van Rijssen, H Jolanda; Schellart, Antonius JM; Anema, Johannes R; van der Beek, Allard J
Background Research in different fields of medicine suggests that communication is important in physician-patient encounters and influences satisfaction with these encounters. It is argued that this also applies to the non-curative tasks that physicians perform, such as sickness certification and medical disability assessments. However, there is no conceptualised theoretical framework that can be used to describe intentions with regard to communication behaviour, communication behaviour itself, and satisfaction with communication behaviour in a medical disability assessment context. Objective The objective of this paper is to describe the conceptualisation of a model for the communication behaviour of physicians performing medical disability assessments in a social insurance context and of their claimants, in face-to-face encounters during medical disability assessment interviews and the preparation thereof. Conceptualisation The behavioural model, based on the Theory of Planned Behaviour (TPB), is conceptualised for the communication behaviour of social insurance physicians and claimants separately, but also combined during the assessment interview. Other important concepts in the model are the evaluation of communication behaviour (satisfaction), intentions, attitudes, skills, and barriers for communication. Conclusion The conceptualisation of the TPB-based behavioural model will help to provide insight into the communication behaviour of social insurance physicians and claimants during disability assessment interviews. After empirical testing of the relationships in the model, it can be used in other studies to obtain more insight into communication behaviour in non-curative medicine, and it could help social insurance physicians to adapt their communication behaviour to their task when performing disability assessments. PMID:19807905
Humphries, Laurie L.
The clinical syndrome which relates most frequently to the reading-disabled child is the attention deficity disorder. The child psychiatrist will generally resort to medication only when behavioral management techniques have failed. The two most frequently used medications are Ritalin and Dexedrine, central nervous system stimulants. (JN)
Fiona Kumari Campbell
The biomedicalist conceptualization of disablement as a personal medical tragedy has been criticized by disability studies scholars for discounting the difference between disability and impairment and the\\u000a ways disability is produced by socio-environmental factors. This paper discusses prospects for partnerships between disability\\u000a studies teaching\\/research and medical education; addresses some of the themes around the necessity of critical disability\\u000a studies training
Shepard, Lorrie A.
The assessment and diagnosis of learning disabilities (LD) in the school is problematic. How do educators determine who is learning disabled? What practices are recommended? The main focus of the paper is on specific, relatively technical points that influence the validity of assessment. Since technical concerns are only one of the factors…
Calvet, Xavier; Motos, Jaume; Villoria, Albert
The present article revises practical aspects on the format and content of the clinical reports used for the evaluation of disability for the Spanish Disability Grants System. As a framework for understanding how these clinical reports should be, the review includes also a short overview of the different types of disability grants and the administrative and court mechanisms for granting. PMID:24216011
Swinburne University of Technology Disability / Medical Documentation Form Disability Services requires students to provide documentation of a disability or medical condition from a relevant professional, before
be accompanied by the qualified health professional's stamp or business card: Disability Information (To impairment Physical Disability Mental Health Condition Learning Disability Neurological Condition Medical
Sieben, Robert L.
The author presents a critical review of popular medical treatments for children with learning disabilities, including dietary treatment (food additives theories, brain allergies, hypoglycemia, megavitamin therapy, and trace mineral tests) and neurophysiologic retraining (patterning, sensory integrative therapy, and optometric training). (IM)
Graduate Medical Education Committee (GMEC) Policy on Accommodations for Disabilities will be required to provide medical verification of a medical condition that he or she believes is a disability Institutional Requirements Approved by GMEC 1/12/07 II.D.4.n Office of Graduate Medical Education West Virginia
5/04 Guidelines Regarding Documentation of a Physical/Medical Disability The following guidelines accommodations. The documentation should include: · A clear statement of the medical diagnosis of the disability; · A description of treatments, medications, assistive devices/services currently prescribed or in use
Disability & Medical Leave Resources A Guide for Employees This guide is a resource for you if you are experiencing difficulties at work related to a disability or chronic medical condition. For example, you may: have a serious health condition and need medical leave be returning to work with restrictions
Brendan P. Lucey; David B. Clifford; Jason Creighton; Robert R. Edwards; Justin C. McArthur; Jennifer Haythornthwaite
Few studies have examined how patients with chronic HIV infection cope with pain and how pain relates to medication adherence. Pain coping strategies such as catastrophizing are often associated with increased pain and disability and may also influence adherence to medications. The goal of our study is to assess the relationship of catastrophizing and depression to pain, disability, and medication
Fittipaldi-Wert, Jeanine; Brock, Sheri J.
Physical activity is important in maintaining and improving overall health for all. Students with disabilities tend to have lower fitness levels due to the lack of participation in physical activities, therefore, progressions and modifications to physical activities are needed. Assessing the physical activity levels of students with disabilities…
Bigler, Erin D.; Lajiness-O'Neill, Renee; Howes, Nancy-Louise
Reviews recent neuroradiologic and brain imaging techniques in the assessment of learning disability. Technologies reviewed include computerized tomography; magnetic resonance imaging; electrophysiological and metabolic imaging; computerized electroencepholographic studies of evoked potentials, event-related potentials, spectral analysis, and…
Dewa, Carolyn S.; Hees, Hiske; Trojanowski, Lucy; Schene, Aart H.
Objective Medical certification is one of the basic administrative mechanisms used by social policies aimed at income protection. The assessment of work disability is central to the income protection application. Yet, there is evidence suggesting that determining work disability related to mental disorders is challenging. Although essential to the disability application process, few studies have looked at physician and other clinician experiences with the process. However, this type of information is critical to developing processes to support providers who participate in the assessments. This purpose of this paper is to explore the experiences of physicians and other clinicians assessing public long-term work disability related to mental disorders. Methods This is an exploratory and descriptive study using qualitative methods. Clinician input was gathered through focus groups and individual in-depth interviews. Verbatim transcripts were analyzed to identify recurrent and significant themes that arose during the focus groups and individual interviews. Results Many of the experiences that the clinicians in this sample discussed related to the difficulty of trying to fill the roles of advocate and medical expert as well as the challenge of determining the impact of functional capacity and work ability. The findings also highlight the current gap in knowledge about the factors that affect successful functioning in general and at work in particular. Conclusions Given the challenges created by the current state of knowledge, it may be useful to consider a category of “partial disability”. In addition, the fact that work disability depends on the interaction between the experience of the mental disorder and specific job requirements and the fact that people applying for public long-term disability are not working, it might be helpful to offer a clear description and guidelines of the meaning of work ability. PMID:25789478
Trupin, Laura; Rice, Dorothy P.; Max, Wendy
This statistical abstract presents data on the sources of payment for medical care for people with disabilities in different age groups. All estimates come from the National Medical Expenditures Survey, a nationally representative survey of the civilian non-institutionalized population of the U.S. conducted in 1987. Six categories of payment…
Abedi, Jamal; Bayley, Robert; Ewers, Nancy; Mundhenk, Kimberly; Leon, Seth; Kao, Jenny; Herman, Joan
Assessments developed and field tested for the mainstream student population may not be accessible for students with disabilities (SWDs) as a result of the impact of extraneous variables, including cognitive features, such as depth of knowledge required, grammatical and lexical complexity, lexical density, and textual/visual features. This study…
Kontu, Elina; Pirttimaa, Raija
The aim of this study was to gather information on the tools used by special education teachers for the assessment of severely intellectually disabled students (SID), preparing an individual education plan, and about the methodology used for monitoring their learning progress. The survey included all Finnish special education teachers working with…
...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...
...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...
...are based on medically acceptable clinical and laboratory techniques. (c) Addiction to alcohol or drugs. If a claimant has a condition diagnosed as addiction to alcohol or drugs, this condition will not, by itself, be a basis for...
Snyder, Alison R; Parsons, John T; Valovich McLeod, Tamara C; Curtis Bay, R; Michener, Lori A; Sauers, Eric L
Objective: To present and discuss disablement models and the benefits of using these models as a framework to assess clinical outcomes in athletic training. Background: Conceptual schemes that form the basic architecture for clinical practice, scholarly activities, and health care policy, disablement models have been in use by health care professions since the 1960s. Disablement models are also the foundation for clinical outcomes assessment. Clinical outcomes assessment serves as the measurement tool for patient-oriented evidence and is a necessary component for evidence-based practice. Description: Disablement models provide benefits to health professions through organization of clinical practice and research activities; creation of a common language among health care professionals; facilitation of the delivery of patient-centered, whole-person health care; and justification of interventions based on a comprehensive assessment of the effect of illness or injury on a person's overall health-related quality of life. Currently, the predominant conceptual frameworks of disability in health care are those of the National Center for Medical Rehabilitation Research and the World Health Organization. Disablement models need to be understood, used, and studied by certified athletic trainers to promote patient-centered care and clinical outcomes assessment for the development of evidence-based practice in athletic training. Clinical and Research Advantages: For clinicians and researchers to determine effective athletic training treatments, prevention programs, and practices, they must understand what is important to patients by collecting patient-oriented evidence. Patient-oriented evidence is the most essential form of outcomes evidence and necessitates an appreciation of all dimensions of health, as outlined by disablement models. The use of disablement models will allow the athletic training profession to communicate, measure, and prioritize the health care needs of patients, which will facilitate organized efforts aimed at assessing the quality of athletic training services and practices and ultimately promote successful evidence-based athletic training practice. PMID:18668176
Ryan D. Edwards
Objective. This paper assesses the potential benefits of increased walking and reduced obesity associated with taking public transit in terms of dollars of medical costs saved and disability avoided. Methods. I conduct a new analysis of a nationally representative U.S. transportation survey to gauge the net increase in walking associated with public transit usage. I translate minutes spent walking into
Amin, S. Massoud
MEDICAL SUPPLEMENT DIRECTIONS--This form assists students in providing documentation of a medical with the Medical Supplement. This form must be completed by the medical provider or by Disability Services if the student is currently registered with and has provided medical documentation surrounding their condition
Schieve, Laura A.; Gonzalez, Vanessa; Boulet, Sheree L.; Visser, Susanna N.; Rice, Catherine E.; Braun, Kim Van Naarden; Boyle, Coleen A.
Studies document various associated health risks for children with developmental disabilities (DDs). Further study is needed by disability type. Using the 2006-2010 National Health Interview Surveys, we assessed the prevalence of numerous medical conditions (e.g. asthma, frequent diarrhea/colitis, seizures), health care use measures (e.g. seeing a…
Oliver, Douglas L.
Page 82 Medical Leave and Short-Term Disability Medical leaves of absence with pay and benefits or disabilities include inpatient care in a hospital or residential medical care facility, continuing treatment by a healthcare provider, and temporary disabilities associated with pregnancy, childbirth, and related medical
Sack, William; Gale, John; Gulati, Sanjay; Gunther, Michael; Nesheim, Robert; Stoddard, Frederick; St. John, Rachel
Members of the committee on disabilities of the Group for the Advancement of Psychiatry (GAP) contacted 107 of 126 American Medical Schools to determine the number of students requesting accommodation for a disability, the time at which the request was made, the type of disability, and the type of accommodation offered. The survey determined that…
Yu, Jay-young; Kwon, Young-Jun; Kim, Yongkyu; Rhie, Jeong-Bae; Jeong, In-Chul
The purpose of this study was to develop a disability rating scale according to job classification using the Korean Academy of Medical Society (KAMS) guidelines. All jobs were categorized based on their level of physical activity and professional skills. The KAMS guidelines were used for the impairment rating. We modified the California Schedule for rating permanent disabilities. The differences were plotted to compare between the impairment rate and the job-adjusted disability rate. The KAMS job-adjusted disability rates were then compared to the McBride and workers' compensation rates. A total of 1,206 occupations were classified into 44 groups. The occupational disability indexes were rated on a scale of 1 to 7. The differences in the McBride disability rates varied inconsistently from 0% to 35%, while the differences in the KAMS disability rates were between 0% and 18%. The KAMS disability rates were slightly higher than the McBride disability rates for the upper extremities, but were lower for the lower extremities and internal organs. This is the first Korean job-adjusted disability rating method. There are several limitations, but its impairment rating is more scientific and reflects the current Korean occupational environment. PMID:23255842
Rasaratnam, R.; Crouch, K.; Regan, A.
To investigate the influence of attitudes of carers of people with intellectual disability (ID) towards giving medication. Ninety-three carers of service users who are currently attending outpatients clinic (Harrow Learning Disability service) were interviewed, using the RAMS (Rating of Attitude to Medication Scale) interview schedule. A…
Siegenthaler, M; Osterwalder, P; Vetter, W
The question if and in what manner changes of the labour market, in first line increasing unemployment, may influence the composition of the collective demanding a disability pension on one hand and the diagnoses relevant for assessment of requests on the other hand have been investigated as well as possible influences on the criteria for assessments. To this end all expert reports elaborated by the Medical Outpatient Clinic of the University Hospital of Zürich and submitted to the disability insurance between 1990 and 1995 have been evaluated retrospectively. The results show that the fraction of men remained stable around 70% over the whole observation period. The number of persons employed in auxiliary functions remained also constantly high. Over the whole period of observation there was a high, growing percentage of foreign applicants. The most marked change during the observation period was a significant increase of unemployment in the collective. This increase particularly affected applicants with higher ranking jobs or persons over 50. Foreigners became an important part of the unemployed applicants. Rheumatoid disorders and "back pain" in particular were of increasing importance among the relevant diagnoses for assessment of disability. There was a significant decline in the extent of invalidity acknowledged in marked contrast to our initial expectation that the strictness of the applied criteria would weaken when confronted with an increasing number of applications. PMID:9844487
Domingues, Renan B; Teixeira, Antônio Lúcio; Domingues, Simone A
The aim of this study was to investigate possible association between migraine and physical practice among 480 medical students who were submitted to a questionnaire about headaches and physical practices. Migraine diagnosis was assessed by ID-Migraine and functional disability was evaluated with MIDAS. The type (aerobic or strength training), the weekly frequency and the intensity of physical practice and body mass index (BMI) were assessed. There was a reduction in functional disability of migraine in students reporting physical practice (no physical practice - MIDAS=8.81±1.40, physical practice - MIDAS=15.49±1.78; P=0.03). Frequency, intensity, and type of physical practices were not associated with functional impact of migraine. BMI did not correlate with migraine impact (normal weight - MIDAS=12.34±1.33, overweight or obese - MIDAS=17.45±3.86; P=0.33). These results were confirmed by multivariate analysis. Our data suggest that physical practice is inversely related with functional disability of migraine in university students regardless of BMI. PMID:21359421
Russell, Andrew T.; Hahn, Joan Earle; Hayward, Katharine
The purpose of this study was to describe the medication management and treatment provided in a specialty outpatient psychiatry clinic for 198 community-residing children and adults with intellectual disability and other developmental disabilities (IDD) referred to the clinic and discharged between 1999 and 2008. Using a descriptive design, data…
Collins, Gary S.
2.12 #12;Medical Surveillance Criteria n Based on risk assessment n Pre-placement n evaluate of numbers exists n Predict an outcome given similar events Medical Surveillance Risk Assessment 2.12 #12;n Infectious for normal healthy adult? n What if adult is immunocompromised? Medical Surveillance Risk
Raggi, A; Leonardi, M; Giovannetti, A M; Schiavolin, S; Bussone, G; Grazzi, L; Usai, S; Curone, M; Di Fiore, P; D'Amico, D
This paper aims to evaluate changes in disease severity, disability and mood state in patients with chronic migraine associated to medication overuse (CM-MO). MIDAS was used for assessing disease activity, WHO-DAS-2 for disability, DBI-2 for mood state. ANOVA was used to test change over time; t-test to assess follow-up differences in WHO-DAS-2 and BDI-2 between patients with MIDAS ?20 and ?21. Change in MIDAS, WHO-DAS-2 and BDI-2 scores were computed: Pearson's index was used to assess correlation between them; linear regression to assess change in WHO-DAS-2, using MIDAS and BDI-2 change as predictors. Mean MIDAS decreased significantly (from 101.9 to 52.0). In 26.1 % of the sample, MIDAS fell below 21 at follow-up: these patients had lower WHO-DAS-2 score. WHO-DAS-2 change was little correlated to MIDAS change and strongly correlated to changes in BDI-2 scores. 57.1 % of WHO-DAS-2 change variance is explained by change in BDI-2 and MIDAS scores. There was a clear clinical improvement 14 months after detoxification, and a modest reduction in disability which is explained by reduced disease activity and improved mood state. An appropriate treatment of CM-MO, based on detoxification and prophylaxis, is likely to reduce disease burden: recognition and treatment of mood problems may be a key factor to reduce disability. PMID:23695064
Moore-Brown, Barbara; Huerta, Maria; Uranga-Hernandez, Yvana; Pena, Elizabeth D.
Dynamic assessment uses a test-teach-retest approach that can assist clinicians in differentiating between children with learning disabilities and children with learning differences. This article describes a model of dynamic assessment of narratives and its use with children from culturally and linguistically diverse backgrounds. Case studies…
Sireci, Stephen G.
The articles in this special issue of the "Journal of Applied Testing Technology" represent significant steps forward in the area of evaluating the validity of methods for assessing the educational achievement of students with disabilities. The studies address some of the most difficult student groups to assess--students with learning…
H E Badr; H Mourad
Objective:To study the role of gender in coping with disability in young visually impaired students attending two schools for blindness.Methods:The WHO Disability Assessment Schedule (WHODAS II), 36-Item Interviewer Administered translated Arabic version was used. It evaluates six domains of everyday living in the last 30 days. These domains are: understanding and communicating, getting around, self care, getting along with people,
Zajicek-Farber, Michaela L; Lotrecchiano, Gaetano R; Long, Toby M; Farber, Jon Matthew
Life course theory sets the framework for strong inclusion of family centered care (FCC) in quality medical homes of children with neurodevelopmental disabilities (CNDD). The purpose of this study was to explore the perceptions of families with their experiences of FCC in medical homes for CNDD. Using a structured questionnaire, the Family-Centered Care Self-Assessment Tool developed by Family Voices, this study surveyed 122 parents of CNDD in a large urban area during 2010-2012. Data collected information on FCC in the provision of primary health care services for CNDD and focused on family-provider partnerships, care setting practices and policies, and community services. Frequency analysis classified participants' responses as strengths in the "most of the time" range, and weaknesses in the "never" range. Only 31 % of parents were satisfied with the primary health care their CNDD received. Based on an accepted definition of medical home services, 16 % of parents reported their CNDD had most aspects of a medical home, 64 % had some, and 20 % had none. Strengths in FCC were primarily evident in the family-provider partnership and care settings when focused on meeting the medical care needs of the child. Weaknesses in FCC were noted in meeting the needs of families, coordination, follow-up, and support with community resources. Improvements in key pediatric health care strategies for CNDD are recommended. CNDD and their families have multifaceted needs that require strong partnerships among parents, providers, and communities. Quality medical homes must include FCC and valued partnerships with diverse families and community-based providers. PMID:25724538
Fowell, S. L.; Bligh, J. G.
Most medical schools in the UK are revising their undergraduate courses in response to the recommendations published by the General Medical Council Education Committee in Tomorrow's doctors. However, achievement of the objectives of curricular change is attendant on revision of the assessment process. This paper reviews traditional and more recently developed methods for assessment of medical education in the light of the General Medical Council's recommendations which relate specifically to summative assessment of the core curriculum. The importance of reliability and validity is highlighted, and the case for criterion-referenced assessment is examined. PMID:9538481
Tyler, Janet Siantz; Colson, Steven
This paper presents definitions of common pediatric disabilities and information about incidence, causes, diagnosis, common characteristics, complications with educational implications, and multidisciplinary intervention approaches. It covers the following conditions: attention deficit hyperactivity disorder, cerebral palsy, Down syndrome, fragile…
Thurlow, Martha L.; Thompson, Sandra J.
The inclusion of students with disabilities in state and district assessments rests on a fundamental belief: all children can learn. This belief centers on all children who receive educational services, even those whose teachers and therapists work with them at home or in the hospital. The purpose of this chapter is to clarify the rationale for…
Johnston, Robert B.
Basic neurological facts pertinent to learning disabilities are reviewed, and the nature, significance, and limitations of the neurological assessment presently utilized in clinical practice are addressed. A brief review is presented of some of the classification attempts that highlight difficulties arising from the heterogeneity of learning…
Woods, Kevin; Parkinson, Gill; Lewis, Sarah
Many countries have established systems for identifying, and providing for, the range of students with disabilities during their formal educational assessments. Most systems include the provision of variously termed "special access arrangements" (SAAs), such as the provision of extra time or practical assistance with some aspect of an examination.…
Bos, Candace S.; And Others
Assessment of learning disabilities is traced. Among the critical issues examined are definitions, eligibility criteria, placement bias, and interpretation of P.L. 94-142 (The Education for All Handicapped Children Act) guidelines. Recommendations are offered for an adequate definition and determination of LD. Future directions, including…
Cannella-Malone, Helen I.; Sabielny, Linsey M.; Jimenez, Eliseo D.; Miller, Megan M.
Research has demonstrated that people with significant intellectual, developmental, and physical disabilities can indicate clear preferences through methodologically rigorous assessments. Once preferred items have been identified, they can be used to reinforce new behaviors, which can assist in the development of a meaningful learning experience.…
Recently the Civil and Administrative Tribunal of New South Wales found that the, University of Newcastle had discriminated against a medical student with borderline personality disorder and bipolar disorder on the grounds of her disability. This column summarises the case, and integrates a psychodynamic account of borderline personality disorder with Fulford's conceptual analysis of mental disorder as action failure, that is no different in principle from physical illnesses, some instances of which appear to uncontroversially rule out of contention some applicants for medical training. It is argued that some applicants for medical and health care programs with mental disorders should not be selected, because their disabilities are not amenable to satisfactory accommodation in the university training period, and they are incompatible with clinical training and practice. Universities should develop "Inherent Requirement" policies that better integrate their responsibility to support disabled students with the responsibility, currently reserved entirely to regulators, to ensure safe practice by their graduates. PMID:25341318
Ailey, Sarah H; Johnson, Tricia J; Fogg, Louis; Friese, Tanya R
People with intellectual disabilities (ID) represent a small but important group of hospitalized patients who have higher rates of complications than do patients without ID hospitalized for the same reasons. Complications are potentially avoidable conditions, such as healthcare-acquired infections, healthcare-acquired skin breakdown, falls, and medication errors and reactions. Addressing factors related to complications can focus efforts to improve hospital care. The purpose of this exploratory study was to analyze data from reviews of academic medical center charts (N ?=? 70) about complications and to examine patient and hospitalization characteristics in relation to complications among adult patients (age ? 18 years) with ID hospitalized for nonpsychiatric reasons. Adults with ID tended to be twice as likely to have complications (?2 ?=? 2.893, df ?=? 1, p ?=? .09) if they had a surgical procedure and were nearly four times as likely to have complications (?2 ?=? 6.836, df ?=? 1, p ?=? .009) if they had multiple chronic health conditions (three of the following: history of cerebral palsy, autism spectrum symptoms, aggressive behavior, respiratory disorder, and admission through the emergency department). Findings suggest preliminary criteria for assessing risk for complications among hospitalized people with ID and the need for attention to their specific needs when hospitalized. PMID:25860449
Allen W. Heinemann; Peggy Kirk; Barbara A. Hastie; Patrick Semik; Byron B. Hamilton; John Michael Linacre; Benjamin D. Wright; Carl Granger
Objective: The increasing use of disability measures requires that the validity of these instruments be adequately demonstrated. This study sought to evaluate the concurrent validity of one disability measure, the Functional Independence Measure (FIMSM) using minutes of care reported by nursing staff.Study Design: Correlational, cohort design.Setting: Eight inpatient medical rehabilitation hospitals that subscribe to the Uniform Data System for Medical
Fisher, Pamela; Goodley, Dan
This paper draws on the narratives of parents of disabled babies in order to conceptualise notions of enabling care. This analysis emerges from the Sheffield site of an ESRC research project Parents, Professionals and Disabled Babies: Identifying Enabling Care, which brings together the Universities of Sheffield and Newcastle-upon-Tyne. The linear heroic narrative is a dominant theme within Western culture. It is competitive and individualistic and tends to be future-orientated in that actions conducted in the present are evaluated according to later outcomes. This linear narrative places much store on modernist interventions such as medicine, and tends to uphold professional boundaries and hierarchies. In the lifeworlds of parents, usually mothers, of disabled babies, this narrative can reinforce disempowering interpretations of disability and impairment. On the basis of 25 in-depth interviews, accompanying stories and ethnographic data, this paper suggests that parents are developing counter-narratives which, at times, resist linear life models and free parents to enjoy their children as they are. If life is perceived as an open book rather than as a concluding chapter, parents are able to develop stories that are neither linear nor heroic but present and becoming. PMID:17286706
Malmgren, Kimber W.; McLaughlin, Margaret J.; Nolet, Victor
The current study investigates school-level factors that affect the performance of students with disabilities on statewide assessments. Data were collected as part of a larger study examining the effects of education policy reform on students with disabilities. Statewide assessment data for students with disabilities from 2 school districts within…
This paper discusses issues regarding the validity and reliability of psychoeducational assessments provided to Disability Services Offices at Canadian Universities. Several vignettes illustrate some current issues and the potential consequences when university students are given less than thorough disability evaluations and ascribed diagnoses.…
Followup 8 years after reduction of antiepileptic drugs in 50 institutionalized developmentally disabled epileptic patients found recurrence of seizures in 26 patients. Predictors for a seizure-free state off medication included few documented seizures in lifetime, no gross neurological abnormalities, and persistently normal electroencephalograms.…
Kancherla, Vijaya; Amendah, Djesika D.; Grosse, Scott D.; Yeargin-Allsopp, Marshalyn; Van Naarden Braun, Kim
This study estimated medical expenditures attributable to cerebral palsy (CP) among children enrolled in Medicaid, stratified by the presence of co-occurring intellectual disability (ID), relative to children without CP or ID. The MarketScan[R] Medicaid Multi-State database was used to identify children with CP for 2003-2005 by using the…
Michael J. Nanna; Shlomo S. Sawilowsky
Many clinical evaluations are subjective, resulting in ordinal level measurements. A widely used example in medical rehabilitation is the Functional Independence Measure (FIM), which provides a measure of disability. The FIM is an 18-item, 7-point Likert scale ranging from complete dependence to complete independence. Parametric statistics are commonly used for the analysis of ordinal data. However, Likert scales often lead
Fouradoulas, M; Risi, G; Gyr, Niklaus
Medical assessments of patients seeking disability benefits are one of the most important services provided by MEDAS/asim Basel for the Swiss Disability Insurance scheme. An evaluation of 593 assessments from 2004 and 2005 was carried out in order to gain initial insights into the characteristics of this special patient population. Information about sociodemographic background, diagnoses and certified fitness to work was collected and evaluated. The majority of the assessed patients were immigrants (61%) from southern and south-eastern Europe, 86% of whom suffered from chronic pain conditions and depression. At the time of the assessments, only 101 patients (17% of the total) were working full- or part-time. For 38% of the patient population under investigation, the last work period in mostly unskilled occupations varied from a few months to several years and had ended 1.5-2.5 years previously. PMID:20166048
Shalev, Ruth S.; Gross-Tsur, Varda
Medical evaluation of seven third-grade children with developmental dyscalculia in a mainstream setting identified neurological conditions (including petit mal seizures, Gerstmann syndrome, and attention deficit disorder without hyperactivity) in all the children. Findings suggest that children who are not improving academically should undergo…
Markowitz, G; Rosner, D
No firm differentiation existed between social and medical standards on silicosis, the salient industrial health problem of the 1920s and 1930s. As a result, professional groups, government and labor officials, and insurance executives negotiated about the causes and consequences of the disabling condition. Debates in the 1930s formed the basis for amending state and federal compensation systems for work-related disease. If attention to silicosis declined after World War II, disputes continued about diagnosis and functional criteria for identifying pulmonary and occupationally based impairments, and about appropriate policies for treating and compensating people disabled through the course of their work. PMID:2532296
Lyon, G. Reid, Ed.
This book offers 27 papers addressing critical issues in the assessment of students with all kinds of learning disabilities. Papers have the following titles and authors: "Critical Issues in the Measurement of Learning Disabilities" (G. Reid Lyon); "A Matrix of Decision Points in the Measurement of Learning Disabilities" (Barbara K. Keogh);…
This article describes a method for identifying test items as disability neutral for children with vision and motor disabilities. Graduate students rated 130 items of the Preschool Language Scale and obtained inter?rater correlation coefficients of 0.58 for ratings of items as disability neutral for children with vision disability, and 0.77 for ratings of items as disability neutral for children with
Levy, Joel M.; Botuck, Shelly; Damiani, Marco R.; Levy, Philip H.; Dern, Thomas A.; Freeman, Stephen E.
The shift in living situations for adults with intellectual and other developmental disabilities (IDDD) from family homes to group homes has raised questions about their healthcare needs and access to appropriate healthcare services. This study was undertaken to describe the disability characteristics and medical conditions in a sample of adults…
Bernhard T. Baune; Riccardo N. Caniato; Volker Arolt; Klaus Berger
Background: We aimed to investigate in medical disorders the effects of comorbid dysthymic disorder as compared to major depressive disorder (MDD) on health-related quality of life (HR-QoL) and disability days in the general population. Methods: In a population-based study 4,181 individuals were assessed for the presence of dysthymic disorder and depression, utilizing the Composite International Diagnostic Interview. Each participant received
...1151(a) for additional disability or death due to hospital care, medical or surgical...1151(a) for additional disability or death due to hospital care, medical or surgical...respect to claims alleging disability or death due to compensated work therapy,...
...1151(a) for additional disability or death due to hospital care, medical or surgical...1151(a) for additional disability or death due to hospital care, medical or surgical...respect to claims alleging disability or death due to compensated work therapy,...
...1151(a) for additional disability or death due to hospital care, medical or surgical...1151(a) for additional disability or death due to hospital care, medical or surgical...respect to claims alleging disability or death due to compensated work therapy,...
Black, Leslie S.; Turnwald, Grant H.; Meldrum, James B.
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)
Koskentausta, Terhi; Iivanainen, Matti; Almqvist, Fredrik
Structured checklists have been used to supplement psychiatric assessment of children with normal intelligence, but for children with intellectual disability, only a few checklists exist. We evaluated the Child Behavior Checklist (CBCL) in the assessment of psychopathology in Finnish children with intellectual disability. The CBCL was completed by…
Mathews, R. Mark; Whang, Paula L.; Fawcett, Stephen B.
This study, using direct observation and measurement techniques, analyzed the differences in occupational skills among learning disabled youths and their non-learning disabled peers . The results showed low levels of ...
Ault, Marilyn Mulligan; And Others
This paper examines the educational relevance for students with profound disabilities of being at risk for poor nutrition and for problems caused by the nontherapeutic effects of some medications. Two classroom-based cases describe the resolution of a nutritional and a medication problem, including the role of the teacher and health-related…
Ferguson, L.; Murphy, G. H.
Background: This study had two aims: to investigate the capacity of individuals with intellectual disabilities (ID) to make decisions about their medications, and to evaluate whether the provision of training (information) sessions on medications would increase their capacity. Method: Twenty-eight adults (18 male and 10 female), with a mild to…
Aim: Migraine headache is a common disorder, several drugs have been tried as a prophylaxis to reduce the attacks of headache. Aim of this study is to see the impact of amitriptyline on quality of life in migraneurs using Migraine Disability Assessment Score. Materials and Methods: In this study 300 patients of either gender who required prophylaxis for migraine without aura were selected. The patients were of the age group 18-60 years. The MIDAS questionnaire was administered to patients before starting treatment and again after 45 days prophylaxis. The improvement was noted. Statistical Analysis: It is a prospective study where the severity of symptoms and ‘quality of life’ in patients is assessed before and after treatment using mean, frequency, standard deviation and paired‘t’ test. Results: A total of 300 patients were subjected to migraine prophylaxis with amiptriptyline. The study showed female preponderance. The mean MIDAS score before and after treatment with amitriptyline was 11.6 and 9.4 respectively. The student‘t’ test showed p-value of <0.005 which was significant. Conclusion: Migraine prophylaxis with amitriptyline for a period of 45 days decreased the severity of symptoms and also reduction in days of migraine attacks. However the long term effects on quality of life could not be assessed. The study needs to be conducted in a large scale to evaluate the consistency and accuracy of the test. PMID:25386467
Computer-assisted teaching and assessment has become a regular feature across many areas of the curriculum in higher education courses around the world in recent years. This development has resulted in the "digital divide" between disabled students and their nondisabled peers regarding their participation in computer-assisted courses. However,…
Katinka AJ van Dongen; Huda Huijer; Jan PF Hamers RN; Sandra MG Zwakhalen; Katinka A. J. van Dongen
Despite the inevitability of painful procedures in life of most children with profound intellectual disability until recently no adequate pain measures were available. The present paper describes several studies facilitating the development of an observational scale to measure pain in this specific paediatric population. First candidate items for the Kids with Intellectual Disabilities Pain Assessment Instrument for Nonverbal Signals (
Lall, Geeta Rani
The etiology and identification of learning disabilities are summarized and a team approach in assessment and treatment is suggested. Topics covered include definition of learning disabilities (definitions which refer to central nervous system functioning and definitions which emphasize the learning and behavior disorders without central nervous…
Gomez-Vela, Maria; Alonso, Miguel Angel Verdugo; Gonzalez, Francisca Gil; Corbella, Marta Badia; Wehmeyer, Michael L.
