index score reached a plateau value. Results The recovery efficiency of WISCI and BBS revealed a statistically significant difference between complete and incomplete impairments of initial AIS and PTSEP. The SCIM and MBI based analysis did not reveal any significant differences in terms of the degree of AIS and PTSEP completeness. Conclusion AIS and PTSEP were highly effective to evaluate the prognosis in post-acute phase SCI patients. BBS and WISCI might be better parameters than other functional indices for activities of daily living to predict the recovery of the walking ability in post-acute SCI. PMID:25024956

  20. Assessing Hospital-Based Wellness Services using an Outcome Measurement System

    Microsoft Academic Search

    James Gibbs; Kristienne Kattapong; Julie St. John; Robert F. Kushner

    2002-01-01

    This article describes the process and results of an effort to develop an outcome measurement system for evaluating and improving hospital-based wellness programs and services. The authors defined a set of outcome measures for each of the wellness programs and services offered by the hospital and piloted health-related outcome and patient satisfaction measures in the following four different types of

  1. Graft selection for anterior cruciate ligament reconstruction: a level I systematic review comparing failure rates and functional outcomes.

    PubMed

    Reinhardt, Keith R; Hetsroni, Iftach; Marx, Robert G

    2010-04-01

    Tear of the anterior cruciate ligament (ACL) is the most common ligamentous injury of the knee. Reconstructing this ligament is often required to restore functional stability of the knee. Many graft options are available for ACL reconstruction, including different autograft and allograft tissues. Autografts include bone-patellar tendon-bone composites (PT), combined semitendinosus and gracilis hamstring tendons (HT), and quadriceps tendon. Allograft options include the same types of tendons harvested from donors, in addition to Achilles and tibialis tendons. Tissue-engineered anterior cruciate grafts are not yet available for clinical use, but may become a feasible alternative in the future. The purpose of this systematic review is to assess whether one of the popular grafts (PT and HT) is preferable for reconstructing the ACL. For this objective, the authors selected only true level I studies that compared these graft choices in functional clinical outcomes, failure rates, and other objective parameters following reconstruction of the ACL. In addition, this review discusses mechanical considerations related to different allograft tissues. PMID:20399364

  2. Using General Outcome Measures to Predict Student Performance on State-Mandated Assessments: An Applied Approach for Establishing Predictive Cutscores

    ERIC Educational Resources Information Center

    Leblanc, Michael; Dufore, Emily; McDougal, James

    2012-01-01

    Cutscores for reading and math (general outcome measures) to predict passage on New York state-mandated assessments were created by using a freely available Excel workbook. The authors used linear regression to create the cutscores and diagnostic indicators were provided. A rationale and procedure for using this method is outlined. This method…

  3. Early outcome assessment for 2228 consecutive carotid endarterectomy procedures: The Cleveland Clinic experience from 1989 to 1995

    Microsoft Academic Search

    Norman R. Hertzer; Patrick J. O'Hara; Edward J. Mascha; Leonard P. Krajewski; Timothy M. Sullivan; Edwin G. Beven

    1997-01-01

    Purpose: Several randomized trials now have established guidelines regarding patient selection for carotid endarterectomy (CEA) that have been widely accepted but have little relevance unless they are considered in the context of perioperative risk. The purpose of this study was to demonstrate the feasibility of early outcome assessment using a computerized database.Methods Since 1989 demographic information and in-hospital results for

  4. Maternal Emotional Styles and Child Social Adjustment: Assessment, Correlates, Outcomes and Goodness of Fit in Early Childhood

    ERIC Educational Resources Information Center

    Lagace-Seguin, Daniel G.; Coplan, Robert J.

    2005-01-01

    The goals of the present research were to develop a modified version of an existing self-assessment questionnaire designed to measure parents' emotional style and to examine how the aspects of child regulation may moderate the relation between the emotional styles and social outcomes in childhood. Participants in Study 1 were 140 mothers and…

  5. Using core competencies to build an evaluative framework: outcome assessment of the University of Guelph Master of Public Health program

    PubMed Central

    2014-01-01

    Background Master of Public Health programs have been developed across Canada in response to the need for graduate-level trained professionals to work in the public health sector. The University of Guelph recently conducted a five-year outcome assessment using the Core Competencies for Public Health in Canada as an evaluative framework to determine whether graduates are receiving adequate training, and identify areas for improvement. Methods A curriculum map of core courses and an online survey of University of Guelph Master of Public Health graduates comprised the outcome assessment. The curriculum map was constructed by evaluating course outlines, assignments, and content to determine the extent to which the Core Competencies were covered in each course. Quantitative survey results were characterized using descriptive statistics. Qualitative survey results were analyzed to identify common themes and patterns in open-ended responses. Results The University of Guelph Master of Public Health program provided a positive learning environment in which graduates gained proficiency across the Core Competencies through core and elective courses, meaningful practicums, and competent faculty. Practice-based learning environments, particularly in collaboration with public health organizations, were deemed to be beneficial to students’ learning experiences. Conclusions The Core Competencies and graduate surveys can be used to conduct a meaningful and informative outcome assessment. We encourage other Master of Public Health programs to conduct their own outcome assessments using a similar framework, and disseminate these results in order to identify best practices and strengthen the Canadian graduate public health education system. PMID:25078124

  6. ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Design and write a research proposal and

    E-print Network

    Barrash, Warren

    COMM498 ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Design and write a research proposal and finished product intended for consumption by a variety of audiences Graded research prospectus and their methodological design and decisions, and how those methods pertain to their specific research project ; Drafts

  7. ULO Course Learning Outcome Assessment Method Pedagogy 09-01 Unit Exams and quizzes. Assign reading skills sufficient to com-

    E-print Network

    Barrash, Warren

    aesthetic sensibilities and value judgments relative to a live, jazz performance and make distinc- tionsMUS102 ULO Course Learning Outcome Assessment Method Pedagogy 09-01 Unit Exams and quizzes. Assign style periods of jazz and all related artists ; Introduce listening/ aural techniques sufficient

  8. Program Outcomes Assessment in Higher Education Hospitality Management Programs: A Qualitative Comparative Case Study of Learning Cultures

    ERIC Educational Resources Information Center

    Hughes, John George

    2010-01-01

    The purpose of this qualitative, comparative case study was to determine the extent to which learning and improvement cultures were perceived to be linked to the traditional and non-traditional accreditation and Program Outcomes Assessment paradigms in use in two university hospitality programs. The findings of this study revealed that the…

  9. Lauroylethanolamide and linoleoylethanolamide improve functional outcome in a rodent model for stroke.

    PubMed

    Garg, Puja; Duncan, R Scott; Kaja, Simon; Zabaneh, Alexander; Chapman, Kent D; Koulen, Peter

    2011-04-01

    Ischemic stroke is a significant health problem affecting over 6 million people in the United States alone. In addition to surgical and thrombolytic therapeutic strategies for stroke, neuroprotective therapies may offer additional benefit. N-acylethanolamines (NAEs) are signaling lipids whose synthesis is upregulated in response to ischemia, suggesting that they may be neuroprotective. To date only three NAEs, arachidonylethanolamide (NAE 20:4), palmitoylethanolamide (NAE 16:0) and oleoylethanolamide (NAE 18:1) have shown to exert neuroprotective effect in animal models for stroke. Here, we describe neuroprotective effects of the hitherto uncharacterized NAEs, lauroylethanolamide (NAE 12:0) and linoleoylethanolamide (NAE 18:2) in a middle cerebral artery occlusion model of stroke. Pretreatment with NAE 18:2 prior to ischemia/reperfusion (I/R) injury resulted in both significantly reduced cortical infarct volume and improved functional outcome as determined using the neurological deficit score. NAE 12:0 improved neurological deficits without a significant reduction lesion size. Our results suggest that NAEs, as a whole, provide neuroprotection during I/R injury and may have therapeutic benefit when used as complementary treatment with other therapies to improve stroke outcome. PMID:21296126

  10. Lauroylethanolamide and linoleoylethanolamide improve functional outcome in a rodent model for stroke

    PubMed Central

    Garg, Puja; Duncan, R. Scott; Kaja, Simon; Zabaneh, Alexander; Chapman, Kent D.; Koulen, Peter

    2011-01-01

    Ischemic stroke is a significant health problem affecting over 6 million people in the United States alone. In addition to surgical and thrombolytic therapeutic strategies for stroke, neuroprotective therapies may offer additional benefit. N-acylethanolamines (NAEs) are signaling lipids whose synthesis is upregulated in response to ischemia, suggesting that they may be neuroprotective. To date only three NAEs, arachidonylethanolamide (NAE 20:4), palmitoylethanolamide (NAE 16:0) and oleoylethanolamide (NAE 18:1) have shown to exert neuroprotective effect in animal models for stroke. Here, we describe neuroprotective effects of the hitherto uncharacterized NAEs, lauroylethanolamide (NAE 12:0) and linoleoylethanolamide (NAE 18:2) in a middle cerebral artery occlusion model of stroke. Pretreatment with NAE 18:2 prior to ischemia/reperfusion (I/R) injury resulted in both significantly reduced cortical infarct volume and improved functional outcome as determined using the neurological deficit score. NAE 12:0 improved neurological deficits without a significant reduction lesion size. Our results suggest that NAEs, as a whole, provide neuroprotection during I/R injury and may have therapeutic benefit when used as complementary treatment with other therapies to improve stroke outcome. PMID:21296126

  11. The impact of thyroid function on intrauterine insemination outcome - a retrospective analysis

    PubMed Central

    2014-01-01

    Background Hashimoto’s thyroiditis is the most common endocrinopathy in premenopausal women, and is associated with various gynecological problems, including recurrent miscarriage and unexplained infertility. A possible influence of Hashimoto’s thyroiditis on the success of intrauterine insemination seems likely, but has not been evaluated as yet. Therefore, the aim of our study was to retrospectively analyze the impact on intrauterine insemination outcome of thyroid function and markers suggestive for Hashimoto’s thyroiditis. Methods Retrospective cohort study in a tertiary care center of 540 women who underwent Intrauterine Insemination. The clinical pregnancy rate was the main outcome parameters. The following possible influencing factors were tested: thyroid-stimulating hormone (TSH); thyroid autoantibodies; age; body mass index; type of sterility (primary/secondary); parity; male factor; presence of PCO syndrome; ovulation induction; ovarian stimulation; and current thyroid medication. Results The overall clinical pregnancy rate was 6.9% (37/540). Age, thyroid hormone supplementation for thyroid-stimulating hormone (TSH) levels >?2.5 micro-IU/ml, and ovulation induction with HCG were significantly predictive in the multivariate analysis (p?

