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Sample records for assess functional outcome

  1. 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…

  2. Assessing effects of environmental chemicals on neuroendocrine systems: potential mechanisms and functional outcomes.

    PubMed

    Ottinger, Mary Ann; Carro, Tiffany; Bohannon, Meredith; Baltos, Leah; Marcell, Allegra M; McKernan, Moira; Dean, Karen M; Lavoie, Emma; Abdelnabi, Mahmoud

    2013-09-01

    Environmental pollutants encompass a vast array of compounds. Most studies in birds have focused on toxicological effects, with little attention to non-lethal effects. Consequently, it has proven difficult to assess potential risk associated with exposure to endocrine disrupting chemicals (EDCs). Assessing potential adverse effects due to exposure is further complicated by the great variation that occurs across avian species. These include variations in reproductive strategies, life span, sexual differentiation, and migration. Differences in reproductive strategies, particularly in the developmental patterns and mechanisms for precocial and altricial chicks, predispose birds to wide variations in response to steroids and steroid-like EDCs. We have investigated the effects of EDCs in precocial birds including Japanese quail (Coturnix japonica) and mallard ducks (Anas platyrhynchos) as well as in wild altricial songbirds. Studies in Japanese quail characterized endogenous steroid hormone changes during development and have demonstrated that the developing embryo uses the yolk as a 'steroid hormone depot'. It appears that actual embryonic exposure is quantitatively lower than indicated by the treatment in egg injections and that the true amount of compound necessary for bioactivity may be quite low relative to the actual dosage delivered. Additionally, embryonic exposure to specific EDCs adversely affected sexual differentiation in quail, especially impacting male sexual behavior as well as neural systems, immune response, and thyroid hormones. Many of these studies considered single compounds; however, wild birds are exposed to complex mixtures and multiple compounds. We tested complex mixtures of polychlorinated biphenyls (PCBs) at concentrations that bracketed those found in eggs in contaminated regions. Results indicated that the predictive value of the toxic equivalency (TEQ), based on comparative activation of the aryl hydrocarbon receptor (AhR) relative to dioxin was not as accurate as expected. We discuss the potential of developing an endocrine disruption index (EDI) to bridge the inconsistencies observed between responses predicted by the TEQ and those observed in vivo following exposure to EDCs. Further, we will discuss how an EDI would complement the adverse outcome pathways analyses to consider the range of effects of endocrine disruptors in birds. PMID:23773971

  3. 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

  4. Outcomes Assessment: Implications for Nursing Education.

    ERIC Educational Resources Information Center

    Thompson, Cesarina; Bartels, Jean E.

    1999-01-01

    Applies the following outcomes assessment principles to Alverno College's nursing program: begin with educational values; view learning as multidimensional, integrated, and revealed over time; have explicit purposes; include experiences leading to outcomes; make assessment ongoing; include wide representation; and make assessment part of larger…

  5. 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 Studies Department of Linguistics, UIUC I. Undergraduate Program A. Mission The undergraduate program

  6. A Portfolio Approach to Outcomes Assessment.

    ERIC Educational Resources Information Center

    Ruholl, Linda Hatke

    2000-01-01

    Describes an outcomes assessment plan developed by the Lake Land College (Illinois) nursing program, which is organized around formative and summative evaluations of twelve graduate program outcomes. Quantitative and qualitative data collected by students are submitted in a portfolio format. The faculty tool for assessing the portfolios is…

  7. 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

  8. 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…

  9. 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

  10. Outcome Assessment in Aphasia: A Survey

    ERIC Educational Resources Information Center

    Simmons-Mackie, Nina; Threats, Travis T.; Kagan, Aura

    2005-01-01

    There has been a marked increase in attention to the measurement of ''outcomes'' after speech-language intervention for adult aphasia. Consumers, speech-language pathologists (SLPs), and funding sources desire evidence of therapy outcomes that improve communication and enhance the quality of life for people with aphasia. While many assessment

  11. 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

  12. A systematic review of outcomes assessed in randomized controlled trials of surgical interventions for carpal tunnel syndrome using the International Classification of Functioning, Disability and Health (ICF) as a reference tool

    PubMed Central

    Jerosch-Herold, Christina; Leite, José C de Carvalho; Song, Fujian

    2006-01-01

    Background A wide range of outcomes have been assessed in trials of interventions for carpal tunnel syndrome (CTS), however there appears to be little consensus on what constitutes the most relevant outcomes. The purpose of this systematic review was to identify the outcomes assessed in randomized clinical trials of surgical interventions for CTS and to compare these to the concepts contained in the International Classification of Functioning, Disability and Health (ICF). Methods The bibliographic databases Medline, AMED and CINAHL were searched for randomized controlled trials of surgical treatment for CTS. The outcomes assessed in these trials were identified, classified and linked to the different domains of the ICF. Results Twenty-eight studies were retrieved which met the inclusion criteria. The most frequently assessed outcomes were self-reported symptom resolution, grip or pinch strength and return to work. The majority of outcome measures employed assessed impairment of body function and body structure and a small number of studies used measures of activity and participation. Conclusion The ICF provides a useful framework for identifying the concepts contained in outcome measures employed to date in trials of surgical intervention for CTS and may help in the selection of the most appropriate domains to be assessed, especially where studies are designed to capture the impact of the intervention at individual and societal level. Comparison of results from different studies and meta-analysis would be facilitated through the use of a core set of standardised outcome measures which cross all domains of the ICF. Further work on developing consensus on such a core set is needed. PMID:17147807

  13. Outcome Assessment of Mentorship Program

    ERIC Educational Resources Information Center

    Johnson, Christopher J.; Bulot, Jay; Johnson, Roxanna H.

    2008-01-01

    This paper reports results of a survey that studied the outcomes of a mentorship program. Students enrolled in a core course for the MA and certificate in gerontology programs were required to select either a long-term care service, a program in aging, or an agency providing services for senior adults, where they could spend a day interacting with…

  14. Distal extension of the midline urethral-plate incision in the Snodgrass hypospadias repair: An objective assessment of the functional and cosmetic outcomes

    PubMed Central

    Al-Adl, Ahmed M.; El-Karamany, Tarek M.; Bassiouny, Ayman S.

    2014-01-01

    Objectives To objectively assess the functional and cosmetic outcomes of a modified tubularised incised-plate (TIP) urethroplasty (Snodgrass) technique, with particular attention to the uroflowmetry study and Hypospadias Objective Scoring Evaluation (HOSE) score. Patients and methods In a prospective case-series study, 43 consecutive patients with primary distal hypospadias were evaluated. The modified Snodgrass technique included an extension of the midline relaxing incision of the urethral plate from within the hypospadiac meatus to the very tip of the glans. The neourethra was tubularised starting at the neomeatus and proceeding proximally. The neourethra was covered with either a single or double dartos flap. In toilet-trained boys, at least 3 months after surgery, the flow pattern, maximum (Qmax), and mean urinary flow rate (Qave) were recorded, and the results plotted against a recently published flow-rate nomogram from normal children. The postvoid residual urine volume was measured using ultrasonography. The cosmetic outcome was assessed using the HOSE system. Results The native meatus was coronal in 11 (26%), subcoronal in 23 (53%) and distal penile in nine (21%) of the patients. The median (range) age was 4.2 (0.5–14) years. The neourethra was covered by a single dorsal dartos flap in 25 and a double dartos flap in 18 patients. At a median (range) follow-up of 6 (3–24) months, the uroflowmetry findings in 26 uncomplicated toilet-trained boys with a median (range) age of 5.2 (3.3–14) years showed an abnormal Qmax below the fifth percentile in four (15%), with the Qave above the fifth percentile in all. The flow pattern was bell-shaped in nine boys (35%), interrupted/intermittent in five (19%), slightly flattened in 10 (39%) and a plateau in two (8%). A vertical slit-like meatus located at the distal glans was created in 39 (91%) boys, and at the proximal glans in four (9%). The urinary stream was single and straight in 39 and angled in four patients. A straight erection was observed in 42 (98%) boys. Four patients had preoperative mild penile torsion of <45°, that was corrected by surgery. The mean (SD, range) HOSE score was 15.8 (0.6, 13–16). Two patients had a small, single subcoronal fistula. Conclusion Extending the midline urethral plate-incision in the modified Snodgrass repair to the apical part of the glans can be done safely with a high rate of locating the neomeatus at the glans tip, with no resultant meatal stenosis. The functional and cosmetic results of the procedure are good, but long-term data and comparative studies are required to confirm these results. PMID:26019935

  15. 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…

  16. Functional dysphonia: strategies to improve patient outcomes

    PubMed Central

    Behlau, Mara; Madazio, Glaucya; Oliveira, Gisele

    2015-01-01

    Functional dysphonia (FD) refers to a voice problem in the absence of a physical condition. It is a multifaceted voice disorder. There is no consensus with regard to its definition and inclusion criteria for diagnosis. FD has many predisposing and precipitating factors, which may include genetic susceptibility, psychological traits, and the vocal behavior itself. The assessment of voice disorders should be multidimensional. In addition to the clinical examination, auditory-perceptual, acoustic, and self-assessment analyses are very important. Self-assessment was introduced in the field of voice 25 years ago and has produced a major impact in the clinical and scientific scenario. The choice of treatment for FD is vocal rehabilitation by means of direct therapy; however, compliance has been an issue, except for cases of functional aphonia or when an intensive training is administered. Nevertheless, there are currently no controlled studies that have explored the different options of treatment regimens for these patients. Strategies to improve patient outcome involve proper multidisciplinary diagnosis in order to exclude neurological and psychiatric disorders, careful voice documentation with quantitative measurement and qualitative description of the vocal deviation for comparison after treatment, acoustic evaluation to gather data on the mechanism involved in voice production, self-assessment questionnaires to map the impact of the voice problem on the basis of the patient’s perspective, referral to psychological evaluation in cases of suspected clinical anxiety and/or depression, identification of dysfunctional coping strategies, self-regulation data to assist patients with their vocal load, and direct and intensive vocal rehabilitation to reduce psychological resistance and to reassure patient’s recovery. An international multicentric effort, involving a large population of voice-disordered patients with no physical pathology, could produce enough data for achieving a consensus regarding this complex problem. PMID:26664248

  17. 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…

  18. Outcome Assessments in Children with Cerebral Palsy, Part II: Discriminatory Ability of Outcome Tools

    ERIC Educational Resources Information Center

    Bagley, Anita M; Gorton, George; Oeffinger, Donna; Barnes, Douglas; Calmes, Janine; Nicholson, Diane; Damiano, Diane; Abel, Mark; Kryscio, Richard; Rogers, Sarah; Tylkowski, Chester

    2007-01-01

    Discriminatory ability of several pediatric outcome tools was assessed relative to Gross Motor Function Classification System (GMFCS) level in patients with cerebral palsy. Five hundred and sixty-two patients (400 with diplegia, 162 with hemiplegia; 339 males, 223 females; age range 4-18y, mean 11y 1mo [SD 3y 7mo]), classified as GMFCS Levels I to…

  19. 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…

  20. 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.…

  1. Assessing Student Learning Outcomes: Performance Accountability Report.

    ERIC Educational Resources Information Center

    Howard Community Coll., Columbia, MD.

    Prepared to document Howard Community College's (HCC's) progress in implementing its plan for assessing student learning outcomes, this performance accountability report describes the implementation of the plan as of November 1991, covering information gathered, actions taken, and proposed activities. Four strategic priorities which apply either…

  2. Nuclear Engineering Student Learning Outcome Assessment Report

    E-print Network

    Missouri-Rolla, University of

    1 Nuclear Engineering Student Learning Outcome Assessment Report 1. Program mission The Nuclear and graduate education to tomorrow's leaders in nuclear engineering. The program provides well-educated nuclear engineering professionals and leaders to Missouri and the nation in the commercial nuclear industry, national

  3. Outcomes Assessment in Veterinary Medical Education.

    ERIC Educational Resources Information Center

    Black, Leslie S.; Turnwald, Grant H.; Meldrum, James B.

    2002-01-01

    Describes the Virginia-Maryland Regional College of Veterinary Medicine's use of outcomes assessment (OA) as part of the accreditation review process for the American Veterinary Medical Association. Discusses its nine OA survey instruments and use of resulting data during accreditation. (EV)

  4. Student Learning Outcome Assessment Plan: Continuous Quality Improvement

    E-print Network

    Fernandez, Eduardo

    Student Learning Outcome Assessment Plan: Continuous Quality Improvement Florida Atlantic January 2013 #12;Page 2 of 10 Student Learning Outcome Assessment at FAU: Continuous Quality for Higher Education's 9 Principles of Good Practice for Assessing Student Learning provided a foundation

  5. Functional outcome after centralization for radius dysplasia.

    PubMed

    Goldfarb, Charles A; Klepps, Steven J; Dailey, Loray A; Manske, Paul R

    2002-01-01

    Centralization for radius dysplasia purportedly offers a more normal appearance, provides length to a shortened forearm, and improves upper-extremity function. Limited objective outcome data, however, exist to substantiate its use. To better define functional status after centralization, the Jebsen-Taylor hand test and the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) were administered to 21 patients (25 wrists) at an average of 20 years after surgery. Jebsen-Taylor scores, a measure of hand function, were significantly altered with an average total score of 48 seconds compared with an average normal score of 30 seconds (62% increase). The DASH questionnaire, a measure of upper-extremity function, showed only a mild disability of 18%. These long-term follow-up data show that hand function remains markedly abnormal while upper-extremity disability is mild. Improved wrist alignment and increased ulna length did not correlate with improved upper-extremity function. PMID:11810625

  6. Clinical Outcome Assessments: Conceptual Foundation-Report of the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force.

    PubMed

    Walton, Marc K; Powers, John H; Hobart, Jeremy; Patrick, Donald; Marquis, Patrick; Vamvakas, Spiros; Isaac, Maria; Molsen, Elizabeth; Cano, Stefan; Burke, Laurie B

    2015-09-01

    An outcome assessment, the patient assessment used in an endpoint, is the measuring instrument that provides a rating or score (categorical or continuous) that is intended to represent some aspect of the patient's health status. Outcome assessments are used to define efficacy endpoints when developing a therapy for a disease or condition. Most efficacy endpoints are based on specified clinical assessments of patients. When clinical assessments are used as clinical trial outcomes, they are called clinical outcome assessments (COAs). COAs include any assessment that may be influenced by human choices, judgment, or motivation. COAs must be well-defined and possess adequate measurement properties to demonstrate (directly or indirectly) the benefits of a treatment. In contrast, a biomarker assessment is one that is subject to little, if any, patient motivational or rater judgmental influence. This is the first of two reports by the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force. This report provides foundational definitions important for an understanding of COA measurement principles. The foundation provided in this report includes what it means to demonstrate a beneficial effect, how assessments of patients relate to the objective of showing a treatment's benefit, and how these assessments are used in clinical trial endpoints. In addition, this report describes intrinsic attributes of patient assessments and clinical trial factors that can affect the properties of the measurements. These factors should be considered when developing or refining assessments. These considerations will aid investigators designing trials in their choice of using an existing assessment or developing a new outcome assessment. Although the focus of this report is on the development of a new COA to define endpoints in a clinical trial, these principles may be applied more generally. A critical element in appraising or developing a COA is to describe the treatment's intended benefit as an effect on a clearly identified aspect of how a patient feels or functions. This aspect must have importance to the patient and be part of the patient's typical life. This meaningful health aspect can be measured directly or measured indirectly when it is impractical to evaluate it directly or when it is difficult to measure. For indirect measurement, a concept of interest (COI) can be identified. The COI must be related to how a patient feels or functions. Procedures are then developed to measure the COI. The relationship of these measurements with how a patient feels or functions in the intended setting and manner of use of the COA (the context of use) could then be defined. A COA has identifiable attributes or characteristics that affect the measurement properties of the COA when used in endpoints. One of these features is whether judgment can influence the measurement, and if so, whose judgment. This attribute defines four categories of COAs: patient reported outcomes, clinician reported outcomes, observer reported outcomes, and performance outcomes. A full description as well as explanation of other important COA features is included in this report. The information in this report should aid in the development, refinement, and standardization of COAs, and, ultimately, improve their measurement properties. PMID:26409600

  7. Functional outcome prediction following intracerebral hemorrhage.

    PubMed

    Appelboom, Geoffrey; Bruce, Samuel S; Han, James; Piazza, Matthew; Hwang, Brian; Hickman, Zachary L; Zacharia, Brad E; Carpenter, Amanda; Monahan, Aimee S; Vaughan, Kerry; Badjatia, Neeraj; Connolly, E Sander

    2012-06-01

    The ICH score is a validated method of assessing the risk of mortality and morbidity after intracerebral hemorrhage (ICH). We sought to compare the ability of the ICH score to predict outcome assessed with three of the most widely used scales: the Barthel Index (BI), modified Rankin Scale (mRS), and Glasgow Outcome Score (GOS). All patients with ICH treated at our institution between February 2009 and March 2011 were followed-up at three months using the mRS, GOS, and BI. The ICH score was highly correlated with the three-month mRS (?=0.59, p<0.001), BI (?=-0.57, p<0.001) and GOS (?=0.61, p<0.001). The ICH score also predicted dependency for each measure well, with areas under the curve falling between 0.826 and 0.833. Our results suggest that future clinical studies that use the ICH score to stratify patients may employ any of the three outcome scales and expect good discrimination of disability. PMID:22516544

  8. An Evaluation of the SCRC Learning Outcomes and Assessment Framework

    E-print Network

    Hayden, Nancy J.

    An Evaluation of the SCRC Learning Outcomes and Assessment Framework 2015 by Simon Jorgenson; An Evaluation of the SCRC Learning Outcomes and Assessment Framework I was asked by the SCRC to evaluate theories of learning outcomes to new methods of training evaluation. Journal of Applied Psychology, 78, 311

  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. New trends in assessing the outcomes of mental health interventions

    PubMed Central

    Thornicroft, Graham; Slade, Mike

    2014-01-01

    Assessing the outcomes of interventions in mental health care is both important and challenging. The aim of this paper is to advance the field of outcomes research by proposing a taxonomy of the decisions that clinicians and researchers need to consider when evaluating outcomes. Our taxonomy has eight components, framed as decisions: Whose outcome will be considered? Which scientific stage is being investigated? What outcome domain(s) matter? What level of assessment will be used? Will clinical and/or recovery outcomes be assessed? Whose perspective will be considered? Will deficits and/or strengths be the focus? Will invariant or individualized measures be preferred? We propose a future focus on understanding what matters most to people using mental health services, and on the use of measures rated by service users as the primary approach to evaluating outcome. PMID:24890055

  12. Outcomes Assessment Plan Department of Industrial and Enterprise Systems Engineering

    E-print Network

    Liberzon, Daniel

    1 Outcomes Assessment Plan Department of Industrial and Enterprise Systems Engineering (IESE) I. Process Used in Developing the Plan The Industrial and Enterprise Systems Engineering Outcome Assessment of the Department of Industrial and Enterprise Systems Engineering should have: (a) an ability to apply knowledge

  13. An International Assessment of Bachelor Degree Graduates' Learning Outcomes

    ERIC Educational Resources Information Center

    Coates, Hamish; Richardson, Sarah

    2012-01-01

    This paper examines rationales, aspirations, assumptions and methods shaping an international assessment of learning outcomes: the OECD's Assessment of Higher Education Learning Outcomes (AHELO) feasibility study. The first part of the paper is analytical, exploring formative rationales, and shaping contexts and normative perspectives that frame…

  14. 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,…

  15. Communication MA Program Plan for Assessment of Student Learning Outcomes

    E-print Network

    New Mexico, University of

    Communication MA Program Plan for Assessment of Student Learning Outcomes The University of New for evaluation of performance, and will respond to students' needs and concerns, in order to maintain in a timely manner. E. Assessment of Student Learning Three-Year Plan 1. Student Learning Outcomes

  16. Faculty Governance and Outcomes Assessment: Compatible or Combustible?

    ERIC Educational Resources Information Center

    DeBoy, James L.; Monsilovich, Sally B.; DeBoy, Joanne R.

    2013-01-01

    This paper identifies the various factors driving the outcomes assessment movement, contrasts the old paradigm with the model now espoused by regional accreditors, discusses the six-step process of student outcomes assessment, emphasizes faculty ownership of the process to prevent administrative usurpation, and proposes specific strategies to…

  17. Outcomes Assessment Planning: An Overview with Applications in Health Sciences.

    ERIC Educational Resources Information Center

    Trent, Ava M.

    2002-01-01

    Provides a brief overview of the process of outcomes assessment and examples of its application in professional health science education. Provides a background for other articles in this issue describing ongoing activities in outcomes assessment in veterinary education and for programs considering developing a plan. Focuses on health professions…

  18. 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

  19. Analyses of functional and oncologic outcomes following supracricoid partial laryngectomy.

    PubMed

    Wang, Yan; Li, Xiaotian; Pan, Zimin

    2015-11-01

    To review the functional and oncologic outcomes of patients who received supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) in our institution. A total of 208 patients who received SCPL with CHEP or CHP from our institution from 1995 to 2007 were involved. Among them, 190 cases were patients with squamous cell carcinoma of the larynx (T1-T4, N0-N2), 14 cases were patients with recurrent larynx cancer and 4 cases were patients with laryngeal stenosis. Forty-four patients also received unilateral neck dissection, and 41 patients received a bilateral neck dissection. All patients were assessed at functional outcome and complications of their treatment. Also, the oncologic outcomes, such as disease-specific survival, total survival, and local recurrence, were measured for patients with tumor. Decannulation was achieved in nearly all patients, with the average time to decannulation being 20 ± 11.52 days in CHEP patients and 28 ± 8.92 days in CHP patients (P < 0.05). The average nasogastric tubes were removed, days postoperation, was 18 ± 7.39 days in CHEP patients and 25 ± 13.87 days in CHP patients (P < 0.05). The 5-year local recurrence rate was 5.77%, the 5-year disease-specific survival was 82.7%, and the 5-year overall survival was 84.1%. The patients with CHEP had a better recovery than the patients with CHP. SCPL was a well-tolerated procedure with generally good functional outcomes for patients with advanced laryngeal cancer, also for some patients with laryngeal stenosis. PMID:25359194

  20. 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

  1. Fundamentals of Clinical Outcomes Assessment for Spinal Disorders: Clinical Outcome Instruments and Applications

    PubMed Central

    Vavken, Patrick; Ganal-Antonio, Anne Kathleen B.; Quidde, Julia; Shen, Francis H.; Chapman, Jens R.; Samartzis, Dino

    2015-01-01

    Study Design?A broad narrative review. Objectives?Outcome assessment in spinal disorders is imperative to help monitor the safety and efficacy of the treatment in an effort to change the clinical practice and improve patient outcomes. The following article, part two of a two-part series, discusses the various outcome tools and instruments utilized to address spinal disorders and their management. Methods?A thorough review of the peer-reviewed literature was performed, irrespective of language, addressing outcome research, instruments and tools, and applications. Results?Numerous articles addressing the development and implementation of health-related quality-of-life, neck and low back pain, overall pain, spinal deformity, and other condition-specific outcome instruments have been reported. Their applications in the context of the clinical trial studies, the economic analyses, and overall evidence-based orthopedics have been noted. Additional issues regarding the problems and potential sources of bias utilizing outcomes scales and the concept of minimally clinically important difference were discussed. Conclusion?Continuing research needs to assess the outcome instruments and tools used in the clinical outcome assessment for spinal disorders. Understanding the fundamental principles in spinal outcome assessment may also advance the field of “personalized spine care.” PMID:26225283

  2. Fundamentals of Clinical Outcomes Assessment for Spinal Disorders: Clinical Outcome Instruments and Applications.

    PubMed

    Vavken, Patrick; Ganal-Antonio, Anne Kathleen B; Quidde, Julia; Shen, Francis H; Chapman, Jens R; Samartzis, Dino

    2015-08-01

    Study Design?A broad narrative review. Objectives?Outcome assessment in spinal disorders is imperative to help monitor the safety and efficacy of the treatment in an effort to change the clinical practice and improve patient outcomes. The following article, part two of a two-part series, discusses the various outcome tools and instruments utilized to address spinal disorders and their management. Methods?A thorough review of the peer-reviewed literature was performed, irrespective of language, addressing outcome research, instruments and tools, and applications. Results?Numerous articles addressing the development and implementation of health-related quality-of-life, neck and low back pain, overall pain, spinal deformity, and other condition-specific outcome instruments have been reported. Their applications in the context of the clinical trial studies, the economic analyses, and overall evidence-based orthopedics have been noted. Additional issues regarding the problems and potential sources of bias utilizing outcomes scales and the concept of minimally clinically important difference were discussed. Conclusion?Continuing research needs to assess the outcome instruments and tools used in the clinical outcome assessment for spinal disorders. Understanding the fundamental principles in spinal outcome assessment may also advance the field of "personalized spine care." PMID:26225283

  3. Appropriately assessing renal function for drug dosing.

    PubMed

    Dong, Kimberly; Quan, David J

    2010-01-01

    Chronic kidney disease affects millions of Americans. Many drugs are eliminated from the body by the kidneys. As renal function declines due to the disease, drugs that are normally eliminated by the kidneys can accumulate, potentially leading to toxicity. Assessing kidney function in patients is essential in determining the appropriate dose of medications to achieve the desired clinical outcome while minimizing the potential for toxicity. PMID:20629469

  4. 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…

  5. Assessment of Learning Outcomes in Finnish Vocational Education and Training

    ERIC Educational Resources Information Center

    Räisänen, Anu; Räkköläinen, Mari

    2014-01-01

    This article provides an outline and critical review of assessment, an evaluation of learning outcomes, in vocational education and training (VET) in Finland. Assessment of VET is formative, development-orientated and criteria-based. There are no national tests and information from vocational skills demonstrations is used instead. Assessment

  6. 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…

  7. Challenges in Assessing Outcomes in Graduate and Professional Education.

    ERIC Educational Resources Information Center

    Bilder, Anne E.; Conrad, Clifton F.

    1996-01-01

    There is a need for cross-disciplinary or cross-institutional research on student learning outcomes in graduate and professional education. Challenges in this endeavor include determining the purposes of assessment and who conducts it, identifying and defining outcomes, and managing the use of results. (MSE)

  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. Regional Accreditation and Learning Outcomes Assessment: Mapping the Territory

    ERIC Educational Resources Information Center

    Provezis, Staci J.

    2010-01-01

    This case study examined the intersection of collegiate-level student learning outcomes assessment with regional accreditation to understand how regional accreditation policies and practices leverage student learning outcomes efforts on US college campuses. To that end, the standards of each of the regional accreditation agencies were carefully…

  10. Functional and radiological outcome of periprosthetic fractures of the ankle.

    PubMed

    Tsitsilonis, S; Schaser, K D; Wichlas, F; Haas, N P; Manegold, S

    2015-07-01

    The incidence of periprosthetic fractures of the ankle is increasing. However, little is known about the outcome of treatment and their management remains controversial. The aim of this study was to assess the impact of periprosthetic fractures on the functional and radiological outcome of patients with a total ankle arthroplasty (TAA). A total of 505 TAAs (488 patients) who underwent TAA were retrospectively evaluated for periprosthetic ankle fracture: these were then classified according to a recent classification which is orientated towards treatment. The outcome was evaluated clinically using the American Orthopedic Foot and Ankle Society (AOFAS) score and a visual analogue scale for pain, and radiologically. A total of 21 patients with a periprosthetic fracture of the ankle were identified. There were 13 women and eight men. The mean age of the patients was 63 years (48 to 74). Thus, the incidence of fracture was 4.17%. There were 11 intra-operative and ten post-operative fractures, of which eight were stress fractures and two were traumatic. The prosthesis was stable in all patients. Five stress fractures were treated conservatively and the remaining three were treated operatively. A total of 17 patients (81%) were examined clinically and radiologically at a mean follow-up of 53.5 months (12 to 112). The mean AOFAS score at follow-up was 79.5 (21 to 100). The mean AOFAS score in those with an intra-operative fracture was 87.6 (80 to 100) and for those with a stress fracture, which were mainly because of varus malpositioning, was 67.3 (21 to 93). Periprosthetic fractures of the ankle do not necessarily adversely affect the clinical outcome, provided that a treatment algorithm is implemented with the help of a new classification system. PMID:26130351

  11. Impact of weather and climate scenarios on conservation assessment outcomes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This paper reviews selected watershed studies of the Conservation Effects Assessment Project (CEAP) and interprets findings from the perspective of potential climate change impacts on conservation outcomes. Primary foci are runoff, soil erosion, sediment transport, watershed sediment yield, and asso...

  12. Rollator use and functional outcome of geriatric rehabilitation.

    PubMed

    Vogt, Lutz; Lucki, Katrin; Bach, Matthias; Banzer, Winfried

    2010-01-01

    In a quasi-experimental pre- and postdesign, we examined the effect of rollator use on functional rehabilitation outcome in geriatric patients.From a sample of 458 geriatric inpatients, we matched 30 subjects who were not using assistive devices in their everyday lives but received a wheeled walker at the time of hospital admission (first-time user group) according to their admission scores on three motor performance tests (Timed Up-and-Go, Five-Times-Sit-to-Stand, and Performance-Oriented Mobility Assessment -Balance) with 30 patients who were actively using rollators as their primary walking aid for at least 3 months (long-term user group) and 30 control subjects without walking-aid assistance. Measurements were repeated after the inpatient rehabilitation regimen.The Kruskal-Wallis test did not reveal significant group differences in rehabilitation progress. Controls and device users, regardless of walking-aid experience, demonstrated nearly comparable mobility, strength, and balance improvements. More than half of each cohort (controls, n = 22; first-time, n = 17; long-term, n = 18) achieved functional gains in all three motor tests.The study showed that rollator assistance does not interfere with rehabilitation outcome and, to some extent, legitimates the prescription of assistive devices to improve confidence and restore or maintain motor ability at the highest possible level. PMID:20593328

  13. Clinical overall score: outcome evaluation after lumbar disc surgery, assessments of reliability and validity.

    PubMed

    Graver, V; Loeb, M; Rasmussen, F; Lie, H; Ljunggren, A E

    1998-12-01

    In previous studies assessing prognostic factors for the outcome of lumbar disc surgery, a Clinical Overall Score (COS) based on four subsets-pain intensity (VAS), physical signs, functional status (Oswestry) and analgesics--was used as the main outcome criterion. Both the patient's and the examiner's opinions of outcome and return to work were registered. In this paper, assessments are made of reliability and validity regarding the COS. The COS was found sensitive to changes, and internal consistency, assessed using Cronbach's alpha, Pearson's correlation analyses and factor analysis, was good. An interrater reliability study of the assessments of the physical signs, using weighted Kappa statistics, demonstrated fair to good levels of agreement for most of the signs. The concurrent validity of the COS was satisfactory; COS compared favourably with the patient's and with the examiner's opinion of outcome and return to work. PMID:9825387

  14. Comprehensive treatment of ambulatory children with cerebral palsy: an outcome assessment.

    PubMed

    Schwartz, Michael H; Viehweger, Elke; Stout, Jean; Novacheck, Tom F; Gage, James R

    2004-01-01

    A retrospective study was used to evaluate the outcome of treatment of 135 ambulatory children with cerebral palsy. Diplegic subjects were selected from the existing database at the Gillette Children's Specialty Healthcare Motion Analysis Laboratory. All subjects had undergone gait analysis before and after intervention, which included orthopaedic surgery, selective dorsal rhizotomy, or both treatments. Outcome was based on gait pathology, gait efficiency, functional walking ability, and higher-level functional skills. Gait pathology was assessed using 16 clinically relevant kinematic parameters. Gait efficiency was assessed with steady-state oxygen consumption. Walking ability and higher-level functional skills were based on patient report surveys. Improvements were seen in all outcome measures. A significant majority of subjects (79%) improved on a predominance of outcome measures; only 7% of subjects worsened. Within the restrictions of this study design, the results indicate that surgical intervention, guided by preoperative gait analysis, is effective and safe for children with cerebral palsy. PMID:14676533

  15. Physical Education Performance Outcomes and Cognitive Function

    ERIC Educational Resources Information Center

    Castelli, Darla M.; Hillman, Charles H.

    2007-01-01

    This article intends to inform physical education teachers about the current research describing the relationship between physical education performance outcomes as identified by the national physical education standards (i.e., regular participation in physical activity, physical fitness, motor competence; National Association of Physical…

  16. Assessing Effective Teaching of Psychology: A Meta-Analytic Integration of Learning Outcomes

    ERIC Educational Resources Information Center

    Tomcho, Thomas J.; Foels, Rob

    2008-01-01

    Teaching researchers can assess learning outcome effectiveness as a function of students' graded performance or changes in knowledge, skills and behaviors, or attitudes. We meta-analyzed 197 studies to determine the effectiveness of teaching activities in "Teaching of Psychology (ToP)" both overall and also as a function of type of learning…

  17. Using Art to Assess Environmental Education Outcomes

    ERIC Educational Resources Information Center

    Flowers, Ami A.; Carroll, John P.; Green, Gary T.; Larson, Lincoln R.

    2015-01-01

    Construction of developmentally appropriate tools for assessing the environmental attitudes and awareness of young learners has proven to be challenging. Art-based assessments that encourage creativity and accommodate different modes of expression may be a particularly useful complement to conventional tools (e.g. surveys), but their efficacy and…

  18. Student Learning Outcomes Assessment Materials Guidebook

    ERIC Educational Resources Information Center

    ACPA College Student Educators International, 2011

    2011-01-01

    The American College Personnel Association's (ACPA's) Sustainability Task Force partnered with the Commission on Assessment and Evaluation with the goal of creating assessment tools to help ACPA members effectively measure student learning around sustainability. Towards these ends, Kimberly Yousey-Elsener (StudentVoice), Diana Richter Keith…

  19. Strategies for assessment and outcome measurement in physical and rehabilitation medicine: an educational review.

    PubMed

    Küçükdeveci, Ay?e A; Tennant, Alan; Grimby, Gunnar; Franchignoni, Franco

    2011-07-01

    The aim of this educational review, which is based upon expert opinion, is to describe to clinicians training in Physical and Rehabilitation Medicine and research students training to work in the field, the appropriate attributes and standards required for assessment and outcome measurement. "What to assess" is discussed in the context of the conceptual framework provided by the International Classification of Functioning, Disability and Health, supplemented with quality of life as an additional construct. The reasons for making the assessment, and the context in which the assessment will be used, are then considered. Examples of recommendations of some international organizations regarding what and how to assess are presented. Suggestions are made about the selection of assessment tools, including examples from two diagnostic groups: stroke and rheumatoid arthritis. Finally, the basic psychometric standards required for any assessment tool, and additional requirements for outcome assessment, are explained. PMID:21687922

  20. Spinal cord injury rehabilitation. 3. Functional outcomes.

    PubMed

    Formal, C S; Cawley, M F; Stiens, S A

    1997-03-01

    This self-directed learning module highlights new advances in this topic area. It is part of the chapter on spinal cord injury rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article contains information about mobility, ambulation, upper extremity function, bowel management, and technology to enhance function in the community. New advances covered in this section include functional electrical stimulation for enhancing mobility and upper extremity function. PMID:9084369

  1. Assessing Outcomes through Congruence of Course Objectives and Reflective Work

    ERIC Educational Resources Information Center

    Lockyer, Jocelyn M.; Fidler, Herta; Hogan, David B.; Pereles, Laurie; Wright, Bruce; Lebeuf, Christine; Gerritsen, Cory

    2005-01-01

    Introduction: Course outcomes have been assessed by examining the congruence between statements of commitment to change (CTCs) and course objectives. Other forms of postcourse reflective exercises (for example, impact and unmet-needs statements) have not been examined for congruence with course objectives or their utility in assessing course…

  2. A Model for Effectively Assessing Student Learning Outcomes

    ERIC Educational Resources Information Center

    Ohia, Uche O.

    2011-01-01

    This paper describes a model proven to be effective for assessing and documenting evidence of student learning outcomes. Specifically, it will share a model, F.A.M.O.U.S. Copyright ©2008, which is an acronym exemplifying six effective steps for complying with institutional accountability and eternal assessment requirements proscribed by the…

  3. 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…

  4. Outcomes Assessment: The Tip of the Iceberg.

    ERIC Educational Resources Information Center

    Cole, Susan S.

    1990-01-01

    Describes the multifaceted process for assessing students over the course of their undergraduate degree work in the Department of Theater and Dance at Appalachian State University in North Carolina. (SR)

  5. COMPARATIVE IMMEDIATE FUNCTIONAL OUTCOMES AMONG CRYOTHERAPEUTIC INTERVENTIONS AT THE ANKLE

    PubMed Central

    Miller, Sayers J.; Sebastianelli, Wayne J.; Vairo, Giampietro L.

    2013-01-01

    Purpose/Background: There is a lack of evidence detailing the immediate effects of different cryotherapy interventions at the ankle on functional outcomes such as balance and jumping tasks in a physically active population; therefore, the purpose of the present study is to compare the immediate effects of varied modes of cryotherapy applications to the ankle joint on Star Excursion Balance Test and vertical jump height performance. The authors hypothesized that cryotherapy would acutely decrease performance when compared to a control, and that concomitant compression would further hinder outcomes. Methods: A crossover study was conducted in a controlled laboratory setting. Thirty (9 men, 21 women) participants (20.6 ± 1.0 years, 1.7 ± 0.1 m, 67.5 ± 11.7 kg) were enrolled. The independent variable was treatment mode; no ice, ice without compression and ice with compression. Dependent variables included center of pressure (COP) excursions, dynamic balance reach distances and vertical jump height for the dominant leg. Participants underwent three separate testing sessions separated by 72?hour rest intervals. The order of treatment and performance measures was randomized to prevent order effects. Normalized dynamic balance reach distances were assessed using the reliable modified Star Excursion Balance Test (SEBT). Center of pressure path length was assessed via a force platform during a single?legged static balance task under eyes?open and eyes?closed conditions. Relative vertical jump height was assessed using a single?legged vertical hop test. Group means and standard deviations were calculated by treatment mode. One?way analyses of variance with Tukey's post hoc test were used to calculate differences among treatment modes. p < 0.05 denoted statistical significance. Results: No statistically significant differences existed for all the performance measures among treatment modes. Conclusions: These findings suggest no immediate differences in lower extremity performance outcome measures between the respective treatment modes applied to the ankle in a young, healthy and physically active population. Additional investigation is warranted to study the related delayed effects of these interventions. Levels of Evidence: III PMID:24377069

  6. 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…

  7. Patient assessment: preparing for a predictable aesthetic outcome.

    PubMed

    Mehta, Shamir B; Banerji, Subir; Aulakh, Raman

    2015-01-01

    The flux of patients seeking to make changes to the appearance of their smile zone appears to be on a pathway of continual increase. This is possibly due to an increase in awareness towards oral health, and perhaps social, peer and media pressures, respectively. Cohorts of dental practitioners have thus responded to the latter demands by attending a plethora of educational courses, often focusing on either restorative techniques or other disciplines, notably orthodontics and clear aligners in particular. Consequently, treatment planning and thus treatment provision may carry the risk of being biased or indeed 'outcome driven' whereby the skills and knowledge of any clinician towards a particular faculty may significantly influence the ultimate treatment plan, with the unfortunate tendency sometimes to overlook the role of the interdisciplinary approach of concomitant restorative and contemporary techniques. The role of orthodontics to facilitate the provision of such treatment, along with predictable enamel bonding, has the distinct advantage of providing an acceptable aesthetic result with minimal biological intervention. However, to achieve an optimal result in such cases requires meticulous treatment planning and patient selection to avoid pitfalls with regards to long-term stability and function. This article suggests a standardized approach to patient assessment, with an interdisciplinary perspective in mind. Clinical Relevance: With the growth of patient demand for improving the appearance of the smile, a meticulous assessment protocol is required along with effective interdisciplinary communication. This enables a comprehensive treatment plan to be developed with the correct priorities. PMID:26062282

  8. Subjective outcome assessments for cervical spine pathology: A narrative review

    PubMed Central

    Resnick, Diane N.

    2005-01-01

    Abstract Background Subjective outcome assessment instruments may be used to determine whether changes occur as a result of a particular treatment intervention. Since 1991, 11 outcome assessment instruments either specific to or validated for use with cervical spine pathologies have been developed and their psychometric properties critically assessed. Though a systematic review of this subject was published in 2002, it included an analysis of only 5 measures available at that time. Objective To present a description of each of the 11 measures and briefly compare their psychometric properties, reliability, validity, and responsiveness to change. Methods Computer-based searches of MEDLINE and CINAHL were performed to capture all data relevant to the eleven outcome assessment tools currently available. Results Data regarding descriptions, reliability and validity of 11 outcome measures were found and collated. Conclusion The choice of which outcome measurement to use becomes a matter of preference based on the particular patient population each clinician treats, the ease of use for the patient and ease of scoring for the clinician, and the domains that are most relevant to a particular patient. PMID:19674654

  9. Beyond the Basics of Clinical Outcomes Assessment: Selecting Appropriate Patient-Rated Outcomes Instruments for Patient Care

    ERIC Educational Resources Information Center

    Valier, Alison R.; Lam, Kenneth C.

    2015-01-01

    The fifth edition of the "Athletic Training Education Competencies" emphasizes the concepts of clinical outcomes assessment. In athletic training, clinical outcomes assessment, especially as it relates to patient-rated outcomes (PRO) instruments, is new, which produces uncertainty with regard to how to integrate PROs into athletic…

  10. 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

  11. Repeat Partial Nephrectomy: Surgical, Functional and Oncological Outcomes

    PubMed Central

    Shuch, Brian; Linehan, W. Marston; Bratslavsky, Gennady

    2011-01-01

    Purpose of Review The greater utilization of partial nephrectomy and ablative procedures has increased the incidence of patients presenting with local renal recurrence. The choice to either perform a partial or radical nephrectomy in these situations can be a challenging decision. Recent Findings Repeat and salvage partial nephrectomy, while challenging and potentially associated with increased complications, offers patients the ability to maintain excellent renal functional outcomes and promising oncologic outcomes at intermediate follow up. Summary Surgeons should be familiar with the surgical complications and the functional and oncologic outcomes of re-operative nephron-sparing surgery. Recent data and outcome analysis support utilization of these procedures in patients presenting with either local recurrence or de novo lesions in the ipsilateral kidney. PMID:21788903

  12. Predicting functional remission in patients with schizophrenia: a cross-sectional study of symptomatic remission, psychosocial remission, functioning, and clinical outcome

    PubMed Central

    Valencia, Marcelo; Fresán, Ana; Barak, Yoram; Juárez, Francisco; Escamilla, Raul; Saracco, Ricardo

    2015-01-01

    Background New approaches to assess outcome in schizophrenia include multidimensional measures such as remission, cognition, psychosocial functioning, and quality of life. Clinical and psychosocial measures have been recently introduced to assess functional outcome. Objective The study presented here was designed to examine the rates of symptomatic remission, psychosocial remission, global functioning, and clinical global impressions in a sample of schizophrenia outpatients in order to assess functional remission and to identify predictive factors for functional remission. Methods A total of 168 consecutive Mexican outpatients receiving pharmacological treatment at the National Institute of Psychiatry in Mexico City were enrolled in a cross-sectional study. Symptomatic remission was assessed according to the definition and criteria proposed by the Remission in Schizophrenia Working Group using the Positive and Negative Symptom Scale. Psychosocial remission was assessed according to Barak criteria using the Psychosocial Remission in Schizophrenia scale. Functioning was measured with the Global Assessment of Functioning, and clinical outcome with the Clinical Global Impressions (CGI) Scale. Results Findings showed that 45.2% of patients fulfilled the symptomatic remission criteria, 32.1% achieved psychosocial remission, and 53% reported adequate functioning. However, the combination of these three outcome criteria – symptomatic, psychosocial remission, and functioning – indicated that 14.9% of the patients achieved our predefined functional remission outcome. The logistic regression model included five predictive variables for functional remission: (1) being employed, (2) use of atypical antipsychotics, (3) lower number of medications, (4) lower negative symptom severity, and (5) lower excitement symptom severity. Conclusion The study demonstrated that symptomatic remission, psychosocial remission, and functioning could be achievable goals for a considerable number of patients. The outcome of functional remission was achieved by a minority of patients, less than 15%. New approaches should include multidimensional measures to assess functional outcome in schizophrenia research. PMID:26396518

  13. Factors predicting functional outcomes of cochlear implants in children.

    PubMed

    Hyde, Merv; Punch, Renée; Grimbeek, Peter

    2011-05-01

    This article reports the relationships between a large number of child- and family-related factors and children's functional outcomes, according to parental report, in the domains of spoken language communication, social skills and participation, academic achievement, and independence and identity, through a series of stepwise regression analyses. Parents of 247 children who had received cochlear implants in three eastern states of Australia completed a survey on their expectations and experiences of their children's outcomes with cochlear implants. A number of the independent variables were found to be associated, either positively or negatively, with children's outcomes. Implications for cochlear implant professionals, early intervention programmes, and educational authorities are discussed. PMID:21756502

  14. Electrophysiological assessment of retinal ganglion cell function.

    PubMed

    Porciatti, Vittorio

    2015-12-01

    The function of retinal ganglion cells (RGCs) can be non-invasively assessed in experimental and genetic models of glaucoma by means of variants of the ERG technique that emphasize the activity of inner retina neurons. The best understood technique is the Pattern Electroretinogram (PERG) in response to contrast-reversing gratings or checkerboards, which selectively depends on the presence of functional RGCs. In glaucoma models, the PERG can be altered before histological loss of RGCs; PERG alterations may be either reversed with moderate IOP lowering or exacerbated with moderate IOP elevation. Under particular luminance-stimulus conditions, the Flash-ERG displays components that may reflect electrical activity originating in the proximal retina and be altered in some experimental glaucoma models (positive Scotopic Threshold response, pSTR; negative Scotopic Threshold Response, nSTR; Photopic Negative Response, PhNR; Oscillatory Potentials, OPs; multifocal ERG, mfERG). It is not yet known which of these components is most sensitive to glaucomatous damage. Electrophysiological assessment of RGC function appears to be a necessary outcome measure in experimental glaucoma models, which complements structural assessment and may even predict it. Neuroprotective strategies could be tested based on enhancement of baseline electrophysiological function that results in improved RGC survival. The use of electrophysiology in glaucoma models may be facilitated by specifically designed instruments that allow high throughput, robust assessment of electrophysiological function. PMID:25998495

  15. 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…

  16. ULO Course Learning Outcome Assessment Method Pedagogy Critical reading

    E-print Network

    Barrash, Warren

    FRENCH101 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Critical reading skills within the discipline Read written discourse in French at the elementary level ; Interpret written discourse in French at the elementary level ; Analyze written discourse in French at the elementary level

  17. ULO Course Learning Outcome Assessment Method Pedagogy Critical reading

    E-print Network

    Barrash, Warren

    FRENCH102 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Critical reading skills within the discipline Read written discourse in French at the elementary level ; Interpret written discourse in. French at the elementary level ; Analyze written discourse in French at the elementary level

  18. Defining and Assessing Affective Outcomes in Undergraduate Pediatric Dentistry.

    ERIC Educational Resources Information Center

    Cullen, Claire L.

    1990-01-01

    The affective aspect of the curriculum is defined as the development of appropriate and measurable values such as ethical behavior, honesty, tolerance, and becoming a life-long learner. In outcome assessment of the affective category, the goal is to evaluate the transition of the student to a professional. (MLW)

  19. Assessment of Student Learning Outcomes in FCS Programs

    ERIC Educational Resources Information Center

    Weaver-Kaulis, Amy; Crutsinger, Christy

    2006-01-01

    Accreditation, budget, and accountability pressures at the institution and program levels lead to the involvement of faculty in assessment-based activities. Increasingly, programs are being expected to document student learning beyond traditional course grades. The use of outcomes as a tool to improve learning relies heavily on the active…

  20. Chemical and Biological Engineering Student Learning Outcome Assessment Report

    E-print Network

    Missouri-Rolla, University of

    1 Chemical and Biological Engineering Student Learning Outcome Assessment Report 1. Department/Program Mission The mission of the Department of Chemical and Biological is to prepare chemical engineers for successful careers of leadership and innovation in chemical engineering and related fields; expands

  1. 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…

  2. 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 ...