The purpose of this study was to assess the self-determination of Spanish high school students with Intellectual Disabilities and other Special Educational Needs (SEN). A total of 371 students between 11 and 17 years of age participated in the study. Of these, 46.4% (n = 171) presented SEN, specifically learning disabilities (n = 97; 26.2%),…
This article discusses basic learning processes utilized by children with profound intellectual disabilities, including classical conditioning, operant conditioning, and habituation. The article also explores how these learning processes may be used in assessing the capabilities and preferences of children with profound intellectual disabilities.…
Koskentausta, Terhi; Almqvist, Fredrik
We evaluated the Developmental Behaviour Checklist (DBC) in the assessment of psychopathology in a Finnish population of children with intellectual disability. Disruptive behaviour was more common in children with mild intellectual disability, and problems with social interaction and communication in those with moderate, severe or profound…
Chi, Wen-Chou; Chang, Kwang-Hwa; Escorpizo, Reuben; Yen, Chia-Feng; Liao, Hua-Fang; Chang, Feng-Hang; Chiou, Hung-Yi; Teng, Sue-Wen; Chiu, Wen-Ta; Liou, Tsan-Hon
The definition of disability had been unclear until the International Classification of Functioning, Disability, and Health was promulgated in 2001 by the World Health Organization (WHO). Disability is a critical but relatively neglected public-health concern. We conducted this study to measure disabilities by using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and identify the factors that contribute to disabilities. We obtained and analyzed the data on people who applied to Taiwan’s disability registration system between September 2012 and August 2013. A total of 158,174 cases were selected for this study. Among the people included in this study, 53% were male, and the females were on average 3 years older than the males. More males than females were of a low socioeconomic status, but the rate of employment was higher among the males than among the females. Age, sex, place of residence, and types and severity of impairment were all determined to be factors that independently contributed to disability. This study has demonstrated that disability can be measured and compared using WHODAS 2.0. Increasing the public-health attention devoted to disability and identifying the factors associated with disability can promote independence and social participation in people with disabilities. PMID:25429682
O'Brien, Kelly K; Solomon, Patricia; Bayoumi, Ahmed M
Objectives To assess the construct validity of the HIV Disability Questionnaire (HDQ), a self-administered questionnaire that describes the presence, severity and episodic nature of disability experienced by people living with HIV. Design We conducted a confirmatory factor analysis. We hypothesised that domains in the HDQ characterised six dimensions of disability, each represented by HDQ items: physical symptoms and impairments (20 items); cognitive symptoms and impairments (3 items); mental and emotional health symptoms and impairments (11 items); uncertainty (14 items); difficulties with day-to-day activities (9 items) and challenges to social inclusion (12 items). We developed a measurement model to test these hypotheses. We used maximum likelihood methods of estimation to determine model fit. We considered a threshold for the Root Mean Square Error of Approximation (RMSEA) of <0.05 as an indication of overall goodness of model fit. We considered variables with factor loadings of >0.30 as representing a given domain of disability. Setting We recruited adults with HIV from hospital clinics, AIDS service organisations and a specialty hospital in Ontario. Participants Of the 361 adults with HIV who completed the HDQ, 80% were men, 36% were 50 or older and 77% reported living with at least two concurrent health conditions in addition to HIV. Outcome Measures We administered the HDQ followed by a demographic questionnaire. Results The model achieved good overall fit as indicated by a RMSEA of 0.030 (90% CI 0.028 to 0.033). All HDQ items represented our hypothesised dimensions of disability (factor loadings >0.30). Factor loadings ranged from 0.34 to 0.90. Domains of disability correlated with each other ranging from r=0.47 (between difficulties with day-to-day activities and uncertainty) to r=0.88 (between mental-emotional health challenges and challenges to social inclusion). Conclusions The six domain structure of the HDQ demonstrated construct validity when administered to adults living with HIV. PMID:25180054
Marjan J. M. Hummel; Rossum van Wouter; Gijsbertus J. Verkerke; Gerhard Rakhorst
Objective: Our study aims to provide a practical contribution to the field of medical technology assessment within a new paradigm. This paradigm indicates the need for more comprehensive technology assessments in the development stage of a new technology. - \\u000aMethod: We introduce a method, based on Saaty’s Analytic Hierarchy Process, which quantitatively supports discussions between the various actors that shape
. In an era of managed care, the very survival of healthcare facilities is linked to the efficient use and application of medical technology. This project will provide a model for implementing a medical technology assessment system. A database of information...
... Section 712.36 Energy DEPARTMENT OF ENERGY HUMAN RELIABILITY PROGRAM Medical Standards § 712.36 Medical assessment...Designated Psychologist and the SOMD, used to evaluate the reliability of the individual. (i) If the disqualifying...
... Section 712.36 Energy DEPARTMENT OF ENERGY HUMAN RELIABILITY PROGRAM Medical Standards § 712.36 Medical assessment...Designated Psychologist and the SOMD, used to evaluate the reliability of the individual. (i) If the disqualifying...
... Section 712.36 Energy DEPARTMENT OF ENERGY HUMAN RELIABILITY PROGRAM Medical Standards § 712.36 Medical assessment...Designated Psychologist and the SOMD, used to evaluate the reliability of the individual. (i) If the disqualifying...
Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David
The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.
Tindal, Gerald; Yovanoff, Paul; Geller, Josh P.
Students with significant disabilities must participate in large-scale assessments, often using an alternate assessment judged against alternate achievement standards. The development and administration of this type of assessment must necessarily balance meaningful participation with accurate measurement. In this study, generalizability theory is…
Stephen N. Elliott; Andrew T. Roach
This article examines three typical approaches to alternate assessment for students with significant cognitive disabilities—portfolios, performance assessments, and rating scales. A detailed analysis of common and unique design features of these approaches is provided, including features of each approach that influence the psychometric quality of their results. Validity imperatives for alternate assessments are reviewed, and approaches for addressing the need
Lohrmann-O'Rourke, Sharon; Browder, Diane M.
A review of the literature provides a synthesis of 18 years of research on preference assessment with individuals who have severe disabilities. Several procedural variables were identified that may influence the outcome of preference assessment, including context, assessment stimuli, selection response, and format. Recommendations for designing…
Sohanpal, S. K.; Deb, S.; Thomas, C.; Soni, R.; Lenotre, L.; Unwin, G.
Background: A comprehensive systematic review was performed to establish the current evidence base regarding the effectiveness of antidepressant medication for the management of behaviour problems in adults with intellectual disabilities. Method: An electronic search of PsycInfo, Embase, Medline and Cinahl databases was conducted spanning the time…
Rebecca Holman; Nadine Weisscher; Cees AW Glas; Marcel GW Dijkgraaf; Marinus Vermeulen; Rob J de Haan; Robert Lindeboom
BACKGROUND: Currently, there is a lot of interest in the flexible framework offered by item banks for measuring patient relevant outcomes. However, there are few item banks, which have been developed to quantify functional status, as expressed by the ability to perform activities of daily life. This paper examines the measurement properties of the Academic Medical Center linear disability score
Jarvikoski, Aila; Martin, Marjatta; Autti-Ramo, Ilona; Harkapaa, Kristiina
Implementation of medical rehabilitation for children with severe disabilities, arranged by the Social Insurance Institution of Finland, is based on collaboration of the family with several professionals and organizations providing the necessary services. Therefore, it sets special challenges for service provision. Parents' experiences of…
Abstract The objective of this study is to examine how much of the relationships between unhealthy body weight, and health and productivity outcomes are attributable to health status, and how much can be ameliorated by weight loss or improvements in health. Cross-sectional and first-difference regressions were conducted of employees' body mass index (BMI) category, illness absences, presenteeism, medical spending, and disability leaves. Employees in the obese BMI category have significantly worse outcomes than employees in the healthy and overweight BMI categories. Controlling for physical and emotional health status mediates much of the observed relationships. Improved health, stress, and psychological distress are associated with reduced illness absence and presenteeism among overweight and obese employees. Obese employees who lost weight experienced reduced presenteeism. The findings suggest that overweight and obese employees can realize improved productivity without weight loss. (Population Health Management 2014;xx:xxx-xxx). PMID:25375972
White, Susan W.; Smith, Laura A.; Schry, Amie R.
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…
Albus, Deb; Thurlow, Martha; Barrera, Manuel; Guven, Kamil; Shyyan, Vitaliy
The purpose of this study was to examine the participation and performance of English language learners with disabilities on the 1999-2000 Minnesota Comprehensive Assessments. For the rest of this report we refer to these students by the term students with limited English proficiency (LEP) who also have disabilities (SLEPD) 1. We wanted to do this…
Kempen, G I; Miedema, I; Ormel, J; Molenaar, W
The conceptual framework, psychometric properties, descriptive statistics, and the rules for administration and scoring of the Groningen Activity Restriction Scale (GARS) for assessing disability in the area of ADL (Activities of Daily Living including mobility) as well as IADL (Instrumental Activities of Daily Living) are presented. The result show that the GARS, which can be administered both face-to-face and by mail questionnaire, is an easy to administer, comprehensive, reliable, hierarchical, and valid measure for assessing disability in older people. By integrating previously developed scales measuring different domains of disability (ADL, IADL, and mobility) and the use of a four-category response format, an accurate and detailed measure of disability can be obtained and a broader range of needs of subjects can be described. The GARS manual, including detailed procedures for administration and scoring, encourages unambiguous administration and interpretation which results in more comparable research outcomes. PMID:8961404
WF Stewart; RB Lipton; K Kolodner; J Liberman; J Sawyer
Background. The Migraine Disability Assessment (MIDAS) score is used to quantify headache-related disability. In a previous study, we showed that the MIDAS score was highly reliable in population-based samples of migraine headache sufferers in two countries.Objectives. To examine the test–retest reliability and internal consistency of the five items comprising the MIDAS score and the overall MIDAS score in a population-based
Gray, Carol Coleman; McDonald, Patricia L.
A medical assessment based on detailed historical data, a complete physical examination, developmental and neurological assessments, laboratory tests, and discussion with parents is the foundation for planning an effective educational program for the handicapped child. (CJ)
Gentile, Julie P.; Stinson, Kelly; Jensen, Jeremy
Objective: The purpose of this study was to determine the effectiveness of psychiatric medical services, counseling, and behavioral treatments for adult patients with intellectual disabilities plus behavioral disorders and/or emotional distress. Methods: Behavioral and medical data were collected at six and 12 months for a consecutive series of 141 adult patients with mild, moderate, or severe/profound intellectual disabilities who had been referred to a dual diagnosis mental health clinic, and treatment outcomes were compared. Results: Most improvement in behavioral problem severity occurred at six months, then plateaued. Treatment improvement for subjects with anxiety disorders was statistically significant across all interventions. In this sample, as expected, patients with intellectual disability had higher incidences of medical illnesses than the general population. Conclusions: Subjects with more behavioral (overt) symptoms tended to receive referrals for behavioral support, and subjects with less overt symptoms were referred to counseling. In a follow-up study, similar individuals with moderate intellectual disabilities will be seen psychiatrically, but then randomly assigned to either supportive counseling or behavior support, or both. They will be followed prospectively, to determine the relative benefits of supportive psychotherapy, behavior support, or a combination, and for what duration of time the treatment should be continued. PMID:25621184
Preston, Tom; Kelly, Michael
The social, legal, and political discussion about the decision to stop feeding and hydration for Terri Schiavo lacked a medical ethics assessment. The authors used the principles of medical indications, quality of life, patient preference, and contextual features as a guide to medical decision-making in this case. Their conclusions include the…
Dunne, Fidelma; McAleer, Sean; Roff, Susan
Objective: To assess the undergraduate educational environment in a large UK medical school. Method: Prospective study using the already validated Dundee Ready Education Environment (DREEM) questionnaire ("Appendix 1"). Setting: A large UK medical school. Participants: All medical students enrolled in the academic year 2002/2003. Main outcome…
... Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.424 Determining total disability:...
Reyes, Jorge R.; Vollmer, Timothy R.; Sloman, Kimberly N.; Hall, Astrid; Reed, Robert; Jansen, Greg; Carr, Sam; Jackson, Kevin; Stoutimore, Michael
Ten individuals, residing in a treatment facility specializing in the rehabilitation of sex offenders with developmental disabilities, participated in an arousal assessment involving the use of the penile plethysmograph. The arousal assessments involved measuring change in penile circumference to various categories of stimuli both appropriate…
Reyes, Jorge R.; Vollmer, Timothy R.; Hall, Astrid
Three adult male sex offenders with developmental disabilities participated in phallometric assessments that involved repeated measures of arousal when exposed to various stimuli. Arousal assessment outcomes were similar to those obtained by Reyes et al. (2006). Additional data-analysis methods provided further information about sexual…
Koritsas, Stella; Iacono, Teresa; Davis, Robert
In 2007 the Australian Commonwealth Government announced the Medicare Health Assessment for People with an Intellectual Disability as part of the Enhanced Primary Care (EPC) program (Department of Health and Ageing, 2008). The annual health assessment is a structured framework for general practitioners (GPs), which enables an annual comprehensive…
Halle, Jim; Meadan, Hedda
The purposes of this article are (a) to describe a structured protocol for assessing request, reject, and repair behavior of young children with autism spectrum disorders and other developmental disabilities and (b) to highlight the importance of assessing these communicative behaviors. These three communicative functions are basic building blocks…
Hampton, Enrica O.; Whitney, Diana Williams; Schwartz, Ilene S.
This article discusses how practitioners can link assessment to action when planning communication interventions for young children with disabilities. It reviews communication components and discusses strategies for collecting information that may be especially useful in the domain of communication. Strategies for turning assessment information…
Thurlow, Martha L.; Kopriva, Rebecca J.
The purpose of this chapter is to review what has happened, and what is likely to happen, as accessibility and accommodations research and practice for content assessments are advanced to ensure the appropriate inclusion and validity of assessment results for English learners (ELs) and students with disabilities. A description of accommodations…
Tsakanikos, Elias; Underwood, Lisa; Sturmey, Peter; Bouras, Nick; McCarthy, Jane
The present study employed the Disability Assessment Schedule (DAS) to assess problem behaviors in a large sample of adults with ID (N = 568) and evaluate the psychometric properties of this instrument. Although the DAS problem behaviors were found to be internally consistent (Cronbach's [alpha] = 0.87), item analysis revealed one weak item…
Di Marco, Mark; Iacono, Teresa
This paper addresses the issues of assessment and psychological interventions of mental health in people with complex communication needs of people with intellectual disability and/or cerebral palsy. The literature indicates that research data have been lacking in this area, with a dearth of appropriate assessment tools and information on how to…
Ysseldyke, James E., Ed.; Mirkin, Phyllis K., Ed.
Proceedings from the Minnesota Roundtable Conference on Assessment of Learning Disabled children include two major presentations reviewing research and reactions to those presentations from conference participants. J. Ysseldyke's presentation "Psychoeducational Assessment and Decision Making" reviews basic considerations underlying his research on…
Chien, Chi-Wen; Brown, Ted; McDonald, Rachael
The Assessment of Children's Hand Skills (ACHS) is a new assessment tool that utilizes a naturalistic observational method to capture children's real-life hand skill performance when engaging in various types of activities. The ACHS also intends to be used with both typically developing children and those presenting with disabilities. The purpose…
Kreiner, Janice; Flexer, Robert
The purpose of this study was to develop and to evaluate the Preferences for Leisure Attributes (PLA) Assessment, a forced-choice computer software program for students with severe disabilities and communication difficulties. In order to determine content validity of the PLA Assessment, four experts in related fields assigned critical attributes…
Virués-Ortega, Javier; Pritchard, Kristen; Grant, Robin L.; North, Sebastian; Hurtado-Parrado, Camilo; Lee, May S. H.; Temple, Bev; Julio, Flavia; Yu, C. T.
Individuals with intellectual or developmental disabilities are able to reliably express their likes and dislikes through direct preference assessment. Preferred items tend to function as rewards and can therefore be used to facilitate the acquisition of new skills and promote task engagement. A number of preference assessment methods are…
Harris, Andrew J. R.; Tough, Susan
Background: Objective actuarial assessments are critical for making risk decisions, determining the necessary level of supervision and intensity of treatment ( Andrews & Bonta 2003). This paper reviews the history of organized risk assessment and discusses some issues in current attitudes towards sexual offenders with intellectual disabilities.…
Olinghouse, Natalie G.; Colwell, Ryan P.
This article provides recommendations for teachers to better prepare 3rd through 12th grade students with learning disabilities for large-scale writing assessments. The variation across large-scale writing assessments and the multiple needs of struggling writers indicate the need for test preparation to be embedded within a comprehensive,…
Glasson, E. J.; Sullivan, S. G.; Hussain, R.; Bittles, A. H.
Background: The health and well-being of Indigenous people is a significant global problem, and Aboriginal Australians suffer from a considerably higher burden of disease and lower life expectancy than the non-Indigenous population. Intellectual disability (ID) can further compromise health, but there is little information that documents the…
Vázquez-Barquero, J L; Vázquez Bourgón, E; Herrera Castanedo, S; Saiz, J; Uriarte, M; Morales, F; Gaite, L; Herrán, A; Ustün, T B
The aim of the present paper is to present the initial phases of the development of the Spanish version of the "World Health Organization Disablement Assessment Schedule II" WHO-DAS-II and also to describe the quantitative and qualitative methodological strategies used in the elaboration process of an instrument: i) compatible with the new International Classification of Functioning and Disability -ICIDH-2- of the World Health Organisation; ii) with criteria of cross-cultural applicability and; iii) to allow us to assess the disability in all its dimensions. PMID:10937388
Galindo-Garre, Francisca; Hidalgo, María Dolores; Guilera, Georgina; Pino, Oscar; Rojo, J Emilio; Gómez-Benito, Juana
The World Health Organization Disability Assessment Schedule II (WHO-DAS II) is a multidimensional instrument developed for measuring disability. It comprises six domains (getting around, self-care, getting along with others, life activities and participation in society). The main purpose of this paper is the evaluation of the psychometric properties for each domain of the WHO-DAS II with parametric and non-parametric Item Response Theory (IRT) models. A secondary objective is to assess whether the WHO-DAS II items within each domain form a hierarchy of invariantly ordered severity indicators of disability. A sample of 352 patients with a schizophrenia spectrum disorder is used in this study. The 36 items WHO-DAS II was administered during the consultation. Partial Credit and Mokken scale models are used to study the psychometric properties of the questionnaire. The psychometric properties of the WHO-DAS II scale are satisfactory for all the domains. However, we identify a few items that do not discriminate satisfactorily between different levels of disability and cannot be invariantly ordered in the scale. In conclusion the WHO-DAS II can be used to assess overall disability in patients with schizophrenia, but some domains are too general to assess functionality in these patients because they contain items that are not applicable to this pathology. PMID:25524862
Kuo, Chia-Ying; Liou, Tsan-Hon; Chang, Kwang-Hwa; Chi, Wen-Chou; Escorpizo, Reuben; Yen, Chia-Feng; Liao, Hua-Fang; Chiou, Hung-Yi; Chiu, Wen-Ta; Tsai, Jo-Ting
The purpose of this study is to compare traumatic brain injuries (TBI) and spinal cord injuries (SCI) patients' function and disability by using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0); and to clarify the factors that contribute to disability. We analyzed data available between September 2012 and August 2013 from Taiwan's national disability registry which is based on the International Classification of Functioning, Disability, and Health (ICF) framework. Of the 2664 cases selected for the study, 1316 pertained to TBI and 1348 to SCI. A larger percentage of patients with TBI compared with those with SCI exhibited poor cognition, self-care, relationships, life activities, and participation in society (all p < 0.001). Age, sex, injury type, socioeconomic status, place of residence, and severity of impairment were determined as factors that independently contribute to disability (all p < 0.05). The WHODAS 2.0 is a generic assessment instrument which is appropriate for assessing the complex and multifaceted disability associated with TBI and SCI. Further studies are needed to validate the WHODAS 2.0 for TBI and SCI from a multidisciplinary perspective. PMID:25874682
J C Bestall; E A Paul; R Garrod; R Garnham; P W Jones; J A Wedzicha
BACKGROUNDMethods of classifying chronic obstructive pulmonary disease (COPD) depend largely upon spirometric measurements but disability is only weakly related to measurements of lung function. With the increased use of pulmonary rehabilitation, a need has been identified for a simple and standardised method of categorising disability in COPD. This study examined the validity of the Medical Research Council (MRC) dyspnoea scale
Elam, Carol I.; Ziegler, Craig H.; Greenberg, Ruth B.; Bailey, Beth A.
One way of assuring professional behavior in doctors is to ensure that only those students who are likely to behave professionally are admitted to medical school. The purpose of this study is to evaluate the usefulness of an instrument to evaluate the professional bearing of applicants at the time of the medical school interview. Specifically,…
Chen, Wei; Fang, Ya; Mao, Fanzhen; Hao, Shichao; Chen, Junze; Yuan, Manqiong; Han, Yaofeng; Hong, Y. Alicia
Background The unprecedented number of elderly individuals in China presents a serious public health challenge. Limited data are available on the prevalence of disability or factors resulting in disability among the elderly in China. Objective We aimed to assess the prevalence of disability and related risk factors among the elderly of Xiamen, China. Methods A cross-sectional study was performed on individuals who were ?60 years of age. The subjects were recruited by multi-stage sampling; a total of 14,292 valid questionnaires were received. Study measurements included activities of daily living (ADL), demographics, and health status. The ADL was assessed by the Katz Index Scale to evaluate disability. Chi-square tests and binary logistic regression were used to identify factors associated with disabilities. Results Among the valid participants, 4.27% had at least one disability. Bathing was the most frequently reported disability and feeding was the least frequently reported disability. Disabilities were significantly associated with female gender, older age, unmarried status, living with family, urban residence, illiteracy, poor economic status, self-rated bad health, chronic illnesses, lower life satisfaction, bad mood, and feelings of loneliness. Conclusion Functional disability among the elderly requires more public attention. Culturally appropriate policies and programs are also needed to address the care for the disabled elderly. PMID:26126109
Ferris, Helena; O'Flynn, Dermot
Within the arena of medical education, it is generally acknowledged that assessment drives learning. Assessment is one of the most significant influences on a student's experience of higher education and improving assessment has a huge impact on the quality of learning (Liu, N. and Carless, D, 2006). Ideally we want to enhance student's capacity…
D. D'Amico; S. Usai; L. Grazzi; A. Rigamonti; A. Solari; M. Leone; G. Bussone
We assessed functional disability and health-related quality of life (HRQOL) in Italian patients suffering from chronic migraine and medication overuse (150 subjects) or chronic cluster headache (22 subjects). We used the validated Italian versions of the Migraine Disability Assessment Score (MIDAS) and of the Short Form 36 (SF-36). Patients with both conditions were characterised by significantly lower scores on most
Gomez-Vela, Maria; Verdugo, Miguel Angel; Gonzalez Gil, Francisca; Corbella, Marta Badia; Wehmeyer, Michael L.
The purpose of this study was to assess the self-determination of Spanish high school students with Intellectual Disability and other Special Educational Needs (SEN). A total of 371 students between 11 and 17 years of age participated in the study. Of these, 46.4% (n=171) presented SEN, specifically learning disabilities (n=97; 26.2%), borderline and intellectual disability with higher IQ scores (n=43; 11.6%) and mild intellectual disability (n=32; 8.6%). The remaining students without SEN made up the control group. The assessment was carried out using a translated and validated Spanish version of The Arc’s Self-Determination Scale (Wehmeyer, 1995). This measure had appropriate psychometric properties. Students with SEN obtained significantly lower scores than their peers without SEN. However, no differences were found in relation to the type of SEN or, more specifically, in relation to the presence of intellectual disability. The educational implications of the results are discussed. PMID:25057433
Tripp, April; Zhu, Weimo
Current federal legislation has shifted the focus of education for students with disabilities from issues of access and opportunity to issues about improving teaching and learning, specifically focusing on students? involvement in the general curriculum. Effective assessment techniques are critical to the educational process in order for the…
Research Summary Assessing the contribution of forestry grants to equal access for disabled people to recreation goods, facilities and services in Scottish woodlands Forestry grants have long been an important of economic, social and environmental benefits. Along with newly emerging schemes, these grants must take
Dunn, Michael W.
There is growing evidence that the current method of identifying students with a learning disability (LD) is ineffective. The wait-to-fail model of assessing students after second/third grade as well as conceptual problems in using intelligence tests for identification result in students not receiving the assistance they need during the…
Smith, Mark; Willner, Paul
Aim: This study examined the responses of care managers and direct care staff to vignettes of inappropriate sexual behaviour (ISB) by a man with an intellectual disability. The aim was to identify psychological factors that influenced their assessment of risk and the perceived need for risk management strategies. Method: The vignettes varied in…
Koski, Katja; Launonen, Kaisa
Background: Speech and language therapists (SLTs) working with adults who have multiple learning disabilities and complex communication needs often deliver their care via indirect therapy where SLTs train carers to communicate with their clients. Yet, very little is known about how SLTs assess the carers' communication skills prior to the training…
Gartin, Barbara C.; Murdick, Nikki L.
As a result of inherent cognitive and language difficulties, individuals with mental retardation/developmental disabilities often are considered difficult to assess appropriately. When cognitive and language difficulties occur in conjunction with behavioral issues, this difficulty is compounded. The IDEA requirement to include a form of…
Kurz, Alexander; Elliott, Stephen N.; Lemons, Christopher J.; Zigmond, Naomi; Kloo, Amanda; Kettler, Ryan J.
Current legislation encourages schools to educate students with disabilities (SWDs) in general education settings to the greatest extent appropriate. However, it is unclear whether inclusion in general education settings provides SWDs a sufficient opportunity to learn the academic content assessed by accountability measures. This initial study was…
Nezu, Christine Maguth; Greenberg, Jeffrey; Nezu, Arthur M.
In this brief article, we provide relevant background concerning the prevalence, characteristics and vulnerabilities of intellectually disabled (ID) sex offenders, as well as scientifically-informed guidelines for treatment. Finally, we provide a description of Project STOP, an outpatient cognitive behavioral assessment an treatment program.
Horrocks, Erin; Higbee, Thomas S.
Previous researchers have used stimulus preference assessment (SPA) methods to identify salient reinforcers for individuals with developmental disabilities including tangible, leisure, edible and olfactory stimuli. In the present study, SPA procedures were used to identify potential auditory reinforcers and determine the reinforcement value of…
Olswang, Lesley B.; Feuerstein, Julie L.; Pinder, Gay Lloyd; Dowden, Patricia
Purpose: This research investigated the use of a dynamic assessment (DA) to identify differences among young children with severe disabilities, which would predict progress in learning behaviors indicating coordinated joint attention (CJA). Method: Six children 10-24 months of age were enrolled in a 16-week treatment for behaviors indicating CJA,…
Liu, Kristin K.; Goldstone, Linda; Thurlow, Martha L.; Ward, Jenna; Hatten, James; Christensen, Laurene L.
English language learners (ELLs) with disabilities are an increasing presence in schools in the United States. Title I and Title III of the Elementary and Secondary Education Act require that these students meet the same academic grade-level standards and participate in content assessments as their fluent-English speaking peers without…
will form the backbone of this system. Various queries can be run to produce the desired results. This system will provide a means for assessing the currently available medical technology. Based on the information present in the system clinical engineers...
Uys, Kitty; Alant, Erna
The purpose of this article is to describe the processes followed to develop an authentic, reliable and valid play-based assessment of communication-related behaviours in young children with severe disabilities. The Daily Multiple Measurement Instrument (DMMI) was developed to be used based on an intervention package of play activities. The…
Minnema, Jane E.; Thurlow, Martha L.; VanGetson, Gretchen R.; Jimenez, Rene
The National Center on Educational Outcomes (NCEO) has for the past four years conducted research on large-scale assessment and instructional issues for English language learners (ELLs) with disabilities, but neither NCEO's research nor any other research study has yet described large-scale assessment experiences at the local school level for…
Boland, M.; Daly, L.; Staines, A.
Background: This paper describes a novel combination of inclusive methods to evaluate health and health promotion needs of service users (clients) with intellectual disability. Sixty centres provide disability services to over 900 clients with intellectual disability in the East Coast Area Health Board region of Ireland (population approximately…
Amin, Tarek Tawfik; Kaliyadan, Feroze; Al-Muhaidib, Nouria Saab
Objective To assess the preferred methods for assessment among medical students at both preclinical and clinical stages of medical education and the possible correlates that promote these preferences. Subjects and methods All medical students from the third year onwards were surveyed. A self-administered anonymous questionnaire was designed to gather information on the preferred assessment method for course achievement. The preferred methods were also evaluated in relation to cognitive functions. Preference for specific exam format, in the form of multiple choices, short essay questions, or both, and the stated reasons for that preference, was also included in the questionnaire. Results Out of 310 questionnaires distributed, 238 were returned. Written tests, projects, portfolios, and take home exams were the preferred modes for assessing students’ achievements in a course; oral tests including a viva voce were the least preferred type of assessment. Questions that tested the domains of ‘understanding’ and ‘application’ were the most preferred type while those entailing ‘analysis’ were the least preferred. Multiple choice question format was the most preferred type of question (68.7%) at both pre- and clinical stages. Conclusion Students’ assessments at the College of Medicine, King Faisal University, Saudi Arabia, do not use the full range of cognitive domains. The emphasis on higher domains for medical students’ assessment incorporating critical thinking should increase as the students’ progress through their medical courses. PMID:23745080
Uehara, Edwina S.; And Others
This study evaluated 2,815 adults with developmental disabilities in 328 Illinois intermediate care and skilled nursing facilities. Only 10 percent were determined to be appropriately placed in medical settings; 27 percent were enrolled in day training programs; and many individuals recommended for alternative residential settings had medical and…
Keitner, Gabor I
Acute and chronic illness exists in a social context. A biopsychosocial assessment should include an evaluation of the patient's social situation, the nature of the patient's interpersonal connections, and his/her family's functioning. Families can influence health by direct biological pathways, health behavior pathways, and psychophysiological pathways. There are a large number of family-based risks factors as well as many protective relational factors that influence the onset and course of illness. A family assessment is the first step in determining both the need for further intervention and the specific areas of family life that might need to be addressed. A family assessment provides information about the social substrate for the evolution of the presenting complaint as well as information to better understand the patient's problems. There are many ways to assess families, and there are a variety of family assessment instruments to help with the assessments. Clinician will be best served by becoming familiar and comfortable with at least one assessment model that is consistent, structured, and evaluates a wide range of family functions. Such an assessment can be incorporated into routine clinical care. A good family assessment can be therapeutic in and of itself even if the decision is made that no further family intervention is indicated. PMID:22056906
Deb, S.; Chaplin, R.; Sohanpal, S.; Unwin, G.; Soni, R.; Lenotre, L.
Background: Psychotropic medications are used to manage behaviour problems in adults with intellectual disability (ID). One group of psychotropic medication are mood stabilizers such as lithium and some antiepileptic drugs. Method: A comprehensive systematic review was performed to determine the evidence base for the effectiveness of mood…
Unwin, Gemma L.; Deb, Shoumitro
The use of medications to manage problem behaviours is widespread. However, robust evidence to support their use seems to be lacking. The aim was to review research evidence into the efficacy of atypical antipsychotic medication in managing problem behaviour in children with intellectual disabilities and borderline intelligence. A systematic…
Ann Lennarson Greer
Promotion of appropriate diffusion of technology in medicine is handicapped by: (1) thorny conceptual, ethical, and methodological problems in technology assessment; (2) a lack of consistent findings on the factors affecting technology adoption and utilization; and (3) a disturbing lack of apparent connection between assessment, adoption, and utilization. This paper reviews published work in these areas of inquiry, highlights areas
R. D. White; J. N. Cammack; R. J. Eyre; D. M. Wilson
In the medical device industry, risk assessment is required for product development and support, regulatory compliance, and manufacturing support. The risk assessment process can be divided into four major steps. The first step, hazard identification, involves determining whether exposure to an agent can cause an increased incidence of an adverse health condition (e.g., acute toxicity, cancer, birth defects, etc.). The
Boulet, John R.; Rebbecchi, Thomas A.; Denton, Elizabeth C.; McKinley, Danette W.; Whelan, Gerald P.