  12. Impact of Executive Function Deficits and Attention-Deficit/Hyperactivity Disorder (ADHD) on Academic Outcomes in Children

    ERIC Educational Resources Information Center

    Biederman, Joseph; Monuteaux, Michael C.; Doyle, Alysa E.; Seidman, Larry J.; Wilens, Timothy E.; Ferrero, Frances; Morgan, Christie L.; Faraone, Stephen V.

    2004-01-01

    The association between executive function deficits (EFDs) and functional outcomes were examined among children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Participants were children and adolescents with (n = 259) and without (n = 222) ADHD, as ascertained from pediatric and psychiatric clinics. The authors defined EFD as…

  13. Influence of body mass index on psychological and functional outcomes in patients with multiple sclerosis: a cross-sectional study.

    PubMed

    Cambil-Martín, Jacobo; Galiano-Castillo, Noelia; Muñoz-Hellín, Elena; Díaz-Rodríguez, Lourdes; Laguarta-Val, Sofía; Fernández-de-Las-Peñas, César; Arroyo-Morales, Manuel

    2014-09-16

    Objectives To analyze the effect of weight on psychological and functional outcomes in multiple sclerosis (MS) patients, including self-perception, depression, functional level, fatigue, and self-rated health status. Methods One hundred and one (n = 101) patients with MS participated in this cross-sectional study. Outcomes were scores in the Beck Depression Inventory, NEO Five-Factor Inventory (NEOFFI), Functional Assessment of Multiple Sclerosis (FAMS), Fatigue Impact Scale, and Quality Short-Form Health Survey 36 (SF-36). Patients were classified as normal weight (18.5 < BMI < 24.9 kg/m(2)) or overweight (25.0 > BMI > 29.9 kg/m(2)). One-way analysis of covariance was conducted with gender, age, and years with disease as covariates. Results Depression levels were significantly higher in overweight versus normal-weight MS patients (F = 6.381; P = 0.013). NEOFFI scores were significantly higher in overweight versus normal-weight MS patients for extraversion (F = 6.331; P = 0.014), conscientiousness (F = 4.794; P = 0.034), and neuroticism (F = 5.422; P = 0.022) but not for openness (F = 2.174; P = 0.109) or agreeableness (F = 0.047; P = 0.829). The two groups did not significantly differ in fatigue (P > 00.5). Scores in general (F = 4.708; P = 0.032) and mental health (F = 4.583; P = 0.035) SF-36 domains were significantly lower in overweight versus normal-weight patients. Scores for FAMS domains of emotional well-being (F = 8.050; P = 0.006), general contentment (F = 7.967; P = 0.006), and family/social well-being (F = 7.662; P = 0.007) were significantly lower in overweight versus normal-weight patients. Conclusions Overweight MS patients evidenced higher depression levels, lower functional capacity, and worse self-rated health status in comparison to normal-weight MS patients. These results suggest that weight control programs should be incorporated into the management of patients with MS. PMID:25225836

  14. Investigation of the role of the jumping-to-conclusions bias for short-term functional outcome in schizophrenia.

    PubMed

    Andreou, Christina; Treszl, András; Roesch-Ely, Daniela; Köther, Ulf; Veckenstedt, Ruth; Moritz, Steffen

    2014-08-30

    Symptom severity and neuropsychological deficits negatively influence functional outcomes in patients with schizophrenia. Recent research implicates specific types of biased thinking styles (e.g. jumping-to-conclusions) in the pathogenesis of schizophrenia. This is the first study to test the impact of jumping-to-conclusions on functional outcome in schizophrenia. The aim of the study was to investigate the association of psychopathology, neuropsychology and JTC with subjective quality of life, vocational outcome and housing status in schizophrenia. Analyses were carried out both cross-sectionally at baseline, and longitudinally over the course of symptomatic improvement in the immediate aftermath of a psychotic exacerbation. Seventy-nine patients with schizophrenia were included in the study. Data concerning the variables of interest were collected at baseline, after one month, and after six months. Positive symptomatology was the most significant predictor of subjective and vocational outcome and changes across time. Verbal memory deficits were associated with functional status cross-sectionally, whereas general cognitive capacity significantly predicted functional changes over time. Improvement of the jumping-to-conclusions bias positively affected vocational outcome. Though limited, the observed effect of this bias on real-world functioning highlights the possible usefulness of interventions aimed at improving (meta)cognitive deficits in schizophrenia. PMID:24836199

  15. Assessing functional status: Exploring the relationship between the multiple sclerosis functional composite and driving

    Microsoft Academic Search

    Marla A. Shawaryn; Maria T. Schultheis; Edward Garay; John DeLuca

    2002-01-01

    Shawaryn MA, Schultheis MT, Garay E, DeLuca J. Assessing functional status: exploring the relationship between the Multiple Sclerosis Functional Composite and driving. Arch Phys Med Rehabil 2002;83:1123-9. Objective: To explore the relationship between the Multiple Sclerosis Functional Composite (MSFC), which is comprised of 3 clinical dimensions (arm and hand function, leg function and ambulation, cognition), and an everyday functional skill,

  16. Functional Behavioral Assessment in Practice: Concepts and Applications

    Microsoft Academic Search

    SANDRA L. HARRIS; BETH A. GLASBERG

    The technology of functional assessment is among the most important developments in several decades for the education and treatment of people with mental retardation, autism, and other developmental disabilities. These powerful methods for understanding maladaptive behavior and linking intervention closely to assessment have made a difference in the lives of countless people with developmental disabilities and should be part of

  17. Validation of the relevant outcome scale for Alzheimer's disease: a novel multidomain assessment for daily medical practice

    PubMed Central

    2011-01-01

    Introduction The Relevant Outcome Scale for Alzheimer's Disease (ROSA) is a new observer rating instrument recently developed for routine medical practice. The validity and reliability of ROSA as well as sensitivity to changes due to intervention were examined in an open-label, single-arm, multicenter clinical study in patients with Alzheimer's disease (AD). Methods The study enrolled 471 patients with a diagnosis of AD consistent with the criteria of the National Institute of Neurological and Communicative Disease and Stroke/Alzheimer's Disease and Related Disorders Association or with the Diagnostic and Statistical Manual Disorders criteria for dementia of Alzheimer's type. Following assessments of the ROSA and other standard assessments (Alzheimer's Disease Assessment Scale - cognitive subscale, Severe Impairment Battery, Neuropsychiatric Inventory, and Disability Assessment for Dementia), patients were treated with memantine for 12 weeks. Factor analysis of the baseline ROSA total scores was performed based on the principal components method using the varimax orthogonal rotational procedure. The psychometric analyses of the ROSA included internal consistency, test-retest reliability, inter-rater reliability, construct validity, and responsiveness to changes over time. Results All items showed adequate factor loadings and were retained in the final ROSA as Factor 1 (all items related to cognition, communication, function, quality of life and caregiver burden) and Factor 2 (all behavior items). The ROSA demonstrated high internal consistency (Cronbach's ? = 0.93), test-retest reliability (intraclass correlation coefficient = 0.93), and inter-rater reliability (intraclass correlation coefficient = 0.91). The correlation coefficients between the ROSA and each of the validated scales ranged between 0.4 and 0.7, confirming the ROSA construct validity. Nonsubstantial floor and ceiling effects were found in middle and late disease stages, whereas a small ceiling effect was observed in the early stage. The ROSA responsiveness to change was high (responsiveness index ?0.8) for all severity stages. Conclusions The ROSA is a valid and reliable instrument to aid medical practitioners in sensitively assessing AD-relevant symptoms over time in their clinical practice. PMID:21914212