  3. Department of Linguistics Plan for Assessment of Student Learning Outcomes

    E-print Network

    New Mexico, University of

    Department of Linguistics Plan for Assessment of Student Learning Outcomes The University of New: Linguistics 3. Date: May 23, 2008 B. Academic Program of Study M.A. in Linguistics C. Contact Person: Breadth of Basic Knowledge To be able to compare and evaluate linguistic theories in several core areas

  4. Department of Linguistics Plan for Assessment of Student Learning Outcomes

    E-print Network

    New Mexico, University of

    Department of Linguistics Plan for Assessment of Student Learning Outcomes The University of New: Linguistics 3. Date: May 23, 2008 B. Academic Program of Study B.A. Linguistics C. Contact Person. Students will demonstrate knowledge and understanding of linguistic diversity and variability within

  5. Department of Linguistics Plan for Assessment of Student Learning Outcomes

    E-print Network

    New Mexico, University of

    Department of Linguistics Plan for Assessment of Student Learning Outcomes The University of New: Linguistics 3. Date: May 23, 2008 B. Academic Program of Study B.S. in Signed Language Interpreting C. Contact, and numerical systems in ASL. 3. Students will apply basic principles of linguistics to the study of signed

  6. Department of Linguistics Plan for Assessment of Student Learning Outcomes

    E-print Network

    New Mexico, University of

    Department of Linguistics Plan for Assessment of Student Learning Outcomes The University of New: Linguistics 3. Date: May 23, 2008 B. Academic Program of Study Ph.D. in Linguistics C. Contact Person: In-Depth Knowledge To demonstrate detailed knowledge of a chosen subarea of linguistics A.1. Students

  7. Multiple Sclerosis Outcome Assessments Consortium: Genesis and initial project plan.

    PubMed

    Rudick, Richard A; Larocca, Nicholas; Hudson, Lynn D

    2014-01-01

    The need for improved clinical outcome measures in multiple sclerosis trials has been recognized for two decades, but only recently has the Food and Drug Administration (FDA) created a pathway for qualification of new clinician-reported outcome (ClinRO) assessments. Additionally, drug development in multiple sclerosis (MS) has been extraordinarily active, with numerous disease-modifying drugs now on the market. This shifting therapeutic landscape, along with the unmet need for drugs to treat the progressive forms of MS and the changing expectations of clinicians, patients, and payers, have led to the call for more sensitive and meaningful disability progression measures. In response to these drivers, the Multiple Sclerosis Outcome Assessments Consortium (MSOAC) was launched. A public-private partnership, MSOAC aims to accelerate the development of new therapies for MS by generating new tools for measuring outcomes in clinical trials. At the first annual MSOAC/FDA meeting, a regulatory path was outlined for qualifying a new tool for assessing efficacy in registration trials of MS. The European Medicines Agency (EMA) and FDA will provide parallel consultation and review. The consensus approach with engagement by all of the stakeholders, prominently including patients with MS, should also increase acceptance of the measure by clinicians and patients. PMID:24057430

  8. Functional outcomes following surgical treatment of bilateral mandibular condylar fractures.

    PubMed

    Chen, C-T; Feng, C-H; Tsay, P-K; Lai, J-P; Chen, Y-R

    2011-01-01

    Debate continues regarding unilateral or bilateral treatment for mandibular condylar fractures. This retrospective study evaluates the functional outcomes of bilateral condylar process fractures after surgical intervention. From May 1994 to December 2004, 51 adult patients with bilateral mandibular condylar process fractures were studied. There were 33 cases of bilateral condylar fractures (type I); 12 cases of condylar-subcondylar fractures (type II); and six cases of bilateral subcondylar fractures (type III). All patients underwent open reduction and internal fixation. Four patients had chin deviation, six had malocclusion, three had poor chewing function and eight had limited mouth opening. Type I patients had a significantly higher incidence of limited mouth opening (P=0.039) and associated maxillary fractures (n=12) and psychiatric disease (n=6) which yielded significantly poor functional outcomes. Complications included transient facial paresis (n=4), fracture and loosening of postoperative plates (n=3) and surgical wound infections (n=2). Open reduction with rigid fixation for bilateral condylar fractures provided satisfactory functional outcomes in this study. Concomitant maxillary fractures and underlying psychiatric problems are poor outcome factors. Aggressive rehabilitation in the first 9 months is important for early functional recovery. PMID:20961735

  9. Outcomes Assessment and Program Improvement Ph.D. in Finance

    E-print Network

    Liberzon, Daniel

    The process underlying the development of an assessment plan began in 2001-2002 with a comprehensive review and the program. SECTION 2 ­ REVISED ASSESSMENT PLAN 1. Plan Development Process The department assessment plan to the body of knowledge in the area Students will demonstrate their ability to function as an independent

  10. Albuminuria prediction of kidney function outcome in kidney transplant recipients.

    PubMed

    El Minshawy, Osama; El-Bassuoni, Eman

    2015-03-01

    To investigate the association of albuminuria and kidney function outcome in kidney transplant recipients, we studied 161 kidney transplant recipients; 95 (59%) of them were males and the mean age of the patients was 46 ± 13 years (range 18-70 years). All the patients received allografts from living related kidney donors. The mean body mass index of the patients was 25 ± 4 kg/m 2 . Forty (25%) patients were diabetic and 72 (45%) patients were hypertensive. All the patients had glomerular filtration rate (iGFR) determination by ( 99m Tc-DTPA) clearance and albumiuria was assessed using the first voided morning urine samples. According to the results of albuminuria, the patients were subdivided into three groups: One group of 90 (56%) patients with normoalbuminuria (<30 mg albumin/g. creatinine), a second group of 52 (32%) patients with microalbuminuria (30-300 mg albumin/g. creatinine) and a third group of 19 (12%) patients with macroalbuminuria (>300 mg/g. creatinine). There was a significant increase in the time post transplantation in the patients with macroalbumiuria in comparison with microalbuminuria and normoalbuminuria (90 ± 28, 60 ± 22 and 18 ± 6 months, respectively), P <0.05. There was a significant decrease of iGFR in the macroalbumiuria group as compared with the microalbumiuria and normoalbuminuria groups (57 ± 24, 74 ± 20 and 74 ± 28 mL/min/1.73 m 2 , respectively), P <0.05. We conclude that there was an association between albuminuria and the status of the renal function in our transplant population, which may reflect renal injury due to proteinuria. Prospective studies are warranted to evaluate the effect of albuminuria on the prognosis of the kidney allografts. PMID:25758867

  11. 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

  12. Functional and economic outcome following microdiscectomy for lumbar disc herniation in 672 patients.

    PubMed

    Schoeggl, A; Reddy, M; Matula, C

    2003-04-01

    A retrospective assessment of 809 patients operated on in 1990-1998 was performed. A patient-based outcome questionnaire also was incorporated into the study. The outcome was graded according to the Functional Economic Rating scale. A total of 64% of the patients were relieved of their complaints 3.2-10.2 years (median 6.3 years) after lumbar disc surgery. An excellent outcome, defined as Prolo scale of 9 or 10, was achieved in 55.8%, a good outcome (Prolo scale 7 or 8) in 20.7%, a fair outcome (Prolo scale 5 or 6) in 11.4%, and a poor outcome (Prolo scale of outcome than patients with less strenuous or sedentary occupations. Criteria for evaluating the results of treating lumbar spinal disorders vary widely. A more universal acceptance of common criteria for judging the outcome of spinal operations should facilitate comparisons among various methods of treatment. PMID:12679669

  13. Assessing Treatment Outcomes in Attention-Deficit/Hyperactivity Disorder: A Narrative Review

    PubMed Central

    Weiss, Margaret D.

    2012-01-01

    Objective: To review measures used to assess treatment response in patients with attention-deficit/hyperactivity disorder (ADHD) across the life span. Data Sources: Keyword searches of English-language articles in the PubMed database up to and including the May 4, 2011, index date were performed with the search strings (1) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (outcome assessment [MeSH] OR adaptation of life skills OR executive function [MeSH]) and (2) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (function OR functioning OR quality of life [MeSH]). Study Selection: Articles found through this search were then selected based on relevance to the topic area; no specific quality criteria were applied. Data Extraction: Narrative review. Results: The vast majority of studies assessing ADHD treatments have measured treatment response using ADHD symptom measures. Additional domains relevant for assessing treatment response among children and adults with ADHD include functional impairment, quality of life, adaptive life skills, and executive function. Validated rating scales exist for assessing these additional domains, but there has been minimal research evaluating the sensitivity of these instruments for detecting treatment response in pediatric and adult samples. Conclusions: Assessment of treatment outcomes in ADHD should move beyond symptom assessment to incorporate measures of functioning, quality of life, adaptive skills, and executive function, especially when assessing long-term treatment response. The authors recommend a potential battery and schedule of measures that could be used to more comprehensively assess treatment response in patients with ADHD. PMID:23585986

  14. Musculoskeletal Outcome in Hemophilia: Bleeds, Joint Structure and Function, Activity, and Health-Related Fitness.

    PubMed

    Poonnoose, Pradeep M; van der Net, Janjaap

    2015-11-01

    Treatment in hemophilia is designed to reduce bleed frequency, minimize joint damage, and maximize functional independence and quality of life. Therefore, success of a factor replacement protocol is usually gauged by its ability to produce near "normal joints"-without any significant pathology. The most commonly used outcome measurement tools are based on the radiological and clinical assessment of joint arthropathy. To improve the sensitivity to early changes, the clinical scores have been refined, and imaging based on magnetic resonance imaging and ultrasonography has been initiated. Although these scores are useful in assessing the structure and function of a joint, they do not consider the impact of arthropathy on overall musculoskeletal function. They are also not capable of assessing the efficacy of interventions on functional independence, participation in life activities, and quality of life. The development of functional scores such as the Functional Independence Score for Hemophilia, the pediatric Hemophilia Activities List, and some quality of life measurement tools have helped provide a more comprehensive assessment of health. This article describes the psychometric properties and limitations of the various clinimetric tools that are used to assess musculoskeletal outcome in hemophilia and suggests an algorithm for their use in clinical practice. PMID:25923063

  15. Idiosyncratic Variables Affecting Functional Analysis Outcomes: A Review (2001–2010)

    PubMed Central

    Schlichenmeyer, Kevin J.; Roscoe, Eileen M.; Rooker, Griffin W.; Wheeler, Emily E.; Dube, William V.

    2013-01-01

    Although typical functional analyses often produce clear outcomes, some studies have reported ambiguous results that cannot be interpreted. Such undifferentiated outcomes may occur if test conditions do not include relevant antecedent or consequent events. Clinicians then may try to modify the functional analysis conditions to include those events. Hanley, Iwata, and McCord (2003) reviewed the functional analysis literature through the year 2000 and described idiosyncratic variables included in modified functional analyses. The objective of the present review was to present a quantitative analysis of idiosyncratic antecedents and consequences in modified functional analyses during the past decade (2001 to 2010). We discuss the range of stimulus parameters tested and the assessment strategies used for informing the modified analysis conditions. PMID:24114110

  16. The Role of Stress Exposure and Family Functioning in Internalizing Outcomes of Urban Families

    PubMed Central

    Henry, David B.; Tolan, Patrick H.; Strachan, Martha K.

    2013-01-01

    Although research suggests that stress exposure and family functioning are associated with internalizing problems in adolescents and caregivers, surprisingly few studies have investigated the mechanisms that underlie this association. To determine whether family functioning buffers the development of internalizing problems in stress-exposed families, we assessed the relation between stress exposure, family functioning, and internalizing symptoms among a large sample of inner-city male youth and their caregivers living in poverty across five waves of data collection. We hypothesized that stress exposure and family functioning would predict development of subsequent youth and caregiver internalizing problems and that family functioning would moderate this relation, with higher functioning families demonstrating greater resiliency to stress exposure. We used a longitudinal, prospective design to evaluate whether family functioning (assessed at waves one through four) activated or buffered the effects of stress exposure (assessed at wave one) on subsequent internalizing symptoms (assessed at waves four and five). Stress from Developmental Transitions and family functioning were significant predictors of depressive symptoms and anxiety in youth; however, family functioning did not moderate the relation. Family functioning mediated the relation between stress from Daily Hassles and internalizing outcomes suggesting that poor parenting practices, low structure, and low emotional cohesion activate depression and anxiety in youth exposed to chronic and frequent everyday stressors. Surprisingly, only family functioning predicted depressive symptoms in caregivers. Results validate the use of a comprehensive, multi-informant assessment of stress when investigating internalizing outcomes in youth and support using family-based interventions in the treatment and prevention of internalizing. PMID:25601821

  17. Self-conscious emotions? role in functional outcomes within clinical populations.

    PubMed

    Macaulay, Rebecca; Cohen, Alex

    2014-04-30

    Patients with severe mental illnesses (SMI) often experience dysfunction in their ability to efficiently carry out everyday roles and/or skills. These deficits are seen across many domains of daily functioning. We suggest that the "self-conscious emotions" of pride and shame play a role in these functional outcomes. Pride and shame appear to facilitate individuals? ability to evaluate their group status, detect social threats, and to adjust their behaviors accordingly. This study utilized an objective performance measure of functional capacity and a self-report of quality of life (QoL) to examine the respective roles of pride and shame in functional outcomes within two SMI patient groups (schizophrenia and affective disorder) and a community control group. The influence of neurocognition, affect and symptomatology on functional outcomes was also assessed. The patient groups did not differ in cognitive functioning, QoL, or shame. The schizophrenia group reported significantly higher pride and displayed worse objective performance than the other groups. Within each of the groups, shame had an inverse relationship with QoL, while pride positively associated with QoL. Shame associated with worse functional capacity in the schizophrenia group. Shame associated with better functional capacity, while pride associated with worse functional capacity within the affective disorder group. PMID:24508025

  18. 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

  19. The Association Between Apolipoprotein E and Functional Outcome After Traumatic Brain Injury

    PubMed Central

    Li, Lizhuo; Bao, Yijun; He, Songbai; Wang, Gang; Guan, Yanlei; Ma, Dexuan; Wu, Rile; Wang, Pengfei; Huang, Xiaolong; Tao, Shanwei; Liu, Qiwen; Wang, Yunjie; Yang, Jingyun

    2015-01-01

    Abstract Traumatic brain injury (TBI) is a leading cause of death and disability. Previous studies have investigated the association of apolipoprotein E (APOE) ?4 with functional outcome after TBI and reported inconsistent results. The purpose of this study was to perform a systematic literature search and conduct meta-analyses to examine whether APOE ?4 is associated with poorer functional outcome in patients with TBI. We performed a systematic literature search in PubMed, Cochrane Library, Embase, Google Scholar, and HuGE. The eligibility criteria of this study included the following: Patients had TBI; the studies reported APOE genotype data or provided odds ratios (ORs) and the corresponding 95% confidence intervals (CIs); the functional outcome was assessed using the Glasgow Outcome Scale (GOS) or the Glasgow Outcome Scale Extended (GOSE); and patients were followed for at least 3 months after TBI. In all meta-analyses, we used random-effects models to calculate the odds ratio as a measure of association. We examined the association of APOE ?4 with functional outcome at different time points after TBI. A total of 12 studies met the eligibility criteria and were included in the meta-analyses. We did not find a significant association between APOE ?4 and functional outcome at 6 (P?=?0.23), 12 (P?=?0.44), and 24 months (P?=?0.85) after TBI. However, APOE ?4 was associated with an increased risk of unfavorable long-term (?6 months) functional outcome after TBI (OR?=?1.36, 95% CI: 1.07–1.74, P?=?0.01). Limitations of this study include The sample size was limited; the initial severity of TBI varied within and across studies; we could not control for potential confounding factors, such as age at injury and sex; a meta-analysis of the genotype dosage effect was not feasible; and we could not examine the association with specific factors such as neurobehavioral or specific cognitive functions. Our meta-analysis indicates APOE ?4 is associated with the long-term functional outcome of patients with TBI. Future studies that control for confounding factors, with large sample sizes and more homogeneous initial TBI severity levels, are needed to validate the findings from this study. PMID:26579811

  20. Department of Communication Outcomes Assessment Plan 1 Unit Plan for Assessing and Improving

    E-print Network

    Liberzon, Daniel

    are spoken, but many of which are not. We also include the study of nonverbal communication, writtenDepartment of Communication Outcomes Assessment Plan 1 Unit Plan for Assessing and Improving Student Learning in Degree Programs Unit: Department of Communication Unit Head approval

  1. Spring Term 2010 Assessment Report Page 1 Spring Term 2010: Assessment of the Learning Outcomes

    E-print Network

    Marsh, David

    Spring Term 2010 Assessment Report Page 1 Spring Term 2010: Assessment of the Learning Outcomes The Washington and Lee University Quality Enhancement Plan: "Revitalizing the Spring Term" Initial Report after First Year of the Revitalized Spring Term 1 September 2010 Overview: The first running

  2. Predictors of functional outcomes and recurrence of chronic subdural hematomas.

    PubMed

    Leroy, Henri-Arthur; Aboukaïs, Rabih; Reyns, Nicolas; Bourgeois, Philippe; Labreuche, Julien; Duhamel, Alain; Lejeune, Jean-Paul

    2015-12-01

    We aimed to evaluate the functional outcome and risk factors of recurrence in patients operated on for a chronic subdural hematoma (CSH), and discuss systematic early postoperative CT scans. CSH is a very common disease in neurosurgical practice, especially in elderly patients who are treated with anticoagulation. The challenge is to rapidly restore the independence of these patients. We retrospectively analyzed data from 164 consecutive surgical procedures performed on 140 CSH patients, including recurrent surgery, at our institution from June 2011 to June 2012. Pre- and postoperative CT scans, and medical records, were systematically reviewed using the institutional computing database. A poor functional outcome was defined by a modified Rankin scale (mRS) score>2 at 3months. Among the 140 patients (mean age 76years; 64% men), a single burr hole craniostomy was performed in 122 patients, and a craniotomy in 18. A poor functional outcome was recorded in 39 patients (28%; 95% confidence interval [CI] 20-35%). In multivariate analyses, an increased risk of poor functional outcome was associated with age >75years (odds ratio [OR] 5.88; 95% CI 1.96-17.63), residual hematoma thickness >14mm (OR 3.79; 95% CI 1.47-9.77), and GCS<15 (OR, 2.96; 95% CI, 1.18-7.40). Recurrences occurred in 24 patients (17%; 95% CI 11-23%), with a median delay to reintervention of 13days. The independent predictors of CSH recurrence were preoperative anticoagulant therapy (OR 3.68; 95% CI 1.13-12.00), and persistence of mass effect on the postoperative CT scan (OR 5.61; 95% CI 1.52-20.66). Three months after surgical treatment, more than one quarter of the CSH patients had a mRS?3. The loss of independence was associated with older age, initial GCS<15, and residual hematoma thickness postoperatively. Anticoagulant therapy and persistence of postoperative mass effect heightened the risk of recurrence. PMID:26260114

  3. REDUCING AMBIGUITY IN THE FUNCTIONAL ASSESSMENT OF PROBLEM BEHAVIOR

    PubMed Central

    Rooker, Griffin W.; DeLeon, Iser G.; Borrero, Carrie S. W.; Frank-Crawford, Michelle A.; Roscoe, Eileen M.

    2015-01-01

    Severe problem behavior (e.g., self-injury and aggression) remains among the most serious challenges for the habilitation of persons with intellectual disabilities and is a significant obstacle to community integration. The current standard of behavior analytic treatment for problem behavior in this population consists of a functional assessment and treatment model. Within that model, the first step is to assess the behavior–environment relations that give rise to and maintain problem behavior, a functional behavioral assessment. Conventional methods of assessing behavioral function include indirect, descriptive, and experimental assessments of problem behavior. Clinical investigators have produced a rich literature demonstrating the relative effectiveness for each method, but in clinical practice, each can produce ambiguous or difficult-to-interpret outcomes that may impede treatment development. This paper outlines potential sources of variability in assessment outcomes and then reviews the evidence on strategies for avoiding ambiguous outcomes and/or clarifying initially ambiguous results. The end result for each assessment method is a set of best practice guidelines, given the available evidence, for conducting the initial assessment. PMID:26236145

  4. 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

  5. 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.

  6. Multiattribute utility assessment of outcomes of treatment for head and neck cancer.

    PubMed

    Hodder, S C; Edwards, M J; Brickley, M R; Shepherd, J P

    1997-01-01

    Good clinical practice is dependent on continuous audit. Most audits of head and neck cancer treatment planning have been subjective, with only 5-year survival rates being considered objectively. Improvements in clinical care require not only measurable goals that relate to patients' perspectives, but also a means of assessing to what extent those goals have been met. In this context, 5-year survival rates are too crude to be useful, although they remain important for other reasons. Because a simple clinical objective measure of outcome applicable to head and neck cancer is not available, multiattribute assessment techniques were used to develop a clinically based scale for outcomes following treatment for head and neck cancer, with domains centred on social function, pain, physical appearance, eating and speech problems, nausea, donor site problems and shoulder function. Domains were weighted relative to each other; pain (mean weight 85) and social function (89) were considered most important followed by physical appearance (76), eating (76) and speech problems (74) A series of graded statements was constructed within each domain and scaled relative to each other. These components were also combined into an overall scale that will enable objective outcome assessment in this important area of medical care. PMID:9062413

  7. Disability eligibility issues and university student assessment outcomes

    E-print Network

    Crank, Joe N.; Deshler, Donald D.

    2001-01-01

    and university student assessment outcomes 223 Table 1 Scores for Project Eligible (LD) and Non-Eligible Students (NLD) Measures LD (n = 31) NLD (n = 22) WJPEB Means Range SD Means Range SD Grade Read 8.62 4.3–12.19 2.62 12.87 12.4–12.9 0.10 Math 9.86 6.0–12.9 3.04... in the non- verbal domain. The PPVT was not administered to these students. 5. Conclusion From conceptualization to operationalization this project addressed critical concerns about the validity and legality of procedures for documenting and evaluat- ing LD...

  8. Assessing overall functioning with adolescent inpatients.

    PubMed

    Haggerty, Greg; Forlenza, Nicholas; Poland, Charlotte; Ray, Sagarika; Zodan, Jennifer; Mehra, Ashwin; Goyal, Ajay; Baity, Matthew R; Siefert, Caleb J; Sobin, Sean; Leite, David; Sinclair, Samuel J

    2014-11-01

    The current study sought to evaluate the validity and reliability of a brief measure of overall functioning for adolescents. Clinicians were asked to complete the Overall Functioning Scale (OFS) for 72 adolescents consecutively admitted to the adolescent psychiatric inpatient service of a community safety net medical center. The results revealed that this new measure is related to the patients' length of stay, clinician-rated measures of social cognition and object relations, Global Assessment of Functioning (GAF) score at admission, as well as global rating of engagement in individual psychotherapy. The results also showed that the OFS was related to the patients' history of nonsuicidal self-harm as well as treatment outcome as assessed by measures of psychological health and well-being as well as symptoms. Hierarchical regressions reveal that the OFS shows incremental validity greater than the admission GAF score in predicting length of stay. The results also showed that the OFS demonstrates interrater reliability in the excellent range (intraclass correlation coefficient(1,2)) of 0.88. Clinical implications of the use of this tool and areas of future research are discussed. PMID:25259948

  9. Assessing overall functioning with adolescent inpatients

    PubMed Central

    Haggerty, Greg; Forlenza, Nicholas; Poland, Charlotte; Ray, Sagarika; Zodan, Jennifer; Mehra, Ashwin; Goyal, Ajay; Baity, Matthew R.; Siefert, Caleb J.; Sobin, Sean; Leite, David; Sinclair, Samuel J.

    2014-01-01

    The current study looks to evaluate the validity and reliability of a brief measure of overall functioning for adolescents. Clinicians were asked to complete the Overall Functioning Scale for 72 adolescents consecutively admitted to the adolescent psychiatric inpatient service of a community safety net medical center. The results revealed that this new measure is related to the patients’ length of stay, clinician-rated measures of social cognition and object relations, Global Assessment of Functioning score at admission, and global rating of engagement in individual psychotherapy. Results also showed that the OFS was related to patients’ history of non-suicidal self-harm as well as treatment outcome as assessed by measures of psychological health and well-being and symtomatology. Hierarchical regressions reveal that the OFS shows incremental validity above the admission GAF score in predicting length of stay. The results also showed that the OFS demonstrates inter-rater reliability in the excellent range (ICC 1,2) of .88. Clinical implications of the use of this tool as well as areas of future research are discussed. PMID:25259948

  10. Intermediate outcomes of a tribal community public health infrastructure assessment.

    PubMed

    English, Kevin C; Wallerstein, Nina; Chino, Michelle; Finster, Carolyn E; Rafelito, Alvin; Adeky, Sarah; Kennedy, Marianna

    2004-01-01

    The purpose of this collaborative participatory project was to assess the strengths and needs of a tribal community as part of a larger public health capacity building program. Key project partners included: the Ramah Band of Navajo Indians, the Albuquerque Area Indian Health Board, the University of New Mexico Masters in Public Health Program, and the University of Nevada, Las Vegas, American Indian Research and Education Center. Principal intervention steps entailed: 1) relationship-building activities among tribal programs and between the Tribe and the scientific community; 2) an orientation to public health; 3) a comprehensive public health infrastructure assessment, utilizing a standardized CDC instrument; and 4) a prioritization of identified needs. The direct outcome was the development and beginning implementation of a community specific public health strategic action plan. Broader results included: 1) increased comprehension of public health within the Tribe; 2) the creation of a community public health task force; 3) the design of a tribally applicable assessment instrument; and 4) improved collaboration between the Tribe and the scientific community. This project demonstrated that public health assessment in tribal communities is feasible and valuable. Further, the development of a tribally applicable instrument highlights a significant tribal contribution to research and assessment. PMID:15682773

  11. Factors associated with long-term functional outcomes and psychological sequelae in women after breast cancer.

    PubMed

    Khan, Fary; Amatya, Bhasker; Pallant, Julie F; Rajapaksa, Ishani

    2012-06-01

    The objective of this study was to examine factors impacting long-term functional outcomes and psychological sequelae in survivors of breast cancer (BC). A clinical assessment and structured interview assessed the impact of BC on participants' (n=85) current activity and restriction in participation, using validated questionnaires: Functional Independence Measure (FIM), Perceived Impact Problem Profile (PIPP) and Depression Anxiety Stress Scale (DASS). Participants showed good functional recovery (median motor FIM score=78). Three-quarters (74%) reported pain, 32% reported upper limb weakness, 31% pain limiting shoulder movement and 29% lymphoedema. One third (32%) reported greatest impact on psychological wellbeing. A substantial number of participants reported high levels of depression (22%), anxiety and stress (19% each). Factors associated with poorer current level of functioning and wellbeing included: younger participants, recent diagnoses, aggressive tumour types, receiving chemotherapy, shoulder limitation due to pain, and lymphoedema. BC survivors require long-term management of psychological sequelae impacting activity and participation. PMID:22342676

  12. Learning Outcomes Assessment: Extrapolating from Study Abroad to International Service-Learning

    ERIC Educational Resources Information Center

    Rubin, Donald L.; Matthews, Paul H.

    2013-01-01

    For international service-learning to thrive, it must document student learning outcomes that accrue to participants. The approaches to international service-learning assessment must be compelling to a variety of stakeholders. Recent large-scale projects in study abroad learning outcomes assessment--including the Georgia Learning Outcomes of…

  13. Assessing Educational Outcomes in Middle Childhood: Validation of the Teacher Academic Attainment Scale

    ERIC Educational Resources Information Center

    Johnson, Samantha; Marlow, Neil; Wolke, Dieter

    2012-01-01

    Aim: Assessing educational outcomes in high-risk populations is crucial for defining long-term outcomes. As standardized tests are costly and time-consuming, we assessed the use of the Teacher Academic Attainment Scale (TAAS) as an outcome measure. Method: Three hundred and forty three children in mainstream schools aged 10 to 11 years (144 males,…

  14. Do Curriculum Outcomes and Assessment Activities in Science Encourage Higher Order Thinking?

    ERIC Educational Resources Information Center

    FitzPatrick, Beverly; Schulz, Henry

    2015-01-01

    The curriculum for two science units in each of Grades 6 and 7 was analyzed to determine the cognitive levels of the outcomes and their cognitive alignment with the assessments that corresponded with these outcomes. This was done for British Columbia, Alberta, Ontario, and Atlantic Canada. The outcomes and assessments included a variety of higher…

  15. Pediatric brain injury: Can DTI scalars predict functional outcome?

    PubMed Central

    Xu, Duan; Mukherjee, Pratik; Barkovich, A James

    2013-01-01

    Diffusion imaging has made significant inroads into the clinical diagnosis of a variety of diseases by inferring changes in microstructure, namely cell membranes, myelin sheath and other structures that inhibit water diffusion. This review discusses recent progress in the use of diffusion parameters in predicting functional outcome. Studies in the literature using only scalar parameters from diffusion measurements, such as apparent diffusion coefficient (ADC) and fractional anisotropy (FA), are summarized. Other more complex mathematical models and post-processing uses are also discussed briefly. PMID:23288477

  16. Linking Mission, Strategy and Student Outcomes Assessment: A Cost-Effective Model

    ERIC Educational Resources Information Center

    Holoviak, Stephen J.; Verney, Thomas P.; Weigle, Jerry A.; Holoviak, Justin S.

    2010-01-01

    The purpose of this paper was to provide a demonstration of the assessment methods and processes that are used by the John L. Grove College of Business to assess student outcomes and how these assessments relate to mission and strategy.

  17. False-Positive Tangible Outcomes of Functional Analyses

    ERIC Educational Resources Information Center

    Rooker, Griffin W.; Iwata, Brian A.; Harper, Jill M.; Fahmie, Tara A.; Camp, Erin M.

    2011-01-01

    Functional analysis (FA) methodology is the most precise method for identifying variables that maintain problem behavior. Occasionally, however, results of an FA may be influenced by idiosyncratic sensitivity to aspects of the assessment conditions. For example, data from several studies suggest that inclusion of a tangible condition during an FA…

  18. 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…

  19. Assessment of the psychosocial outcome after severe head injury.

    PubMed

    Bond, M R

    1975-01-01

    Rehabilitation services for the severely brain injured are often inadequate and one of the chief factors responsible is undue emphasis on the contribution of physical disability with scant attention to the serious emotional and intellectual handicaps incurred. Weakness, spasticity and dysphasis tend to recover eventually to a variable extent but mental handicap is often the cause of serious and lasting disablement. For a determination of the outcome of severe brain injury in terms of its effect on daily living, the relation between physical disability, mental handicap and social reintegration has been assessed quantitatively. Three assessment scales have been constructed and used in a study of 58 severely brain damaged patients. This revealed that the duration of post-traumatic amnesia correlates highly with the degree of social, mental and physical disability incurred. Daily living was affected primarily by impairment of intellect and personality and, to a lesser extent, by physical incapacity, but only rarely by the developments of symptoms of mental illness. Using the Wechsler Adult Intelligence Scale, the time course of cognitive recovery was also assessed. Recovery curves and the relation of cognitive impairment to social and physical handicap will be demonstrated. PMID:1045990

  20. 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

  1. Achieving Faculty Buy-In: Motivation Performance in Learning Outcome Assessment

    ERIC Educational Resources Information Center

    Sujitparapitaya, Sutee

    2014-01-01

    Despite the great value of student learning outcome assessment (SLOA), faculty have not fully embraced the assessment movement, and many remain locked in debates on its merits. To gain faculty buy-in and explain why many faculty were motivated to engage in outcome assessment, the modified CANE (Commitment And Necessary Effort) model was used to…

  2. Adult Diagnostic and Functional Outcomes of DSM-5 Disruptive Mood Dysregulation Disorder

    PubMed Central

    Copeland, William E.; Shanahan, Lilly; Egger, Helen; Angold, Adrian; Costello, E. Jane

    2014-01-01

    Objective Disruptive mood dysregulation disorder is a new disorder for DSM-5 that is uncommon and frequently co-occurs with other psychiatric disorders. Here, we test whether meeting diagnostic criteria for this disorder in childhood predicts adult diagnostic and functional outcomes. Methods In a prospective, population-based study, subjects were assessed with structured interviews up to 6 times in childhood and adolescence (ages 10 to 16; 5336 observations of 1420 subjects) for symptoms of disruptive mood dysregulation disorder and 3 times in young adulthood (ages 19, 21, and 24-26; 3215 observations of 1273 subjects) for psychiatric and functional outcomes (health, risky/illegal behavior, financial/educational and social functioning). Results Young adults with a history of childhood disruptive mood dysregulation disorders had elevated rates of anxiety and depression and were more likely to meet criteria for more than one adult disorder as compared to controls with no history of childhood psychiatric problems (noncases) or subjects meeting criteria for psychiatric disorders other than disruptive mood dysregulation disorder in childhood/adolescence (psychiatric controls). Participants with a history of disruptive mood dysregulation disorder also were more likely to have adverse health outcomes, be impoverished, have reported police contact, and have low educational attainment as adults compared to either psychiatric or noncase controls. Conclusions The long-term prognosis of children with disruptive mood dysregulation disorder cases is one of pervasive impaired functioning that in many cases is worse than that of other childhood psychiatric cases. PMID:24781389

  3. 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 Central

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

    2014-01-01

    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

  4. Development and Applications of an Outcomes Assessment Framework for Care Management Programs in Learning Health Systems

    PubMed Central

    Wang, Lin; Kuntz-Melcavage, Kara; Forrest, Christopher B.; Lu, Yanyan; Piet, Leslie; Evans, Kathy; Uriyo, Maria; Sherry, Melissa; Richardson, Regina; Hawkins, Michelle; Neale, Donna

    2015-01-01

    Purpose: To develop and apply an outcomes assessment framework (OAF) for care management programs in health care delivery settings. Background: Care management (CM) refers to a regimen of organized activities that are designed to promote health in a population with particular chronic conditions or risk profiles, with focus on the triple aim for populations: improving the quality of care, advancing health outcomes, and lowering health care costs. CM has become an integral part of a care continuum for population-based health care management. To sustain a CM program, it is essential to assure and improve CM effectiveness through rigorous outcomes assessment. To this end, we constructed the OAF as the foundation of a systematic approach to CM outcomes assessment. Innovations: To construct the OAF, we first systematically analyzed the operation process of a CM program; then, based on the operation analysis, we identified causal relationships between interventions and outcomes at various implementation stages of the program. This set of causal relationships established a roadmap for the rest of the outcomes assessment. Built upon knowledge from multiple disciplines, we (1) formalized a systematic approach to CM outcomes assessment, and (2) integrated proven analytics methodologies and industrial best practices into operation-oriented CM outcomes assessment. Conclusion: This systematic approach to OAF for assessing the outcomes of CM programs offers an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings. PMID:25992387

  5. Assessing patient reported outcome measures: A practical guide for gastroenterologists

    PubMed Central

    Hutchings, Hayley A; Williams, John G

    2014-01-01

    Gastrointestinal illnesses cause physical, emotional and social impact on patients. Patient reported outcome measures (PROMs) are increasingly used in clinical decision-making, clinical research and approval of new therapies. In the last decade, there has been a rapid increase in the number of PROMs in gastroenterology and, therefore, the choice between which of these PROMs to use can be difficult. Not all PROM instruments currently used in research and clinical practice in gastroenterology have gone through a rigorous development methodology. New drugs and therapies will not have access to the market if the PROMs used in their clinical trials are not validated according to the guidelines of the international agencies. Therefore, it is important to know the required properties of PROMs when choosing or evaluating a drug or a clinical intervention. This paper reviews the current literature on how to assess the validity and reliability of PROMs. It summarises the required properties into a practical guide for gastroenterologists to use in assessing an instrument for use in clinical practice or research. PMID:25452841

  6. Expansion of the Homeostasis Model Assessment of ?-Cell Function and Insulin Resistance to Enable Clinical Trial Outcome Modeling Through the Interactive Adjustment of Physiology and Treatment Effects: iHOMA2

    PubMed Central

    Hill, Nathan R.; Levy, Jonathan C.; Matthews, David R.

    2013-01-01

    OBJECTIVE To describe and make available an interactive, 24-variable homeostasis model assessment (iHOMA2) that extends the HOMA2 model, enabling the modeling of physiology and treatment effects, to present equations of the HOMA2 and iHOMA2 models, and to exemplify iHOMA2 in two widely differing scenarios: changes in insulin sensitivity with thiazolidinediones and changes in renal threshold with sodium glucose transporter 2 (SGLT2) inhibition. RESEARCH DESIGN AND METHODS iHOMA2 enables a user of the available software to examine and modify the mathematical functions describing the organs and tissues involved in the glucose and hormonal compartments. We exemplify this with SGLT2 inhibition modeling (by changing the renal threshold parameters) using published data of renal effect, showing that the modeled effect is concordant with the effects on fasting glucose from independent data. RESULTS iHOMA2 modeling of thiazolidinediones effect suggested that changes in insulin sensitivity in the fasting state are predominantly hepatic. SGLT2 inhibition modeled by iHOMA2 resulted in a decrease in mean glucose of 1.1 mmol/L. Observed data showed a decrease in glucose of 0.9 mmol/L. There was no significant difference between the model and the independent data. Manipulation of iHOMA2's renal excretion threshold variable suggested that a decrease of 17% was required to obtain a 0.9 mmol/L decrease in mean glucose. CONCLUSIONS iHOMA2 is an extended mathematical model for the assessment of insulin resistance and ?-cell function. The model can be used to evaluate therapeutic agents and predict effects on fasting glucose and insulin and on ?-cell function and insulin sensitivity. PMID:23564921

  7. Functional outcomes in patients with Borrelia burgdorferi reinfection.

    PubMed

    Jares, Tyler M; Mathiason, Michelle A; Kowalski, Todd J

    2014-02-01

    When Lyme disease is treated with appropriate antibiotic therapy in the early stages, long-term outcomes are good. However, a few patients have persistent symptoms despite appropriate therapy. Whether these patients' symptoms are any different from those of patients with reinfection is unclear. Our objective was to compare long-term symptoms and functional outcomes of patients with Borrelia burgdorferi reinfection with those of patients with only 1 episode of infection and with no history of infection. We compared outcomes of Lyme reinfection patients, characterized by recurrent erythema migrans (EM) lesions, with those of patients with 1 episode of Lyme disease (Lyme control) and with no history of Lyme disease (non-Lyme control) by retrospective medical record review and a survey consisting of a 36-item Short-Form Health Survey (SF-36) and a 10-item symptom questionnaire. Analysis of variance (ANOVA) for continuous variables and ?(2) analysis for categorical variables were used. In cases of low cell counts, Fisher's exact tests were used. Bonferroni correction was used for multiple comparisons when ANOVA was significant. Reinfection was identified in 23/673 (3.4%) patients who had a diagnosis of Lyme disease in our health system during 2000-2004. Of the 23, 15 had long-term follow-up data and were age- and sex-matched to 45 Lyme control and 60 non-Lyme control group patients. Clinical characteristics were similar in the reinfection and Lyme control groups. SF-36 results were similar between groups for all domains except energy/vitality (VT). The SF-36 domain of VT was significantly different between groups: 63.0 vs. 54.5 vs. 64.5 in the reinfection, Lyme control, and non-Lyme control groups, respectively (p=0.047). Clinical features and long-term outcomes of patients with recurrent EM lesions were similar to those of the control groups and consistent with B. burgdorferi reinfection, not persistent infection. Patients with Lyme reinfection should be treated with antibiotic regimens similar to those used for patients with an initial episode of Lyme disease. PMID:24215678

  8. The Extent to Which Collaborative Teams of Educators Link the Results of Functional Assessment to Function-Based Interventions

    ERIC Educational Resources Information Center

    de Courcy-Bower, Laurie

    2010-01-01

    A promising approach to addressing challenging behavior in schools is to develop and implement "function-based interventions" (Dunlap et al., 2006; Hanley, Iwata, & McCord, 2003). Function-based interventions are individualized interventions in which five key outcomes of functional assessment (i.e., identification of challenging behavior,…

  9. Community College Strategies: Linking Course, Program, and Institutional Learning Outcomes--An Embedded Assessment Model

    ERIC Educational Resources Information Center

    Popovich, Paulette M.; Vierheller, Tim R.

    2005-01-01

    Faculty at The University of Akron Wayne College, the two-year regional branch campus of the University of Akron, developed and implemented a plan to assess student learning in 1997. The plan was based on an embedded outcomes model, linking course-level student learning outcomes to program outcomes for each of six technical associate degree…

  10. 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

  11. Posterior shoulder instability in the athletic population: Variations in assessment, clinical outcomes, and return to sport

    PubMed Central

    DeLong, Jeffrey M; Bradley, James P

    2015-01-01

    Posterior instability of the shoulder is becoming an increasingly recognized shoulder injury in the athletic population. Diagnostic elements, such as etiology, directionality, and degree of instability are essential factors to assess in the unstable athletic shoulder. Concomitant injuries and associated pathologic lesions continue to be a significant challenge in the surgical management of posterior shoulder instability. Return to sport and previous level of play is ultimately the goal for every committed athlete and surgeon, thus subpopulations of athletes should be recognized as distinct entities requiring unique diagnostic, functional outcome measures, and surgical approaches. PMID:26716088

  12. Handgrip Strength is an Independent Predictor of Functional Outcome in Hip-Fracture Women

    PubMed Central

    Di Monaco, Marco; Castiglioni, Carlotta; De Toma, Elena; Gardin, Luisa; Giordano, Silvia; Tappero, Rosa

    2015-01-01

    Abstract 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

  13. The social functional outcome of being naturalistically treated with paliperidone extended-release in patients with schizophrenia

    PubMed Central

    Nakagawa, Ryoko; Ohnishi, Takashi; Kobayashi, Hisanori; Wakamatsu, Akihide; Tanimura, Ai; Morita, Kazuo; Yamaoka, Toshio; Usui, Hideo; Ogawa, Yoshimasa; Fujino, Akiko; Yoshizawa, Kazutake

    2015-01-01

    Background Social functioning is an important outcome for patients with schizophrenia. To evaluate the effects of paliperidone extended-release (PAL-ER) on social function, symptomatology, and safety in the routine clinical practice, we conducted a 1-year post-marketing surveillance study of PAL-ER. We also explored relationships between symptomatic improvement and socially functional outcome in patients with schizophrenia. Patients and methods Patients with an established diagnosis of schizophrenia were allowed flexible 3–12 mg/day dosing during the surveillance. Patients were assessed on social functioning using the Social and Occupational Functioning Assessment Scale (SOFAS) and on symptomatology using the Clinical Global Impression–Schizophrenia scale. All adverse events (AEs) were also collected. Results A total of 1,429 patients were enrolled in the surveillance study, of whom 1,405 were evaluable for safety and 1,142 were evaluable for efficacy. The treatment discontinuation rate for any reason during the observation period was 34.66%. Significant improvements were observed on both Social and Occupational Functioning Assessment Scale and Clinical Global Impression–Schizophrenia scale during the observation period. The percentage of patients with socially functional remission (SOFAS ?61) also increased significantly. A significant association between early improvements in positive symptoms, sex, severity of negative symptoms at baseline, and socially functional remission was observed. A total of 33.52% of patients had AEs and 8.75% of patients had serious AEs. Despite the recommendation of monotherapy with PAL-ER, 65.84% of patients were given additional antipsychotics (polypharmacy). Post hoc comparisons of monotherapy versus polypharmacy revealed that the monotherapy group had better outcomes and fewer AEs than the polypharmacy treated group. The improvement in social functioning and the rate of socially functional remission did not differ between groups. Conclusion PAL-ER treatment showed effective symptom control and improvement in social functioning. The data suggest that early response to antipsychotic treatment should be important for functional outcomes. PMID:26150722

  14. Effect of the Interaction between Recanalization and Collateral Circulation on Functional Outcome in Acute Ischaemic Stroke.

    PubMed

    Mangiafico, Salvatore; Saia, Valentina; Nencini, Patrizia; Romani, Ilaria; Palumbo, Vanessa; Pracucci, Giovanni; Consoli, Arturo; Rosi, Andrea; Renieri, Leonardo; Nappini, Sergio; Limbucci, Nicola; Inzitari, Domenico; Gensini, Gian Franco

    2014-12-01

    Identification of patients with acute ischaemic stroke who could most benefit from arterial recanalization after endovascular treatment remains an unsettled issue. Although several classifications of collateral circulation have been proposed, the clinical role of collaterals is still debated. We evaluated the effect of the collateral circulation in relation to recanalization as a predictor of clinical outcome. Data were prospectively collected from 103 patients consecutively treated for proximal middle cerebral or internal carotid artery occlusion. The collateral circulation was evaluated with a novel semiquantitative-qualitative score, the Careggi collateral score (CCS), in six grades. Both CCS and recanalization grades (TICI) were analysed in relation to clinical outcome. A statistical analysis was performed to evaluate the effect of interaction between recanalization and collateral circulation on clinical outcome. Out of the 103 patients, 37 (36.3%) had poor collaterals, and 65 (63.7%) had good collaterals. Patients with good collaterals had lower basal National Institute of Health Stroke Scale (NIHSS), more distal occlusion, smaller lesions at 24h CT scan and better functional outcome. After multivariate analysis, the interaction between recanalization and collateral grades was significantly stronger as a predictor of good outcome (OR 6.87, 95% CI 2.11-22.31) or death (OR 4.66, 95%CI 1.48-14.73) compared to the effect of the single variables. Collaterals showed an effect of interaction with the recanalization grade in determining a favourable clinical outcome. Assessment of the collateral circulation might help predict clinical results after recanalization in patients undergoing endovascular treatment for acute ischaemic stroke. PMID:25496680

  15. Component alignment and functional outcome following computer assisted and jig based total knee arthroplasty

    PubMed Central

    Lad, Dnyanesh G; Thilak, Jai; Thadi, Mohan

    2013-01-01

    Background: Incorrect positioning of the implant and improper alignment of the limb following total knee arthroplasty (TKA) can lead to rapid implant wear, loosening, and suboptimal function. Studies suggest that alignment errors of > 3° are associated with rapid failure and less satisfactory function. Computer navigated systems have been developed to enhance precision in instrumentation during surgery. The aim of the study was to compare component alignment following computer assisted surgery (CAS) and jig based TKA as well as functional outcome. Materials and Methods: This is a prospective study of 100 knees to compare computer-assisted TKA and jig-based surgery in relation to femoral and tibial component alignment and functional outcome. The postoperative x-rays (anteroposterior and lateral) of the knee and CT scanogram from hip to foot were obtained. The coronal alignment of the femoral and tibial components and rotational alignment of femoral component was calculated. Knee society score at 24 months was used to assess the function. Results: Results of our study show that mean placement of the tibial component in coronal plane (91.3037°) and sagittal planes (3.6058°) was significantly better with CAS. The difference was statistically insignificant in case of mean coronal alignment of the femoral components (90.34210° in navigation group and 90.5444° in jig group) and in case of the mean femoral condylar twist angle (external rotation 2.3406° in navigation group versus 2.3593° in jig group). Conclusions: A significantly improved placement of the component was found in the coronal and sagittal planes of the tibial component by CAS. The placement of the components in the other planes was comparable with the values recorded in the jig-based surgery group. Functional outcome was not significantly different. PMID:23533002

  16. 76 FR 45271 - Review and Qualification of Clinical Outcome Assessments; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-28

    ... From the Federal Register Online via the Government Printing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Review and Qualification of Clinical Outcome Assessments; Public... clinical outcome assessments (COAs) for use in clinical trials for new drugs. COAs include...

  17. Standardized Testing for Outcome Assessment: Analysis of the Educational Testing Systems MBA Tests

    ERIC Educational Resources Information Center

    Wright, Robert E.

    2010-01-01

    The use of standardized tests for outcome assessment has grown dramatically in recent years. Two driving factors have been the No Child Left Behind legislation, and the increase in outcome assessment measures by accrediting agencies such as AACSB, the international accrediting body for business schools. Despite the growth in usage, little effort…

  18. 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...

  19. Assessing Outcomes of a Realistic Major Preview in an Introductory Sport Management Course

    ERIC Educational Resources Information Center

    Pierce, David; Wanless, Elizabeth; Johnson, James

    2014-01-01

    This paper assessed the outcomes of a field experience assignment (FEA) in an introductory sport management course designed as a realistic major preview. Student learning outcomes assessed were commitment to the major, intent to pursue the major, expectation of a career in sports, and perceived preparation for a career in sports. A…

  20. 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

  1. Functional outcomes of adults with 22q11.2 deletion syndrome

    PubMed Central

    Butcher, Nancy J.; Chow, Eva W.C.; Costain, Gregory; Karas, Dominique; Ho, Andrew; Bassett, Anne S.

    2012-01-01

    Purpose The 22q11.2 deletion syndrome is a common multisystem genomic disorder with congenital and later-onset manifestations, including congenital heart disease, intellectual disability, and psychiatric illness, that may affect long-term functioning. There are limited data on adult functioning in 22q11.2 deletion syndrome. Methods We used the Vineland Adaptive Behavior Scales to assess functioning in 100 adults with 22q11.2 deletion syndrome (n = 46 male; mean age = 28.8 (standard deviation = 9.7) years) where intellect ranged from average to borderline (n = 57) to mild intellectual disability (n = 43). Results More than 75% of the subjects scored in the functional deficit range. Although personal, vocational, and financial demographics confirmed widespread functional impairment, daily living skills and employment were relative strengths. Intelligence quotient was a significant predictor (P < 0.001) of overall and domain-specific adaptive functioning skills. A diagnosis of schizophrenia was a significant predictor (P < 0.05) of overall adaptive functioning, daily living skills, and socialization scores. Notably, congenital heart disease, history of mood/anxiety disorders, sex, and age were not significant predictors of functioning. Conclusion Despite functional impairment in adulthood that is primarily mediated by cognitive and psychiatric phenotypes, relative strengths in activities of daily living and employment have important implications for services and long-term planning. These results may help to inform expectations about outcomes for patients with 22q11.2 deletion syndrome. PMID:22744446

  2. Validating the Measurement of Real-World Functional Outcomes: Phase I Results of the VALERO Study

    PubMed Central

    Harvey, Philip D.; Raykov, Tenko; Twamley, Elizabeth; Vella, Lea; Heaton, Robert K.; Patterson, Thomas L.