The ECFMG[R] Clinical Skills Assessment (CSA[R]) was developed to evaluate whether graduates of international medical schools (IMGs) are ready to enter graduate training programs in the United States. The patient note (PN) exercise, conducted after a 15-minute interview with a standardized patient (SP), is specifically used to assess a candidate's…
Carlson, Jerry S.
The final report describes a project investigating the utility of dynamic assessment in measuring the cognitive functioning and learning characteristics of children with specific learning disabilities. Subjects were 229 fourth and fifth grade children with 75 of these diagnosed as children with specific learning disabilities. Measures of cognitive…
Martin-Fumadó, Carles; Martí Amengual, Gabriel; Puig Bausili, Lluïsa; Arimany-Manso, Josep
Temporary disability is the condition that workers face when, as the result of illness (common or professional) or accident (work-related or not), they are temporarily prevented from performing their work and require health care. The management of temporary disability is a medical act that involves (in addition to a complex clinical assessment) obvious social, occupational and financial connotations and requires continuing medical follow-up from doctors, as well as responses to medical-legal conflicts. The regulatory framework on the subject is extensive in the Spanish setting and highly diverse in the European setting. Beyond the regulatory framework, the repercussions of temporary disability are self-evident at all levels. Although determining temporary disability is a common medical act for practicing physicians, it is not exempt from risks or difficulties arising from the assessment itself and the characteristics of practicing medical care. Established medical-legal conflicts include the processing of health data and the requirements for transferring information related to workers' temporary disability to their company's medical services. The interest and usefulness demonstrated by the data obtained from forensic medicine for public health require the incorporation of these data into general healthcare information, as it could be essential to the surveillance of worker health. The recommendations established by medical societies, as good practice guidelines, are especially useful in this type of conflict. PMID:24913752
Kobayashi, Yumi; Peters, Greg M; Ashbolt, Nicholas J; Shiels, Sean; Khan, Stuart J
Disability adjusted life years (DALYs) have been used to quantify endpoint indicators of the human burden of disease in life cycle assessment (LCA). The purpose of this paper was to examine the current use of DALYs in LCA, and also to consider whether DALYs as used in LCA have the potential to be compatible with DALYs as used in quantitative risk assessment (QRA) to facilitate direct comparison of the results of the two approaches. A literature review of current usage of DALYs in LCA was undertaken. Two prominent methods were identified: ReCiPe 2008 and LIME2. The methods and assumptions used in their calculations were then critically reviewed. The assumptions used for the derivation of characterization factors in DALYs were found to be considerably different between LCA methods. In many cases, transparency of these calculations and assumptions is lacking. Furthermore, global average DALY values are often used in these calculations, but may not be applicable for impact categories where the local factors play a significant role. The concept of DALYs seems beneficial since it enables direct comparison and aggregation of different health impacts. However, given the different assumptions used in each LCA method, it is important that LCA practitioners are aware of the differences and select the appropriate method for the focus of their study. When applying DALYs as a common metric between LCA and QRA, understanding the background information on how DALYs were derived is crucial to ensure the consistency of DALYs used in LCA and QRA for resulting DALYs to be comparable and to minimize any double counting of effects. PMID:26042893
RAEE, HOJAT; AMINI, MITRA; MOMEN NASAB, AMENEH; MALEK POUR, ABDOLRASOUL; JAFARI, MOHAMMAD MORAD
Introduction: Self and peer assessment provides important information about the individual’s performance and behavior in all aspects of their professional environment work. The aim of this study is to evaluate the professional behavior and performance in medical students in the form of team based assessment. Methods: In a cross-sectional study, 100 medical students in the 7th year of education were randomly selected and enrolled; for each student five questionnaires were filled out, including one self-assessment, two peer assessments and two residents assessment. The scoring system of the questionnaires was based on seven point Likert scale. After filling out the questions in the questionnaire, numerical data and written comments provided to the students were collected, analyzed and discussed. Internal consistency (Cronbach’s alpha) of the questionnaires was assessed. A p<0.05 was considered as significant level. Results: Internal consistency was acceptable (Cronbach’s alpha 0.83). Interviews revealed that the majority of students and assessors interviewed found the method acceptable. The range of scores was 1-6 (Mean±SD=4.39±0.57) for the residents' assessment, 2-6 (Mean±SD= 4.49±0.53) for peer assessment, and 3-7 (Mean±SD=5.04±0.32) for self-assessment. There was a significant difference between self assessment and other methods of assessment. Conclusions: This study demonstrates that a team-based assessment is an acceptable and feasible method for peer and self-assessment of medical students’ learning in a clinical clerkship, and has some advantages over traditional assessment methods. Further studies are needed to focus on the strengths and weaknesses. PMID:25512933
Suggested guidelines for rating cardiac disability in workers' compensation. Medical and Chiropractic Advisory Committee to the Administrative Director of the California Division of Industrial Accidents.
Clark, W L; Alpern, H L; Breall, W S; Hyman, R M; Markovitz, A; O'Brien, J B; Starke, R D
Cardiac disability ratings in workers' compensation cases currently lack any consistent scientific basis, with varying medical evidence used by different examiners in the same case. Opinions about the extent of disability may differ with the same patient, delaying resolution and the delivery of benefits. We describe guidelines for determining cardiac impairment and suggest a schedule for rating disability based on evidence. Our experience is in California, but arriving at equitable ratings for disability purposes is a nationwide challenge. Exercise stress testing provides the best reproducible data to test the heart's ability to do work. When exercise stress testing is not possible or adequate, alternative or supplemental testing is necessary. Certain conditions, such as hypertension, arrhythmias, coronary artery spasm, and a history of coronary artery operations or myocardial infarction, may affect "cardiac disability" but may not necessarily be reflected in exercise testing. PMID:8460507
Rauf, Ayesha; Shamim, Muhammad Shahid; Aly, Syed Moyn; Chundrigar, Tariq; Alam, Shams Nadeem
Formative assessment, described as "the process of appraising, judging or evaluating students' work or performance and using this to shape and improve students' competence", is generally missing from medical schools of Pakistan. Progressive institutions conduct "formative assessment" as a fleeting part of the curriculum by using various methods that may or may not include feedback to learners. The most important factor in the success of formative assessment is the quality of feedback, shown to have the maximum impact on student accomplishment. Inclusion of formative assessment into the curriculum and its implementation will require the following: Enabling Environment, Faculty and student Training, Role of Department of Medical Education (DME). Many issues can be predicted that may jeopardize the effectiveness of formative assessment including faculty resistance, lack of motivation from students and faculty and paucity of commitment from the top administration. For improvement in medical education in Pakistan, we need to develop a system considered worthy by national and international standards. This paper will give an overview of formative assessment, its implications and recommendations for implementation in medical institutes of Pakistan. PMID:24605718
Tindall, Daniel; Foley, John
The main goals of the sport education model (SEM) are to help students become competent, literate, and enthusiastic sportspersons by offering learning opportunities through contextualized sport experiences within the physical education setting. While various resources recommend suitable and easy-to-use assessment tools for physical education…
Myers, Jerry G., Jr.; Leandowski, Beth E.; Brooker, John E.; Weaver, Aaron S.
Despite over half a century of manned space flight, the space flight community is only now coming to fully assess the short and long term medical dangers of exposure to reduced gravity environments. Further, as new manned spacecraft are designed and with the advent of commercial flight capabilities to the general public, a full understanding of medical risk becomes even more critical for maintaining and understanding mission safety and crew health. To address these critical issues, the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) has begun to address the medical hazards with a formalized risk management approach by effectively identifying and attempting to mitigate acute and chronic medical risks to manned space flight. This paper describes NASA Glenn Research Center?s (GRC) efforts to develop a systematic methodology to assess the likelihood of in-flight medical conditions. Using a probabilistic approach, medical risks are assessed using well established and accepted biomedical and human performance models in combination with fundamentally observed data that defines the astronauts? physical conditions, environment and activity levels. Two different examples of space flight risk are used to show the versatility of our approach and how it successfully integrates disparate information to provide HRP decision makers with a valuable source of information which is otherwise lacking.
Dervaux, Benoît; Szwarcensztein, Karine; Josseran, Anne; Barna, Alexandre; Carbonneil, Cédric; Chevrie, Karine; Debroucker, Frédérique; Grumblat, Anne; Grumel, Olivier; Massol, Jacques; Maugendre, Philippe; Méchin, Hubert; Orlikowski, David; Roussel, Christophe; Rumeau-Pichon, Catherine; Sales, Jean-Patrick; Vicaut, Eric
Medical devices (MDs) cover a wide variety of products. They accompany changes in medical practice in step with technology innovations. Innovations in the field of MDs can improve the conditions of use of health technology and/or modify the organisation of care beyond the strict diagnostic or therapeutic benefit for the patients. However, these non purely clinical criteria seem to be only rarely documented or taken into account in the assessment of MDs during reimbursement decisions at national level or for formulary listing by hospitals even though multidimensional models for the assessment of health technologies have been developed that take into account the views of all stakeholders in the healthcare system In this article, after summarising the background concerning the assessment of health technologies in France, a definition of non-clinical criteria for the assessment of MDs is proposed and a decision tree for the assessment of MDs is described. Future lines of approach are proposed as a conclusion. PMID:25747839
Dan Wilcox; Anthony Beech; Helena F. Markall; Janine Blacker
This study examines the effectiveness of three risk assessment instruments: Static-99, Risk Matrix 2000 (RM2000) and the Rapid Risk of Sex Offender Recidivism (RRASOR), in predicting sexual recidivism among 27 intellectually disabled sex offenders. The overall sexual offence reconviction rate was 30%, while non-recidivists remained offence-free over 76 months of follow-up. Static-99 presented as performing as well as guided clinical
Abstract Background: Patients with heart disease experience limited activities of daily living (ADL). This is a cross-country comparison of the additive effects of Socioeconomics, health behaviors, and the number of medical comorbidities on disability among patients with heart disease. Methods: The current study used a cross-sectional design. Data came from the Research on Early Life and Aging Trends and Effects (RELATE). The current analysis utilized data on elderly individuals (age ?60 y) from 13 countries. The outcome was any ADL limitation (i.e. bathing, dressing, using toilet, transferring, lifting heavy things, shopping, and eating meals). Socioeconomics (i.e. age, gender, education, and income), health behaviors (i.e. exercise, smoking, and drinking), and number of chronic medical conditions (i.e. hypertension, respiratory, arthritis, stroke, and diabetes) were entered into country-specific logistic regressions, considering at least one limitation in ADL as the main outcome. Results: Number of comorbid medical conditions and age were positively associated with disability in 85% of the countries. Physical activity and drinking were linked to disability in 54%and 31% of countries, respectively. Higher education and income were associated with lower disability in 31% and 23% of the countries, respectively. Female gender was associated with higher disability only in 15% of the countries. Smoking was not associated with disability, while the effects of socioeconomics, drinking, exercise, and medical comorbidities were controlled. Conclusion: Determinants of disability depend on the country; accordingly, locally designed health promotion interventions may be superior to the universal interventions for patients with heart disease. Medical comorbidities, however, should be universally diagnosed and treated.
Horner-Johnson, Willi; Bailey, Danielle
People with intellectual disabilities are often excluded from research, in part because they may be perceived as lacking capacity to provide informed consent. A requirement of informed decision making about research participation is ability to understand the study description and disclosures presented during the consent process. The authors’ aims were to determine the extent to which study participants with intellectual disabilities were able to answer questions about key aspects of study disclosures, identify ways in which people who provided appropriate answers for all of the questions differed from those who had difficulty with one or more of the questions, and examine patterns of responses to see if certain issues were more difficult to understand than others. The authors piloted a short set of questions to assess the extent to which adults with intellectual disabilities were able to answer questions about key aspects of a health promotion study. More than half of study participants correctly answered all of the questions. For those not able to answer all questions, identifying potential risks of being in the study proved the most challenging. The findings indicate that many people with intellectual disabilities likely can provide their own consent to participate in low risk studies. PMID:24223054
Chatterji, Somnath; Kostanjsek, Nenad; Rehm, Jürgen; Kennedy, Cille; Epping-Jordan, Joanne; Saxena, Shekhar; von Korff, Michael; Pull, Charles
Abstract Objective To describe the development of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for measuring functioning and disability in accordance with the International Classification of Functioning, Disability and Health. WHODAS 2.0 is a standard metric for ensuring scientific comparability across different populations. Methods A series of studies was carried out globally. Over 65?000 respondents drawn from the general population and from specific patient populations were interviewed by trained interviewers who applied the WHODAS 2.0 (with 36 items in its full version and 12 items in a shortened version). Findings The WHODAS 2.0 was found to have high internal consistency (Cronbach's alpha, ?: 0.86), a stable factor structure; high test-retest reliability (intraclass correlation coefficient:?0.98); good concurrent validity in patient classification when compared with other recognized disability measurement instruments; conformity to Rasch scaling properties across populations, and good responsiveness (i.e. sensitivity to change). Effect sizes ranged from 0.44 to 1.38 for different health interventions targeting various health conditions. Conclusion The WHODAS 2.0 meets the need for a robust instrument that can be easily administered to measure the impact of health conditions, monitor the effectiveness of interventions and estimate the burden of both mental and physical disorders across different populations. PMID:21076562
Most types of medical technology assessments are performed after the technology has been developed. Consequently, they have only minor effects on changes in clinical practice. Our study introduces a new method of constructive medical technology assessment that can change the development and diffusion of a medical device to improve its later effectiveness in clinical practice. The method, based on Saaty's
Simon J. Williams; Michael R. Bury
Chronic obstructive airways disease (COAD) is a major, though neglected, medical and social problem in the United Kingdom today. Dyspnoea is one of the most distressing and disabling symptoms of COAD, which is itself the largest single cause of absence from work in the United Kingdom. 92 patients suffering from COAD were interviewed in order to assess impairment, disability and
To assess and manage pain in children and adolescents with mild to moderate intellectual disability, healthcare providers need access to updated tools and current knowledge. Recent studies show that these children can verbally express pain and use self-assessment tools accurately. Moreover, they know pain coping strategies. Finally, they show mental imaging skills and are able to recall autobiographical memories. These new data suggest that such children and adolescents could be candidates to for hypno-analgesia protocols and behavioral relaxation. PMID:24350192
Kantrowitz, Martin P.; Divasto, Peter V.; Starks, Ann M.; Counsellor, Aleksandra; Orgel, Linda
In 1981 a decision was made by the University of New Mexico School of Medicine to create a new Office of Community Professional Education whose primary function was to create continuing medical education programs tailored to its constituency. To accomplish this, a needs assessment survey was distributed to a stratified random sample of members of the New Mexico Medical Society practicing throughout the state to determine preferred learning styles, locations of programs and times of year, as well as other determinants for attending such programs. The survey was received by 647 physicians and 469 returned them—a response rate of 72.4 percent. Conclusions reached as a result of the needs assessment will serve as a basis of policy formation for the delivery of continuing medical education at the University of New Mexico School of Medicine. PMID:6837015
Mueller, Paul S.
Professionalism is a core competency of physicians. Clinical knowledge and skills (and their maintenance and improvement), good communication skills, and sound understanding of ethics constitute the foundation of professionalism. Rising from this foundation are behaviors and attributes of professionalism: accountability, altruism, excellence, and humanism, the capstone of which is professionalism. Patients, medical societies, and accrediting organizations expect physicians to be professional. Furthermore, professionalism is associated with better clinical outcomes. Hence, medical learners and practicing physicians should be taught and assessed for professionalism. A number of methods can be used to teach professionalism (e.g. didactic lectures, web-based modules, role modeling, reflection, interactive methods, etc.). Because of the nature of professionalism, no single tool for assessing it among medical learners and practicing physicians exists. Instead, multiple assessment tools must be used (e.g. multi-source feedback using 360-degree reviews, patient feedback, critical incident reports, etc.). Data should be gathered continuously throughout an individual’s career. For the individual learner or practicing physician, data generated by these tools can be used to create a “professionalism portfolio,” the totality of which represents a picture of the individual’s professionalism. This portfolio in turn can be used for formative and summative feedback. Data from professionalism assessments can also be used for developing professionalism curricula and generating research hypotheses. Health care leaders should support teaching and assessing professionalism at all levels of learning and practice and promote learning environments and institutional cultures that are consistent with professionalism precepts. PMID:25973263
Fernando Viesca has a 24-year-old son who suffers from Angelman Syndrome, a little known chromosomal disorder that has left him with significant functional deficiencies. When Nando lived at home, his father took care of him full time, thus alleviating any worries about medical care. However, now that Nando lives in a group home, his father is no…
Chou, Yueh-Ching; Lee, Yue-Chune; Chang, Shu-chuan; Yu, Amy Pei-Lung
This study evaluated the potential of using the Supports Intensity Scale (SIS) for resource allocation for people with intellectual disabilities (ID) in Taiwan. SIS scores were compared with those obtained from three tools that are currently used in Taiwan for homecare services: the medical diagnosis issued by local authorities and two scales…
Moore, Timothy R.; Tervo, Raymond C.; McComas, Jennifer J.; Rivard, Patrick F.; Symons, Frank J.
This quasi-longitudinal descriptive case study evaluated problem behavior for an adolescent boy with developmental disabilities via repeated functional behavioral analysis (FBA) probes during a blinded cross-over from the atypical neuroleptic Risperdal (Risperidone) to Seroquel (Quetiapine). The repeated FBA probes showed no medication differences…
Unwin, Gemma L.; Deb, Shoumitro
The aim was to investigate prescribing practices surrounding the use of medication for the management of behavioural problems in adults with intellectual disabilities with reference to a national guideline development project. A case note review methodology was employed to explore adherence to the audit criteria that were derived from the…
Ruggerini, Ciro; Guaraldi, Gian Paolo; Russo, Angela; Neviani, Vittoria; Castagnini, Augusto
Since the implementation of a psychiatric service in a long-term facility for people with intellectual disability, the usage of psychotropic and anti-convulsant drugs has been surveyed over the 5-year period 1994-1999. At that time, although the overall prevalence rate of residents on medication was not declining significantly, a decrease in…
Bindels-de Heus, Karen G. C. B.; van Staa, AnneLoes; van Vliet, Ingeborg; Ewals, Frans V. P. M.; Hilberink, Sander R.
Many children with profound intellectual and multiple disabilities (PIMD) now reach adulthood. The aim of this study was to elicit parents' experiences with the transfer from pediatric to adult medical care. A convenience sample of 131 Dutch parents of young people with PIMD (16--26 years) completed a web-based questionnaire. Twenty-two…
Background Variation in assessments is a universal given, and work disability assessments by insurance physicians are no exception. Little is known about the considerations and views of insurance physicians that may partly explain such variation. On the basis of the Attitude - Social norm - self Efficacy (ASE) model, we have developed measurement instruments for assessment behaviour and its determinants. Methods Based on theory and interviews with insurance physicians the questionnaire included blocks of items concerning background variables, intentions, attitudes, social norms, self-efficacy, knowledge, barriers and behaviour of the insurance physicians in relation to work disability assessment issues. The responses of 231 insurance physicians were suitable for further analysis. Factor analysis and reliability analysis were used to form scale variables and homogeneity analysis was used to form dimension variables. Thus, we included 169 of the 177 original items. Results Factor analysis and reliability analysis yielded 29 scales with sufficient reliability. Homogeneity analysis yielded 19 dimensions. Scales and dimensions fitted with the concepts of the ASE model. We slightly modified the ASE model by dividing behaviour into two blocks: behaviour that reflects the assessment process and behaviour that reflects assessment behaviour. The picture that emerged from the descriptive results was of a group of physicians who were motivated in their job and positive about the Dutch social security system in general. However, only half of them had a positive opinion about the Dutch Work and Income (Capacity for Work) Act (WIA). They also reported serious barriers, the most common of which was work pressure. Finally, 73% of the insurance physicians described the majority of their cases as 'difficult'. Conclusions The scales and dimensions developed appear to be valid and offer a promising basis for future research. The results suggest that the underlying ASE model, in modified form, is suitable for describing the assessment behaviour of insurance physicians and the determinants of this behaviour. The next step in this line of research should be to validate the model using structural equation modelling. Finally, the predictive value should be tested in relation to outcome measurements of work disability assessments. PMID:21199570
Cardiac rehabilitation and cardiovascular disability: role in assessment and improving functional capacity: a position statement from the American Association of Cardiovascular and Pulmonary Rehabilitation.
Hamm, Larry F; Wenger, Nanette K; Arena, Ross; Forman, Daniel E; Lavie, Carl J; Miller, Todd D; Thomas, Randal J
The Social Security Administration (SSA) oversees the disability determination process and the payment of disability benefits to Americans. According to recent SSA data, approximately 900 000 persons are receiving cardiovascular disability payments and about 145 000 adult claims for cardiovascular disability are processed by the SSA annually. An objective and comprehensive examination of functional capacity is an important part of the disability assessment process. This statement reviews various protocols for disability assessment of aerobic capacity, muscle function, and the physical requirements of job tasks. Cardiac rehabilitation programs are ideal settings for conducting comprehensive disability assessments of functional capacity in persons with cardiovascular disease. In addition, exercise training provided by cardiac rehabilitation programs can increase functional capacity in most patients. PMID:23254246
Olswang, Lesley B.; Feuerstein, Julie L.; Pinder, Gay Lloyd; Dowden, Patricia
Purpose This research investigated a dynamic assessment (DA) to identify differences among young children with severe disabilities, which would predict progress in learning behaviors indicating coordinated joint attention (CJA). Method Six children 11–24 months of age were enrolled in a 16-week treatment for behaviors indicating CJA, specifically triadic gaze (TG), a three-point gaze shift between object and adult. An initial static assessment documented eligibility and baseline performance of TG. DA procedures were then implemented to determine each child’s performance with examiner support in producing behaviors suggesting joint attention (i.e., tracking, gaze toward an object or an adult, scanning between objects, scanning an object and adult, and TG). Results Results demonstrated differences among children during the DA via a DA score and a behavioral profile. Further, these results were predictive of differences among children in subsequent learning of TG. Conclusions These data support the validity of DA for describing heterogeneity among young children with severe disabilities who look similar on static assessment but appear differently ready to learn behaviors associated with joint attention. This knowledge will assist clinicians in planning more efficacious services for young children who struggle to communicate and are at risk for extended therapeutic needs. PMID:23813200
Pearce, Jacob; Edwards, Daniel; Fraillon, Julian; Coates, Hamish; Canny, Benedict J; Wilkinson, David
An assessment framework provides a structured conceptual map of the learning outcomes of a programme of study along with details of how achievement of the outcomes can be measured. The rationale for using frameworks to underpin the targeting of essential content components is especially relevant for the medical education community. Frameworks have the capacity to improve validity and reliability in assessment, allowing test developers to more easily create robust assessment instruments. The framework used by the Australian Medical Assessment Collaboration (AMAC) is an interesting and relevant case study for the international community as it draws and builds on established processes in higher education assessment. The AMAC experience offers an insight into important considerations for designing assessment frameworks and implementing frameworks in differing contexts. There are lessons which have the potential to improve assessment and reporting practice and quality in not only medical education, but in other domains of assessment. Prior to implementing any programme of assessment, the framework considerations outlined here will hopefully improve the quality of assessment and reporting practice by making implicit assumptions explicit, and allowing more critical reflection and evaluation throughout assessment processes. PMID:25962966
Millar, Dorothy Squatrito
The main purpose of this article is to add to the transition assessment resources by introducing the Guardianship Alternative Assessment Template (GAAT) as it relates to guardianship prevention for youth and adults who have an intellectual disability. Guardianship refers to a legal intervention when a court determines that adult individuals are…
Reyer, H. S.; Sturmey, P.
Background: Prior studies have showed that presentation methods could affect the accuracy of a choice assessment. Methods: In the current study, high- and low- preferred work tasks were identified in nine adults with developmental disabilities. Both tasks were then introduced in pairs within a choice assessment using the actual tasks, pictures of…
J. Perry; C. Linehan; M. Kerr; L. Salvador-Carulla; E. Zeilinger; G. Weber; P. Walsh; H. M. J. van Schrojenstein Lantman; M. Haveman; B. Azema; S. Buono; A. C. Cara; A. Germanavicius; G. van Hove; T. Maatta; D. M. Berger; J. Tossebro
BACKGROUND: Health disparities between adults with intellectual disabilities (ID) and the general population have been well documented but, to date, no dedicated assessment battery for measuring health disparity has been available. This paper reports on the development and testing of a multinational assessment battery for collecting data on a range of health indicators relevant to adults with ID. METHODS: An
Moskowitz, Lauren J.; Mulder, Emile; Walsh, Caitlin E.; McLaughlin, Darlene Magito; Zarcone, Jennifer R.; Proudfit, Greg Hajcak; Carr, Edward G.
Despite the increased risk for anxiety disorders in children with autism spectrum disorders (ASD), there is a lack of research on the assessment and treatment of anxiety in this population, particularly for those with an intellectual disability (ID). The present study evaluated a multimethod strategy for the assessment of anxiety and problem…
Bechard, Sue; Sheinker, Jan; Abell, Rosemary; Barton, Karen; Burling, Kelly; Camacho, Christopher; Cameto, Renee; Haertel, Geneva; Hansen, Eric; Johnstone, Chris; Kingston, Neal; Murray, Elizabeth; Parker, Caroline E.; Redfield, Doris; Tucker, Bill
This article represents one outcome from the "Invitational Research Symposium on Technology-Enabled and Universally Designed Assessments," which examined technology-enabled assessments (TEA) and universal design (UD) as they relate to students with disabilities (SWD). It was developed to stimulate research into TEAs designed to better understand…
Perry, J.; Linehan, C.; Kerr, M.; Salvador-Carulla, L.; Zeilinger, E.; Weber, G.; Walsh, P.; Van Schrojenstein Lantman-De-Valk, H.; Haveman, M.; Azema, B.; Buono, S.; Cara, A. C.; Germanavicius, A.; Van Hove, G.; Maatta, T.; Berger, D. M.; Tossebro, J.
Background: Health disparities between adults with intellectual disabilities (ID) and the general population have been well documented but, to date, no dedicated assessment battery for measuring health disparity has been available. This paper reports on the development and testing of a multinational assessment battery for collecting data on a…
Background Professionalism and communication skills constitute important components of the integral formation of physicians which has repercussion on the quality of health care and medical education. The objective of this study was to assess medical graduates’ professionalism and communication skills from the patients’ perspective and to examine its association with patients’ socio-demographic variables. Methods This is a hospital based cross-sectional study. It involved 315 patients and 105 medical graduates selected by convenient sampling method. A modified and validated version of the American Board of Internal Medicine’s (ABIM) Patient Assessment survey questionnaire was used for data collection through a face to face interview. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. Mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the patients’ assessment was influenced by variables such as age, gender, education, at a level of significance, p ? 0.05. Results Female patients constituted 46% of the sample, whereas males constituted 54%. The mean age was 36?±?16. Patients’ scoring of the graduate’s skills ranged from 3.29 to 3.83 with a mean of 3.64 on a five-point Likert scale. Items assessing the “patient involvement in decision-making” were assigned the minimum mean values, while items dealing with “establishing adequate communication with patient” assigned the maximum mean values. Patients, who were older than 45 years, gave higher scores than younger ones (p?0.001). Patients with higher education reported much lower scores than those with lower education (p?=?0.003). Patients’ gender did not show any statistically significant influence on the rating level. Conclusion Generally patients rated the medical graduates’ professionalism and communication skills at a good level. Patients’ age and educational level were significantly associated with the rating level. PMID:24517316
Sylfa Fassassi; Yanik Bianchi; Friedrich Stiefel; Gérard Waeber
BACKGROUND: Assessment of capacity to consent to treatment is an important legal and ethical issue in daily medical practice. In this study we carefully evaluated the capacity to consent to treatment in patients admitted to an acute medical ward using an assessment by members of the medical team, the specific Silberfeld's score, the MMSE and an assessment by a senior
Scior, Katrina; Furnham, Adrian
Research into the general public's responses to individuals with intellectual disabilities has been dominated by attitudinal research. While this approach has unquestionably generated useful findings, it ignores important aspects, such as lay knowledge, explanatory models and beliefs about suitable interventions that can produce a multi-faceted…
Kielinen, Marko; Rantala, Heikki; Timonen, Eija; Linna, Sirkka-Liisa; Moilanen, Irma
A population-based survey was conducted among 152,732 Finnish children and adolescents aged under 16 years and living in northern Finland. Diagnoses and associated medical conditions were derived from the hospital and institutional records of this area. One hundred and eighty-seven children with DSM-IV autistic disorder were identified. Associated medical disorders or associated disorders of known or suspected genetic origin were found in 12.3 percent, including tuberous sclerosis, Down syndrome, fragile X syndrome, Klinefelter syndrome, XYY syndrome, chromosome 17 deletion, chromosome 46, XX, dup(8) (p) and mitochondriopathy. Other associated medical disorders identified were epilepsy, hydrocephalus, foetal alcohol syndrome and cerebral palsy. Hearing impairments were found in 8.6 percent and severe impairment of vision in 3.7 percent of the individuals with autistic disorder. Medical disorders seem to have a special impact on the genesis of autistic disorder and need to be thoroughly examined in each child with autistic disorder. PMID:15070547
Ricketts, Chris; Brice, Julie; Coombes, Lee
The purpose of multiple choice tests of medical knowledge is to estimate as accurately as possible a candidate's level of knowledge. However, concern is sometimes expressed that multiple choice tests may also discriminate in undesirable and irrelevant ways, such as between minority ethnic groups or by sex of candidates. There is little literature…
O'Reilly, Mark F; Lancioni, Giulio E; Sigafoos, Jeff
In this study, we used a paired-choice assessment protocol to identify the relative reinforcing value of stimuli and activities for a child with severe disabilities when she failed to settle to sleep at night. The results of this assessment indicated that the child preferred the mother's attention relative to other activities presented. Assessment results were incorporated into an intervention, that produced a reduction in sleep disturbance that was maintained at a 12-month follow up. PMID:15293639
Scranton, Thomas R.; And Others
To determine the effects of medication on the classroom learning of learning disabled children, five educationally relevant tasks were administered by the teacher to two 8-year-old boys receiving continuous Ritalin dosages interspersed with Ritalin or placebo dosaged on a random basis. (Author)
...involving an infant older than one year of age...medically indicated treatment from disabled infants...medically indicated treatment from disabled infants...medically indicated treatment from disabled infants...prescribing specific medical treatments for specific...
Hall, Jean P.; Starrett, B.
Youth with disabilities comprise a special category of children with disabilities because they are in transition from a health care environment that includes parental and school-based supports to one that requires independence ...
Berit Ydreborg; Kerstin Ekberg; Kerstin Nilsson
BACKGROUND: In this study the focus is on social insurance officers judging applications for disability pensions. The number of applications for disability pension increased during the late 1990s, which has resulted in an increasing number of disability pensions in Sweden. A more restrictive attitude towards the clients has however evolved, as societal costs have increased and governmental guidelines now focus
Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Oliva, Doretta; Campodonico, Francesca; Groeneweg, Jop
This study assessed the effects of automatically delivered stimulation on the activity level and mood of three students with multiple disabilities during their use of a stepper and a stationary bicycle. Stimuli from a pool of favorite stimulus events were delivered electronically while students were actively exercising. Findings indicated the…
Bergstrom, H.; Hochwalder, J.; Kottorp, A.; Elinder, L. S.
Background: In the context of a health intervention among people with intellectual disabilities (ID), there was a need to assess satisfaction with some aspects of life, in order to monitor both potential positive and negative effects of the intervention. The aim of the present study was to develop and evaluate an easily administered scale for…
Kerstman, Eric; Minard, Charles G.; Saile, Lynn; FreiredeCarvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Lopez, Vilma
The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission planners and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight.