  18. Assessment set for evaluation of clinical outcomes in multiple sclerosis: psychometric properties

    PubMed Central

    Rasova, Kamila; Martinkova, Patricia; Vyskotova, Jana; Sedova, Michaela

    2012-01-01

    Purpose: Multiple sclerosis (MS) manifests itself in a wide range of symptoms. Physiotherapy plays an important role in the treatment of those symptoms connected with mobility. For this therapy to be at its most effective it should be based on a systematic examination that is able to describe and classify damaged clinical functions meaningfully. The purpose of this study was to develop and validate a battery of tests and composite tests that can be used to systematically evaluate clinical features of MS treatable by physiotherapy. Methods: The authors assembled a proposed battery of tests comprising known, standard, and validated assessments (low-contrast letter acuity testing; the Motricity Index; the Modified Ashworth Scale; the Berg Balance Scale; scales of postural reactions, tremor, dysdiadochokinesia, and dysmetria; the Nine-Hole Peg Test; the Timed 25-Foot Walk; and the 3-minute version of the Paced Auditory Serial Addition Test) and one test (knee hyperextension) of the authors’ own. Normalization was calculated and six composite assessments were measured. Seventeen ambulatory subjects with MS were tested twice with the assessment set before undergoing physiotherapy, and 12 were also tested with the assessment set after the physiotherapy. The test–retest reliability, stability, internal consistency of composite measurements, sensitivity to changes after therapy, and correlation between measurements and the Kurtzke Expanded Disability Status Scale score were evaluated for all tests in the assessment set. Results: A good internal consistency was confirmed for all tests in the proposed battery, and most of the tests also showed good test–retest reliability. While no significant changes occurred without treatment, significant posttreatment improvement was proved in all tests except for low-contrast letter acuity testing, where only a trend to improvement was proved. Conclusion: The proposed assessment set is a good tool for the evaluation of clinical features of MS treatable by physiotherapy. This battery of tests is applicable in both clinical practice and research. PMID:23185123

  19. Functional outcome in acute stroke patients with oropharyngeal Dysphagia after swallowing therapy.

    PubMed

    Huang, Kun-Ling; Liu, Ting-Yuan; Huang, Yu-Chi; Leong, Chau-Peng; Lin, Wei-Che; Pong, Ya-Ping

    2014-01-01

    Dysphagia after stroke is associated with mortality and increased pulmonary complications. Swallowing therapies may decrease pulmonary complications and improve patients' quality of life after stroke. This study used clinical swallowing assessments and videofluoroscopy (VFS) to assess the functional recovery of acute stroke patients with dysphagia after different swallowing therapies. We enrolled 29 acute stroke patients with dysphagia and randomly divided them into 3 therapy groups: traditional swallowing (TS), oropharyngeal neuromuscular electrical stimulation (NMES), and combined NMES/TS. All patients were assessed using the clinical functional oral intake scale (FOIS), 8-point penetration-aspiration scale (PAS), and functional dysphagia scale (FDS) of VFS before and after treatment. There were no differences in the clinical parameters and swallowing results of the FOIS and VFS before swallowing treatment among the 3 groups (P > .05). TS therapy and combined therapy both had significant swallowing improvement after therapy according to the FOIS and 8-point PAS (P < .05). When comparing the results of the VFS among the 3 groups, we found significant improvements in patients eating cookies and thick liquid after combined NMES/TS therapy (P < .05). In acute stroke patients with dysphagia, combined NMES/TS therapy is the most effective swallowing therapy in taking solid diets and thick liquids. PMID:25245482

  20. Retrolisthesis and lumbar disc herniation: a postoperative assessment of patient function

    PubMed Central

    Kang, Kevin K.; Shen, Michael S.; Zhao, Wenyan; Lurie, Jon D.; Razi, Afshin E.

    2013-01-01

    BACKGROUND CONTEXT The presence of retrolisthesis has been associated with the degenerative changes of the lumbar spine. However, retrolisthesis in patients with L5–S1 disc herniation has not been shown to have a significant relationship with worse baseline pain or function. Whether it can affect the outcomes after discectomy, is yet to be established. PURPOSE The purpose of this study was to determine the relationship between retrolisthesis (alone or in combination with other degenerative conditions) and postoperative low back pain, physical function, and quality of life. This study was intended to be a follow-up to a previous investigation that looked at the preoperative assessment of patient function in those with retrolisthesis and lumbar disc herniation. STUDY DESIGN Cross-sectional study. PATIENT SAMPLE Patients enrolled in SPORT (Spine Patient Outcomes Research Trial) who had undergone L5–S1 discectomy and had a complete magnetic resonance imaging scan available for review (n=125). Individuals with anterolisthesis were excluded. OUTCOME MEASURES Time-weighted averages over 4 years for the Short Form (SF)-36 bodily pain scale, SF-36 physical function scale, Oswestry Disability Index (ODI), and Sciatica Bothersomeness Index (SBI). METHODS Retrolisthesis was defined as a posterior subluxation of 8% or more. Disc degeneration was defined as any loss of disc signal on T2 imaging. Modic changes were graded 1 to 3 and collectively classified as vertebral end plate degenerative changes. The presence of facet arthropathy and ligamentum flavum hypertrophy was classified jointly as posterior degenerative changes. Longitudinal regression models were used to compare the time-weighted outcomes over 4 years. RESULTS Patients with retrolisthesis did significantly worse with regard to bodily pain and physical function over 4 years. However, there were no significant differences in terms of ODI or SBI. Similarly, retrolisthesis was not a significant factor in the operative time, blood loss, lengths of stay, complications, rate of additional spine surgeries, or recurrent disc herniations. Disc degeneration, modic changes, and posterior degenerative changes did not affect the outcomes. CONCLUSIONS Although retrolisthesis in patients with L5–S1 disc herniation did not affect the baseline pain or function, postoperative outcomes appeared to be somewhat worse. It is possible that the contribution of pain or dysfunction related to retrolisthesis became more evident after removal of the disc herniation. PMID:23201024

  1. Assessing Thalamocortical Functional Connectivity with Granger Causality

    PubMed Central

    Israel, David; Thakor, Nitish V.; Jia, Xiaofeng

    2014-01-01

    Assessment of network connectivity across multiple brain regions is critical to understanding the mechanisms underlying various neurological disorders. Conventional methods for assessing dynamic interactions include cross-correlation and coherence analysis. However, these methods do not reveal the direction of information flow, which is important for studying the highly directional neurological system. Granger causality (GC) analysis can characterize the directional influences between two systems. We tested GC analysis for its capability to capture directional interactions within both simulated and in-vivo neural networks. The simulated networks consisted of Hindmarsh-Rose neurons; GC analysis was used to estimate the causal influences between two model networks. Our analysis successfully detected asymmetrical interactions between these networks (p<10?10, t-test). Next, we characterized the relationship between the “electrical synaptic strength” in the model networks and interactions estimated by GC analysis. We demonstrated the novel application of GC to monitor interactions between thalamic and cortical neurons following ischemia induced brain injury in a rat model of cardiac arrest (CA). We observed that during the post-CA acute period the GC interactions from the thalamus to the cortex were consistently higher than those from the cortex to the thalamus (1.983±0.278 times higher, p=0.021). In addition, the dynamics of GC interactions between the thalamus and the cortex were frequency dependent. Our study demonstrated the feasibility of GC to monitor the dynamics of thalamocortical interactions after a global nervous system injury such as CA-induced ischemia, and offers preferred alternative applications in characterizing other inter-regional interactions in an injured brain. PMID:23864221

  2. Enriched environment induces angiogenesis and improves neural function outcomes in rat stroke model.

    PubMed

    Yu, Kewei; Wu, Yi; Zhang, Qi; Xie, Hongyu; Liu, Gang; Guo, Zhenzhen; Li, Fang; Jia, Jie; Kuang, Shenyi; Hu, Ruiping

    2014-12-15

    Increasing evidence shows that exposure to an enriched environment (EE) after cerebral ischemia/reperfusion injury has neuroprotective benefits in animal models, including enhancing functional recovery after ischemic stroke. However, the mechanism underlying this effect remains unclear. To clarify this critical issue, the current study investigated the effects of EE on the improvement of damaged neural function and the induction of angiogenesis. Adult rats were subjected to ischemia induced by middle cerebral artery occlusion followed by reperfusion. Neurological status scores were used to evaluate neural function on postoperative days 2, 7, and 14. A beam-walking task was used to test the recovery of motor behavior on postoperative days 2, 5, 10, and 15. We also used a Morris water maze task to examine whether EE protected learning and memory performance. The specific marker of angiogenesis of CD31 was examined by western blot. Angiogenesis around the peri-infarction region was assayed by laser scanning confocal microscopy (LSCM) after 14 days of EE exposure starting 24h after ischemia. Neurological status scores of animals in the EE group were significantly higher than those in the standard housing condition (SC) control group from the seventh day after ischemic. EE accelerated the recovery of motor coordination and integration and also improved learning and memory performance after cerebral ischemia. Furthermore, EE increased CD31 levels and promoted angiogenesis of cortex in the peri-infarction region compared to the SC group. Neural function outcomes are positively correlated with post-ischemia angiogenesis. These findings suggest that EE plays an important role in the recovery of damaged neural function via regulation of angiogenesis after ischemia. PMID:25455300

  3. Transoral Robotic Surgery for Oropharyngeal Cancer: Long Term Quality of Life and Functional Outcomes

    PubMed Central

    Dziegielewski, Peter T.; Teknos, Theodoros N.; Durmus, Kasim; Old, Matthew; Agrawalm, Amit; Kakarala, Kiran; Marcinow, Anna; Ozer, Enver