    2013-01-01

    Objective Cognitive deficits are associated with disability in people with schizophrenia so treatment of cognitive impairment has been proposed as an intervention to reduce disability. However, studies relying on patient self-report have found very minimal relationships between ratings of real-world functioning and cognitive performance, raising questions about the measurement of real-world functioning as a treatment outcome. The Validation of Everyday Real-world Outcomes (VALERO) study was conducted to evaluate functional rating scales and to identify the rating scale or scales most robustly related to performance-based measures of cognition and everyday living skills. Method 198 adults with schizophrenia were tested with the neurocognitive measures from the MATRICS Consensus cognitive Battery and performed the UCSD performance-based skills assessment-Brief and advanced finances subtest from the Everyday Functioning Battery. They and a friend, relative, clinician, or case manager also reported their everyday functioning on 6 ratings scales: Social Behavior Schedule, Social Adjustment Scale, Heinrichs Carpenter Quality of Life Scale, Specific Levels of Functioning, Independent Living skills Survey, and Life Skills Profile. Best judgment ratings were generated by an interviewer who administered the rating scales to patients and informants. Results Statistical analyses developed an ability latent trait that reflected scores on the three performance-based (i.e., ability) measures and canonical correlation analysis related interviewer ratings to the latent trait. The overall fit of the model with all six rating scales was good: ?2 = 78.100, df = 56, p = .027, and RMSEA = .078. Individual rating scales that did not improve the fit of the model were systematically deleted and a final model with two rating scales fit the data: ?2 = 32.059, df = 24, p = .126, RMSEA = .072. A regression analysis found that the Specific Levels of Functioning was a superior predictor of the three-performance based ability measures. Conclusions We found that systematic assessments of real world functioning are related to performance on neurocognitive and functional capacity measures. Of the six rating scales evaluated, the Specific Levels of Functioning (SLOF) was best in this study. Use of a single rating scale provides a very efficient assessment of real-world functioning that accounts for considerable variance in performance-based scores. PMID:21572166

  3. Simple assessment of outcome after acute brain injury using the Glasgow Outcome Scale.

    PubMed

    Hellawell, D J; Signorini, D F; Pentland, B

    2000-03-01

    To evaluate alternative methods of determining Glasgow Outcome Scale scores, a postal survey was made of 288 general practitioners and 128 relatives of patients who had sustained acute brain injuries 5-7 years previously. The Glasgow Outcome Scale score from the general practitioner and relative were compared with that calculated from questionnaire information by an experienced rater. There was poor agreement between general practitioner and rater (K = 0.17) and relative and rater (K = 0.35) scores. Both general practitioners and relatives indicated more favourable outcomes than the rater, with a higher level of agreement (K = 0.61) between them. When Glasgow Outcome Scale scores are used, the methods employed should be valid and reliable; failure to ensure this may be responsible for a considerable proportion of variability in reported studies of brain injury outcome. PMID:10782938

  4. Functional diffusion map as an imaging predictor of functional outcome in patients with primary intracerebral haemorrhage

    PubMed Central

    Tsai, Y-H; Hsu, L-M; Weng, H-H; Lee, M-H; Yang, J-T; Lin, C-P

    2013-01-01

    Objective Predicting outcome in patients with primary intracerebral haemorrhage (ICH) in the acute stage can provide information to determine the best therapeutic and rehabilitation strategies. We prospectively investigated the predictive value of the functional diffusion map (fDM) in the acute stage of ICH. Methods 47 patients with ICH were enrolled for clinical evaluation and MRI within 24 h of symptom onset and 5 days after ICH. Functional diffusion mapping prospectively monitored the apparent diffusion coefficient (ADC) maps of perihaematomal oedema. Consequently, the change in perihaematomal oedema was classified into three categories: increased, decreased, or no significant change. Clinical outcomes were evaluated 6 months after ICH according to the modified Rankin Scale. Correlation between clinical outcome and the fDMs was performed. Results Among the clinical variables, thalamic haematoma, serum glucose level and National Institutes of Health Stroke Scale scores were significantly different between the good- and poor-outcome groups. The percentage of oedematous tissue undergoing significant change between baseline and Day 5 was also significantly different between the groups. Conclusion fDMs allow for spatial voxel-by-voxel tracking of changes in ADC values. It may be feasible to use fDMs to predict the functional outcome of patients with ICH during the acute stage. Advances in knowledge The use of fDMs for stroke study is demonstrated. fDMs may be more suitable to reflect the pathophysiological heterogeneity within oedemas and may facilitate another thinking process for imaging study of stroke and other neurological diseases. PMID:23255534

  5. Assessing the Symptoms of Cancer Using Patient-Reported Outcomes (ASCPRO): searching for standards.

    PubMed

    Cleeland, Charles S; Sloan, Jeff A

    2010-06-01

    The U.S. Food and Drug Administration (FDA) 2006 draft guidance on "Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims" has engendered wide discussion about patient-reported outcome (PRO) domains that should be endpoints in clinical trials. Reducing the severity and impact of symptoms is a natural intervention endpoint for cancer, a condition associated with considerable symptom burden. Because symptoms are best described by patients who have them, including PROs as measures of treatment effectiveness or the differences among treatments provides essential information about the efficacy and toxicity of a treatment and its effects on function. The FDA guidance provides a framework for addressing such issues as clinical significance, study design, and statistical methods as they relate to applications for labeling claims; however, no set of recommended approaches for assessing specific symptoms by patient report in clinical trials exists, other than for pain. Accordingly, an interdisciplinary workgroup, Assessing the Symptoms of Cancer using Patient-Reported Outcomes (ASCPRO), has been formed to generate evidence-based recommendations for the assessment of patient-reported cancer-related symptoms and the use of that information to facilitate clinical research and decision making. ASCPRO is among the first working groups to focus primarily on nonpain symptoms, including fatigue, sleep disturbance, appetite loss, depression, cognitive impairment, and shortness of breath. ASCPRO members are stakeholders in optimal symptom assessment, including patient advocates, academics, clinicians, those who pay for symptom control and monitor quality of care, and those who produce products that palliate cancer-related symptoms but that may also engender treatment-related symptoms. PMID:20538189

  6. 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,…

  7. What Do They Measure? Comparing Three Learning Outcomes Assessments

    ERIC Educational Resources Information Center

    Steedle, Jeffrey; Kugelmass, Heather; Nemeth, Alex

    2010-01-01

    Many postsecondary institutions currently administer standardized tests of general college outcomes; more than a quarter of Association of American Colleges and Universities (AAC&U) member institutions do so. Using standardized tests for accountability purposes has been contentious mainly because these tests do not measure every important outcome

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

    E-print Network

    Barrash, Warren

    parallel, testable hypotheses that explain their observa- tions, 3) design a simple experiment to test each to Foundations Program) Learning outcome supported by:­ hands-on laboratory activities­ lecture, think skill ques- tions reported to Foundations Program) Learning outcome supported by:­ hands-on laboratory

  9. DTI measures track and predict motor function outcomes in stroke rehabilitation utilizing BCI technology

    PubMed Central

    Song, Jie; Nair, Veena A.; Young, Brittany M.; Walton, Leo M.; Nigogosyan, Zack; Remsik, Alexander; Tyler, Mitchell E.; Farrar-Edwards, Dorothy; Caldera, Kristin E.; Sattin, Justin A.; Williams, Justin C.; Prabhakaran, Vivek

    2015-01-01

    Tracking and predicting motor outcomes is important in determining effective stroke rehabilitation strategies. Diffusion tensor imaging (DTI) allows for evaluation of the underlying structural integrity of brain white matter tracts and may serve as a potential biomarker for tracking and predicting motor recovery. In this study, we examined the longitudinal relationship between DTI measures of the posterior limb of the internal capsule (PLIC) and upper-limb motor outcomes in 13 stroke patients (median 20-month post-stroke) who completed up to 15 sessions of intervention using brain–computer interface (BCI) technology. Patients’ upper-limb motor outcomes and PLIC DTI measures including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were assessed longitudinally at four time points: pre-, mid-, immediately post- and 1-month-post intervention. DTI measures and ratios of each DTI measure comparing the ipsilesional and contralesional PLIC were correlated with patients’ motor outcomes to examine the relationship between structural integrity of the PLIC and patients’ motor recovery. We found that lower diffusivity and higher FA values of the ipsilesional PLIC were significantly correlated with better upper-limb motor function. Baseline DTI ratios were significantly correlated with motor outcomes measured immediately post and 1-month-post BCI interventions. A few patients achieved improvements in motor recovery meeting the minimum clinically important difference (MCID). These findings suggest that upper-limb motor recovery in stroke patients receiving BCI interventions relates to the microstructural status of the PLIC. Lower diffusivity and higher FA measures of the ipsilesional PLIC contribute toward better motor recovery in the stroke-affected upper-limb. DTI-derived measures may be a clinically useful biomarker in tracking and predicting motor recovery in stroke patients receiving BCI interventions. PMID:25964753

  10. DTI measures track and predict motor function outcomes in stroke rehabilitation utilizing BCI technology.

    PubMed

    Song, Jie; Nair, Veena A; Young, Brittany M; Walton, Leo M; Nigogosyan, Zack; Remsik, Alexander; Tyler, Mitchell E; Farrar-Edwards, Dorothy; Caldera, Kristin E; Sattin, Justin A; Williams, Justin C; Prabhakaran, Vivek

    2015-01-01

    Tracking and predicting motor outcomes is important in determining effective stroke rehabilitation strategies. Diffusion tensor imaging (DTI) allows for evaluation of the underlying structural integrity of brain white matter tracts and may serve as a potential biomarker for tracking and predicting motor recovery. In this study, we examined the longitudinal relationship between DTI measures of the posterior limb of the internal capsule (PLIC) and upper-limb motor outcomes in 13 stroke patients (median 20-month post-stroke) who completed up to 15 sessions of intervention using brain-computer interface (BCI) technology. Patients' upper-limb motor outcomes and PLIC DTI measures including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were assessed longitudinally at four time points: pre-, mid-, immediately post- and 1-month-post intervention. DTI measures and ratios of each DTI measure comparing the ipsilesional and contralesional PLIC were correlated with patients' motor outcomes to examine the relationship between structural integrity of the PLIC and patients' motor recovery. We found that lower diffusivity and higher FA values of the ipsilesional PLIC were significantly correlated with better upper-limb motor function. Baseline DTI ratios were significantly correlated with motor outcomes measured immediately post and 1-month-post BCI interventions. A few patients achieved improvements in motor recovery meeting the minimum clinically important difference (MCID). These findings suggest that upper-limb motor recovery in stroke patients receiving BCI interventions relates to the microstructural status of the PLIC. Lower diffusivity and higher FA measures of the ipsilesional PLIC contribute toward better motor recovery in the stroke-affected upper-limb. DTI-derived measures may be a clinically useful biomarker in tracking and predicting motor recovery in stroke patients receiving BCI interventions. PMID:25964753

  11. Voice and Functional Outcomes of Transoral Laser Microsurgery for Early Glottic Cancer: Ventricular Fold Resection as a Surrogate

    PubMed Central

    Berania, Ilyes; Dagenais, Christophe; Moubayed, Sami P.; Ayad, Tareck; Olivier, Marie-Jo; Guertin, Louis; Bissada, Eric; Tabet, Jean-Claude; Christopoulos, Apostolos

    2015-01-01

    Background The aim of the study was to evaluate the oncological and functional outcomes with transoral laser microsurgery (TOLM) of patients with early glottic cancer. Methods We have prospectively evaluated patients treated with TOLM for Tis, T1 or T2 glottic squamous cell carcinoma. Evaluation of oncological outcomes, and voice and functional outcomes was assessed using voice-handicap index 10 (VHI-10) and performance status scale for head & neck cancer patients (PSS-H&N). Predictors of poor voice quality were evaluated using Student’s t-test. Results Thirty patients were included, with 17.7 months mean follow-up. There were no cases of locoregional recurrence. Twelve patients (40%) were considered as having a problematic voice outcome. Four subjects out of 30 (13.3%) had significant problems with understandability of speech. Significant differences (P < 0.05) in VHI-10 score were found with tumor stage and partial resection of the ventricular fold. Conclusions We report excellent oncological and functional outcomes in early glottic cancer treated with TOLM, with advanced tumors and partial resection of the ventricular fold as a surrogate predicting worse voice outcomes. PMID:26124910

  12. An outcomes evaluation of an emergency department early pregnancy assessment service and early pregnancy assessment protocol

    PubMed Central

    Wendt, Kim; Crilly, Julia; May, Chris; Bates, Kym; Saxena, Rakhee

    2014-01-01

    Background Complications in early pregnancy, such as threatened or actual miscarriage is a common occurrence resulting in many women presenting to the emergency department (ED). Early pregnancy service delivery models described in the literature vary in terms of approach, setting and outcomes. Our objective was to determine outcomes of women who presented to an Australian regional ED with diagnoses consistent with early pregnancy complications following the implementation of an early pregnancy assessment service (EPAS) and early pregnancy assessment protocol (EPAP) in July 2011. Methods A descriptive, comparative (6?months before and after) study was undertaken. Data were extracted from the hospital ED information system and medical healthcare records. Outcome measures included: time to see a clinician, ED length of stay, admission rate, re-presentation rate, hospital admission and types of pathology tests ordered. Results Over the 12?-month period, 584 ED presentations were made to the ED with complications of early pregnancy (268 PRE and 316 POST EPAS–EPAP). Outcomes that improved statistically and clinically following implementation included: time to see a clinician (decreased by 6?min from 35 to 29?min), admission rate (decreased 6% from 14.5% to 8.5%), increase in ?-human chorionic gonadotrophin ordering by 10% (up to 80% POST), increase in ultrasound (USS) performed by 10% (up to 73% POST) and increase in pain score documentation by 23% (up to 36% POST). Conclusions The results indicate that patient and service delivery improvements can be achieved following the implementation of targeted service delivery models such as EPAS and EPAP in the ED. PMID:24136123

  13. Functional Outcome of Hemorrhagic Transformation after Thrombolysis for Ischemic Stroke: A Prospective Study

    PubMed Central

    Annan, Mariam; Gaudron, Marie; Cottier, Jean-Philippe; Cazals, Xavier; Dejobert, Maelle; Corcia, Philippe; Bertrand, Philippe; Mondon, Karl; de Toffol, Bertrand; Debiais, Séverine

    2015-01-01

    Background/Aims Hemorrhagic transformation (HT) is usually taken into account when symptomatic, but the role of asymptomatic HT is not well known. The aim of our study was to evaluate the link between HT after thrombolysis for ischemic stroke and functional outcome at 3 months, with particular emphasis on asymptomatic HT. Methods Our study was performed prospectively between June 2012 and June 2013 in the Stroke Unit of the University Hospital Center of Tours (France). All patients treated with intravenous thrombolysis were consecutively included. HT was classified on susceptibility-weighted imaging (SWI) with 3-tesla MRI at 7 ± 3 days after treatment. We evaluated functional outcome at 3 months using the modified Rankin Scale (mRS). Dependency was defined as an mRS score of ?3. Results After 1 year, 128 patients had received thrombolytic therapy for ischemic stroke, of whom 90 patients underwent both 3-tesla MRI and SWI at day 7. Fifty-two had HT, including 8 symptomatic cases. At 3 months, 68% of those patients were dependent compared to 31% of patients without HT [OR 4.6 (1.9-11.4), p = 0.001]. In asymptomatic HT, the rate was 62% [OR 3.5 (1.4-8.9), p = 0.007], but did not reach significance after adjustment for stroke severity. Discussion Our study found no statistically significant effect of HT on outcome after adjustment for initial stroke severity. However, the innocuousness of HT is not certain, and only few studies have already highlighted the increased risk of dependency. Using 3-tesla MRI with SWI allows us to increase the detection rate of small hemorrhage. Conclusion HT after thrombolysis is very frequent on SWI, but the initial stroke severity is an important predictor to assess the role of HT for patient outcome. PMID:26648965

  14. 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…

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

    PubMed

    Behere, Rishikesh V

    2013-04-01

    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

  16. Outcome measures for hand function naturally reveal three latent domains in older adults: strength, coordinated upper extremity function, and sensorimotor processing

    PubMed Central

    Lawrence, Emily L.; Dayanidhi, Sudarshan; Fassola, Isabella; Requejo, Philip; Leclercq, Caroline; Winstein, Carolee J.; Valero-Cuevas, Francisco J.

    2015-01-01

    Understanding the mapping between individual outcome measures and the latent functional domains of interest is critical to a quantitative evaluation and rehabilitation of hand function. We examined whether and how the associations among six hand-specific outcome measures reveal latent functional domains in elderly individuals. We asked 66 healthy older adult participants (38F, 28M, 66.1 ± 11.6 years, range: 45–88 years) and 33 older adults (65.8 ± 9.7 years, 44–81 years, 51 hands) diagnosed with osteoarthritis (OA) of the carpometacarpal (CMC) joint, to complete six functional assessments: hand strength (Grip, Key and Precision Pinch), Box and Block, Nine Hole Pegboard, and Strength-Dexterity tests. The first three principal components suffice to explain 86% of variance among the six outcome measures in healthy older adults, and 84% of variance in older adults with CMC OA. The composition of these dominant associations revealed three distinct latent functional domains: strength, coordinated upper extremity function, and sensorimotor processing. Furthermore, in participants with thumb CMC OA we found a blurring of the associations between the latent functional domains of strength and coordinated upper extremity function. This motivates future work to understand how the physiological effects of thumb CMC OA lead upper extremity coordination to become strongly associated with strength, while dynamic sensorimotor ability remains an independent functional domain. Thus, when assessing the level of hand function in our growing older adult populations, it is particularly important to acknowledge its multidimensional nature—and explicitly consider how each outcome measure maps to these three latent and fundamental domains of function. Moreover, this ability to distinguish among latent functional domains may facilitate the design of treatment modalities to target the rehabilitation of each of them. PMID:26097455

  17. 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

  18. Significance of adverse outcome pathways in biomarker-based environmental risk assessment in aquatic organisms.

    PubMed

    Lee, Jin Wuk; Won, Eun-Ji; Raisuddin, Sheikh; Lee, Jae-Seong

    2015-09-01

    In environmental risk assessments (ERA), biomarkers have been widely used as an early warning signal of environmental contamination. However, biomarker responses have limitation due to its low relevance to adverse outcomes (e.g., fluctuations in community structure, decreases in population size, and other similar ecobiologically relevant indicators of community structure and function). To mitigate these limitations, the concept of adverse outcome pathways (AOPs) was developed. An AOP is an analytical, sequentially progressive pathway that links a molecular initiating event (MIE) to an adverse outcome. Recently, AOPs have been recognized as a potential informational tool by which the implications of molecular biomarkers in ERA can be better understood. To demonstrate the utility of AOPs in biomarker-based ERA, here we discuss a series of three different biological repercussions caused by exposure to benzo(a)pyrene (BaP), silver nanoparticles (AgNPs), and selenium (Se). Using mainly aquatic invertebrates and selected vertebrates as model species, we focus on the development of the AOP concept. Aquatic organisms are suitable bioindicator species whose entire lifespans can be observed over a short period; moreover, these species can be studied on the molecular and population levels. Also, interspecific differences between aquatic organisms are important to consider in an AOP framework, since these differences are an integral part of the natural environment. The development of an environmental pollutant-mediated AOP may enable a better understanding of the effects of environmental pollutants in different scenarios in the diverse community of an ecosystem. PMID:26354700

  19. 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)

  20. Anticipating the future: assessment of occupational function.

    PubMed

    Trombly, C

    1993-03-01

    I believe that the occupational therapy assessment procedure should reflect our conceptualization of occupational functioning and that there should be a congruence among goals, assessments, and treatment. I believe that there should be a universal occupational therapy intake assessment procedure that follows a top-down approach to clarify for the client that the role of occupational therapy is to promote his or her occupational functioning. All the layers of function that we treat should be assessed, with the particulars of context incorporated into assessments at the activity and higher levels. Further and most important, occupational functioning should be fully conceptualized and the relevant constructs and their relationships verified and made clear to all. PMID:8456926

  1. Comparison of measures to assess outcomes in total hip replacement surgery.

    PubMed Central

    Dawson, J; Fitzpatrick, R; Murray, D; Carr, A

    1996-01-01

    OBJECTIVES--To compare the performance of a disease specific and a general health questionnaire in assessing changes resulting from total hip replacement. DESIGN--Two stage prospective study of patients undergoing total hip replacement surgery involving an assessment at a clinic before and six months after surgery. 60(32%) patients were followed up by post. SETTING--Outpatient departments at a specialist orthopaedic hospital and peripheral clinics within Oxfordshire. PATIENTS--188 patients admitted for unilateral total hip replacement between February and mid-August 1994. MAIN MEASURES--Patients' self assessed scores with the 12 item Oxford hip score and SF-36 general health questionnaire together with surgeons' assessment with Charnley hip score obtained before and again at six months after surgery. RESULTS--186 patients were followed up six months after total hip replacement; a subsample (n=60) by post. Of the 60 postal patients, 59(98.3%) fully completed the Oxford hip score compared with 44(73.3%) who fully completed the SF-36. For the followup sample as a whole, post operative changes in scores produced a large effect size of 2.75 on the Oxford hip score, compared with -1.89 physical function (SF-36), -2.13 pain (SF-36). With the exception of physical function and role (physical), postoperative SF-36 scores were shown to be similar to or better than those found by two population surveys on patients of comparable age. The responsiveness of a disease specific questionnaire, the Oxford hip score, and relevant sections of a general questionnaire, SF-36, were found to be similar as assessed by three different criteria. CONCLUSIONS--A disease specific questionnaire, the Oxford hip score, and a general state of health questionnaire, SF-36, performed similarly in assessing outcomes of total hip replacement except that the disease specific questionnaire resulted in a higher completion rate and greater responsiveness in some sections. On the other hand the general health questionnaire drew attention to broader problems of physical function not considered by the Oxford hip score. The health questionnaires examined here offer a valid and practical means of monitoring outcomes of hip replacement surgery. PMID:10158596

  2. 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

  3. [Distant functional outcomes of treatment and physiotherapy of tibial eminence fractures in adults].

    PubMed

    Nowak, Sebastian; Golec, Edward; Golec, Joanna; Szczygie?, Elzbieta; Ciszek, Elzbieta; Walocha, Jerzy; Mizia, Ewa

    2009-01-01

    Authors of paper present distant functional outcomes of treatment and physiotherapy of tibial eminence fractures basing on clinical material covering years from 1998 to 2006, that make up 15 patients, 7 women (46.7%) and 8 men (53.3%), aged between 18 and 57 years, on average 37.5-years-old. Subject fractures ware classified basing on Meyers i McKeever criteria, however obtained outcomes basing on IKDC (International Knee Documentation Committee) system. Obtained outcomes persuade authors to standpoint, that inoperative treatment of fractures type I leads to good functional outcomes, operative treatment of fracture type II leads to good functional outcomes too and operative treatment of fracture type III and III+ leads to sufficient outcomes. PMID:20201332

  4. 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.…

  5. A Web-Based Course Assessment Tool with Direct Mapping to Student Outcomes

    ERIC Educational Resources Information Center

    Ibrahim, Walid; Atif, Yacine; Shuaib, Khaled; Sampson, Demetrios

    2015-01-01

    The assessment of curriculum outcomes is an essential element for continuous academic improvement. However, the collection, aggregation and analysis of assessment data are notoriously complex and time-consuming processes. At the same time, only few developments of supporting electronic processes and tools for continuous academic program assessment

  6. 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…

  7. ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Compose a focused, answerable, and policy-

    E-print Network

    Barrash, Warren

    and peer assessments administered at various points throughout the research project. In-class discussion to assist with specification of timetable ; Online peer assessments administered periodically, anonymousECON422 ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Compose a focused, answerable

  8. Accountability, Program Quality, Outcome Assessment, and Graduate Education for Public Affairs and Administration.

    ERIC Educational Resources Information Center

    Jennings, Edward T., Jr.

    1989-01-01

    Examines the development of the movement toward accountability in public higher education and its implication for Master of Public Administration (MPA) programs. Analyzes prior and existing efforts to ensure and assess quality in MPA programs and the different forms that outcome assessment might take and describes assessment techniques.…

  9. 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

  10. Budgeting Attitudes in Smaller Universities: A Function of the Environment, Environmental Outcomes, and Personal Outcomes.

    ERIC Educational Resources Information Center

    Schell, Bernadette; Tarnopolsky, Debra

    1990-01-01

    A survey of academic and administrative staff involved in budgeting in four small-to-medium Ontario universities gathered information on budgeting attitudes as they relate to content, context, process, environmental outcomes, and personal factors. Differences between administrators and faculty were also investigated. (MSE)

  11. Predicting Election Outcomes from Positive and Negative Trait Assessments of Candidate Imagespops_745 41..58

    E-print Network

    Todorov, Alex

    Predicting Election Outcomes from Positive and Negative Trait Assessments of Candidate Imagespops election outcomes, we found that the candidates chosen as more likely to physically threaten the subjects, Mandisodza, Goren, and Hall (2005) by showing a positive correlation between the competence judgments

  12. The Other Half: Non-Tenure Track Faculty Thoughts on Student Learning Outcomes Assessment

    ERIC Educational Resources Information Center

    Danley-Scott, Jennifer; Scott, Gray

    2014-01-01

    Articles on student learning outcomes assessment often treat faculty as one homogenous body. Yet the exponential growth of contingent faculty in universities and colleges has created two distinct faculty groups with varied concerns and thoughts on everything from the future of higher education to shared governance to student learning outcomes.…

  13. 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…

  14. Assessing the Utility of a Demand Assessment for Functional Analysis

    ERIC Educational Resources Information Center

    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…

  15. The measurement of outcomes in the assessment of educational program effectiveness.

    PubMed

    Kassebaum, D G

    1990-05-01

    Postsecondary accrediting agencies recognized by the U.S. Secretary of Education and the Council on Postsecondary Accreditation, including the Liaison Committee on Medical Education (LCME), are required to evaluate educational program effectiveness by determining that institutions and programs document the achievement of their students and graduates in verifiable and consistent ways, indicating that institutional and program purposes are met. For the assessment of medical education programs this represents a departure from the traditional method of inferring quality from institutional compliance with standards for program organization and function. In the new assessment calculus, success is measured as the integrated product of the outcomes, the indicators of achievement that medical schools already are collecting from many sources, for instance, data on premedical achievement and attributes, medical school performance, graduate education ratings and test results, specialty certification, licensure, and practice. Although a recent LCME enquiry showed that 80% of U.S. medical schools were collecting outcome data on students and graduates, there was a lack of coherence and system, little integrated analysis, rare longitudinal study, and limited use of the information to evaluate and revise the curriculum or to validate admissions, promotion, and graduation criteria. The longitudinal study of the quantified results of educational programs need not resurrect old controversies about the linkage between learning in medical school and the quality of doctors' later practice. The purpose of examining outcomes is to gain sharper focus on the achievement of distinctive institutional goals, to facilitate program improvement and renewal, and to better assure the competence of graduates within the boundaries of achievement that schools have drawn as their educational objectives. PMID:2337430

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

    E-print Network

    Chen, Tsuhan

    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

  17. 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

  18. Impact of Regional Left Ventricular Function on Outcome for Patients with AL Amyloidosis

    PubMed Central

    Herrmann, Sebastian; Cikes, Maja; Störk, Stefan; Beer, Meinrad; Gaudron, Philipp Daniel; Morbach, Caroline; Knop, Stefan; Geissinger, Eva; Ertl, Georg; Bijnens, Bart; Weidemann, Frank

    2013-01-01

    Objectives The aim of this study was to explore the left ventricular (LV) deformation changes and the potential impact of deformation on outcome in patients with proven light-chain (AL) amyloidosis and LV hypertrophy. Background Cardiac involvement in AL amyloidosis patients is associated with poor outcome. Detecting regional cardiac function by advanced non-invasive techniques might be favorable for predicting outcome. Methods LV longitudinal, circumferential and radial peak systolic strains (Ssys) were assessed by speckle tracking imaging (STI) in 44 biopsy-proven systemic AL amyloidosis patients with LV hypertrophy (CA) and in 30 normal controls. Patients were divided into compensated (n?=?18) and decompensated (n?=?26) group based on clinical assessment and followed-up for a median period of 345 days. Results Ejection fraction (EF) was preserved while longitudinal Ssys (LSsys) was significantly reduced in both compensated and decompensated groups. Survival was significantly reduced in decompensated group (35% vs. compensated 78%, P?=?0.001). LSsys were similar in apical segments and significantly reduced in basal segments between two patient groups. LSsys at mid-segments were significantly reduced in all LV walls of decompensated group. Patients were further divided into 4 subgroups according to the presence or absence of reduced LSsys in no (normal), only basal (mild), basal and mid (intermediate) and all segments of the septum (severe). This staging revealed continuously worse prognosis in proportion to increasing number of segments with reduced LSsys (mortality: normal 14%, mild 27%, intermediate 67%, and severe 64%). Mid-septum LSsys<11% suggested a 4.8-fold mortality risk than mid-septum LSsys?11%. Multivariate regression analysis showed NYHA class and mid-septum LSsys were independent predictors for survival. Conclusions Reduced deformation at mid-septum is associated with worse prognosis in systemic amyloidosis patients with LV hypertrophy. PMID:23520459

  19. Does Computer-Aided Formative Assessment Improve Learning Outcomes?

    ERIC Educational Resources Information Center

    Hannah, John; James, Alex; Williams, Phillipa

    2014-01-01

    Two first-year engineering mathematics courses used computer-aided assessment (CAA) to provide students with opportunities for formative assessment via a series of weekly quizzes. Most students used the assessment until they achieved very high (>90%) quiz scores. Although there is a positive correlation between these quiz marks and the final…

  20. Methodological Quandaries in Studying Process and Outcomes in Peer Assessment

    ERIC Educational Resources Information Center

    Topping, Keith J.

    2010-01-01

    Peer assessment is very various in its implementation. Six studies of peer assessment are reviewed, four of them in higher education. A literature review is followed by five empirical studies. Strengths and weaknesses of each study are considered and issues are raised. Variables in peer assessment needing further exploration are extricated--in…

  1. 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…

  2. Balancing the Dual Functions of Portfolio Assessment

    ERIC Educational Resources Information Center

    Lam, Ricky; Lee, Icy

    2010-01-01

    While research on portfolio assessment (PA) has focused largely on the summative aspects of writing assessment, not much has been done to find out its formative potential. Drawing upon student questionnaires and student and teacher interview data, this paper aims to explore the formative functions of PA and, specifically, how the formative…

  3. Serum 25-hydroxyvitamin D and functional outcomes in the elderly

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this paper is to consider key evidence that treatment of vitamin D insufficiency has measurable clinical benefits for the musculoskeletal system in the elderly. The outcomes considered are increased bone mass, decreased rates of bone loss, improved muscle performance, reduced risk o...

  4. Reward Circuitry Function in Autism during Face Anticipation and Outcomes

    ERIC Educational Resources Information Center

    Dichter, Gabriel S.; Richey, J. Anthony; Rittenberg, Alison M.; Sabatino, Antoinette; Bodfish, James W.

    2012-01-01

    The aim of this study was to investigate reward circuitry responses in autism during reward anticipation and outcomes for monetary and social rewards. During monetary anticipation, participants with autism spectrum disorders (ASDs) showed hypoactivation in right nucleus accumbens and hyperactivation in right hippocampus, whereas during monetary…

  5. 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…

  6. Individual prediction of chronic motor outcome in the acute post-stroke stage: Behavioral parameters versus functional imaging.

    PubMed

    Rehme, Anne K; Volz, Lukas J; Feis, Delia-Lisa; Eickhoff, Simon B; Fink, Gereon R; Grefkes, Christian

    2015-11-01

    Several neurobiological factors have been found to correlate with functional recovery after brain lesions. However, predicting the individual potential of recovery remains difficult. Here we used multivariate support vector machine (SVM) classification to explore the prognostic value of functional magnetic resonance imaging (fMRI) to predict individual motor outcome at 4-6 months post-stroke. To this end, 21 first-ever stroke patients with hand motor deficits participated in an fMRI hand motor task in the first few days post-stroke. Motor impairment was quantified assessing grip force and the Action Research Arm Test. Linear SVM classifiers were trained to predict good versus poor motor outcome of unseen new patients. We found that fMRI activity acquired in the first week post-stroke correctly predicted the outcome for 86% of all patients. In contrast, the concurrent assessment of motor function provided 76% accuracy with low sensitivity (<60%). Furthermore, the outcome of patients with initially moderate impairment and high outcome variability could not be predicted based on motor tests. In contrast, fMRI provided 87.5% prediction accuracy in these patients. Classifications were driven by activity in ipsilesional motor areas and contralesional cerebellum. The accuracy of subacute fMRI data (two weeks post-stroke), age, time post-stroke, lesion volume, and location were at 50%-chance-level. In conclusion, multivariate decoding of fMRI data with SVM early after stroke enables a robust prediction of motor recovery. The potential for recovery is influenced by the initial dysfunction of the active motor system, particularly in those patients whose outcome cannot be predicted by behavioral tests. Hum Brain Mapp 36:4553-4565, 2015. © 2015 Wiley Periodicals, Inc. PMID:26381168

  7. 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

  8. Decellularized Nerves for Upper Limb Nerve Reconstruction: A Systematic Review of Functional Outcomes.

    PubMed

    Deslivia, Maria Florencia; Lee, Hyun-Joo; Adikrishna, Arnold; Jeon, In-Ho

    2015-11-01

    Background?This is a systematic review for evaluating the evidence for functional outcomes after decellularized nerve use in clinical setting. Decellularized nerves are allografts whose antigenic components have been removed, leaving only a scaffold that promotes the full regeneration of axons. Methods?Literature research was performed using the PubMed/MEDLINE database for English language studies with the keywords "decellularized nerve" and "processed nerve allograft." Inclusion criteria were prospective and retrospective case reviews in clinical settings. Exclusion criteria were case reports and case series. Results?We retrieved six level VIII studies and one level VI study (classified according to the Jovell and Navarro-Rubio scale) with a total of 131 reconstructions. The basic data ranges of the studies were as follows: patient age, 18 to 86 years; duration between initial injury and nerve reconstruction procedure, 8 hours to 4 years; and follow-up period, 40 days to 2 years. The maximum lengths of the nerve gap for chemically washed decellularized nerves and cryopreserved decellularized nerves were 50 and 100?mm, respectively. Quantitatively, the functional outcome ranges were as follows: static two-point discrimination, 3 to 5?mm; and moving two-point discrimination, 2 to 15 mm. For motor assessment, all patients had a?>?M3 Medical Research Council score. It is also important to notice that a large variability occurs in almost every factor in the reviewed studies. Conclusion?Our study is the first to summarize the clinical results of decellularized nerves. Decellularized nerves have been used to bridge nerve gaps ranging from 5 to 100?mm with associated satisfactory outcomes in static and moving two-point discriminations. PMID:26280520

  9. 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…

  10. Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006

    PubMed Central

    Langguth, B.; Goodey, R.; Azevedo, A.; Bjorne, A.; Cacace, A.; Crocetti, A.; Del Bo, L.; De Ridder, D.; Diges, I.; Elbert, T.; Flor, H.; Herraiz, C.; Sanchez, T. Ganz; Eichhammer, P.; Figueiredo, R.; Hajak, G.; Kleinjung, T.; Landgrebe, M.; Londero, A.; Lainez, M.J.A.; Mazzoli, M.; Meikle, M.B.; Melcher, J.; Rauschecker, J.P.; Sand, P.G.; Struve, M.; Van de Heyning, P.; Van Dijk, P.; Vergara, R.

    2014-01-01

    There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinnitus Research Initiative meeting held in Regensburg in July 2006 an attempt was made through workshops to gain a consensus both for patient assessments and for outcome measurements. It is hoped that this will contribute towards better cooperation between research centres in finding and evaluating treatments for tinnitus by allowing better comparability between studies. PMID:17956816

  11. Imaging and assessment of placental function.

    PubMed

    Moran, Mary; McAuliffe, Fionnuala M

    2011-09-01

    The placenta is the vital support organ for the developing fetus. This article reviews current ultrasound (US) methods of assessing placental function. The ability of ultrasound to detect placental pathology is discussed. Doppler technology to investigate the fetal, placental, and maternal circulations in both high-risk and uncomplicated pregnancies is discussed and the current literature on the value of three-dimensional power Doppler studies to assess placental volume and vascularization is also evaluated. The article highlights the need for further research into three-dimensional ultrasound and alternative methods of placental evaluation if progress is to be made in optimizing placental function assessment. PMID:21656781

  12. 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

  13. 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...

  14. 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…

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

    E-print Network

    Barrash, Warren

    , geologic time, mountain building and geologic structures, and surficial processes. Summative assessment parallel, testable hypotheses that explain their observa- tions, 3) design a simple experiment to test each

  16. 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

  17. Outcome of humeral shaft fractures treated by functional cast brace

    PubMed Central

    Pal, Jitendra Nath; Biswas, Prahas; Roy, Avik; Hazra, Sunit; Mahato, Somnath

    2015-01-01

    Background: Functional brace application for isolated humeral shaft fracture persistently yields good results. Nonunion though uncommon involves usually the proximal third shaft fractures. Instead of polyethylene bivalve functional brace four plaster sleeves wrapped and molded with little more proximal extension expected to prevent nonunion of proximal third fractures. Periodic compressibility of the cast is likely to yield a better result. This can be applied on the 1st day of the presentation as an outpatient basis. Comprehensive objective scoring system befitting for fracture humeral shaft is a need. Materials and Methods: Sixty six (male = 40, female = 26) unilateral humeral shaft fractures of mean age 34.4 years (range 11–75 years) involving 38 left and 28 right hands were included in this study during April 2008 to December 2012. Fractures involved proximal (n = 18), mid (n = 35) and distal (n = 13) of humerus. Transverse, oblique, comminuted and spiral orientations in 18, 35 and 13 patients respectively. One had segmental fracture and three had a pathological fracture with cystic bone lesion. Mechanisms of injuries as identified in this study were road traffic accidents 57.6% (n = 38), fall 37.9% (n = 25). 12.1% (n = 8) had radial nerve palsy 7.6% (n = 5) had Type I open fracture. Four plaster strips of 12 layers and 5–7.5 cm broad depending on the girth of arm were prepared. Arm was then wrapped with single layer compressed cotton. Lateral and medial strips were applied and then after molding anterior and posterior strips were applied in such a way that permits full elbow range of motion and partial abduction of the shoulder. Care was taken to prevent adherence of one strip with other except in the proximal end. Limb was then put in loose collar and cuff sling intermittently allowing active motion of the elbow ROM and pendular movement of the shoulder. Weekly tightening of the cast by fresh layers of bandage over the existing cast brace continued. Results: The results were assessed using 100 point scoring system where union allotted 30 points and 60 points allotted for angulations (10), elbow motion (10), shoulder abduction (10), shortening (5), rotation (5), absence of infection (10), absence of nerve palsy during treatment (10). Remaining 10 points were allotted for five items with two points each. They were the absence of skin sore, absence of vascular problem, absence of reflex sympathetic dystrophy (RSD), recovery of paralyzed nerve during injury and recovery of paralyzed nerve during treatment. Results were considered excellent with 90 and above, good with 80–89, fair with 70–79 and poor below 70 point. Results at 6 months were excellent in 43.94% (n = 29), good in 42.42% (n = 28), fair in 9.1% (n = 6), poor in 4.55% (n = 3). Union took place in 98.48% (n = 65) with an average of 10.3 weeks (range 6–16 weeks). 87.5% (n = 7) paralyzed radial nerve recovered. All wounds healed. Four patients had transient skin problem. One patient with mid shaft fracture had nonunion due to the muscle interposition. Conclusion: Modified functional cast brace is one of the options in treatment for humeral shaft fractures as it can be applied on the 1st day of the presentation in most of the situations. Simple objective scoring system was useful particularly in uneducated patients. PMID:26229161

  18. Critical Assessment of Function Annotation Meeting, 2011

    SciTech Connect

    Friedberg, Iddo

    2015-01-21

    The Critical Assessment of Function Annotation meeting was held July 14-15, 2011 at the Austria Conference Center in Vienna, Austria. There were 73 registered delegates at the meeting. We thank the DOE for this award. It helped us organize and support a scientific meeting AFP 2011 as a special interest group (SIG) meeting associated with the ISMB 2011 conference. The conference was held in Vienna, Austria, in July 2011. The AFP SIG was held on July 15-16, 2011 (immediately preceding the conference). The meeting consisted of two components, the first being a series of talks (invited and contributed) and discussion sections dedicated to protein function research, with an emphasis on the theory and practice of computational methods utilized in functional annotation. The second component provided a large-scale assessment of computational methods through participation in the Critical Assessment of Functional Annotation (CAFA).

  19. 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…

  20. Assessing the Outcomes of Instruction in Earth Science

    ERIC Educational Resources Information Center

    Hassard, John R.

    1973-01-01

    Describes an assessment system currently being developed by the Florida Educational Research and Development Program that is relevant for earth science teaching. Designed to be comprehensive in scope, to provide flexibility for classroom teachers, and to make assessment on individualized process. (Author/JR)

  1. 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…

  2. 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

  3. Educational Quality, Outcomes Assessment, and Policy Change: The Virginia Example

    ERIC Educational Resources Information Center

    Culver, Steve

    2010-01-01

    The higher education system in the Commonwealth of Virginia in the United States provides a case model for how discussions regarding educational quality and assessment of that quality have affected institutions' policy decisions and implementation. Using Levin's (1998) policy analysis framework, this essay explores how assessment of student…

  4. Relationship between Parental PODCI Questionnaire and School Function Assessment in Measuring Performance in Children with CP

    ERIC Educational Resources Information Center

    Gates, Philip E.; Otsuka, Norman Y.; Sanders, James O.; McGee-Brown, Jeanie

    2008-01-01

    Little data exists assessing the relationship between functional limitations in children with cerebral palsy (CP) and their participation in everyday activities. This prospective study evaluates the relationship between the Pediatric Outcomes Data Collection Instrument (PODCI), a functional health-related quality of life instrument for children…

  5. 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.

  6. Implementation of Mock Competency Skill Assessments to Improve Student Outcomes.

    PubMed

    Payne, Camille; Ziegler, M Penny; Baughman, Diana M; Jones, Jackie

    2015-01-01

    A primary responsibility for nurse educators is to provide students with theoretical knowledge and clinical skills for professional nursing. In this study, laboratory faculty developed a creative pedagogical strategy to reduce nursing student stress during assessment of skill performance. Mock competencies were structured so that students participated in peer-to-peer evaluations in simulated competency assessments. The purpose of this study was to determine whether this pedagogical strategy had an impact on first-round pass rates for skills competency assessments. PMID:25950797

  7. 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…

  8. Learning in a Comfort Zone: Cultural and Social Capital inside an Outcome-Based Assessment Regime

    ERIC Educational Resources Information Center

    Ecclestone, Kathryn

    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…

  9. 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.…

  10. 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…

  11. Psychometric validation of patient-reported outcome measures assessing chronic constipation

    PubMed Central

    Nelson, Lauren M; Williams, Valerie SL; Fehnel, Sheri E; Carson, Robyn T; MacDougall, James; Baird, Mollie J; Tourkodimitris, Stavros; Kurtz, Caroline B; Johnston, Jeffrey M

    2014-01-01

    Background Measures assessing treatment outcomes in previous CC clinical trials have not met the requirements described in the US Food and Drug Administration’s guidance on patient-reported outcomes. Aim Psychometric analyses using data from one Phase IIb study and two Phase III trials of linaclotide for the treatment of chronic constipation (CC) were conducted to document the measurement properties of patient-reported CC Symptom Severity Measures. Study methods Each study had a multicenter, randomized, double-blind, placebo-controlled, parallel-group design, comparing placebo to four doses of oral linaclotide taken once daily for 4 weeks in the Phase IIb dose-ranging study (n=307) and to two doses of linaclotide taken once daily for 12 weeks in the Phase III trials (n=1,272). The CC Symptom Severity Measures addressing bowel function (Bowel Movement Frequency, Stool Consistency, Straining) and abdominal symptoms (Bloating, Abdominal Discomfort, Abdominal Pain) were administered daily using interactive voice-response system technology. Intraclass correlations, Pearson correlations, factor analyses, F-tests, and effect sizes were computed. Results The CC Symptom Severity Measures demonstrated satisfactory test–retest reliability and construct validity. Factor analyses indicated one factor for abdominal symptoms and another for bowel symptoms. Known-groups F-tests substantiated the discriminating ability of the CC Symptom Severity Measures. Responsiveness statistics were moderate to strong, indicating that these measures are capable of detecting change. Conclusion In large studies of CC patients, linaclotide significantly improved abdominal and bowel symptoms. These psychometric analyses support the reliability, validity, discriminating ability, and responsiveness of the CC Symptom Severity Measures for evaluating treatment outcomes in the linaclotide clinical studies. PMID:25298737

  12. Assessing Patient-Reported Outcomes Following Orthognathic Surgery and Osseous Genioplasty.

    PubMed

    Schwitzer, Jonathan A; Albino, Frank P; Mathis, Ryan K; Scott, Amie M; Gamble, Laurie; Baker, Stephen B

    2015-11-01

    Primary outcomes for orthognathic surgery and genioplasty patients include satisfaction with appearance, improved motor function, and enhanced quality of life. The goal of this study was to assess outcomes among patients undergoing these procedures, and to highlight the potential use of FACE-Q instrument for use in patients with dentofacial deformities. A total of 56 patients presenting for orthognathic surgery and/or osseous genioplasty completed the FACE-Q during preoperative and/or at postoperative visits. FACE-Q scores increased following surgery in satisfaction with facial appearance overall (+24.5, P?outcomes possible for patients undergoing these procedures. PMID:26501967

  13. Relationship between Sleep Disturbance and Functional Outcomes in Daily Life Habits of Children with Down Syndrome

    PubMed Central

    Churchill, Shervin S.; Kieckhefer, Gail M.; Bjornson, Kristie F.; Herting, Jerald R.

    2015-01-01

    Objectives: The goal of this study was to describe sleep patterns and accomplishment of daily life habits in children with Down syndrome (DS) and to investigate the relationship between subjective indicators of sleep disturbance with functional outcomes in daily life. Design: Cross-sectional study with an Internet sample Setting: Online survey filled out at home Participants: 110 parents of children with DS and 29 parents of children with typical development (TD), age 5 to 18 years. Interventions: N/A. Measurements and Results: Children's Sleep Habits Questionnaire was employed to collect information about sleep disturbances in 8 domains (subscales) and a total score. The Life Habits questionnaire (Life-H) sampled information about daily life habits in 11 domains. Multivariable regression modeling was used to assess the associations between sleep disturbances and the accomplishment of daily life habits. Sleep disordered breathing (SDB) was a significant explanatory factor in 10 of 11 daily life habits and the total Life-H score. Sleep anxiety and parasomnias significantly influenced the accomplishment of life habits in children with DS as compared to children with typical development. When evaluated in multivariable models in conjunction with the other 7 domains of sleep disturbances, SDB was the most dominant explanatory factor for accomplishment of life habits. Conclusions: Sleep disturbances are negatively related to accomplishment of daily life functions. Prevention and treatment of sleep problems, particularly sleep disordered breathing, in children with Down syndrome may lead to enhanced accomplishment of daily life habits and activities. Citation: Churchill SS, Kieckhefer GM, Bjornson KF, Herting JR. Relationship between sleep disturbance and functional outcomes in daily life habits of children with Down syndrome. SLEEP 2015;38(1):61–71. PMID:25325444

  14. The relevance of the Rorschach and patient-examiner relationship in treatment planning and outcome assessment.

    PubMed

    Bram, Anthony D

    2010-03-01

    In this era of evidence-based mental health care, traditional forms of depth-oriented psychotherapy and psychological assessment have been marginalized in graduate training in clinical psychology. As a counterpoint, this article presents the evaluation and treatment of an adolescent client, along with an outcome assessment, and illustrates ways that aspects of traditional psychological testing, including the Rorschach (Exner, 1986) and the patient-examiner relationship, can enhance psychodiagnosis and treatment planning. Additionally, this case illustrates ways that test data can illuminate the concept of underlying disturbance and its utility in diagnostic formulation, treatment planning, and outcome assessment. PMID:20155560

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

    E-print Network

    Hornback, Joseph Edward

    2013-05-31

    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...

  16. 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)

  17. 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.

  18. 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

  19. Gross Motor Function Outcome After Intensive Rehabilitation in Children With Bilateral Spastic Cerebral Palsy

    PubMed Central

    Lee, Seung Hoon; Shim, Jae Sun; Kim, Kiyoung; Moon, Jinkyoo

    2015-01-01

    Objective To compare gross motor function outcomes in children with moderate to severe degrees of bilateral spastic cerebral palsy (CP) who received either intensive inpatient rehabilitation or intermittent rehabilitation on an outpatient basis. Methods A non-biased retrospective chart review was done for patients diagnosed with bilateral spastic CP who received rehabilitation therapy. The intensive rehabilitation group (inpatient group) agreed to be hospitalized to receive 22 sessions of physical and occupational therapy per week for 1 month. The intermittent rehabilitation group (outpatient group) received four sessions of physical and occupational therapy per week for 3 months in an outpatient setting. Changes in the total score on the Gross Motor Function Measure (GMFM) between baseline and the follow-up period were analyzed. Results Both groups showed significant improvements in total GMFM scores at the follow-up assessment compared to that at baseline (p=0.000 for inpatient group, p=0.001 for outpatient group). The increase in mean total GMFM score after 1 month was significantly greater in the inpatient group than that in the outpatient group (p=0.020). Higher increase in GMFM score was observed in younger subjects as revealed by the negative correlation between age and the increase in GMFM score after 1 month (p=0.002, r=-0.460). Conclusion Intensive inpatient rehabilitation therapy for patients with bilateral spastic CP of moderate to severe degree was more effective for improving gross motor function than intermittent rehabilitation therapy on an outpatient basis. PMID:26361600

  20. Practical framework for Bloom's based teaching and assessment of engineering outcomes

    NASA Astrophysics Data System (ADS)

    Mead, Patricia F.; Bennett, Mary M.

    2009-06-01

    ABET's outcomes-based assessment and evaluation requirements for engineering school accreditation has been a catalyst for curricular reform for engineering programs across the U.S. and around the world. Norfolk State University launched programs in Electronics and Optical Engineering in 2003. In 2007, Norfolk State became one of only six accredited Optical Engineering programs in the United States. In preparation for their first ABET evaluation in fall 2007, the faculty initiated an embedded-assessment program to insure continuous improvement toward the desired learning outcomes. The initial program design includes embedded assessments that have been generated using a practical framework for the creation of course activities based on Bloom's Learning Taxonomy. The framework includes specific performance criteria for each ABET-defined learning outcome. The embedded assessments are generated by individual faculty for courses that they are assigned to teach, and the performance criteria provide sufficient information to guide the faculty as they generate the embedded assignments. The assignments are typically administered through course exams, projects, electronic portfolio assignments, and other structured educational activities. The effectiveness of the assessment design is being evaluated through faculty surveys, faculty group discussions, and student performance. This paper outlines the assessment and evaluation plan, and the integrated processes that have been used to support the evaluation of learning outcomes using embedded assessment instruments.

  1. Ipsilateral lower extremity joint involvement increases the risk of poor pain and function outcomes after hip or knee arthroplasty

    PubMed Central

    2013-01-01

    Background Poor pain and function outcomes are undesirable after an elective surgery such as total hip or knee arthroplasty (THA/TKA). Recent studies have indicated that the presence of contralateral joint influences outcomes of THA/TKA, however the impact of ipsilateral knee/hip involvement on THA/TKA outcomes has not been explored. The objective of this study was to assess the association of ipsilateral knee/hip joint involvement on short-term and medium-term pain and function outcomes after THA/TKA. Methods In this retrospective study of prospectively collected data, we used the data from the Mayo Clinic Total Joint Registry to assess the association of ipsilateral knee or hip joint involvement with moderate to severe pain and moderate to severe activity limitation at 2-year and 5-year follow-up after primary and revision THA and TKA using multivariable-adjusted logistic regression analyses. Results At 2 years, 3,823 primary THA, 4,701 primary TKA, 1,218 revision THA and 725 revision TKA procedures were studied. After adjusting for multiple covariates, ipsilateral knee pain was significantly associated with outcomes after primary THA (all P values <0.01): (1) moderate to severe pain: at 2 years, odds ratio (OR), 2.3 (95% confidence interval (CI) 1.5 to 3.6); at 5 years, OR 1.8 (95% CI 1.1 to 2.7); (2) moderate to severe activity limitation: at 2 years, OR 3.1 (95% CI 2.3 to 4.3); at 5 years, OR 3.6 (95% CI 2.6 to 5.0). Ipsilateral hip pain was significantly associated with outcomes after primary TKA (all P values <0.01): (1) moderate to severe pain: at 2 years, OR 3.3 (95% CI 2.3 to 4.7); at 5 years, OR 1.8 (95% CI 1.1 to 2.7); (2) moderate to severe activity limitation: at 2 years, OR 3.6 (95% CI 2.6 to 4.9); at 5 years, OR 2.2 (95% CI 1.6 to 3.2). Similar associations were noted for revision THA and TKA patients. Conclusions To the best of our knowledge, this is the first study showing that the presence of ipsilateral joint involvement after THA or TKA is strongly associated with poor pain and function outcomes. A potential way to improve outcomes is to address ipsilateral lower extremity joint involvement. PMID:23738845

  2. The Effects of Reinforcement Magnitude on Functional Analysis Outcomes

    ERIC Educational Resources Information Center

    Volkert, Valerie M.; Lerman, Dorothea C.; Vorndran, Christina

    2005-01-01

    The duration or magnitude of reinforcement has varied and often appears to have been selected arbitrarily in functional analysis research. Few studies have evaluated the effects of reinforcement magnitude on problem behavior, even though basic findings indicate that this parameter may affect response rates during functional analyses. In the…

  3. Putting the Patient in Patient Reported Outcomes: A Robust Methodology for Health Outcomes Assessment.

    PubMed

    McCarthy, Ian M

    2015-12-01

    When analyzing many health-related quality-of-life (HRQoL) outcomes, statistical inference is often based on the summary score formed by combining the individual domains of the HRQoL profile into a single measure. Through a series of Monte Carlo simulations, this paper illustrates that reliance solely on the summary score may lead to biased estimates of incremental effects, and I propose a novel two-stage approach that allows for unbiased estimation of incremental effects. The proposed methodology essentially reverses the order of the analysis, from one of 'aggregate, then estimate' to one of 'estimate, then aggregate'. Compared to relying solely on the summary score, the approach also offers a more patient-centered interpretation of results by estimating regression coefficients and incremental effects in each of the HRQoL domains, while still providing estimated effects in terms of the overall summary score. I provide an application to the estimation of incremental effects of demographic and clinical variables on HRQoL following surgical treatment for adult scoliosis and spinal deformity. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25303748

  4. Mismatch negativity, social cognition, and functional outcomes in patients after traumatic brain injury

    PubMed Central

    Sun, Hui-yan; Li, Qiang; Chen, Xi-ping; Tao, Lu-yang

    2015-01-01

    Mismatch negativity is generated automatically, and is an early monitoring indicator of neuronal integrity impairment and functional abnormality in patients with brain injury, leading to decline of cognitive function. Antipsychotic medication cannot affect mismatch negativity. The present study aimed to explore the relationships of mismatch negativity with neurocognition, daily life and social functional outcomes in patients after brain injury. Twelve patients with traumatic brain injury and 12 healthy controls were recruited in this study. We examined neurocognition with the Wechsler Adult Intelligence Scale-Revised China, and daily and social functional outcomes with the Activity of Daily Living Scale and Social Disability Screening Schedule, respectively. Mismatch negativity was analyzed from electroencephalogram recording. The results showed that mismatch negativity amplitudes decreased in patients with traumatic brain injury compared with healthy controls. Mismatch negativity amplitude was negatively correlated with measurements of neurocognition and positively correlated with functional outcomes in patients after traumatic brain injury. Further, the most significant positive correlations were found between mismatch negativity in the fronto-central region and measures of functional outcomes. The most significant positive correlations were also found between mismatch negativity at the FCz electrode and daily living function. Mismatch negativity amplitudes were extremely positively associated with Social Disability Screening Schedule scores at the Fz electrode in brain injury patients. These experimental findings suggest that mismatch negativity might efficiently reflect functional outcomes in patients after traumatic brain injury. PMID:26170824

  5. Functional outcome and prognostic factors in anti-Jo1 patients with antisynthetase syndrome

    PubMed Central

    2013-01-01

    Introduction The aims of this present study were firstly to assess the outcome, including functional course, in anti-Jo1 positive patients with antisynthetase syndrome (ASS), and secondly to determine predictive parameters of poor outcome in these patients. Methods The medical records of 86 consecutive anti-Jo1 patients with ASS were reviewed in 4 academic centers. Results 13 patients (15.1%) achieved remission of ASS, whereas 55 (63.9%) improved and 18 (20.9%) deteriorated in their clinical status. Both steroid and cytotoxic drugs could be discontinued in only 4.7% of patients. ASS was associated with decreased quality of life at long-term follow-up: only 69.2% of patients considered to be in remission experienced a return to previous normal activities; and 24.7% of other patients with non-remitting ASS still had a marked reduction of activities (as shown by the disability scale of the Health Assessment Questionnaire). Decreased quality of life was further due to calcinosis cutis (8.1%) and adverse effects of steroid therapy (36%). Factors associated with ASS deterioration were older age, pulmonary and esophageal involvement, calcinosis cutis and cancer. Higher anti-Jo1 levels were further associated with disease severity in ASS patients. Conclusions The present study shows high morbidity related to ASS. Furthermore, we suggest that patients with predictive factors of ASS deterioration may require more aggressive therapy. Our findings also suggest that in anti-Jo1 patients with severe esophageal manifestations, combined high dose steroids and intravenous immunoglobulins might be proposed as the first line therapy. Finally, as cancer occurred in 14% of anti-Jo1 patients, our findings underscore that the search for cancer should be performed in these patients. PMID:24286268

  6. Clinical application of 3D imaging for assessment of treatment outcomes

    PubMed Central

    Cevidanes, Lucia H.C.; Oliveira, Ana Emilia Figueiredo; Grauer, Dan; Styner, Martin; Proffit, William R.