Diard, Julien; Rynik, Vincent; Lorenceau, Jean
This research involves a novel apparatus, in which the user is presented with an illusion inducing visual stimulus. The user perceives illusory movement that can be followed by the eye, so that smooth pursuit eye movements can be sustained in arbitrary directions. Thus, free-flow trajectories of any shape can be traced. In other words, coupled with an eye-tracking device, this apparatus enables “eye writing,” which appears to be an original object of study. We adapt a previous model of reading and writing to this context. We describe a probabilistic model called the Bayesian Action-Perception for Eye On-Line model (BAP-EOL). It encodes probabilistic knowledge about isolated letter trajectories, their size, high-frequency components of the produced trajectory, and pupil diameter. We show how Bayesian inference, in this single model, can be used to solve several tasks, like letter recognition and novelty detection (i.e., recognizing when a presented character is not part of the learned database). We are interested in the potential use of the eye writing apparatus by motor impaired patients: the final task we solve by Bayesian inference is disability assessment (i.e., measuring and tracking the evolution of motor characteristics of produced trajectories). Preliminary experimental results are presented, which illustrate the method, showing the feasibility of character recognition in the context of eye writing. We then show experimentally how a model of the unknown character can be used to detect trajectories that are likely to be new symbols, and how disability assessment can be performed by opportunistically observing characteristics of fine motor control, as letter are being traced. Experimental analyses also help identify specificities of eye writing, as compared to handwriting, and the resulting technical challenges. PMID:24273525
Tamashiro, Lilian Mayumi Chinen; Peres, Heloisa Helena Ciqueto
OBJECTIVES: to develop and assess a learning object about intramuscular medication administration for nursing undergraduates and nurses. METHOD: a random, intentional and non-probabilistic sample was selected of nurses from a Brazilian social network of nursing and students from the Undergraduate Program at the University of São Paulo School of Nursing to serve as research subjects and assess the object. RESULTS: the participants, 8 nurses and 8 students, studied the object and answered an assessment instrument that included the following criteria: educational aspects (relevance of the theme, objectives and texts/hypertexts), interface of the environment (navigation, accessibility and screen design) and didactic resources (interactivity and presentation of resources). In total, 128 significant answers were obtained, 124 (97%) of which were positive, assessed as excellent and satisfactory, considered as a flexible, dynamic, objective resources that is appropriate to the nursing learning process. CONCLUSION: the educational technology shows a clear and easily understandable language and the teaching method could be applied in other themes, contributing to the education and training of nursing professionals, positively affecting nursing teaching, stimulating the knowledge, autonomous and independent learning, aligned with the new professional education requirements. PMID:25493665
Munger, Kelly M; Gill, Carol J; Ormond, Kelly E; Kirschner, Kristi L
Recent scientific discoveries have made it much easier to test prenatally for various genetic disabilities, such as Down syndrome. However, while many observers have heralded such "advances" for their effectiveness in detecting certain conditions, others have argued that they perpetuate discrimination by preventing the birth of children with disabilities. This article examines the ethical and social implications of the Human Genome Project for individuals with intellectual disabilities and their families. It details the critique of prenatal testing articulated by many disability rights activists as well as scholarly and professional responses to that critique. A review of the pertinent research literature includes perspectives of genetic professionals, ethicists, disability studies scholars, parents of children with disabilities, and disabled individuals themselves. Finally, the article explores how future research endeavors, policies, and practices may more effectively integrate and respect the positions of these various stakeholders. PMID:17563891
van den Berg, Thomas J.T.P.; (René) van Rijn, L.J.; Kaper-Bongers, R.; Vonhoff, D.J.; Völker-Dieben, H.J.; Grabner, G.; Nischler, C.; Emesz, M.; Wilhelm, H.; Gamer, D.; Schuster, A.; Franssen, L.; de Wit, G.C.; Coppens, J.E.
Purpose To compare different methods for the assessment of disability glare sensitivity in the elderly, to arrive at an objective assessment of the condition of the eye. To delineate the importance of straylight values in vision. Methods Three groups of subjects were studied: 1) Young subjects without any eye disease, 2) elderly subjects without any eye disease and 3) elderly subjects with (early) cataract in at least one eye. All subjects underwent 2 glare tests, 2 straylight tests, ETDRS visual acuity test, Pelli Robson contrast sensitivity test, refraction, LOCS III cataract classification. Straylight was quantified by means of the straylight parameter s. Results Repeatability, discriminative ability, and added value as compared to visual acuity were low for the glare tests and good for the straylight measurements. For young normal subjects, with log(s)=0.9, the standard glare situation with low beams gives a contrast reduction of 1.3, whereas for the healthy 77 year olds this increases to 2. With cataract hardly affecting visual acuity, log(s) can be as high as 1.8, resulting in a contrast reduction of 3.4. Conclusion Straylight measurement is of relevance for the assessment of the glare-related hindrance during driving, and can be used to objectify complaints and aid in the decision-making regarding cataract surgery.
Wilbanks, Jammie T.
Research has been conducted on the effectiveness of formative assessments and on effectively teaching medical terminology; however, research had not been conducted on the use of formative assessments in a medical terminology course. A quantitative study was performed which captured data from a pretest, self-assessment, four module exams, and a…
Wang, Peng-Wei; Cheng, Cheng-Chung; Chou, Frank Huang-Chih; Tsang, Hin-Yeung; Chang, Yu-San; Huang, Mei-Feng; Yen, Cheng-Fang
Background: No single assessment method can successfully evaluate the clinical ability of medical students in psychiatric clerkships; however, few studies have examined the efficacy of multiple assessments, especially in psychiatry. The aim of this study was to examine the relationship among different types of assessments of medical students'…
BACKGROUND: After a survey of medical graduates' skills found a lack of confidence in developmental assessment, a program was introduced with the broad aims of increasing medical student confidence and respect for the parents' role in childhood developmental assessment. Research has shown that parents' concerns are as accurate as quality screening tests in assessing development, so the program utilised the
Lehmann, Ilana; Crimando, William
Although some writers have suggested that the Americans With Disabilities Act (ADA), contrary to its intent, was responsible for a decline in employment for persons with disabilities, there is little strong empirical support for such an assertion. This study is an attempt to demonstrate that, in fact, the dismal labor market experience following…
Bhagwanji, Yash; Bennett, Tess
The Great Lakes Quality Improvement Center for Disabilities (Region V QIC-D or GLQIC-D) serves Head Start Programs in Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin, and conducts an annual needs assessment of the Head Start Disability Services Coordinators. For 1998, 264 coordinators completed the survey, which gathered information…
Wolbarst, Anthony B.; Hendee, William R. [Department of Radiology, College of Medicine and Division of Radiation Sciences, College of Health Sciences, University of Kentucky, Lexington, Kentucky 40536 (United States); Department of Radiology, Mayo Clinic, Rochester, Minnesota 55901 (United States)
Purpose: This letter suggests a formalism, the medical effective dose (MED), that is suitable for assessing stochastic radiogenic risks in diagnostic medical procedures. Methods: The MED is derived from radiobiological and probabilistic first principals, including: (1) The independence of radiation-induced biological effects in neighboring voxels at low doses; (2) the linear no-threshold assumption for stochastic radiation injury (although other dose-response relationships could be incorporated, instead); (3) the best human radiation dose-response data currently available; and (4) the built-in possibility that the carcinogenic risk to an irradiated organ may depend on its volume. The MED involves a dose-risk summation over irradiated voxels at high spatial resolution; it reduces to the traditional effective dose when every organ is irradiated uniformly and when the dependence of risk on organ volumes is ignored. Standard relative-risk tissue weighting factors can be used with the MED approach until more refined data become available. Results: The MED is intended for clinical and phantom dosimetry, and it provides an estimate of overall relative radiogenic stochastic risk for any given dose distribution. A result of the MED derivation is that the stochastic risk may increase with the volume of tissue (i.e., the number of cells) irradiated, a feature that can be activated when forthcoming radiobiological research warrants it. In this regard, the MED resembles neither the standard effective dose (E) nor the CT dose index (CTDI), but it is somewhat like the CT dose-length product (DLP). Conclusions: The MED is a novel, probabilistically and biologically based means of estimating stochastic-risk-weighted doses associated with medical imaging. Built in, ab initio, is the ability to link radiogenic risk to organ volume and other clinical factors. It is straightforward to implement when medical dose distributions are available, provided that one is content, for the time being, to accept the relative tissue weighting factors published by the International Commission of Radiological Protection (ICRP). It requires no new radiobiological data and avoids major problems encountered by the E, CTDI, and CT-E formalisms. It makes possible relative inter-patient dosimetry, and also realistic intercomparisons of stochastic risks from different protocols that yield images of comparable quality.
Performance Trends and Use of Accommodations on a Statewide Assessment: Students with Disabilities in the KIRIS On-Demand Assessments from 1992-93 through 1995-96. State Assessment Series, Maryland/Kentucky Report 3.
This report discusses the performance of students with disabilities on the Kentucky Instructional Results Information System (KIRIS) on-demand assessments. These assessments, which consist of constructed response or essay-like questions over the period of 1992-93 through 1995-96, are part of the regular KIRIS assessment, which also includes…
Jacke, C O; Kalder, M; Koller, M; Wagner, U; Albert, U S
Public health research depends on empirical information that is based on data of high quality. The aim of this study was to apply the current guidelines developed by the Technology and Methodology Platform for Networked Medical Research (TMF) for the independent assessment and enhancement of data quality. A clinical register of female breast cancer patients from two periods (N?=?389 of 1996-1997 and N?=?488 of 2003-2004) was used. To check the plausibility, organization, and correctness of the data quality levels, data quality indicators (DQI) were chosen, operationalized, and the variance ratios of normative-analytic-defined thresholds were calculated. Significant deviations led to data improvement, which included the commonly known source data verification (SDV). A summary data quality score was calculated before and after application of the guidelines. Eleven out of 24 DQIs were tested. Data quality systematically increased from 51.6 to 67.7%. The guidelines facilitate a systematic assessment and improvement of data quality with a reasonable use of resources. This target-oriented procedure allows for a high transparency of the available data quality, which is essential for health research. PMID:23114449
Lofthouse, Rachael E.; Lindsay, William R.; Totsika, Vasiliki; Hastings, Richard P.; Boer, Douglas P.; Haaven, James L.
Background: The purpose of the present study was to add to the literature on the predictive accuracy of a dynamic intellectual disability specific risk assessment tool. Method: A dynamic risk assessment for sexual reoffending (ARMIDILO-S), a static risk assessment for sexual offending (STATIC-99), and a static risk assessment for violence…
Gilkey, Kelly M.; Myers, Jerry G.; McRae, Michael P.; Griffin, Elise A.; Kallrui, Aditya S.
The Exploration Medical Capability project is creating a catalog of risk assessments using the Integrated Medical Model (IMM). The IMM is a software-based system intended to assist mission planners in preparing for spaceflight missions by helping them to make informed decisions about medical preparations and supplies needed for combating and treating various medical events using Probabilistic Risk Assessment. The objective is to use statistical analyses to inform the IMM decision tool with estimated probabilities of medical events occurring during an exploration mission. Because data regarding astronaut health are limited, Bayesian statistical analysis is used. Bayesian inference combines prior knowledge, such as data from the general U.S. population, the U.S. Submarine Force, or the analog astronaut population located at the NASA Johnson Space Center, with observed data for the medical condition of interest. The posterior results reflect the best evidence for specific medical events occurring in flight. Bayes theorem provides a formal mechanism for combining available observed data with data from similar studies to support the quantification process. The IMM team performed Bayesian updates on the following medical events: angina, appendicitis, atrial fibrillation, atrial flutter, dental abscess, dental caries, dental periodontal disease, gallstone disease, herpes zoster, renal stones, seizure, and stroke.
Verbrugge, L. M.; Juarez, L.
Using the 1994-95 National Health Interview Supplement Disability Supplement, the authors study levels of disabilities and accommodations among US adults with arthritis disability, compared to people with disability due to other conditions. Arthritis-disabled people are defined in two ways. One definition covers a broad range of arthritis and rheumatic conditions, and the other concentrates solely on arthritis. The authors find that arthritis-disabled people have more total disabilities than other-disabled peop e. However, their disabilities are less severe, have shorter durations, and accumulate more gradually over time. Despite more disabilities, people with arthritis disability use fewer assistive and service accommodations than other-disabled people. They do use more mobility aids. Because arthritis is the leading chronic condition for middle-aged and older adults, th s profile of extensive but mild-to-moderate disability is experienced by many millions of adults. Accommodations for arthritis may also be extensive but aimed more toward self-care than toward assistive and medical services. PMID:11889283
Olivieri, N F; Matsui, D; Hermann, C; Koren, G
The accurate assessment of patient compliance is especially crucial in evaluating the efficacy of a new treatment. Because of the problems associated with parenteral desferrioxamine, the development of a safe, effective, and convenient iron chelator is of high priority. The high morbidity and mortality associated with iron overload requires careful evaluation of the ability of any new agent to promote long term effective iron chelation. Patients' compliance with an orally available chelating agent, 1,2,-dimethyl-3-hydroxypyrid-4-one (L1), that has been demonstrated to induce in vivo iron excretion equivalent to that of desferrioxamine during supervised short term administration, was examined. Compliance was assessed in seven patients by patient interview, by daily diaries reviewed monthly with each patient, and with the use of the Medication Event Monitoring System (MEMS) standard pill bottles with microprocessors in the cap that record the timing and frequency of bottle openings. L1 was dispensed in MEMS containers to the patients, who, unaware of their significance, recorded compliance using a daily diary. Overall compliance rate (% of prescribed doses taken) measured by MEMS was 88.7 +/- 6.8%. When 'doubling of doses' was accounted for, significantly poorer compliance with L1 was noted by MEMS (91.7 +/- 7.4%) than by patients' diaries (95.7 +/- 5.2%). There was no significant difference in patient compliance recorded between the first and last 30 day period of drug administration. MEMS can eliminate the confounding variable of erratic patient compliance in the evaluation of a new drug's efficacy. As MEMS cannot distinguish a missed dose from one doubled at the next bottle opening, the use of patient diaries is a useful adjunct to the accurate assessment of compliance and should be combined with the use of MEMS. PMID:1776885
Ralfs, Sonya; Beail, Nigel
Background: Because of a lack of research investigating empathy in sex offenders with intellectual disabilities, this study explored empathy in sex offenders and non-offenders with intellectual disabilities. Specific aims were to explore differences between these groups on measures of the components of empathy. Methods: The scores of 21…
This article reviews critical issues with integrating different procedures for identifying children with specific learning disabilities permitted in the federal regulations of the 2004 Individual With Disabilities Education Act 2004. Theoretical differences between behavioral approaches that focus on recording behavioral responses based on…
Hare, Dougal Julian; Searson, Ruth; Knowles, Rebecca
Many people with intellectual disabilities are still not being listened to by the services providing them with care and support, and when they become upset and frustrated, they are all too readily regarded as being mentally ill. To help people with intellectual disabilities describe and make sense of their experiences and feelings in a…
Many people with learning disabilities are not well supported when someone close to them dies. This can make it an even more difficult time than it needs to be. This is about how staff can help people with learning disabilities when somebody close to them dies. It has some questions for them to think about. It is well documented that the death of…
Boon, Helen Joanna; Pagliano, Paul; Brown, Lawrence; Tsey, Komla
Recent weather-related disasters (i.e., floods, fires) impacting Australia may potentially increase in frequency and severity as a result of predicted climate variability. The dearth of literature pertaining to school emergency response planning for vulnerable students with disabilities (including those with intellectual disabilities) when such…
and acceptance criteria for acceptance testing and quality control of medical display devices. This paperAssessment of display performance for medical imaging systems: Executive summary of AAPM TG18 Roehrig University of Arizona Lois Rutz Gammex/RMI Ehsan Samei Duke University Medical Center Jeffrey
Kaklanis, Nikolaos; Stavropoulos, Georgios; Tzovaras, Dimitrios
Virtual User Models (VUMs) can be a valuable tool for accessibility and ergonomic evaluation of designs in simulation environments. As increasing the accessibility of a design is usually translated into additional costs and increased development time, the need for specifying the percentage of population for which the design will be accessible is crucial. This paper addresses the development of VUMs representing specific groups of people with disabilities. In order to create such VUMs, we need to know the functional limitations, i.e. disability parameters, caused by each disability and their variability over the population. Measurements were obtained from 90 subjects with motor disabilities and were analyzed using both parametric and nonparametric regression methods as well as a proposed hybrid regression method able to handle small sample sizes. Validation results showed that in most cases the proposed regression analysis can produce valid estimations on the variability of each disability parameter. PMID:26154211
...MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN THE STATES, DISTRICT OF COLUMBIA, THE NORTHERN MARIANA ISLANDS, AND AMERICAN SAMOA Optional Coverage of the Medically Needy § 435.330 Medically needy coverage of the aged, blind, and...
Davies, Patricia L; Soon, Pepper Lee; Young, Michele; Clausen-Yamaki, Amy
This study examined validity of the School Function Assessment (SFA) and interrater reliability of occupational therapist and teacher ratings of students' school function. The validity of the SFA was examined using the known-group method in 35 participants in kindergarten through 7th grade attending elementary schools; 15 students with learning disabilities (LD), 11 students with autism, and 9 students with traumatic brain injury (TBI). The SFA criterion scores for the 23 individual scales were clustered into five distinct parts for the validity analyses. Significant differences in SFA scores among the 3 groups of students were found using Kruskal-Wallis analyses (Chi2 ranged from 9.28 to 20.55, p <.01). Two discriminant analyses demonstrated high correct classification of students with autism and LD, but showed less accurate classification of students with TBI, indicating that the SFA scores of students with TBI did not fall into a systematic pattern for classification. For the interrater reliability study, 16 students' ratings by their teacher and occupational therapist were analyzed. Intraclass correlations resulted in moderate relationships between teacher and occupational therapist ratings for the average criterion scores for the three main sections of the SFA: participation,.70; task supports,.68; and activity performance,.73. Results of this study are discussed in terms of validity of score interpretation and the reliability of different team members completing the SFA questionnaire. PMID:15257967
14 Aeronautics and Space 4 2012-01-01 2012-01-01...23 Section 382.23 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT...NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to...
14 Aeronautics and Space 4 2013-01-01 2013-01-01...23 Section 382.23 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT...NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to...
14 Aeronautics and Space 4 2010-01-01 2010-01-01...23 Section 382.23 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT...NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to...
14 Aeronautics and Space 4 2014-01-01 2014-01-01...23 Section 382.23 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT...NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to...
14 Aeronautics and Space 4 2011-01-01 2011-01-01...23 Section 382.23 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT...NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Nondiscrimination and Access to...
The increased complexity of medical technology makes usability an important selection criterion when new equipment is purchased. However, this requires an understanding of what usability is in a medical technology context and what usability evaluation methods are suitable. A questionnaire was used to investigate what users of medical technology regard as the largest component of usability. The component ‘difficult to
Traci, Meg Ann; Seekins, Tom; Szalda-Petree, Ann; Ravesloot, Craig
Pope (1992) asserted that there was a significant need to examine secondary conditions among individuals with development disabilities. In the present study we focused on that need. The development of a secondary conditions surveillance instrument is described, as are the results of a pilot survey conducted with adults receiving state developmental disabilities program supports and with their direct-care service providers. Results of a pilot survey are presented to illustrate how survey data might be used to improve systems of services and supports to enhance the health and participation of adults with developmental disabilities in community life. PMID:11925266
G Zuccalà; G Onder; C Pedone; A Cocchi; L Carosella; C Cattel; P U Carbonin; R Bernabei
Cognitive dysfunction is a frequent finding among older patients with left ventricular systolic dysfunction; however, the clinical outcomes of such a finding are unknown. Also, disability is a common condition in heart failure, poorly responding to commonly used cardiovascular medications. The association between cognitive dysfunction and disability was assessed in 1583 patients with heart failure, but without cerebrovascular disease, previous
Chen, Mel Y
This article examines concepts whose strictly medical applications have only partly informed their widespread use and suggests that demonstrably shared logics motivate our thinking across domains in the interest of a politically just engagement. It considers exchanges between the culturally complex concepts of 'toxicity' and 'intoxication', assessing the racialised conditions of their animation in several geopolitically-and quite radically-distinct scenarios. First, the article sets the framework through considering the racial implications of impairment and disability language of 'non-toxic' finance capital in the contemporary US financial crisis. Shifting material foci from 'illiquid financial bodies' to opiates while insisting that neither is 'more' metaphorically toxic than the other, the article turns to address the role of opium and temporality in the interanimations of race and disability in two sites of 19th-century British empire: Langdon Down's clinic for idiocy, and China's retort on opium to Queen Victoria. The article concludes with a provocation that suggests yet another crossing of borders, that between researcher and researched: 'intoxicated method' is a hypothetical mode of approach that refuses idealised research positions by 'critically disabling' the idealised cognitive and conceptual lens of analysis. PMID:26052116
Certo, N J; Schleien, S J; Hunter, D
Severely disabled individuals have long been systematically excluded from actively participating in normalized recreation/leisure activities in integrated community settings. Severely disabled individuals should be taught functional and age appropriate skills, based upon the performance characteristics of nonhandicapped peers. In order to present this position, typical assumptions of leisure skill instruction for severely disabled individuals are discussed and opposing points of view are presented. Finally, the article presents a concrete strategy, or inventory, that is divided into three interrelated areas including: skill selection and skill/facility description, component skills and adaptations for full/partial participation, and supportive skills. The inventory can be used by therapeutic recreation specialists and other educators to develop functional, age appropriate leisure skill instructional content. It is expected that this approach, coupled with longitudinal planning, will facilitate the provision of opportunities for severely disabled individuals to actively participate in normalized recreation/leisure skills in integrated community settings. PMID:10317401
Mubuuke, Aloysius Gonzaga; Mwesigwa, Catherine; Maling, Samuel; Rukundo, Godfrey; Kagawa, Mike; Kitara, David Lagoro; Kiguli, Sarah
Introduction Health professions education is gradually moving away from the more traditional approaches to new innovative ways of training aimed at producing professionals with the necessary competencies to address the community health needs. In response to these emerging trends, Medical Education for Equitable Services to All Ugandans (MESAU), a consortium of Ugandan medical schools developed key competencies desirable of graduates and successfully implemented Competency Based Education (CBE) for undergraduate medical students. Objectives To examine the current situation and establish whether assessment methods of the competencies are standardized across MESAU schools as well as establish the challenges, opportunities and lessons learned from the MESAU consortium. Methods It was a cross-sectional descriptive study involving faculty of the medical schools in Uganda. Data was collected using focus group discussions and document reviews. Findings were presented in form of themes. Results Although the MESAU schools have implemented the developed competencies within their curricular, the assessment methods are still not standardized with each institution having its own assessment procedures. Lack of knowledge and skills regarding assessment of the competencies was evident amongst the faculty. The fear for change amongst lecturers was also noted as a major challenge. However, the institutional collaboration created while developing competencies was identified as key strength. Conclusion Findings demonstrated that despite having common competencies, there is no standardized assessment blue print applicable to all MESAU schools. Continued collaboration and faculty development in assessment is strongly recommended. PMID:25995778
Moguchaia, O V; Gumanenko, E K; Simonova, I A; Shchedrenok, V V; Romashova, O V; Kaurova, T A
An analysis of 658 medical records of inpatient treatment from 15 hospitals of St.Petersburg was made using a computer-aided technology of the assessment of medical care quality. It was revealed that a proper quality of medical care in craniocerebral trauma was only in 52.9% cases. Different defects of medical care were noted in the rest of observations. It influenced on the condition of the patients (1.0%), the delivery and assessment of health care (40% and 38%, respectively), health resources (18%), social resources (1.0%). Defects of medical records were indicated in 38% patients. It caused a reduction of medical care. Risks of occurrence of medical care defects are low in children hospitals in the case of combined craniocerebral trauma. PMID:25552116
Roszek B; Drongelen AW van; Geertsma RE; Tienhoven EAE van
An investigation was carried out on the availability and quality of the\\u000atechnical documentation (file) of medical devices. Manufacturers of\\u000amedical devices are obliged to prepare and maintain documentation\\u000acomplying with the provisions in the Medical Device Directive (MDD). \\u000aManufacturers are legally required to affix a CE mark to their medical\\u000adevices in order to gain access to the European
Gannon, Sam C.
Academic medical centers are well-known for their emphasis on teaching, research and public service; however, like most large, bureaucratic organizations, they oftentimes suffer from an inability to learn as an organization. The role of the research administrator in the academic medical center has grown over time as the profession itself has…
Hidalgo, Jesús López-Torres; Pretel, Fernando Andrés; Bravo, Beatriz Navarro; Rabadan, Francisco Escobar; Serrano Selva, Juan Pedro; Latorre Postigo, Jose Miguel; Martínez, Ignacio Párraga
Objective: To examine the ability of medical students to identify hazardous drinkers using screening tools recommended in clinical practice. Design: Observational cross-sectional study. Setting: Faculty of Medicine of Castilla-La Mancha, Spain. Method: The medical students learnt to use Alcohol Use Disorders Identification Test (AUDIT) and…
Orwig, Denise; Brandt, Nicole; Gruber-Baldini, Ann L.
Purpose: The purpose of this study was to describe the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and to provide results of reliability and validity testing. Design and Methods: Participants were 50 older adults, aged 65 and older, who lived in the community, took at least one prescription medication, and were then…
Butler, Doug; Bauman, David; Johnson-Throop, Kathy
The Integrated Medical Model (IMM) Project has been developing a probabilistic risk assessment tool, the IMM, to help evaluate in-flight crew health needs and impacts to the mission due to medical events. This package is a follow-up to a data package provided in June 2009. The IMM currently represents 83 medical conditions and associated ISS resources required to mitigate medical events. IMM end state forecasts relevant to the ISS PRA model include evacuation (EVAC) and loss of crew life (LOCL). The current version of the IMM provides the basis for the operational version of IMM expected in the January 2011 timeframe. The objectives of this data package are: 1. To provide a preliminary understanding of medical risk data used to update the ISS PRA Model. The IMM has had limited validation and an initial characterization of maturity has been completed using NASA STD 7009 Standard for Models and Simulation. The IMM has been internally validated by IMM personnel but has not been validated by an independent body external to the IMM Project. 2. To support a continued dialogue between the ISS PRA and IMM teams. To ensure accurate data interpretation, and that IMM output format and content meets the needs of the ISS Risk Management Office and ISS PRA Model, periodic discussions are anticipated between the risk teams. 3. To help assess the differences between the current ISS PRA and IMM medical risk forecasts of EVAC and LOCL. Follow-on activities are anticipated based on the differences between the current ISS PRA medical risk data and the latest medical risk data produced by IMM.
Stringfellow, Thomas D; Rohrer, Rebecca M; Loewenthal, Lola; Gorrard-Smith, Connor; Sheriff, Ibrahim H N; Armit, Kirsten; Lees, Peter D; Spurgeon, Peter C
Abstract Medical leadership and management (MLM) skills are essential in preventing failings of healthcare; it is unknown how these attitudes can be developed during undergraduate medical education. This paper aims to quantify interest in MLM and recommends preferred methods of teaching and assessment at UK medical schools. Two questionnaires were developed, one sent to all UK medical school faculties, to assess executed and planned curriculum changes, and the other sent to medical students nationally to assess their preferences for teaching and assessment. Forty-eight percent of UK medical schools and 260 individual student responses were recorded. Student responses represented 60% of UK medical schools. 65% of schools valued or highly valued the importance of teaching MLM topics, compared with 93.2% of students. Students' favoured teaching methods were seminars or lectures (89.4%) and audit and quality improvement (QI) projects (77.8%). Medical schools preferred portfolio entries (55%) and presentations (35%) as assessment methods, whilst simulation exercises (76%) and audit reports (61%) were preferred by students. Preferred methods encompass experiential learning or simulation and a greater emphasis should be placed on encouraging student audit and QI projects. The curriculum changes necessary could be achieved via further integration into future editions of Tomorrow's Doctors. PMID:25301039
This paper presents testimony before the New York State Assembly Joint Hearings on Workers' Compensation. The testimony first establishes the background of the speaker in relation to the problems in the workers' compensation system. A brief summary of the problem including the increased prevalence of work-related musculoskeletal disorders and their contribution to work disability, the rising costs of insurance premiums,
Jackson, G; Patel, S; Khan, S
Counterfeit medicines pose an ever-increasing threat to public health, although precise tracking of illegal counterfeit prescription drug activity is difficult. Available data indicate that all types of medications have been targeted. Adverse health effects, including death, have resulted from using counterfeit medications; consumers who self-medicate without appropriate interactions with the healthcare system rarely receive adequate healthcare. The Internet provides a large, convenient route for counterfeiters to reach potential buyers with unregulated, often dangerous, products. The majority of medicines purchased via unverified Internet sites are counterfeit; often, these products lack the purported drug compound or have variable concentrations of active ingredients and sometimes contain dangerous toxins. Although many consumers acknowledge some degree of risk with purchasing medications via the Internet, speed, convenience and cost often prompt these purchases. Counterfeit medications also have been detected in the legitimate supply chain, but represent a significantly smaller proportion of sales than those purchased via the Internet. Pilot programmes in Europe have demonstrated that product verification systems prevent penetration of counterfeit products into the legitimate supply chain. Significant EU legislation, including stronger penalties for counterfeiting, is in development. In the United Kingdom, the Medicines and Healthcare Products Regulatory Agency (MHRA) launched an initiative against counterfeit medication. Healthcare professionals should report suspected cases of counterfeit medication to the MHRA, be alert to threats to the medicine supply, and provide practical advice to patients about ordering medications online, including avoiding unregulated Internet pharmacies, and being suspicious of sites offering substantial discounts and prescription-only medication without a prescription. PMID:22070229
Burnett, S E; Yerxa, E J
A descriptive survey was conducted to determine the self-perceived needs of physically disabled persons as a preliminary step toward establishing or designing a knowledge base for occupational therapy intervention at a community college. Demographic and needs data were statistically compared with those from a sample of nondisabled college students. Significant differences in the confidence to perform congnitive/problem-solving, social/recreational, school/vocational, home and community mobility skills were found, with the disabled reporting lowered or less confidence. Confidence in performing basic activities of daily living was the only area in which the difference was not significant. No significant differences were obtained in general interests except that a higher frequency of disabled reported not wanting to participate in sports. The greatest amounts of interest were in crafts/fine arts and in social/recreational activities. Implications were drawn for occupational therapy programming to improve confidence in independent living skills by using the subjects' predominant interests. PMID:6445158
Iosa, Marco; Morelli, Daniela; Nisi, Enrica; Sorbara, Carlo; Negrini, Stefano; Gentili, Paola; Paolucci, Stefano; Fusco, Augusto
There is an increasing interest about upper body accelerations during locomotion and how they are altered by physical impairments. Recent studies have demonstrated that cognitive impairments affect gait stability in the elderly (i.e., their capacity for smoothing upper body accelerations during walking) but little attention has been paid to young adults with intellectual disabilities. The purpose of this study was to examine upright stability in young adults with intellectual disabilities during walking, running, and dual-task running (playing soccer). To this aim a wearable trunk-mounted device that permits on-field assessment was used to quantify trunk acceleration of 18 male teenagers with intellectual disabilities (IDG) and 7 mental-age-matched healthy children (HCG) who participated in the same soccer program. We did not find any significant difference during walking in terms of speed, whereas speed differences were found during running (p=.001). Upper body accelerations were altered in a pathology-specific manner during the dual task: the performance of subjects with autistic disorders was compromised while running and controlling the ball with the feet. Differences in upright locomotor patterns between IDG and HCG emerged during more demanding motor tasks in terms of a loss in the capacity of smoothing accelerations at the trunk level. PMID:24630612
Verri, A. P.; Maraschio, P.; Uggetti, C.; Pucci, E.; Ronchi, G.; Nespoli, L.; Destefani, V.; Ramponi, A.; Federico, A.
The diagnosis of intellectual disability (ID) is highly dependent on a comprehensive personal and family medical history, a complete physical examination and a careful developmental assessment of the patient. Our study intended to: (1) classify the aetiology of mild and severe ID in an adult population of 140 Italian subjects; (2) evaluate the…
Lin, Pei-Ying; Lin, Lan-Ping; Lin, Jin-Ding
The present paper aims to assess the hypertension, hyperglycemia and hyperlipidemia prevalence of adolescents with intellectual disabilities, and to recognize the health disparities between the study participants and the general population. This study conducted a cross-sectional medical chart analysis of 856 students who participated in school…
Woodward, Christel A.
The longitudinal study efforts at McMaster University's medical school are used to illustrate the problems that confront educators interested in studying the impact of a curriculum on the later professional activities of its graduates. (Author/MLW)
Brodsky, Carroll M.