    2014-01-01

    Objective To determine swallowing, speech and quality of life (QOL) outcomes following transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC). Design Prospective cohort study. Setting Tertiary care academic comprehensive cancer center. Patients 81 patients with previously untreated OPSCC. Intervention Primary surgical resection via TORS and neck dissection as indicated. Main Outcome Measures Patients were asked to complete the Head and Neck Cancer Inventory (HNCI) pre-operatively and at 3 weeks as well as 3, 6 and 12 months post-operatively. Swallowing ability was assessed by independence from a gastrostomy tube (G-Tube). Clinicopathological and follow-up data were also collected. Results Mean follow-up time was 22.7 months. HNCI response rates at 3 weeks and 3, 6, and 12 months were 79%, 60%, 63%, 67% respectively. There were overall declines in speech, eating, aesthetic, social and overall QOL domains in the early post-operative periods. However, at 1 year post-TORS scores for aesthetic, social and overall QOL remained high. Radiation therapy was negatively correlated with multiple QOL domains (p<0.05), while age > 55 years correlated with lower speech and aesthetic scores (p<0.05). HPV status did not correlate with any QOL domain. G-Tube rates at 6 and 12 months were 24% and 9%, respectively. The extent of TORS (> 1 oropharyngeal site resected) and age > 55 years predicted the need for a G-Tube at any point after TORS (p<0.05). Conclusions Patients with OPSCC treated with TORS maintain a high QOL at 1 year after surgery. Adjuvant treatment and advanced age tend to decrease QOL. PMID:23576186

  4. Fundamentals of Clinical Outcomes Assessment for Spinal Disorders: Study Designs, Methodologies, and Analyses

    PubMed Central

    Vavken, Patrick; Ganal-Antonio, Anne Kathleen B.; Shen, Francis H.; Chapman, Jens R.; Samartzis, Dino

    2015-01-01

    Study Design?A broad narrative review. Objective?Management of spinal disorders is continuously evolving, with new technologies being constantly developed. Regardless, assessment of patient outcomes is key in understanding the safety and efficacy of various therapeutic interventions. As such, evidence-based spine care is an essential component to the armamentarium of the spine specialist in an effort to critically analyze the reported literature and execute studies in an effort to improve patient care and change clinical practice. The following article, part one of a two-part series, is meant to bring attention to the pros and cons of various study designs, their methodological issues, as well as statistical considerations. Methods?An extensive review of the peer-reviewed literature was performed, irrespective of language of publication, addressing study designs and their methodologies as well as statistical concepts. Results?Numerous articles and concepts addressing study designs and their methodological considerations as well as statistical analytical concepts have been reported. Their applications in the context of spine-related conditions and disorders were noted. Conclusion?Understanding the fundamental principles of study designs and their methodological considerations as well as statistical analyses can further advance and improve future spine-related research.

  5. Adverse outcome pathway-based screening strategies for an animal-free safety assessment of chemicals.

    PubMed

    Landesmann, Brigitte; Mennecozzi, Milena; Berggren, Elisabet; Whelan, Maurice

    2013-12-01

    Currently, the assessment of risk to human health from exposure to manufactured chemicals is mainly based on experiments performed on living animals (in vivo). Substantial efforts are being undertaken to develop alternative solutions to in vivo toxicity testing. This new paradigm, based on the Mode-of-Action (MoA) framework, postulates that any adverse human health effect caused by exposure to an exogenous substance can be described by a series of causally-linked biochemical or biological key events with measurable parameters. The elaboration of mechanistic knowledge through literature research is necessary for a MoA-driven design of integrated testing strategies using in vitro methods for in vivo predictions. The objective of our ongoing research is to demonstrate the feasibility of an integrated approach to predict human toxicity following the Adverse Outcome Pathway (AOP) framework. In our previous work on MoA with the HepaRG cell model, we developed a strategy to identify chemicals that were hepatotoxic. This pioneered an innovative way of using data from in vitro experiments to group chemicals based on their MoA, which is likely to be an important step in a toxicity testing strategy. PMID:24512230

  6. School Competence and Fluent Academic Performance: Informing Assessment of Educational Outcomes in Survivors of Pediatric Medulloblastoma.

    PubMed

    Holland, Alice Ann; Hughes, Carroll W; Stavinoha, Peter L

    2014-11-14

    Academic difficulties are widely acknowledged but not adequately studied in survivors of pediatric medulloblastoma. Although most survivors require special education services and are significantly less likely than healthy peers to finish high school, measured academic skills are typically average. This study sought to identify potential factors associated with academic difficulties in this population and focused on school competence and fluent academic performance. Thirty-six patients (ages 7-18 years old) were recruited through the Departments of Neurosurgery and Neuro-Oncology at Children's Medical Center Dallas and Cook Children's Medical Center in Fort Worth, TX. Participants completed a neuropsychological screening battery including selected Woodcock-Johnson III Tests of Achievement subtests. Parents completed the Child Behavior Checklist. School competence was significantly correlated with measured academic skills and fluency. Basic academic skill development was broadly average, in contrast to significantly worse fluent academic performance. School competence may have utility as a measure estimating levels of educational success in this population. Additionally, academic difficulties experienced by childhood medulloblastoma survivors may be better captured by measuring deficits in fluent academic performance rather than skills. Identification of these potential factors associated with educational outcomes of pediatric medulloblastoma survivors has significant implications for research, clinical assessment, and academic services/interventions. PMID:25398080

  7. Fundamentals of clinical outcomes assessment for spinal disorders: study designs, methodologies, and analyses.

    PubMed

    Vavken, Patrick; Ganal-Antonio, Anne Kathleen B; Shen, Francis H; Chapman, Jens R; Samartzis, Dino

    2015-04-01

    Study Design?A broad narrative review. Objective?Management of spinal disorders is continuously evolving, with new technologies being constantly developed. Regardless, assessment of patient outcomes is key in understanding the safety and efficacy of various therapeutic interventions. As such, evidence-based spine care is an essential component to the armamentarium of the spine specialist in an effort to critically analyze the reported literature and execute studies in an effort to improve patient care and change clinical practice. The following article, part one of a two-part series, is meant to bring attention to the pros and cons of various study designs, their methodological issues, as well as statistical considerations. Methods?An extensive review of the peer-reviewed literature was performed, irrespective of language of publication, addressing study designs and their methodologies as well as statistical concepts. Results?Numerous articles and concepts addressing study designs and their methodological considerations as well as statistical analytical concepts have been reported. Their applications in the context of spine-related conditions and disorders were noted. Conclusion?Understanding the fundamental principles of study designs and their methodological considerations as well as statistical analyses can further advance and improve future spine-related research. PMID:25844291

  8. Pediatric aplastic anemia and refractory cytopenia: A retrospective analysis assessing outcomes and histomorphologic predictors.

    PubMed

    Forester, Craig M; Sartain, Sarah E; Guo, Dongjing; Harris, Marian H; Weinberg, Olga K; Fleming, Mark D; London, Wendy B; Williams, David A; Hofmann, Inga

    2015-04-01

    Pediatric acquired aplastic anemia (AA) is a bone marrow disorder that is difficult to distinguish from inherited bone marrow failure syndromes and hypocellular refractory cytopenia of childhood (RCC). Historically, patients with hypocellular RCC have been given the diagnosis of AA. To assess the clinical and histologic distinction between RCC and AA, we performed a retrospective analysis of 149 patients previously diagnosed with AA between 1976 and 2010. We evaluated event free survival (EFS), overall survival (OS), response rates to immunosuppressive therapy, treatment-related toxicities and clonal evolution. The 5-year EFS and OS were 50.8%?±?5.5% and 73.1%?±?4.7%, respectively. Patients with very severe AA had worse OS compared to patients with severe and moderately severe AA. Seventy-two patients had diagnostic pathology specimens available for review. Three pediatric hematopathologists reviewed and reclassified these specimens as AA, RCC or Other based on 2008 WHO Criteria. The concordance between pathologists in the diagnosis of AA or RCC was modest. RCC was associated with a trend toward improved OS and EFS and was not prognostic of immunosuppression therapy treatment failure. There was a low rate of clonal evolution exclusively associated with moderately severe AA. Our findings indicate that a diagnosis of RCC is difficult to establish with certainty and does not predict outcomes, calling into question the reproducibility and clinical significance of the RCC classification and warranting further studies. Am. J. Hematol. 90:320-326, 2015. © 2015 Wiley Periodicals, Inc. PMID:25580823

  9. Vestibular function assessment using the NIH Toolbox

    PubMed Central

    Schubert, Michael C.; Whitney, Susan L.; Roberts, Dale; Redfern, Mark S.; Musolino, Mark C.; Roche, Jennica L.; Steed, Daniel P.; Corbin, Bree; Lin, Chia-Cheng; Marchetti, Greg F.; Beaumont, Jennifer; Carey, John P.; Shepard, Neil P.; Jacobson, Gary P.; Wrisley, Diane M.; Hoffman, Howard J.; Furman, Gabriel; Slotkin, Jerry

    2013-01-01

    Objective: Development of an easy to administer, low-cost test of vestibular function. Methods: Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was completed to identify and develop appropriate software and hardware. More than 300 subjects between the ages of 3 and 85 years, with and without vestibular dysfunction, were recruited and tested. Currently accepted gold standard measures of static visual acuity, vestibular function, dynamic visual acuity, and balance were performed to determine validity. Repeat testing was performed to examine reliability. Results: The DVA and BAM tests are affordable and appropriate for use for individuals 3 through 85 years of age. The DVA had fair to good reliability (0.41–0.94) and sensitivity and specificity (50%–73%), depending on age and optotype chosen. The BAM test was moderately correlated with center of pressure (r = 0.42–0.48) and dynamic posturography (r = ?0.48), depending on age and test condition. Both tests differentiated those with and without vestibular impairment and the young from the old. Each test was reliable. Conclusion: The newly created DVA test provides a valid measure of visual acuity with the head still and moving quickly. The novel BAM is a valid measure of balance. Both tests are sensitive to age-related changes and are able to screen for impairment of the vestibular system. PMID:23479540