    2011-01-01

    This paper outlines the clinical application of CBCT for assessment of treatment outcomes, and discusses current work to superimpose digital dental models and 3D photographs. Superimposition of CBCTs on stable structures of reference now allow assessment of 3D dental, skeletal and soft tissue changes for both growing and non-growing patients. Additionally, we describe clinical findings from CBCT superimpositions in assessment of surgery and skeletal anchorage treatment. PMID:21516170

  7. Interactive Outcome-Based Assessment Using Barna Szabados

    E-print Network

    Szabados, Barna

    Engineering Director Power Research Laboratory McMaster University, Ontario, Canada szabados. It is certainly a good method of presentation, and students can flip through the presentation later and refresh electronics course, imbedding many new presentation techniques, and moreover a discussion of the assessment

  8. Outcomes Assessment and Program Improvement Master of Business Administration

    E-print Network

    Liberzon, Daniel

    of business principles as well as to develop and hone interpersonal communication and team skills areas into a strategic perspective of the discipline. SECTION 2 ­ REVISED ASSESSMENT PLAN 1. Plan to focus in oral and written communication skills as well as to develop and apply evaluation rubrics

  9. 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…

  10. Intensive Stuttering Modification Therapy: A Multidimensional Assessment of Treatment Outcomes

    ERIC Educational Resources Information Center

    Blomgren, Michael; Roy, Nelson; Callister, Thomas; Merrill, Ray M.

    2005-01-01

    Nineteen adults who stutter participated in a 3-week intensive stuttering modification treatment program (the Successful Stuttering Management Program [SSMP]). A series of 14 fluency and affective-based measures were assessed before treatment, immediately after treatment, and 6 months after treatment. Measures included stuttering frequency; the…

  11. Outcome measurement tools currently used to assess pediatric burn patients: an occupational therapy and physiotherapy perspective.

    PubMed

    Heath, Kathryn; Timbrell, Vanessa; Calvert, Philip; Stiller, Kathy

    2011-01-01

    Given the high incidence of burn injuries in children, it is important that all clinicians involved in the care of these patients, including occupational therapists and physiotherapists, are able to assess patients with valid, sensitive, and reliable measurement tools to optimize outcomes and clinical management. The aims of this study were to identify therapist- relevant outcome measurement tools that have been previously used with pediatric burn patients and to ascertain the outcome measurement tools currently used by occupational therapists and physiotherapists working in pediatric burns units. A literature review was undertaken to identify therapist-relevant outcome measurement tools that have been used in the pediatric burn population. A survey involving therapists working in Australian pediatric burns units was then conducted to identify outcome measurement tools in common usage. Few outcome measurement tools were identified that had been specifically validated for use, or were in common usage in Australia, with pediatric patients with burn injury. The lack of validated and widely used measurement tools adversely impacts on the ability of therapists to accurately assess outcomes of treatment and undertake clinical research involving pediatric patients with burn injury. PMID:22002208

  12. 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

  13. The Relationship between Preoperative Expectations and the Short-Term Postoperative Satisfaction and Functional Outcome in Lumbar Spine Surgery: A Systematic Review.

    PubMed

    Ellis, Daniel J; Mallozzi, Scott S; Mathews, Jacob E; Moss, Isaac L; Ouellet, Jean A; Jarzem, Peter; Weber, Michael H

    2015-10-01

    Study Design?Systematic review. Objective?To examine the relationship between the patient's preoperative expectations and short-term postoperative satisfaction and functional outcome in lumbar spine surgery. Methods?The Medline, Embase, and Cochrane databases were queried using a predefined search algorithm to identify all lumbar spine studies analyzing the influence of preoperative expectations on postoperative satisfaction and functional outcome. Two independent reviewers and a third independent mediator reviewed the literature and performed study screening, selection, methodological assessment, and data extraction using an objective protocol. Results?Of 444 studies identified, 13 met the inclusion criteria. Methodological quality scores ranged from 59 to 100% with the greatest variability in defining patient characteristics and the methods of assessing patient expectations. Patient expectations were assessed in 22 areas, most frequently back and leg pain expectations and general expectations. Functional outcome was assessed by 13 tools; the most common were the visual analog scale, Oswestry Disability Index (ODI), and Short Form Health Survey (SF-36). Positive expectations for symptomatology, activity, general health, and recovery correlated with satisfaction. General expectations correlated with higher SF-36 Physical Subcomponent scores, better global function, and lower ODI outcome. Conclusions on the influence of the expectations for pain were limited due to the study heterogeneity, but the evidence suggests a positive correlation between the expectation and outcome for back and leg pain. Conclusions?Positive expectations correlated significantly with short-term postoperative satisfaction and functional outcome, including higher SF-36 scores, earlier return to work, and decreased ODI scores. Future expectation-based investigations will benefit from implementation of the standardized methods of expectation, satisfaction, and outcome analysis discussed herein. PMID:26430599

  14. 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

  15. Functional Plasticity in Childhood Brain Disorders: When, What, How, and Whom to Assess

    PubMed Central

    Dennis, Maureen; Spiegler, Brenda J.; Simic, Nevena; Sinopoli, Katia J.; Wilkinson, Amy; Yeates, Keith Owen; Taylor, H. Gerry; Bigler, Erin D.; Fletcher, Jack M.

    2014-01-01

    At every point in the lifespan, the brain balances malleable processes representing neural plasticity that promote change with homeostatic processes that promote stability. Whether a child develops typically or with brain injury, his or her neural and behavioral outcome is constructed through transactions between plastic and homeostatic processes and the environment. In clinical research with children in whom the developing brain has been malformed or injured, behavioral outcomes provide an index of the result of plasticity, homeostasis, and environmental transactions. When should we assess outcome in relation to age at brain insult, time since brain insult, and age of the child at testing? What should we measure? Functions involving reacting to the past and predicting the future, as well as social-affective skills, are important. How should we assess outcome? Information from performance variability, direct measures and informants, overt and covert measures, and laboratory and ecological measures should be considered. In whom are we assessing outcome? Assessment should be cognizant of individual differences in gene, socio-economic status (SES), parenting, nutrition, and interpersonal supports, which are moderators that interact with other factors influencing functional outcome. PMID:24821533

  16. Functional Assessment: Old Wine in New Bottles.

    ERIC Educational Resources Information Center

    Ervin, Ruth A.; Ehrhardt, Kristal E.; Poling, Alan

    2001-01-01

    Traces functional assessment (FA) in school settings to early contributions by B. F. Skinner. FA plays an important role in behavior analysis, and the value of this approach in dealing with behavior problems in many settings has long been evident. Although interest in FA in school settings has only recently become widespread, FA in education has a…

  17. Assessment of glomerular and tubular function.

    PubMed

    Kher, Kanwal; Mistry, Kirtida

    2014-01-01

    At birth, GFR and tubular function of neonates is compromised as compared to older children and adults. These functions are even less developed in premature infants. These facts have a direct bearing on drug dosing, fluid and electrolyte administration, and maintenance of acid-base balance in neonates. Although many detailed methods of assessing renal functions have been provided in this article, laboratory and radiologic studies available in most healthcare facilities are often sufficient to provide a clinically relevant data in most patients, including neonates. PMID:25088268

  18. Outcomes Assessment and Program Improvement Master of Science in Finance

    E-print Network

    Liberzon, Daniel

    Engineering, Banking & Capital Markets, Insurance & Risk Management, and Real Estate. Previously, the Finance sections of the finance industry. Emphasis can be in Corporate Finance, Asset Management, Financial Competence Students will demonstrate an in-depth understanding of the various functional areas of financial

  19. 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

  20. Cascading and combined effects of cognitive deficits and residual symptoms on functional outcome in schizophrenia - A path-analytical approach.

    PubMed

    Bhagyavathi, Haralahalli D; Mehta, Urvakhsh Meherwan; Thirthalli, Jagadisha; Kumar, C Naveen; Kumar, J Keshav; Subbakrishna, D K; Gangadhar, Bangalore N

    2015-09-30

    Understanding the complex relationship among determinants of real-world functioning in schizophrenia patients in remission is important in planning recovery-oriented interventions. We explored two path-analytical models of functioning in schizophrenia. 170 Schizophrenia patients remitted from positive symptoms underwent fairly comprehensive assessments of cognition - neurocognition (NC) and social cognition (SC), residual symptoms - insight, motivation and other negative symptoms, and socio-occupational functioning. We explored (a) a cascading model, where NC predicted functional outcome through its effects on other determinants and (b) a combined model, incorporating additional direct paths from each of the determinants. The combined model, and not the cascading model demonstrated a good fit. Post-hoc trimming of the combined model by elimination of non-significant paths maintained the goodness-of-fit and was retained as the final model. In addition to the direct paths, this final model demonstrated that (a) NC influenced functioning through SC and insight and (b) SC influenced functioning through motivation and negative symptoms. This suggests that NC and SC may influence functional outcome directly, as well as indirectly, via specific impact on insight, and motivation and negative symptoms respectively. PMID:26208988

  1. Behavioral, Brain Imaging and Genomic Measures to Predict Functional Outcomes Post - Bed Rest and Spaceflight

    NASA Technical Reports Server (NTRS)

    Mulavara, A. P.; DeDios, Y. E.; Gadd, N. E.; Caldwell, E. E.; Batson, C. D.; Goel, R.; Seidler, R. D.; Oddsson, L.; Zanello, S.; Clarke, T.; Peters, B.; Cohen, H. S.; Reschke, M.; Wood, S.; Bloomberg, J. J.

    2016-01-01

    Astronauts experience sensorimotor disturbances during their initial exposure to microgravity and during the re-adaptation phase following a return to an Earth-gravitational environment. These alterations may disrupt crewmembers' ability to perform mission critical functional tasks requiring ambulation, manual control and gaze stability. Interestingly, astronauts who return from spaceflight show substantial differences in their abilities to readapt to a gravitational environment. The ability to predict the manner and degree to which individual astronauts would be affected would improve the effectiveness of countermeasure training programs designed to enhance sensorimotor adaptability. For such an approach to succeed, we must develop predictive measures of sensorimotor adaptability that will allow us to foresee, before actual spaceflight, which crewmembers are likely to experience the greatest challenges to their adaptive capacities. The goals of this project are to identify and characterize this set of predictive measures. Our approach includes: 1) behavioral tests to assess sensory bias and adaptability quantified using both strategic and plastic-adaptive responses; 2) imaging to determine individual brain morphological and functional features, using structural magnetic resonance imaging (MRI), diffusion tensor imaging, resting state functional connectivity MRI, and sensorimotor adaptation task-related functional brain activation; and 3) assessment of genotypic markers of genetic polymorphisms in the catechol-O-methyl transferase, dopamine receptor D2, and brain-derived neurotrophic factor genes and genetic polymorphisms of alpha2-adrenergic receptors that play a role in the neural pathways underlying sensorimotor adaptation. We anticipate that these predictive measures will be significantly correlated with individual differences in sensorimotor adaptability after long-duration spaceflight and exposure to an analog bed rest environment. We will be conducting a retrospective study, leveraging data already collected from relevant ongoing or completed bed rest and spaceflight studies. These data will be combined with predictor metrics that will be collected prospectively (as described for behavioral, brain imaging and genomic measures) from these returning subjects to build models for predicting post-mission (bed rest - non-astronauts or space flight - astronauts) adaptive capability as manifested in their outcome measures. To date we have completed a study on 15 normal subjects with all of the above measures. In this presentation we will discuss the optimized set of tests for predictive metrics to be used for evaluating post mission adaptive capability as manifested in their outcome measures. Comparisons of model performance will allow us to better design and implement sensorimotor adaptability training countermeasures against decrements in post-mission adaptive capability that are customized for each crewmember's sensory biases, adaptive capacity, brain structure and functional capacities, and genetic predispositions. The ability to customize adaptability training will allow more efficient use of crew time during training and will optimize training prescriptions for astronauts to ensure expected outcomes.

  2. Multilevel quantile function modeling with application to birth outcomes.

    PubMed

    Smith, Luke B; Reich, Brian J; Herring, Amy H; Langlois, Peter H; Fuentes, Montserrat

    2015-06-01

    Infants born preterm or small for gestational age have elevated rates of morbidity and mortality. Using birth certificate records in Texas from 2002 to 2004 and Environmental Protection Agency air pollution estimates, we relate the quantile functions of birth weight and gestational age to ozone exposure and multiple predictors, including parental age, race, and education level. We introduce a semi-parametric Bayesian quantile approach that models the full quantile function rather than just a few quantile levels. Our multilevel quantile function model establishes relationships between birth weight and the predictors separately for each week of gestational age and between gestational age and the predictors separately across Texas Public Health Regions. We permit these relationships to vary nonlinearly across gestational age, spatial domain and quantile level and we unite them in a hierarchical model via a basis expansion on the regression coefficients that preserves interpretability. Very low birth weight is a primary concern, so we leverage extreme value theory to supplement our model in the tail of the distribution. Gestational ages are recorded in completed weeks of gestation (integer-valued), so we present methodology for modeling quantile functions of discrete response data. In a simulation study we show that pooling information across gestational age and quantile level substantially reduces MSE of predictor effects. We find that ozone is negatively associated with the lower tail of gestational age in south Texas and across the distribution of birth weight for high gestational ages. Our methods are available in the R package BSquare. PMID:25761678

  3. Supratentorial Ependymoma: Disease Control, Complications, and Functional Outcomes After Irradiation

    SciTech Connect

    Landau, Efrat; Boop, Frederick A.; Conklin, Heather M.; Wu, Shengjie; Xiong, Xiaoping; Merchant, Thomas E.

    2013-03-15

    Purpose: Ependymoma is less commonly found in the supratentorial brain and has known clinical and molecular features that are unique. Our single-institution series provides valuable information about disease control for supratentorial ependymoma and the complications of supratentorial irradiation in children. Methods and Materials: A total of 50 children with newly diagnosed supratentorial ependymoma were treated with adjuvant radiation therapy (RT); conformal methods were used in 36 after 1996. The median age at RT was 6.5 years (range, 1-18.9 years). The entire group was characterized according to sex (girls 27), race (white 43), extent of resection (gross-total 46), and tumor grade (anaplastic 28). The conformal RT group was prospectively evaluated for neurologic, endocrine, and cognitive effects. Results: With a median follow-up time of 9.1 years from the start of RT for survivors (range, 0.2-23.2 years), the 10-year progression-free and overall survival were 73% + 7% and 76% + 6%, respectively. None of the evaluated factors was prognostic for disease control. Local and distant failures were evenly divided among the 16 patients who experienced progression. Eleven patients died of disease, and 1 of central nervous system necrosis. Seizure disorders were present in 17 patients, and 4 were considered to be clinically disabled. Clinically significant cognitive effects were limited to children with difficult-to-control seizures. The average values for intelligence quotient and academic achievement (reading, spelling, and math) were within the range of normal through 10 years of follow-up. Central hypothyroidism was the most commonly treated endocrinopathy. Conclusion: RT may be administered with acceptable risks for complications in children with supratentorial ependymoma. These results suggest that outcomes for these children are improving and that complications may be limited by use of focal irradiation methods.

  4. Social Work Assessment Notes: A Comprehensive Outcomes-Based Hospice Documentation System.

    PubMed

    Hansen, Angela Gregory; Martin, Ellen; Jones, Barbara L; Pomeroy, Elizabeth C

    2015-08-01

    This article describes the development of an integrated psychosocial patient and caregiver assessment and plan of care for hospice social work documentation. A team of hospice social workers developed the Social Work Assessment Notes as a quality improvement project in collaboration with the information technology department. Using the Social Work Assessment Tool as an organizing framework, this comprehensive hospice social work documentation system is designed to integrate assessment, planning, and outcomes measurement. The system was developed to guide the assessment of patients' and caregivers' needs related to end-of-life psychosocial issues, to facilitate collaborative care plan development, and to measure patient- and family-centered outcomes. Goals established with the patient and the caregiver are documented in the plan of care and become the foundation for patient-centered, strengths-based interventions. Likert scales are used to assign numerical severity levels for identified issues and progress made toward goals and to track the outcome of social work interventions across nine psychosocial constructs. The documentation system was developed for use in an electronic health record but can be used for paper charting. Future plans include automated aggregate outcomes measurement to identify the most effective interventions and best practices in end-of-life care. PMID:26285358

  5. Assessing outcomes of a study abroad course for nursing students.

    PubMed

    Carpenter, Linda J; Garcia, Alexandra A

    2012-01-01

    There is little debate about the importance of preparing nursing graduates to provide culturally sensitive care to an increasingly diverse society. However, it is difficult for nurse educators to fit learning experiences that help students develop cultural competence into already full programs and create mechanisms to evaluate the results. This article describes a study to assess the impact of a study abroad program on developing cultural competence, including cultural awareness, sensitivity, knowledge, and skills. Results from the Cultural Awareness Survey, reflective journals, and interviews illustrate how the study abroad experience influenced the development of components of cultural competence and might influence clinical practice. Results suggest effective teaching strategies to assist students in becoming culturally competent are experiential in nature and include role modeling, reflective activities, and group discussion. PMID:22616405

  6. Defining, Valuing, and Teaching Clinical Outcomes Assessment in Professional and Post-Professional Athletic Training Education Programs

    ERIC Educational Resources Information Center

    Snyder, Alison R.; McLeod, Tamara C. Valovich; Sauers, Eric L.

    2007-01-01

    Objective: To provide a basic introduction for athletic training educators about the importance of clinical outcomes measures and to recommend strategies for implementing clinical outcomes assessment education in professional and post-professional athletic training education programs. Background: Outcomes is a frequently used term amongst…

  7. 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

  8. Risk assessment tools used to predict outcomes of total hip and total knee arthroplasty.

    PubMed

    Konopka, Joseph F; Hansen, Viktor J; Rubash, Harry E; Freiberg, Andrew A

    2015-07-01

    This article reviews recently proposed clinical tools for predicting risks and outcomes in total hip arthroplasty and total knee arthroplasty patients. Additionally, we share the Massachusetts General Hospital experience with using the Risk Assessment and Prediction Tool to predict the need for an extended care facility after total joint arthroplasty. PMID:26043049

  9. From Retention to Satisfaction: New Outcomes for Assessing the Freshman Experience. AIR 1994 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Sanders, Liz; And Others

    To meet accountability challenges from a customer-satisfaction perspective, an urban institution of higher education has developed an integrated approach to studying the freshman year experience in order to develop comprehensive outcomes measures for assessing freshman success. Multiple sources of data (freshman satisfaction survey data,…

  10. Ph.D. in French Studies Plan for Assessment of Student Learning Outcomes

    E-print Network

    New Mexico, University of

    Ph.D. in French Studies Plan for Assessment of Student Learning Outcomes The University of New, Assistant Professor of French, rvallury@unm.edu D. Broad Program Goals & Measurable Student Learning and Literatures 3. Date: January 15, 2009 B. Academic Program of Study Ph.D. in French Studies C. Contact Person

  11. FRENCH111/112 ULO Course Learning Outcome Assessment Method Pedagogy

    E-print Network

    Barrash, Warren

    FRENCH111/112 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read and understand written discourse in French at the elementary level Exams and Quizzes. Portions of this course will use Tutoring 10-02 Write and/or speak clearly and suitably in French for a variety of purposes

  12. Two Loops That Need Closing: Contingent Faculty Perceptions of Outcomes Assessment

    ERIC Educational Resources Information Center

    Scott, Gray; Danley-Scott, Jennifer

    2015-01-01

    The existing literature on non-tenure-track (NTT) faculty focuses largely on whether relying on contingent faculty is harmful to students. However, studies rarely survey contingent faculty or explore how to increase NTT faculty participation in outcomes assessment, even though contingent faculty teach most general education courses. Our survey of…

  13. 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…

  14. Outcomes Assessment and Program Improvement Ph.D. in Business Administration

    E-print Network

    Liberzon, Daniel

    of Business Administration encourages close, personal contact between faculty and students. SmallOutcomes Assessment and Program Improvement Ph.D. in Business Administration SECTION 1 ­ PAST.D. curriculum, and revised the Ph.D. handbook. The program was adopted by the Department of Business

  15. 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…

  16. Outcomes Assessment and Program Improvement Master of Science in Technology Management

    E-print Network

    Liberzon, Daniel

    Outcomes Assessment and Program Improvement Master of Science in Technology Management SECTION 1 conceived Master of Science in Technology Management Program. As part of the campus approval process for new of Science in Business Administration with an emphasis in Technology Management. The Technology Management

  17. Assessment of Educational Outcomes in Pediatric Dentistry: A Site Examiner's Perspective.

    ERIC Educational Resources Information Center

    Casamassimo, Paul S.

    1990-01-01

    Outcomes assessment reduced to its simplest definition is quality control. Characteristics of the new Accreditation Standards for Dental Education Programs include: patient oriented, take a definite posture in relation to the specialties, create a minimally educated practitioner, are process oriented, and provide a form of quality assurance in…

  18. Outcomes Assessment in Postsecondary Occupational Programs: A Consortial Approach. Project Report.

    ERIC Educational Resources Information Center

    State Univ. of New York, Albany. Two Year Coll. Development Center.

    Outcome assessment has come to mean documentation, beyond grades and numbers of graduates, of higher education's results as proof of quality and evidence of improving undergraduate education. This document describes a consortium formed by the Two-Year College Development Center of the State University of New York, the Bureau of Postsecondary…

  19. 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…

  20. Faculty and Administrator Beliefs Regarding Assessment of Student Learning Outcomes: A Community College Case Study

    ERIC Educational Resources Information Center

    Strollo, Toni Marie

    2011-01-01

    This study examined higher education faculty and academic administrator (AO) beliefs regarding the value of assessment of student learning outcomes (ASLO) as a means for improving teaching and learning at a Southeastern community college known for its commitment as a learning college and as an exemplar for such efforts. Faculty and AOs at this…

  1. A Qualitative Assessment of the Learning Outcomes of Teaching Introductory American Politics in Comparative Perspective

    ERIC Educational Resources Information Center

    Gelbman, Shamira M.

    2011-01-01

    This article discusses the findings of an ethnographic content analysis of students' written reflections as a means for assessing the learning outcomes of teaching introductory American politics in comparative perspective. It focuses especially on determining whether and how this approach enhanced students' understanding and retention of knowledge…

  2. 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…

  3. The Integration of Outcomes Assessment Information in the Management of Arizona Community Colleges

    ERIC Educational Resources Information Center

    Fleishman, Joseph H.

    2009-01-01

    Colleges and universities throughout the country are increasingly coming under pressure from accrediting institutions and legislative bodies to implement comprehensive outcomes assessment initiatives designed to measure and document student performance. Over the past ten years pressure has been directed towards colleges to reshape their current…

  4. 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...

  5. Assessment Theory and Practice of Students' Outcomes in the Nordic Countries

    ERIC Educational Resources Information Center

    Lysne, Anders

    2006-01-01

    In the latest decades assessment in education has become a very controversial issue in many western countries, and especially so in the Nordic countries, where the controversy became most passionate in Norway. It was really not a debate about whether or not formal marks should be used in communication of educational outcomes for the individual…

  6. Speech and Hearing Sciences Plan for Assessment of Student Learning Outcomes

    E-print Network

    New Mexico, University of

    Speech and Hearing Sciences Plan for Assessment of Student Learning Outcomes The University of New Mexico A. College, Department, and Date 1. College: Arts and Sciences 2. Department: Speech and Hearing Sciences 3. Date: 05/12/08 B. Academic Program of Study B.A., Speech and Hearing Sciences C. Contact

  7. 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…

  8. The Impact of Pain Assessment on Critically Ill Patients' Outcomes: A Systematic Review

    PubMed Central

    Georgiou, Evanthia; Hadjibalassi, Maria; Lambrinou, Ekaterini; Andreou, Panayiota; Papathanassoglou, Elizabeth D. E.

    2015-01-01

    In critically ill patients, pain is a major problem. Efficient pain management depends on a systematic, comprehensive assessment of pain. We aimed to review and synthesize current evidence on the impact of a systematic approach to pain assessment on critically ill patients' outcomes. A systematic review of published studies (CINAHL, PUBMED, SCOPUS, EMBASE, and COCHRANE databases) with predetermined eligibility criteria was undertaken. Methodological quality was assessed by the EPHPP quality assessment tool. A total of 10 eligible studies were identified. Due to big heterogeneity, quantitative synthesis was not feasible. Most studies indicated the frequency, duration of pain assessment, and types of pain assessment tools. Methodological quality assessment yielded “strong” ratings for 5/10 and “weak” ratings for 3/10 studies. Implementation of systematic approaches to pain assessment appears to associate with more frequent documented reports of pain and more efficient decisions for pain management. There was evidence of favorable effects on pain intensity, duration of mechanical ventilation, length of ICU stay, mortality, adverse events, and complications. This systematic review demonstrates a link between systematic pain assessment and outcome in critical illness. However, the current level of evidence is insufficient to draw firm conclusions. More high quality randomized clinical studies are needed. PMID:26558273

  9. ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Create a portfolio that accentuates the indiv-

    E-print Network

    Barrash, Warren

    and peer assessment of curriculum vita/ resume ; Faculty and peer assessment of letter. Lecture on content;Faculty and peer assessment of curriculum vita/ resume;Faculty and peer assessment of letter. Lecture on contentANTH492 ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Create a portfolio

  10. 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…

  11. 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…

  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. 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

  14. Executive Functioning in Individuals with a History of ASDs Who Have Achieved Optimal Outcomes

    PubMed Central

    Troyb, Eva; Rosenthal, Michael; Eigsti, Inge-Marie; Kelley, Elizabeth; Tyson, Katherine; Orinstein, Alyssa; Barton, Marianne; Fein, Deborah

    2014-01-01

    Executive functioning (EF) is examined among children and adolescents once diagnosed with an autism spectrum disorder (ASD), but who no longer meet diagnostic criteria. These individuals have average social and language skills, receive minimal school support and are considered to have achieved “optimal outcomes” (OOs). Since residual impairments in these individuals might be expected in deficits central to autism, and in developmentally advanced skills, EF was examined in: 34 individuals who achieved OOs, 43 individuals with high-functioning autism (HFA), and 34 typically-developing (TD) peers. Groups were matched on age (M=13.49), gender, and NVIQ, but differed on VIQ (HFAassessment, all three groups demonstrated average EF; however, the OO and HFA groups exhibited more impulsivity and less efficient planning and problem-solving than the TD group, and more HFA participants exhibited below average inhibition than did OO and TD participants. Parent report measures revealed average EF among the OO and TD groups; however, the OO group exhibited more difficulty than the TD group on set-shifting and working memory. HFA participants demonstrated more difficulty on all parent reported EF domains, with a clinical impairment in attention-shifting. Results suggest that EF in OO appears to be within the average range, even for functions that were impaired among individuals with HFA. Despite their average performance, however, the OO and TD groups differed on measures of impulsivity, set-shifting, problem-solving, working memory, and planning, suggesting that the OO group does not have the above-average EF scores of the TD group despite their high-average IQs. PMID:23731181

  15. Interventions for postnatal depression assessing the mother–infant relationship and child developmental outcomes: a systematic review

    PubMed Central

    Tsivos, Zoe-Lydia; Calam, Rachel; Sanders, Matthew R; Wittkowski, Anja

    2015-01-01

    Postnatal depression (PND) has negative effects on maternal well-being as well as implications for the mother–infant relationship, subsequent infant development, and family functioning. There is growing evidence demonstrating that PND impacts on a mother’s ability to interact with sensitivity and responsiveness as a caregiver, which may have implications for the infant’s development of self-regulatory skills, making the infant more vulnerable to later psychopathology. Given the possible intergenerational transmission of risk to the infant, the mother–infant relationship is a focus for treatment and research. However, few studies have assessed the effect of treatment on the mother–infant relationship and child developmental outcomes. The main aim of this paper was to conduct a systematic review and investigate effect sizes of interventions for PND, which assess the quality of the mother–infant dyad relationship and/or child outcomes in addition to maternal mood. Nineteen studies were selected for review, and their methodological quality was evaluated, where possible, effect sizes across maternal mood, quality of dyadic relationship, and child developmental outcomes were calculated. Finally, clinical implications in the treatment of PND are highlighted and recommendations made for further research. PMID:25960678

  16. Outcomes of Proton Therapy for Patients With Functional Pituitary Adenomas

    SciTech Connect

    Wattson, Daniel A.; Tanguturi, Shyam K.; Spiegel, Daphna Y.; Niemierko, Andrzej; Biller, Beverly M.K.; Nachtigall, Lisa B.; Bussière, Marc R.; Swearingen, Brooke; Chapman, Paul H.; Loeffler, Jay S.; Shih, Helen A.

    2014-11-01

    Purpose/Objective(s): This study evaluated the efficacy and toxicity of proton therapy for functional pituitary adenomas (FPAs). Methods and Materials: We analyzed 165 patients with FPAs who were treated at a single institution with proton therapy between 1992 and 2012 and had at least 6 months of follow-up. All but 3 patients underwent prior resection, and 14 received prior photon irradiation. Proton stereotactic radiosurgery was used for 92% of patients, with a median dose of 20 Gy(RBE). The remainder received fractionated stereotactic proton therapy. Time to biochemical complete response (CR, defined as ?3 months of normal laboratory values with no medical treatment), local control, and adverse effects are reported. Results: With a median follow-up time of 4.3 years (range, 0.5-20.6 years) for 144 evaluable patients, the actuarial 3-year CR rate and the median time to CR were 54% and 32 months among 74 patients with Cushing disease (CD), 63% and 27 months among 8 patients with Nelson syndrome (NS), 26% and 62 months among 50 patients with acromegaly, and 22% and 60 months among 9 patients with prolactinomas, respectively. One of 3 patients with thyroid stimulating hormone—secreting tumors achieved CR. Actuarial time to CR was significantly shorter for corticotroph FPAs (CD/NS) compared with other subtypes (P=.001). At a median imaging follow-up time of 43 months, tumor control was 98% among 140 patients. The actuarial 3-year and 5-year rates of development of new hypopituitarism were 45% and 62%, and the median time to deficiency was 40 months. Larger radiosurgery target volume as a continuous variable was a significant predictor of hypopituitarism (adjusted hazard ratio 1.3, P=.004). Four patients had new-onset postradiosurgery seizures suspected to be related to generously defined target volumes. There were no radiation-induced tumors. Conclusions: Proton irradiation is an effective treatment for FPAs, and hypopituitarism remains the primary adverse effect.

  17. Programmatic assessment of a university-based implant training program using patient-reported outcomes.

    PubMed

    Al-Sabbagh, Mohanad; Jenkins, Diane W; de Leeuw, Reny; Nihill, Patricia; Robinson, Fonda G; Thomas, Mark V

    2014-11-01

    The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program. PMID:25362695

  18. [Assessment of cognitive functions in internal medicine].

    PubMed

    Capron, J

    2015-12-01

    The evaluation of cognitive functions can be performed using two approaches: a quantitative one, based on screening tools; a qualitative one, based on the examination of specific cognitive functions. The quantitative approach offers a pragmatic process: to screen rapidly for a cognitive dysfunction that may require assistance or treatments. We will present three screening tools and their diagnostic value: the clock test, the Mini Mental State Examination and the Montreal Cognitive Assessment. They help select patients who require a more detailed examination to precisely diagnose their cognitive dysfunction. We propose a way to perform a detailed cognitive examination at the bedside, including the examination of alertness, attention, memory, language, frontal functions, praxis and hemi-neglect. This simple examination indicates the location of the cerebral lesion and sometimes suggests the underlying disease. PMID:26346265

  19. 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

  20. 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

  1. New Dental Accreditation Standard on Critical Thinking: A Call for Learning Models, Outcomes, Assessments.

    PubMed

    Johnsen, David C; Williams, John N; Baughman, Pauletta Gay; Roesch, Darren M; Feldman, Cecile A

    2015-10-01

    This opinion article applauds the recent introduction of a new dental accreditation standard addressing critical thinking and problem-solving, but expresses a need for additional means for dental schools to demonstrate they are meeting the new standard because articulated outcomes, learning models, and assessments of competence are still being developed. Validated, research-based learning models are needed to define reference points against which schools can design and assess the education they provide to their students. This article presents one possible learning model for this purpose and calls for national experts from within and outside dental education to develop models that will help schools define outcomes and assess performance in educating their students to become practitioners who are effective critical thinkers and problem-solvers. PMID:26427773

  2. Agents of Change: Examining the Role of Student Learning Outcomes and Assessment Coordinators in California Community Colleges

    ERIC Educational Resources Information Center

    Gilbert, Greg, Ed.; Buechner, Marybeth, Ed.

    2007-01-01

    Formally stating and assessing student learning outcomes (SLOs) is a new focus for California community colleges required by the 2002 Accreditation Standards. This paper, the first in a series, explores one aspect of this sea change across the state: the emergence of a new group of faculty leaders, Student Learning Outcomes and Assessment

  3. Epigenetic regulation of human placental function and pregnancy outcome: considerations for causal inference.

    PubMed

    Januar, Vania; Desoye, Gernot; Novakovic, Boris; Cvitic, Silvija; Saffery, Richard

    2015-10-01

    Epigenetic mechanisms, often defined as regulating gene activity independently of underlying DNA sequence, are crucial for healthy development. The sum total of epigenetic marks within a cell or tissue (the epigenome) is sensitive to environmental influence, and disruption of the epigenome in utero has been associated with adverse pregnancy outcomes. Not surprisingly, given its multifaceted functions and important role in regulating pregnancy outcome, the placenta shows unique epigenetic features. Interestingly however, many of these are only otherwise seen in human malignancy (the pseudomalignant placental epigenome). Epigenetic variation in the placenta is now emerging as a candidate mediator of environmental influence on placental functioning and a key regulator of pregnancy outcome. However, replication of findings is generally lacking, most likely due to small sample sizes and a lack of standardization of analytical approaches. Defining DNA methylation "signatures" in the placenta associated with maternal and fetal outcomes offers tremendous potential to improve pregnancy outcomes, but care must be taken in interpretation of findings. Future placental epigenetic research would do well to address the issues present in epigenetic epidemiology more generally, including careful consideration of sample size, potentially confounding factors, issues of tissue heterogeneity, reverse causation, and the role of genetics in modulating epigenetic profile. The importance of animal or in vitro models in establishing a functional role of epigenetic variation identified in human beings, which is key to establishing causation, should not be underestimated. PMID:26428498

  4. Comparison of ASSESS neutralization module results with actual small force engagement outcomes

    SciTech Connect

    Gardner, B.H.; Snell, M.K.; Paulus, W.K. )

    1991-01-01

    The ASSESS Neutralization module (Neutralization) is part of the Analytic System and Software for Evaluation of Safeguards and Security (ASSESS), a vulnerability assessment tool. Neutralization models a fire fight between security inspectors (SIs) and adversaries. This paper reports that a comparison has been made between actual outcomes of police and small military engagements and the results predicted by the Neutralization module for similar scenarios. The results of this comparison show a surprising correlation between predicted outcomes (based on numbers of combatants, weapon types, and exposures, etc.) and the actual outcomes of the engagements analyzed. The importance of this analysis is that given the defenders have intelligence on actual adversary characteristics or are protecting against a design basis threat, defense capabilities can be evaluated before an engagement. Results could then be used to develop a favorable probability of a desired outcome. For example, law enforcement agencies are frequently able to compile the number of criminals, types of weaponry, willingness to use force, etc., from analysis of crime scenes.

  5. Direct and Mediated Effects of Cognitive Function with Multidimensional Outcome Measures in Schizophrenia: The Role of Functional Capacity

    PubMed Central

    Ho, Jennifer S.; Moore, Raeanne C.; Davine, Taylor; Cardenas, Veronica; Bowie, Christopher R.; Patterson, Thomas L.; Mausbach, Brent T.

    2013-01-01

    Although cognitive ability is a known predictor of real-world functioning in schizophrenia, there has been an expanded interest in understanding the mechanisms by which it explains real-world functioning in this population. We examined the extent to which functional capacity (i.e., skills necessary to live independently) mediated the relationship between cognitive ability and both observer and self-reported real-world functioning in 138 outpatients with schizophrenia. Functional capacity significantly mediated the relations between cognitive ability and observer rated real world functioning, but not self-reported real world functioning, with small to medium effect sizes observed for all outcomes. The role of cognitive ability in observer vs. self-reported real-world functioning may be explained by different mechanisms. PMID:23984631

  6. Gait Analysis at Multiple Speeds Reveals Differential Functional and Structural Outcomes in Response to Graded Spinal Cord Injury

    PubMed Central

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

    2014-01-01

    Abstract 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

  7. 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

  8. 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

  9. Aesthetic and Functional Outcomes of the Innervated and Thinned Anterolateral Thigh Flap in Reconstruction of Upper Limb Defects

    PubMed Central

    Torres-Ortíz Zermeño, Carlos Alberto; López Mendoza, Javier

    2014-01-01

    Background. The anterolateral thigh (ALT) flap has been widely described in reconstruction of the upper extremity. However, some details require refinement to improve both functional and aesthetic results. Methods. After reconstruction of upper extremity defects using thinned and innervated ALT flaps, functional and aesthetic outcomes were evaluated with the QuickDASH scale and a Likert scale for aesthetic assessment of free flaps, respectively. Results. Seven patients with a mean follow-up of 11.57 months and average flap thickness of 5?mm underwent innervation by an end-to-end neurorrhaphy. The average percentage of disability (QuickDASH) was 21.88% with tenderness, pain, temperature, and two-point discrimination present in 100% of cases, and the aesthetic result gave an overall result of 15.40 (good) with the best scores in color and texture. Conclusions. Simultaneous thinning and innervation of the ALT flap lead to a good cosmetic result and functional outcome with a low percentage of disability, which could result in minor surgical procedures and better recovery of motor and sensory function. Level of Evidence. IV. PMID:25478219

  10. 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…

  11. Customizing Instruction To Maximize Functional Outcomes for Students with Profound Multiple Disabilities.

    ERIC Educational Resources Information Center

    Smith, Pamela D.; Gast, David L.; Logan, Kent R.; Jacobs, Heidi A.

    2001-01-01

    This article describes a process for customizing instruction for students with profound multiple disabilities that has been used to design instructional programs and maximize attainment of functional outcomes. The process focuses on collaborative teamwork and problem solving to design and implement instructional programs and includes five major…

  12. Functional Outcomes and Consumer Satisfaction in the Independent Living Program for Older Individuals Who Are Blind

    ERIC Educational Resources Information Center

    Moore, J. Elton; Steinman, Bernard A.; Giesen, J. Martin; Frank, John J.

    2006-01-01

    This study of a national sample of elders served by the Independent Living Program for Older Individuals Who Are Blind found that, overall, they were highly satisfied with the quality and timeliness of services and help in achieving independent living goals. A slight improvement was found in their perceptions of functional outcomes from 1999 to…

  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. 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...

  15. 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…

  16. 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…

  17. Thyroid function tests and early outcomes of acute ischemic stroke in older euthyroid patients.

    PubMed

    Forti, Paola; Maioli, Fabiola; Coveri, Maura; Nativio, Valeria; Arnone, Giorgia; Loreti, Alice; Zoli, Marco; Sacquegna, Tommaso; Procaccianti, Gaetano

    2015-01-01

    Blood thyroid function tests (TFT) are routinely used to screen for thyroid disorders in several clinical settings. TFT on hospital admission may also be useful prognostic predictors of acute IS: according to recent evidence, poststroke outcome is better in patients with lower thyroid function and worse in those with higher thyroid function. However, previous reports are few and mostly compared patients with thyroid disorders to euthyroid patients. Thyroid disorders are known risk factors for cerebrovascular disease. However, hyperthyroidism is related to cardioembolic IS whereas hypothyroidism is related to atherosclerotic risk factors. Therefore, findings from available studies of TFT might just reflect the worse prognosis of cardioembolic IS compared to other IS subtypes. Another limitation of previous studies is the lack of information for older persons, who represent three quarters of all IS patients. In this paper, we investigated whether serum thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) measured on Stroke Unit (SU) admission are associated with early outcomes of acute IS in 775 euthyroid patients aged ?65 years (mean age 80.1±8.7 years). Two composite outcomes were investigated: poor functional outcome (death during SU stay or disability at SU discharge), and unfavorable discharge setting (death during SU stay, transfer from SU to other acute hospital unit or transfer from SU to long-term care-facilities as opposed to direct discharge home). Analyses were performed using logistic regression models. Curvilinear associations were tested including TFT as polynomial terms. Models were adjusted for demographics, prestroke, and IS-related confounders. We found that lower TSH had a complex curvilinear association with poor functional outcome and that the shape of the associations changed with age. At age 65, the curve was U-shaped: outcome risk decreased with increasing TSH, reached its minimum at TSH near 3.00mUI/L and then started to rise. Between ages 70 and 75, however, the shape of the curve straightened and, starting from age 80 took an inverted U-shape: outcome risk rose with increasing TSH, reached its maximum at TSH values that progressively shifted upward with increasing age (from 1.70mU/L at age 80 to about 2.20mUI/L at age 90), then started to decrease. A linear inverse association was found between FT3 and unfavorable discharge setting. Our study suggests that measurement of TFT on SU admission can provide independent prognostic information for early outcomes of acute IS in older euthyroid patients. PMID:25449856

  18. Assessing the Validity of Surrogate Outcomes for ESRD: A Meta-Analysis.

    PubMed

    Jun, Min; Turin, Tanvir Chowdhury; Woodward, Mark; Perkovic, Vlado; Lambers Heerspink, Hiddo J; Manns, Braden J; Tonelli, Marcello; Hemmelgarn, Brenda R

    2015-09-01

    Validation of current and promising surrogate outcomes for ESRD in randomized controlled trials (RCTs) has been limited. We conducted a systematic review and meta-analysis of RCTs to further inform the ability of surrogate outcomes for ESRD to predict the efficacy of various interventions on ESRD. MEDLINE, EMBASE, and CENTRAL (from inception through September 2013) were searched. All RCTs in adults with proteinuria, diabetes, or CKD stages 1-4 or renal transplant recipients reporting ?10 ESRD events and a surrogate outcome (change in proteinuria or doubling of serum creatinine [DSCR]) for ESRD during a ?1-year follow-up were included. Two reviewers abstracted trial characteristics and outcome data independently. To assess the correlation between the surrogate outcomes and ESRD, we determined the treatment effect ratio (TER), defined as the ratio of the treatment effects on ESRD and the effects on the change in surrogate outcomes. TERs close to 1 indicate greater agreement between ESRD and the surrogate, and these ratios were pooled across interventions. We identified 27 trials (97,458 participants; 4187 participants with ESRD). Seven trials reported the effects on change in proteinuria and showed consistent effects for proteinuria and ESRD (TER, 0.82; 95% confidence interval, 0.59 to 1.16), with minimal heterogeneity. Twenty trials reported on DSCR. Treatment effects on DSCR were consistent with the effects on ESRD (TER, 0.98; 95% confidence interval, 0.85 to 1.14), with moderate heterogeneity. In conclusion, DSCR is generally a good surrogate for ESRD, whereas data on proteinuria were limited. Further assessment of the surrogacy of proteinuria using prospective RCTs is warranted. PMID:25556165

  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. Longitudinal Cognitive and Neurobehavioral Functional Outcomes Before and After Repairing Otic Capsule Dehiscence

    PubMed Central

    Wackym, P. Ashley; Balaban, Carey D.; Mackay, Heather T.; Wood, Scott J.; Lundell, Christopher J.; Carter, Dale M.; Siker, David A.

    2016-01-01

    Objective: Patients with peripheral vestibular dysfunction because of gravitational receptor asymmetries display signs of cognitive dysfunction and are assumed to have neurobehavioral sequelae. This was tested with pre- and postoperatively quantitative measurements in three cohort groups with superior semicircular canal dehiscence syndrome (SSCDS) symptoms with: 1) superior canal dehiscence (SCD) repaired via a middle cranial fossa craniotomy and canal plugging only; 2) otic capsule defects not visualized with imaging (no-iOCD) repaired with round window reinforcement (RWR) only; or 3) both SCD plugging and subsequent development of no-iOCD followed by RWR. Study Design: Prospective patient series. Setting: Tertiary referral center. Patients: There were 13 adult and 4 pediatric patients with SSCDS who had completion of neuropsychology test batteries pre- and every 3 months postoperatively. Eight patients had no-iOCD and RWR exclusively, 5 had SCD and plugging exclusively, and 4 had both SCD plugging and then development of no-iOCD with RWR. These cohorts included SSCDS with 2 different dehiscence locations. Interventions: Completion of a neuropsychology test battery preoperatively and at 3, 6, 9, and 12 months postoperatively that included: Beck Depression Inventory-II (BDI); Wide Range Intelligence Test (WRIT FSIQ) including average verbal (crystallized intelligence) and visual (fluid intelligence); Wide Range Assessment of Memory and Learning (WRAML), including the four domains of verbal memory, visual memory, attention/concentration, and working memory; and Delis–Kaplan Executive Function System (D-KEFS). The Dizziness Handicap Inventory (DHI) and the Headache Impact Test (HIT-6) were also completed to assess the impact of their disease on activities pre- and postoperatively. Main Outcome Measures: Quantitative and statistical analysis of their cognitive and neurobehavioral function. Results: The pattern of differences between the SCD group and the no-iOCD group from WRAML verbal, visual, and attention test performance indicate different postoperative clinical trajectories. For the WRAML, there was a statistically significant improvement for visual memory and verbal memory for the no-iOCD only and both (SCD and subsequent no-iOCD) groups, but no mean improvement for the SCD only group. By contrast, the no-iOCD group had significantly lower scores on the WRAML attention test preoperatively, but they recovered postoperatively to match the other groups. The preoperative findings and postoperative outcomes did not differ significantly among patient groups on the WRAML working memory test, D-KEFS motor scores, D-KEFS number and letter scores, or Wide Range Intelligence Test scores. There was a significant decrease in the BDI for all groups. The IQ scores were unchanged. There was a statistically significant improvement in the DHI and HIT-6 scores postoperatively in all groups. Conclusions: There was a marked overall improvement in cognitive and neurobehavioral function postoperatively. Variability may result from duration of underlying disease before intervention. The initial decrement or delay in performance improvement measured in several patients may represent brain reorganization. Greater longitudinal data and greater subject numbers are necessary to better understand and optimize cognitive recovery. PMID:26649608

  1. 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

  2. Assessment of respiratory muscle function and strength.

    PubMed Central

    Syabbalo, N.

    1998-01-01

    Measurement of respiratory muscle strength is useful in order to detect respiratory muscle weakness and to quantify its severity. In patients with severe respiratory muscle weakness, vital capacity is reduced but is a non-specific and relatively insensitive measure. Conventionally, inspiratory and expiratory muscle strength has been assessed by maximal inspiratory and expiratory mouth pressures sustained for 1 s (PImax and PEmax) during maximal static manoeuvre against a closed shutter. However, PImax and PEmax are volitional tests, and are poorly reproducible with an average coefficient of variation of 25%. The sniff manoeuvre is natural and probably easier to perform. Sniff pressure, and sniff transdiaphragmatic pressure are more reproducible and useful measure of diaphragmatic strength. Nevertheless, the sniff manoeuvre is also volition-dependent, and submaximal efforts are most likely to occur in patients who are ill or breathless. Non-volitional tests include measurements of twitch oesophageal, gastric and transdiaphragmatic pressure during bilateral electrical and magnetic phrenic nerve stimulation. Electrical phrenic nerve stimulation is technically difficult and is also uncomfortable and painful. Magnetic phrenic nerve stimulation is less painful and transdiaphragmatic pressure is reproducible in normal subjects. It is a relatively easy test that has the potential to become a widely adopted method for the assessment of diaphragm strength. The development of a technique to measure diaphragmatic sound (phonomyogram) during magnetic phrenic nerve stimulation opens the way for noninvasive assessment of diaphragmatic function. PMID:9683973

  3. Functional Behavior Assessment in Schools: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Anderson, Cynthia M.; Rodriguez, Billie Jo; Campbell, Amy

    2015-01-01

    Functional behavior assessment is becoming a commonly used practice in school settings. Accompanying this growth has been an increase in research on functional behavior assessment. We reviewed the extant literature on documenting indirect and direct methods of functional behavior assessment in school settings. To discern best practice guidelines…

  4. 42 CFR 441.535 - Assessment of functional need.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 false Assessment of functional need. 441.535 Section...441.535 Assessment of functional need. States must conduct...additional qualifications or training requirements for the operation... (c) The assessment of functional need must be conducted...