A substantial amount of literature suggests that illness behavior in the United States is a product of a patient's core culture; equally credible findings do not support this contention. Most students and graduates in the health care professions believe that illness and disability behavior are affected by a patient's culture, but they are hard put to find convincing examples of that relationship. In experience with medical students studying the social and cultural bases of illness behavior, with patients who are disabled and with persons who claim disability in the absence of physical disease or disabling psychopathology, I observed no deviant disability behavior that was typical for the members of any cultural group, and no behavior was displayed by the members of one cultural group that was not seen in members of other cultural groups. No cultural stereotypes were upheld. I did find evidence that disability behavior is influenced by personality factors, social situations and the gains derived from the disability status. Evolving concepts of “entitlement,” which are closely related to socioeconomic status, also have a significant influence. The impact of feedback from others in a person's many social and medical subcultures is a more crucial determinant of illness and disability behavior, except in those for whom illness and disability behavior is determined by the limitations imposed by the disease or by a personality structure resistant to cultural expectations and social feedback. PMID:6666106
Background Surgery for subacromial impingement syndrome is often performed in working age and postoperative physiotherapy exercises are widely used to help restore function. A recent Danish study showed that 10% of a nationwide cohort of patients retired prematurely within two years after surgery. Few studies have compared effects of different postoperative exercise programmes on shoulder function, and no studies have evaluated workplace-oriented interventions to reduce postoperative work disability. This study aims to evaluate the effectiveness of physiotherapy exercises and occupational medical assistance compared with usual care in improving shoulder function and reducing postoperative work disability after arthroscopic subacromial decompression. Methods/Design The study is a mainly pragmatic multicentre randomised controlled trial. The trial is embedded in a cohort study of shoulder patients referred to public departments of orthopaedic surgery in Central Denmark Region. Patients aged ?18–?63 years, who still have shoulder symptoms 8–12 weeks after surgery, constitute the study population. Around 130 participants are allocated to: 1) physiotherapy exercises, 2) occupational medical assistance, 3) physiotherapy exercises and occupational medical assistance, and 4) usual care. Intervention manuals allow individual tailoring. Primary outcome measures include Oxford Shoulder Score and sickness absence due to symptoms from the operated shoulder. Randomisation is computerised with allocation concealment by randomly permuted block sizes. Statistical analyses will primarily be performed according to the intention-to-treat principle. Discussion The paper presents the rationale, design, methods, and operational aspects of the Shoulder Intervention Project (SIP). SIP evaluates a new rehabilitation approach, where physiotherapy and occupational interventions are provided in continuity of surgical episodes of care. If successful, the project may serve as a model for rehabilitation of surgical shoulder patients. Trial registration Current Controlled Trials ISRCTN55768749. PMID:24952581
. Laboratory technician Handling unfixed tissues Voles Hr min. Custodian/Janitor Husbandry & care of animalsMedical Monitoring Program for Vertebrate Animal Users Enrollment and Risk Assessment Form-8842), Campus Mail (Mail code 4481), or deliver it to 1200 Carothers Hall. Please note that the Medical
Seth, Vikas; Upadhyaya, Prerna; Ahmad, Mushtaq; Kumar, Virendra
The aim of the study was to assess the medical teachers' preference for various lecture delivery methods like the lectures using chalkboard, utilizing transparencies with an overhead projector (OHP) or lectures using a PowerPoint presentation and their frequency of use of teaching aids. The faculty of the medical college was asked to fill in the…
OBJECTIVE--To assess comprehensively the validity of the data in the Finnish Medical Birth Registry (MBR) by the combined use of several controls and internal analysis of the data. DESIGN--The MBR data were individually linked to a medical record sample (n = 775) and to all perinatal death certificates in 1987. The data were also compared with annual hospital statistics. The
James Sherman; Alan Hutson; Sandra Baumstein; Leslie Hendels
Objective: To determine whether a prescription refill history obtained by telephoning patients' pharmacies identifies poor adherence with asthma medications more frequently than physician assessment.Methods: The study population consisted of 116 children with persistent asthma who were Medicaid recipients; patients who received medication samples were excluded. During a clinic visit pulmonologists interviewed patients, caretakers, or both and estimated adherence on a
Roane, David M.; Tucker, Jennifer; Eisenstadt, Ellen; Gomez, Maria; Kennedy, Gary J.
Objective: Authors assessed the benefit of including medical students on geropsychiatric home-visits. Method: Medical students, during their psychiatry clerkship, were assigned to a home-visit group (N=43) or control group (N=81). Home-visit participants attended the initial visit of a home-bound geriatric patient. The Maxwell-Sullivan Attitude…
Teeter, Phyllis Anne; Smith, Philip L.
The final report of the 2-year project describes the development and validation of microcomputer software to help assess reading disabled elementary grade children and to provide basic reading instruction. Accomplishments of the first year included: design of the STAR Neuro-Cognitive Assessment Program which includes a reproduction of…
Luiselli, James K., Ed.
Challenging behavior is a significant barrier to communication, education, and positive social relationships. This practical book helps psychologists, educators, rehabilitation specialists, and other professionals recognize and address the causes of these problems in individuals with developmental disabilities--and resolve even the most difficult…
Shannon, Patrick; Tappan, Christine
The purpose of this study was to examine the ability of a Child Protective Services (CPS) screening and investigation process to identify children with developmental disabilities. The study used an emergent design, ethnographic interviews, purposive sampling, inductive data analysis, and grounded theory building. Ethnographic interviews were…
Carter, Erik W.; Lane, Kathleen Lynne; Cooney, Molly; Weir, Katherine; Moss, Colleen K.; Machalicek, Wendy
Fostering student self-determination is now considered an essential element of special education and transition services for children and youth with intellectual disability and/or autism. Yet, little is known about the pivotal role parents might play beyond the school campus in fostering self-determination among their children with developmental…
Munger, Kelly M.; Gill, Carol J.; Ormond, Kelly E.; Kirschner, Kristi L.
Recent scientific discoveries have made it much easier to test prenatally for various genetic disabilities, such as Down syndrome. However, while many observers have heralded such "advances" for their effectiveness in detecting certain conditions, others have argued that they perpetuate discrimination by preventing the birth of children with…
Chantel C. Burkitt; Lynn M. Breau; Marc Zabalia
Pain coping is thought to be the most significant behavioural contribution to the adjustment to pain. Little is known about how those with intellectual and developmental disabilities (IDD) cope with pain. We describe parental reported coping styles and how coping relates to individual factors. Seventy-seven caregivers of children and adults with IDD reported on coping styles using the Pediatric Pain
Hale, L.; Bray, A.; Littmann, A.
Background: Although it is common for people with intellectual disability (ID) to fall, the reasons for this have not yet been identified. This pilot study aimed to explore the balance capabilities of a sample of adults with profound ID who had experienced a fall, in order to identify possible reasons for falling and to identify potential tests…
Lerman, Dorothea C.; Parten, Mandy; Addison, Laura R.; Vorndran, Christina M.; Volkert, Valerie M.; Kodak, Tiffany
An approach based on Skinner's (1957) theory of verbal behavior has been developed to understand and teach elementary communication skills to children with autism and developmental disabilities (Sundberg & Partington, 1998). However, few studies have directly examined the characteristics of emerging language in children with developmental…
Stephen E. Condrey; Jeffrey L. Brudney
The Americans With Disabilities Act of 1990 (ADA) has been heralded as the most comprehensive piece of federal legislation since the Civil Rights Act of 1964. To date, research on the ADA has been largely speculative and anecdotal. The present research helps to fill this gap by analyzing and reporting results from a survey of municipal governments encompassing all cities
Guscia, Roma; Harries, Julia; Kirby, Neil; Nettelbeck, Ted; Taplin, John
Measures for estimating costs associated with the provision of disability services in Australia have not previously been available. Because such instruments are scarce worldwide, decisions about funding services have relied more on historical precedent and less on individual need. Recognising the necessity for an objective measure, Gould (1998)…
Neufeld, Victor R.
The nontraditional methods of teaching used in McMaster University's M.D. program pose problems for student assessment. Changes proposed for the system include a clearer statement of objectives that serve as the basis for assessment, improvement of measurement tools, and increased emphasis on the training of those who participate in assessment.…
Taking a young child to the doctor is not always the easiest of tasks, even when the child does not have a disability. This can be seen in the sheer number of children's books on the subject. Using key words such as "going to the doctor," a quick search of Amazon.com's children's book listing brings up a list of over 1,200 books. While the books…
Roszek B; Bruijn ACP de; Drongelen AW van; Geertsma RE
The technical documentation on non-market approved medical devices\\u000aintended for clinical investigation contains major shortcomings. This\\u000acould imply increased risks which could affect patient safety. The\\u000ainvestigation described here focused on the availability and quality of\\u000athe technical documentation which is required in the Medical Devices\\u000aDirective 93\\/42\\/EEC (MDD), complemented by items directly related to the\\u000ause and safety of
Kennedy, Craig H.; Meyer, Kim A.
This article reviews basic literature on behavioral pharmacology and integrates these findings with existing applied research regarding psychotropic medication. Suggestions are provided for improving research practices, increasing the diversity of people in decision-making regarding medication use, and developing consumer-friendly strategies for…
Masic, Izet; Ciric, Damir; Pulja, Artan; Kulasin, Igor; Pandza, Haris
Extensive and fast advancements in biomedical sciences created a significant delay in receiving relevant and updated information in medical practice - physicians use old techniques and treat patients incorrectly. Bosnia and Herzegovina signed the Bologna Declaration on 18 September 2003, and in the light of this new approach to university education, and the process of joining The European Union, the authors set the following aims: to determine the current level of knowledge among medical students at the Medical Faculty of the University of Sarajevo, to determine the level of knowledge among medical students before their enrolment at the faculty, and to find out students opinion on their needs for further education. Students also left their suggestions on what should be changed in the curriculum. 203 students were included in the survey and results show that they demand more practical work, direct contact with patients and presentation of interesting clinical cases. Many of them use the internet as professional education means. Professional papers are rarely used. At present, the availability of learning material is insufficient at the faculty library. PMID:19745442
Noveko, a leading manufacturer of medical devices, wanted to market a new surgical mask that contained several plastic additives, including two antimicrobial compounds. The registration of products with antimicrobial properties can be very challenging in the US and all claims of performance, efficacy and labeling are closely scrutinized by the EPA and FDA. The safety of such articles must also
Beth A. Schueler; Todd B. Parrish; Bruce E. Hammer; Brian J. Pangrle; E. Russell Ritenour; John Kucharczyk; Charles L. Truwit
We have developed a protocol to evaluate the magnetic resonance (MR) compatibility of implantable medical de- vices. The testing protocol consists of the evaluation of magnetic field-induced movement, electric current, heat- ing, image distortion, and device operation. In addition, current induction is evaluated with a finite element analy- sis simulation technique that models the effect of radiofre- quency fields on
Ironside, Roderick A.
In 1969, the Medical School of the University of Puerto Rico (UPR) received a grant from the National Center for Health Services Research and Development (Public Health Service, HEW) to plan and conduct--as a demonstration project--a special retraining program for physicians who had failed to approve the licensure examinations of the Puerto Rico…
Rothwell, P. M.; McDowell, Z.; Wong, C. K.; Dorman, P. J.
OBJECTIVES: To compare the judgments of clinicians on which domains of health in the short form questionnaire (SF-36) would be most important to patients with multiple sclerosis with the opinions of patients themselves; to compare assessment of physical disability in multiple sclerosis by a clinician using Kurtzke's expanded disability status scale and a non-clinically qualified assistant using the Office of Population Census and Surveys' (OPCS) disability scale with self assessment of disability and other domains of health related quality of life by patients using the SF-36 and the EuroQol questionnaire; and to compare the scores of patients for each domain of the SF-36 with control data matched for age and sex. DESIGN: Cross sectional study. SETTING: Clinical department of neurology, Edinburgh. SUBJECTS: 42 consecutive patients with multiple sclerosis attending a neurology outpatient clinic for review or a neurology ward for rehabilitation. MAIN OUTCOME MEASURES: Scores on the SF-36; EuroQol; Kurtzke's expanded disability status scale; the OPCS disability scale. RESULTS: Patients and clinicians disagreed on which domains of health status were most important (chi 2 = 21, df = 7, P = 0.003). Patients' assessment of their physical disability using the physical functioning domain of the SF-36 was highly correlated with the clinicians' assessment (r = -0.87, P < 0.001) and the non-clinical assessment (r = -0.90, P < 0.001). However, none of the measures of physical disability correlated with overall health related quality of life measured with EuroQol, Quality of life correlated with vitality, general health, and mental health in the SF-36, each of which patients rated as more important than clinicians and for each of which patients scored lower than the controls. CONCLUSIONS: Patients with multiple sclerosis and possibly those with other chronic diseases are less concerned than their clinicians about physical disability in their illness. Clinical trials in multiple sclerosis should assess the effect of treatment on the other elements of health status that patients consider important, which are also affected by the disease process, are more closely related to overall health related quality of life, and may well be adversely affected by side effects of treatment. PMID:9169401
Spevack, Sara; Yu, C. T.; Lee, May S.; Martin, Garry L.
We evaluated the use of passive approach to assess preferences of two children, with severe and profound intellectual disabilities. Both children had physical challenges and exhibited minimal physical movement. We also compared the relative reinforcing effects of the identified high and low preference stimuli for a switch pressing response, and for a more passive looking response. High and low preference stimuli were identified for both children. Moreover, the high preference stimulus maintained higher rates of responding than the low preference stimulus for both children for the passive looking response, but not for switch pressing. The study extended the use of passive approach to assess preferences and identified the choice of target response as a potential limiting factor during reinforcer tests for these children. PMID:23539237
Thomas, Bini; Courtenay, Ken; Hassiotis, Angela; Strydom, Andre; Rantell, Khadija
Aims and method To develop a programme to help undergraduate medical students and postgraduate trainees to improve their skills in communicating with people with intellectual disabilities through teaching sessions that had input from simulated patients with intellectual disabilities. We conducted four sessions of training for 47 undergraduate 4th-year medical students. The training involved a multiprofessional taught session followed by a clinical scenario role-play with simulated patients who were people with intellectual disabilities. The training was assessed by completing the healthcare provider questionnaire before and after the training. Results There were improvements in the students’ perceived skill, comfort and the type of clinical approach across all three scenarios. Clinical implications By involving people with intellectual disabilities in training medical students there has been a significant improvement in students’ communication skills in areas of perceived skills, comfort and type of clinical approach which will raise the quality of care provided by them in the future. PMID:25237524
Pell, Godfrey; Homer, Matthew S.; Roberts, Trudie E.
Increasingly, academic institutions are being required to improve the validity of the assessment process; unfortunately, often this is at the expense of reliability. In medical schools (such as Leeds), standardized tests of clinical skills, such as "Objective Structured Clinical Examinations" (OSCEs) are widely used to assess clinical competence,…
Cilliers, Francois J.; Schuwirth, Lambert W.; Adendorff, Hanelie J.; Herman, Nicoline; van der Vleuten, Cees P.
It has become axiomatic that assessment impacts powerfully on student learning, but there is a surprising dearth of research on how. This study explored the mechanism of impact of summative assessment on the process of learning of theory in higher education. Individual, in-depth interviews were conducted with medical students and analyzed…
John W. Jones; Bruce N. Barge; Brian D. Steffy; Lisa M. Fay; Lisa K. Kunz; Lisa J. Wuebker
Four studies were conducted to examine both the relation between stress and medical malpractice and the impact of stress management programs in reducing malpractice risk. Sixty-seven hospitals and more than 12,000 individuals participated. In Study 1, hospital departments with a current record of malpractice reported higher levels of on-the-job stress than did matched, low-risk departments. In Study 2, workplace stress
Asgari, Fatemeh; Haghdoost, Faraidoon; Masjedi, Samaneh Sadat; Manouchehri, Navid; Banihashemi, Mahboobeh; Ghorbani, Abbas; Najafi, Mohammad Reza; Saadatnia, Mohammad; Lipton, Richard B.
Introduction. MIDAS is a valid and reliable short questionnaire for assessment of headache related disability. Linguistic validation of Persian MIDAS and assessment of psychometric properties between tension type headache (TTH) and migraine were the aims of this study. Methods. Patients with migraine or TTH were included. At the first visit, we administered a headache symptom questionnaire, MIDAS, and SF-36. Patients filled out MIDAS in second and third visit within three and eight weeks after base line visit. Internal consistency (Cronbach ?) and test-retest reproducibility (Spearman correlation coefficient) were used to assess reliability. Convergent validity and MIDAS capability to differentiate between chronic and episodic headaches (migraine and TTH) were also assessed. Results. The 267 participants had episodic migraine (EM-64%), chronic migraine (CM-13.5%), episodic TTH (ETTH-13.5%), and chronic TTH (CTTH-9). Internal consistency reliability was 0.8 for the entire sample, 0.72 for TTH, and 0.82 for migraine. Test-retest reliability for all questions between visit 1 and visit 2 varied from 0.54 to 0.71. Convergent validity was assessed using SF-36 as an external referent. Patients with episodic headaches (EM and ETTH) had significantly lower MIDAS scores than chronic headaches (CM and CTTH). Conclusion. Persian MIDAS is a valid and reliable questionnaire for migraine and TTH that can differentiate between episodic headache and chronic headache. PMID:24527462
Rudick, Richard A.; Miller, Deborah; Bethoux, Francois; Rao, Stephen M.; Lee, Jar-Chi; Stough, Darlene; Reece, Christine; Schindler, David; Mamone, Bernadett; Alberts, Jay
Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the Multiple Sclerosis Performance Test (MSPT), which represents a new approach to quantifying MS related disability. The MSPT takes advantage of advances in computer technology, information technology, biomechanics, and clinical measurement science. The resulting MSPT represents a computer-based platform for precise, valid measurement of MS severity. Based on, but extending the Multiple Sclerosis Functional Composite (MSFC), the MSPT provides precise, quantitative data on walking speed, balance, manual dexterity, visual function, and cognitive processing speed. The MSPT was tested by 51 MS patients and 49 healthy controls (HC). MSPT scores were highly reproducible, correlated strongly with technician-administered test scores, discriminated MS from HC and severe from mild MS, and correlated with patient reported outcomes. Measures of reliability, sensitivity, and clinical meaning for MSPT scores were favorable compared with technician-based testing. The MSPT is a potentially transformative approach for collecting MS disability outcome data for patient care and research. Because the testing is computer-based, test performance can be analyzed in traditional or novel ways and data can be directly entered into research or clinical databases. The MSPT could be widely disseminated to clinicians in practice settings who are not connected to clinical trial performance sites or who are practicing in rural settings, drastically improving access to clinical trials for clinicians and patients. The MSPT could be adapted to out of clinic settings, like the patient’s home, thereby providing more meaningful real world data. The MSPT represents a new paradigm for neuroperformance testing. This method could have the same transformative effect on clinical care and research in MS as standardized computer-adapted testing has had in the education field, with clear potential to accelerate progress in clinical care and research. PMID:25046650
Hans Troidl; Ernst Eypasch; Ahmed Al-Jaziri; Wolfgang Spangenberger; Achim Dietrich
When any new procedure or technique is inaugurated and practiced, it is essential to assess its worth. New technologies have a characteristic life cycle which is characterized by a sequence: promising reports, professional adoption, public acceptance as a standard procedure, professional denunciation, and finally discreditation. Endoscopic surgery, especially laparascopic cholecystectomy, is an extremely promising innovation. In order to avoid the
Heintz, Phyllis; Buchholz, Malcolm
Critical care units serve the vital function of patient rescue through life-saving and life-preserving treatments. When an older patient's life hangs in the balance, preserving life takes priority over potential serious adverse drug events. There may be a tendency to consider transfer out of the unit as a less serious event; therefore, less attention is given to medication assessment. Often thought of by nurses as an almost clerical level task, the professional nurse plays a key role in identifying potentially harmful medications or medication combinations. If older patients remain on medications considered to be potentially dangerous, then patients are at risk for adverse drug events. Once the emergent nature of critical care interventions has passed, it is important to judiciously appraise patient status and conduct a medication assessment to discontinue or change the medication regimen to safer alternatives for older adults. Nurses can be instrumental in further research, education, and awareness for practitioners, patients, and families regarding the role of medications for older adults. Beers Criteria are not intended to be a clinical mandate, rather a designated as a clinical guideline with a clinical recommendation to support a provider's clinical judgment. PMID:26039653
Hall, Julie; Morgan, Robert L.; Salzberg, Charles L.
We investigated the effects of preference and degree of match on job performance of four 19 to 20-year-old young adults with developmental disabilities placed in community-based job conditions. We identified high-preference, high-matched and low-preference, low-matched job tasks using a video web-based assessment program. The job matching…
Enkelaar, Lotte; Smulders, Ellen; Lantman-de Valk, Henny van Schrojenstein; Weerdesteyn, Vivian; Geurts, Alexander C. H.
Mobility limitations are common in persons with Intellectual Disabilities (ID). Differences in balance and gait capacities between persons with ID and controls have mainly been demonstrated by instrumented assessments (e.g. posturography and gait analysis), which require sophisticated and expensive equipment such as force plates or a 3D motion…
Howlin, Frances; Halligan, Phil; O'Toole, Sinead
Equality and disability legislation, coupled with increasing numbers of students with a disability, and inadequate supports in clinical practice, acted as catalysts to explore how best to support undergraduate nursing and midwifery students on clinical placements. Historically, higher education institutions provide reasonable accommodations for theoretical rather than clinical modules for practice placements. This paper describes the development and implementation of a Clinical Needs Assessment designed to identify the necessary supports or reasonable accommodations for nursing and midwifery students with a disability undertaking work placements in clinical practice. The existing literature, and consultation with an expert panel, revealed that needs assessments should be competency based and clearly identify the core skills or elements of practice that the student must attain to achieve proficiency and competence. The five Domains of Competence, advocated by An Bord Altranais, the Nursing and Midwifery Board of Ireland, formed the framework for the Clinical Needs Assessment. A panel of experts generated performance indicators to enable the identification of individualised reasonable accommodations for year 1 nursing and midwifery students in one Irish University. Development and implementation of the Clinical Needs Assessment promoted equality, inclusion and a level playing field for nursing and midwifery students with a disability in clinical practice. PMID:25127124
Christensen, L.; Carver, W.; VanDeZande, J.; Lazarus, S.
The Council of Chief State School Officers' "Accommodations Manual: How to Select, Administer, and Evaluate the Use of Accommodations for Instruction and Assessment of Students with Disabilities" was first developed to establish guidelines for states to use for the selection, administration, and evaluation of accommodations for…
Silva, Soraia Micaela; Corrêa, Fernanda Ishida; Faria, Christina Danielli Coelho de Morais; Buchalla, Cássia Maria; Silva, Paula Fernanda da Costa; Corrêa, João Carlos Ferrari
This study aimed to identify the International Classification of Functioning, Disability, and Health categories addressed by the assessment tools commonly used in post-stroke rehabilitation and characterize patients based on its evaluation model. [Subjects and Methods] An exploratory, descriptive, cross-sectional study was conducted involving 35 individuals with chronic post-stroke hemiparesis. Handgrip strength was assessed to evaluate body functions and structures. The 10-meter gait speed test and Timed Up and Go test were administered to evaluate activity. The Stroke Specific Quality of Life scale was used to evaluate participation. Moreover, a systematic review of the literature was performed to identify studies that have associated these assessment tools with the International Classification of Functioning, Disability, and Health categories. [Results] The tools employed in this study for evaluating function addressed 63 International Classification of Functioning, Disability, and Health categories: 24 related to body functions and structures; 36 related to activity and participation; and 3 related to environmental factors. [Conclusion] The assessment tools employed in this study addressed 63 International Classification of Functioning, Disability, and Health categories and allowed a more complete evaluation of stroke survivors with hemiparesis. Use of this classification can therefore be more easily incorporated into clinical practice. PMID:26180294
Hill, Doris Adams; Flores, Margaret M.; Kearley, Regina F.
The authors supervised and trained pre-service teachers while conducting extended school year (ESY) services for pre-kindergarten and elementary students with autism spectrum disorder (ASD) and other developmental disabilities (DD). Each classroom was responsible for conducting communication assessments and developing interventions focused on…
Over the past decade, medical schools have made new efforts to provide accurate, reliable, and timely assessments of the competence of trainees. All methods of assessment have strengths and intrinsic flaws. Written examination questions forms an important item in knowledge assessment and are typically classified according to whether they are open-ended or multiple choices. At present questions are prepared casually just before the examination and are not put through any quality check to correct any possible mistakes or ambiguity in the questions. This may lead to confusion or wrong understanding of the questions by the students which will be reflected in their answers as well. Question Vetting is the process when an expert person examines or evaluates and edits questions to make it free of any mistakes. The importance of vetting and re-vetting of examination questions cannot be overstated in the present scenario of medical education. There is a prescribed structure and protocol of question setting and vetting for examinations in medical education programmes. The areas that need to be examined during question vetting are for technical accuracy, content level and language aspects. The use of the prescribed structure and protocol of question vetting ensures a consistently high standard of question presentation during examinations which will help the students to understand the questions better and to answer them correctly. This article is intended to highlight the importance of introducing question vetting in our medical education scenario in order to improve the quality of assessment of medical students. PMID:25386509
Solarsh, Geoff; Lindley, Jennifer; Whyte, Gordon; Fahey, Michael; Walker, Amanda
The learning objectives, curriculum content, and assessment standards for distributed medical education programs must be aligned across the health care systems and community contexts in which their students train. In this article, the authors describe their experiences at Monash University implementing a distributed medical education program at metropolitan, regional, and rural Australian sites and an offshore Malaysian site, using four different implementation models. Standardizing learning objectives, curriculum content, and assessment standards across all sites while allowing for site-specific implementation models created challenges for educational alignment. At the same time, this diversity created opportunities to customize the curriculum to fit a variety of settings and for innovations that have enriched the educational system as a whole.Developing these distributed medical education programs required a detailed review of Monash's learning objectives and curriculum content and their relevance to the four different sites. It also required a review of assessment methods to ensure an identical and equitable system of assessment for students at all sites. It additionally demanded changes to the systems of governance and the management of the educational program away from a centrally constructed and mandated curriculum to more collaborative approaches to curriculum design and implementation involving discipline leaders at multiple sites.Distributed medical education programs, like that at Monash, in which cohorts of students undertake the same curriculum in different contexts, provide potentially powerful research platforms to compare different pedagogical approaches to medical education and the impact of context on learning outcomes. PMID:22643380
Mazur, Marcus D; McEvoy, Sara; Schmidt, Meic H; Bisson, Erica F
OBJECT Patient satisfaction scores have become a common metric for health care quality. Because satisfaction scores are right-skewed, even small differences in mean scores can have a large impact. Little information, however, is available on the specific factors that play a role in satisfaction in patients with spinal disorders. The authors investigated whether disability severity and the surgeon's recommendation for or against surgical intervention were associated with patient satisfaction scores. METHODS The authors conducted a retrospective cohort study involving adult patients who were referred to a spine surgeon for an outpatient evaluation of back pain. Patients completed the Oswestry Disability Index (ODI) before their clinic appointment and a Press Ganey patient satisfaction survey after their visit. Patients were grouped by self-assessed disability severity: mild to moderate (ODI < 40%) and severe (? 40%). Satisfaction scores were graded from 0 (very poor) to 100 (very good). Nonparametric tests were used to evaluate the association between patient satisfaction and current disability self-assessment. The authors also investigated whether the surgeon's recommendation against surgery negatively affected patient satisfaction. RESULTS One hundred thirty patients completed the ODI questionnaire before and satisfaction surveys after seeing a spine surgeon for a new outpatient back pain consultation. Of these, 68 patients had severe disability, 62 had mild to moderate disability, 67 received a recommendation for surgery, and 63 received a recommendation against surgery. Composite satisfaction scores were lower among patients who had severe disability than among those with mild to moderate disability (median [interquartile range]: 91.7 [83.7-96.4] vs 95.8 [91.0-99.3], respectively; p = 0.0040). Patients who received a recommendation against surgery reported lower satisfaction scores than those who received a recommendation for surgery (91.7 [83.5-95.8] vs 95.8 [88.5-99.8]; p = 0.0059). CONCLUSIONS High self-assessment of disability and a surgeon's recommendation against surgical intervention are associated with lower satisfaction scores in patients with spinal disorders. PMID:25793469
Palsbo, Susan E; Ho, Pei-Shu
Disability care coordination organizations (DCCOs) arrange comprehensive, disability-competent social and medical services for people with disabilities. This study used consumer ratings of access and quality to measure outcomes in one of the first operational DCCOs over a three-year period. Working-age Medicaid adults with physical disabilities reported statistically significant improvements in service coordination, patient education, system-wide disability competency, comprehensive assessment, health visit support, and self-direction of care. Global quality ratings showed statistically significant and sustained improvement over two years, with the percentage of people rating the health system as excellent rising from 7% before enrollment to 44% in the DCCO. The percentage of people rating primary care physicians as excellent rose from 18% before enrollment to 38% in the DCCO. Over time, enrollees became more knowledgeable about the need for preventive health care services, were more likely to receive needed care and medical equipment, and reduced their need for rehabilitation therapies. Disability care coordination organizations can reduce disparities and improve access to care for this vulnerable population. PMID:17982213
Mellard, Daryl; Johnson, Richard
The Road to Success (RtS) program was designed to introduce hard-to-employ adults with learning disabilities and other cognitive barriers to ways of learning that are will enable them to learn the skills and knowledge they will need as employees and in their everyday lives. Originally developed to serve welfare recipients in Kansas, RtS was…
Weller, A C
Many factors are weighed in judging the quality of a journal. Editorial policies in the instructions to authors section offer an important, though often neglected, source of information. In addition to directions on formatting and style, this section often includes financial disclosures and policies on coverage, peer review, confidentiality, human experimentation and duplicate submissions. This study analyzes the contents of instructions sections from several categories of medical journals to determine their usefulness in making collection development decisions. Included are journals currently considered the most prestigious, indexed in Index Medicus and Abridged Index Medicus, and not indexed in Index Medicus or subscribed to by a typical large academic health sciences library. It was found that in a statistically significant number of journals, the instructions to authors section is more likely to be included and substantive in highly regarded journals than in less prestigious journals. It is concluded that the amount of information in the instructions section is related to the quality of the journal and that these sections are a useful collection development tool. PMID:3450342
Robert D. Rondinelli; Winnie Dunn; Khatahb M. Hassanein; Christine A. Keesling; Sharon C. Meredith; Trina L. Schulz; Nancy J. Lawrence
Objectives: To determine whether simulation of significant impairment of the hand will have a predictable impact on degree of functional loss at the wrist and hand.Design: Single subject repeat measures using before-after trial comparisons and healthy volunteer subjects.Setting: Occupational therapy section of a large academic medical center.Other Participants: Twenty adult volunteer student subjects from an occupational therapy education (OTE) department
Field, Michael J
The Australian Medical Council (AMC) is an independent company for quality assurance and quality improvement in medical education in Australia and New Zealand. Accreditation procedures for the 20 medical schools in these two countries are somewhat different for three different circumstances or stages of school development: existing medical schools, established courses undergoing major changes, and new schools. This paper will outline some issues involved in major changes to existing courses, and new medical school programs. Major changes have included change from a 6 year undergraduate course to a 5 year undergraduate course or 4 year graduate-entry course, introduction of a lateral graduate-entry stream, new domestic site of course delivery, offshore course delivery, joint program between two universities, and major change to curriculum. In the case of a major change assessment, accreditation of the new or revised course may be granted for a period up to two years after the full course has been implemented. In the assessment of proposals for introduction of new medical courses, six issues needing careful consideration have arisen: forward planning, academic staffing, adequate clinical experience, acceptable research program, adequacy of resources, postgraduate training program and employment. PMID:21738838
The Australian Medical Council (AMC) is an independent company for quality assurance and quality improvement in medical education in Australia and New Zealand. Accreditation procedures for the 20 medical schools in these two countries are somewhat different for three different circumstances or stages of school development: existing medical schools, established courses undergoing major changes, and new schools. This paper will outline some issues involved in major changes to existing courses, and new medical school programs. Major changes have included change from a 6 year undergraduate course to a 5 year undergraduate course or 4 year graduate-entry course, introduction of a lateral graduate-entry stream, new domestic site of course delivery, offshore course delivery, joint program between two universities, and major change to curriculum. In the case of a major change assessment, accreditation of the new or revised course may be granted for a period up to two years after the full course has been implemented. In the assessment of proposals for introduction of new medical courses, six issues needing careful consideration have arisen: forward planning, academic staffing, adequate clinical experience, acceptable research program, adequacy of resources, postgraduate training program and employment. PMID:21738838
Clow, John, Ed.; Woolschlager, Ruth B., Ed.