  10. Comparison of Bayesian and classical methods in the analysis of cluster randomized controlled trials with a binary outcome: The Community Hypertension Assessment Trial (CHAT)

    Microsoft Academic Search

    Jinhui Ma; Lehana Thabane; Janusz Kaczorowski; Larry Chambers; Lisa Dolovich; Tina Karwalajtys; Cheryl Levitt

    2009-01-01

    BACKGROUND: Cluster randomized trials (CRTs) are increasingly used to assess the effectiveness of interventions to improve health outcomes or prevent diseases. However, the efficiency and consistency of using different analytical methods in the analysis of binary outcome have received little attention. We described and compared various statistical approaches in the analysis of CRTs using the Community Hypertension Assessment Trial (CHAT)

  11. Evaluation of a pre-treatment assessment to select mand topographies for functional communication training.

    PubMed

    Ringdahl, Joel E; Falcomata, Terry S; Christensen, Tory J; Bass-Ringdahl, Sandie M; Lentz, Alison; Dutt, Anuradha; Schuh-Claus, Jessica

    2009-01-01

    Recent research has suggested that variables related to specific mand topographies targeted during functional communication training (FCT) can affect treatment outcomes. These include effort, novelty of mands, previous relationships with problem behavior, and preference. However, there is little extant research on procedures for identifying which mand topographies to incorporate into FCT. In the current study, a mand topography assessment was conducted following functional analyses to identify the proficiency with which individuals used several different mand topographies. Two mand topographies (high and low proficiency) were then compared during FCT-based treatments. FCT was more effective when the mand topography identified as high proficiency was incorporated into FCT as compared to FCT that included the lower proficiency response. The results are discussed in terms of the need for individualized assessment procedures for selecting mand topographies that are targeted during FCT. PMID:18672344

  12. Ranking of physiotherapeutic evaluation methods as outcome measures of stifle functionality in dogs

    PubMed Central

    2013-01-01

    Background Various physiotherapeutic evaluation methods are used to assess the functionality of dogs with stifle problems. Neither validity nor sensitivity of these methods has been investigated. This study aimed to determine the most valid and sensitive physiotherapeutic evaluation methods for assessing functional capacity in hind limbs of dogs with stifle problems and to serve as a basis for developing an indexed test for these dogs. A group of 43 dogs with unilateral surgically treated cranial cruciate ligament deficiency and osteoarthritic findings was used to test different physiotherapeutic evaluation methods. Twenty-one healthy dogs served as the control group and were used to determine normal variation in static weight bearing and range of motion. The protocol consisted of 14 different evaluation methods: visual evaluation of lameness, visual evaluation of diagonal movement, visual evaluation of functional active range of motion and difference in thrust of hind limbs via functional tests (sit-to-move and lie-to-move), movement in stairs, evaluation of hind limb muscle atrophy, manual evaluation of hind limb static weight bearing, quantitative measurement of static weight bearing of hind limbs with bathroom scales, and passive range of motion of hind limb stifle (flexion and extension) and tarsal (flexion and extension) joints using a universal goniometer. The results were compared with those from an orthopaedic examination, force plate analysis, radiographic evaluation, and a conclusive assessment. Congruity of the methods was assessed with a combination of three statistical approaches (Fisher’s exact test and two differently calculated proportions of agreeing observations), and the components were ranked from best to worst. Sensitivities of all of the physiotherapeutic evaluation methods against each standard were calculated. Results Evaluation of asymmetry in a sitting and lying position, assessment of muscle atrophy, manual and measured static weight bearing, and measurement of stifle passive range of motion were the most valid and sensitive physiotherapeutic evaluation methods. Conclusions Ranking of the various physiotherapeutic evaluation methods was accomplished. Several of these methods can be considered valid and sensitive when examining the functionality of dogs with stifle problems. PMID:23566355

  13. Handgrip Strength is an Independent Predictor of Functional Outcome in Hip-Fracture Women: A Prospective Study With 6-Month Follow-Up.

    PubMed

    Di Monaco, Marco; Castiglioni, Carlotta; De Toma, Elena; Gardin, Luisa; Giordano, Silvia; Tappero, Rosa

    2015-02-01

    The objective of this study was to investigate the contribution of handgrip strength in predicting the functional outcome after hip fracture in women.We prospectively investigated white women (N?=?193 of 207) who were consecutively admitted to a rehabilitation hospital after a hip fracture. We measured handgrip strength with a Jamar dynamometer (Lafayette Instrument Co, Lafayette, IN), on admission to rehabilitation. Ability to function in activities of daily living was assessed by the Barthel index both on discharge from rehabilitation and at a 6-month follow-up.We found significant correlations between handgrip strength measured before rehabilitation and Barthel index scores assessed both on discharge from rehabilitation (??=?0.52, P?assessed both preinjury and on admission to rehabilitation (P?=?0.001). Further adjustments for both Barthel index scores and Timed Up-and-Go test assessed at rehabilitation ending did not erase the significant association between handgrip strength and the Barthel index scores at the 6-month evaluation (P?=?0.007). To define successful rehabilitation, we categorized the Barthel index scores as either high (85 or higher) or low (<85). The adjusted odds ratio for 1 SD increase in grip strength was 1.73 (95% confidence interval [CI] 1.05-2.84, P?=?0.032) for having a high Barthel index score at the end of inpatient rehabilitation and 2.24 (95% CI 1.06-5.18) for having a high Barthel index score at the 6-month follow-up.Handgrip strength assessed before rehabilitation independently predicted the functional outcome both after inpatient rehabilitation and at a 6-month follow-up in hip-fracture women. PMID:25674760

  14. A comprehensive assessment of gray and white matter volumes and their relationship to outcome and severity in schizophrenia

    PubMed Central

    Mitelman, Serge A.; Brickman, Adam M.; Shihabuddin, Lina; Newmark, Randall E.; Hazlett, Erin A.; Haznedar, M. Mehmet; Buchsbaum, Monte S.

    2007-01-01

    Preliminary data suggest an association of posterior cortical gray matter reduction with poor outcome in schizophrenia. We made a systematic MRI assessment of regional gray and white matter volumes, parcellated into 40 Brodmann’s areas, in 104 patients with schizophrenia (51 with good outcomes, 53 with poor outcomes) and 41 normal comparison subjects, and investigated correlations of regional morphometry with outcome and severity of the illness. Schizophrenia patients displayed differential reductions in frontal and to a lesser degree temporal gray matter volumes in both hemispheres, most pronounced in the frontal pole and lateral temporal cortex. White matter volumes in schizophrenia patients were bilaterally increased, primarily in the frontal, parietal, and isolated temporal regions, with volume reductions confined to anterior cingulate gyrus. In patients with schizophrenia as a group, higher illness severity was associated with reduced temporal gray matter volumes and expanded frontal white matter volumes in both hemispheres. In comparison to good-outcome group, patients with poor outcomes had lower temporal, occipital, and to a lesser degree parietal gray matter volumes in both hemispheres and temporal, parietal, occipital, and posterior cingulate white matter volumes in the right hemisphere. While gray matter deficits in the granular cortex were observed in all schizophrenia patients, agranular cortical deficits in the left hemisphere were peculiar to patients with poor outcomes. These results provide support for frontotemporal gray matter reduction and frontoparietal white matter expansion in schizophrenia. Poor outcome is associated with more posterior distribution (posteriorization) of both gray and white matter changes, and with preferential impairment in the unimodal visual and paralimbic cortical regions. PMID:17587598

  15. Equality Impact Assessment Summary Name of policy, function or service

    E-print Network

    Equality Impact Assessment Summary Name of policy, function or service Community Involvement with community involvement with woodlands. Who will benefit mainly from this policy, function or service? . The audiences for this Policy Position are woodland owners and managers, community groups, public, private

  16. Impaired endothelial function with essential hypertension assessed by ultrasonography

    Microsoft Academic Search

    Kaeko Iiyama; Masahiro Nagano; Yoshikage Yo; Noriko Nagano; Kei Kamide; Jitsuo Higaki; Hiroshi Mikami; Toshio Ogihara

    1996-01-01

    The objective of this investigation was to evaluate the role of hypertension in endothelial function, changes in which are known to be an early event of atherosclerosis. We assessed endothelial function in 13 subjects with normal blood pressure and 13 subjects with essential hypertension who had never been treated for hypertension or hyperlipidemia and who had no history of smoking

  17. Motor balance and coordination training enhances functional outcome in rat with transient middle cerebral artery occlusion.