  5. 42 CFR 441.535 - Assessment of functional need.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 false Assessment of functional need. 441.535 Section...441.535 Assessment of functional need. States must conduct...additional qualifications or training requirements for the operation... (c) The assessment of functional need must be conducted...

  6. 42 CFR 441.535 - Assessment of functional need.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 false Assessment of functional need. 441.535 Section...441.535 Assessment of functional need. States must conduct...additional qualifications or training requirements for the operation... (c) The assessment of functional need must be conducted...

  7. Functional and neuropsychological late outcomes in posterior fossa tumors in children.

    PubMed

    Lassaletta, Alvaro; Bouffet, Eric; Mabbott, Donald; Kulkarni, Abhaya V

    2015-10-01

    Tumors of the posterior fossa (PF) account for up to 60 % of all childhood intracranial tumors. Over the last decades, the mortality rate of children with posterior fossa tumors has gradually decreased. While survival has been the primary objective in most reports, quality of survival increasingly appears to be an important indicator of a successful outcome. Children with a PF tumor can sustain damage to the cerebellum and other brain structures from the tumor itself, concomitant hydrocephalus, the consequences of treatment (surgery, chemotherapy, radiotherapy), or a combination of these factors. Together, these contribute to long-term sequelae in physical functioning, neuropsychological late outcomes (including academic outcome, working memory, perception and estimation of time, and selective attention, long-term neuromotor speech deficits, and executive functioning). Long-term quality of life can also be affected by endocrinological complication or the occurrence of secondary tumors. A significant proportion of survivors of PF tumors require long-term special education services and have reduced rates of high school graduation and employment. Interventions to improve neuropsychological functioning in childhood PF tumor survivors include (1) pharmacological interventions (such as methylphenidate, modafinil, or donepezil), (2) cognitive remediation, and (3) home-based computerized cognitive training. In order to achieve the best possible outcome for survivors, and ultimately minimize long-term complications, new interventions must be developed to prevent and ameliorate the neuro-toxic effects experienced by these children. PMID:26351237

  8. Validation of GAITRite and PROMIS as High-Throughput Physical Function Outcome Measures Following ACL Reconstruction

    PubMed Central

    Papuga, M. Owen; Beck, Christopher A.; Kates, Stephen L.; Schwarz, Edward M.; Maloney, Michael D.

    2014-01-01

    New healthcare demands for quality measures of elective procedures, such as anterior cruciate ligament (ACL) reconstructive surgery, warrant the establishment of high through-put outcomes for high volume clinics. To this end we evaluated the PROMIS and GAITRite as physical function outcome measures to quantify early healing and post-operative complications in 106 patients at pre-op and 3, 10, 20 and 52 weeks post-ACL reconstruction with bone-tendon-bone autograft, and compared the results to the current IKDC validated outcome measure. The results showed that both PROMIS and GAITRite were significantly quicker to administer versus IKDC (p < 0.0001). Additional advantages were that PROMIS and GAITRite detected a significant decrease in physical function at 3 weeks post-op, and a significant improvement at 10 weeks post-op, versus pre-op (p<0.001), which were not detected with IKDC. GAITRite was limited by a low ceiling that could not detect improvement of physical function beyond 20 weeks, while both PROMIS and IKDC detected significant improvement out to 52 weeks postop (p<0.001). Linear regressions demonstrated a significant relationship between IKDC and PROMIS, with a combined correlation value of 0.8954 (p<.001) for all time points. Finally, ROC curve analysis demonstrated that PROMIS is a diagnostic test for poor outcomes. PMID:24532421

  9. Progression free survival and functional outcome after surgical resection of intramedullary ependymomas.

    PubMed

    Abdullah, Kalil G; Lubelski, Daniel; Miller, Jacob; Steinmetz, Michael P; Shin, John H; Krishnaney, Ajit; Mroz, Thomas E; Benzel, Edward C

    2015-12-01

    We present a 15year institutional analysis of the factors affecting progression free survival (PFS) and overall survival (OS) in patients undergoing attempted resection of adult intramedullary spinal cord ependymomas. Intramedullary spinal cord tumors are rare but important clinical entities, and ependymomas are the most commonly encountered intramedullary tumor. In total, 53 adult patients over the span of 15years were analyzed for OS, PFS, and the effects of plane of dissection (POD) and gross total resection (GTR) on functional and long term outcomes. The mean age was 45years and median follow-up was 54months. The follow-up neurological outcome and modified McCormick scale were used to determine the functional outcome. Kaplan-Meier curves were used to calculate progression and survival. The overall ability to achieve GTR was significantly correlated to identification of an intraoperative POD (p<0.001). There was a trend towards increased PFS with the ability to achieve a GTR. There was no significant difference in the pre- and postoperative functional outcome scores. The ability to achieve a GTR is strongly correlated to the identification of a POD in ependymomas. There is a trend towards an increased probability of PFS in intramedullary spinal cord tumors when GTR is achieved. The resection of these tumors is likely to halt, but not reverse, neurological deterioration. PMID:26234635

  10. Neuropsychological Functioning Predicts Community Outcomes in Affective and Non-Affective Psychoses: A 6-month follow-up

    PubMed Central

    Lewandowski, Kathryn E.; Cohen, Bruce M.; Keshavan, Matcheri S.; Sperry, Sarah H.; Öngür, Dost

    2013-01-01

    Introduction Neurocognitive dysfunction is a major symptom feature of schizophrenia and bipolar disorder. A prognostic relationship between cognition and community outcomes is well-documented in schizophrenia and increasingly recognized in bipolar disorder. However, specific associations amongst neurocognition, diagnosis, state symptomatology, and community functioning are unclear, and few studies have compared these relationships amongst patients with affective and non-affective psychoses in the same study. We examined neurocognitive, clinical, and community functioning in a cross-diagnostic sample of patients with psychotic disorders over a 6-month follow-up interval. Method Neurocognitive, clinical and community functioning were assessed in participants with schizophrenia (n=13), schizoaffective disorder (n=17), or bipolar disorder with psychosis (n=18), and healthy controls (n=18) at baseline and 6 months later. Results Neurocognitive functioning was impaired in all diagnostic groups and, despite reductions in primary symptoms, did not recover on most measures over the follow-up period. Neurocognitive impairment was not associated with diagnosis or clinical improvement. Several neurocognitive scores at baseline (but not diagnosis or clinical baseline or follow-up scores) predicted community functioning at follow-up. Discussion In one of the few studies to longitudinally examine neurocognition in association with clinical and outcomes variables in a cross diagnostic sample of psychotic disorders patients, neurocognitive deficits were pronounced across diagnoses and did not recover on most measures despite significant reductions in clinical symptoms. Baseline neurocognitive functioning was the only significant predictor of patients’ community functioning six months later. Efforts to recognize and address cognitive deficits, an approach that has shown promise in schizophrenia, should be extended to all patients with psychosis. PMID:23791391

  11. Assessing the rhinoplasty outcome: inter-rater variability of aesthetic perception in the light of objective facial analysis.

    PubMed

    Ozturk, Kerem; Gode, Sercan; Karahan, Ceyda; Midilli, Rasit

    2015-12-01

    The aim of this study was to assess the success of rhinoplasty by evaluating the inter-rater variability in the light of primary indication as functional or cosmetic. Subjective aesthetic perception was compared with objective facial analysis. 45 rhinoplasty patients were included in the study. 25 had cosmetic plus functional reasons with septal deviation (group 1) and 20 had pure cosmetic reasons without septal deviation (group 2). Preoperatively and 6 months postoperatively, four individuals (patient, surgeon, 2 independent surgeons) rated the aesthetic appearance of the nose with visual analogue scale. Facial photogrammetric analysis was applied. The patient's aesthetic perception score was significantly correlated with the two independent surgeons (p < 0.05) whereas not with the primary surgeons. Regarding the objective parameters, patient's aesthetic perception was significantly correlated with the dorsal alignment in both groups (p < 0.05). General satisfaction score was significantly correlated with the nasal breathing as well as with the aesthetic perception scores in both groups. This correlation was higher for aesthetic perception in group 1 and nasal breathing in group 2. Inter-rater variability of outcome perception was higher in cosmetic patients. Nasal dorsal alignment was the only objective parameter which was correlated with the patient's perception. Patient's perception of outcome has better represented the objective photogrammetric analysis rather than the primary surgeons. An interesting finding was the more significant correlation of general satisfaction with aesthetic perception in the functional group whereas nasal breathing in the cosmetic group. PMID:25563240

  12. Functional and speech outcomes of superiorly based flap pharyngoplasty combined with radical intravelar veloplasty

    PubMed Central

    Ezzat, Abdelrahman E. M.; Khalifa, Rana A.; Akel, Mabrouk M.; El-Shenawy, Hanna M.

    2015-01-01

    Objective The aim of this study was to evaluate functional and speech outcomes of superiorly based pharyngeal flap (SBF) pharyngoplasty combined with radical intravelar veloplasty (RIVVP) for the management of velopharyngeal insufficiency (VPI) following surgically repaired cleft palate. Design A case series with chart review. The study was conducted in academic tertiary care medical centre. Patients and Methods Fifteen patients with VPIs following surgically repaired cleft palate were managed between May 2011 and August 2014, with SBF pharyngoplasty combined with RIVVP. Results We found that the speech defects improved by a success rate of 93.4%; the VP function became normal (circular pattern of closure) in 80% of patients and the postoperative overall success rate of VP competence grades was 93.4%. Moreover, we found that the overall incidence of complications were 33.3%. Conclusion By doing SBF pharyngoplasty combined with RIVVP the surgical procedure was satisfactory in both functional and speech outcomes. PMID:26005709

  13. 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

  14. Pharmacological treatment for attention deficit hyperactivity disorder: functional outcomes in children and adolescents from non-Western countries

    PubMed Central

    Altin, Murat; El-Shafei, Ahmed A; Yu, Maria; Desaiah, Durisala; Treuer, Tamas; Zavadenko, Nikolay; Gao, Hong Yun

    2013-01-01

    Objective: Functional outcomes were measured over a 12-month period in children and adolescents with attention deficit hyperactivity disorder (ADHD) after they received monotherapy. Design: Prospective, observational, noninterventional study. Setting: Conducted in six non-Western countries. Participants: Outpatients 6 to 17 years of age with a verified diagnosis of ADHD in accordance with the Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR), together with their physicians, decided to initiate or switch treatment for ADHD. Patients were prescribed pharmacological monotherapy: methylphenidate (n=221), nootropic agents (n=91), or atomoxetine (n=234). Measurements: Patients were followed for changes in their functional status and quality of life, which were assessed with the Child Health and Illness Profile–Child Edition (CHIP-CE) Achievement domain. Results: At the end of the study, a mean improvement on the CHIP-CE Achievement domain score was observed for all countries and therapies except in Taiwan, where patients received atomoxetine, and in Lebanon, where patients received methylphenidate. No patient experienced a serious adverse event during the study. Four patients discontinued due to a treatment-emergent adverse event. Conclusion: After 12 months of treatment, clinical and functional outcomes were improved in children and adolescents from non-Western countries who initiated and remained on their prescribed pharmacological monotherapy. PMID:24432046

  15. 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

  16. 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

  17. Oxford unicompartmental knee arthroplasty: medial pain and functional outcome in the medium term

    PubMed Central

    2011-01-01

    Background In our experience results of the Oxford unicompartmental knee replacement have not been as good as had been expected. A common post operative complaint is of persistent medial knee discomfort, it is not clear why this phenomenon occurs and we have attempted to address this in our study. Methods 48 patients were retrospectively identified at a mean of 4.5 years (range = 3 to 6 years) following consecutive Oxford medial Unicompartmental Knee arthroplasties for varus anteromedial osteoarthritis. The mean age at implantation was 67 years (range 57-86). Of these 48 patients, 4 had died, 4 had undergone revision of their unicompartmental knee replacements and 2 had been lost to follow up leaving 38 patients with 40 replaced knees available for analysis using the 'new Oxford Knee Score' questionnaire. During assessment patients were asked specifically whether or not they still experienced medial knee discomfort or pain. Results The mean 'Oxford score' was only 32.7 (range = 16 to 48) and 22 of the 40 knees were uncomfortable or painful medially. The accuracy of component positioning was recorded, using standard post operative xrays, by summing the angulation or displacement of each component in two planes from the ideal position (according to the 'Oxford knee system radiographic criteria'). No correlation was demonstrated between the radiographic scores and the 'Oxford scores', or with the presence or absence of medial knee discomfort or pain. Conclusion In our hands the functional outcome following Oxford Unicompartmental knee replacement was variable, with a high incidence of medial knee discomfort which did not correlate with the postoperative radiographic scores, pre-op arthritis and positioning of the prosthesis. PMID:21981987

  18. Is the Complete Resection of Craniopharyngiomas in Adults Feasible Considering Both the Oncologic and Functional Outcomes?

    PubMed Central

    Lee, Eun Jung; Cho, Young Hyun; Hong, Seok Ho; Kim, Jeong Hoon

    2015-01-01

    Objective To assess the impact of the complete resection of craniopharyngioma (CP) in adults on oncologic and functional outcomes. Methods We retrospectively analyzed 82 patients with CP who were surgically treated by the same neurosurgeon at our institution between January 1994 and December 2012. Results Gross total resection (GTR) was achieved in 71 patients (86.6%), near total resection (NTR) in 7 patients (8.5%), and subtotal resection (STR) in 3 patients (3.7%). The disease-specific overall survival rate was 100% with the exclusion of 2 surgery-related mortalities. The overall recurrence rate was 12.2% (10 of 82 patients), however the recurrence rate according to extent of resection (EOR) was 9.9% (7 of 71 patients) after GTR, 14.3% (1 of 7 patients) after NTR, and 66.7% (2 of 3 patients) after STR. The overall recurrence-free survival (RFS) rates at 5 and 10 years were 87.0% and 76.8%, respectively. Postoperatively, most patients (86.3%) needed hormone replacement for at least 1 hypothalamic-pituitary axis. Vision improved in 56.4% of the patients with preoperative abnormal vision, but deteriorated in 27.4% of patients. Hypothalamic dysfunction developed in 32.9% of patients. There were no significant differences in the risks of pituitary dysfunction, visual deterioration, or hypothalamic dysfunction between the groups with complete vs. incomplete removal. The overall rate of postoperative complications was 22.0%, which did not differ between groups (p=0.053). Conclusion The complete removal of a CP at first surgery can provide a chance for a cure with acceptable morbidity and mortality risks. PMID:26713143

  19. 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.

  20. An analysis of assessment outcomes from eight years' operation of the Australian border weed risk assessment system.

    PubMed

    Weber, Jason; Dane Panetta, F; Virtue, John; Pheloung, Paul

    2009-02-01

    The majority of Australian weeds are exotic plant species that were intentionally introduced for a variety of horticultural and agricultural purposes. A border weed risk assessment system (WRA) was implemented in 1997 in order to reduce the high economic costs and massive environmental damage associated with introducing serious weeds. We review the behaviour of this system with regard to eight years of data collected from the assessment of species proposed for importation or held within genetic resource centres in Australia. From a taxonomic perspective, species from the Chenopodiaceae and Poaceae were most likely to be rejected and those from the Arecaceae and Flacourtiaceae were most likely to be accepted. Dendrogram analysis and classification and regression tree (TREE) models were also used to analyse the data. The latter revealed that a small subset of the 35 variables assessed was highly associated with the outcome of the original assessment. The TREE model examining all of the data contained just five variables: unintentional human dispersal, congeneric weed, weed elsewhere, tolerates or benefits from mutilation, cultivation or fire, and reproduction by vegetative propagation. It gave the same outcome as the full WRA model for 71% of species. Weed elsewhere was not the first splitting variable in this model, indicating that the WRA has a capacity for capturing species that have no history of weediness. A reduced TREE model (in which human-mediated variables had been removed) contained four variables: broad climate suitability, reproduction in less or than equal to 1year, self-fertilisation, and tolerates and benefits from mutilation, cultivation or fire. It yielded the same outcome as the full WRA model for 65% of species. Data inconsistencies and the relative importance of questions are discussed, with some recommendations made for improving the use of the system. PMID:18339471

  1. A numerical scale to assess the outcomes of metabolic/bariatric surgery (NOMS)

    PubMed Central

    Michalik, Maciej; Buchwald, Henry

    2015-01-01

    Introduction Absent today is a simple numerical system of outcomes assessment that recognizes that bariatric surgery is metabolic surgery and incorporates weight loss, hypertension control, and type 2 diabetes control. Aim To introduce a simple, new Numerical Scale to Assess the Outcomes of Metabolic Surgery (NOMS). Material and methods For the stratification of weight outcomes, we used the percentage excess weight loss (%EWL); for hypertension, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) combined with medication usage; and for type 2 diabetes, the hemoglobin A1c (HbA1c) value combined with medication usage. Results Utilizing the guidelines of the American Diabetes Association, the Working Group of the European Society of Hypertension, the European Society of Cardiology, and the American College of Cardiology/American Heart Association, we propose for %EWL: W1 ? 50, W2 > 25 and < 50, and W3 ? 25; for hypertension H1 SBP/DPB < 140/90 mm Hg on no medication, H2 SBP/DBP ? 140/90 mm Hg with improvement of SBP or possible reduction of antihypertensive medication, and H3 no change or SBP higher than before surgery; for diabetes mellitus D1 HbA1c ? 7% and no medication, D2 HbA1c > 7% with a decrease of the HbA1c level or possible reduction of medication, D3 no change in HbA1c or HbA1c higher than before surgery. Designations of H0 and D0 are given if hypertension or diabetes was not present before surgery. Patient examples for numerical scores are provided. Conclusions The introduction of our numerical scale (NOMS) can be of benefit in metabolic/bariatric outcomes assessment; communications among metabolic/bariatric surgery centers, physicians, and patients; and for more precise reporting in the evidence-based literature.

  2. Posttraumatic midshaft clavicular shortening does not result in relevant functional outcome changes

    PubMed Central

    Stegeman, Sylvia A; de Witte, Pieter Bas; Boonstra, Sjoerd; de Groot, Jurriaan H; Nagels, Jochem; Krijnen, Pieta; Schipper, Inger B

    2015-01-01

    Background and purpose Shoulder function may be changed after healing of a nonoperatively treated clavicular fracture, especially in cases of clavicular shortening or mal-union. We investigated scapular orientations and functional outcome in healed clavicular fractures with and without clavicular shortening. Patients and methods 32 participants with a healed nonoperatively treated midshaft clavicular fracture were investigated. Motions of the thorax, arm, and shoulder were recorded by standardized electromagnetic 3D motion tracking. The DASH score and Constant-Murley score were used to evaluate functional outcome. Orientation of the scapula and humerus at rest and during standardized tasks, and strength and function of the affected shoulders were compared with corresponding values for the uninjured contralateral shoulders. Results Mean clavicular shortening was 25 mm (SD 16). Scapula protraction had increased by mean 4.4° in rest position in the affected shoulders. During abduction, slightly more protraction, slightly more lateral rotation, and slightly less backward tilt was found for the affected shoulders. For anteflexion, the scapular orientations of the affected shoulders also showed slightly increased protraction, slightly increased lateral rotation, and slightly reduced backward tilt. Scapulohumeral kinematics, maximum humerus angles, and strength were not associated with the degree of clavicular shortening. All participants had excellent performance on the Constant-Murley score and DASH score. Interpretation Scapulohumeral kinematics in shoulders with a healed clavicular fracture differ from those in uninjured shoulders, but these changes are small, do not result in clinically relevant changes in outcome, and do not relate to the amount of clavicular shortening. These findings do not support routine operative reduction and fixation of shortened midshaft clavicular fractures based on the argument of functional outcome. PMID:25872962

  3. Serum YKL-40 Levels Correlate with Infarct Volume, Stroke Severity, and Functional Outcome in Acute Ischemic Stroke Patients

    PubMed Central

    Park, Hyun Young; Jun, Chang-Duk; Jeon, Se-Jeong; Choi, See-Sung; Kim, Hak-Ryul; Choi, Dan-Bee; Kwak, Seongae; Lee, Hak-Seung; Cheong, Jin Sung; So, Hong-Seob; Lee, Young-Jin; Park, Do-Sim

    2012-01-01

    Background and Purpose YKL-40 is associated with various neurological disorders. However, circulatory YKL-40 levels early after onset of acute ischemic stroke (AIS) have not been systematically assessed. We aimed to identify the temporal changes and clinical usefulness of measuring serum YKL-40 immediately following AIS. Methods Serum YKL-40 and C-reactive protein (CRP) levels were monitored over time in AIS patients (n?=?105) and compared with those of stroke-free controls (n?=?34). Infarct volume and stroke severity (National Institutes of Health Stroke Scale; NIHSS) were measured within 48 hours of symptom onset, and functional outcome (modified Rankin Scale; mRS) was measured 3 months after AIS. Results Within 12 hours of symptom onset, levels of YKL-40 (251 vs. 41 ng/mL) and CRP (1.50 vs. 0.96 µg/mL) were elevated in AIS patients compared to controls. The power of YKL-40 for discriminating AIS patients from controls was superior to that of CRP (area under the curve 0.84 vs. 0.64) and YKL-40 (r?=?0.26, P<0.001) but not CRP levels were correlated with mRS. On day 2 of admission (D2), YKL-40 levels correlated with infarct volume and NIHSS. High YKL-40 levels predicted poor functional outcome (odds ratio 5.73, P?=?0.03). YKL-40 levels peaked on D2 and declined on D3, whereas CRP levels were highest on D3. Conclusions Our results demonstrate serial changes in serum YKL-40 levels immediately following AIS and provide the first evidence that it is a valid indicator of AIS extent and an early predictor of functional outcome. PMID:23272150

  4. Heterogeneous Disease Trajectories Explain Variable Radiographic, Function and Quality of Life Outcomes in the Canadian Early Arthritis Cohort (CATCH).

    PubMed

    Barnabe, Cheryl; Sun, Ye; Boire, Gilles; Hitchon, Carol A; Haraoui, Boulos; Thorne, J Carter; Tin, Diane; van der Heijde, Désirée; Curtis, Jeffrey R; Jamal, Shahin; Pope, Janet E; Keystone, Edward C; Bartlett, Susan; Bykerk, Vivian P

    2015-01-01

    Our objective was to identify distinct trajectories of disease activity state (DAS) and assess variation in radiographic progression, function and quality of life over the first two years of early rheumatoid arthritis (ERA). The CATCH (Canadian early ArThritis CoHort) is a prospective study recruiting ERA patients from academic and community rheumatology clinics in Canada. Sequential DAS28 scores were used to identify five mutually exclusive groups in the cohort (n = 1,586) using growth-based trajectory modeling. Distinguishing baseline sociodemographic and disease variables, treatment required, and differences in radiographic progression and quality of life measures over two years were assessed. The trajectory groups are characterized as: Group 1 (20%) initial high DAS improving rapidly to remission (REM); Group 2 (21%) initial moderate DAS improving rapidly to REM; Group 3 (30%) initial moderate DAS improving gradually to low DAS; Group 4 (19%) initial high DAS improving continuously to low DAS; and Group 5 (10%) initial high DAS improving gradually only to moderate DAS. Groups differed significantly in age, sex, race, education, employment, income and presence of comorbidities. Group 5 had persistent steroid requirements and the highest biologic therapy use. Group 2 had lower odds (OR 0.22, 95%CI 0.09 to 0.58) and Group 4 higher odds (OR 1.94, 95%CI 0.90 to 4.20) of radiographic progression compared to Group 1. Group 1 had the best improvement in physical function (Health Assessment Questionnaire 1.08 (SD 0.68) units), Physical Component Score (16.4 (SD 10.2) units), Mental Component Score (9.7 (SD 12.5) units) and fatigue (4.1 (SD 3.3) units). In conclusion, distinct disease activity state trajectories explain variable outcomes in ERA. Early prediction of disease course to tailor therapy and addressing social determinants of health could optimize outcomes. PMID:26301589

  5. Heterogeneous Disease Trajectories Explain Variable Radiographic, Function and Quality of Life Outcomes in the Canadian Early Arthritis Cohort (CATCH)

    PubMed Central

    Barnabe, Cheryl; Sun, Ye; Boire, Gilles; Hitchon, Carol A.; Haraoui, Boulos; Thorne, J. Carter; Tin, Diane; van der Heijde, Désirée; Curtis, Jeffrey R.; Jamal, Shahin; Pope, Janet E.; Keystone, Edward C.; Bartlett, Susan; Bykerk, Vivian P.

    2015-01-01

    Our objective was to identify distinct trajectories of disease activity state (DAS) and assess variation in radiographic progression, function and quality of life over the first two years of early rheumatoid arthritis (ERA). The CATCH (Canadian early ArThritis CoHort) is a prospective study recruiting ERA patients from academic and community rheumatology clinics in Canada. Sequential DAS28 scores were used to identify five mutually exclusive groups in the cohort (n = 1,586) using growth-based trajectory modeling. Distinguishing baseline sociodemographic and disease variables, treatment required, and differences in radiographic progression and quality of life measures over two years were assessed. The trajectory groups are characterized as: Group 1 (20%) initial high DAS improving rapidly to remission (REM); Group 2 (21%) initial moderate DAS improving rapidly to REM; Group 3 (30%) initial moderate DAS improving gradually to low DAS; Group 4 (19%) initial high DAS improving continuously to low DAS; and Group 5 (10%) initial high DAS improving gradually only to moderate DAS. Groups differed significantly in age, sex, race, education, employment, income and presence of comorbidities. Group 5 had persistent steroid requirements and the highest biologic therapy use. Group 2 had lower odds (OR 0.22, 95%CI 0.09 to 0.58) and Group 4 higher odds (OR 1.94, 95%CI 0.90 to 4.20) of radiographic progression compared to Group 1. Group 1 had the best improvement in physical function (Health Assessment Questionnaire 1.08 (SD 0.68) units), Physical Component Score (16.4 (SD 10.2) units), Mental Component Score (9.7 (SD 12.5) units) and fatigue (4.1 (SD 3.3) units). In conclusion, distinct disease activity state trajectories explain variable outcomes in ERA. Early prediction of disease course to tailor therapy and addressing social determinants of health could optimize outcomes. PMID:26301589

  6. Outcome Expectancies of Partner Abuse: Assessing Perpetrators' Expectancies and Their Associations with Readiness to Change, Abuse, and Relevant Problems

    ERIC Educational Resources Information Center

    Meis, Laura A.; Murphy, Christopher M.; Winters, Jamie J.

    2010-01-01

    Concerns about low motivation to change among perpetrators of intimate partner violence (IPV) have heightened interest employing behavior change models with this population. In the present investigation, a new scale was developed, the Outcome Expectancies for Partner Abuse (OEPA) Scale, assessing the negative and positive outcome expectancies of…

  7. Assessing the reproducibility of discriminant function analyses

    PubMed Central

    Andrew, Rose L.; Albert, Arianne Y.K.; Renaut, Sebastien; Rennison, Diana J.; Bock, Dan G.

    2015-01-01

    Data are the foundation of empirical research, yet all too often the datasets underlying published papers are unavailable, incorrect, or poorly curated. This is a serious issue, because future researchers are then unable to validate published results or reuse data to explore new ideas and hypotheses. Even if data files are securely stored and accessible, they must also be accompanied by accurate labels and identifiers. To assess how often problems with metadata or data curation affect the reproducibility of published results, we attempted to reproduce Discriminant Function Analyses (DFAs) from the field of organismal biology. DFA is a commonly used statistical analysis that has changed little since its inception almost eight decades ago, and therefore provides an opportunity to test reproducibility among datasets of varying ages. Out of 100 papers we initially surveyed, fourteen were excluded because they did not present the common types of quantitative result from their DFA or gave insufficient details of their DFA. Of the remaining 86 datasets, there were 15 cases for which we were unable to confidently relate the dataset we received to the one used in the published analysis. The reasons ranged from incomprehensible or absent variable labels, the DFA being performed on an unspecified subset of the data, or the dataset we received being incomplete. We focused on reproducing three common summary statistics from DFAs: the percent variance explained, the percentage correctly assigned and the largest discriminant function coefficient. The reproducibility of the first two was fairly high (20 of 26, and 44 of 60 datasets, respectively), whereas our success rate with the discriminant function coefficients was lower (15 of 26 datasets). When considering all three summary statistics, we were able to completely reproduce 46 (65%) of 71 datasets. While our results show that a majority of studies are reproducible, they highlight the fact that many studies still are not the carefully curated research that the scientific community and public expects. PMID:26290793

  8. Functional outcomes of acutely infected knee arthroplasty: a comparison of different surgical treatment options

    PubMed Central

    Dzaja, Ivan; Howard, James; Somerville, Lyndsay; Lanting, Brent

    2015-01-01

    Background An infected total knee arthroplasty (TKA) can be treated with irrigation and débridement with polyethylene exchange (IDPE) or a 2-staged revision (2SR). Although research has examined infection eradication rates of both treatments, patient outcomes have not been reported. We examined patient-reported outcomes following treatment compared with matched, noninfected controls. Methods We retrospectively identified patients with infected TKAs who had undergone the index procedure between May 1991 and November 2011. Patient-reported outcomes included the 12-item Short Form Health Survey, Western Ontario and McMaster Universities Arthritis Index, and Knee Society Scores as well as range of motion. Patients with noninfected primary TKAs matched by age and age-adjusted Charlson Comorbidity Index score were used as controls. Intention-to-treat groups of 2SR and IDPE were used, with the IDPE group subdivided into successful and unsuccessful groups. Results We included 145 patients with infected TKAs with mean follow-up of 64.2 months and 145 controls with a mean follow-up of 35.4 months in our analysis. Outcomes of the controls and the successful IDPE groups were equivalent. The 2SR cohort had lower scores in all categories than controls. There was a 39% success rate in eradicating infection with IDPE. Patients in whom IDPE failed had lower scores in all categories than controls. There was no difference between the failed IDPE group and the 2SR group. Conclusion Controversy regarding treatment options for acutely infected TKA has been focused on infection eradication. However, functional outcomes following treatment need to be taken into consideration. Patients whose infections were successfully treated with IDPE had equivalent outcomes to controls. PMID:26574832

  9. Tagged MRI and PET in severe CAD: discrepancy between preoperative inotropic reserve and intramyocardial functional outcome after revascularization.

    PubMed

    Mazzadi, Alejandro N; Janier, Marc F; Brossier, Benjamin; André-Fouët, Xavier; Revel, Didier; Croisille, Pierre

    2004-11-01

    In severe coronary artery disease (CAD), it has been shown that intramyocardial inotropic reserve as assessed with tagged magnetic resonance imaging (MRI) is uniformly distributed among positron emission tomography (PET) patterns reflecting normal or concomitant reductions in perfusion and glucose metabolism. This preliminary study aimed to delineate the relationship between preoperative values of intramyocardial inotropic reserve (in different PET patterns of perfusion and glucose uptake) and intramyocardial functional outcome after surgical revascularization in severe CAD. Twelve patients underwent preoperative tagged MRI (baseline, 10 microg.kg(-1).min(-1) of dobutamine), H2 15O/[18F]fluorodeoxyglucose PET imaging, and postoperative resting tagged MRI. Regional midmyocardial circumferential shortening (Ecc, in %) and PET patterns (normal, match viable, mismatch viable, and infarcted) were assessed in three tagged MRI/PET short-axis slices. Ecc at baseline ranged from 12 +/- 6 to 8 +/- 5 and 4 +/- 4% in normal, match-viable, and infarcted regions, respectively (P <0.05) and was 8 +/- 5% in mismatch-viable regions. Of the 429 regions studied, 187 showed preoperative inotropic reserve with dobutamine, but 238 showed postoperative functional improvement. Postoperative functional improvement was less common in infarcted regions (41 vs. approximately 60% in the other PET patterns), but the extent of improvement was similar among PET patterns (approximately 6%). Postoperative functional improvement occurred in 53% of all (normal, match viable, and mismatch viable) regions without inotropic reserve. In severe CAD, revascularization affords greater intramyocardial functional benefit than expected from the evaluation of intramyocardial inotropic reserve with low-dose dobutamine. Postoperative functional improvement in PET-viable regions without inotropic reserve suggests that factors other than regionally enhanced perfusion contribute to such functional improvement. PMID:15231499

  10. 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

  11. 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

  12. 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

  13. Adverse Outcome Pathways can drive non-animal approaches for safety assessment

    PubMed Central

    Burden, Natalie; Sewell, Fiona; Andersen, Melvin E; Boobis, Alan; Chipman, J Kevin; Cronin, Mark T D; Hutchinson, Thomas H; Kimber, Ian; Whelan, Maurice

    2015-01-01

    Adverse Outcome Pathways (AOPs) provide an opportunity to develop new and more accurate safety assessment processes for drugs and other chemicals, and may ultimately play an important role in regulatory decision making. Not only can the development and application of AOPs pave the way for the development of improved evidence-based approaches for hazard and risk assessment, there is also the promise of a significant impact on animal welfare, with a reduced reliance on animal-based methods. The establishment of a useable and coherent knowledge framework under which AOPs will be developed and applied has been a first critical step towards realizing this opportunity. This article explores how the development of AOPs under this framework, and their application in practice, could benefit the science and practice of safety assessment, while in parallel stimulating a move away from traditional methods towards an increased acceptance of non-animal approaches. We discuss here the key areas where current, and future initiatives should be focused to enable the translation of AOPs into routine chemical safety assessment, and lasting 3Rs benefits. © 2015 The Authors. Journal of Applied Toxicology published by John Wiley & Sons Ltd. This article explores how the development and application of Adverse Outcome Pathways (AOPs) could benefit the science and practice of chemical safety assessment, with a particular focus on how their use in practice could reduce reliance on traditional animal toxicity tests. This includes discussion of the key areas where current and future initiatives should be focused to enable the translation of AOPs into routine chemical safety assessment, and lasting 3Rs benefits. PMID:25943792

  14. Long-term post-injury functional recovery: Outcomes of geriatric consultation

    PubMed Central

    Tillou, Areti; Kelley-Quon, Lorraine; Burruss, Sigrid; Morley, Eric; Cryer, Henry; Cohen, Marilyn; Min, Lillian

    2013-01-01

    Importance Functional recovery is an important outcome following injury. Functional impairment is persistent in the year following injury for older trauma patients. Objective To measure the impact of routine geriatric consultation on functional outcomes in older trauma patients. Design Pretest-posttest study. The pretest control group (n=37) was retrospectively-identified (December 2006-November 2007). The posttest geriatric consultation (GC) group (n=85) was prospectively enrolled (December 2007-June 2010). We then followed both groups for 1 year after enrollment. Setting Academic Level-1 trauma center Participants Adults ? 65 years of age admitted as an activated code trauma Intervention Routine geriatric consultation Main Outcome Measure The Short Functional Status (SFS) survey of five Activities of Daily Living (ADLs) on admission and 3, 6, and 12 months post-injury. Results The unadjusted SFS (GC group only) declined from 4.6 pre-injury to 3.7 at 12 months post-injury, a decline of nearly one full ADL (p<.05). The ability to shop for personal items was the specific ADL more commonly retained by the GC compared to the control group. The GC group had a better recovery of function in the year following injury than the GC group controlling for age, gender, ethnicity, length of stay, co-morbidity, injury severity, post-discharge rehabilitation, complication, and whether surgery was performed (p<.01), a difference of 0.67 ADL abilities retained by the GC compared to the control group (95% CI 0.06–1.4). Conclusions and Relevance Functional recovery for older adults following injury may be improved by geriatric consultation. Early introduction of multidisciplinary care in geriatric trauma patients warrants further investigation. PMID:24284836

  15. Impact of Patient Characteristics on Hospital-Level Outcomes Assessment in Congenital Heart Surgery

    PubMed Central

    Pasquali, Sara K.; Jacobs, Marshall L.; O’Brien, Sean M.; He, Xia; Gaynor, J. William; Gaies, Michael G.; Peterson, Eric D.; Hirsch-Romano, Jennifer C.; Mayer, John E.; Jacobs, Jeffrey P.

    2015-01-01

    Background Accurate hospital outcome measures in congenital heart surgery are important to multiple initiatives. While methods have been developed to account for differences in procedural case-mix, characteristics patients bring into the operation that may also vary across hospitals and influence outcome have received less attention. We evaluated the impact of these characteristics in a large cohort. Methods Patients undergoing congenital heart surgery at centers participating in The Society of Thoracic Surgeons Congenital Heart Surgery Database (2010 to 2013) with adequate data quality were included. Variation across hospitals in important patient characteristics was examined, and hospital operative mortality rates were compared with and without adjustment for patient characteristics. Results Overall, 86 centers (52,224 patients) were included. There was greater than twofold variation across hospitals for nearly all patient characteristics examined. For example, the proportion of a center’s surgical population comprised of neonates ranged from 12.8% to 26.6% across hospitals; the proportion with a non-cardiac anomaly ranged from 0.7% to 5.0%. When hospital mortality rankings were evaluated based on “standard” (adjustment for differences in procedural case-mix alone) versus “full” models (adjustment for both differences in procedural case-mix and patient characteristics), 14.0% changed their ranking for mortality by 20 or greater positions, 34.9% of centers changed which mortality quartile they were classified in, and 14.0% changed their statistical classification (statistically higher, lower, or same-as-expected mortality). Conclusions Characteristics of patients undergoing congenital heart surgery vary across centers and impact hospital outcomes assessment. Methods to assess outcomes and relative performance should account for these characteristics. PMID:26245503

  16. Anatomical and functional outcomes following a precise, graded, dorsal laceration spinal cord injury in C57BL/6 mice.

    PubMed

    Hill, Rachel L; Zhang, Yi Ping; Burke, Darlene A; Devries, William H; Zhang, Yongjie; Magnuson, David S K; Whittemore, Scott R; Shields, Christopher B

    2009-01-01

    To study the pathophysiology of spinal cord injury (SCI), we used the LISA-Vibraknife to generate a precise and reproducible dorsal laceration SCI in the mouse. The surgical procedure involved a T9 laminectomy, dural resection, and a spinal cord laceration to a precisely controlled depth. Four dorsal hemisection injuries with lesion depths of 0.5, 0.8, 1.1, and 1.4 mm, as well as normal, sham (laminectomy and dural removal only), and transection controls were examined. Assessments including the Basso Mouse Scale (BMS), footprint analysis, beam walk, toe spread reflex, Hargreaves' test, and transcranial magnetic motor-evoked potential (tcMMEP) analysis were performed to assess motor, sensorimotor, and sensory function. These outcome measures demonstrated significant increases in functional deficits as the depth of the lesion increased, and significant behavioral recovery was observed in the groups over time. Quantitative histological examination showed significant differences between the injury groups and insignificant lesion depth variance within each of the groups. Statistically significant differences were additionally found in the amount of ventral spared tissue at the lesion site between the injury groups. This novel, graded, reproducible laceration SCI model can be used in future studies to look more closely at underlying mechanisms that lead to functional deficits following SCI, as well as to determine the efficacy of therapeutic intervention strategies in the injury and recovery processes following SCI. PMID:19196178

  17. Quality of life, social impact and functional outcome following ileal pouch-anal anastomosis for ulcerative colitis and familial adenomatous polyposis.

    PubMed

    Raviram, S; Rajan, Ramesh; Sindhu, R S; Bonny, N; Kuruvilla, A P; Subhalal, N

    2015-05-01

    This study aims to assess quality of life (QoL), functional outcome, and social impact following ileal pouch anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP) since Indian data is limited. Data was collected prospectively from patients who underwent IPAA for UC or FAP from 2004 to 2013. QoL and functional outcome at 1, 3, and 5 years after surgery, return to work, and change of job (social impact) were documented. QoL was assessed using the validated Cleveland Global Quality of Life (CGQL) score, the normal score being 1.0. Twenty-five patients were analyzed. Mean CGQL scores before surgery and at 1, 3, and 5 years were 0.5, 0.63, 0.73, and 0.8, respectively. FAP patients had better scores at 3 and 5 years. Only 40 % returned to same job. Sixty-four percent returned to work within a year. The median number of bowel movements per 24 h was less for FAP patients at 3 and 5 years. UC patients on long-term steroids had poorer function at 3 years. Long-term QoL and functional outcomes following IPAA are acceptable. Initial deterioration in QoL, mainly in FAP and long-term adverse social impact in both groups should not be underestimated. UC patients on long-term steroids showed delayed improvement in pouch function. PMID:25947582

  18. Metric qualities of the cognitive behavioral assessment for outcome evaluation to estimate psychological treatment effects

    PubMed Central

    Bertolotti, Giorgio; Michielin, Paolo; Vidotto, Giulio; Sanavio, Ezio; Bottesi, Gioia; Bettinardi, Ornella; Zotti, Anna Maria

    2015-01-01

    Background Cognitive behavioral assessment for outcome evaluation was developed to evaluate psychological treatment interventions, especially for counseling and psychotherapy. It is made up of 80 items and five scales: anxiety, well-being, perception of positive change, depression, and psychological distress. The aim of the study was to present the metric qualities and to show validity and reliability of the five constructs of the questionnaire both in nonclinical and clinical subjects. Methods Four steps were completed to assess reliability and factor structure: criterion-related and concurrent validity, responsiveness, and convergent–divergent validity. A nonclinical group of 269 subjects was enrolled, as was a clinical group comprising 168 adults undergoing psychotherapy and psychological counseling provided by the Italian public health service. Results Cronbach’s alphas were between 0.80 and 0.91 for the clinical sample and between 0.74 and 0.91 in the nonclinical one. We observed an excellent structural validity for the five interrelated dimensions. The clinical group showed higher scores in the anxiety, depression, and psychological distress scales, as well as lower scores in well-being and perception of positive change scales than those observed in the nonclinical group. Responsiveness was large for the anxiety, well-being, and depression scales; the psychological distress and perception of positive change scales showed a moderate effect. Conclusion The questionnaire showed excellent psychometric properties, thus demonstrating that the questionnaire is a good evaluative instrument, with which to assess pre- and post-treatment outcomes. PMID:26442466

  19. 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

  20. Outcome Measures of Functionality, Social Interaction, and Pain in Patients with Cervical Spondylotic Myelopathy: A Validation Study for the Iranian Version of the Copenhagen Neck Functional Disability Scale

    PubMed Central

    Nayeb Aghaei, Hossein; Shahzadi, Sohrab; Azhari, Shirzad; Mohammadi, Hassan Reza; Alizadeh, Pooyan; Montazeri, Ali

    2015-01-01

    Study Design Cross-sectional. Purpose To translate and validate the Iranian version of the Copenhagen Neck Functional Disability Scale (CNFDS). Overview of Literature Instruments measuring patient-reported outcomes should satisfy certain psychometric properties. Methods Ninety-three cases of cervical spondylotic myelopathy were entered into the study and completed the CNFDS pre and postoperatively at the 6 month follow-up. The modified Japanese Orthopedic Association Score was also completed. The internal consistency, test-retest, convergent validity, construct validity (item scale correlation), and responsiveness to change were assessed. Results Mean age of the patients was 54.3 years (standard deviation, 8.9). The Cronbach ? coefficient was satisfactory (?=0.84). Test-retest reliability as assessed by the intraclass correlation coefficient analysis was 0.95 (95% confidence interval, 0.92-0.98). The modified Japanese Orthopedic Association score correlated strongly with the CNFDS score, lending support to its good convergent validity (r=-0.80; p<0.001). Additionally, the correlation of each item with its hypothesized domain on the CNFDS was acceptable, suggesting that the items had a substantial relationship with their own domains. These results also indicate that the instrument was responsive to change (p<0.0001). Conclusions The findings suggest that the Iranian version of the CNFDS is a valid measure to assess functionality, social interaction, and pain among patients with cervical spondylotic myelopathy. PMID:26713123

  1. Early assessment of patient perception of outcome in total knee replacement

    PubMed Central

    BONIFORTI, FILIPPO; MACAIONE, ANTONIO; GAGLIARDI, STEFANO; GIANGRASSO, FRANCESCO; DI MARZO, DAVIDE; GIACCO, FRANCESCO

    2014-01-01

    Purpose the aim of the present study was to measure patient perception in the early period after knee replacement surgery and to correlate health status with the surgery-related outcome. Methods thirty-eight consecutive patients who underwent total knee replacement were evaluated before surgery; at the time Radiographic evaluation was used to assess limb alignment and the Oxford Knee Score (OKS) to assess objective outcome. Health outcome was measured with the three-level version of the EuroQol – five dimension (EQ-5D-3L) self-administered questionnaire, a standardized instrument used to measure patient’s perception of health status. Evaluation was performed before surgery, at discharge from hospital, and six weeks after surgery. Results the mean overall EQ-5D-3L scores were 10.23 before surgery, 8.34 at discharge from the hospital, and 6.52 at six weeks. The overall EQ-5D-3L score before surgery was greater than 8 points in 31 of the 38 patients, ranging from 5 to 8 points in 21 of the 38 patients at the discharge and greater than 8 points in six of the 38 patients six weeks after surgery. Patients with scores of over 8 points at six weeks also scored more than 10 points on the discharge assessment. Conclusions analysis of early patient reports of performance after TKR showed marked changes in the level of satisfaction during the first six weeks after surgery. An EQ-5D-3L score of 8 or more at follow-up should be considered a sign that the patient has not achieved satisfaction and, accordingly, should be studied in the context of a personalized follow-up schedule in order to identify as soon as possible the causes of impairment. Level of Evidence Level IV, prognostic case series. PMID:25606546

  2. Integrating place-specific livelihood and equity outcomes into global assessments of bioenergy deployment

    NASA Astrophysics Data System (ADS)

    Creutzig, Felix; Corbera, Esteve; Bolwig, Simon; Hunsberger, Carol

    2013-09-01

    Integrated assessment models suggest that the large-scale deployment of bioenergy could contribute to ambitious climate change mitigation efforts. However, such a shift would intensify the global competition for land, with possible consequences for 1.5 billion smallholder livelihoods that these models do not consider. Maintaining and enhancing robust livelihoods upon bioenergy deployment is an equally important sustainability goal that warrants greater attention. The social implications of biofuel production are complex, varied and place-specific, difficult to model, operationalize and quantify. However, a rapidly developing body of social science literature is advancing the understanding of these interactions. In this letter we link human geography research on the interaction between biofuel crops and livelihoods in developing countries to integrated assessments on biofuels. We review case-study research focused on first-generation biofuel crops to demonstrate that food, income, land and other assets such as health are key livelihood dimensions that can be impacted by such crops and we highlight how place-specific and global dynamics influence both aggregate and distributional outcomes across these livelihood dimensions. We argue that place-specific production models and land tenure regimes mediate livelihood outcomes, which are also in turn affected by global and regional markets and their resulting equilibrium dynamics. The place-specific perspective suggests that distributional consequences are a crucial complement to aggregate outcomes; this has not been given enough weight in comprehensive assessments to date. By narrowing the gap between place-specific case studies and global models, our discussion offers a route towards integrating livelihood and equity considerations into scenarios of future bioenergy deployment, thus contributing to a key challenge in sustainability sciences.

  3. On the Correspondence between Preference Assessment Outcomes and Progressive-Ratio Schedule Assessments of Stimulus Value

    ERIC Educational Resources Information Center

    DeLeon, Iser G.; Frank, Michelle A.; Gregory, Meagan K.; Allman, Melissa J.

    2009-01-01

    The current study examined whether stimuli of different preference levels would be associated with different amounts of work maintained by the stimuli, as determined through progressive-ratio schedule break points. Using a paired-choice preference assessment, stimuli were classified as high, moderate, or low preference for 4 individuals with…

  4. Outcomes of patients with cirrhosis undergoing non-hepatic surgery: Risk assessment and management

    PubMed Central

    Millwala, Farida; Nguyen, Geoffrey C; Thuluvath, Paul J

    2007-01-01

    The reported mortality rates in patients with cirrhosis undergoing various non-transplant surgical procedures range from 8.3% to 25%. This wide range of mortality rates is related to severity of liver disease, type of surgery, demographics of patient population, expertise of the surgical, anesthesia and intensive care unit team and finally, reporting bias. In this article, we will review the pathophysiology, morbidity and mortality associated with non-hepatic surgery in patients with cirrhosis, and then recommend an algorithm for risk assessment and evidence based management strategy to optimize post-surgical outcomes. PMID:17696222

  5. 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...