The learning disabilities monograph contains five brief articles dealing with various aspects of learning disabilities as they related to business education. "Learning Disabilities: A Challenge for the Vocational Business Educator" (Dorothy Munger) concerns screening students with learning disabilities into rather than out of business education…
Anandarajah, G; Hight, E
The relationship between spirituality and medicine has been the focus of considerable interest in recent years. Studies suggest that many patients believe spirituality plays an important role in their lives, that there is a positive correlation between a patient's spirituality or religious commitment and health outcomes, and that patients would like physicians to consider these factors in their medical care. A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patient's spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process. The HOPE concepts for discussion are as follows: H--sources of hope, strength, comfort, meaning, peace, love and connection; O--the role of organized religion for the patient; P--personal spirituality and practices; E--effects on medical care and end-of-life decisions. PMID:11195773
John P. Benner; Genevieve Brauning; Mike Green; Wendy Caldwell; Matthew P. Borloz; William J. Brady
Study objectiveTo determine the rate of disagreement in assessment of significant illness or injury between air medical transport team assessment and emergency department (ED) diagnosis in patients transferred from the scene of an incident to the ED.
Klemenc-Ketis, Zalika; Vrecko, Helena
Objectives To develop and validate a scale for the assess-ment of professionalism in medical students based on students' perceptions of and attitudes towards professional-ism in medicine. Methods This was a mixed methods study with under-graduate medical students. Two focus groups were carried out with 12 students, followed by a transcript analysis (grounded theory method with open coding). Then, a 3-round Delphi with 20 family medicine experts was carried out. A psychometric assessment of the scale was performed with a group of 449 students. The items of the Professional-ism Assessment Scale could be answered on a five-point Likert scale. Results After the focus groups, the first version of the PAS consisted of 56 items and after the Delphi study, 30 items remained. The final sample for quantitative study consisted of 122 students (27.2% response rate). There were 95 (77.9%) female students in the sample. The mean age of the sample was 22.1 ± 2.1 years. After the principal component analysis, we removed 8 items and produced the final version of the PAS (22 items). The Cronbach's alpha of the scale was 0.88. Factor analysis revealed three factors: empathy and humanism, professional relationships and development and responsibility. Conclusions The new Professionalism Assessment Scale proved to be valid and reliable. It can be used for the assessment of professionalism in undergraduate medical students. PMID:25382090
In accordance with the National Environmental Policy Act (NEPA) of 1969 as amended, and OPNAVINST 5O90.lB, Chapter 2, an Environmental Assessment is to be prepared when a Federal action has the potential to impact the human environment. At Naval Security Group Activity Northwest (hereafter Northwest or the Installation), a new medical/dental clinic is proposed for construction. A Navy Exchange (NEX) and gas station with car wash have also been proposed for construction in the vicinity of the medical/dental clinic. Construction of the projects will not take place during the same timeframe. The first project, the medical/dental clinic, is scheduled for construction in FY96. The projects are sited for the northeastern portion of the Installation. This action, its justification and need, and associated environmental impacts directly or indirectly caused by the action will be assessed.
Spike, Jeffrey P.
Three cases are presented that demonstrate the difficulty of assessing medical decision-making capacity in patients with psychiatric illness who are refusing care. Health professionals often assess capacity differently in practice. Provided their patients have some understanding of their illness and have some plans for meeting basic needs, psychiatrists are often inclined to give patients the freedom to refuse care even if they do not exhibit a full understanding of the medical facts of their case and why they are refusing it. Adult medicine physicians, in contrast, are inclined to require patients to state a more complete understanding of the benefits and burdens of evaluation and treatment before allowing them to refuse care when their refusals might result in adverse medical outcomes. The 3 cases exemplify the tension between these approaches and highlight the role of hospital ethics consultation in addressing this conflict. PMID:25834754
Abrishami, Payam; Boer, Albert; Horstman, Klasien
Rapid proliferation of medical innovations in the face of demographic changes and scarce resources is demanding a value-conscious entry of medical innovations into health care systems. An inquiry into value gains significance during the early diffusion phase of an innovation and becomes indispensable as the complexity of an innovation increases. In this editorial, we argue that a value assessment must pay attention to the social processes shaping the innovation's adoption and use, in particular, to the "promises" of the technology and actual "practices" with it. Promises and practices represent real-world value as they account for both outcomes and costs in practice. A systematic exploration of these loci of value, using insights from constructive technology assessment, enables us to make well-informed decisions on complex medical technologies. PMID:25963313
Yang, Eun Joo; Kim, Bo-ram; Shin, Hyung Ik
Purpose To develop a patient self-completed questionnaire from the items of the Brief Core Set Questionnaire for Breast Cancer (BCSQ-BC) and to investigate the prevalence of specific dysfunctions throughout the course of cancer and treatments. Methods From January 2010 to February 2011, 96 breast cancer patients were evaluated with BCSQ-BC developed for clinical application of International Classification of Functioning, Disability and Health (ICF). Quality of life and upper limb dysfunction using disabilities of arm, shoulder and hand (DASH) were assessed. Content validity was evaluated using correlations between BCSQ-BC and European Organization for Research and Treatment of Cancer (EORTC) QLQ and DASH scores. Construct validity was computed using exploratory factor analysis. Kappa statistics were computed for agreement between test-retest ICF data. The level of significance and odds ratios were reported for individuals with early post-acute and long-term context and with total mastectomy and breast conservative surgery. Results There was consistently good test-retest agreement in patient-completed questionnaires (kappa value, 0.76). Body function, activity and participation subscales are significantly related with EORTC QLQ and DASH. Problems with activity and participation were strongly associated with physical functional domains of EORTC QLQ (r=-0.708, p<0.001) and DASH (r=0.761, p<0.001). The prevalence of dysfunctions varied with type of surgery and time after cancer. Immobility of joint (15% vs. 7%) and lymphatic dysfunction (17% vs. 3%) were indexed more frequently in extensive surgery cases than in conservative surgery. Muscle power (16% vs. 8%), exercise tolerance functions (12% vs. 4%) and looking after one's health (10% vs. 2%) were impaired within 1 year after surgery, while sleep dysfunction (8% vs. 14%) was a major problem over 1 year after surgery. Conclusion The BCSQ-BC identifies the problems comprehensively in functioning of patients with breast cancer. We revealed the interaction with the ICF framework adopting a multifactor understanding of function and disability. PMID:22493627
Frank J. Molnar; Malcolm Man-Son-Hing; William B. Dalziel; Susan L. Mitchell; Barbara E. Power; Anna M. Byszewski
A b s t r a c t Background: Medical advice columns in newspapers can provide a valuable ser- vice by educating the general public about important health-related issues. However, these columns may be harmful if the advice or information given in them is incomplete, inappropriate or misleading. The objective of this study was to assess the safety and appropriateness
Decision-making methods that could be used to assess the value of medical devices P1 D3 V1.2 050331 product subsequently fails to sell adequately. Managers therefore need robust decision- making tools in making such complex decisions: · The need to cast the decision in words, although most analytical tools
The Scoping Assessment addresses the need for medical isotope production and the capability of the Fast Flux Test Facility to provide such isotopes. Included in the discussion are types of isotopes used in radiopharmaceuticals, which types of cancers are targets, and in what way isotopes provide treatment and/or pain relief for patients.
Sharon E. Mace; Andrew I. Bern
Pediatric patients are likely victims in a disaster and are more vulnerable in a disaster than adults, yet they have been essentially overlooked in disaster management according to the Pediatric Institute of Medicine Report. We did a needs assessment of Disaster Medical Assistance Teams regarding pediatric issues. Results were as follows: pediatric patients comprise a significant percentage of disaster victims
Barratt, Barnaby B.; Rand, Marsha A.
The importance of including sexual health assessment (SHA) within the biopsychosocial evaluations of mental health and medical practice is discussed, and various protocols available in the extant literature are reviewed. Six principles for SHA are presented as well as a model protocol consisting of six basic lines of questioning with specific…
Monroe, Katherine Swint
The rapid pace of scientific discovery has catalyzed the need for medical students to be able to find and assess new information. The knowledge required for physicians' skillful practice will change of the course of their careers, and, to keep up, they must be able to recognized their deficiencies, search for new knowledge, and critically evaluate…
Given the significant impact of computing on society, it is important that all cultures, especially underrepresented cultures, are fully engaged in the field of computing to ensure that everyone benefits from the advances in computing. This proposal is focused on the field of high performance computing. The lack of cultural diversity in computing, in particular high performance computing, is especially evident with respect to the following ethnic groups – African Americans, Hispanics, and Native Americans – as well as People with Disabilities. The goal of this proposal is to organize and coordinate a National Laboratory Career Development Workshop focused on underrepresented cultures (ethnic cultures and disability cultures) in high performance computing. It is expected that the proposed workshop will increase the engagement of underrepresented cultures in HPC through increased exposure to the excellent work at the national laboratories. The National Laboratory Workshops are focused on the recruitment of senior graduate students and the retention of junior lab staff through the various panels and discussions at the workshop. Further, the workshop will include a community building component that extends beyond the workshop. The workshop was held was held at the Lawrence Livermore National Laboratory campus in Livermore, CA. from June 14 - 15, 2012. The grant provided funding for 25 participants from underrepresented groups. The workshop also included another 25 local participants in the summer programs at Lawrence Livermore National Laboratory. Below are some key results from the assessment of the workshops: 86% of the participants indicated strongly agree or agree to the statement "I am more likely to consider/continue a career at a national laboratory as a result of participating in this workshop." 77% indicated strongly agree or agree to the statement "I plan to pursue a summer internship at a national laboratory." 100% of the participants indicated strongly agree or agree to the statement "The CMD-IT NLPDEV workshop was a valuable experience."
Meyen, Edward L.; Greer, Diana L.
This article discusses the theoretical framework, instructional design, formative assessment results, capacity for national distribution, and generalization of the Blending Assessment with Instruction Program (BAIP) model to other content areas such as science. The BAIP, developed and validated at the University of Kansas, employs technology to…
Gong, Brian; Marion, Scott
Dealing with flexibility--or its converse, the extent of standardization--is fundamental to alignment, assessment design, and interpretation of results in fully inclusive assessment systems. Highly standardized tests make it easier to compare (performances, students, and schools) across time and to common standards because certain conditions are…
Talkowski, Michael E.; Mullegama, Sureni V.; Rosenfeld, Jill A.; van Bon, Bregje W.M.; Shen, Yiping; Repnikova, Elena A.; Gastier-Foster, Julie; Thrush, Devon Lamb; Kathiresan, Sekar; Ruderfer, Douglas M.; Chiang, Colby; Hanscom, Carrie; Ernst, Carl; Lindgren, Amelia M.; Morton, Cynthia C.; An, Yu; Astbury, Caroline; Brueton, Louise A.; Lichtenbelt, Klaske D.; Ades, Lesley C.; Fichera, Marco; Romano, Corrado; Innis, Jeffrey W.; Williams, Charles A.; Bartholomew, Dennis; Van Allen, Margot I.; Parikh, Aditi; Zhang, Lilei; Wu, Bai-Lin; Pyatt, Robert E.; Schwartz, Stuart; Shaffer, Lisa G.; de Vries, Bert B.A.; Gusella, James F.; Elsea, Sarah H.
Persons with neurodevelopmental disorders or autism spectrum disorder (ASD) often harbor chromosomal microdeletions, yet the individual genetic contributors within these regions have not been systematically evaluated. We established a consortium of clinical diagnostic and research laboratories to accumulate a large cohort with genetic alterations of chromosomal region 2q23.1 and acquired 65 subjects with microdeletion or translocation. We sequenced translocation breakpoints; aligned microdeletions to determine the critical region; assessed effects on mRNA expression; and examined medical records, photos, and clinical evaluations. We identified a single gene, methyl-CpG-binding domain 5 (MBD5), as the only locus that defined the critical region. Partial or complete deletion of MBD5 was associated with haploinsufficiency of mRNA expression, intellectual disability, epilepsy, and autistic features. Fourteen alterations, including partial deletions of noncoding regions not typically captured or considered pathogenic by current diagnostic screening, disrupted MBD5 alone. Expression profiles and clinical characteristics were largely indistinguishable between MBD5-specific alteration and deletion of the entire 2q23.1 interval. No copy-number alterations of MBD5 were observed in 7878 controls, suggesting MBD5 alterations are highly penetrant. We surveyed MBD5 coding variations among 747 ASD subjects compared to 2043 non-ASD subjects analyzed by whole-exome sequencing and detected an association with a highly conserved methyl-CpG-binding domain missense variant, p.79Gly>Glu (c.236G>A) (p = 0.012). These results suggest that genetic alterations of MBD5 cause features of 2q23.1 microdeletion syndrome and that this epigenetic regulator significantly contributes to ASD risk, warranting further consideration in research and clinical diagnostic screening and highlighting the importance of chromatin remodeling in the etiology of these complex disorders. PMID:21981781
Many children are surviving prematurity and serious childhood illnesses due to advances in technology and medical care. As a result, more children are entering public school systems with complex health care needs and intellectual and developmental disabilities. School nurses are responsible for caring for these children; however, many nurses feel unprepared due to a lack education on disability studies in nursing school, difficulty with effective communication, and a lack of experience. A qualitative study was conducted to explore the perceptions and challenges of school nurses who worked with students with intellectual and developmental disabilities. Participants included eight nurses who worked in a public school setting, and data were collected through personal interviews, observations, and field notes. Results were analyzed categorically, and data showed that school nurses identified that they lacked education in disability studies and encountered challenges with communication, conducting health assessments, and screenings in students with intellectual and developmental disabilities. PMID:23015606
Depp, Colin A; Cain, Ashley E; Palmer, Barton W; Moore, David J; Eyler, Lisa T; Lebowitz, Barry D; Patterson, Thomas L; Jeste, Dilip V
Medication nonadherence is a key clinical concern in bipolar disorder (BD) across the life span. Cognitive deficits in older adults with BD may hinder medication management ability, which, in turn, may lead to nonadherence. Using an innovative performance-based measure of medication management ability, the Medication Management Ability Assessment (MMAA), we compared performance of 29 middle-aged older community-dwelling outpatients with BD who were clinically stable (mean age, 61 years; SD, 11 years; range, 45-86 years) with those of 59 normal control subjects (NCs) and 219 outpatients with schizophrenia. The MMAA is a role-play task that simulates a medication regimen likely to be encountered by older adults. Within the BD group, we examined the relationships of MMAA scores to demographic, psychiatric symptoms severity, and the Mattis Dementia Rating Scale (DRS) scores. The BD group made 2.8 times the errors on the MMAA than NCs (BD group, 6.2; SD, 5.5 vs NCs, 2.2; SD, 2.5) and did not significantly differ from the Schizophrenia group in errors on the MMAA. Errors in the BD group were more likely to be taking in too few medications as taking in too many. Within the BD group, a significant correlation was seen between MMAA scores and the DRS Total score, but not with age, education, Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale, number of psychiatric medications, or medical conditions. Among DRS subscales, the Memory Subscale correlated most strongly with MMAA errors. This small cross-sectional study suggests that deficits in medication management ability may be present in later-life BD. Neurocognitive deficits may be important in understanding problems with unintentional nonadherence. PMID:18344736
Hudson, Darren; Kushniruk, Andre W; Borycki, Elizabeth M
Electronic medical records (EMRs) has been expected to decrease health professional workload. The NASA Task Load Index has become an important tool for assessing workload in many domains. However, its application in assessing the impact of an EMR on nurse's workload has remained to be explored. In this paper we report the results of a study of workload and we explore the utility of applying the NASA Task Load Index to assess impact of an EMR at the end of its lifecycle on nurses' workload. It was found that mental and temporal demands were the most responsible for the workload. Further work along these lines is recommended. PMID:25676971
Butcher, Jana S; Wolraich, Mark L; Gillaspy, Stephen R; Martin, Vyonda G; Wild, Robert C
Primary care provided in a Medical Home (MH) can improve outcomes for Children with Special Health Care Needs. It is important for residents to experience MH in their training. The Oklahoma Family Support 360 project, a five-year collaborative initiative, established a MH in a pediatric primary care resident continuity clinic at the University of Oklahoma Health Sciences Center. A study of the effects of enhancement of the seven key MH attributes showed a significant decrease in Emergency Service use, a significant increase in Dental Service use, high satisfaction with MH activities, and high ratings for a positive impact on quality of life for the child and family. The project demonstrated that a MH could be established in a pediatric academic program, improved health service use, and had a high level of satisfaction from participating families. This model provides a good example of the MH qualities for residents in training. PMID:25790586
Sinai, Amanda; Werner, Shirli; Stawski, Mike
Background: It is well established that people with intellectual disabilities are at higher risk of developing mental illnesses. This study aimed to assess the need for a specialized service for people (children and adults) with intellectual disabilities and mental health problems living in Israel. Methods: Our research question was: is there a need for a specialist mental health service for people with intellectual disabilities living in Israel and, if so, what type of service would be most appropriate? We conducted a qualitative study using semi-structured interviews with 14 major stakeholders to identify key themes in response to our research question. The data were coded and themes were identified. Results: Participants were generally not satisfied with current mental health care for people with intellectual disabilities and there was a general agreement that services are in need of improvement. We identified three major themes from the data. These were: current services, future services, and ways to facilitate change. Conclusion: We hope that our findings will be instrumental in shaping the ongoing debate about the best form of delivery of services to this population in Israel. Specifically, we suggest the development of a more specialized system, with the formation of multidisciplinary regional assessment and treatment units in parallel with improved relevant training for all mental health workers and the possibility of referral to specialized teams in more complex cases. PMID:24400294
Khosravi Khorashad, Ahmad; Salari, Somayyeh; Baharvahdat, Humain; Hejazi, Sepideh; Lari, Shiva M; Salari, Maasoomeh; Mazloomi, Maryam; Lari, Shahrzad M
Background: The objective structured clinical examination (OSCE) has been introduced as an efficient method for the assessment of medical students. Objectives: The aim of the present study was to determine the satisfaction level of undergraduate medical students of internal medicine department with the OSCE. Materials and Methods: This was a descriptive cross-sectional study, performed on all available undergraduate students at the end of their internal medicine training period in Mashhad University of Medical Sciences. The students responded to 15 multiple-choice questions with confirmed validity and reliability. Results: The majority of the students (94.5%) had a positive attitude toward the OSCE and mentioned that the OSCE format was a more appropriate type of exam than other methods of testing; however, 79.1% thought that the OSCE format was stressful. In addition, the participants’ sex had no effect on their level of satisfaction with the examination. Likewise, there was no significant correlation between their level of satisfaction and their age, marital status, or lack of previous experience with this type of exam. Conclusions: If the exam standards are met and a uniform dispersion of the scientific content is maintained, the OSCE method of assessment can be recommended as an efficient and applicable method for assessing medical students. PMID:25389474
Background After a survey of medical graduates' skills found a lack of confidence in developmental assessment, a program was introduced with the broad aims of increasing medical student confidence and respect for the parents' role in childhood developmental assessment. Research has shown that parents' concerns are as accurate as quality screening tests in assessing development, so the program utilised the Ages and Stages Questionnaire, a parent completed, child development assessment tool. Method To evaluate the program, an interpretative analysis was completed on the students' reports written during the program and a questionnaire was administered to the parents to gain their perception of the experience. As well, student confidence levels in assessing growth and development were measured at the end of the paediatric term. Results Although there was an increase in student confidence in developmental assessment at the end of the term, it was not statistically significant. However the findings indicated that students gained increased understanding of the process and enhanced recognition of the parental role, and the study suggested there was increased confidence in some students. Parents indicated that they thought they should be involved in the teaching of students. Conclusion The ASQ was shown to have been useful in an education program at the level of advanced beginners in developmental assessment. PMID:16716208
Automated evaluation of claims for medical and disability insurance benefits poses a difficult challenge that will take years to be solved. The precise wording of insurance rules and the terse language in medical history ...
Elwyn, G; Rhydderch, M; Edwards, A; Hutchings, H; Marshall, M; Myres, P; Grol, R
Objective: To design and develop an instrument to assess the degree of organisational development achieved in primary medical care organisations. Design: An iterative development, feasibility and validation study of an organisational assessment instrument. Setting: Primary medical care organisations. Participants: Primary care teams and external facilitators. Main outcome measures: Responses to an evaluation questionnaire, qualitative process feedback, hypothesis testing, and quantitative psychometric analysis (face and construct validity) of the results of a Maturity MatrixTM assessment in 55 primary medical care organisations. Results: Evaluations by 390 participants revealed high face validity with respect to its usefulness as a review and planning tool at the practice level. Feedback from facilitators suggests that it helped practices to prioritise their organisational development. With respect to construct validity, there was some support for the hypothesis that training and non-training status affected the degree and pattern of organisational development. The size of the organisation did not have a significant impact on the degree of organisational development. Conclusion: This practice based facilitated group evaluation method was found to be both useful and enjoyable by the participating organisations. Psychometric validation revealed high face validity. Further developments are in place to ensure acceptability for summative work (benchmarking) and formative feedback processes (quality improvement). PMID:15289632
Craig, Joyce A; Carr, Louise; Hutton, John; Glanville, Julie; Iglesias, Cynthia P; Sims, Andrew J
Whereas the economic evaluation of pharmaceuticals is an established practice within international health technology assessment (HTA) and is often produced with the support of comprehensive methodological guidance, the equivalent procedure for medical devices is less developed. Medical devices, including diagnostic products, are a rapidly growing market in healthcare, with over 10,000 medical technology patent applications filed in Europe in 2012-nearly double the number filed for pharmaceuticals. This increase in the market place, in combination with the limited, or constricting, budgets that healthcare decision makers face, has led to a greater level of examination with respect to the economic evaluation of medical devices. However, methodological questions that arise due to the unique characteristics of medical devices have yet to be addressed fully. This review of journal publications and HTA guidance identified these characteristics and the challenges they may subsequently pose from an economic evaluation perspective. These unique features of devices can be grouped into four categories: (1) data quality issues; (2) learning curve; (3) measuring long-term outcomes from diagnostic devices; and (4) wider impact from organisational change. We review the current evaluation toolbox available to researchers and explore potential future approaches to improve the economic evaluation of medical devices. PMID:25139635
Background Intellectual Disabilities (ID) and Attention Deficit Hyperactivity Disorder (ADHD) are recognized psychological vulnerabilities in police interviews and court proceedings in England and Wales. The aims of this study were to investigate: (a) the prevalence of ID and/or ADHD among suspects detained at a large London metropolitan police station and their relationship with conduct disorder (CD), (b) the impact of their condition on police staff resources, (c) the effectiveness of current custody assessment tools in identifying psychological vulnerabilities, and (d) the use of ‘Appropriate Adults’ in interviews. Method A total of 200 individuals in a police custody suite were interviewed and screened for ID, ADHD (current symptoms) and CD. Results The screening rates for these three disorders were 6.7%, 23.5% and 76.3%, respectively. ADHD contributed significantly to increased requests being made of staff after controlling for CD and duration of time in custody. This is a novel finding. Reading and writing difficulties and mental health problems were often identified from the custody risk assessment tools, but they were not used effectively to inform on the need for the use of an Appropriate Adult. The frequency with which Appropriate Adults were provided to support detainees in police interviews (4.2%) remains almost identical to that found in a similar study conducted 20 years previously. Conclusions The current findings suggest that in spite of reforms recently made in custodial settings, procedures may not have had the anticipated impact of improving safeguards for vulnerable suspects. Detainees with ID and ADHD require an Appropriate Adult during police interviews and other formal custody procedures, which they commonly do not currently receive. The findings of the current study suggest this may be due, in large part, to the ineffective use of risk-assessment tools and healthcare professionals, which represent missed opportunities to identify such vulnerabilities. PMID:24261542
Schuwirth, Lambert W.; Adendorff, Hanelie J.; Herman, Nicoline; van der Vleuten, Cees P.
It has become axiomatic that assessment impacts powerfully on student learning, but there is a surprising dearth of research on how. This study explored the mechanism of impact of summative assessment on the process of learning of theory in higher education. Individual, in-depth interviews were conducted with medical students and analyzed qualitatively. The impact of assessment on learning was mediated through various determinants of action. Respondents’ learning behaviour was influenced by: appraising the impact of assessment; appraising their learning response; their perceptions of agency; and contextual factors. This study adds to scant extant evidence and proposes a mechanism to explain this impact. It should help enhance the use of assessment as a tool to augment learning. PMID:20455078
Reichard, Amanda; Stolzle, Hayley
Using a retrospective analysis of data from the 2006 Medical Expenditures Panel Survey (MEPS), we assessed the health status of working-age adults with cognitive limitations in comparison to adults with no disability (unweighted N = 27,116; weighted N = 240,343,457). Adults with cognitive limitations had a significantly higher prevalence of…
Afek, Arnon; Meilik, Ahuva; Rotstein, Zeev
Today, medical organizations have to contend with a highly competitive environment, an atmosphere saturated with a multitude of innovative new technologies and ever-increasing costs. The ability of these organizations to survive and to develop and expand their services mandates adoption of management guidelines based on the world of finance/commerce, adapted to make them relevant to the world of medical service. In this article the authors chose to present a management administration assessment which is a process that ensures that the management will effectively administer the organization's resources, and meet the goals set by the organization. The system demands that hospital "centers of responsibility" be defined, a management information system be set up, activities be priced, budget be defined and the expenses assessed. These processes make it possible to formulate a budget and assess any possible deviation between the budget and the actual running costs. An assessment of deviations will reveal any possible deviation of the most significant factor--efficiency. Medical organization managers, with the cooperation of the directors of the "centers of responsibility", can assess subunit activities and gain an understanding of the significance of management decisions and thus improve the quality of management, and the medical organization. The goal of this management system is not only to Lower costs and to meet the financial goals that were set; it is a tool that ensures quality. Decreasing expenditure is important in this case, but is only secondary in importance and will be a result of reducing the costs incurred by services lacking in quality. PMID:19320392
Perner, Darlene E.
Neither school reform nor the focus on developing accountability systems that measure and evaluate the success of schooling are new or innovative educational practices. Even before the No Child Left Behind (NCLB) Act of 2001, many states had changed or were changing their accountability and assessment systems. Similarly, individual school…
Bruce, Susan M.; Vargas, Claudia
Introduction: This article discusses the impact of blindness and low vision on the development of object permanence and provides suggestions for assessment and instruction. Methods: The reviewed literature was identified by searching both ERIC and Psych Info using combinations of search terms such as "object permanence" and "visual impairment" or…
The document describes a process-oriented strategy for assessing children with atypical motor development. The Ordinal Scales of Psychological Development in Infancy by I. Uzgiris and J. Hunt are used as the content base. The intervention program focuses on teaching parents techniques for enhancing the child's functioning in sensorimotor, motor,…
The paper reviews cognitive development during the sensorimotor period (approximately the first two years of life) and considers approaches to assessing multihandicapped, deaf-blind, or severely/profoundly retarded students functioning at this level. Evaluation and training of basic sensorimotor schemes (visual fixation and tracking, sucking, and…
Davies, Patricia L.; Soon, Pepper Lee; Young, Michele; Clausen-Yamaki, Amy
This study examined validity of the School Function Assessment (SFA) and interrater reliability of occupational therapist and teacher ratings of students' school function. The validity of the SFA was examined using the known-group method in 35 participants in kindergarten through 7th grade attending elementary schools; 15 students with learning…
Noreau, Luc; Lepage, Celine; Boissiere, Lucie; Picard, Roger; Fougeyrollas, Patrick; Mathieu, Jean; Desmarais, Gilbert; Nadeau, Line
The objectives of this study were: (1) to examine the psychometric properties of the Assessment of Life Habits (LIFE-H) for children; and (2) to draw a profile of the level of participation among children of 5 to 13 years of age with various impairments. The research team adapted the adult version of the LIFE-H in order to render it more…
Allison, Susannah M.; Koenig, Linda J.; Marhefka, Stephanie L.; Carter, Rosalind J.; Abrams, Elaine J.; Bulterys, Marc; Tepper, Vicki; Palumbo, Paul E.; Bachanas, Pamela J.; Farley, John J.
Medication adherence is critical for children’s HIV treatment success, but obtaining accurate assessments is challenging when complex measurement technologies are not feasible. Our goal was to evaluate a multidimensional adherence interview designed to improve upon existing adherence measures. Data from caregivers (N = 126) of perinatally infected children were analyzed to determine the ability of the revised interview guide to detect potential treatment non-adherence. Questions related to viral load (VL) on a bivariate level included proportion of doses taken in the previous 3 days and 6 months, caregivers’ knowledge of prescribed dosing frequencies, and caregivers’ reports of problems associated with medication administration. VL was not associated with 3-day recall of missed doses. In multivariate analyses, only caregiver knowledge of prescribed dosing frequencies was uniquely associated with VL. Our modified interview appears to successfully identify family struggles with adherence and to have the capacity to help clinicians address medication adherence challenges. PMID:20452242
Background Homeopathy is widely used, and many European physicians practice homeopathy in addition to conventional medicine. Adverse effects in homeopathy are not expected by homeopaths due to the negligible quantities of active substances in a remedy. However, we questioned if homeopathic aggravation, which is described as a temporary worsening of existing symptoms following a correct homeopathic remedy, should be regarded as adverse effects or ruled out as desirable events of the treatment. In order to improve knowledge in an unexplored area of patient safety, we explored how medical homeopath discriminate between homeopathic aggravations and adverse effects, and how they assessed patient safety in medical practice. Method A qualitative approach was employed using focus group interviews. Two interviews with seven medical homeopaths were performed in Oslo, Norway. The participants practiced homeopathy besides conventional medicine. Qualitative content analysis was used to analyze the text data. The codes were defined before and during the data analysis. Results According to the medical homeopaths, a feeling of well-being may be a criterion to distinguish homeopathic aggravations from adverse effects. There was disagreement among the participants whether or not homeopathic treatment produced adverse effects. However, they agreed when an incorrect remedy was administrated, it may create a disruption or suppressive reaction in the patient. This was not perceived as adverse effects but a possibility to prescribe a new remedy as new symptoms emerge. This study revealed several advantages for the patients as the medical homeopaths looked for dangerous symptoms which may enhance safety. The patient was given time and space, which enabled the practitioner to see the complete picture. A more comprehensive toolkit gave the medical homeopaths a feeling of professionalism. Conclusion This explorative study investigated how Medical Homeopaths understood and assessed risk in their clinical practice. A feeling of well-being emerging soon after taking the remedy was the most important criterion for discriminating between Homeopathic Aggravations and Adverse Effects in clinical practice. The Medical Homeopaths used the view of both professions and always looked for red flag situations in the consultation room. They combined knowledge from two treatment systems which may have advantages for the patient. These tentative results deserve further research efforts to improve patient safety among users of homeopathy. For further research we find it important to improve and develop concepts that are unique to homeopathy in order to validate and modernize this medical practice. PMID:22967054
Chen, Yukun; Wrenn, Jesse; Xu, Hua; Spickard, Anderson; Habermann, Ralf; Powers, James; Denny, Joshua C
Competence is essential for health care professionals. Current methods to assess competency, however, do not efficiently capture medical students' experience. In this preliminary study, we used machine learning and natural language processing (NLP) to identify geriatric competency exposures from students' clinical notes. The system applied NLP to generate the concepts and related features from notes. We extracted a refined list of concepts associated with corresponding competencies. This system was evaluated through 10-fold cross validation for six geriatric competency domains: "medication management (MedMgmt)", "cognitive and behavioral disorders (CBD)", "falls, balance, gait disorders (Falls)", "self-care capacity (SCC)", "palliative care (PC)", "hospital care for elders (HCE)" - each an American Association of Medical Colleges competency for medical students. The systems could accurately assess MedMgmt, SCC, HCE, and Falls competencies with F-measures of 0.94, 0.86, 0.85, and 0.84, respectively, but did not attain good performance for PC and CBD (0.69 and 0.62 in F-measure, respectively). PMID:25954341
Kumari, A Krishna; Krishnamoorthy, K; Harichandrakumar, KT; Das, LK
Background Lymphatic filariasis has been identified as one of the six diseases that can be potentially eliminated. Global programme to eliminate lymphatic filariasis has been launched, applying principal strategies of mass drug administration to interrupt transmission and morbidity management to prevent disability. The strategy for mass drug administration has been clearly laid out and guidelines have been well documented for implementation, monitoring and evaluation of the programme but such a guideline is warranted for morbidity management and disability prevention activities. Discussion Health Related Quality of Life, a multidimensional construct referring to patients' perceptions of the impact of disease and treatment on their physical, psychological and social function and well being is crucial in the evaluation of health care interventions. Lymphatic filariasis has a wide clinical spectrum and disability is more pronounced in the advanced stages of lymphoedema and hydrocele. Since the advanced stages of lymphoedema are not reversible, morbidity management and disability prevention activities can lessen the disabilities due to secondary infections and there by improve the quality of life of the patient. Thus, an improvement in quality of life is considered to be important as a primary outcome in the determination of therapeutic benefit. Therefore it can be used as an indicator to assess the impact of morbidity management and disability prevention activities in global programme to eliminate lymphatic filariasis. Summary Disease specific Health Related Quality of Life instrument can be used to measure the longitudinal changes in quality of life of patients following the intervention. High responsiveness, clinical relevance to patients and its sensitiveness to detect small changes are the merits of disease specific instrument. Morbidity management and disability prevention activities under filariasis elimination programme aim at improving the quality of life of patients with irreversible manifestations. Therefore there is an urgent need to develop an instrument to assess the health related quality of life, specific for lymphatic filariasis by incorporating all the difficulties and problems caused to patients by the disease in the physical, mental and social domains of health. PMID:17723155
Silvia Miano; Oliviero Bruni; Debora Aricò; Maurizio Elia; Raffaele Ferri
The aim of this study was to assess the presence of sleep breathing disorder and periodic leg movements during sleep (PLMS),\\u000a and to evaluate NREM sleep instability in a group of children with mental retardation (MR) and epilepsy. Eleven subjects with\\u000a MR and epilepsy (6 males, age range 9–17 years) were recruited for this study. A control group was formed by
Guzman, Juan Manuel; Salazar, Elva García
Recent disability-related data are available from the 13th National Census of Population and Housing, which was performed in 2010. Disability assessment followed the recommendations of the Washington Group on Disability Statistics and identified 5,739,270 (5.1%) persons with disability, 51.1% of whom were women. Almost 60% of all persons 85 yrs or older reported disabilities. Policies and legislation endorse the rights of persons with disabilities. However, little is known about the real-life situation of persons with disabilities in Mexico as well as the met and unmet needs for rehabilitation. Rehabilitation services in Mexico are mainly organized by the Mexican Institute of Social Security. Because of the increasing need for rehabilitation, an innovative model of small first-level rehabilitation services has been designed and successfully implemented. This model has increased the capacity of rehabilitation services by 60% since 2003. PMID:24356080
The contribution of workplace exposures to the prevalence of asthma in adults has been minimized in the epidemiology of this illness. Analysis of the 1978 Social Security Disability Survey provides a population-based assessment as a novel approach utilizing self-attributed, occupationally related asthma as a measure of disease. Of 6063 respondents, 468 (7.7 percent) identified asthma as a personal medical condition; 72 (1.2 percent (15.4 percent of all those with asthma)) attributed it to workplace exposures. These subjects were older and included more men and cigarette smokers than groups of both asthmatic and nonasthmatic subjects. The relative risk for occupationally attributed asthma was elevated among industrial and agricultural workers as compared with white collar and service occupations. Analysis of disability benefit status did not indicate that this introduced major reporting bias in this survey. This study suggests that occupational factors may have a greater role in adult asthma than previously thought.