    PubMed

    Ding, Y; Li, J; Lai, Q; Rafols, J A; Luan, X; Clark, J; Diaz, F G

    2004-01-01

    The goal of this study was to determine if relatively complex motor training on Rota-rod involving balance and coordination plays an essential role in improving motor function in ischemic rats, as compared with simple locomotor exercise on treadmill. Adult male Sprague-Dawley rats with (n=40) or without (n=40) ischemia were trained under each of three conditions: (1) motor balance and coordination training on Rota-rod; (2) simple exercise on treadmill; and (3) non-trained controls. Motor function was evaluated by a series of tests (foot fault placing, parallel bar crossing, rope and ladder climbing) before and at 14 or 28 days after training procedures in both ischemic and normal animals. Infarct volume in ischemic animals was determined with Nissl staining. Compared with both treadmill exercised and non-trained animals, Rota-rod-trained animals with or without ischemia significantly (P<0.01) improved motor performance of all tasks except for foot fault placing after 14 days of training, with normal rats having better performance. Animals trained for up to 28 days on the treadmill did not show significantly improved function. With regard to foot fault placing task, performance on foot placing was improved in ischemic rats across the three measurements at 0, 14 and 28 days regardless of training condition, while the normal group reached their best performance at the beginning of measurement. No significant differences in infarct volume were found in rats trained either with Rota-rod (47+/-4%; mean+/-S.E.), treadmill (45+/-5%) or non-exercised control (45+/-3%). In addition, no obvious difference could be detected in the location of the damage which included the dorso-lateral portion of the neostriatum and the frontoparietal cortex, the main regions supplied by the middle cerebral artery. The data suggest that complex motor training rather than simple exercise effectively improves functional outcome. PMID:14706778

  18. Triangle tilt and humeral surgery: Meta-analysis of efficacy and functional outcome

    PubMed Central

    Nath, Rahul K; Somasundaram, Chandra

    2015-01-01

    AIM: To systematically review and analyze the overall impact and effectiveness of bony surgical procedures, the triangle tilt and humeral surgery in a comparative manner in permanent obstetric brachial plexus injury (OBPI) patients. METHODS: We conducted a literature search and identified original full research articles of OBPI patients treated with a secondary bony surgery, particularly addressing the limitation of shoulder abduction and functions. Further, we analyzed and compared the efficacy and the surgical outcomes of 9 humeral surgery papers with 179 patients, and 4 of our secondary bony procedure, the triangle tilt surgical papers with 86 patients. RESULTS: Seven hundred and thirty-one articles were identified, using the search term “brachial plexus” and obstetric or pediatric (246 articles) or neonatal (219 articles) or congenital (188 articles) or “birth palsy” (121 articles). Further, only a few articles were identified using the bony surgery search, osteotomy “brachial plexus” obstetric (35), “humeral osteotomy” and “brachial plexus” (17), and triangle tilt “brachial plexus” (14). Of all, 12 studies reporting pre- and post- operative or improvement in total Mallet functional score were included in this study. Among these, 9 studies reported the humeral surgery and 4 were triangle tilt surgery. We used modified total Mallet functional score in this analysis. Various studies with humeral surgery showed improvement of 1.4, 2.3, 5.0 and 5.6 total Mallet score, whereas the triangle tilt surgery showed improvement of 5.0, 5.5, 6.0 and 6.2. CONCLUSION: The triangle tilt surgery improves on what was achieved by humeral osteotomy in the management of shoulder function in OBPI patients. PMID:25621221

  19. Evaluation of functional and esthetic outcome after correction of mandibular hypoplasia secondary to temporomandibular ankylosis treated by distraction osteogenesis.

    PubMed

    Gupta, Gaurav Mahesh; Gupta, Pranjali; Sharma, Ashish; Patel, Nehal; Singh, Abhishek

    2014-06-01

    Patient with TMJ ankylosis are affected with mandibular hypoplasia which in turn causes functional and esthetic problems. Restoration of normal function and esthetics is the prime goal in treatment of such patients with distraction becoming an important treatment option. The present study also was conducted on patients with mandibular hypoplasia secondarily to TMJ ankylosis treated with distraction. Since function and esthetics improvement was the prime aim behind the treatment with distraction, evaluation of functional and esthetics outcome becomes an important aspect. Thus the study was indigenously designed and aimed at qualitative evaluation of the functional and esthetic outcome after correction of mandibular hypoplasia secondary to temporomandibular ankylosis with Distraction osteogenesis. Patients treated with distraction were evaluated on the basis of parameters for function and esthetics. Parameters for function were occlusion, airway, mouth opening and chewing-biting perception of patient pre and post distraction. Parameters for esthetics used were patient and panel perception. All parameters for function and occlusion improved with distraction in all the patients except one in whom occlusion and chewing- biting pattern worsened. It is concluded that distraction is a good option for improving patients functional and esthetic outcome in cases of mandibular hypoplasia secondary to temporomandibular ankylosis as the results achieved are stable with negligible chances of relapse. PMID:24822007

  20. Do Psychopathic Traits Assessed in Mid-Adolescence Predict Mental Health, Psychosocial, and Antisocial, Including Criminal Outcomes, Over the Subsequent 5 Years?

    PubMed Central

    Hemphälä, Malin; Hodgins, Sheilagh

    2014-01-01

    Objective: To determine whether psychopathic traits assessed in mid-adolescence predicted mental health, psychosocial, and antisocial (including criminal) outcomes 5 years later and would thereby provide advantages over diagnosing conduct disorder (CD). Method: Eighty-six women and 61 men were assessed in mid-adolescence when they first contacted a clinic for substance misuse and were reassessed 5 years later. Assessments in adolescence include the Psychopathy Checklist—Youth Version (PCL-YV), and depending on their age, either the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Aged Children or the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Assessments in early adulthood included the SCID, self-reports of psychosocial functioning, aggressive behaviour, and criminality and official criminal records. Results: The antisocial facet score positively predicted the number of anxiety symptoms and likelihood of receiving treatment for substance use disorders (SUDs). Lifestyle and antisocial facet scores negatively predicted Global Assessment of Functioning scores. By contrast, the interpersonal score and male sex independently and positively predicted the number of months worked or studied, as did the interaction of Lifestyle × Sex indicating that among men, but not women, an increase in lifestyle facet score was associated with less time worked or studied. Interpersonal and antisocial scores positively predicted school drop-out. Antisocial facet scores predicted the number of symptoms of antisocial personality disorder, alcohol and SUDs, and violent and nonviolent criminality but much more strongly among males than females. Predictions from numbers of CD symptoms were similar. Conclusions: Psychopathic traits among adolescents who misuse substances predict an array of outcomes over the subsequent 5 years. Information on the levels of these traits may be useful for planning treatment. PMID:24444323

  1. How do we know that research ethics committees are really working? The neglected role of outcomes assessment in research ethics review

    PubMed Central

    Coleman, Carl H; Bouësseau, Marie-Charlotte

    2008-01-01

    Background Countries are increasingly devoting significant resources to creating or strengthening research ethics committees, but there has been insufficient attention to assessing whether these committees are actually improving the protection of human research participants. Discussion Research ethics committees face numerous obstacles to achieving their goal of improving research participant protection. These include the inherently amorphous nature of ethics review, the tendency of regulatory systems to encourage a focus on form over substance, financial and resource constraints, and conflicts of interest. Auditing and accreditation programs can improve the quality of ethics review by encouraging the development of standardized policies and procedures, promoting a common base of knowledge, and enhancing the status of research ethics committees within their own institutions. However, these mechanisms focus largely on questions of structure and process and are therefore incapable of answering many critical questions about ethics committees' actual impact on research practices. The first step in determining whether research ethics committees are achieving their intended function is to identify what prospective research participants and their communities hope to get out of the ethics review process. Answers to this question can help guide the development of effective outcomes assessment measures. It is also important to determine whether research ethics committees' guidance to investigators is actually being followed. Finally, the information developed through outcomes assessment must be disseminated to key decision-makers and incorporated into practice. This article offers concrete suggestions for achieving these goals. Conclusion Outcomes assessment of research ethics committees should address the following questions: First, does research ethics committee review improve participants' understanding of the risks and potential benefits of studies? Second, does the process affect prospective participants' decisions about whether to participate in research? Third, does it change participants' subjective experiences in studies or their attitudes about research? Fourth, does it reduce the riskiness of research? Fifth, does it result in more research responsive to the local community's self-identified needs? Sixth, is research ethics committees' guidance to researchers actually being followed? PMID:18373857

  2. Improving the ecological validity of executive functioning assessment.

    PubMed

    Chaytor, Naomi; Schmitter-Edgecombe, Maureen; Burr, Robert

    2006-04-01

    The current study investigated ways to improve the ecological validity of the neuropsychological assessment of executive functioning through the formal assessment of compensatory strategies and environmental cognitive demands. Results indicated that the group of executive functioning tests (i.e., Trail Making Test, Wisconsin Card Sorting Test, Stroop, and Controlled Oral Word Association Test) accounted for 18-20% of the variance in everyday executive ability as measured by the Dysexecutive Questionnaire and Brock Adaptive Functioning Questionnaire. The addition of extra-test variables significantly increased the variance in everyday executive ability accounted for. The current study adds to the literature on the ecological validity of executive functioning assessment by highlighting the importance of extra-test variables when trying to understand the complex relationship between cognitive testing and real world performance. PMID:16554143