  6. Endogenous ocular candidiasis: changes in epidemiology and factors associated with poor functional outcome.

    PubMed

    Horcajada, Juan P; Fernández-Sampedro, Marta; García-Palomo, Daniel; Cañal, Joaquín; Salesa, Ricardo; Farinas, María C

    2007-01-01

    The evolution of the incidence and the epidemiology of ocular candidiasis in our hospital during the past 12 y, as well as the factors associated with poor functional outcome were analysed. A retrospective study of all cases of ocular candidiasis admitted to a university hospital between 1993 and 2004 was performed. Epidemiological, clinical and final outcome data were recorded. 37 episodes of ocular candidiasis in 36 patients were studied. 28 (75%) episodes occurred between 1993 and 1998 (13.09 episodes/100,000 admissions/y), and all of these patients were intravenous drug users. In contrast, only 9 episodes of ocular candidiasis were recorded between 1999 and 2004 (4.42 episodes/100,000 admissions/y; p<.0001) and 3 (33%) patients were not drug users (p<0.01). 19 (57%) cases had final visual acuity <0.1. Treatment with conventional amphotericin B instead of other newer antifungal drugs was associated with poor visual prognosis in the univariate (p = 0.03) and multivariate (p = 0.03) analysis. In conclusion, the incidence of ocular candidiasis has decreased significantly in recent y and the epidemiology has changed. Currently, one-third of patients are immunocompromised non-drug users. Therapy with conventional amphotericin B instead of newer antifungal drugs appears to be associated with a poorer functional outcome. PMID:17366052

  7. Multiclass Support Vector Machine-Based Lesion Mapping Predicts Functional Outcome in Ischemic Stroke Patients

    PubMed Central

    Forkert, Nils Daniel; Verleger, Tobias; Cheng, Bastian; Thomalla, Götz; Hilgetag, Claus C.; Fiehler, Jens

    2015-01-01

    Purpose The aim of this study was to investigate if ischemic stroke final infarction volume and location can be used to predict the associated functional outcome using a multi-class support vector machine (SVM). Material and Methods Sixty-eight follow-up MR FLAIR datasets of ischemic stroke patients with known modified Rankin Scale (mRS) functional outcome after 30 days were used. The infarct regions were segmented and used to calculate the percentage of lesioned voxels in the predefined MNI, Harvard-Oxford cortical and subcortical atlas regions as well as using four problem-specific VOIs, which were identified from the database using voxel-based lesion symptom mapping. An overall of 12 SVM classification models for predicting the corresponding mRS score were generated using the lesion overlap values from the different brain region definitions, stroke laterality information, and the optional parameters infarct volume, admission NIHSS, and patient age. Results Leave-one-out cross validations revealed that including information about the stroke location in terms of lesion overlap measurements led to improved mRS prediction results compared to classification models not utilizing the stroke location information. Furthermore, integration of the optional features led to improved mRS prediction results in all cases tested. The problem-specific brain regions and additional integration of the optional features led to the best mRS predictions with a precise multi-value mRS prediction accuracy of 56%, sliding window multi-value mRS prediction accuracy (mRS±1) of 82%, and binary mRS (0-2 vs. 3-5) prediction accuracy of 85%. Conclusion Therefore, a graded SVM-based functional stroke outcome prediction using the problem-specific brain regions for lesion overlap quantification leads to promising results but needs to be further validated using an independent database to rule out a potential methodical bias and overfitting effects. The prediction of the graded mRS functional outcome could be a valuable tool if combined with voxel-wise tissue outcome predictions based on multi-parametric datasets acquired at the acute phase. PMID:26098418

  8. Anatomic and functional outcomes of retinectomy for the management of complicated retinal detachment with proliferative vitreoretinopathy

    PubMed Central

    Tranos, Paraschos; Vakalis, Athanasios; Asteriadis, Solon; Lokovitis, Evaggelos; Georgalas, Ilias; Stavrakas, Panagiotis

    2015-01-01

    The aim of this study is to report the anatomic and functional outcomes of retinectomy for the management of rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy (PVR), comparing them with previously reported data and determining prognostic factors. Fifty-one eyes of 51 patients with established PVR grade C in which retinectomy was performed were retrospectively enrolled in the study. Primary outcome measures were anatomic success rate and final visual acuity. Secondary outcome measures were intraoperative complications, number of re-operations, and postoperative hypotony. Prognostic factors in relation to retinal re-attachment and final visual acuity were retrospectively analyzed. The rate of complete retinal re-attachment after one operation was 80% and after two operations it was 84%. At the end of the follow-up, the macula was attached in 96% of the cases. Mean LogMAR best-corrected visual acuity (BCVA) improved significantly from 2.45±0.66 preoperatively to 1.37±0.75 at the end of the follow-up (P<0.001). BCVA improved in 37 eyes (72%), remained the same in eleven eyes (22%) and worsened in three eyes (6%). Postoperative hypotony was observed in 2% of cases. Postoperative BCVA was significantly correlated with preoperative BCVA (P<0.001), extension of PVR (P=0.013), preoperative use of gas instead of silicone oil (SO) (P=0.01), and removal of SO (P=0.05). SO was left in situ in 35% of eyes. In conclusion, retinectomy is a surgical option providing good anatomical and reasonable visual outcomes in complicated retinal detachment with PVR. Better preoperative visual acuity, lesser extension of PVR, and the use of gas tamponade during the primary repair are relevant factors for a successful outcome whereas re-proliferation of epiretinal membranes seems to be the main reason of anatomical failure. PMID:26491338

  9. 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

  10. Functional outcome of patients undergoing replantation of hand at wrist level-7 year experience

    PubMed Central

    Mahajan, Ravi Kumar; Mittal, Seema

    2013-01-01

    Background: Replantation is defined as reattachment of amputated limb using neurovascular and musculoskeletal structures in order to obtain recovery of limb. Re-vascularisation involves all the above steps in case of limb injuries that result in a near total amputation. Aim and Objective: To study the functional outcome of patients undergoing replantation of hand at wrist level. Material and Methods: This is a retrospective study of patients who underwent replantation of total amputation of hand at wrist level within a period of Jan 2003-June 2010. We evaluated post operative functional outcome compared to uninjured hand taking into consideration: 1. The patient's overall satisfaction with the hand. 2. Recovery of flexor and extensor function of thumb and fingers. 3. Recovery of thumb opposition. 4. Recovery of sensations in the median and ulnar nerve distribution. 5. Ability of surviving hand to perform daily tasks. Results: There were total seventeen patients and age range was two years to 55 years. Out of 17 patients,16 were males. All the replantations were successful except for one. Summary: The results showed that, although the replanted hands were never functionally as good as the contralateral hand the patients were able to perform most of the daily activities. PMID:24459349

  11. Impact of obesity on functional and oncological outcomes in radical perineal prostatectomy

    PubMed Central

    Altay, Bulent; Erkurt, Bulent; Guzelburc, Vahit; Kiremit, Murat Can; Boz, Mustafa Yucel; Albayrak, Selami

    2015-01-01

    Introduction: We evaluated the impact of obesity on perioperative morbidity, functional, and oncological outcomes after radical perineal prostatectomy (RPP). Methods: A total of 298 consecutive patients underwent RPP at our institution. Patients were categorized into 3 groups based on their body mass index (BMI): Normal weight <25 kg/m2 (Group 1), overweight 25 to <30 kg/m2 (Group 2), and obese ?30 kg/m2 (Group 3). We compared the groups with respect to perioperative data, postoperative oncologic, and functional outcomes. Evaluation of urinary continence and erectile function was performed using a patient-reported questionnaire and the International Index of Erectile Function-5 questionnaire, respectively, administered preoperatively and at 3, 6, and 12 months. Limitations included short follow-up time, retrospective design and lack of a morbidly obese group. Results: No significant differences were found among the 3 groups with regard to operative time, estimated blood loss, length of hospital stay, catheter removal time, positive surgical margin, and complication rates. At 12 months, 94.7%, 95% and 95% of normal, overweight and obese patients, respectively, were continent (free of pad use) (p = 0.81). At 12 months, 30.6%, 29.8% and 30.4% of patients had spontaneous erections and were able to penetrate and complete intercourse in Group 1, Group 2, and Group 3, respectively (p = 0.63). Conclusions: In this cohort of patients, no clinically relevant risks were associated with increasing BMI. PMID:26600881

  12. Environmental justice, impact assessment and the politics of knowledge: The implications of assessing the social distribution of environmental outcomes

    SciTech Connect

    Walker, Gordon

    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.

  13. A review of functional outcome measures for cervical spine disorders: literature review

    PubMed Central

    Bussières, André

    1994-01-01

    The purpose of this paper is to assess the reliability, validity and usefulness of three outcome measures: cervical ranges of motion, sagittal neck muscle strength and presence or absence of the flexion relaxation phenomenon (FRP) in the neck. The literature search included the Index Medicus and computerized database of MEDLINE for relevant material. Articles were selected if they contained primary data on neck range of motion, sagittal muscle strength and FRP. The results of 59 articles and 2 textbooks were analyzed. Normative values of cervical ROM have been reported in healthy subjects ranging in age from 18 to 74 years. The extent of degrees of motion lost per year did not differ between male or female subjects, but females started with higher degrees of active range of motion, which they maintained throughout life. Instrumented methods of recording muscle strength have included strain gauge dynamometers and modified sphygmomanometers. Parameters such as gender, age and stature were also observed to have important effects on muscle strength. The ratio of extension to flexion maximum isometric peak force has been estimated to range between 1.40-1.70 in normal subjects. Therefore, the extensor muscles of the neck are approximately 40% stronger then the neck flexor muscles. Evidence suggested that neck pain sufferers have weaker neck flexors than normal subjects. The FRP refers to the absence of myoelectrical activity in extensor muscles upon full forward flexion and has been documented in the cervical spine of asymptomatic subjects. In conclusion, inclinometric methods used for measurements of cervical range of motion were found to be safe, effective and reliable. The Cervical Range of Motion Device appeared to be well suited for clinical practice. The ratio of cervical extension-flexion maximum isometric voluntary contraction has been determined in asymptomatic subjects. The presence of the FRP in the neck has also been observed in normals. Future study is needed to investigate the functional limitations relating to acute and chronic mechanical neck pain which account for a portion of total neck disability.

  14. 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

  15. A new approach to assessing function in elderly people.

    PubMed Central

    Williams, Mark E.; Owens, Justine E.; Parker, B. Eugene; Granata, Kevin P.

    2003-01-01

    Current functional assessment methods and measures of elderly people are limited in their ability to detect small decrements in function or in discriminating between different patterns of functional loss. Nor do they directly assess function in the patient's usual environment. Recent technological advances have led to the development of small, wearable microelectronic devices that detect motion, velocity and acceleration. These devices can be used to develop new tools for more precise monitoring, assessment, and prediction of function by characterizing the 'electronic signatures' of successful or unsuccessful task-specific performance, and to allow for continuous assessment in a home environment. This presentation will summarize current efforts to translate new technologies into a clinical and research tool for improved assessment, monitoring, and prediction of function among older individuals. Images Fig. 1 PMID:12813921

  16. Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study

    PubMed Central

    Arockiaraj, Justin; Amritanand, Rohit; Venkatesh, Krishnan; David, Kenny Samuel

    2015-01-01

    Study Design Non-concurrent prospective study. Purpose To determine the functional outcome after open 'fragment' discectomy for recurrent lumbar disc herniation, and to analyze the factors that may affect the outcome. Overview of Literature Literature search revealed only four studies where the factors affecting the outcome of a revision surgery for recurrent disc herniation have been evaluated. None of these studies analyzed for diabetes, disc degeneration and facet arthropathy. We have analyzed these features, in addition to the demographic and clinical factors. Methods Thirty-four patients who underwent the procedure were followed up for an average period of 27.1 months. The Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI) were used to assess the functional outcome. Age, gender, smoking, diabetic status, duration of recurrent symptoms, the side of leg pain, level and type of disc herniation, degree of disc degeneration on magnetic resonance imaging, and facet joint arthritis before first and second surgeries, were analyzed as factors affecting the outcome. Results The average Hirabayashi improvement in JOA was 56.4%. The mean preoperative ODI was 74.5% and the mean ODI at final follow-up was 32.2%, the difference being statistically significant (p<0.01). Patients with diabetes, all of whom had poor long term glycemic control, were found to have a poor outcome in terms of ODI improvement (p=0.03). Conclusions Open fragment discectomy is a safe and effective surgical technique for the treatment of recurrent disc herniation. However, patients with uncontrolled diabetes may have a less favorable outcome. PMID:26435791

  17. The influence of hepatic function on prostate cancer outcomes after radical prostatectomy.

    PubMed

    Bañez, L L; Loftis, R M; Freedland, S J; Presti, J C; Aronson, W J; Amling, C L; Kane, C J; Terris, M K

    2010-06-01

    Prostate growth is dependent on circulating androgens, which can be influenced by hepatic function. Liver disease has been suggested to influence prostate cancer (CaP) incidence. However, the effect of hepatic function on CaP outcomes has not been investigated. A total of 1181 patients who underwent radical prostatectomy (RP) between 1988 and 2008 at four Veterans Affairs hospitals that comprise the Shared Equal Access Regional Cancer Hospital database and had available liver function test (LFT) data were included in the study. Independent associations of LFTs with unfavorable pathological features and biochemical recurrence were determined using logistic and Cox regression analyses. Serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) levels were elevated in 8.2 and 4.4% of patients, respectively. After controlling for CaP features, logistic regression revealed a significant association between SGOT levels and pathological Gleason sum > or =7(4+3) cancer (odds ratio=2.12; 95% confidence interval=1.11-4.05; P=0.02). Mild hepatic dysfunction was significantly associated with adverse CaP grade, but was not significantly associated with other adverse pathological features or biochemical recurrence in a cohort of men undergoing RP. The effect of moderate-to-severe liver disease on disease outcomes in CaP patients managed non-surgically remains to be investigated. PMID:20195294

  18. The Influence of Hepatic Function on Prostate Cancer Outcomes Following Radical Prostatectomy

    PubMed Central

    Bañez, Lionel L.; Loftis, Richard M.; Freedland, Stephen J.; Presti, Joseph C.; Aronson, William J.; Amling, Christopher L.; Kane, Christopher J.; Terris, Martha K.

    2010-01-01

    Prostate growth is dependent on circulating androgens which can be influenced by hepatic function. Liver disease has been suggested to influence prostate cancer (CaP) incidence. However, the effect of hepatic function on CaP outcomes has not been investigated. A total of 1,181 patients who underwent radical prostatectomy (RP) between 1988 and 2008 at four Veterans Affairs hospitals that comprise the Shared Equal Access Regional Cancer Hospital (SEARCH) database and had available liver function test (LFT) data were included in the study. Independent associations of LFTs with unfavorable pathological features and biochemical recurrence were determined using logistic and Cox regression analyses. Serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) levels were elevated in 8.2% and 4.4% of patients, respectively. After controlling for CaP features, logistic regression revealed a significant association between SGOT levels and pathological Gleason sum ?7(4+3) cancer (odds ratio=2.12; 95% confidence interval=1.11-4.05; p=0.02). Mild hepatic dysfunction was significantly associated with adverse CaP grade but was not significantly associated with other adverse pathological features or biochemical recurrence in a cohort of men undergoing R. The effect of moderate to severe liver disease on disease outcomes in CaP patients managed non-surgically remains to be investigated. PMID:20195294

  19. Family Perception and 6-Month Symptomatic and Functioning Outcomes in Young Adolescents at Clinical High Risk for Psychosis in a General Population in China

    PubMed Central

    Wang, Lu; Shi, JingYu; Chen, FaZhan; Yao, YuHong; Zhan, ChenYu; Yin, XiaoWen; Fang, XiaoYan; Wang, HaoJie; Yuan, JiaBei; Zhao, XuDong

    2015-01-01

    Background and Aims Given the difficulty of treating schizophrenia and other forms of psychosis, researchers have shifted focus to early detection and intervention of individuals at clinical high risk (CHR) for psychosis. Previous studies have shown that elements in family functioning could predict symptom outcome in CHR individuals. However, associations between self reported family functioning and symptom or functioning outcome of CHR individuals was rarely reported. Our study aimed to investigate the characteristics and the role of family functioning in the development of CHR individuals among young adolescents. Methods A sample of 32 CHR individuals was recruited from 2800 university students. The characteristics of family perception were evaluated by both Family Assessment Device (FAD) and Family cohesion and adaptability evaluation Scale II (FACES II). 6 month follow up data was available with 25 of the recruited CHR individuals. Baseline socio-demographic characteristics and family functioning were compared between CHR and control group. We also measured the associations between different dimensions of perceived family functioning and both severity of prodromal symptoms and global functioning at baseline and 6-month follow up. Results CHR individuals showed more maladaptive family functioning compared to control in nearly all of the dimensions of FAD and FACES II except for Affective Involvement. Better Problem Solving and Affective Responsiveness predicted less severe positive and negative symptoms respectively. Family cohesion and adaptability were not only correlated with the baseline severity of general symptoms, but also positively associated with the general and disorganized symptom outcome. Conclusions This study contributed preliminary evidence towards the associations between family perception and symptom outcome of CHR individuals. It also provided evidence for the importance of family interventions on CHR individuals. PMID:26394221

  20. Comparison of Structural and Functional Ocular Outcomes Between 14- and 70 Day Bed Rest

    NASA Technical Reports Server (NTRS)

    Cromwell, R. L.; Taibbi, G.; Zanello, S. B.; Yarbough, P. O.; Ploutz-Snyder, R. J.; Vizzeri, G.

    2016-01-01

    Purpose: To compare structural and functional ocular outcomes in healthy human subjects undergoing 14- and/or 70-day head-down-tilt bed rest (HDTBR). We hypothesized the amount of HDTBR-induced ocular changes be affected by the HDTBR duration. Methods: The studies were conducted at the NASA Flight Analogs Research Unit, The University of Texas Medical Branch at Galveston, Galveston, TX. Participants were selected using NASA standard screening procedures. Standardized NASA screening procedures and bed rest conditions (e.g., strict sleep-wake cycle, standardized diet, continuous video monitoring) were implemented in both studies. Participants maintained a 6deg HDTBR position for 14 and/or 70 consecutive days and did not engage in exercise. Weekly ophthalmological examinations were conducted in the sitting (pre/post-bed rest only) and HDT positions. Ocular outcomes of interest included: near best-corrected visual acuity (BCVA); spherical equivalent, as determined by cycloplegic autorefraction; Goldmann applanation tonometry and iCare (Icare Finland Oy, Espoo, Finland) intraocular pressure (IOP) measurement; color vision; red dot test; modified Amsler grid test; confrontational visual field; stereoscopic color fundus photography; Spectralis OCT (Heidelberg Engineering, GmbH, Heidelberg, Germany) retinal nerve fiber layer thickness (RNFLT), peripapillary and macular retinal thicknesses. Mixed-effects linear models were used to compare pre- and post-HDTBR observations between 14- and 70-day HDTBR for our continuously scaled outcomes.

  1. Oncological and functional outcomes of 722 robot-assisted radical prostatectomy (RARP) cases: The largest Canadian 5-year experience

    PubMed Central

    Tholomier, Côme; Bienz, Marc; Hueber, Pierre-Alain; Trinh, Quoc Dien; Hakim, Assaad El; Alhathal, Naif; Lebeau, Thierry; Benayoun, Serge; Valdivieso, Roger; Liberman, Dan; Saad, Fred; Lattouf, Jean-Baptiste; Widmer, Hugues; Begin, Louis; Latour, Mathieu; Zorn, Kevin C.

    2014-01-01

    Introduction: While RARP (robotic-assisted radical prostatectomy) has become the predominant surgical approach to treat localized prostate cancer, there is little Canadian data on its oncological and functional outcomes. We describe the largest RARP experience in Canada. Methods: Data from 722 patients who underwent RARP performed by 7 surgeons (AEH performed 288, TH 69, JBL 23, SB 17, HW 15, QT 7, and KCZ 303 patients) were collected prospectively from October 2006 to December 2013. Preoperative characteristics, as well as postoperative surgical and pathological outcomes, were collected. Functional and oncological outcomes were also assessed up to 72 months postoperative. Results: The median follow-up (Q1–Q3) was 18 months (9–36). The D’Amico risk stratification distribution was 31% low, 58% intermediate and 11% high-risk. The median operative time was 178 minutes (142–205), blood loss was 200 mL (150–300) and the postoperative hospital stay was 1 day (1–23). The transfusion rate was only 1.0%. There were 0.7% major (Clavien III–IV) and 10.1% minor (Clavien I–II) postoperative complications, with no mortality. Pathologically, 445 men (70%) were stage pT2, of which 81 (18%) had a positive surgical margin (PSM). In addition, 189 patients (30%) were stage pT3 and 87 (46%) with PSM. Urinary continence (0-pads/day) returned at 3, 6, and 12 months for 68%, 80%, and 90% of patients, respectively. Overall, the potency rates (successful penetration) for all men at 6, 12, and 24 months were 37%, 52%, and 59%, respectively. Biochemical recurrence was observed in 28 patients (4.9%), and 14 patients (2.4%) were referred for early salvage radiotherapy. In total, 49 patients (8.4%) underwent radio-therapy and/or hormonal therapy. Conclusions: This study shows similar results compared to other high-volume RARP programs. Being the largest RARP experience in Canada, we report that RARP is safe with acceptable oncologic outcomes in a Canadian setting. PMID:25024790

  2. Adverse Outcome Pathways can drive non-animal approaches for safety assessment.

    PubMed

    Burden, Natalie; Sewell, Fiona; Andersen, Melvin E; Boobis, Alan; Chipman, J Kevin; Cronin, Mark T D; Hutchinson, Thomas H; Kimber, Ian; Whelan, Maurice

    2015-09-01

    Adverse Outcome Pathways (AOPs) provide an opportunity to develop new and more accurate safety assessment processes for drugs and other chemicals, and may ultimately play an important role in regulatory decision making. Not only can the development and application of AOPs pave the way for the development of improved evidence-based approaches for hazard and risk assessment, there is also the promise of a significant impact on animal welfare, with a reduced reliance on animal-based methods. The establishment of a useable and coherent knowledge framework under which AOPs will be developed and applied has been a first critical step towards realizing this opportunity. This article explores how the development of AOPs under this framework, and their application in practice, could benefit the science and practice of safety assessment, while in parallel stimulating a move away from traditional methods towards an increased acceptance of non-animal approaches. We discuss here the key areas where current, and future initiatives should be focused to enable the translation of AOPs into routine chemical safety assessment, and lasting 3Rs benefits. PMID:25943792

  3. 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

  4. Effects of the Resident Assessment Instrument on the care process and health outcomes in nursing homes. A review of the literature.

    PubMed

    Achterberg, W P; van Campen, C; Pot, A M; Kerkstra, A; Ribbe, M W

    1999-09-01

    The objective of the paper is to review the effects of the implementation of the Resident Assessment Instrument (RAI) on process measures (quality of care plans and staff satisfaction) and outcome measures (health problems and quality of life) in nursing homes. All available publications on the effects of the RAI were included in the review. The most positive effects of the RAI were found in improvements in the comprehensiveness and accuracy of the care plans. As regards outcome quality, the RAI method had most positive effects on the health condition of nursing home residents with diminished physical and mental functioning. In psychosocial areas of assessment, fewer positive effects were found. We concluded that positive effects have been found, based on pre-test-post-test noncontrolled designs. Control-group designs are needed in future evaluation studies to determine if these positive results will hold. PMID:10458311

  5. Vitamin D Receptor Gene Ablation in the Conceptus Has Limited Effects on Placental Morphology, Function and Pregnancy Outcome

    PubMed Central

    Laurence, Jessica A.; Leemaqz, Shalem; O’Leary, Sean; Bianco-Miotto, Tina; Du, Jing; Anderson, Paul H.; Roberts, Claire T.

    2015-01-01

    Vitamin D deficiency has been implicated in the pathogenesis of several pregnancy complications attributed to impaired or abnormal placental function, but there are few clues indicating the mechanistic role of vitamin D in their pathogenesis. To further understand the role of vitamin D receptor (VDR)-mediated activity in placental function, we used heterozygous Vdr ablated C57Bl6 mice to assess fetal growth, morphological parameters and global gene expression in Vdr null placentae. Twelve Vdr+/- dams were mated at 10–12 weeks of age with Vdr+/- males. At day 18.5 of the 19.5 day gestation in our colony, females were euthanised and placental and fetal samples were collected, weighed and subsequently genotyped as either Vdr+/+, Vdr+/- or Vdr-/-. Morphological assessment of placentae using immunohistochemistry was performed and RNA was extracted and subject to microarray analysis. This revealed 25 genes that were significantly differentially expressed between Vdr+/+ and Vdr-/- placentae. The greatest difference was a 6.47-fold change in expression of Cyp24a1 which was significantly lower in the Vdr-/- placentae (P<0.01). Other differentially expressed genes in Vdr-/- placentae included those involved in RNA modification (Snord123), autophagy (Atg4b), cytoskeletal modification (Shroom4), cell signalling (Plscr1, Pex5) and mammalian target of rapamycin (mTOR) signalling (Deptor and Prr5). Interrogation of the upstream sequence of differentially expressed genes identified that many contain putative vitamin D receptor elements (VDREs). Despite the gene expression differences, this did not contribute to any differences in overall placental morphology, nor was function affected as there was no difference in fetal growth as determined by fetal weight near term. Given our dams still expressed a functional VDR gene, our results suggest that cross-talk between the maternal decidua and the placenta, as well as maternal vitamin D status, may be more important in determining pregnancy outcome than conceptus expression of VDR. PMID:26121239

  6. Analysis of a Urinary Biomarker Panel for Clinical Outcomes Assessment in Cirrhosis

    PubMed Central

    Ariza, Xavier; Solà, Elsa; Elia, Chiara; Barreto, Rogelio; Moreira, Rebeca; Morales-Ruiz, Manuel; Graupera, Isabel; Rodríguez, Ezequiel; Huelin, Patricia; Solé, Cristina; Fernández, Javier; Jiménez, Wladimiro; Arroyo, Vicente; Ginès, Pere

    2015-01-01

    Background Biomarkers are potentially useful in assessment of outcomes in patients with cirrhosis, but information is very limited. Given the large number of biomarkers, adequate choice of which biomarker(s) to investigate first is important. Aim Analysis of potential usefulness of a panel of urinary biomarkers in outcome assessment in cirrhosis. Patients and Methods Fifty-five patients with acute decompensation of cirrhosis were studied: 39 had Acute Kidney Injury (AKI) (Prerenal 12, type-1 HRS (hepatorenal syndrome) 15 and Acute Tubular Necrosis (ATN) 12) and 16 acute decompensation without AKI. Thirty-four patients had Acute-on-chronic liver failure (ACLF). A panel of 12 urinary biomarkers was assessed, using a multiplex assay, for their relationship with ATN, ACLF and mortality. Results Biomarker with best accuracy for ATN diagnosis was NGAL (neutrophil-gelatinase associated lipocalin): 36 [26-125], 104 [58-208] and 1807 [494-3,716] ?g/g creatinine in Prerenal-AKI, type-1 HRS and ATN, respectively; p<0.0001 (AUROC 0.957). Other attractive biomarkers for ATN diagnosis were IL-18, albumin, trefoil-factor-3 (TFF-3) and glutathione-S-transferase-? (GST-?) Biomarkers with less accuracy for ATN AUCROC<0.8 were ?2-microglobulin, calbindin, cystatin-C, clusterin and KIM-1 (kidney injury molecule-1). For ACLF, the biomarker with the best accuracy was NGAL (ACLF vs. No-ACLF: 165 [67-676] and 32 [19-40] ?g/g creatinine; respectively; p<0.0001; AUROC 0.878). Interestingly, other biomarkers with high accuracy for ACLF were osteopontin, albumin, and TFF-3. Biomarkers with best accuracy for prognosis were those associated with ACLF. Conclusions A number of biomarkers appear promising for differential diagnosis between ATN and other types of AKI. The most interesting biomarkers for ACLF and prognosis are NGAL, osteopontin, albumin, and TFF-3. These results support the role of major inflammatory reaction in the pathogenesis of ACLF. PMID:26042740

  7. 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…

  8. Bridge Functionality Relationships for Improved Seismic Risk Assessment

    E-print Network

    Padgett, Jamie Ellen

    Bridge Functionality Relationships for Improved Seismic Risk Assessment of Transportation Networks Jamie E. Padgett,a... M.EERI, and Reginald DesRoches,b... M.EERI Relationships between bridge damage and the resulting loss of functionality of the bridge are critical to assessing the impact of an earthquake event

  9. Residential Treatment for Sexually Abusive Youth: An Assessment of Treatment Outcomes

    ERIC Educational Resources Information Center

    Jones, Christopher D.; Chancey, Roy; Lowe, Laura A.; Risler, Edwin A.

    2010-01-01

    Objective: This research study assesses the effectiveness of participation in a multimodal/holistic residential treatment program on changing deviant sexual interests and functional impairment among sexually abusive youth. Method: A one-group pretest posttest design was utilized to examine pretest (intake) and posttest (discharge) scores for 58…

  10. Evaluation of Functional Outcomes after Stapes Surgery in Patients with Clinical Otosclerosis in a Teaching Institution

    PubMed Central

    Souza, José Celso Rodriques de; Bento, Ricardo Ferreira; Pereira, Larissa Vilela; Ikari, Liliane; Souza, Stephanie Rugeri; Della Torre, Ana Adelina Giantomasi; Fonseca, Anna Carolina de Oliveira

    2015-01-01

    Introduction?Otosclerosis is a primary disease of the temporal bone that leads to stapes ankylosis. Hearing loss is the main symptom. Treatment includes surgery, medical treatment, and sound amplification therapy alone or in combination. Objective?To evaluate the functional outcomes of patients with clinical diagnosis of otosclerosis undergoing primary stapes surgery in a teaching institution. Method?Retrospective descriptive study. Results?A total of 210 ears of 163 patients underwent stapes surgery. Of the 163 patients, 116 (71.2%) underwent unilateral surgery and 47 (28.8%) underwent bilateral surgery. Six of the 210 operated ears had obliterative otosclerosis. The average preoperative and postoperative air–bone gap was 32.06 and 4.39?dB, respectively. The mean preoperative and postoperative bone conduction threshold was 23.17 and 19.82?dB, respectively. A total of 184 (87.6%) ears had a residual air–bone gap <10?dB, and 196 (93.3%) had a residual air–bone gap ?15 dB. Two patients (0.95%) had severe sensorineural hearing loss. Conclusion?Stapes surgery showed excellent functional hearing outcomes in this study. This surgery may be performed in educational institutions with the supervision of experienced surgeons. PMID:26722344

  11. Expressed Emotion, Family Functioning, and Treatment Outcome for Adolescents with Anorexia Nervosa.

    PubMed

    Rienecke, Renee D; Accurso, Erin C; Lock, James; Le Grange, Daniel

    2016-01-01

    The current study examined the relation between parental expressed emotion (EE) and treatment outcome among adolescents participating in a treatment study for adolescent anorexia nervosa, as well as its impact on family functioning. One hundred and twenty-one families were assigned to family-based treatment or adolescent-focused therapy. Paternal criticism predicted lesser improvement in eating disorder psychopathology at end of treatment. There was also a significant interaction between maternal hostility and treatment, indicating that adolescents whose mothers displayed hostility had greater increases in percent of expected body weight in adolescent-focused therapy than family-based treatment. In addition, maternal hostility predicted less improvement in general family functioning and family communication at the end of treatment. Findings suggest that maternal and paternal EE may differentially impact treatment outcome and should be directly attended to in clinical settings. Future research is needed to further explore ways in which parental EE can be effectively modified in treatment. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. PMID:26201083

  12. Morphological and functional outcomes following modified early treatment diabetic retinopathy study laser in diabetic macular edema

    PubMed Central

    Raman, Rajiv; Santhanam, Kiruthika; Gella, Laxmi; Pal, Bikramjit P.; Sharma, Tarun

    2015-01-01

    Aim: The aim was to report morphological and functional outcomes following modified early treatment diabetic retinopathy study (ETDRS) laser in diabetic macular edema (DME). Materials and Methods: Structural and functional changes using spectral domain optical coherence tomography (OCT) and microperimetry (MP) were studied before and 4 months after laser in 37 eyes with clinically significant macular edema (ME) requiring modified ETDRS laser treatment. Paired t-test was used to compare pre and postlaser outcomes P < 0.05 was considered statistically significant. Results: Central foveal thickness showed a significant reduction after laser P = 0.004. There was a significant reduction in mean retinal thickness (MRT) and retinal volume in all the quadrants of ETDRS except for the temporal and nasal quadrants in outer 6 mm ring. Maximum reduction in MRT was seen in eyes with DME having neurosensory detachment (382.66 ? to 292.61 ?). Retinal sensitivities reduced in all quadrants following laser, however, fixation patterns showed improvements. The change in VA was positively correlated to change in MRT (r = 0.468, P = 0.032). Conclusion: Laser not only causes structural benefits such as reduction of retinal thickness and volume, it also causes improvement of fixation patterns.

  13. Functional MYCN signature predicts outcome of neuroblastoma irrespective of MYCN amplification

    PubMed Central

    Valentijn, Linda J.; Koster, Jan; Haneveld, Franciska; Aissa, Rachida Ait; van Sluis, Peter; Broekmans, Marloes E. C.; Molenaar, Jan J.; van Nes, Johan; Versteeg, Rogier

    2012-01-01

    Neuroblastoma is a pediatric tumor of the sympathetic nervous system. MYCN (V-myc myelocytomatosis viral-related oncogene, neuroblastoma derived [avian]) is amplified in 20% of neuroblastomas, and these tumors carry a poor prognosis. However, tumors without MYCN amplification also may have a poor outcome. Here, we identified downstream targets of MYCN by shRNA-mediated silencing MYCN in neuroblastoma cells. From these targets, 157 genes showed an expression profile correlating with MYCN mRNA levels in NB88, a series of 88 neuroblastoma tumors, and therefore represent in vivo relevant MYCN pathway genes. This 157-gene signature identified very poor prognosis tumors in NB88 and independent neuroblastoma cohorts and was more powerful than MYCN amplification or MYCN expression alone. Remarkably, this signature also identified poor outcome of a group of tumors without MYCN amplification. Most of these tumors have low MYCN mRNA levels but high nuclear MYCN protein levels, suggesting stabilization of MYCN at the protein level. One tumor has an MYC amplification and high MYC expression. Chip-on-chip analyses showed that most genes in this signature are directly regulated by MYCN. MYCN induces genes functioning in cell cycle and DNA repair while repressing neuronal differentiation genes. The functional MYCN-157 signature recognizes classical neuroblastoma with MYCN amplification, as well as a newly identified group marked by MYCN protein stabilization. PMID:23091029

  14. 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

  15. CBCT in orthodontics: assessment of treatment outcomes and indications for its use.

    PubMed

    Kapila, S D; Nervina, J M

    2015-01-01

    Since its introduction into dentistry in 1998, CBCT has become increasingly utilized for orthodontic diagnosis, treatment planning and research. The utilization of CBCT for these purposes has been facilitated by the relative advantages of three-dimensional (3D) over two-dimensional radiography. Despite many suggested indications of CBCT, scientific evidence that its utilization improves diagnosis and treatment plans or outcomes has only recently begun to emerge for some of these applications. This article provides a comprehensive and current review of key studies on the applications of CBCT in orthodontic therapy and for research to decipher treatment outcomes and 3D craniofacial anatomy. The current diagnostic and treatment planning indications for CBCT include impacted teeth, cleft lip and palate and skeletal discrepancies requiring surgical intervention. The use of CBCT in these and other situations such as root resorption, supernumerary teeth, temporomandibular joint (TMJ) pathology, asymmetries and alveolar boundary conditions should be justified on the basis of the merits relative to risks of imaging. CBCT has also been used to assess 3D craniofacial anatomy in health and disease and of treatment outcomes including that of root morphology and angulation; alveolar boundary conditions; maxillary transverse dimensions and maxillary expansion; airway morphology, vertical malocclusion and obstructive sleep apnoea; TMJ morphology and pathology contributing to malocclusion; and temporary anchorage devices. Finally, this article utilizes findings of these studies and current voids in knowledge to provide ideas for future research that could be beneficial for further optimizing the use of CBCT in research and the clinical practice of orthodontics. PMID:25358833

  16. Long-Term Function, Pain and Medication Use Outcomes of Radiofrequency Ablation for Lumbar Facet Syndrome

    PubMed Central

    McCormick, Zachary L.; Marshall, Benjamin; Walker, Jeremy; McCarthy, Robert; Walega, David R.

    2015-01-01

    Objective Radiofrequency ablation (RFA) of the medial branch nerves for facet-mediated low back pain demonstrates clinical benefit for 6–12 months and possibly up to 2 years. This study investigated function, pain, and medication use outcomes of RFA for lumbar facet syndrome in a cohort with long-term follow-up. Methods Individuals evaluated in a tertiary academic pain practice between January, 2007–December, 2013, 18–60 years of age, with a clinical and radiologic diagnosis of lumbar facet syndrome, who underwent ?1set of diagnostic medial branch blocks with resultant >75% pain relief and subsequent RFA were included. Outcomes measured were the proportion of individuals who reported ?50% improvement in function, ?50% improvement in pain; change in median NRS pain score, daily morphine equivalent consumption (DME), Medication Quantification Scale III (MSQ III) score and procedure complications. Results Sixty-two consecutive individuals with a median age and 25%–75% interquartile range (IQR) of 34 years (35, 52) met inclusion criteria. Seven individuals were lost to follow-up. Duration of pain was <2 years in 42%, 2–5 years in 40%, >5 years in 18% of individuals. Median duration of follow-up was 39 months (16, 60). Function and pain improved by ?50% in 58% (CI 45%, 71%) and 53% (CI 40%, 66%) of individuals, respectively. The median reduction in MQS III score was 3.4 points (0, 8.8). No complications occurred in this cohort. Conclusions This study demonstrates a durable treatment effect of RFA for lumbar facet syndrome at long-term follow-up, as measured by improvement in function, pain, and analgesic use. PMID:26005713

  17. 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

  18. Trends in survival and early functional outcomes from hospitalized severe adult traumatic brain injuries, Pennsylvania, 1998–2007

    PubMed Central

    Sánchez, Álvaro I; Krafty, Robert T; Weiss, Harold B; Rubiano, Andrés M; Peitzman, Andrew B; Puyana, Juan Carlos

    2011-01-01

    Objective To determine trends for in-hospital survival and functional outcomes at acute care hospital discharge for severe adult traumatic brain injury (SATBI) patients in Pennsylvania, during 1998–2007. Methods Secondary analysis of the Pennsylvania trauma outcome study database. Main Outcome Measures Survival and functional status scores of five domains (feeding, locomotion, expression, transfer mobility, and social interaction) fitted into logistic regression models adjusted for age, sex, race, co-morbidities, injury mechanism, extra-cranial injuries, severity scores, hospital stay, trauma center, and hospital level. Sensitivity analyses for functional outcomes were performed. Results There were 26,234 SATBI patients. Annual numbers of SATBI increased from 1,757 to 3,808 during 1998–2007. Falls accounted for 47.7% of all SATBI. Survival increased significantly from 72.5% to 82.7% (OR 1.10, 95%CI 1.08–1.11, P<0.001). In sensitivity analyses, trends of complete independence in functional outcomes increased significantly for expression (OR 1.01, 95%CI 1.00–1.02, P=0.011) and social interaction (OR 1.01, 95%CI 1.00–1.03, P=0.002). There were no significant variations over time for feeding, locomotion, and transfer mobility. Conclusions Trends for SATBI served by Pennsylvania’s established trauma system showed increases in rates but substantial reductions in mortality and significant improvements in functional outcomes at discharge for expression and social interaction. PMID:21386713

  19. Functional Outcome Changes in Surgery for Pituitary Adenomas After Intraoperative Occurrence of the Trigeminocardiac Reflex

    PubMed Central

    Chowdhury, T.; Nöthen, C.; Filis, A.; Sandu, N.; Buchfelder, M.; Schaller, Bernhard

    2015-01-01

    Abstract Trigeminocardiac reflex (TCR) represents now a nearly ubiquitary phenomenon in skull base surgery. Functional relevance of the intrainterventional TCR occurrence is hitherto only proven for vestibular schwannoma. In a retrospective observational study, 19 out of 338 (8%) enrolled adult patients demonstrated a TCR during transsphenoidal/transcranial surgery for pituitary adenomas. The 2 subgroups (TCR vs non-TCR) had similar patient's characteristics, risk factors, and histology. Preoperatively, there was a similar distribution of normal pituitary function in the TCR and non-TCR subgroups. In this TCR subgroup, there was a significant decrease of that normal pituitary function after operation (37%) compared to the non-TCR group (60%) (P?function compared with the non-TCR subgroup (P?functional hormonal outcome after pituitary surgery and strongly underline again the importance of the TCR in clinical daily practice. As a consequence, TCR should be considered as a negative prognostic factor of hormonal normalization after surgery for pituitary adenomas that should be included into routine practice. PMID:26376385

  20. Treatment Outcomes, Growth Height, and Neuroendocrine Functions in Patients With Intracranial Germ Cell Tumors Treated With Chemoradiation Therapy

    SciTech Connect

    Odagiri, Kazumasa; Department of Radiology, Kanagawa Children's Medical Center, Yokohama ; Omura, Motoko; Department of Radiology, Kanagawa Children's Medical Center, Yokohama ; Hata, Masaharu; Aida, Noriko; Niwa, Tetsu; Ogino, Ichiro; Kigasawa, Hisato; Adachi, Masataka; Inoue, Tomio

    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.

  1. Electroencephalography/functional magnetic resonance imaging responses help predict surgical outcome in focal epilepsy

    PubMed Central

    An, Dongmei; Fahoum, Firas; Hall, Jeffery; Olivier, André; Gotman, Jean; Dubeau, François

    2015-01-01

    Summary Purpose Simultaneous electroencephalography/functional magnetic resonance imaging (EEG/fMRI) recording can noninvasively map in the whole brain the hemodynamic response following an interictal epileptic discharge. EEG/fMRI is gaining interest as a presurgical evaluation tool. This study aims to determine how hemodynamic responses related to epileptic activity can help predict surgical outcome in patients considered for epilepsy surgery. Methods Thirty-five consecutive patients with focal epilepsy who had significant hemodynamic responses and eventually surgical resection, were studied. The statistical map of hemodynamic responses were generated and coregistered to postoperative anatomic imaging. Patients were classified into four groups defined by the relative relationship between the location of the maximum hemodynamic response and the resection: group 1, fully concordant; group 2, partially concordant; group 3, partially discordant; and group 4, fully discordant. These findings were correlated with surgical outcome with at least 12-month follow-up. Key Findings Ten patients in group 1 had the maximum t value (t-max) inside the resection; nine in group 2 had the t-max outside but close to the resection and the cluster with t-max overlapped the resection; five in group 3 had the t-max remote from resection, but with another less significant cluster in the resection; and 11 in group 4 had no response in the resection. The degree of concordance correlated largely with surgical outcome: a good surgical outcome (Engel’s class I) was found in 7 of 10 patients of group 1, 4 of 9 of group 2, 3 of 5 of group 3, and only 1 of 11 of group 4. These results indicate that the partially concordant and partially discordant groups are best considered as inconclusive. In contrast, in the fully concordant and fully discordant groups, the sensitivity, specificity, positive predictive value, and negative predictive value were high, 87.5%, 76.9%, 70%, and 90.9%, respectively. Significance This study demonstrates that hemodynamic responses related to epileptic activity can help delineate the epileptogenic region. Full concordance between maximum response and surgical resection is indicative of seizure freedom, whereas a resection leaving the maximum response intact is likely to lead to a poor outcome. EEG/fMRI is noninvasive but is limited to patients in whom interictal epileptic discharges can be recorded during the 60–90 min scan. PMID:24304438

  2. Statistical issues in risk assessment of reproductive outcomes with chemical mixtures

    SciTech Connect

    Hertzber, V.S.; Lemasters, G.K.; Hansen, K. ); Zenick, H.M. )

    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.

  3. ESPRESSO: taking into account assessment errors on outcome and exposures in power analysis for association studies

    PubMed Central

    Gaye, Amadou; Burton, Thomas W. Y.; Burton, Paul R.

    2015-01-01

    Motivation: Very large studies are required to provide sufficiently big sample sizes for adequately powered association analyses. This can be an expensive undertaking and it is important that an accurate sample size is identified. For more realistic sample size calculation and power analysis, the impact of unmeasured aetiological determinants and the quality of measurement of both outcome and explanatory variables should be taken into account. Conventional methods to analyse power use closed-form solutions that are not flexible enough to cater for all of these elements easily. They often result in a potentially substantial overestimation of the actual power. Results: In this article, we describe the Estimating Sample-size and Power in R by Exploring Simulated Study Outcomes tool that allows assessment errors in power calculation under various biomedical scenarios to be incorporated. We also report a real world analysis where we used this tool to answer an important strategic question for an existing cohort. Availability and implementation: The software is available for online calculation and downloads at http://espresso-research.org. The code is freely available at https://github.com/ESPRESSO-research. Contact: louqman@gmail.com Supplementary information: Supplementary data are available at Bioinformatics online. PMID:25908791

  4. 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. PMID:25620744

  5. Acute Coronary Syndrome and Cardiac Arrest: Using Simulation to Assess Resident Performance and Program Outcomes

    PubMed Central

    Opar, Susan P.; Short, Matthew W.; Jorgensen, Jennifer E.; Blankenship, Robert B.; Roth, Bernard J.

    2010-01-01

    Background Simulation training has emerged as an effective method of educating residents in cardiac emergencies. Few studies have used emergency simulation scenarios as an outcome measure to identify training deficiencies within residency programs. Purpose The purpose of this study was to evaluate postgraduate year-1 (PGY-1) residents on their ability to manage an acute coronary syndrome and cardiac arrest scenario before and after internship in order to provide outcome data to improve program performance. Methods A total of 58 PGY-1 residents from 10 medical specialties were evaluated using a human patient simulator before and after internship. They were given 12 minutes to manage a patient with acute coronary syndrome and ventricular fibrillation due to hyperkalemia. An objective checklist following basic and advanced cardiac life support guidelines was used to assess performance. Results A total of 58 interns (age, 25 to 44 years [mean, 29.1]; 38 [65.6%] men; 41 [70.7%] allopathic medical school graduates) participated in both the incoming and outgoing examination. Overall chest pain scores increased from a mean of 60.0% to 76.1% (P < .01). Medical knowledge performance improved from 51.1% to 76.1% (P < .01). Systems-based practice performance improved from 40.9% to 71.0% (P < .01). However, patient care performance declined from 93.4% to 80.2% (P < .01). Conclusions A simulated acute coronary syndrome and cardiac arrest scenario can evaluate incoming PGY-1 competency performance and test for interval improvement. This assessment tool can measure resident competency performance and evaluate program effectiveness. PMID:21976090

  6. Early Clinical Outcomes Demonstrate Preserved Cognitive Function in Children With Average-Risk Medulloblastoma When Treated With Hyperfractionated Radiation Therapy

    SciTech Connect

    Gupta, Tejpal; Jalali, Rakesh; Goswami, Savita; Nair, Vimoj; Moiyadi, Aliasgar; Epari, Sridhar; Sarin, Rajiv

    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.

  7. 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…

  8. Renal Function and Oncologic Outcomes after Cryoablation or Partial Nephrectomy for Tumors in Solitary Kidneys

    PubMed Central

    Goyal, Jatinder; Sidana, Abhinav; Georgiades, Christos S.

    2011-01-01

    Purpose Preservation of renal function is of paramount importance in patients with tumors in solitary kidneys. We compared the renal function and oncologic outcomes of patients treated by partial nephrectomy with those of patients treated by cryoablation for solitary kidney tumors. Materials and Methods All patients with solitary kidneys who were treated for renal tumors at our institution between 1997 and 2007 were included in the screen. We retrospectively identified 23 patients who underwent cryoablation and 15 patients who underwent partial nephrectomy. Results The two groups were similar with regard to age, gender, and tumor laterality. Patients in the partial nephrectomy group had a larger tumor size (3.4 cm vs. 2.5 cm, p=0.01), higher mean estimated blood loss (316 cc vs. 87 cc, p<0.001), longer duration of hospital stay (5.8 vs. 1.8 days, p<0.001), and a higher rate of perioperative complications (53.3% vs. 8.7% patients, p=0.03). Percentage changes in the glomerular filtration rate postoperatively and on follow-up were found to be similar in the two groups. Both the cryoablation and the partial nephrectomy groups with mean follow-ups of 31.2 months and 30.8 months, respectively, had evidence of local or distant recurrence in 3 patients each (13% and 20% respectively, p=0.7). Both groups had a similar mean overall survival (88.9 and 86.9 months in the cryoablation and partial nephrectomy groups, respectively, p=0.8). Conclusions For tumors in solitary kidneys, renal functional and clinical outcomes for cryoablation were not significantly different from those for partial nephrectomy. However, cryoablation has the distinct advantage of a lower morbidity rate and can be preferentially offered to selected cases. PMID:21750748

  9. The effect of language on functional capacity assessment in middle-aged and older US Latinos with schizophrenia

    PubMed Central

    Bengoetxea, Eneritz; Burton, Cynthia Z.; Mausbach, Brent T.; Patterson, Thomas L.; Twamley, Elizabeth W.

    2014-01-01

    The U.S. Latino population is steadily increasing, prompting a need for cross-cultural outcome measures in schizophrenia research. This study examined the contribution of language to functional assessment in middle-aged Latino patients with schizophrenia by comparing 29 monolingual Spanish-speakers, 29 Latino English-speakers, and 29 non-Latino English-speakers who were matched on relevant demographic variables and who completed cognitive and functional assessments in their native language. There were no statistically significant differences between groups on the four everyday functioning variables (UCSD Performance-Based Skills Assessment [UPSA], Social Skills Performance Assessment [SSPA], Medication Management Ability Assessment [MMAA], and the Global Assessment of Functioning [GAF]). The results support the cross-linguistic and cross-cultural acceptability of these functional assessment instruments. It appears that demographic variables other than language (e.g., age, education) better explain differences in functional assessment among ethnically diverse subpopulations. Considering the influence of these other factors in addition to language on functional assessments will help ensure that measures can be appropriately interpreted among the diverse residents of the United States. PMID:24751379

  10. The effect of polymer degradation time on functional outcomes of temporary elastic patch support in ischemic cardiomyopathy.

    PubMed

    Hashizume, Ryotaro; Hong, Yi; Takanari, Keisuke; Fujimoto, Kazuro L; Tobita, Kimimasa; Wagner, William R

    2013-10-01

    Biodegradable polyurethane patches have been applied as temporary mechanical supports to positively alter the remodeling and functional loss following myocardial infarction. How long such materials need to remain in place is unclear. Our objective was to compare the efficacy of porous onlay support patches made from one of three types of biodegradable polyurethane with relatively fast (poly(ester urethane)urea; PEUU), moderate (poly(ester carbonate urethane)urea; PECUU), and slow (poly(carbonate urethane)urea; PCUU) degradation rates in a rat model of ischemic cardiomyopathy. Microporous PEUU, PECUU or PCUU (n = 10 each) patches were implanted over left ventricular lesions 2 wk following myocardial infarction in rat hearts. Infarcted rats without patching and age-matched healthy rats (n = 10 each) were controls. Echocardiography was performed every 4 wk up to 16 wk, at which time hemodynamic and histological assessments were performed. The end-diastolic area for the PEUU group at 12 and 16 wk was significantly larger than for the PECUU or PCUU groups. Histological analysis demonstrated greater vascular density in the infarct region for the PECUU or PCUU versus PEUU group at 16 wk. Improved left ventricular contractility and diastolic performance in the PECUU group was observed at 16 wk compared to infarction controls. The results indicate that the degradation rate of an applied elastic patch influences the functional benefits associated patch placement, with a moderately slow degrading PECUU patch providing improved outcomes. PMID:23827185

  11. The effect of polymer degradation time on functional outcomes of temporary elastic patch support in ischemic cardiomyopathy

    PubMed Central

    Hashizume, Ryotaro; Hong, Yi; Takanari, Keisuke; Fujimoto, Kazuro L.; Tobita, Kimimasa; Wagner, William R.