Barkley, S E; Mason, J L; Kappelman, M M
The purpose of this survey was to determine entering freshman medical student awareness of and attitudes toward AIDS. It is encouraging to find that, in general, students are well informed about AIDS before entering medical school; they have very real concerns about the possibility of contracting AIDS themselves as future care givers; and that they, in the final analysis, will consent to function as care givers to patients who have or may have AIDS while assuming responsibility to take appropriate precautions. It is important to stress that this survey reflects the pre-formed attitudes of entering freshman medical students. The University of Maryland School of Medicine is actively involved with the integration of AIDS education officially into the medical school curriculum. The results of this survey highlight the need for the inclusion of learning experiences designed to enhance physician/patient interaction skills when administering care to AIDS patients. It is believed that the acquisition of these desirable skills will generalize to better quality care for all patients. It is planned to administer the HIV/AIDS Questionnaire in a follow-up study to graduating seniors to assess their knowledge and attitudes toward AIDS. This will permit a comparison of attitude change among medical students, and an evaluation of newly implemented curricular changes. PMID:3218860
Daniel Bruns; John Mark Disorbio
There is a growing body of evidence that psychosocial variables have a significant ability to predict the outcome of medical\\u000a treatment procedures, especially when the procedure is performed to reduce pain. The study described in this paper serves\\u000a as an illustration of the valuable role psychologists can play in dealing with the challenges of biopsychosocial assessment\\u000a of patients who are
Lavigne, J V; Schulein, M J; Hahn, Y S
The assessment and development of pain in children is reviewed in the first part of a two-part series. Assessment of pain in children has relied on self-report measures that have included visual analogue procedures using concrete stimuli for ratings. Behavioral assessment procedures are more sophisticated, but research on behavioral assessment of pediatric pain has begun to emergy only recently. There has been very little research on the developmental aspects of pain tolerance and pain threshold in children. There are preliminary indications that children's thoughts and attitudes about pain may change with age in a manner that contributes to more intense feelings of pain in adolescence than childhood. Children undergoing painful medical procedures show declining emotional outbursts with age and increasing signs of self-control and muscular rigidity. Possibilities for integrating the study of the developmental aspects of pain with social learning theory, cognitive developmental theory, and the psychology of physical symptom perception are discussed. PMID:3540810
Phillips, Alexander C.; Holland, Anthony J.
Objective To investigate, using accelerometers, the levels of physical activity being undertaken by individuals with intellectual disabilities with and without Down's syndrome. Methods One hundred and fifty two individuals with intellectual disabilities aged 12–70 years from East and South-East England. Physical activity levels in counts per minute (counts/min), steps per day (steps/day), and minutes of sedentary, light, moderate, vigorous, and moderate to vigorous physical activity (MVPA) measured with a uni-axial accelerometer (Actigraph GT1M) for seven days. Results No individuals with intellectual disabilities met current physical activity recommendations. Males were more active than females. There was a trend for physical activity to decline and sedentary behaviour to increase with age, and for those with more severe levels of intellectual disability to be more sedentary and less physically active, however any relationship was not significant when adjusted for confounding variables. Participants with Down's syndrome engaged in significantly less physical activity than those with intellectual disabilities without Down's syndrome and levels of activity declined significantly with age. Conclusions Individuals with intellectual disabilities, especially those with Down's syndrome may be at risk of developing diseases associated with physical inactivity. There is a need for well-designed, accessible, preventive health promotion strategies and interventions designed to raise the levels of physical activity for individuals with intellectual disabilities. We propose that there are physiological reasons why individuals with Down's syndrome have particularly low levels of physical activity that also decline markedly with age. PMID:22205957
This paper aims to discuss how science and technology studies (STS) can inform disability studies and challenge dominant approaches, such as the medical and the social models, in the ordering and representation of disability. Disability studies and STS have followed somewhat parallel paths in the history of ideas. From a positivist approach to…
Michael Feuerstein; Ronald W. Thebarge
Pain-related work disability can be influenced by a number of medical, physical, and psychosocial factors. The present study investigated the role of perceived disability, occupational stress, pain, and distress in patients with chronic pain disorders who work despite pain and patients who are work disabled. A total of 165 patients referred to a multidisciplinary pain treatment center for chronic pain
Gerben DeJong; Andrew I. Batavia
The passage of the Americans with Disabilities Act (ADA) reflects a new stage in American disability policy. However, important policy issues that pre-date the passage of ADA remain unresolved. The most important concern policy assumptions that have guided various disability income and medical assistance programs since their inception in the 1950s and 1960s. The most detrimental assumption is that, to
Baglieri, Susan; Valle, Jan W.; Connor, David J.; Gallagher, Deborah J.
This article asserts that the field of special education, historically founded on conceptions of disability originating within scientific, psychological, and medical frameworks, will benefit from acknowledging broader understandings of disability. Although well intended, traditional understandings of disability in special education have…
Hirst, Michael A.
The study attempted to relate patterns of disabilities to amounts of money received in social security benefits. Findings from structured interviews with parents of 248 disabled young adults (ages 18-22) indicated that the United Kingdom social security system gives more recognition to costs arising from physical than from mental disability.…
Irvine-Meek, Janice; Gould, Odette N; Wheaton, Hannah; Todd, Laura E
Background: A majority of community-dwelling older adults manage their own medication regimens. This study describes the development and first phase of testing of the Self-Medication Assessment Tool (SMAT), designed to screen for cognitive and functional deficits in relation to medication self-management among community-dwelling geriatric patients. Objective: To evaluate the face validity of the SMAT and to determine its acceptability among pharmacists. Methods: An instrument was designed, with 5 assessment scales to measure function, cognition, medication recall, and 2 aspects of adherence. The instrument included a standardized test kit and instructions for testers. Focus groups interviews, individual interviews, and surveys were used to determine the reactions of community and hospital-based pharmacists to the tool. Transcripts of the focus group and individual interviews were coded for main themes. Pharmacists’ ratings of usefulness, thoroughness, and ease of use, as well as their willingness to use the instrument, were compared with a neutral rating on a 7-point scale by means of 1-sample t tests. Results: Focus group interviews or individual interviews were conducted with 17 pharmacists and 3 pharmacy students (out of a potential population of about 300) who responded to an invitation to participate. The pharmacists felt that the tool would be useful in identifying difficulties with medication management and potential interventions, and they expressed a willingness to use it in their respective practices. Pharmacists working in hospital settings were slightly more willing than community pharmacists to use the tool. Interviewees highlighted ways to improve the tool before testing of its psychometric properties in the planned second phase of this project. Conclusions: The SMAT had strong face validity and was particularly acceptable for use by pharmacists in hospital settings. PMID:22478982
Kasanda, C D; Mitonga, K H; Veii, K; Zimba, R F
Many students at the University of Namibia have frequently complained about ineffective assessment practices used at the institution. On many occasions, these complaints have not been substantiated with evidence of any kind. The purpose of this study was to obtain some empirical evidence that would ascertain undergraduate students' perceptions of the University of Namibia's grading and assessment practices. Using a structured scaled questionnaire, data were obtained from a representative sample of the University's undergraduate students studying for Medical and Pharmacy degrees. The questionnaire items covered matters related to students' experiences of assessment practices, feedback on assessment tasks, reliability and validity of assessment tools used by lecturers, efficacy of processes of administering examinations, perceptions of irregular and unfair assessment practices, impact of assessment regimes on students' cost of studies, motivation, morale, rate of progression in studies and graduation, the degree of compliance with assessment ethics and on academic quality assurance. According to the data reported in this article, the majority of the respondents perceived that the Schools of Medicine and Pharmacy at the University of Namibia applied assessment practices that yielded reliable and valid results. This was the case because most lecturers in the two schools used appropriate assessment tools and provided their students with prompt and informative feedback on the results of assignments, tests and examinations. In addition, most respondents reported that whereas examination procedures used in the two schools were efficient and effective, lecturers graded examination scripts fairly. These and other results are discussed in the article to communicate the message that the assessment procedures used in the Schools of Medicine and Pharmacy at the University of Namibia would promote effective learning and understanding amongst students as they were of high quality. PMID:23847582
Silk, Larry; Watt, Jackie; Pilon, Nancy; Draper, Chad
This article describes a psychotropic PRN Evaluative Tool developed by interprofessional clinicians to address inconsistent reporting and assessment of the effectiveness of PRN medications used for people who are developmentally disabled. Fifty-nine participants (37 males, 22 females), ages 16 to 60 years, were included in the review, all…
Wong, Jessica J.; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah
Objective We assessed the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after a 1-hour educational intervention. Methods A mixed-methods approach was used with a 52-item cross-sectional paper survey and 1 focus group of third-year medical students. The views of these medical students towards chiropractic were assessed previously in their second-year of medical school. ANOVA and the Wilcoxon rank-sum test were used to assess between-group differences between the medical students' views before and after the educational intervention. The constant comparative method for analyzing qualitative data was used to identify emergent themes from the focus group transcript. Results Of 112 third-year medical students, 58 completed the survey (51.7% response rate). The focus group consisted of 6 medical students. Self-reported understanding of chiropractic and number of attitude-positive responses were significantly higher in the group after the educational session. The average number of correct responses assessing knowledge on chiropractic also was significantly higher. Focus group themes were that medical students wanted exposure to chiropractic in clinical settings, had negative attitudes towards chiropractic formed from hidden curriculum, had concerns regarding evidence and safety of chiropractic, and thought that timing of the session on chiropractic was too late in the curriculum. Conclusions The attitudes and knowledge of medical students towards chiropractic improved immediately after a 1-hour educational intervention. Formally educating medical students on chiropractic may help minimize hidden curriculum issues regarding chiropractic, as identified by the medical students, and facilitate collaboration between medical and chiropractic providers. PMID:25237768
Wong, Jessica J; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah
Objective : We assessed the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after a 1-hour educational intervention. Methods : A mixed-methods approach was used with a 52-item cross-sectional paper survey and 1 focus group of third-year medical students. The views of these medical students towards chiropractic were assessed previously in their second-year of medical school. ANOVA and the Wilcoxon rank-sum test were used to assess between-group differences between the medical students' views before and after the educational intervention. The constant comparative method for analyzing qualitative data was used to identify emergent themes from the focus group transcript. Results : Of 112 third-year medical students, 58 completed the survey (51.7% response rate). The focus group consisted of 6 medical students. Self-reported understanding of chiropractic and number of attitude-positive responses were significantly higher in the group after the educational session. The average number of correct responses assessing knowledge on chiropractic also was significantly higher. Focus group themes were that medical students wanted exposure to chiropractic in clinical settings, had negative attitudes towards chiropractic formed from hidden curriculum, had concerns regarding evidence and safety of chiropractic, and thought that timing of the session on chiropractic was too late in the curriculum. Conclusions : The attitudes and knowledge of medical students towards chiropractic improved immediately after a 1-hour educational intervention. Formally educating medical students on chiropractic may help minimize hidden curriculum issues regarding chiropractic, as identified by the medical students, and facilitate collaboration between medical and chiropractic providers. PMID:25237768
Li, Tuotuo; Geng, Jason; Li, Shidong
Recent development in optical 3D surface imaging technologies provide better ways to digitalize the 3D surface and its motion in real-time. The non-invasive 3D surface imaging approach has great potential for many medical imaging applications, such as motion monitoring of radiotherapy, pre/post evaluation of plastic surgery and dermatology, to name a few. Various commercial 3D surface imaging systems have appeared on the market with different dimension, speed and accuracy. For clinical applications, the accuracy, reproducibility and robustness across the widely heterogeneous skin color, tone, texture, shape properties, and ambient lighting is very crucial. Till now, a systematic approach for evaluating the performance of different 3D surface imaging systems still yet exist. In this paper, we present a systematic performance assessment approach to 3D surface imaging system assessment for medical applications. We use this assessment approach to exam a new real-time surface imaging system we developed, dubbed "Neo3D Camera", for image-guided radiotherapy (IGRT). The assessments include accuracy, field of view, coverage, repeatability, speed and sensitivity to environment, texture and color.
Simmenroth-Nayda, Anne; Heinemann, Stephanie; Nolte, Catharina; Fischer, Thomas; Himmel, Wolfgang
Objectives: The aim of this study was to analyse the psychometric properties of the short version of the Calgary Cambridge Guides and to decide whether it can be recommended for use in the assessment of communications skills in young undergraduate medical students. Methods: Using a translated version of the Guide, 30 members from the Department of General Practice rated 5 videotaped encounters between students and simulated patients twice. Item analysis should detect possible floor and/or ceiling effects. The construct validity was investigated using exploratory factor analysis. Intra-rater reliability was measured in an interval of 3 months, inter-rater reliability was assessed by the intraclass correlation coefficient. Results: The score distribution of the items showed no ceiling or floor effects. Four of the five factors extracted from the factor analysis represented important constructs of doctor-patient communication The ratings for the first and second round of assessing the videos correlated at 0.75 (p < 0.0001). Intraclass correlation coefficients for each item ranged were moderate and ranged from 0.05 to 0.57. Conclusions: Reasonable score distributions of most items without ceiling or floor effects as well as a good test-retest reliability and construct validity recommend the C-CG as an instrument for assessing communication skills in undergraduate medical students. Some deficiencies in inter-rater reliability are a clear indication that raters need a thorough instruction before using the C-CG. PMID:25480988
Uric Acid May Limit Stroke Disability In Women But study found no benefit for men, and plan further research ... recovering without disabilities if they're given uric acid along with standard "clot-busting" medication, a new ...
Irvine-Meek, Janice M; Gould, Odette N
Background: Most community-dwelling older adults are engaged in medication self-management activities. Deviation in these activities can lead to adverse outcomes for patients and an increased burden on the health care system. Successful medication self-management involves a complex interaction among cognitive, functional, and psychosocial variables. Several assessment instruments have been developed, but there remains a need for an effective and comprehensive tool. Objective: To evaluate the psychometric properties (inter-rater reliability, test–retest reliability, and validity), as well as the usability, of the Self-Medication Assessment Tool (SMAT), an instrument designed to measure elderly patients’ ability to manage their medications. Methods: The study enrolled patients 65 years of age or older who were living independently and were admitted to family medicine beds in a community hospital in eastern Canada. Three subsamples of the population were identified. The inter-rater reliability group was videotaped and scored independently by 2 pharmacists. The test–retest reliability group was tested with the SMAT and was retested with the same tool a week later. The usability group was interviewed after using the SMAT to determine their satisfaction. Standard neuropsychological measures (Cognitive Competency Test, clock-drawing test, and Mini Mental State Examination [MMSE]) were used to determine convergent and divergent validity. Pill counts, refill rates, and use of adherence aids or reminders before study enrolment were used as measures of concurrent validity. Results: A total of 121 patients (mean age 81.5 years) were enrolled. The scales of the SMAT were determined to have good internal consistency and high inter-rater and test–retest reliability. Convergent validity was evidenced by the high positive correlation between the functional scale of the SMAT and the results of the clock-drawing and Cognitive Competency tests (p < 0.01) and between the cognitive and recall scales of the SMAT and the results of the clock-drawing test (p < 0.05), the MMSE (p < 0.01), and the Cognitive Competency Test (p < 0.01). Patients reported being highly satisfied with their experience. Conclusion: The SMAT is a practical, reliable, comprehensive instrument with demonstrated convergent validity, strong patient acceptability, and various internally consistent scales that assess multiple dimensions of elderly patients’ ability to self-manage their medications. Further testing is required to show that the SMAT correlates with medication adherence. PMID:22479024
Objective Although electronic medical records (EMRs) have facilitated care for children with juvenile idiopathic arthritis (JIA), analyses of treatment outcomes have required paper based or manually re-entered data. We have started EMR discrete data entry for JIA patient visits, including joint examination and global assessment, by physician and patient. In this preliminary study, we extracted data from the EMR to Xenobase™ (TransMed Systems, Inc., Cupertino, CA), an application permitting cohort analyses of the relationship between global assessment to joint examination and subtype. Methods During clinic visits, data were entered into discrete fields in ambulatory visit forms in the EMR (EpicCare™, Epic Systems, Verona, WI). Data were extracted using Clarity Reports, then de-identified and uploaded for analyses to Xenobase™. Parameters included joint examination, ILAR diagnostic classification, physician global assessment, patient global assessment, and patient pain score. Data for a single visit for each of 160 patients over a 2 month period, beginning March, 2010, were analyzed. Results In systemic JIA patients, strong correlations for physician global assessment were found with pain score, joint count and patient assessment. In contrast, physician assessment for patients with persistent oligoarticular and rheumatoid factor negative patients showed strong correlation with joint counts, but only moderate correlation with pain scores and patient global assessment. Conversely, for enthesitis patients, physician assessment correlated strongly with pain scores, and moderately with joint count and patient global assessment. Rheumatoid factor positive patients, the smallest group studied, showed moderate correlation for all three measures. Patient global assessment for systemic patients showed strong correlations with pain scores and joint count, similar to data for physician assessment. For polyarticular and enthesitis patients, correlation of patient global assessment with pain scores was strong. Moderate correlations were found between patient global assessment and joint count in oligoarticular and polyarticular patients. Conclusion Data extraction from the EMR is feasible and useful to evaluate JIA patients for indicators of treatment responsiveness. In this pilot study, we found correlates for physician global assessment of arthritis differed, according to disease subtype. Further data extraction and analyses will determine if these findings can be confirmed, and will assess other outcome measures, compare longitudinal responses to treatment, and export extracted data to multi-center databases. PMID:21492466
Reinhardt, Jan D.; Li, Jianan; Gosney, James; Rathore, Farooq A.; Haig, Andrew J.; Marx, Michael; Delisa, Joel A.
Background Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention. Objectives To examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability. Design Qualitative literature review and secondary data analysis. Results Absolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in natural disaster relief may result in additional burdening of the health system capacity, exacerbating baseline weak rehabilitation and health system infrastructure. Little scientific evidence on the effectiveness of health-related rehabilitation interventions following natural disaster exists, however. Although systematic assessment and measurement of disability after a natural disaster is currently lacking, new approaches have been suggested. Conclusion Health-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response by the host and international communities. Significant systematic challenges to effective delivery of rehabilitation interventions during disaster include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures. Additional development of health-related rehabilitation following natural disaster is urgently required. PMID:21866223
This reference is concerned with the Crossroads of Humanity workshop which is part of the Environmental Hazards Assessment Program at the Medical University of South Carolina. This workshop was held during the months of June and July 1994. Topics discussed include: Radioactive contamination, aging, medical ethics, and environmental risk analysis.
Hopkins, Pamela Jean Clinton
The purpose of this study was to assess nurse and medical assistant perceived needs prior to implementing an expended web-based training (WBT) program in physician clinics. This case study was conducted with a mixed-data ...
Kerstman, Eric L.; Minard, Charles; FreiredeCarvalho, Mary H.; Walton, Marlei E.; Myers, Jerry G., Jr.; Saile, Lynn G.; Lopez, Vilma; Butler, Douglas J.; Johnson-Throop, Kathy A.
This slide presentation reviews the Integrated Medical Model (IMM) and its use as a risk assessment and decision support tool for human space flight missions. The IMM is an integrated, quantified, evidence-based decision support tool useful to NASA crew health and mission planners. It is intended to assist in optimizing crew health, safety and mission success within the constraints of the space flight environment for in-flight operations. It uses ISS data to assist in planning for the Exploration Program and it is not intended to assist in post flight research. The IMM was used to update Probability Risk Assessment (PRA) for the purpose of updating forecasts for the conditions requiring evacuation (EVAC) or Loss of Crew Life (LOC) for the ISS. The IMM validation approach includes comparison with actual events and involves both qualitative and quantitaive approaches. The results of these comparisons are reviewed. Another use of the IMM is to optimize the medical kits taking into consideration the specific mission and the crew profile. An example of the use of the IMM to optimize the medical kits is reviewed.
Ehteshami, Asghar; Sadoughi, Farahnaz; Saeedbakhsh, Saeed; Isfahani, Mahtab Kasaei
Introduction Hospital managers and personnel need to Hospital Information System (HIS) to increase the efficiency and effectiveness in their organization. Accurate, appropriate, precise, timely, valid information, and Suitable Information system for their tasks is required and the basis for decision making in various levels of the hospital management, since, this study was conducted to Assess of Selected HIS in Isfahan University of Medical Science Hospitals According to ISO 9241-10. Methods This paper obtained from an applied, descriptive cross sectional study, in which the medical records module of IUMS selected HIS in Isfahan University of Medical Science affiliated seven hospitals were assessed with ISO 9241-10 questionnaire contained 7 principles and 74 items. The obtained data were analyzed with SPSS software and descriptive statistics were used to examine measures of central tendencies. Results The analysis of data revealed the following about the software: Suitability for user tasks, self descriptiveness, controllability by user, Conformity with user expectations, error tolerance, suitability for individualization, and suitability for user learning, respectively, was 68, 67, 70, 74, 69, 53, and 68 percent. Total compliance with ISO 9241-10 was 67 percent. Conclusion Information is the basis for policy and decision making in various levels of the hospital management. Consequently, it seems that HIS developers should decrease HIS errors and increase its suitability for tasks, self descriptiveness, controllability, conformity with user expectations, error tolerance, suitability for individualization, suitability for user learning. PMID:23572860
Carpenter, Christopher R.; Heard, Kennon; Wilber, Scott; Ginde, Adit A.; Stiffler, Kirk; Gerson, Lowell W.; Wenger, Neal S.; Miller, Douglas K.
Background Geriatric adults represent an increasing proportion of emergency department (ED) users, and can be particularly vulnerable to acute illnesses. Health care providers have recently begun to focus upon the development of quality indicators to define a minimal standard of care. Objectives The original objective of this project was to develop additional ED-specific quality indicators for older patients within the domains of medication management, screening and prevention, and functional assessment, but the quantity and quality of evidence was insufficient to justify unequivocal minimal standards of care for these three domains. Accordingly, the authors modified the project objectives to identify key research opportunities within these three domains that can be used to develop quality indicators in the future. Methods Each domain was assigned one or two content experts who created potential quality indicators (QI) based on a systematic review of the literature, supplemented by expert opinion. Candidate quality indicators were then reviewed by four groups: the Society for Academic Emergency Medicine (SAEM) Geriatric Task Force, the SAEM Geriatric Interest Group, and audiences at the 2008 SAEM Annual Meeting and the 2009 American Geriatrics Society Annual Meeting, using anonymous audience response system technology as well as verbal and written feedback. Results High-quality evidence based on patient-oriented outcomes was insufficient or non-existent for all three domains. The participatory audiences did not reach a consensus on any of the proposed QIs. Key research questions for medication management (3), screening and prevention (2), and functional assessment (3) are presented based upon proposed QIs that the majority of participants accepted. Conclusions In assessing a minimal standard of care by which to systematically derive geriatric QIs for medication management, screening and prevention, and functional assessment, compelling clinical research evidence is lacking. Patient-oriented research questions that are essential to justify and characterize future quality indicators within these domains are described. PMID:21676064
Lumley, Mark A.; Neely, Lynn C.; Burger, Amanda J.
The construct of alexithymia encompasses the characteristics of difficulty identifying feelings, difficulty describing feelings, externally oriented thinking, and a limited imaginal capacity. These characteristics are thought to reflect deficits in the cognitive processing and regulation of emotions and to contribute to the onset or maintenance of several medical and psychiatric disorders. This article reviews recent methods for assessing alexithymia and examines how assessing alexithymia can inform clinical practice. Alexithymia is associated with heightened physiological arousal, the tendency to notice and report physical symptoms, and unhealthy compulsive behaviors. Alexithymic patients may respond poorly to psychological treatments, although perhaps not to cognitive-behavioral techniques, and it is unclear whether alexithymia can be improved through treatment. Interpretive problems regarding alexithymia include its overlap with other traits, whether it is secondary to illness or trauma, the possibility of subtypes, and low correlations among multiple measures. Nonetheless, we encourage the assessment of alexithymia in applied settings. PMID:18001224
Tarricone, Rosanna; Torbica, Aleksandra; Ferré, Francesca; Drummond, Mike
Assessing the value of health technologies, through health technology assessment is critically dependent on the existence of relevant and robust clinical data on the efficacy, safety and ideally, effectiveness of the technologies concerned. However, in the case of medical devices, such clinical data may not always be available, because of the different nature of the regulatory requirements in different jurisdictions. Therefore, we conducted a systematic review of the regulatory requirements in seven major jurisdictions in order to identify current challenges and to suggest possible improvements. There are differences in the requirements across jurisdictions and in the balance between pre-market and post-market controls. Several improvements are required in order to generate adequate clinical data for health technology assessment. PMID:25196848
Low, W Y; Zubir, T N
Sexuality of persons with spinal cord injury has received increased attention especially in the Western countries. However, in the local context, studies pertaining to the sexuality of the disabled are almost nil. This paper utilized a qualitative approach in assessing sexual knowledge, attitudes and practices of persons with spinal cord injury. Eight focus group discussions consisting of 28 adult spinal cord injured persons were carried out. The results showed that the frequency of sexual activity decreased following injury. The disabled themselves have a negative self-concept and a low self-esteem and this affects their attitudes towards sexuality and their sexual behaviour. Health care professionals tend to neglect this issue perhaps due to their insensitivity to the sexual needs for the disabled or a lack of understanding and expertise in this area. A need for sexual information related to their disability is warranted in the areas of reproduction, contraception and their ability/disability in achieving an erection or ejaculation. This study indicated a need for more comprehensive research in this neglected area of sexual issues of persons with disabilities. Public health education and counseling is deemed necessary for the disabled themselves so as to accommodate their sexual lives to their physical capabilities and desires. Attitudes and misconceptions of the public need to be corrected. Above all, there is a need for education and training for health care professionals in the area of sexual rehabilitation, which is currently non-existent in the country. Perhaps, it is timely to incorporate sexual rehabilitation as part of a holistic medical rehabilitation of the disabled. PMID:11338746
Hanan Daher; Steffen Flessa
Background Microfinance is a generally accepted tool for improving the economic situation of the poor in developing countries. However,\\u000a it has hardly been used to finance medical devices required by the disabled, although the incapability of these groups to\\u000a buy wheelchairs and other equipment is a major source of poverty.\\u000a \\u000a \\u000a \\u000a \\u000a Aim This paper analyzes the need for microfinance as a tool for
Whicker, Shari Ann
The purpose of the study was to examine the relationship between resident communication skills competence and their ability to self-assess within that domain. Six research questions guided the study. The first research question sought to explore the varied levels with which residents demonstrated competence within the domain of communication…
Biswal, B M; Zakaria, A; Baba, A A; Ja'afar, R
We conducted a questionnaire survey among 261 year-4 and year-5 medical students containing 27 questions related to cancer, radiotherapy, general oncology and palliative care to assess their knowledge, understanding, and exposure to oncology and palliative care in our medical school. Out of 261 students, 139 students returned their questionnaire for analysis. Twenty nine percent (29%) of the students had rarely visited the Radiotherapy and Oncology unit. There were profound deficiencies in the basic knowledge of cancer (46%), principles of radiotherapy treatment (59%), palliative care (64%), and cancer prevention (48%). They reported no specific teaching about early detection of common malignancies and cancer prevention. The main input of instruction about cancer came from surgery (46%) and pathology (28%) teachings. This study revealed that there is deficiency in cancer education in the undergraduate teaching program in our institution. PMID:15535340
Weiner, M.; Schadow, G.; Lindbergh, D.; Warvel, J.; Abernathy, G.; Dexter, P.; McDonald, C. J.