  3. Liver Function Parameters in Hip Fracture Patients: Relations to Age, Adipokines, Comorbidities and Outcomes

    PubMed Central

    Fisher, Leon; Srikusalanukul, Wichat; Fisher, Alexander; Smith, Paul

    2015-01-01

    Aim: To asses liver markers in older patients with hip fracture (HF) in relation to age, comorbidities, metabolic characteristics and short-term outcomes. Methods: In 294 patients with HF (mean age 82.0±7.9 years, 72.1% women) serum alanine aminotransferase (ALT), gammaglutamyltransferase (GGT), alkaline phosphatase (ALP), albumin, bilirubin, 25(OH)vitaminD, PTH, calcium, phosphate, magnesium, adiponectin, leptin, resistin, thyroid function and cardiac troponin I were measured. Results: Elevated ALT, GGT, ALP or bilirubin levels on admission were observed in 1.7% - 9.9% of patients. With age GGT, ALT and leptin decrease, while PTH and adiponectin concentrations increase. Higher GGT (>30U/L, median level) was associated with coronary artery disease (CAD), diabetes mellitus (DM), and alcohol overuse; lower ALT (?20U/L, median level) with dementia; total bilirubin >20?mol/L with CAD and alcohol overuse; and albumin >33g/L with CAD. Multivariate adjusted regression analyses revealed ALT, ALP, adiponectin, alcohol overuse and DM as independent and significant determinants of GGT (as continuous or categorical variable); GGT for each other liver marker; and PTH for adiponectin. The risk of prolonged hospital stay (>20 days) was about two times higher in patients with GGT>30U/L or adiponectin >17.14 ng/L (median level) and 4.7 times higher if both conditions coexisted. The risk of in-hospital death was 3 times higher if albumin was <33g/L. Conclusions: In older HF patients liver markers even within the normal range are associated with age-related disorders and outcomes. Adiponectin (but not 25(OH)vitaminD, PTH, leptin or resistin) is an independent contributor to higher GGT. Serum GGT and albumin predict prolonged hospital stay and in-hospital death, respectively. A unifying hypothesis of the findings presented. PMID:25589886

  4. Upper-Extremity and Mobility Subdomains From the Patient-Reported Outcomes Measurement Information System (PROMIS) Adult Physical Functioning Item Bank

    PubMed Central

    Hays, Ron D.; Spritzer, Karen L.; Amtmann, Dagmar; Lai, Jin-Shei; DeWitt, Esi Morgan; Rothrock, Nan; DeWalt, Darren A.; Riley, William T.; Fries, James F.; Krishnan, Eswar

    2013-01-01

    Objective To create upper-extremity and mobility subdomain scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning adult item bank. Design Expert reviews were used to identify upper-extremity and mobility items from the PROMIS item bank. Psychometric analyses were conducted to assess empirical support for scoring upper-extremity and mobility subdomains. Setting Data were collected from the U.S. general population and multiple disease groups via self-administered surveys. Participants The sample (N=21,773) included 21,133 English-speaking adults who participated in the PROMIS wave 1 data collection and 640 Spanish-speaking Latino adults recruited separately. Interventions Not applicable. Main Outcome Measures We used English- and Spanish-language data and existing PROMIS item parameters for the physical functioning item bank to estimate upper-extremity and mobility scores. In addition, we fit graded response models to calibrate the upper-extremity items and mobility items separately, compare separate to combined calibrations, and produce subdomain scores. Results After eliminating items because of local dependency, 16 items remained to assess upper extremity and 17 items to assess mobility. The estimated correlation between upper extremity and mobility was .59 using existing PROMIS physical functioning item parameters (r=.60 using parameters calibrated separately for upper-extremity and mobility items). Conclusions Upper-extremity and mobility subdomains shared about 35% of the variance in common, and produced comparable scores whether calibrated separately or together. The identification of the subset of items tapping these 2 aspects of physical functioning and scored using the existing PROMIS parameters provides the option of scoring these subdomains in addition to the overall physical functioning score. PMID:23751290

  5. A crossover pilot study evaluating the functional outcomes of two different types of robotic movement training in chronic stroke survivors using the arm exoskeleton BONES

    PubMed Central

    2013-01-01

    Background To date, the limited degrees of freedom (DOF) of most robotic training devices hinders them from providing functional training following stroke. We developed a 6-DOF exoskeleton (“BONES”) that allows movement of the upper limb to assist in rehabilitation. The objectives of this pilot study were to evaluate the impact of training with BONES on function of the affected upper limb, and to assess whether multijoint functional robotic training would translate into greater gains in arm function than single joint robotic training also conducted with BONES. Methods Twenty subjects with mild to moderate chronic stroke participated in this crossover study. Each subject experienced multijoint functional training and single joint training three sessions per week, for four weeks, with the order of presentation randomized. The primary outcome measure was the change in Box and Block Test (BBT). The secondary outcome measures were the changes in Fugl-Meyer Arm Motor Scale (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and quantitative measures of strength and speed of reaching. These measures were assessed at baseline, after each training period, and at a 3-month follow-up evaluation session. Results Training with the robotic exoskeleton resulted in significant improvements in the BBT, FMA, WMFT, MAL, shoulder and elbow strength, and reaching speed (p?functional and single joint robotic training programs. However, for the BBT, WMFT and MAL, inequality of carryover effects were noted; subsequent analysis on the change in score between the baseline and first period of training again revealed no difference in the gains obtained between the types of training. Conclusions Training with the 6 DOF arm exoskeleton improved motor function after chronic stroke, challenging the idea that robotic therapy is only useful for impairment reduction. The pilot results presented here also suggest that multijoint functional robotic training is not decisively superior to single joint robotic training. This challenges the idea that functionally-oriented games during training is a key element for improving behavioral outcomes. Trial registration NCT01050231. PMID:24354476

  6. Does Post-Acute Care Site Matter? A longitudinal study assessing functional recovery after a stroke

    PubMed Central

    Chan, Leighton; Sandel, M. Elizabeth; Jette, Alan M.; Appelman, Jed; Brandt, Diane E.; Cheng, Pengfei; TeSelle, Marian; Delmonico, Richard; Terdiman, Joseph F.; Rasch, Elizabeth K.

    2012-01-01

    Objective To determine the impact of post acute care site on stroke outcomes. Following a stroke, patients may receive post acute care in a number of different sites: inpatient rehabilitation (IRF), skilled nursing facility (SNF), and home health care/outpatient (HH/OP). We hypothesized that patients who received IRF would have better six-month functional outcomes than those who received care in other settings after controlling for patient characteristics. Design Prospective Cohort Study. Setting Four Northern California hospitals which are part of a single health maintenance organization. Participants 222 patients with stroke enrolled between February 2008 and July 2010. Intervention Not Applicable. Main Outcome Measure Baseline and 6 month assessments were performed using the Activity Measure for Post Acute Care (AM-PAC™), a test of self-reported function in three domains: Basic Mobility, Daily Activities, and Applied Cognition. Results Of the 222 patients analyzed, 36% went home with no treatment, 22% received HH/OP care, 30% included IRF in their care trajectory, and 13% included SNF (but not IRF) in their care trajectory. At six months, after controlling for important variables such as age, functional status at acute care discharge, and total hours of rehabilitation, patients who went to an IRF had functional scores that were at least 8 points higher (twice the minimally detectable change for the AM-PAC) than those who went to a SNF in all 3 domains and in two out of three functional domains compared to those who received HH/OP care. Conclusions Patients with stroke may make more functional gains if their post-acute care includes an IRF. This finding may have important implications as post-acute care delivery is reshaped through health care reform. PMID:23124133

  7. Occupational Physical Activities and Long-Term Functional and Radiographic Outcomes in Patients With Ankylosing Spondylitis

    PubMed Central

    Ward, Michael M.; Reveille, John D.; Learch, Thomas J.; Davis, John C.; Weisman, Michael H.

    2009-01-01

    Objective We sought to identify specific occupational activities associated with functional limitations and radiographic damage in patients with longstanding ankylosing spondylitis (AS). Methods We asked patients diagnosed with AS for ?20 years to report all past occupations, which we mapped to specific physical activities using the Occupational Information Network, which is the US Department of Labor job classification database. For each occupation reported, we obtained ratings for 13 physical abilities of the worker and 13 aspects of the work environment or work tasks (work context) thought to be most relevant to patients with AS. Averages for each measure, weighted by the number of years in each job, were related to the degree of functional limitation as assessed by the Bath AS Functional Index (BASFI) and to the extent of spinal radiographic damage as assessed by the Bath AS Radiology Index for the spine (BASRI-s). Results Among 397 patients, those with a history of jobs requiring dynamic flexibility (the ability to repeatedly bend, stretch, twist, or reach) had more functional limitations than those whose past jobs required little or no dynamic flexibility (adjusted mean BASFI score 48.3 in the top quartile versus 38.1 in all others). Those whose past jobs required more dynamic flexibility, extent flexibility, and exposure to whole body vibration also had significantly higher BASRI-s scores. Conclusion Bending, twisting, and stretching are the occupational activities associated with greater functional limitations and radiographic damage in patients with longstanding AS. Exposure to whole body vibration was also associated with more radiographic damage. PMID:18512723

  8. Assessing Undergraduate Learning Outcomes between Accelerated Degree and Traditional Student Populations

    ERIC Educational Resources Information Center

    Rawls, Janita; Hammons, Stacy

    2012-01-01

    This study investigated learning outcomes in both traditional and accelerated degree populations. Using the National Survey of Student Engagement, outcomes were examined relating to critical thinking, oral and written communication, and cultural and global understanding. Literature from life stage development and degree delivery mode areas were…

  9. Development of a National Survey to Assess Student Learning Outcomes of Community-Based Research

    ERIC Educational Resources Information Center

    Lichtenstein, Gary; Thorme, Trisha; Cutforth, Nick; Tombari, Martin L.