    2013-01-01

    Biodegradable polyurethane patches have been applied as temporary mechanical supports to positively alter the remodeling and functional loss following myocardial infarction. How long such materials need to remain in place is unclear. Our objective was to compare the efficacy of porous onlay support patches made from one of three types of biodegradable polyurethane with relatively fast (poly(ester urethane) urea; PEUU), moderate (poly(ester carbonate urethane)urea; PECUU), and slow (poly(carbonate urethane) urea; PCUU) degradation rates in a rat model of ischemic cardiomyopathy. Microporous PEUU, PECUU or PCUU (n = 10 each) patches were implanted over left ventricular lesions 2 wk following myocardial infarction in rat hearts. Infarcted rats without patching and age-matched healthy rats (n = 10 each) were controls. Echocardiography was performed every 4 wk up to 16 wk, at which time hemodynamic and histological assessments were performed. The end-diastolic area for the PEUU group at 12 and 16 wk was significantly larger than for the PECUU or PCUU groups. Histological analysis demonstrated greater vascular density in the infarct region for the PECUU or PCUU versus PEUU group at 16 wk. Improved left ventricular contractility and diastolic performance in the PECUU group was observed at 16 wk compared to infarction controls. The results indicate that the degradation rate of an applied elastic patch influences the functional benefits associated patch placement, with a moderately slow degrading PECUU patch providing improved outcomes. PMID:23827185

  12. Functional outcome in athletes at five years of arthroscopic anterior cruciate ligament reconstruction.

    PubMed

    Devgan, Ashish; Magu, N K; Siwach, R C; Rohilla, Rajesh; Sangwan, S S

    2011-01-01

    Introduction. The purpose of this study was to analyze the functional outcome in competitive level athletes at 5 years after ACL reconstruction with regard to return to sports and the factors or reasons in those who either stopped sports or showed a fall in their sporting levels. Methods. 48 competitive athletes who had undergone arthroscopic assisted ACL reconstruction with a minimum follow up of at least 5 years were successfully recalled and were analyzed. Results. 22 patients had returned to the preinjury levels of sports and 18 showed a decrease in their sporting levels. Of the 18 patients, 12 referred to fear of reinjuring the same or contra-lateral knee as the prime reason for the same while 6 patients reported persisting knee pain and instability as reasons for a fall in their sporting abilities. The difference in the scores of these groups was statistically significant. 8 patients out of the 48 had left sports completely due to reasons other than sports, even though they had good knee outcome scores. Conclusion. Fear of reinjury and psychosocial issues that are relevant to the social milieu of the athlete are very important and affect the overall results of the surgery with respect to return to sports. PMID:24977065

  13. Social Function and Communication in Optimal Outcome Children and Adolescents with an Autism History on Structured Test Measures

    ERIC Educational Resources Information Center

    Orinstein, Alyssa J.; Suh, Joyce; Porter, Kaitlyn; De Yoe, Kaitlin A.; Tyson, Katherine E.; Troyb, Eva; Barton, Marianne L.; Eigsti, Inge-Marie; Stevens, Michael C.; Fein, Deborah A.

    2015-01-01

    Youth who lose their ASD diagnosis may have subtle social and communication difficulties. We examined social and communication functioning in 44 high-functioning autism (HFA), 34 optimal outcome (OO) and 34 typically developing (TD) youth. Results indicated that OO participants had no autism communication symptoms, no pragmatic language deficits,…

  14. 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.

  15. Do healthy cities work? A logic of method for assessing impact and outcome of healthy cities.

    PubMed

    de Leeuw, Evelyne

    2012-04-01

    In this article, we discuss an appropriate methodology for assessing complex urban programs such as the WHO European Healthy Cities Network. The basic tenets and parameters for this project are reviewed, and situated in the broader urban health tradition. This leads to a delineation of the types of questions researchers can address when looking at a complex urban health program. Such questions reach appropriately beyond traditional public health concepts involving proximal and distal determinants of health (and associated upstream, midstream, and downstream rhetoric). Espousing a multi-level, reciprocal pathways perspective on Healthy Cities research, we also adopt a distinction between impacts and outcomes of Healthy Cities. The former are value-driven, the latter intervention-driven. These approaches lead to the acknowledgment of a logic of method that includes situational and contextual appreciation of unique Healthy City experiences in a Realist Evaluation paradigm. The article concludes with a reflection of evaluation and assessment procedures applied to Phase IV (2003-2008) of the WHO European Healthy Cities Network and an interpretation of response rates to the range of methods that have been adopted. PMID:22002303

  16. Assessment of Treatment Patterns and Patient Outcomes in Levodopa-Induced Dyskinesias (ASTROID): A US Chart Review Study

    PubMed Central

    Lennert, Barb; Bibeau, Wendy; Farrelly, Eileen; Sacco, Patricia; Schoor, Tessa

    2012-01-01

    Background No curative therapy is available for Parkinson's disease; therefore, one of the main goals of treatment is to control motor symptoms, often via the use of levodopa (also known as L-dopa). However, prolonged levodopa treatment in Parkinson's disease has been associated with the development of motor fluctuations and the occurrence of levodopa-induced dyskinesias (LIDs). Objective To gain a clear, empirical understanding of the current real-world approach to treatment and patient outcomes associated with Parkinson's disease and LIDs. Methods This study used a mixed methodology, combining a cross-sectional survey of neurologists practicing in the United States, a retrospective chart review of patients with Parkinson's disease and LIDs, and cross-sectional surveys of health-related quality of life (QOL) and physical functioning in patients with Parkinson's disease. The surveys included the 39-item Parkinson's Disease Questionnaire, the Unified Parkinson's Disease Rating Scale, the Parkinson Disease Dyskinesia 26-item Scale, and the modified Abnormal Involuntary Movement Scale (mAIMS). Survey and chart data were collected between May 2010 and July 2011. Descriptive analyses were used to evaluate the distribution of study variables, treatment patterns, patient QOL, and patient physical functioning. Results Data from 7 neurologists and from 172 patients with Parkinson's disease and LIDs were collected. Results from the physician survey indicate that prescribing patterns depend largely on the severity of LIDs, assessed via mAIMS. Most patients (88%) received pharmacologic therapy as first-line treatment for LIDs, with monotherapy favored in patients with mild LIDs and combination therapy in patients with moderate-to-severe LIDs. The mean time from the diagnosis of LID to the administration of first-line treatment for the condition was 10.7 months (standard deviation, 14.0 months). The study population reflects a mean time from levodopa initiation to the onset of LIDs of slightly more than 5 years, regardless of the levodopa dosage. Results from the chart review and the physician survey suggest a strong alignment in severity classification among the assessment scales used. Conclusion These findings indicate that the diagnosis and the treatment of Parkinson's disease and LIDs are not optimal, because of the length of time from diagnosis to treatment, and because of the variability in treatment selection and response. Additional real-world studies are recommended to better understand treatment patterns, compliance with guidelines, and their potential impact on patient outcomes. PMID:24991332

  17. Validity of the Functional Loewenstein Occupational Therapy Cognitive Assessment (FLOTCA).

    PubMed

    Schwartz, Yifat; Averbuch, Sara; Katz, Noomi; Sagiv, Aliza

    2016-01-01

    The Functional Loewenstein Occupational Therapy Cognitive Assessment (FLOTCA) was developed to assess integrative higher cognitive abilities in people with traumatic brain injury (TBI). The FLOTCA measures performance on three tasks: navigating on a map, organizing a toolbox, and planning a daily schedule. This study assessed the psychometric properties of the FLOTCA with a sample of 25 participants with TBI ages 18-49 and 25 matched healthy participants. The FLOTCA showed high interrater reliability (intraclass correlation = .996) and internal consistency reliability for the total score (? = .82). Construct validity was supported for the total score, t?(48) = -5.48, d = 1.52, and the separate tasks. Moderate ecological validity was obtained with the combined FIM™ and Functional Assessment Measure, r?(19) = .44, p < .05. The results indicate that the FLOTCA can be used to assess higher cognitive abilities in functioning and can serve as the basis for intervention planning. PMID:26709431

  18. Smart Home-Based Longitudinal Functional Assessment

    E-print Network

    Cook, Diane J.

    permissions from permissions@acm.org. Abstract In this paper, we investigate methods of performing automated sensor-based change algorithms that can predict specific components of cognitive and physical health. Activities of daily living (ADL) such as sleeping, grooming, and eating are essential everyday functions

  19. 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)

  20. Assessment of hand function in Duchenne muscular dystrophy.

    PubMed

    Wagner, M B; Vignos, P J; Carlozzi, C; Hull, A L

    1993-08-01

    Eighteen boys with Duchenne muscular dystrophy (DMD) were assessed for their ability to perform tasks involving wrist and hand function. Each subject was assessed using the Jebsen Test of Hand Function, range of motion measurements, and muscle strength tests. Writing and simulated page turning were performed successfully by boys in all age groups. Boys over age 15 had difficulty completing simulated feeding and picking up large and small objects. The muscle strength of the wrist extensors and the radial deviation range of motion at the wrist were found to be strongly correlated with six of the seven tasks assessed. These two clinical assessments appear to be good indicators of overall wrist and hand function. Life expectancy with DMD is increasing with advances in respiratory care making preservation of wrist and hand function, the major activity remaining with advanced disease, increasingly important. PMID:8347064

  1. Contributions of physical function and satisfaction with social roles to emotional distress in chronic pain: a Collaborative Health Outcomes Information Registry (CHOIR) study.

    PubMed

    Sturgeon, John A; Dixon, Eric A; Darnall, Beth D; Mackey, Sean C

    2015-12-01

    Individuals with chronic pain show greater vulnerability to depression or anger than those without chronic pain, and also show greater interpersonal difficulties and physical disability. The present study examined data from 675 individuals with chronic pain during their initial visits to a tertiary care pain clinic using assessments from Stanford University's Collaborative Health Outcomes Information Registry (CHOIR). Using a path modeling analysis, the mediating roles of Patient-Reported Outcomes Measurement Information Systems (PROMIS) Physical Function and PROMIS Satisfaction with Social Roles and Activities were tested between pain intensity and PROMIS Depression and Anger. Pain intensity significantly predicted both depression and anger, and both physical function and satisfaction with social roles mediated these relationships when modeled in separate 1-mediator models. Notably, however, when modeled together, ratings of satisfaction with social roles mediated the relationship between physical function and both anger and depression. Our results suggest that the process by which chronic pain disrupts emotional well-being involves both physical function and disrupted social functioning. However, the more salient factor in determining pain-related emotional distress seems to be disruption of social relationships, than global physical impairment. These results highlight the particular importance of social factors to pain-related distress, and highlight social functioning as an important target for clinical intervention in chronic pain. PMID:26230739

  2. Dual Use of Bladder Anticholinergics and Cholinesterase Inhibitors: Long-Term Functional and Cognitive Outcomes

    PubMed Central

    Sink, Kaycee M.; Thomas, Joseph; Xu, Huiping; Craig, Bruce; Kritchevsky, Steven; Sands, Laura P.

    2015-01-01

    OBJECTIVES To determine the cognitive and functional consequences of dual use of cholinesterase inhibitors (ChIs) and the bladder anticholinergics oxybutynin or tolterodine. DESIGN Prospective cohort study. SETTING Nursing homes (NHs) in the state of Indiana. PARTICIPANTS Three thousand five hundred thirty-six Medicaid-eligible NH residents aged 65 and older taking a ChI between January 1, 2003, and December 31, 2004. Residents were excluded if they were taking an anticholinergic other than oxybutynin or tolterodine. MEASUREMENTS Indiana Medicaid claims data were merged with data from the Minimum Data Set (MDS). Repeated-measures analyses were performed to assess the effects of dual therapy on change in cognitive function measured using the MDS Cognition Scale (MDS-COGS; scored 0–10) and change in activity of daily living (ADL) function using the seven ADL items in the MDS (scored 0–28). Potential covariates included age, sex, race, number of medications, and Charlson Comorbidity Index score. RESULTS Three hundred seventy-six (10.6%) residents were prescribed oxybutynin or tolterodine concomitantly with a ChI. In residents in the top quartile of ADL function, ADL function declined an average of 1.08 points per quarter when not taking bladder anticholinergics (ChI alone), compared with 1.62 points per quarter when taking dual therapy, a 50% greater rate in quarterly decline in ADL function (P =.01). There was no excess decline attributable to dual therapy in MDS-COGS scores or in ADL function for residents who started out with lower functioning. CONCLUSION In higher-functioning NH residents, dual use of ChIs and bladder anticholinergics may result in greater rates of functional decline than use of ChIs alone. The MDS-COGS may not be sensitive enough to detect differences in cognition due to dual use. PMID:18384584

  3. The Impact of Mental Health Issues on Students with Mental Retardation: The Relationship of Teacher Report of Symptoms, Adaptive Functioning, and School Outcomes for Adolescents with Mild Mental Retardation

    ERIC Educational Resources Information Center

    Wright, Jennifer Adams

    2010-01-01

    This study investigated the relationship of mental health issues, adaptive functioning, and school outcomes for students with mild mental retardation (MMR). Mental health (MH) was measured using the Teacher Report Form (TRF) of the Achenbach System of Empirically Based Assessment (ASEBA). Teachers also completed the Adaptive Behavior Inventory…

  4. 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

  5. Measurement Properties of Indirect Assessment Methods for Functional Behavioral Assessment: A Review of Research

    ERIC Educational Resources Information Center

    Floyd, Randy G.; Phaneuf, Robin L.; Wilczynski, Susan M.

    2005-01-01

    Indirect assessment instruments used during functional behavioral assessment, such as rating scales, interviews, and self-report instruments, represent the least intrusive techniques for acquiring information about the function of problem behavior. This article provides criteria for examining the measurement properties of these instruments…

  6. Quantitative Assessment of Neuromotor Function in Adolescents with High Functioning Autism and Asperger Syndrome

    ERIC Educational Resources Information Center

    Freitag, Christine M.; Kleser, Christina; Schneider, Marc; von Gontard, Alexander

    2007-01-01

    Background: Motor impairment in children with Asperger Syndrome (AS) or High functioning autism (HFA) has been reported previously. This study presents results of a quantitative assessment of neuromotor skills in 14-22 year old HFA/AS. Methods: 16 HFA/AS and 16 IQ-matched controls were assessed by the Zurich Neuromotor Assessment (ZNA). Results:…

  7. ULO Course Learning Outcome Assessment Method Pedagogy 02-01 Build on what public speaking entails to adv-

    E-print Network

    Barrash, Warren

    COMM441 ULO Course Learning Outcome Assessment Method Pedagogy 02-01 Build on what public speaking, extemporaneous style, and proficient speaking about a specific topic. 02-02 Build on what public speaking entails, extemporaneous style, and proficient speaking about a specific topic. 03-01 Build on what public speaking entails

  8. ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read written discourse in French at the in-

    E-print Network

    Barrash, Warren

    FRENCH202 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read written discourse in French at the in- termediate level ; Interpret written discourse in French at the intermediate level ; Analyze written discourse in French at the interme- diate level ; Evaluate written discourse in French

  9. ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Write effectively in French with a clearly

    E-print Network

    Barrash, Warren

    FRENCH303 ULO Course Learning Outcome Assessment Method Pedagogy 01-01 Write effectively in French with a clearly defined purpose ; Adopt an appropriate voice, tone, and level of formality in French Apply standards of correct French grammar, syntax and spelling. Multiple Drafts of varied writing assign- ments

  10. ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read written discourse in French at the in-

    E-print Network

    Barrash, Warren

    FRENCH201 ULO Course Learning Outcome Assessment Method Pedagogy 10-01 Read written discourse in French at the in- termediate level ; Interpret written discourse in French at the intermediate level ; Analyze written discourse in French at the interme- diate level ; Evaluate written discourse in French

  11. The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials.

    PubMed

    Schmitt, Jochen; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric; Furue, Masutaka; Deckert, Stefanie; Dohil, Magdalene; Apfelbacher, Christian; Singh, Jasvinder A; Chalmers, Joanne; Williams, Hywel C

    2014-10-01

    The lack of core outcome sets for atopic eczema (AE) is a major obstacle for advancing evidence-based treatment. The global Harmonising Outcome Measures for Eczema (HOME) initiative has already defined clinical signs, symptoms, quality of life, and long-term control of flares as core outcome domains for AE trials. This article deals with the standardization of measurement instruments to assess clinical signs of AE. To resolve the current lack of standardization of the assessment of clinical signs of AE, we followed a structured process of systematic reviews and international consensus sessions to identify 1 core outcome measurement instrument for assessment of clinical signs in all future AE trials. Systematic reviews indicated that from 16 different instruments identified to assess clinical signs of AE, only the Eczema Area and Severity Index (EASI) and the objective Scoring Atopic Dermatitis (SCORAD) index were identified as extensively validated. The EASI has adequate validity, responsiveness, internal consistency, and intraobserver reliability. The objective SCORAD index has adequate validity, responsiveness, and interobserver reliability but unclear intraobserver reliability to measure clinical signs of AE. In an international consensus study, patients, physicians, nurses, methodologists, and pharmaceutical industry representatives agreed that the EASI is the preferred core instrument to measure clinical signs in all future AE trials. All stakeholders involved in designing, reporting, and using clinical trials on AE are asked to comply with this consensus to enable better evidence-based decision making, clearer scientific communication, and improved patient care. PMID:25282560

  12. 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…

  13. Improving Institutional Effectiveness: The Relationship between Assessing Student Learning Outcomes and Strategic Planning in California Community Colleges

    ERIC Educational Resources Information Center

    Gallagher, Mary

    2008-01-01

    Community colleges in California are grappling with developing and assessing student learning outcomes (SLOs), as the accrediting agency is holding them accountable for providing evidence of student learning as one measure of institutional effectiveness. One means of demonstrating accountability is to use strategic planning to direct the…

  14. 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

  15. Evaluation of treatment outcomes in a 3 years post-graduate orthodontic program using the peer assessment rating (par)

    PubMed Central

    Bellot-Arcís, Carlos; Montiel-Company, José M.; Gandía-Franco, José L.

    2014-01-01

    Objectives: To maintain high treatment quality it is important to evaluate orthodontic treatment results using objective methods. Outcome assessments allow private practitioners and university students to evaluate their results and raise the level of treatment outcomes. The aim of this study was to assess the orthodontic treatment outcome in a post-graduate orthodontics program in the University of Valencia (Spain) and to determine whether the treatment outcome is related to several factors as gender, age at start of the treatment, treatment duration, treatment method, extraction-non extraction treatment and cooperation needed. Material and Methods: A sample of 50 patients treated in the post-graduate clinic was randomly selected. Pre-treatment and post-treatment study casts have been assessed by the Peer Assessment Rating (PAR index). The influence of various factors: gender, age at start of the treatment, treatment duration, treatment method, extraction-non extraction treatment, cooperation needed and number of students finishing each case, were statistically analyzed. Results: According to the PAR index, orthodontic treatment reduced the malocclusion in a mean point reduction of 21.4 (CI 95% 18.7-24.1) and a mean percentage reduction of 80.5% (CI 95% 75.9-85.1). The total of the cases improved, 44% of the patients were in greatly improved category. Conclusions: None of the variables studied influenced significantly the treatment outcomes regarding the PAR. Based on the general classification criteria of the index, the results showed that the patients received a high standard treatment. Key words:Treatment outcome, orthodontics education, PAR Index. PMID:25593657

  16. A survey of variables used by speech-language pathologists to assess function and predict functional recovery in oral cancer patients.

    PubMed

    Husaini, Hasan; Krisciunas, Gintas P; Langmore, Susan; Mojica, Jacqueline K; Urken, Mark L; Jacobson, Adam S; Lazarus, Cathy L

    2014-06-01

    Oromotor and clinical swallow assessments are routinely performed by speech-language pathologists (SLPs) who see head and neck cancer (HNC) patients. However, the tools used to assess some of these variables vary. SLPs routinely identify and quantify abnormal functioning in order to rehabilitate the patient. However, function in terms of tongue range of motion (ROM) is typically described using a subjective severity rating scale. The primary objective of this study was to gain insight via survey into what variables SLPs consider important in assessing and documenting function after HNC treatment. A second objective was to seek feedback regarding a scale designed by the authors for assessing tongue ROM for this cohort of patients. This survey also was developed to elucidate salient factors that might have an impact on the prognosis for speech and swallow outcomes. Of the 1,816 SLPs who were sent the survey, 292 responded who work with HNC patients. Results revealed that although 95 % of SLPs assess tongue strength, only 13 % use instrumental methods. Although 98 % assess tongue ROM, 88 % estimate ROM based on clinical assessment. The majority of respondents agreed with the utility of the proposed tongue ROM rating scale. Several variables were identified by respondents as having an impact on overall prognosis for speech and swallow functioning. Tracking progress and change in function with treatment can be accomplished only with measurable assessment techniques. Furthermore, a consistent measuring system can benefit patients with other diagnoses that affect lingual mobility and strength. PMID:24609610

  17. Functional Outcomes of a New Mobile-Bearing Ultra-Congruent TKA System: Comparison With the Posterior Stabilized System.

    PubMed

    Machhindra, Morey Vivek; Kang, Jong Yeal; Kang, Yeon Gwi; Chowdhry, Madhav; Kim, Tae Kyun

    2015-12-01

    We determined whether a new mobile-bearing ultra-congruent (UC) TKA system provides better functional outcomes than an established posterior-stabilized (PS) prosthesis. The functional outcomes (motion arc, AKS scores, WOMAC Index, and SForm-36 scores evaluated at 1 and 2years postoperatively), satisfaction and incidences of adverse events were compared between the knees implanted with mobile-bearing UC prosthesis (n=103) and the mobile-bearing PS prosthesis (n=99). At 2years, mobile-bearing UC TKAs showed similar functional outcomes and satisfaction, but smaller motion arc compared to mobile-bearing PS TKAs (126° vs. 131°). There were no differences in the incidence of adverse events. Mobile-bearing UC prosthesis can be considered a safe and viable alternative to the PS design, with an expectation of smaller postoperative maximum flexion. PMID:26187388

  18. 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

  19. 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

  20. Assessing Mitochondrial Functions in Candida albicans.

    PubMed

    Li, Dongmei; Calderone, Richard

    2016-01-01

    This chapter is designed to present methods for characterizing the annotation of genes associated with mitochondrial functions in Candida spp. Methods include drop plate assays for evaluating inhibitors of the respiratory electron transport system complexes as well as measuring the enzyme activity of complex I-V enzyme activities. Assays are also presented to measure toxic ROS production that accompanies gene mutations or gene loss and chronological aging that often is shortened in Complex I dysfunction. Also presented are methods to isolate mitochondria, visualize mitochondria, and extract mitochondrial proteins. PMID:26519065

  1. 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

  2. Characterizing Tumor Heterogeneity With Functional Imaging and Quantifying High-Risk Tumor Volume for Early Prediction of Treatment Outcome: Cervical Cancer as a Model

    SciTech Connect

    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.

    2012-07-01

    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 IB{sub 2}-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 cm{sup 3}, respectively, significantly predicted unfavorable 6-year primary tumor control (p = 0.003, 7.3 Multiplication-Sign 10{sup -8}, 2.0 Multiplication-Sign 10{sup -8}) and disease-specific survival (p = 1.9 Multiplication-Sign 10{sup -4}, 2.1 Multiplication-Sign 10{sup -6}, 2.5 Multiplication-Sign 10{sup -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.

  3. 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

  4. Blue Cone Monochromacy: Visual Function and Efficacy Outcome Measures for Clinical Trials

    PubMed Central

    Iannaccone, Alessandro; Roman, Alejandro J.; Ditta, Lauren C.; Jennings, Barbara J.; Yatsenko, Svetlana A.; Sheplock, Rebecca; Sumaroka, Alexander; Swider, Malgorzata; Schwartz, Sharon B.; Wissinger, Bernd; Kohl, Susanne; Jacobson, Samuel G.

    2015-01-01

    Background Blue Cone Monochromacy (BCM) is an X-linked retinopathy caused by mutations in the OPN1LW / OPN1MW gene cluster, encoding long (L)- and middle (M)-wavelength sensitive cone opsins. Recent evidence shows sufficient structural integrity of cone photoreceptors in BCM to warrant consideration of a gene therapy approach to the disease. In the present study, the vision in BCM is examined, specifically seeking clinically-feasible outcomes for a future clinical trial. Methods BCM patients (n = 25, ages 5–72) were studied with kinetic and static chromatic perimetry, full-field sensitivity testing, and eye movement recordings. Vision at the fovea and parafovea was probed with chromatic microperimetry. Results Kinetic fields with a Goldmann size V target were generally full. Short-wavelength (S-) sensitive cone function was normal or near normal in most patients. Light-adapted perimetry results on conventional background lights were abnormally reduced; 600-nm stimuli were seen by rods whereas white stimuli were seen by both rods and S-cones. Under dark-adapted conditions, 500-nm stimuli were seen by rods in both BCM and normals. Spectral sensitivity functions in the superior retina showed retained rod and S-cone functions in BCM under dark-adapted and light-adapted conditions. In the fovea, normal subjects showed L/M-cone mediation using a 650-nm stimulus under dark-adapted conditions, whereas BCM patients had reduced sensitivity driven by rod vision. Full-field red stimuli on bright blue backgrounds were seen by L/M-cones in normal subjects whereas BCM patients had abnormally reduced and rod-mediated sensitivities. Fixation location could vary from fovea to parafovea. Chromatic microperimetry demonstrated a large loss of sensitivity to red stimuli presented on a cyan adapting background at the anatomical fovea and surrounding parafovea. Conclusions BCM rods continue to signal vision under conditions normally associated with daylight vision. Localized and retina-wide outcome measures were examined to evaluate possible improvement of L/M-cone-based vision in a clinical trial. PMID:25909963

  5. Outcome G. Graduates will have an ability to communicate effectively. The assessment is performed with respect to the key abilities that the students are expected to acquire in specific courses that have been

    E-print Network

    Mohaghegh, Shahab

    Outcome G. Graduates will have an ability to communicate effectively. The assessment is performed Indictor Performance Indicator Rubric Outcome G "Graduates will have an ability to communicate effectively

  6. WESTERN WATER ASSESSMENT Climate Change and the Functioning of Water

    E-print Network

    Neff, Jason

    WESTERN WATER ASSESSMENT REPORT Climate Change and the Functioning of Water Rights: A Search;CLIMATE CHANGE AND THE FUNCTIONING OF WATER RIGHTS: A SEARCH OF THE LITERATURE by Julie Shapiro, Douglas. Thesearchalsoincludedajournal-by-journalreviewofallonlinejournalsaccessiblethrough theUniversityofColoradolibrarysystemthatcontainthewords"water"or"climate

  7. Functional Outcome Following Arthroscopic ACL Reconstruction with Rigid Fix: A Retrospective Observational Study

    PubMed Central

    Shervegar, Satish; Nagaraj, Prashanth; Grover, Amit; DJ, Niranthara Ganesh; Ravoof, Abdul

    2015-01-01

    Background: No uniform consensus exists to decide type of fixation for arthroscopic anterior cruciate ligament reconstruction. Hypothsis: There is similar functional outcome after rigid fix compared to other methods of fixation which has been published. Study design: Retrospective observational study. Methods: A total of 50 patients underwent arthroscopic anterior cruciate ligament reconstruction with hamstring tendons using femoral Rigid fix cross-pin and interference screw tibial fixation. The evaluation methods were clinical examination, IKDC scores, Lysholm and pre injury and post reconstruction Tegner score. Patients were followed up from minimum of 6 months to 4 year seven months. Results: C In our study of sample size 50 we found that mean age of patients was 30.8 Years with male preponderance. Mean post operative IKDC and Lysholm score has been 75.6 and 84.4 respectively. Mean Tegner pre-injury score and post reconstruction score has been 5.4 and 4.26. Box plot comparison of pre injury and post operativeTegner score reveals a statistically significant difference with respect to paired t test P<0.001. Conclusions: Arthroscopic anterior cruciate ligament reconstruction with femoral rigid fix cross pins and tibial interference screws results in comparable short term to midterm functional results compared to other types of fixation PMID:26550591

  8. Function of prostaglandin E2 EP receptors in the acute outcome of rodent hypoxic ischemic encephalopathy

    PubMed Central

    Taniguchi, Hidetoshi; Anacker, Christoph; Suarez-Mier, Gabriela Beatriz; Wang, Qian; Andreasson, Katrin

    2011-01-01

    Neonatal hypoxic-ischemic encephalopathy (HIE) is a leading cause of severe and permanent neurologic disability after birth. The inducible cyclooxygenase COX-2, which along with COX-1 catalyzes the first committed step in prostaglandin (PG) synthesis, elicits significant brain injury in models of cerebral ischemia, however its downstream PG receptor pathways trigger both toxic and paradoxically protective effects. Here, we investigated the function of PGE2 E-prostanoid (EP) receptors in the acute outcome of hypoxic-ischemic (HI) injury in the neonatal rat. We determined the temporal and cellular expression patterns of the EP1-4 receptors before and after HIE and tested whether modulation of EP1-4 receptor function could protect against cerebral injury acutely after HIE. All four EP receptors were expressed in forebrain neurons and were induced in endothelial cells after HIE. Inhibition of EP1 signaling with the selective antagonist SC-51089 or co-activation of EP2-4 receptors with the agonist misoprostol significantly reduced HIE cerebral injury 24h after injury. These receptor ligands also protected brain endothelial cells subjected to oxygen glucose deprivation, suggesting that activation of EP receptor signaling is directly cytoprotective. These data indicate that the G-protein coupled EP receptors may be amenable to pharmacologic targeting in the acute setting of neonatal HIE. PMID:21939736

  9. Function of prostaglandin E2 EP receptors in the acute outcome of rodent hypoxic ischemic encephalopathy.

    PubMed

    Taniguchi, Hidetoshi; Anacker, Christoph; Suarez-Mier, Gabriela Beatriz; Wang, Qian; Andreasson, Katrin

    2011-10-31

    Neonatal hypoxic-ischemic encephalopathy (HIE) is a leading cause of severe and permanent neurologic disability after birth. The inducible cyclooxygenase COX-2, which along with COX-1 catalyzes the first committed step in prostaglandin (PG) synthesis, elicits significant brain injury in models of cerebral ischemia; however its downstream PG receptor pathways trigger both toxic and paradoxically protective effects. Here, we investigated the function of PGE(2) E-prostanoid (EP) receptors in the acute outcome of hypoxic-ischemic (HI) injury in the neonatal rat. We determined the temporal and cellular expression patterns of the EP1-4 receptors before and after HIE and tested whether modulation of EP1-4 receptor function could protect against cerebral injury acutely after HIE. All four EP receptors were expressed in forebrain neurons and were induced in endothelial cells after HIE. Inhibition of EP1 signaling with the selective antagonist SC-51089 or co-activation of EP2-4 receptors with the agonist misoprostol significantly reduced HIE cerebral injury 24 h after injury. These receptor ligands also protected brain endothelial cells subjected to oxygen glucose deprivation, suggesting that activation of EP receptor signaling is directly cytoprotective. These data indicate that the G-protein coupled EP receptors may be amenable to pharmacologic targeting in the acute setting of neonatal HIE. PMID:21939736

  10. The interplay of pain-related self-efficacy and fear on functional outcomes among youth with headache

    PubMed Central

    Carpino, Elizabeth; Segal, Sharon; Logan, Deirdre; Lebel, Alyssa; Simons, Laura E.

    2014-01-01

    Pain-related self-efficacy and pain-related fear have been proposed as opposing predictors of pain-related functional outcomes in youth with chronic pain. Self-efficacy is a potential resiliency factor that can mitigate the influence pain-related fear has on outcomes in youth with chronic pain. Drawing from theoretical assertions tested among adults with chronic pain, this study aimed to determine whether pain-related self-efficacy mediates the adverse influence of pain-related fear on functional outcomes in a sample of youth with chronic headache. In a cross-sectional design of 199 youth with headache, self-efficacy was strongly associated with fear, disability, school impairment, and depressive symptoms. Pain intensity and self-efficacy were only modestly related, indicating level of pain has less influence on one’s confidence functioning with pain. Self-efficacy partially mediated relationships between pain-related fear and both functional disability and school functioning but did not mediate the relationship between pain-related fear and depressive symptoms. These results suggest that one’s confidence in the ability to function despite pain and fear avoidance both uniquely contribute to pain-related outcomes in youth with chronic headache. These results further suggest that treatment for chronic headache in youth must focus on not only decreasing pain-related fear but also on enhancing a patient’s pain-related self-efficacy. Perspective Pain-related self-efficacy is an important resiliency factor impacting the influence of pain-related fear on functional disability and school functioning in youth with headache. Enhancing self-efficacy may be a key mechanism for improving behavioral outcomes. Clinicians can reduce pain-related fear and enhance pain-related self-efficacy through interventions that encourage accomplishment and self-confidence. PMID:24462790

  11. 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

  12. Functional outcome after successful internal fixation versus salvage arthroplasty of patients with a femoral neck fracture

    PubMed Central

    Zielinski, Stephanie M.; Keijsers, Noël L.; Praet, Stephan F.E.; Heetveld, Martin J.; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; Van Lieshout, Esther M.M.

    2014-01-01

    Objectives To determine patient independency, health-related and disease-specific quality of life (QOL), gait pattern, and muscle strength in patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture. Design Secondary cohort study to a randomized controlled trial. Setting Multicenter trial in the Netherlands, including 14 academic and non-academic hospitals Patients Patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture were studied. A comparison was made with patients who healed uneventfully after internal fixation. Intervention None (observatory study) Main outcome measurements Patient characteristics, SF-12, and WOMAC scores were collected. Gait parameters were measured using plantar pressure measurement. Maximum isometric forces of the hip muscles were measured using a handheld dynamometer. Differences between the fractured and contralateral leg were calculated. Groups were compared using univariate analysis. Results Of 248 internal fixation patients (median age 72 years), salvage arthroplasty was performed in 68 patients (27%). Salvage arthroplasty patients had a significantly lower WOMAC score (median 73 versus 90, P=0.016) than patients who healed uneventfully after internal fixation. Health-related QOL (SF-12) and patient independency did not differ significantly between the groups. Gait analysis showed a significantly impaired progression of the center of pressure in the salvage surgery patients (median ratio ?8.9 versus 0.4, P=0.013) and a significant greater loss of abduction strength (median ?25.4 versus ?20.4 N, P=0.025). Conclusion Despite a similar level of dependency and QOL, salvage arthroplasty patients have inferior functional outcome than patients who heal after internal fixation of a femoral neck fracture. PMID:24835623

  13. A systematic review of the prevalence of mildly abnormal liver function tests and associated health outcomes.

    PubMed

    Radcke, Sven; Dillon, John F; Murray, Aja L

    2015-01-01

    Liver function tests (LFTs) are commonly performed to investigate asymptomatic individuals or those with nonspecific symptoms. Understanding the prevalence of mildly abnormal LFTs in the general population and the prevalence of liver disease following abnormal LFTs has important implications for the planning of care pathways and the provision of healthcare services. A systematic review of the literature on the prevalence of abnormal LFTs in the general population and their respective health outcomes was conducted. A total of 37 studies reporting data on the prevalence of abnormal LFTs (published between 2000 and 2014) were identified from online database searches or were manually selected from article bibliographies. The prevalence of mildly abnormal LFTs, with one or more abnormal constituents in the LFT, was high at 10-21.7%. The prevalence of severe liver disease within cohorts with abnormal LFTs is relatively low (<5%), and a large proportion of abnormal LFTs remains unexplained. Among individuals with unexplained abnormal LFTs, risk factors include obesity and insulin resistance. Common aetiologies for abnormal LFTs were non-alcohol-related fatty liver disease (NAFLD), followed by alcohol use and viral infections. In addition, normal LFTs do not rule out liver disease. The prevalence of abnormal LFTs depends on the definition and population but is likely to be between 10 and 20% in the general population. Abnormal LFTs are associated with a range of health outcomes but are not necessarily strongly diagnostic of severe liver pathology. Important areas of future research include further studies on the prevalence and predictive ability of LFTs in large, population-representative samples. PMID:25380394

  14. 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

  15. Assessment Plan: B.S. in Mathematics Statistics Option Five learning outcomes will be used to assess the undergraduate program in Statistics. The

    E-print Network

    Barge, Marcy

    Assessment Plan: B.S. in Mathematics ­Statistics Option Five learning outcomes will be used) Given a scientific question, students will design an appropriate sampling plan or experimental design 2) Given a sampling plan or experimental design, students will be able to execute the plan or design. 3

  16. Assessment of Conative Educational Processes and Outcomes: Status Report of Empirical Studies. Project 2.3: Enhancing the Utility of Performance Assessments: Domain-Independent R&D.

    ERIC Educational Resources Information Center

    Snow, Richard E.; Jackson, Douglas N.

    Research planned to improve understanding of conative educational processes and outcomes is described. Over the past year, literature reviews have been conducted aimed at defining categories of assessment of student persistence, freedom from distraction, engagement, and other school-and-work related attitudes and motivations, both as learning…

  17. Functional Assessment of Spatial Neglect: A Review of the Catherine Bergego Scale and an Introduction of the Kessler Foundation Neglect Assessment Process

    PubMed Central

    Chen, Peii; Hreha, Kimberly; Fortis, Paola; Goedert, Kelly M.; Barrett, Anna M.

    2012-01-01

    Spatial neglect is a debilitating post-stroke neurocognitive disorder, associated with longer hospitalization and worse rehabilitation outcomes. Prior literature suggests a high prevalence of this disorder, but in reality clinicians have difficulty reliably identifying affected survivors. This discrepancy may result from suboptimal use of validated neglect assessment procedures. In this article, we suggest a validated assessment tool, sensitive to identify neglect and its functional consequences, the Catherine Bergego Scale (CBS). We provide detailed item-by-item CBS instructions for observation and scoring: the Kessler Foundation Neglect Assessment Process (KF-NAP). We describe a unique attribute of the CBS and the KF-NAP: rehabilitation researchers may be able to use them to measure both ecological outcomes, and specific, separable perceptual-attentional and motor-exploratory spatial behaviors. PMID:22982830

  18. 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

  19. Prospective Study Comparing Functional Outcomes and Revision Rates Between Hip Resurfacing and Total Hip Arthroplasty: Preliminary Results for 2 Years

    PubMed Central

    Pailhé, Régis; Reina, Nicolas; Cavaignac, Etienne; Sharma, Akash; Lafontan, Valérie; Laffosse, Jean-Michel; Chiron, Philippe

    2013-01-01

    There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the Partial Pelvic Replacement Hip Project by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS) and Postel-Merle d’Aubigné (MDA) score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1) [100 Durom® (Zimmer Inc., Warsaw, IN, USA) and 42 Birmingham Hip Resurfacing® (Smith & Nephew, Memphis, TN, USA)] and 278 patients with total hip arthroplasty (group 2). The results showed significantly greater gain of HHS, MDA and Devane score with hip resurfacing procedures. However, considering all the complications, the rate was significantly higher in group 16.4% vs 1.79% in group 2 (P<0.0001). In group 1 we observed 6 complications only concerned males with Durom® implants. The follow up of this cohort is still on going and may deliver more information on the evolution of these results in time. PMID:24191180

  20. Prospective study comparing functional outcomes and revision rates between hip resurfacing and total hip arthroplasty: preliminary results for 2 years.

    PubMed

    Pailhé, Régis; Reina, Nicolas; Cavaignac, Etienne; Sharma, Akash; Lafontan, Valérie; Laffosse, Jean-Michel; Chiron, Philippe

    2013-01-01

    There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the Partial Pelvic Replacement Hip Project by a single surgeon between January 2007 and January 2010. Patients were assessed with the Harris Hip Score (HHS) and Postel-Merle d'Aubigné (MDA) score and Devane Score. The end point of the study was reoperation for any cause related to the prosthesis. At a mean follow up of 38.6 months there were a total of 142 patients with hip resurfacing (group 1) [100 Durom(®) (Zimmer Inc., Warsaw, IN, USA) and 42 Birmingham Hip Resurfacing(®) (Smith & Nephew, Memphis, TN, USA)] and 278 patients with total hip arthroplasty (group 2). The results showed significantly greater gain of HHS, MDA and Devane score with hip resurfacing procedures. However, considering all the complications, the rate was significantly higher in group 16.4% vs 1.79% in group 2 (P<0.0001). In group 1 we observed 6 complications only concerned males with Durom(®) implants. The follow up of this cohort is still on going and may deliver more information on the evolution of these results in time. PMID:24191180

  1. 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

    2015-01-01

    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

  2. Adverse Birth Outcomes in Colorado: Assessing the Impact of a Statewide Initiative to Prevent Unintended Pregnancy

    PubMed Central

    Duca, Lindsey; Johnson, Randi K.; Ostendorf, Danielle; Sheeder, Jeanelle

    2015-01-01

    Objectives. We assessed whether living in counties with Title X clinics and increased use of long-acting reversible contraception (LARC) in Colorado are associated with decreased risk of adverse birth outcomes. Methods. We linked Title X clinic counties to the Colorado birth data set by using the mother’s county of residence. We compared low birth weight (LBW) and preterm birth (PTB) in 2008 and 2012, in counties with and without Title X clinics. We compared the relationship between LARC use and the incidence of LBW or PTB in 2012 for women living in counties with Title X clinics. Results. For women living in counties with Title X clinics, the odds of PTB were significantly lower in 2012 compared with 2008 (odds ratio?=?0.85; 95% confidence interval?=?0.81, 0.89; interaction P?=?.02). For women living in Title X clinic counties in 2012, a higher proportion of LARC use (>?12.4%) was significantly associated with decreased risk of PTB (P?=?.02) compared with a low proportion of LARC use (??4.96%). Conclusions. Improved access to family planning services and increased use of LARC are associated with lower risk of PTB. PMID:26180990

  3. 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. PMID:25844291

  4. Assessing community-wide outcomes of prevention marketing campaigns through telephone surveys.

    PubMed

    Myllyluoma, J; Greenberg, P; Wolters, C; Kaifer, P

    2000-03-01

    This random sample survey assesses the outcomes of the community-wide HIV prevention marketing campaigns for adolescents through telephone surveys, as well as the decisions that were made to address these concerns. The study employed repeated cross-sectional analysis to collect data from 1402 adolescents over a 23-month period. Likewise, a dual sampling strategy combined with Random Digit Dialing with Listed Household samples were used. The study was conducted in a manner that protects the anonymity, privacy, and confidentiality; and at the same time, gathers an adequate response rate. Results of the study confirm that the success of the evaluation program depended on the adequacy of the response rate, which includes the use of advanced letters and toll-free phone line, as well as sensitivity to the needs and concerns of the target population. The success that was achieved is still inadequate since the results confirm the challenge of developing feasible, affordable, tailored techniques for measuring risk behavior change in members of these groups. PMID:12349592

  5. Adverse Outcome Pathways and Ecological Risk Assessment: Bridging to Population-Level Effects

    SciTech Connect

    Kramer, Vincent J.; Etterson, Matthew A.; Hecker, Markus; Murphy, Cheryl A.; Roesijadi, Guritno; Spade, Daniel J.; Spromberg, Julann A.; Wang, Magnus; Ankley, Gerald T.

    2010-11-24

    The viability of populations of plants and animals is a key focus for environmental regulation. Population-level responses integrate the cumulative effects of chemical stressors on individuals as those individuals interact with and are affected by their con-specifics, competitors, predators, prey, habitat and other biotic and abiotic factors. Models of population-level effects of contaminants can integrate information from lower levels of biological organization and feed that information into higher-level community and ecosystem models. As individual-level endpoints are utilized to predict population responses, this requires that biological responses at lower levels of organization be translated into a form that is useable by the population modeler. In this paper we describe how mechanistic data, as captured in adverse outcome pathways, can be translated into modeling focused on population-level risk assessments. First, we present a succinct overview of different approaches to population modeling, and discuss the types of data needed for these models. Then we discuss how toxicity data are used currently for population modeling, and provide recommendations as to how testing might be modified to better generate information to support modeling. From this we describe how different key processes measured at the level of the individual serve as the bridge between mechanistic toxicology data and predictions of population status, and provide case examples of how this linkage has been/can be achieved.

  6. 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

  7. Outcomes Assessment and Its Role in Self-Reviews of Undergraduate Education: In the Context of Japanese Higher Education Reforms since the 1990s

    ERIC Educational Resources Information Center

    Kushimoto, Takeshi

    2010-01-01

    Under the recent state of higher education, "Outcomes Assessment" has become a familiar term in Japan as in other nations all over the world. However, actual conditions of outcomes assessment and its contribution toward educational improvement are not always obvious. Thus, this article attempts to clarify: (1) Japanese higher education reforms…

  8. Brain function assessment in different conscious states

    PubMed Central

    2010-01-01

    Background The study of brain functioning is a major challenge in neuroscience fields as human brain has a dynamic and ever changing information processing. Case is worsened with conditions where brain undergoes major changes in so-called different conscious states. Even though the exact definition of consciousness is a hard one, there are certain conditions where the descriptions have reached a consensus. The sleep and the anesthesia are different conditions which are separable from each other and also from wakefulness. The aim of our group has been to tackle the issue of brain functioning with setting up similar research conditions for these three conscious states. Methods In order to achieve this goal we have designed an auditory stimulation battery with changing conditions to be recorded during a 40 channel EEG polygraph (Nuamps) session. The stimuli (modified mismatch, auditory evoked etc.) have been administered both in the operation room and the sleep lab via Embedded Interactive Stimulus Unit which was developed in our lab. The overall study has provided some results for three domains of consciousness. In order to be able to monitor the changes we have incorporated Bispectral Index Monitoring to both sleep and anesthesia conditions. Results The first stage results have provided a basic understanding in these altered states such that auditory stimuli have been successfully processed in both light and deep sleep stages. The anesthesia provides a sudden change in brain responsiveness; therefore a dosage dependent anesthetic administration has proved to be useful. The auditory processing was exemplified targeting N1 wave, with a thorough analysis from spectrogram to sLORETA. The frequency components were observed to be shifting throughout the stages. The propofol administration and the deeper sleep stages both resulted in the decreasing of N1 component. The sLORETA revealed similar activity at BA7 in sleep (BIS 70) and target propofol concentration of 1.2 µg/mL. Conclusions The current study utilized similar stimulation and recording system and incorporated BIS dependent values to validate a common approach to sleep and anesthesia. Accordingly the brain has a complex behavior pattern, dynamically changing its responsiveness in accordance with stimulations and states. PMID:20522267

  9. Functional Outcomes of Multiple Sural Nerve Grafts for Facial Nerve Defects after Tumor-Ablative Surgery

    PubMed Central

    Lee, Myung Chul; Kim, Dae Hee; Jeon, Yeo Reum; Rah, Dong Kyun; Lew, Dae Hyun; Choi, Eun Chang

    2015-01-01

    Background Functional restoration of the facial expression is necessary after facial nerve resection to treat head and neck tumors. This study was conducted to evaluate the functional outcomes of patients who underwent facial nerve cable grafting immediately after tumor resection. Methods Patients who underwent cable grafting from April 2007 to August 2011 were reviewed, in which a harvested branch of the sural nerve was grafted onto each facial nerve division. Twelve patients underwent facial nerve cable grafting after radical parotidectomy, total parotidectomy, or schwannoma resection, and the functional facial expression of each patient was evaluated using the Facial Nerve Grading Scale 2.0. The results were analyzed according to patient age, follow-up duration, and the use of postoperative radiation therapy. Results Among the 12 patients who were evaluated, the mean follow-up duration was 21.8 months, the mean age at the time of surgery was 42.8 years, and the mean facial expression score was 14.6 points, indicating moderate dysfunction. Facial expression scores were not influenced by age at the time of surgery, follow-up duration, or the use of postoperative radiation therapy. Conclusions The results of this study indicate that facial nerve cable grafting using the sural nerve can restore facial expression. Although patients were provided with appropriate treatment, the survival rate for salivary gland cancer was poor. We conclude that immediate facial nerve reconstruction is a worthwhile procedure that improves quality of life by allowing the recovery of facial expression, even in patients who are older or may require radiation therapy. PMID:26217567

  10. Diverse functional outcomes of Plasmodium falciparum ligation of EPCR: potential implications for malarial pathogenesis.

    PubMed

    Gillrie, Mark R; Avril, Marion; Brazier, Andrew J; Davis, Shevaun P; Stins, Monique F; Smith, Joseph D; Ho, May

    2015-12-01

    Plasmodium falciparum-infected erythrocytes (IRBC) expressing the domain cassettes (DC) 8 and 13 of the cytoadherent ligand P.?falciparum erythrocyte membrane protein 1 adhere to the endothelial protein C receptor (EPCR). By interfering with EPCR anti-coagulant and pro-endothelial barrier functions, IRBC adhesion could promote coagulation and vascular permeability that contribute to the pathogenesis of cerebral malaria. In this study, we examined the adhesion of DC8- and DC13-expressing parasite lines to endothelial cells from different microvasculature, and the consequences of EPCR engagement on endothelial cell function. We found that IRBC from IT4var19 (DC8) and IT4var07 (DC13) parasite lines adhered to human brain, lung and dermal endothelial cells under shear stress. However, the relative contribution of EPCR to parasite cytoadherence on different types of endothelial cell varied. We also observed divergent functional outcomes for DC8 cysteine-rich interdomain region (CIDR)?1.1 and DC13 CIDR?1.4 domains. IT4var07 CIDR?1.4 inhibited generation of activated protein C (APC) on lung and dermal endothelial cells and blocked the APC-EPCR binding interaction on brain endothelial cells. IT4var19 CIDR?1.1 inhibited thrombin-induced endothelial barrier dysfunction in lung endothelial cells, whereas IT4var07 CIDR?1.4 inhibited the protective effect of APC on thrombin-induced permeability. Overall, these findings reveal a much greater complexity of how CIDR?1-expressing parasites may modulate malaria pathogenesis through EPCR adhesion. PMID:26119044

  11. 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

  12. Does the technique employed for skin temperature assessment alter outcomes? A systematic review.

    PubMed

    Bach, Aaron J E; Stewart, Ian B; Minett, Geoffrey M; Costello, Joseph T

    2015-09-01

    Skin temperature is an important physiological measure that can reflect the presence of illness and injury as well as provide insight into the localised interactions between the body and the environment. The aim of this systematic review was to analyse the agreement between conductive and infrared means of assessing skin temperature which are commonly employed in in clinical, occupational, sports medicine, public health and research settings.Full-text eligibility was determined independently by two reviewers. Studies meeting the following criteria were included in the review: (1) the literature was written in English, (2) participants were human (in vivo), (3) skin surface temperature was assessed at the same site, (4) with at least two commercially available devices employed-one conductive and one infrared-and (5) had skin temperature data reported in the study.A computerised search of four electronic databases, using a combination of 21 keywords, and citation tracking was performed in January 2015. A total of 8,602 were returned.Methodology quality was assessed by two authors independently, using the Cochrane risk of bias tool.A total of 16 articles (n = 245) met the inclusion criteria.Devices are classified to be in agreement if they met the clinically meaningful recommendations of mean differences within??±0.5?°C and limits of agreement of??±1.0?°C.Twelve of the included studies found mean differences greater than??±0.5?°C between conductive and infrared devices. In the presence of external stimulus (e.g. exercise and/or heat) five studies found exacerbated measurement differences between conductive and infrared devices.This is the first review that has attempted to investigate presence of any systemic bias between infrared and conductive measures by collectively evaluating the current evidence base. There was also a consistently high risk of bias across the studies, in terms of sample size, random sequence generation, allocation concealment, blinding and incomplete outcome data.This systematic review questions the suitability of using infrared cameras in stable, resting, laboratory conditions. Furthermore, both infrared cameras and thermometers in the presence of sweat and environmental heat demonstrate poor agreement when compared to conductive devices. These findings have implications for clinical, occupational, public health, sports science and research fields. PMID:26261099

  13. Introduction and empirical assessment of executive functioning as a predictor of job performance.

    PubMed

    Culbertson, Satoris S; Huffcutt, Allen I; Goebl, Allen P

    2013-08-01

    The primary purposes of this study were (a) to introduce the concept of executive functioning (higher-level cognitive processes which monitor events, actions, and outcomes) to the employee selection literature and (b) to provide an empirical assessment of executive functioning in relation to key selection variables. Two of the three main components of executive functioning (set shifting and inhibition) appear to have considerable potential for selection because of their unique nature (e.g., self-directed, goal-oriented) and because they appear to be only modestly associated with general mental ability. While our empirical results were inconsistent, there may be underlying reasons for this, such as the unstable nature of the retail job sector. We believe there is considerable justification for continued exploration of this unique and potentially promising construct, and identify a number of directions for future research. PMID:26271179

  14. Objectively-assessed outcome measures: a translation and cross-cultural adaptation procedure applied to the Chedoke McMaster Arm and Hand Activity Inventory (CAHAI)

    PubMed Central

    2010-01-01

    Background Standardised translation and cross-cultural adaptation (TCCA) procedures are vital to describe language translation, cultural adaptation, and to evaluate quality factors of transformed outcome measures. No TCCA procedure for objectively-assessed outcome (OAO) measures exists. Furthermore, no official German version of the Canadian Chedoke Arm and Hand Activity Inventory (CAHAI) is available. Methods An eight-step for TCCA procedure for OAO was developed (TCCA-OAO) based on the existing TCCA procedure for patient-reported outcomes. The TCCA-OAO procedure was applied to develop a German version of the CAHAI (CAHAI-G). Inter-rater reliability of the CAHAI-G was determined through video rating of CAHAI-G. Validity evaluation of the CAHAI-G was assessed using the Chedoke-McMaster Stroke Assessment (CMSA). All ratings were performed by trained, independent raters. In a cross-sectional study, patients were tested within 31 hours after the initial CAHAI-G scoring, for their motor function level using the subscales for arm and hand of the CMSA. Inpatients and outpatients of the occupational therapy department who experienced a cerebrovascular accident or an intracerebral haemorrhage were included. Results Performance of 23 patients (mean age 69.4, SD 12.9; six females; mean time since stroke onset: 1.5 years, SD 2.5 years) have been assessed. A high inter-rater reliability was calculated with ICCs for 4 CAHAI-G versions (13, 9, 8, 7 items) ranging between r = 0.96 and r = 0.99 (p < 0.001). Correlation between the CAHAI-G and CMSA subscales for hand and arm was r = 0.74 (p < 0.001) and r = 0.67 (p < 0.001) respectively. Internal consistency of the CAHAI-G for all four versions ranged between ? = 0.974 and ? = 0.979. Conclusions The TCCA-OAO procedure was validated regarding its feasibility and applicability for objectively-assessed outcome measures. The resulting German CAHAI can be used as a valid and reliable assessment for bilateral upper limb performance in ADL in patients after stroke. PMID:21114807

  15. Function preservation using transoral laser surgery for T2-T3 glottic cancer: oncologic, vocal, and swallowing outcomes.

    PubMed

    Peretti, Giorgio; Piazza, Cesare; Del Bon, Francesca; Mora, Renzo; Grazioli, Paola; Barbieri, Diego; Mangili, Stefano; Nicolai, Piero

    2013-08-01

    Aim of this study was to retrospectively analyze oncologic and functional results of a cohort of T2 and selected T3 glottic tumors treated by transoral laser surgery (TLS). Eighty-nine patients affected by T2 and T3 glottic tumors were treated by TLS from 2005 to 2010 at an academic institution by Type V cordectomies using an "en bloc" or, more frequently, a "piece-meal" technique depending on a number of variables. Kaplan-Meier curves were used to evaluate 5-year overall, disease-specific survivals, local control with laser, and organ preservation rates. Univariate analysis of the impact of different variables was performed. At least 1 year after surgery, we examined: subjective voice evaluation by voice handicap index (VHI), perceptive analysis by GRBAS scale, objective measurements with multidimensional voice program (MDVP), swallowing assessment with the M.D. Anderson Dysphagia Inventory (MDADI), videonasal endoscopic evaluation of swallowing (VEES), and videofluoroscopy (VFS). Fifty-nine patients were pT2 and 30 pT3. The 5-year overall, disease-specific survivals, local control with laser, and organ preservation rates were 92.4, 98.7, 68.5, and 82.1 %, respectively. VHI mean score was 20 (mild dysphonia). Mild and moderate dysphonias were detected by GRBAS in 82 and 18% of patients, respectively. Mean values of Jitter, Shimmer, and noise-to-harmonic ratio by MDVP resulted 7.87%, 24.8%, and 0.37, respectively. Mean value of MDADI was 95.75. Only 2% of patients at VEES and 4% at VFS showed tracheal aspiration. Our results highlight that T2 and selected T3 glottic tumors treated by TLS have favorable oncologic and functional outcomes. PMID:23568037

  16. 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…

  17. Conceptual model for assessing criteria air pollutants in a multipollutant context: A modified adverse outcome pathway approach.

    PubMed

    Buckley, Barbara; Farraj, Aimen

    2015-09-01

    Air pollution consists of a complex mixture of particulate and gaseous components. Individual criteria and other hazardous air pollutants have been linked to adverse respiratory and cardiovascular health outcomes. However, assessing risk of air pollutant mixtures is difficult since components are present in different combinations and concentrations in ambient air. Recent mechanistic studies have limited utility because of the inability to link measured changes to adverse outcomes that are relevant to risk assessment. New approaches are needed to address this challenge. The purpose of this manuscript is to describe a conceptual model, based on the adverse outcome pathway approach, which connects initiating events at the cellular and molecular level to population-wide impacts. This may facilitate hazard assessment of air pollution mixtures. In the case reports presented here, airway hyperresponsiveness and endothelial dysfunction are measurable endpoints that serve to integrate the effects of individual criteria air pollutants found in inhaled mixtures. This approach incorporates information from experimental and observational studies into a sequential series of higher order effects. The proposed model has the potential to facilitate multipollutant risk assessment by providing a framework that can be used to converge the effects of air pollutants in light of common underlying mechanisms. This approach may provide a ready-to-use tool to facilitate evaluation of health effects resulting from exposure to air pollution mixtures. PMID:26196529

  18. Functional assessment of long-term deficits in rodent models of traumatic brain injury.

    PubMed

    Gold, Eric M; Su, Diane; López-Velázquez, Luci; Haus, Daniel L; Perez, Harvey; Lacuesta, George A; Anderson, Aileen J; Cummings, Brian J

    2013-07-01

    Traumatic brain injury (TBI) ranks as the leading cause of mortality and disability in the young population worldwide. The annual US incidence of TBI in the general population is estimated at 1.7 million per year, with an estimated financial burden in excess of US$75 billion a year in the USA alone. Despite the prevalence and cost of TBI to individuals and society, no treatments have passed clinical trial to clinical implementation. The rapid expansion of stem cell research and technology offers an alternative to traditional pharmacological approaches targeting acute neuroprotection. However, preclinical testing of these approaches depends on the selection and characterization of appropriate animal models. In this article we consider the underlying pathophysiology for the focal and diffuse TBI subtypes, discuss the existing preclinical TBI models and functional outcome tasks used for assessment of injury and recovery, identify criteria particular to preclinical animal models of TBI in which stem cell therapies can be tested for safety and efficacy, and review these criteria in the context of the existing TBI literature. We suggest that 2 months post-TBI is the minimum period needed to evaluate human cell transplant efficacy and safety. Comprehensive review of the published TBI literature revealed that only 32% of rodent TBI papers evaluated functional outcome ?1 month post-TBI, and only 10% evaluated functional outcomes ?2 months post-TBI. Not all published papers that evaluated functional deficits at a minimum of 2 months post-TBI reported deficits; hence, only 8.6% of overall TBI papers captured in this review demonstrated functional deficits at 2 months or more postinjury. A 2-month survival and assessment period would allow sufficient time for differentiation and integration of human neural stem cells with the host. Critically, while trophic effects might be observed at earlier time points, it will also be important to demonstrate the sustainability of such an effect, supporting the importance of an extended period of in vivo observation. Furthermore, regulatory bodies will likely require at least 6 months survival post-transplantation for assessment of toxicology/safety, particularly in the context of assessing cell abnormalities. PMID:23826701

  19. Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation

    PubMed Central

    Seo, Chang Ho; Ju, Jeong Il; Kim, Mi-Hyeong; Jun, Kang Woong; Ahn, Sang-Hyun; Kim, Sang Dong; Park, Sun Cheol; Choi, Bum Soon; Kim, Ji Il; Yang, Chul Woo; Kim, Yong Soo; Moon, In Sung

    2015-01-01

    Purpose The purpose of this study was to analyze the risk factors for delayed graft function (DGF) and determine its impact on the outcomes of deceased donor (DD) kidney transplantation (KT). Methods Between January 2000 and December 2011, we performed 195 DD renal transplants. After the exclusion of primary nonfunctional grafts (n = 4), the study recipients were divided into two groups-group I, DGF (n = 31, 16.2%); group II, non-DGF (n = 160, 83.8%). The following variables were compared: donor and recipient characteristics, patient and graft survival, postoperative renal function, acute rejection (AR) episodes, and the rates of surgical and infectious complications. Results Donor-related variables that showed significant differences included hypertension (P = 0.042), diabetes (P = 0.025), and prerecovery serum creatinine levels (P < 0.001). However, there were no significant differences in recipient-related factors. One significantly different transplant-related factor was positive panel reactive antibody (PRA > 20%, P = 0.008). On multivariate analysis, only the prerecovery serum creatinine level (P < 0.001; hazard ratio [HR], 1.814) was an independent risk factor for the development of DGF. A Cox multivariate analysis of risk factors for graft survival identified these independent risk factors for graft survival: nephron mass (donor kidney weight to recipient body weight ratio) index (P = 0.026; HR, 2.328), CMV infection (P = 0.038; HR, 0.114), and AR episode (P = 0.038; HR, 0.166). Conclusion In DD KT, an independent risk factor for DGF was the prerecovery serum creatinine level. Although there was a significant difference in graft survival between the DGF and non-DGF groups, DGF was not an independent risk factor for graft failure in this study. PMID:26446498

  20. Intervention History of Children and Adolescents with High-Functioning Autism and Optimal Outcomes

    PubMed Central

    Orinstein, Alyssa J.; Helt, Molly; Troyb, Eva; Tyson, Katherine E.; Barton, Marianne L.; Eigsti, Inge-Marie; Naigles, Letitia; Fein, Deborah A.

    2015-01-01

    Objective Autism spectrum disorders (ASDs) were once considered lifelong disorders, but recent findings indicate that some children with ASDs no longer meet diagnostic criteria for any ASD and reach normal cognitive function. These children are considered to have achieved ‘optimal outcomes’ (OO). The present study aimed to retrospectively examine group differences in the intervention history of children and adolescents with OO and those with high-functioning autism (HFA) Method The current study examined intervention histories in 34 individuals with OO and 44 individuals with HFA (currently ages 8-21), who did not differ on age, sex, nonverbal IQ or family income. Intervention history was collected through detailed parent questionnaires. Results Children in the OO group had earlier parent concern, received earlier referrals to specialists, and earlier and more intensive intervention than those in the HFA group. Substantially more OO children received Applied Behavior Analysis (ABA) therapy than HFA children, although the intensity of ABA did not vary between groups. Children in the HFA group were more likely to have received medication, especially anti-psychotics and anti-depressants. There were no group differences in the percent of children receiving special diets or supplements. Conclusion These data suggest that OO individuals generally receive earlier, more intense interventions and more ABA, while HFA individuals receive more pharmacologic treatments. While the use of retrospective data is a clear limitation to the current study, the substantial differences in reported provision of early intervention, and ABA in particular, are highly suggestive and should be replicated in prospective studies. PMID:24799263

  1. Assessment of Musculoskeletal Malignancies with Functional MR Imaging.

    PubMed

    Vilanova, Joan C; Baleato-Gonzalez, Sandra; Romero, Maria José; Carrascoso-Arranz, Javier; Luna, Antonio

    2016-02-01

    Functional MR imaging is the technique of choice to evaluate and manage malignant musculoskeletal masses. Advanced MR imaging sequences include chemical shift MR imaging, diffusion-weighted imaging with apparent diffusion coefficient mapping, MR spectroscopy imaging, and dynamic contrast-enhanced perfusion imaging. Functional MR imaging adds value to morphologic sequences in the detection, characterization, staging, and posttherapy assessment of malignant musculoskeletal malignancies. This article reviews the technical role of each functional sequence and their clinical applications to allow more confident decisions to be made. Multiparametric analysis of functional and anatomic MR sequences allows musculoskeletal tumors analysis to be improved. PMID:26613884

  2. Productivity in Academia: An Assessment of Causal Linkages between Output and Outcome Indicators

    ERIC Educational Resources Information Center

    Wamala, Robert; Ssembatya, Vincent A.

    2015-01-01

    Purpose: The purpose of this paper is to investigate causal linkages between output and outcome indicators of productivity in academia. Design/methodology/approach: The duration of teaching service and the number of graduate students supervised to completion were adopted as output indicators of productivity. Equivalent outcome indicators were the…

  3. 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…

  4. 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…

  5. Assessing Academic Outcomes at the United States Coast Guard Academy: The Role of Student Attitudes.

    ERIC Educational Resources Information Center

    Rezendes, George J.; Gable, Robert K.

    This paper discusses the efforts of the Department of Mathematics at the United States Coast Guard Academy (USCGA) to determine the degree to which their courses support the published academic outcomes of the institution, and presents the results of a survey of student attitudes toward the academic outcomes. A survey questionnaire was developed…

  6. Evaluating Programs for At-Risk Adolescents: Toward an Outcome-Based Assessment Framework

    ERIC Educational Resources Information Center

    Sloat, Elizabeth A.; Audas, Richard P.; Willms, J. Douglas

    2007-01-01

    This article presents an outcome-based model for evaluating school and community programs serving at-risk adolescents, and a cost-effective technique for comparing the progress of youth receiving an intervention with youth in a pseudocontrol group. The outcomes considered most important for success were derived from the literature pertaining to…

  7. The Ineffective Role of Cathodal tDCS in Enhancing the Functional Motor Outcomes in Early Phase of Stroke Rehabilitation: An Experimental Trial

    PubMed Central

    Assenza, Federica; Izzo, Simona; Paolucci, Stefano; Vernieri, Fabrizio

    2014-01-01

    Transcranial direct current stimulation (tDCS) is a noninvasive technique that could improve the rehabilitation outcomes in stroke, eliciting neuroplastic mechanisms. At the same time conflicting results have been reported in subacute phase of stroke, when neuroplasticity is crucial. The aim of this double-blind, randomized, and sham-controlled study was to determine whether a treatment with cathodal tDCS before the rehabilitative training might augment the final outcomes (upper limb function, hand dexterity and manual force, locomotion, and activities of daily living) in respect of a traditional rehabilitation for a sample of patients affected by ischemic stroke in the subacute phase. An experimental group (cathodal tDCS plus rehabilitation) and a control group (sham tDCS plus rehabilitation) were assessed at the beginning of the protocol, after 10 days of stimulation, after 30 days from ending of stimulation, and at the end of inpatient rehabilitation. Both groups showed significant improvements for all the assessed domains during the rehabilitation, except for the manual force, while no significant differences were demonstrated between groups. These results seem to indicate that the cathodal tDCS, provided in an early phase of stroke, does not lead to a functional improvement. To depict a more comprehensive scenario, further studies are needed. PMID:24895588

  8. THE STATISTICAL ANALYSIS OF DISCRETE AND CONTINUOUS OUTCOMES USING DESIRABILITY FUNCTIONS.

    EPA Science Inventory

    Multiple types of outcomes are sometimes measured on each animal in toxicology dose-response experiments. In this paper we introduce a method of deriving a composite score for a dose-response experiment that combines information from discrete and continuous outcomes through the ...

  9. Methods of Intracanal Reinforcement in Primary Anterior Teeth–Assessing the Outcomes through a Systematic Literature Review

    PubMed Central

    Bhatia, Hind Pal; Haider, Khushtar

    2015-01-01

    ABSTRACT Aim: To assess how the various methods of intracanal reinforcement (short root canal posts) performed in their clinical and radiographic outcomes for restoring grossly broken down primary anterior teeth after pulpectomy for 1 year or longer follow-up period. Materials and methods: Literature search of electronic databases (Sept 2013) and various journals (1980-Sept 2013) using medical subject headings and free text terms was conducted. For inclusion in quality assessment, prespecified inclusion criteria were applied. Quality assessment was performed by using ‘The Cochrane collaboration’s tool for assessing risk of bias’. Results: Seven relevant papers were selected for full text evaluation. After applying the inclusion criteria, only two trials could be considered for quality assessment. Both of these were classified as having high risk of bias. Conclusion: The evidence to support any method of intracanal reinforcement for restoring grossly broken down anterior teeth is presently lacking. Further trials with well-defined methodology are needed. How to cite this article: Mittal N, Bhatia HP, Haider K. Methods of Intracanal Reinforcement in Primary Anterior Teeth– Assessing the Outcomes through a Systematic Literature Review. Int J Clin Pediatr Dent 2015;8(1):48-54. PMID:26124581

  10. Assessment of outcome in patients undergoing surgery for intradural spinal tumor using the multidimensional patient-rated Core Outcome Measures Index and the modified McCormick Scale.

    PubMed

    Bellut, David; Burkhardt, Jan-Karl; Mannion, Anne F; Porchet, François

    2015-08-01

    OBJECT The aim of this study was to evaluate outcome in patients undergoing surgical treatment for intradural spinal tumor using a patient-oriented, self-rated, outcome instrument and a physician-based disease-specific instrument. METHODS Prospectively collected data from 63 patients with intradural spinal tumor were analyzed in relation to scores on the multidimensional patient-rated Core Outcome Measures Index (COMI) and the physician-rated modified McCormick Scale, before and at 3 and 12 months after surgery. RESULTS There was no statistically significant difference between the scores on the modified McCormick Scale preoperatively and at the 3-month follow-up, though there was a trend for improvement (p = 0.073); however, comparisons between the scores determined preoperatively and at the 12-month follow-up, as well as 3- versus 12-month follow-ups, showed a statistically significant improvement in each case (p < 0.004). The COMI scores for axial pain, peripheral pain, and back-related function showed a significant reduction (p < 0.001) from before surgery to 3 months after surgery, and thereafter showed no further change (p > 0.05) up to 12 months postoperatively. In contrast, the overall COMI score, "worst pain," quality of life, and social disability not only showed a significant reduction from before surgery to 3 months after surgery (p < 0.001), but also a further significant reduction up to 12 months postoperatively (p < 0.001). The scores for work disability showed no significant improvement from before surgery to the 3-month follow-up (p > 0.05), but did show a significant improvement (p = 0.011) from 3 months to 12 months after surgery. At the 3- and 12-month follow-ups, 85.2% and 83.9% of patients, respectively, declared that the surgical procedure had helped/helped a lot; 95.1% and 95.2%, respectively, declared that they were satisfied/very satisfied with their care. CONCLUSIONS COMI is a feasible tool to use in the evaluation of baseline symptoms and outcome in patients undergoing surgery for intradural spinal tumor. COMI was able to detect changes in outcome at 3 months after surgery (before changes were apparent on the modified McCormick Scale) and on later postoperative follow-up. The COMI subdomains are valuable for monitoring the patient's reintegration into society and the work environment. The addition of an item that specifically covers neurological deficits may further increase the value of COMI in patients with spinal tumors. PMID:26235018

  11. Functional and Biomechanical Outcomes After Using Biofeedback for Retraining Symmetrical Movement Patterns After Total Knee Arthroplasty: A Case Report

    PubMed Central

    MCCLELLAND, JODIE; ZENI, JOSEPH; HALEY, ROSS M.; SNYDER-MACKLER, LYNN

    2013-01-01

    STUDY DESIGN Case report. BACKGROUND Rehabilitation that includes progressive quadriceps strengthening after total knee arthroplasty (TKA) leads to superior outcomes. Though patients with TKA show marked functional improvement after outpatient physical therapy, they continue to adopt movement asymmetries characterized by reduced knee excursion on the operated limb and excessive loading on the contralateral limb. The purpose of this case report was to describe the functional and biomechanical improvements in a patient who, after TKA, participated in a novel physical therapy protocol that included retraining of symmetrical movement patterns. CASE DESCRIPTION A 57-year-old female with unilateral knee osteoarthritis was evaluated prior to TKA and at 3 and 10 weeks after surgery. Postoperative rehabilitation included progressive quadriceps strengthening and movement retraining that consisted of visual, verbal, and tactile feedback to promote symmetrical weight bearing during strengthening exercises and functional activities. Outcomes were compared to a historical cohort of patients with TKA. OUTCOMES Prior to TKA, the patient scored below average on all functional measures and walked with knee biomechanics that were abnormal and asymmetrical. After symmetry retraining, her knee motion and moments were restored to normal levels. The patient also walked with greater magnitude and more symmetrical knee excursion compared to a cohort of similar patients. DISCUSSION This case report describes the use of a novel rehabilitation protocol intended to improve walking biomechanics and functional outcomes after TKA. Restoration of symmetrical movement patterns could improve long-term outcomes of TKA. Further research is needed to evaluate the effectiveness and implementation of similar rehabilitation strategies in a wide range of patients after TKA. PMID:22333656

  12. Social justice in education: how the function of selection in educational institutions predicts support for (non)egalitarian assessment practices

    PubMed Central

    Autin, Frédérique; Batruch, Anatolia; Butera, Fabrizio

    2015-01-01

    Educational institutions are considered a keystone for the establishment of a meritocratic society. They supposedly serve two functions: an educational function that promotes learning for all, and a selection function that sorts individuals into different programs, and ultimately social positions, based on individual merit. We study how the function of selection relates to support for assessment practices known to harm vs. benefit lower status students, through the perceived justice principles underlying these practices. We study two assessment practices: normative assessment—focused on ranking and social comparison, known to hinder the success of lower status students—and formative assessment—focused on learning and improvement, known to benefit lower status students. Normative assessment is usually perceived as relying on an equity principle, with rewards being allocated based on merit and should thus appear as positively associated with the function of selection. Formative assessment is usually perceived as relying on corrective justice that aims to ensure equality of outcomes by considering students’ needs, which makes it less suitable for the function of selection. A questionnaire measuring these constructs was administered to university students. Results showed that believing that education is intended to select the best students positively predicts support for normative assessment, through increased perception of its reliance on equity, and negatively predicts support for formative assessment, through reduced perception of its ability to establish corrective justice. This study suggests that the belief in the function of selection as inherent to educational institutions can contribute to the reproduction of social inequalities by preventing change from assessment practices known to disadvantage lower-status student, namely normative assessment, to more favorable practices, namely formative assessment, and by promoting matching beliefs in justice principles. PMID:26097460

  13. Piloting yoga and assessing outcomes in a residential behavioural health unit.

    PubMed

    McIlvain, S J; Miller, B; Lawhead, B A; Barbosa-Leiker, C; Anderson, A

    2015-04-01

    This study examined if adolescents on a residential behavioural health unit would participate in a yoga intervention. Yoga has been used as a mind-body practice for more than 2000 years; however, studies are limited regarding its effects on adolescents with mental illness on an inpatient unit. Yoga was added, twice weekly, to the program schedule. Trait Emotional Intelligence Questionnaire-Adolescent Short Form (TEIQue-ASF) scores were measured over 8 weeks. Additional measures included daily numbers of quiet times, time outs, and point card scores. Twenty-two adolescents completed the study. The TEIQue-ASF assessment was able to detect changes in total scores over 8 weeks. Increased yoga participation was related to higher values of the TEIQue-ASF subdomain of sociability, increase in weekly point card totals, a decrease in behavioural time outs, and a decrease in combined behavioural interventions at various time points throughout the programme. This study was relevant because it was conducted on an adolescent inpatient unit. It provides support that yoga, as part of a residential programme, is a feasible intervention for adolescents with mental illness. Changes in the various measures cannot be directly linked to yoga because of lack of a comparison group. Additional studies with a larger sample, and randomization, are needed to evaluate the potential benefits of yoga and to determine if changes to the TEIQue-ASF can be attributed to yoga or other behavioural-based interventions. Little is known about how yoga will impact behavioural health outcomes for adolescents with mental illness in an inpatient setting. This study examined if adolescents on a residential behavioural health unit would participate in a yoga intervention to address emotional regulation. A single cohort study design was used. Yoga was added to the programme schedule twice weekly. Trait Emotional Intelligence Questionnaire-Adolescent Short Form (TEIQue-ASF) scores and additional behavioural measures were tracked over 8 weeks. Adolescents participated in yoga, with a higher participation rate for girls compared with boys. The TEIQue-ASF assessment detected changes in total score over 8 weeks. Increased yoga participation was related to higher values of the TEIQue-ASF subdomain of sociability, increase in weekly point card totals, and a decrease in combined behavioural interventions at various time points throughout the programme. This study was relevant because it was conducted on an adolescent inpatient unit. Further studies are needed to determine if changes can be attributed to yoga or other behavioural-based interventions. If supported by further studies, yoga has the potential to be a complimentary therapy that can be integrated into the multidisciplinary treatment approach for mental health patients. PMID:25808462

  14. Functional assessment and performance evaluation for assistive robotic manipulators: Literature review

    PubMed Central

    Chung, Cheng-Shiu; Wang, Hongwu; Cooper, Rory A.

    2013-01-01

    Context The user interface development of assistive robotic manipulators can be traced back to the 1960s. Studies include kinematic designs, cost-efficiency, user experience involvements, and performance evaluation. This paper is to review studies conducted with clinical trials using activities of daily living (ADLs) tasks to evaluate performance categorized using the International Classification of Functioning, Disability, and Health (ICF) frameworks, in order to give the scope of current research and provide suggestions for future studies. Methods We conducted a literature search of assistive robotic manipulators from 1970 to 2012 in PubMed, Google Scholar, and University of Pittsburgh Library System – PITTCat. Results Twenty relevant studies were identified. Conclusion Studies were separated into two broad categories: user task preferences and user-interface performance measurements of commercialized and developing assistive robotic manipulators. The outcome measures and ICF codes associated with the performance evaluations are reported. Suggestions for the future studies include (1) standardized ADL tasks for the quantitative and qualitative evaluation of task efficiency and performance to build comparable measures between research groups, (2) studies relevant to the tasks from user priority lists and ICF codes, and (3) appropriate clinical functional assessment tests with consideration of constraints in assistive robotic manipulator user interfaces. In addition, these outcome measures will help physicians and therapists build standardized tools while prescribing and assessing assistive robotic manipulators. PMID:23820143

  15. Assessment and Outcomes of Teacher Professional Development Programs That Promote the Use of Authentic Science Research in Classrooms

    NASA Astrophysics Data System (ADS)

    Buxner, S.

    2012-12-01

    Recent education research and national policy documents actively promote the use of authentic science research in the classroom as an effective way to help students to learn first-hand how science is done. One strategy for increasing the use of authentic science research in classrooms is engaging science teachers in authentic research experiences. These experiences occur at universities, labs, and field-sites across the United States funded by government grants and private organizations. Assessments of program outcomes often target increases in teachers' knowledge and intention to use inquiry methods. Many programs also aim to engage students in authentic science research experiences of these teachers. This paper will present assessment strategies used to research and evaluate several research experiences for teachers that have been completed in the last five years at various sites across the United States for both pre-service and in-service teachers. The discussion will include benefits and challenges of different quantitative and qualitative strategies for assessing program outcomes. Research and evaluation outcomes of these programs include many personal and professional values for teachers, increases in implementation of reformed teaching methods including engaging students in scientific inquiry, and best practices that lead to increased student engagement in research in the classroom. Recent research has followed teachers for several years after their research internships to understand how their research experiences have led to changes in their teaching practice.

  16. RAPID ASSESSMENT OF URBAN WETLANDS: FUNCTIONAL ASSESSMENT MODEL DEVELOPMENT AND EVALUATION

    EPA Science Inventory

    The objective of this study was to test the ability of existing hydrogeomorphic (HGM) functional assessment models and our own proposed models to predict rates of nitrate production and removal, functions critical to water quality protection, in forested riparian wetlands in nort...

  17. Early Childhood Practitioner Involvement in Functional Behavioral Assessment and Function-Based Interventions: A Literature Review

    ERIC Educational Resources Information Center

    Wood, Brenna K.; Drogan, Robin R.; Janney, Donna M.

    2014-01-01

    Reviewers analyzed studies published from 1990 to 2012 to determine early childhood practitioner involvement in functional behavioral assessment (FBA) and function-based behavioral intervention plans (BIP) for children with challenging behavior, age 6 and younger. Coding of 30 studies included practitioner involvement in FBA and BIP processes,…

  18. Functional and Quality-of-Life Outcomes of Transoral Robotic Surgery for Carcinoma of Unknown Primary

    PubMed Central

    Durmus, Kasim; Patwa, Hafiz S.; Gokozan, Hamza N.; Kucur, Cuneyt; Teknos, Theodoros N.; Agrawal, Amit; Old, Matthew O.; Ozer, Enver

    2014-01-01

    Objectives/Hypothesis To determine speech, eating, aesthetics, social disruption, and overall quality-of-life outcomes over a year period in patients who underwent transoral robotic surgery as part of carcinoma of unknown primary diagnosis and treatment. Study Design Observational prospective study. Methods Twenty-two patients who underwent transoral robotic surgery for the management of carcinoma of unknown primary were included. Patients prospectively completed the Head and Neck Cancer Inventory during a preoperative visit, and at 3-week, 3-month, 6-month, and 12-month postoperative visits. Patients’ demographic, pathological, and follow-up information were also collected. Results The mean follow-up time was 19.8 months. There were overall declines in all quality of life scores during treatment period, which was followed by a continuous recovery. The scores immediately after transoral robotic surgery (3 weeks) were significantly higher than the scores after conclusion of adjuvant therapy (3 months) in multiple domains (P <.05) and the 6-month scores in speech (P = .02) and eating (P = .008) domains. All scores, except for eating (P = .01) returned to pre-treatment levels at 1 year. Patients with detected primaries displayed similar quality-of-life scores compared to patients with occult primaries. Human papillomavirus status and type of adjuvant treatment had no significant impact on quality of life. Conclusions Transoral robotic surgery is a promising, minimally invasive procedure for the surgical management of carcinoma of unknown primary. Patients maintain high functional and quality-of-life status at 1 year after surgery. PMID:24706455

  19. Comprehensive psychological intervention to improve outcome in functional gastrointestinal disorder: a cohort study

    PubMed Central

    Wang, Yu Tien; Kwok, Kah Foo Victor; Tan, Shian Ming; Yek, Ming Hwei; Ong, Wai Choung; Barbier, Sylvaine; Ng, Beng Yeong

    2015-01-01

    INTRODUCTION Patients with functional gastrointestinal disorders (FGIDs) have a decreased quality of life (QoL). Psychological illnesses are strongly associated with FGIDs. This study examined the effect of a comprehensive psychological intervention programme designed for refractory FGID patients. METHODS Refractory FGID patients at a tertiary gastroenterology unit were encouraged to participate in a psychological intervention programme, which included screening for anxiety and depression in patients, educating patients and physicians on FGIDs, and providing early access to psychiatric consultation for patients with significant psychological illnesses. The duration of follow-up was six months. Outcomes were measured using the Irritable Bowel Syndrome-QoL (IBS-QoL) instrument and the EuroQol five dimensions (EQ-5D) questionnaire. RESULTS A total of 1,189 patients (68% female, 80% Chinese, mean age 48.6 years) participated in the programme. Among these participants, 51% had a significant psychological disorder (Hospital Anxiety and Depression Scale [HADS] anxiety or depression score > 7). These participants had a significantly poorer QoL (IBS-QoL and EQ-5D, both p < 0.0001), and were more likely to be single or English-speaking, as compared to the participants without psychological disorders. Participants who completed ? 3 months of follow-up (n = 906) showed significant and durable improvement. High baseline HADS anxiety score predicted improvement (p < 0.001), with participant IBS-QoL and EQ-5D scores decreasing over time. CONCLUSION The intervention programme was associated with a clinically meaningful improvement in the QoL of patients with refractory FGIDs. High baseline anxiety was predictive of improvement. PMID:26243975

  20. Validation of School Function Assessment with Elementary School Children.

    ERIC Educational Resources Information Center

    Hwang, Jeng-Liang; Davies, Patricia L.; Taylor, Maureen P.; Gavin, William J.

    2002-01-01

    The validity of the School Function Assessment was tested with 29 children with disabilities, 18 with learning disabilities; and 17 with cerebral palsy. Discriminant analysis showed the instrument correctly classified a high percentage and should be considered a valid instrument for use in school settings. (Contains 31 references.) (JOW)

  1. LSCI in Functional Behavior Assessment and Positive Behavioral Intervention.

    ERIC Educational Resources Information Center

    Marston, John R.

    2001-01-01

    The Individuals with Disabilities Education Act (IDEA) Amendments of 1997 mandated a shift from reactive strategies toward proactive interventions with students who experience both disability and behavioral challenges. The author describes how the methodology of Life Space Crisis Intervention can provide a source of data for functional assessment

  2. Upper Limb Assessment in Tetraplegia: Clinical, Functional and Kinematic Correlations

    ERIC Educational Resources Information Center

    Cacho, Enio Walker Azevedo; de Oliveira, Roberta; Ortolan, Rodrigo L.; Varoto, Renato; Cliquet, Alberto

    2011-01-01

    The aim of this study was to correlate clinical and functional evaluations with kinematic variables of upper limp reach-to-grasp movement in patients with tetraplegia. Twenty chronic patients were selected to perform reach-to-grasp kinematic assessment using a target placed at a distance equal to the arm's length. Kinematic variables (hand peak…

  3. Assessment of Kidney Function Using Dynamic Contrast Enhanced

    E-print Network

    Louisville, University of

    Assessment of Kidney Function Using Dynamic Contrast Enhanced MRI Techniques Melih S. Aslan of Louisville, USA Mohamed Abou El-Ghar University of Mansoura, Egypt Abstract Graft failure of kidneys after transplantation is most often the consequence of the acute rejection. Hence, early detection of the kidney

  4. Deep mutational scanning: assessing protein function on a massive scale

    E-print Network

    Fields, Stan

    Deep mutational scanning: assessing protein function on a massive scale Carlos L. Araya1 of mutants that span the activity range from high to low. Such deep mutational scanning approaches are rapid and inexpensive, with the potential for broad utility. Here, we discuss the emergence of deep mutational scanning

  5. Assessing Recollection and Familiarity in Low Functioning Autism

    ERIC Educational Resources Information Center

    Ni Chuileann, Susan; Quigley, Jean

    2013-01-01

    Methods to assess recollection and familiarity separately in autism spectrum disorder were recently developed and piloted (Bigham et al. in J Autism Dev Disord 40:878-889, 2010). The preliminary data obtained via these methods showed that whereas recollection was mildly impaired in high functioning autism, familiarity was spared. The current study…

  6. Assessing Interrater Reliability of GARF Ratings of Couples' Functioning.

    ERIC Educational Resources Information Center

    Corcoran, Kevin J.; White, Lyle J.; Michels, Jennifer L.; Gilbert, David G.

    Recently, a great deal of attention has been focused on the development of a system of relational diagnosis to be incorporated into the American Psychiatric Association's diagnostic system, that of the Diagnostic and Statistical Manual (DSM). One of the more intriguing components of this effort is the Global Assessment of Relational Functioning

  7. Functional Assessment-Based Intervention for Selective Mutism

    ERIC Educational Resources Information Center

    Kern, Lee; Starosta, Kristin M.; Bambara, Linda M.; Cook, Clayton R.; Gresham, Frank R.

    2007-01-01

    The process of functional assessment has emerged as an essential component for intervention development. Applications across divergent types of problem behavior, however, remain limited. This study evaluated the applicability of this promising approach to students with selective mutism. Two middle school students served as participants. The…

  8. Changing Resistant Consultees: Functional Assessment Leading to Strategic Intervention

    ERIC Educational Resources Information Center

    Knoff, Howard M.

    2013-01-01

    Some consultees resist implementing, or implementing with integrity, effective academic or behavioral interventions that their consultants believe are needed to resolve specific student problems. In order to address consultee resistance, it is recommended that consultants complete functional assessments to determine the underlying reasons for the…

  9. Preliminary Functional Assessment of a Multigrasp Myoelectric Prosthesis

    PubMed Central

    Dalley, Skyler A.; Bennett, Daniel A.; Goldfarb, Michael

    2015-01-01

    The authors have previously described a multigrasp hand prosthesis prototype, and a two-site surface EMG based multigrasp control interface for its control. In this paper, the authors present a preliminary assessment of the efficacy of the prosthesis and multigrasp controller in performing tasks requiring interaction and manipulation. The authors use as a performance measure the Southampton Hand Assessment Procedure (SHAP), which entails manipulation of various objects designed to emulate activities of daily living, and provides a set of scores that indicate level of functionality in various types of hand function. In this preliminary assessment, a single non-amputee subject performed the SHAP while wearing the multigrasp prosthesis via an able-bodied adaptor. The results from this testing are presented, and compared to recently published SHAP results obtained with commercially available single-grasp and multigrasp prosthetic hands. PMID:23366847

  10. Comparative endocrinology of leptin: Assessing function in a phylogenetic context

    PubMed Central

    Londraville, Richard L.; Macotela, Yazmin; Duff, Robert J.; Easterling, Marietta R.; Liu, Qin; Crespi, Erica J.

    2014-01-01

    As we approach the end of two decades of leptin research, the comparative biology of leptin is just beginning. We now have several leptin orthologs described from nearly every major clade among vertebrates, and are moving beyond gene descriptions to functional studies. Even at this early stage, it is clear that non-mammals display clear functional similarities and differences with their better-studied mammalian counterparts. This review assesses what we know about leptin function in mammals and non-mammals, and gives examples of how these data can inform leptin biology in humans. PMID:24525452

  11. Differential relationships between apathy and depression with white matter microstructural changes and functional outcomes

    PubMed Central

    Lawrence, Andrew J.; Brookes, Rebecca L.; Barrick, Thomas R.; Morris, Robin G.; Husain, Masud; Markus, Hugh S.

    2015-01-01

    Small vessel disease is a stroke subtype characterized by pathology of the small perforating arteries, which supply the sub-cortical structures of the brain. Small vessel disease is associated with high rates of apathy and depression, thought to be caused by a disruption of white matter cortical-subcortical pathways important for emotion regulation. It provides an important biological model to investigate mechanisms underlying these key neuropsychiatric disorders. This study investigated whether apathy and depression can be distinguished in small vessel disease both in terms of their relative relationship with white matter microstructure, and secondly whether they can independently predict functional outcomes. Participants with small vessel disease (n = 118; mean age = 68.9 years; 65% male) defined as a clinical and magnetic resonance imaging confirmed lacunar stroke with radiological leukoaraiosis were recruited and completed cognitive testing, measures of apathy, depression, quality of life and diffusion tensor imaging. Healthy controls (n = 398; mean age = 64.3 years; 52% male) were also studied in order to interpret the degree of apathy and depression found within the small vessel disease group. Firstly, a multilevel structural equation modelling approach was used to identify: (i) the relationships between median fractional anisotropy and apathy, depression and cognitive impairment; and (ii) if apathy and depression make independent contributions to quality of life in patients with small vessel disease. Secondly, we applied a whole-brain voxel-based analysis to investigate which regions of white matter were associated with apathy and depression, controlling for age, gender and cognitive functioning. Structural equation modelling results indicated both apathy (r = ?0.23, P ? 0.001) and depression (r = ?0.41, P ? 0.001) were independent predictors of quality of life. A reduced median fractional anisotropy was significantly associated with apathy (r = ?0.38, P ? 0.001), but not depression (r = ?0.16, P = 0.09). On voxel-based analysis, apathy was associated with widespread reduction in white matter integrity, with the strongest effects in limbic association tracts such as the anterior cingulum, fornix and uncinate fasciculus. In contrast, when controlling for apathy, we found no significant relationship between our white matter parameters and symptoms of depression. In conclusion, white matter microstructural changes in small vessel disease are associated with apathy but not directly with depressive symptoms. These results suggest that apathy, but not depression, in small vessel disease is related to damage to cortical-subcortical networks associated with emotion regulation, reward and goal-directed behaviour. PMID:26490330

  12. Differential relationships between apathy and depression with white matter microstructural changes and functional outcomes.

    PubMed

    Hollocks, Matthew J; Lawrence, Andrew J; Brookes, Rebecca L; Barrick, Thomas R; Morris, Robin G; Husain, Masud; Markus, Hugh S

    2015-12-01

    Small vessel disease is a stroke subtype characterized by pathology of the small perforating arteries, which supply the sub-cortical structures of the brain. Small vessel disease is associated with high rates of apathy and depression, thought to be caused by a disruption of white matter cortical-subcortical pathways important for emotion regulation. It provides an important biological model to investigate mechanisms underlying these key neuropsychiatric disorders. This study investigated whether apathy and depression can be distinguished in small vessel disease both in terms of their relative relationship with white matter microstructure, and secondly whether they can independently predict functional outcomes. Participants with small vessel disease (n = 118; mean age = 68.9 years; 65% male) defined as a clinical and magnetic resonance imaging confirmed lacunar stroke with radiological leukoaraiosis were recruited and completed cognitive testing, measures of apathy, depression, quality of life and diffusion tensor imaging. Healthy controls (n = 398; mean age = 64.3 years; 52% male) were also studied in order to interpret the degree of apathy and depression found within the small vessel disease group. Firstly, a multilevel structural equation modelling approach was used to identify: (i) the relationships between median fractional anisotropy and apathy, depression and cognitive impairment; and (ii) if apathy and depression make independent contributions to quality of life in patients with small vessel disease. Secondly, we applied a whole-brain voxel-based analysis to investigate which regions of white matter were associated with apathy and depression, controlling for age, gender and cognitive functioning. Structural equation modelling results indicated both apathy (r = -0.23, P ? 0.001) and depression (r = -0.41, P ? 0.001) were independent predictors of quality of life. A reduced median fractional anisotropy was significantly associated with apathy (r = -0.38, P ? 0.001), but not depression (r = -0.16, P = 0.09). On voxel-based analysis, apathy was associated with widespread reduction in white matter integrity, with the strongest effects in limbic association tracts such as the anterior cingulum, fornix and uncinate fasciculus. In contrast, when controlling for apathy, we found no significant relationship between our white matter parameters and symptoms of depression. In conclusion, white matter microstructural changes in small vessel disease are associated with apathy but not directly with depressive symptoms. These results suggest that apathy, but not depression, in small vessel disease is related to damage to cortical-subcortical networks associated with emotion regulation, reward and goal-directed behaviour. PMID:26490330

  13. Mapping causal functional contributions derived from the clinical assessment of brain damage after stroke

    PubMed Central

    Zavaglia, Melissa; Forkert, Nils D.; Cheng, Bastian; Gerloff, Christian; Thomalla, Götz; Hilgetag, Claus C.

    2015-01-01

    Lesion analysis reveals causal contributions of brain regions to mental functions, aiding the understanding of normal brain function as well as rehabilitation of brain-damaged patients. We applied a novel lesion inference technique based on game theory, Multi-perturbation Shapley value Analysis (MSA), to a large clinical lesion dataset. We used MSA to analyze the lesion patterns of 148 acute stroke patients together with their neurological deficits, as assessed by the National Institutes of Health Stroke Scale (NIHSS). The results revealed regional functional contributions to essential behavioral and cognitive functions as reflected in the NIHSS, particularly by subcortical structures. There were also side specific differences of functional contributions between the right and left hemispheric brain regions which may reflect the dominance of the left hemispheric syndrome aphasia in the NIHSS. Comparison of MSA to established lesion inference methods demonstrated the feasibility of the approach for analyzing clinical data and indicated its capability for objectively inferring functional contributions from multiple injured, potentially interacting sites, at the cost of having to predict the outcome of unknown lesion configurations. The analysis of regional functional contributions to neurological symptoms measured by the NIHSS contributes to the interpretation of this widely used standardized stroke scale in clinical practice as well as clinical trials and provides a first approximation of a ‘map of stroke’. PMID:26448908

  14. Arm weight support training improves functional motor outcome and movement smoothness after stroke

    PubMed Central

    Bartolo, Michelangelo; De Nunzio, Alessandro Marco; Sebastiano, Fabio; Spicciato, Francesca; Tortola, Paolo; Nilsson, Jan; Pierelli, Francesco

    2014-01-01

    Summary The aim of this study was to compare the effectiveness in acute stroke patients of a rehabilitation program performed with or without an arm weight support device. Twenty-eight acute, first-ever unilateral stroke patients were enrolled in a single-blind, randomized controlled trial. Clinical evaluation included Fugl-Mayer Assessment, Functional Independence Measure and kinematic analysis [maximum and mean hand velocity, maximum range of motion (Max RoM), normalized jerk (NJ)]. Patients received 12 daily 30-minute sessions (6/week) of additional upper limb therapy performed using an arm weight support device (study group) or additional traditional physiotherapy (control group). The patients were evaluated on admission and at the end of the rehabilitation intervention. The two groups were clinically comparable on admission (p>0.05). Both groups showed significant improvements in clinical scale scores and in Max RoM in flexion-extension, while only the study group showed improvements in NJ and in Max RoM in adduction-abduction. Rehabilitation training using an arm weight support device appears to be a useful method to supplement conventional therapy in acute stroke patients, increasing smoothness of movement and motor function. PMID:25014045

  15. Automated Administration of the Wolf Motor Function Test for Post-Stroke Assessment

    E-print Network

    Mataric, Maja J.

    Automated Administration of the Wolf Motor Function Test for Post-Stroke Assessment Eric Wade accuracy. The Wolf Motor Function Test (WMFT) is one such application. This assessment is an instrument) assessment, and the Wolf Motor Function Test (WMFT) assessment [20], [21], [25]. These assessments can

  16. Assessment of Glial Function in the In Vivo Retina

    PubMed Central

    Srienc, Anja I.; Kornfield, Tess E.; Mishra, Anusha; Burian, Michael A.; Newman, Eric A.

    2013-01-01

    Glial cells, traditionally viewed as passive elements in the CNS, are now known to have many essential functions. Many of these functions have been revealed by work on retinal glial cells. This work has been conducted almost exclusively on ex vivo preparations and it is essential that retinal glial cell functions be characterized in vivo as well. To this end, we describe an in vivo rat preparation to assess the functions of retinal glial cells. The retina of anesthetized, paralyzed rats is viewed with confocal microscopy and laser speckle flowmetry to monitor glial cell responses and retinal blood flow. Retinal glial cells are labeled with the Ca2+ indicator dye Oregon Green 488 BAPTA-1 and the caged Ca2+ compound NP-EGTA by injection of the compounds into the vitreous humor. Glial cells are stimulated by photolysis of caged Ca2+ and the activation state of the cells assessed by monitoring Ca2+ indicator dye fluorescence. We find that, as in the ex vivo retina, retinal glial cells in vivo generate both spontaneous and evoked intercellular Ca2+ waves. We also find that stimulation of glial cells leads to the dilation of neighboring retinal arterioles, supporting the hypothesis that glial cells regulate blood flow in the retina. This in vivo preparation holds great promise for assessing glial cell function in the healthy and pathological retina. PMID:22144328

  17. An occupational therapy approach to assessing psychiatric patients' adaptive functioning.

    PubMed

    Oakley, F; Kielhofner, G; Barris, R

    1985-03-01

    This study focused on the relative utility of the model of human occupation for occupational therapy assessment of persons having mental disorders. The organizational status of the human system and its relationship to adaptive level of functioning and degree of symptomatology were examined in a sample of 30 adult psychiatric patients. We used a six-test assessment battery developed for this study, which was based on the model of human occupation, to measure the organizational status of the following components of the human system: locus of control, goals, temporal orientation, interests, roles, and skills. Subtests of the American Association on Mental Deficiency (AAMD) Adoptive Behavior Scale and the Modified Brief Psychiatric Rating Scale were used to measure adaptive level functioning and symptomatology, respectively. When we compared organizational status with psychiatric diagnosis and symptomatology, we found organizational status to be the more significant index of adaptive level of functioning. PMID:3993720

  18. Self-Assessment of Employability Skill Outcomes among Undergraduates and Alignment with Academic Ratings

    ERIC Educational Resources Information Center

    Jackson, Denise

    2014-01-01

    Despite acknowledgement of the benefits of self-assessment in higher education, disparity between student and academic assessments, with associated trends in overrating and underrating, plagues its meaningful use, particularly as a tool for formal assessment. This study examines self-assessment of capabilities in certain employability skills in…

  19. The Usefulness of Accreditation-Mandated Outcomes Assessment in College Foreign Language Education

    ERIC Educational Resources Information Center

    Davis, John McE.

    2012-01-01

    This dissertation investigated the extent to which accreditation-mandated assessment capacity contributes to assessment use in tertiary foreign language (FL) programs. Four research questions were posed to pursue this concern: What is the nature and extent of assessment capacity in college FL programs? Which assessment uses are occurring in…

  20. COGNITIVE-HD study: protocol of an observational study of neurocognitive functioning and association with clinical outcomes in adults with end-stage kidney disease treated with haemodialysis

    PubMed Central

    Palmer, Suetonia C; Ruospo, Marinella; Barulli, Maria Rosaria; Iurillo, Annalisa; Saglimbene, Valeria; Natale, Patrizia; Gargano, Letizia; Murgo, Angelo M; Loy, Clement; van Zwieten, Anita; Wong, Germaine; Tortelli, Rosanna; Craig, Jonathan C; Johnson, David W; Tonelli, Marcello; Hegbrant, Jörgen; Wollheim, Charlotta; Logroscino, Giancarlo; Strippoli, G F M

    2015-01-01

    Introduction The prevalence of cognitive impairment may be increased in adults with end-stage kidney disease compared with the general population. However, the specific patterns of cognitive impairment and association of cognitive dysfunction with activities of daily living and clinical outcomes (including withdrawal from treatment) among haemodialysis patients remain incompletely understood. The COGNITIVE impairment in adults with end-stage kidney disease treated with HemoDialysis (COGNITIVE-HD) study aims to characterise the age-adjusted and education-adjusted patterns of cognitive impairment (using comprehensive testing for executive function, perceptual-motor function, language, learning and memory, and complex attention) in patients on haemodialysis and association with clinical outcomes. Methods and analysis A prospective, longitudinal, cohort study of 750 adults with end-stage kidney disease treated with long-term haemodialysis has been recruited within haemodialysis centres in Italy (July 2013 to April 2014). Testing for neurocognitive function was carried out by a trained psychologist at baseline to assess cognitive functioning. The primary study factor is cognitive impairment and secondary study factors will be specific domains of cognitive function. The primary outcome will be total mortality. Secondary outcomes will be cause-specific mortality, major cardiovascular events, fatal and non-fatal myocardial infarction and stroke, institutionalisation, and withdrawal from treatment at 12?months. Ethics and dissemination This protocol was approved before study conduct by the following responsible ethics committees: Catania (approval reference 186/BE; 26/09/2013), Agrigento (protocol numbers 61–62; 28/6/2013), USL Roma C (CE 39217; 24/6/2013), USL Roma F (protocol number 0041708; 23/7/2013), USL Latina (protocol number 20090/A001/2011; 12/7/2013), Trapani (protocol number 3413; 16/7/2013) and Brindisi (protocol number 40259; 6/6/2013). All participants have provided written and informed consent and can withdraw from the study at any time. The findings of the study will be disseminated through peer-reviewed journals and national and international conference presentations and to the participants through communication within the dialysis network in which this study is conducted. PMID:26656022