    2011-01-01

    With the goal of codifying student learning outcomes of community-based research (CBR), the authors created a conceptually valid and statistically reliable CBR Student Learning Outcomes Survey. The project began with individual interviews and focus groups with 70 undergraduates and faculty at six colleges and universities nationwide discussing…

  10. Assessing the Psychological Changes of Gifted Students Attending a Residential High School with an Outcome Measurement

    ERIC Educational Resources Information Center

    Rollins, Marlon R.; Cross, Tracy L.

    2014-01-01

    This study examined the psychological changes that 272 students experienced while attending a residential school for gifted adolescents in the Midwest. This article shares the quantitative portion of a mixed-methods study. Outcome measurement data from the Youth Outcome Questionnaire Self-Report 2.0 (YOQ-SR) tracked students' level of…

  11. Self Directed Learning In Gross Human Anatomy: Assessment Outcomes and Student Perceptions

    NSDL National Science Digital Library

    2008-08-01

    This article explains a study comparing learning outcomes between the distance education portion of a gross anatomy course versus a lecture based course. Outcomes include qualitative (questionnaires on perceptions of course) and quantitative surveys (quizzes and exams). Suggestions on how to approach teaching distance education courses is provided.

  12. Sources of Bias in Outcome Assessment in Randomised Controlled Trials: A Case Study

    ERIC Educational Resources Information Center

    Ainsworth, Hannah; Hewitt, Catherine E.; Higgins, Steve; Wiggins, Andy; Torgerson, David J.; Torgerson, Carole J.

    2015-01-01

    Randomised controlled trials (RCTs) can be at risk of bias. Using data from a RCT, we considered the impact of post-randomisation bias. We compared the trial primary outcome, which was administered blindly, with the secondary outcome, which was not administered blindly. From 44 schools, 522 children were randomised to receive a one-to-one maths…

  13. Treatment and functional outcome of patients with cystoid macular edema: a single-center experience.

    PubMed

    Taraborelli, Mara; Cavazzana, Ilaria; Fredi, Micaela; Airò, Paolo; Nascimbeni, Giuseppe; Tincani, Angela; Franceschini, Franco

    2015-04-01

    The aim of this study was to describe a single-center experience in the treatment and follow-up of cystoid macular edema patients. Clinical records of all patients with cystoid macular edema followed up in the Rheumatologic and Ophthalmological Unit of our center between 1993 and 2013 were retrospectively evaluated. The outcome was assessed by visual acuity and optical coherence tomography status during follow-up. Comparisons were made by Fisher's exact test (p?

  14. Predictors of improved functional outcome in elderly inpatients after rehabilitation: a retrospective study

    PubMed Central

    Naruishi, Koji; Kunita, Akiko; Kubo, Katsuyuki; Nagata, Toshihiko; Takashiba, Shogo; Adachi, Seiji

    2014-01-01

    Purpose The number of elderly inpatients has been steadily increasing worldwide. However, the ability to predict the degree of improvement of functional capacity after comprehensive examination of elderly inpatients is still lacking. The purpose of this study was to investigate the predictors of improved functional outcome after rehabilitation of elderly inpatients. Methods We performed a retrospective cohort study with 1,079 patients (age <70 years: N=331, age ?70 years: N=748) who had been admitted to Tottori Municipal Hospital. Functional Independence Measure (FIM) scores were measured both at admission and discharge to calculate FIM gain and efficiency. Of these patients, 262 patients had oral examinations on admission. The Mann–Whitney U-test or chi-square test was used for statistical analyses. Conditional logistic regression analysis was used to compute the odds ratio (OR) and 95% confidence interval (CI). Cut-off values of FIM scores to determine if elderly inpatients were able to return home after discharge were determined using a receiver operating characteristic curve. Results FIM scores, including FIM gain and efficiency, of elderly patients were significantly lower than those of middle-aged patients. Inability to close the lips and dysfunctional tongue movement, but not the loss of teeth, were correlated with a reduced improvement of FIM scores. Cognitive impairment and aspiration pneumonia, but not cerebrovascular disease, were also correlated with a reduced improvement of FIM scores. Interestingly, FIM scores were significantly lower in patients with both cerebrovascular disease and a loss of posterior occlusion. Factors shown to have a significant impact on the improvement of FIM scores included the stable posterior occlusion (OR: 2.23, 95% CI: 1.2–4.1), closed lips (OR: 5.15, 95% CI: 2.3–11.7), functional tongue movement (OR: 5.74, 95% CI: 3.0–11.0), presence of cognitive impairment (OR: 0.31, 95% CI: 0.17–0.49), and presence of aspiration pneumonia (OR: 0.27, 95% CI: 0.15–0.51). Conclusion Age and disorder of oral function may be significant predictors of improved functional capacity after rehabilitation for elderly inpatients. PMID:25584025

  15. Impaired renal function is associated with worse self-reported outcomes after kidney transplantation

    Microsoft Academic Search

    Luca Neri; Jonathan Dukes; Daniel C. Brennan; Paulo R. Salvalaggio; Susmitha Seelam; Srividya Desiraju; Mark Schnitzler

    Purpose  We sought to determine the association between health-related quality of life (HRQOL) and graft function in renal transplant\\u000a recipients.\\u000a \\u000a \\u000a \\u000a \\u000a Design and Methods  We enrolled 577 kidney transplant recipients aged 18–74 years (response rate 87%). Recipients with multiple or multi-organ\\u000a transplantation, creatine kinase >200 U\\/L, acute renal failure or cellular rejection (n = 64), and without creatinine assessments in 3 months pre-enrollment (n = 127) were excluded. The

  16. Fatty Infiltration and Atrophy of the Rotator Cuff Do Not Improve After Rotator Cuff Repair and Correlate With Poor Functional Outcome

    Microsoft Academic Search

    James N. Gladstone; Julie Y. Bishop; Ian K. Y. Lo; Evan L. Flatow

    2007-01-01

    Background: The role of degenerative changes in rotator cuff musculature with respect to the functional outcomes of rotator cuff repair have only recently been recognized and are still not well understood. In addition, the reversibility of these changes with repair of the tendons is questionable.Hypothesis: Poorer preoperative muscle quality negatively affects outcome, and a successful outcome (in terms of a

  17. Functional Assessment and Binge Eating: A Review of the Literature and Suggestions for Future Research.

    ERIC Educational Resources Information Center

    Lee, Marcella I.; Miltenberger, Raymond G.

    1997-01-01

    Discusses the process of conducting a functional assessment of a problem behavior. Reviews current research on functional assessment methods, such as direct observation and indirect assessment, and covers applications of functional assessment. Applies functional assessment to binge eating and the antecedents and consequences of binge eating…

  18. Modified Quad surgery significantly improves the median nerve conduction and functional outcomes in obstetric brachial plexus nerve injury

    PubMed Central

    2013-01-01

    Background Nerve conduction studies or somatosensory evoked potentials (SSEPs) have become an important tool in the investigation of peripheral nerve lesions, and is sensitive in detecting brachial plexus nerve injury, and other nerve injuries. To investigate whether the modified Quad surgical procedure improves nerve conductivity and functional outcomes in obstetric brachial plexus nerve injury (OBPI) patients. Methods All nerves were tested with direct functional electrical stimulation. A Prass probe was used to stimulate the nerves, and recording the response, the compound motor action potential (CMAP) in the muscle. SSEP monitoring was performed pre- and post modified Quad surgery, stimulating the median and ulnar nerves at the wrist, the radial nerve over the dorsum of the hand, recording the peripheral, cervical and cortical responses. All patients have had the modified Quad surgery (n?=?19). The modified Quad surgery is a muscle release and transfer surgery with nerve decompressions. All patients were assessed preoperatively and postoperatively by evaluating video recordings of standardized movements, the modified Mallet scale to index active shoulder movements. Results The cervical responses were significantly lower in amplitude in the affected arm than the un-affected arm. The median nerve conduction was significantly improved from 8.04 to 9.26 (P?

  19. Outcomes-Based Education in South Africa: Using an Instrument to Assess School-Level Environments during the Implementation

    Microsoft Academic Search

    Rüdiger C. Laugksch; Jill M. Aldridge; Barry J. Fraser

    In this study, we developed and validated a questionnaire t o assess teachers' perceptions of their actual and preferred school-level environment, investi gated whether teachers involved with outcomes-based education perceive the school-level envir onment differently from those who are not, and investigated factors in the scho ol-level environment (such as resources and staff freedom) linked with a school's likeli hood

  20. Minocycline Treatment Reduces Delayed Oligodendrocyte Death, Attenuates Axonal Dieback, and Improves Functional Outcome after Spinal Cord Injury

    Microsoft Academic Search

    D. P. Stirling; Kourosh Khodarahmi; Jie Liu; Lowell T. Mcphail; Christopher B. Mcbride; John D. Steeves; Matt S. Ramer; Wolfram Tetzlaff

    2004-01-01

    Minocycline has been demonstrated to be neuroprotective after spinal cord injury (SCI). However, the cellular consequences of minocy- cline treatment on the secondary injury response are poorly understood. We examined the ability of minocycline to reduce oligodendro- cyte apoptosis, microglial\\/macrophage activation, corticospinal tract (CST) dieback, and lesion size and to improve functional outcome after SCI. Adult rats were subjected to