Although video-based teleconferencing is becoming more widespread in the medical profession, especially for scheduled consultations, applications for rapid assessment of acute medical problems are rare. Use of such a video system in a nursing facility may be especially beneficial, because physicians are often not immediately available to evaluate patients. We have assembled and tested a portable, wireless conferencing system to prepare for a randomized trial of the system s influence on resource utilization and satisfaction. The system includes a rolling cart with video conferencing hardware and software, a remotely controllable digital camera, light, wireless network, and battery. A semi-automated paging system informs physicians of patient s study status and indications for conferencing. Data transmission occurs wirelessly in the nursing home and then through Internet cables to the physician s home. This provides sufficient bandwidth to support quality motion images. IPsec secures communications. Despite human and technical challenges, this system is affordable and functional. Images Figure 1 PMID:11825286
Sally Krasne; Paul F. Wimmers; Anju Relan; Thomas A. Drake
Formative assessments are systematically designed instructional interventions to assess and provide feedback on students’\\u000a strengths and weaknesses in the course of teaching and learning. Despite their known benefits to student attitudes and learning,\\u000a medical school curricula have been slow to integrate such assessments into the curriculum. This study investigates how performance\\u000a on two different modes of formative assessment relate to
Background Today’s medical students are the future physicians of people living with HIV/AIDS (PLWHA). It is therefore essential that medical students possess the appropriate knowledge and attitudes regarding PLWHA. This study aims to evaluate knowledge and attitudes of pre-clinical Israeli medical students and to assess whether their knowledge and attitudes change throughout their pre-clinical studies. Methods A cross-sectional study was conducted among all pre-clinical medical students from the four medical schools in Israel during the academic year of 2010/2011 (a total of 1,470 students). A self-administered questionnaire was distributed. The questionnaire sought student responses pertaining to knowledge of HIV transmission and non-transmission routes, basic knowledge of HIV/AIDS treatment and attitudes towards HIV/AIDS. Results The study’s response rate was 62.24 percent. Knowledge among pre-clinical medical students was generally high and showed a statistically significant improvement as students progressed through their pre-clinical studies. However, there were some misconceptions, mostly regarding HIV transmission via breastfeeding and knowledge of HIV prevention after exposure to the virus. Students’ attitudes were found to include stigmatizing notions. Furthermore, the majority of medical students correlated HIV with shame and fear. In addition, students’ attitudes toward HIV testing and providing confidential medical information were contradictory to health laws, protocols and guidelines. Overall, no positive changes in students’ attitudes were observed during the pre-clinical years of medical school. Conclusion The knowledge of pre-clinical medical students in Israel is generally high, although there are some knowledge inadequacies that require more emphasis in the curricula of the medical schools. Contrary to HIV-related knowledge, medical students’ attitudes are unaffected by their progression through medical school. Therefore, medical schools in Israel should modify their curricula to include teaching methods aimed at improving HIV-related attitudes and adherence to medical professionalism. PMID:24650351
Brenner, H; Kliebsch, U; Siebert, H
Objective assessment of need for nursing care should be based on well defined criteria. In 1993, the Federal German Social Court ("Bundessozialgericht", BSG) has given criteria for identifying individuals in permanent need of very intensive nursing care ("Schwerpfledgebedürftige"), who qualified for benefits granted by the Germany statutory health insurance system at that time. The criteria were primarily based on the number of activities of daily living for which the applicants were in need of help. The criteria were largely, but not entirely, consistent with previously established criteria employed by the Medical Service of the Health Insurances ("Medizinischer Dienst der Krankenversicherung", MDK), who was responsible for the assessment. An analysis of 4185 examinations carried out by MDK in the region of Augsburg in 1991-1993 showed that the majority of judgments were in agreement with the criteria given by BSG. However, individuals with psychiatric disorders or symptoms were often rated by MDK as being in permanent need of very intensive nursing care even if BSG criteria were not fulfilled. Exclusive judgement of nursing dependency on the basis of single activities of daily living appears to be inadequate for this group of persons. PMID:8704364
Christopher, Paul P.; Boland, Robert J.; Recupero, Patricia R.; Phillips, Katharine A.
Objective: The increasing frequency and societal cost of psychiatric disability underscore the need for accuracy in evaluating patients who seek disability benefits. The authors investigated senior psychiatric residents' experiences performing disability evaluations, their self-assessment of competence for this task, and whether they perceived a…
Guo, Yan; Sippola, Emily; Feng, Xinglin; Dong, Zhe; Wang, Debing; Moyer, Cheryl A.; Stern, David T.
To explore the need for faculty development among Chinese medical educators. Leaders at each medical school in China were asked to complete a 123-item survey to identify interest in various topics and barriers and perceived benefits of participating in faculty development programs. Interest levels were high for all topics. Experience with Hospital…
Gro Dahlseng Håkonsen; Steve Hudson; Thrina Loennechen
Objective A clinical tool to examine prescribing in cancer pain management may provide a means to help establish acceptable standards\\u000a of adherence to treatment guidelines. The study aim was to design and validate a Medication Assessment Tool for Cancer Pain\\u000a Management (MAT-CP).\\u000a \\u000a \\u000a \\u000a Setting Hospitals in Northern Norway\\u000a \\u000a \\u000a \\u000a Method The MAT-CP was designed from guideline criteria based on a previously developed method. The tool
Royer-Bertrand, Beryl; Rivolta, Carlo
The past decade has seen the emergence of next-generation sequencing (NGS) technologies, which have revolutionized the field of human molecular genetics. With NGS, significant portions of the human genome can now be assessed by direct sequence analysis, highlighting normal and pathological variants of our DNA. Recent advances have also allowed the sequencing of complete genomes, by a method referred to as whole genome sequencing (WGS). In this work, we review the use of WGS in medical genetics, with specific emphasis on the benefits and the disadvantages of this technique for detecting genomic alterations leading to Mendelian human diseases and to cancer. PMID:25548800
Rosenberg, David; Eichorn, Ann; Alarcon, Mauricio; McCullagh, Lauren; McGinn, Thomas; Spyropoulos, Alex C.
Background Hospitalized medical patients are at risk for venous thromboembolism (VTE). Universal application of pharmacological thromboprophylaxis has the potential to place a large number of patients at increased bleeding risk. In this study, we aimed to externally validate the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) VTE risk assessment model in a hospitalized general medical population. Methods and Results We identified medical discharges that met the IMPROVE protocol. Cases were defined as hospital?acquired VTE and confirmed by diagnostic study within 90 days of index hospitalization; matched controls were also identified. Risk factors for VTE were based on the IMPROVE risk assessment model (aged >60 years, prior VTE, intensive care unit or coronary care unit stay, lower limb paralysis, immobility, known thrombophilia, and cancer) and were measured and assessed. A total of 19 217 patients met the inclusion criteria. The overall VTE event rate was 0.7%. The IMPROVE risk assessment model identified 2 groups of the cohort by VTE incidence rate: The low?risk group had a VTE event rate of 0.42 (95% CI 0.31 to 0.53), corresponding to a score of 0 to 2, and the at?risk group had a VTE event rate of 1.29 (95% CI 1.01 to 1.57), corresponding to a score of ?3. Low?risk status for VTE encompassed 68% of the patient cohort. The area under the receiver operating characteristic curve was 0.702, which was in line with the derivation cohort findings. Conclusions The IMPROVE VTE risk assessment model validation cohort revealed good discrimination and calibration for both the overall VTE risk model and the identification of low?risk and at?risk medical patient groups, using a risk score of ?3. More than two thirds of the entire cohort had a score ?2. PMID:25404191
Is there such a thing as a social conception of disability? Recently two writers in this journal have suggested not only that there is a coherent social conception of disability but that all non-social conceptions, or "medical models" of disability are fatally flawed. One serious and worrying dimension of their claims is that once the social dimensions of disability have been resolved no seriously "disabling" features remain. This paper examines and rejects conceptions of disability based on social factors but notes that physical and mental conditions which disadvantage the individual have social dimensions. Key Words: Disability • handicap • impairment • social deprivation • social exclusion • discrimination PMID:10786318
Markonis, Dimitrios; Baroz, Frederic; Ruiz De Castaneda, Rafael Luis; Boyer, Celia; Müller, Henning
Content-based image retrieval (CBIR) has often been proposed to assist medical decision making in complement to textual information search. However, applications of this novel technology have rarely reached the end users. The study presented in this paper describes the design and setup for performing pilot user tests in order to assess a medical information retrieval system that supports CBIR with the goal of having more detailed tests with an updated system. Five individuals with medical education participated in the study at the University hospitals of Geneva. They were recorded and observed while interacting with the system, and then provided feedback on the usability of the system. Participants seemed to understand the concept and practical uses of the new tools, and needed 10-15 minutes to feel confident with the system. The results of this pilot study will be used for improving the system functionalities as well as an input for designing a new iteration of larger-scale user tests among radiologists. PMID:23920549
Mache, Stefanie; Scutaru, Cristian; Vitzthum, Karin; Gerber, Alexander; Quarcoo, David; Welte, Tobias; Bauer, Torsten T; Spallek, Michael; Seidler, Andreas; Nienhaus, Albert; Klapp, Burghard F; Groneberg, David A
Background There are several ways to conduct a job task analysis in medical work environments including pencil-paper observations, interviews and questionnaires. However these methods implicate bias problems such as high inter-individual deviations and risks of misjudgement. Computer-based observation helps to reduce these problems. The aim of this paper is to give an overview of the development process of a computer-based job task analysis instrument for real-time observations to quantify the job tasks performed by physicians working in different medical settings. In addition reliability and validity data of this instrument will be demonstrated. Methods This instrument was developed in consequential steps. First, lists comprising tasks performed by physicians in different care settings were classified. Afterwards content validity of task lists was proved. After establishing the final task categories, computer software was programmed and implemented in a mobile personal computer. At least inter-observer reliability was evaluated. Two trained observers recorded simultaneously tasks of the same physician. Results Content validity of the task lists was confirmed by observations and experienced specialists of each medical area. Development process of the job task analysis instrument was completed successfully. Simultaneous records showed adequate interrater reliability. Conclusion Initial results of this analysis supported the validity and reliability of this developed method for assessing physicians' working routines as well as organizational context factors. Based on results using this method, possible improvements for health professionals' work organisation can be identified. PMID:19094213
Boulet, John R.; McKinley, Danette W.; Rebbecchi, Thomas; Whelan, Gerald P.
The ECFMG[R] Clinical Skills Assessment (CSA[R]) was developed to evaluate whether graduates of international medical schools are ready to enter graduate training programs in the United States. The performance-based patient note exercise is specifically used to assess an examinee's ability to summarize, synthesize and interpret the data collected…
Bekkink, Marleen Olde; Donders, Rogier; van Muijen, Goos N. P.; Ruiter, Dirk J.
Until now, positive effects of assessment at a medical curriculum level have not been demonstrated. This study was performed to determine whether an interim assessment, taken during a small group work session of an ongoing biomedical course, results in students' increased performance at the formal course examination. A randomized controlled trial…
Gaspar, Maria Filomena; Pinto, Anabela Mota; da Conceicao, Hugo Camilo F.; da Silva, Jose Antonio Pereira
The purpose of this study was to develop a teaching quality assessment questionnaire and assess its reliability by using it with a sample of first-year medical students. Principal components analysis with varimax orthogonal rotation resulted in the development of a 12-item, two-component tool, adequate for use in lectures and small-group sessions.…
The Medical University of South Carolina`s vision is to become the premier national resource for medical information and for environmental/health risk assessment. A key component to the success of the many missions of the Environmental Hazards Assessment Program (EHAP) is timely access to large volumes of data. This study documents the results of the needs assessment effort conducted to determine the information access and processing requirements of EHAP. This report addresses the Department of Environmental Health Science, education and training initiative.
Geskin, Albert; Legowski, Elizabeth; Chakka, Anish; Chandran, Uma R; Barmada, M. Michael; LaFramboise, William A.; Berg, Jeremy; Jacobson, Rebecca S.
Next Generation Sequencing (NGS) methods are driving profound changes in biomedical research, with a growing impact on patient care. Many academic medical centers are evaluating potential models to prepare for the rapid increase in NGS information needs. This study sought to investigate (1) how and where sequencing data is generated and analyzed, (2) research objectives and goals for NGS, (3) workforce capacity and unmet needs, (4) storage capacity and unmet needs, (5) available and anticipated funding resources, and (6) future challenges. As a precursor to informed decision making at our institution, we undertook a systematic needs assessment of investigators using survey methods. We recruited 331 investigators from over 60 departments and divisions at the University of Pittsburgh Schools of Health Sciences and had 140 respondents, or a 42% response rate. Results suggest that both sequencing and analysis bottlenecks currently exist. Significant educational needs were identified, including both investigator-focused needs, such as selection of NGS methods suitable for specific research objectives, and program-focused needs, such as support for training an analytic workforce. The absence of centralized infrastructure was identified as an important institutional gap. Key principles for organizations managing this change were formulated based on the survey responses. This needs assessment provides an in-depth case study which may be useful to other academic medical centers as they identify and plan for future needs. PMID:26115441
Psychometric Properties of the "Aberrant Behavior Checklist," the "Anxiety, Depression and Mood Scale," the "Assessment of Dual Diagnosis" and the "Social Performance Survey Schedule" in Adults with Intellectual Disabilities
Rojahn, Johannes; Rowe, Ellen W.; Kasdan, Shana; Moore, Linda; van Ingen, Daniel J.
Progress in clinical research and in empirically supported interventions in the area of psychopathology in intellectual disabilities (ID) depends on high-quality assessment instruments. To this end, psychometric properties of four instruments were examined: the "Aberrant Behavior Checklist" (ABC), the "Assessment of Dual Diagnosis" (ADD), the…
Williams, Carrie Wehmann; Hounshell, Paul B.
Addresses the dearth of materials in science for the learning disabled student. Suggests some teaching strategies such as a student assignment journal, the usefulness of mnemonics, and incorporating technology such as computers as much as possible. Also discusses classroom organization, assessment strategies, and how to build confidence. (AIM)
Rosenblum, Yonatan; Larochette, Anne-Claire; Harrison, Allyson G.; Armstrong, Irene
Learning Disabilities (LDs) affect a significant number of students in elementary and secondary school. In order for these students, along with parents and teachers, to understand the nature of their specific difficulties, and have equal opportunity in academic settings, a comprehensive psychological report containing properly informed…
Lancioni, Giulio E; O'Reilly, Mark F.; Singh, Nirbhay N.; Pidala, Sara; Piazzolla, Giorgia; Oliva, Doretta; Groeneweg, Jop
One major objective of programs for persons with severe or profound intellectual and multiple disabilities is to teach these persons occupational and vocational tasks and to enable them to carry out these tasks independently (Davis, Brady, Williams, & Burta, 1992; Lancioni et al., 1991; Steed & Lutzker, 1997). The performance of such tasks has…
Park, Yujeong; Benedict, Amber E.; Brownell, Mary T.
The factor structure of the CORE Phonics Survey was analyzed using a sample of 165 students in upper elementary school with specific learning disabilities. Confirmatory factor analysis was used to identify the hypothesized constructs of the CORE Phonics Survey and predictive validity of the CORE Phonics Survey to predict students' success in…
Roeden, John M.; Maaskant, Marian A.; Koomen, Helma M. Y.; Candel, Math J. J. M.; Curfs, Leopold M. G.
Improvements in client-caregiver relationships may lead to improvements in the quality of life of clients with intellectual disabilities (ID). For this reason, interventions aimed at influencing these relationships are important. To gain insight into the nature and intention of these relationships in the ID population, suitable measurement…
Matson, Johnny L.; Hess, Julie A.; Mahan, Sara; Fodstad, Jill C.; Neal, Daniene
Individuals diagnosed with an intellectual disability (ID) share overlapping traits with those diagnosed with both ID and an Autism Spectrum Disorder (ASD). Therefore, the purpose of this study was to determine if caregivers' reports of symptoms of ASD are of value (i.e., when comparing them to clinical diagnoses of ASD) and to determine which…
Alexander, Jeffrey A.; Paustian, Michael; Wise, Christopher G.; Green, Lee A.; Fetters, Michael D.; Mason, Margaret; El Reda, Darline K.
PURPOSE Our goal was to describe an approach to patient-centered medical home (PCMH) measurement based on delineating the desired properties of the measurement relative to assumptions about the PCMH and the uses of the measure by Blue Cross Blue Shield of Michigan (BCBSM) and health services researchers. METHODS We developed and validated an approach to assess 13 functional domains of PCMHs and 128 capabilities within those domains. A measure of PCMH implementation was constructed using data from the validated self-assessment and then tested on a large sample of primary care practices in Michigan. RESULTS Our results suggest that the measure adequately addresses the specific requirements and assumptions underlying the BCBSM PCMH program—ability to assess change in level of implementation; ability to compare across practices regardless of size, affiliation, or payer mix; and ability to assess implementation of the PCMH through different sequencing of capabilities and domains. CONCLUSIONS Our experience illustrates that approaches to measuring PCMH should be driven by the measures’ intended use(s) and users, and that a one-size-fits-all approach may not be appropriate. Rather than promoting the BCBSM PCMH measure as the gold standard, our study highlights the challenges, strengths, and limitations of developing a standardized approach to PCMH measurement. PMID:23690390
Chung, Jae Hoon
Purpose To assess the quality of randomized controlled urological trials conducted by Korean medical institutions. Materials and Methods Quality assessment was conducted by using the Jadad scale; in addition, the van Tulder scale and the Cochrane Collaboration risk of bias tool were used as individual indices. All assessments were performed by two reviewers. If the outcomes differed, the two reviewers and a third reviewer adjusted the discrepancy in the results through discussion. Starting from 1986, a quality analysis of randomized controlled trials (RCTs) was conducted in 1-year and 5-year units. The quality assessment was conducted by subject, type of intervention, presence of double blinding, presence of funding, and review by an Institutional Review Board (IRB). Results Whereas the number of RCTs published has gradually increased, there was no significant difference in the quality of the RCTs according to publication year. Drug studies, double-blind studies, studies with funding, and studies reviewed by IRBs had higher quality scores and a higher percentage of high-quality RCTs than did other studies. Thirty-six RCTs were published in journals included in the Science Citation Index and 20 RCTs were published in journals included in the Science Citation Index Expanded. The largest number of RCTs (32.32%) were published by the Korean Journal of Urology. Conclusions A quantitative increase was observed in RCTs over time, but no qualitative improvement in the RCTs was observed. It seems necessary to put effort into the quality improvement of RCTs at the design stage. PMID:23700493
The Medical University of South Carolina`s vision is to become the premier national resource for medical information and for environmental/health risk assessment. A key component to the success of the many missions of the Environmental Hazards Assessment Program (EHAP) is timely access to large volumes of data. This study documents the results of the needs assessment effort conducted to determine the information access and processing requirement of EHAP. The following topics are addressed in this report: environmental medicine and risk communication: curriculum and a professional support network-Department of Family Medicine; environmental hazards assessment and education program in pharmacy graduate education in risk assessment; and graduate education risk assessment.
Thomas, Adrian; Vaughn, Edwin D.; Doyle, Andrea; Bubb, Robert
The authors assessed 3 of the currently available implicit association tests designed to measure attitudes toward persons with disabilities. The Revised Multiple Disability Implicit Association Test, the Implicit Association Test for Attitudes Toward Athletes With Disabilities, and the Disability Attitude Implicit Association Test were related to…
Rembis, Michael A.
In this article, I offer a brief assessment of the international disability rights and culture movements and disability studies, as well as a commentary on the future of disability and disability studies. A diverse group of activists, artists, and scholars have brought about momentous legal changes in dozens of countries around the world. They…
Kiosses, Dimitris N.; Arean, Patricia A.; Teri, Linda; Alexopoulos, George S.
Objectives This preliminary study examines the efficacy of 12-week home-delivered Problem Adaptation Therapy (PATH) vs. home-delivered Supportive Therapy (ST) in reducing depression and disability in 30 depressed, cognitively impaired, disabled older adults. Design A 12-week randomized clinical trial. Research assistants were unaware of the participants' randomization status. Assessments were conducted at baseline, 6 and 12 weeks. Setting Weill Cornell - Advanced Center for Interventions and Services Research (ACISR). Participants Thirty elders with major depression, cognitive impairment, and disability were recruited through advertisement and the Home-Delivered Meals Program of the Westchester County Department of Senior Programs and Services. Intervention PATH is a home-delivered intervention designed to reduce depression and disability in depressed, cognitively impaired, disabled elders. PATH is based on Problem Solving Therapy (PST) and integrates environmental adaptation and caregiver participation. PATH is consistent with Lawton's ecological model of adaptive functioning in aging. Measurements Depression and disability were measured with Hamilton Depression Rating Scale – 24 items and Sheehan Disability Scale, respectively. Client Satisfaction Questionnaire was used to assess patient satisfaction with treatment. Results Mixed-effects model analyses revealed that PATH was more efficacious than ST in reducing depression and disability at 12 weeks. Participants in both treatment groups were satisfied with treatment. Conclusions This preliminary study suggests that PATH is well accepted and efficacious in depressed elders with major depression, cognitive impairment, and disability. Because this population may not adequately respond to antidepressant medication treatment, PATH may provide relief to many patients who would otherwise remain depressed and suffer. PMID:20808092
de Kuijper, Gerda M; Vrijmoeth, P
Challenging behaviour in patients with intellectual disability may be caused by physical, psychological and environmental factors. In 3 case histories, a multidisciplinary assessment in diagnosis and treatment is shown to be needed. A 48-year-old man with mild intellectual disability presented with cognitive deterioration, aggressive behaviour and physical symptoms. The diagnosis was mood disorder and dissociative symptoms. His functioning improved during and after treatment with psychotropic drugs and non-verbal psychotherapy. A 10-year-old girl with moderate intellectual disability who presented with temper tantrums was diagnosed as having no psychiatric disorder, but symptoms caused by environmental factors. After proper support and education for the parents, the patient's challenging behaviour disappeared. A 61-year-old woman with Down syndrome and Alzheimer's dementia presented with screaming, restlessness, struggling during daily care, and confusion. She was prescribed haloperidol and oxazepam and the screaming behaviour decreased. However, she kept on struggling while being cared for and was restless while sitting in her wheelchair. After a proper medical examination it appeared that the problem behaviour was caused by collapsed vertebrae and osteoporosis. PMID:25492732
... 2013-04-01 2013-04-01 false Medical equivalence for adults and children. 416...DISABLED Determining Disability and Blindness Medical Considerations § 416.926 Medical equivalence for adults and children....
... 2012-04-01 2012-04-01 false Medical equivalence for adults and children. 416...DISABLED Determining Disability and Blindness Medical Considerations § 416.926 Medical equivalence for adults and children....
... 2014-04-01 2014-04-01 false Medical equivalence for adults and children. 416...DISABLED Determining Disability and Blindness Medical Considerations § 416.926 Medical equivalence for adults and children....
Guyer, Barbara P.; Guyer, Kenneth E.
This article discusses the characteristics of the medical students and physicians who have been diagnosed as having learning disabilities and/or attention deficit disorders and suggests appropriate accommodations that should be made by medical schools and testing agencies. The organization Medical H.E.L.P. (Higher Education for Learning Problems)…
Davis, Georgiann; Allison, Rachel
Despite increases in the number of women entering the medical profession during the past four decades, female medical students remain more likely than their male colleagues to enter less prestigious medical specialties. ...
Serong, Julia; Anhäuser, Marcus; Wormer, Holger
A current research project deals with the question of how the quality of medical health information changes on its way from the academic journal via press releases to the news media. In an exploratory study a sample of 30 news items has been selected stage-by-stage from an adjusted total sample of 1,695 journalistic news items on medical research in 2013. Using a multidimensional set of criteria the news items as well as the corresponding academic articles, abstracts and press releases are examined by science journalists and medical experts. Together with a content analysis of the expert assessments, it will be verified to what extent established quality standards for medical journalism can be applied to medical health communication and public relations or even to studies and abstracts as well. PMID:26028455
Stroke is a major cause of disability and death worldwide. Although different clinical studies and trials used Magnetic Resonance Imaging (MRI) to examine patterns of change in different imaging modalities (eg: perfusion ...
Physical disability is an enormous psychosocio-economic-medical problem that affects over 24 million Americans. Public policy endorses a multi-disciplinary approach in analyzing this issue. Legislation has broadened the meaning of physical disability to include persons with mental and emotional disorders. Some of the costs associated with physical…
Recommendations of the German Society for Medical Education and the German Association of Medical Faculties regarding university-specific assessments during the study of human, dental and veterinary medicine.
Jünger, Jana; Just, Ingo
The practice of assessing student performance in human, dental and veterinary medicine at universities in German-speaking countries has undergone significant changes in the past decade. Turning the focus to practical requirements regarding medical practice during undergraduate study away from an often theory-dominated curriculum, the academic scrutiny of the basics of teaching medical knowledge and skills, and amendments to legislation, all require ongoing adjustments to curricula and the ways in which assessments are done during undergraduate medical education. To establish quality standards, the Gesellschaft für medizinische Ausbildung (GMA German Society for Medical Education) reached a consensus in 2008 on recommendations for administering medical school-specific exams which have now been updated and approved by the GMA assessments committee, together with the Medizinischer Fakultätentag (MFT German Association of Medical Faculties), as recommendations for the administration of high-quality assessments. PMID:25228936
Miller, Eva; Chen, Roy; Glover-Graf, Noreen M.; Kranz, Peter
This study examined the willingness of persons without disabilities (PWODs) to engage in personal relationships with persons with disabilities (PWDs). Participants (N = 305) were primarily female Hispanic students (91%) preparing for careers in the helping professions. The "Relationships and Disability Survey" assessed the effect of the category…
McKenzie, Karen; Michie, Amanda; Murray, Aja; Hales, Charlene
The study assessed the validity of an intellectual disability screening tool, the Learning Disability Screening Questionnaire (LDSQ), in three forensic settings: a community intellectual disability forensic service; a forensic in-patient secure unit and a prison, using data for 94 individuals. A significant positive relationship was found between…
Background One of the major challenges in the current century is the increasing number of post-conflict states where infrastructures are debilitated. The dysfunctional health care systems in post-conflict settings are putting the lives of the populations in these zones at increased risk. One of the approaches to improve such situations is to strengthen human resources by organizing training programmes to meet the special needs in post-conflict zones. Evaluations of these training programmes are essential to assure effectiveness and adaptation to the health service needs in these conditions. Methods A specialized qualitative evaluation was conducted to assess and improve a post-conflict continuing medical education (CME) programme that was conducted in Nagorno Karabagh. Qualitative research guides were designed for this post-conflict zone that included focus group discussions with physician programme participants and semi-structured in-depth interviews with directors of hospitals and training supervisors. Results Saturation was achieved among the three participating groups in the themes of impact of participation in the CME and obstacles to application of obtained skills. All respondents indicated that the continuing medical education programme created important physician networks absent in this post-conflict zone, updated professional skills, and improved professional confidence among participants. However, all respondents indicated that some skills gained were inapplicable in Nagorno Karabagh hospitals and clinics due to lack of appropriate medical equipment, qualified supporting human resources and facilities. Conclusion The qualitative research methods evaluation highlighted the fact that the health care human resources training should be closely linked to appropriate technologies, supplies, facilities and human resources available in post-conflict zones and identified the central importance of creating health professional networks and professional confidence among physicians in these zones. The qualitative research approach most effectively identifies these limitations and strengths and can directly inform the optimal adjustments for effective CME planning in these difficult areas of greatest need. PMID:25096177
Witticke, Diana; Seidling, Hanna Marita; Klimm, Hans-Dieter; Haefeli, Walter Emil
Background: The aim of this pilot study was to evaluate patients’ self-reported attitudes towards medication-related factors known to impair adherence and to assess their prevalence in ambulatory care as an essential prerequisite to improve patient adherence. Methods: We conducted a face-to-face interview with 110 primary care patients maintained on at least one drug. For each drug, the patient was asked to specify medication-related factors of interest, ie, dosage form, dosage interval, required relationship with food intake, and the planned time of day for intake, and to rate the individual relevance of each prevalent parameter on a three-point Likert scale (discriminating between prefer, neutral, and dislike). Results: Tablets with a once-daily dosage frequency were the most preferred dosage form, with a high prevalence in the ambulatory setting. Drug intake in the morning and evening were most preferred, and drug intake at noon was least preferred, but also had a low prevalence in contrast with drug intake independent of meals that was most preferred. Interestingly, only one quarter (26.4%) of all the patients were able to indicate clear preferences or dislikes. Conclusion: When patients are asked to specify their preferences for relevant medication regimen characteristics, they clearly indicated regimens that have been associated with better adherence in earlier studies. Therefore, our results suggest that adaptation of drug regimens to individual preferences might be a promising strategy to improve adherence. Because the German health care system may differ from other systems in relevant aspects, our findings should be confirmed by evaluation of patient preferences in other health care systems. Once generalizability of the study results is shown, these findings could be a promising basis upon which to promote patient adherence right from the beginning of drug therapy. PMID:23055701
... understand risks and make plans and decisions. Social: Nutrition programs can reduce disability associated with malnutrition. Early intervention in situations involving abuse and poverty will also help. Toxic: Preventing exposure to lead, ...
Marten, Lisa R; Chow, Dominic C; Valcour, Nicole A; Shikuma, Cecilia M
To assess HIV medical care needs in Hawai'i, data was collected through surveys of both providers and consumers, from insurance companies, from the Department of Health, and from key programs who serve the HIV-infected population. HIV care in Hawai'i is provided through a mix of private, public and charitable sources, with most ancillary services provided separately by AIDS Service Organizations. Private providers with a specialty in HIV care are not being replaced at the rate which they retire or depart. Heavy reliance on public assistance to pay for care and patient characteristics such as substance abuse, limit choice of providers for some patients. Institutions are playing a greater role in filling patient care needs. It was found that most patients in care are highly satisfied with their care providers. People living with HIV who are not in care are likely to have multiple challenges which affect access to care such as homelessness, poverty, low levels of education, being of Asian Pacific Islander ethnicity, and receiving public assistance. Those who adhere to their medication are most likely to be employed and to have received counseling by a pharmacist, while those who are from Hawai'i and who were infected through injection drug use are less likely to be adherent. Supporting more than one provider option and linking with ancillary services may help keep HIV patients in care. PMID:19583108
Dowers, Kristy L; Schoenfeld-Tacher, Regina M; Hellyer, Peter W; Kogan, Lori R
The ethics document of the Association of American Veterinary Medical Colleges provides guiding principles for veterinary schools to develop conflict of interest policies. These policies regulate faculty and student interactions with industry, potentially reducing the influence companies have on students' perceptions and future prescribing practices. This paper examines the implementation of a conflict of interest policy and related instructional activities at one veterinary college in the US. To inform policy and curricular development, survey data were collected regarding veterinary students' attitudes toward pharmaceutical marketing, including their perceptions of their own susceptibility to bias in therapeutic decisions. Responses from this group of students later served as control data for assessing the effectiveness of educational programs in the content area. A conflict of interest policy was then implemented and presented to subsequent classes of entering students. Classroom instruction and relevant readings were provided on ethics, ethical decision making, corporate influences, and the issue of corporate influence in medical student training. Within seven days of completing a learning program on conflict of interest issues, another cohort of veterinary students (the treatment group) were administered the same survey that had been administered to the control group. When compared with the control group who received no instruction, survey results for the treatment group showed moderate shifts in opinion, with more students questioning the practice of industry-sponsored events and use of corporate funds to reduce tuition. However, many veterinary students in the treatment group still reported they would not be personally influenced by corporate gifts. PMID:25526761
Melville, John D; Kellogg, Nancy D; Perez, Nadia; Lukefahr, James L
The purpose of this study was to describe behavioural and emotional symptoms and to examine the effect of abuse-related factors, family responses to disclosure, and child self-blame on these symptoms in children presenting for medical evaluations after disclosure of sexual abuse. A retrospective review was conducted of 501 children ages 8-17. Trauma symptoms were determined by two sets of qualitative measures. Abstracted data included gender, ethnicity, and age; severity of abuse and abuser relationship to child; child responses regarding difficulty with sleep, school, appetite/weight, sadness, or self-harm, parent belief in abuse disclosure, and abuse-specific self-blame; responses to the Trauma Symptom Checklist in Children-Alternate; and the parent's degree of belief in the child's sexual abuse disclosure. Overall, 83% of the children had at least one trauma symptom; 60% had difficulty sleeping and one-third had thoughts of self-harm. Child age and abuse severity were associated with 3 of 12 trauma symptoms, and abuse-specific self-blame was associated with 10 trauma symptoms, after controlling for other variables. The children of parents who did not completely believe the initial disclosure of abuse were twice as likely to endorse self-blame as children of parents who completely believed the initial disclosure. Screening for behavioural and emotional problems during the medical assessment of suspected sexual abuse should include assessment of self-blame and family responses to the child's disclosures. In addition, parents should be informed of the importance of believing their child during the initial disclosure of abuse and of the impact this has on the child's emotional response to the abuse. PMID:24630439
Schluederberg, A; Straus, S E; Peterson, P; Blumenthal, S; Komaroff, A L; Spring, S B; Landay, A; Buchwald, D
A workshop was held 18 to 19 March 1991 at the National Institutes of Health to address critical issues in research concerning the chronic fatigue syndrome (CFS). Case definition, confounding diagnoses, and medical outcome assessment by laboratory and other means were considered from the perspectives of key medical specialties involved in CFS research. It was recommended that published Centers for Disease Control (CDC) case-definition criteria be modified to exclude fewer patients from analysis because of a history of psychiatric disorder. Specific recommendations were made concerning the inclusion or exclusion of other major confounding diagnoses, and a standard panel of laboratory tests was specified for initial patient evaluation. The workshop emphasized the importance of recognizing other conditions that could explain the patient's symptoms and that may be treatable. It was viewed as essential for the investigator to screen for psychiatric disorder using a combination of self-report instruments followed by at least one structured interview to identify patients who should be excluded from studies or considered as a separate subgroup in data analysis. Because CFS is not a homogeneous abnormality and because there is no single pathogenic mechanism, research progress may depend upon delineation of these and other patient subgroups for separate data analysis. Despite preliminary data, no physical finding or laboratory test was deemed confirmatory of the diagnosis of CFS. For assessment of clinical status, investigators must rely on the use of standardized instruments for patient self-reporting of fatigue, mood disturbance, functional status, sleep disorder, global well-being, and pain. Further research is needed to develop better instruments for quantifying these domains in patients with CFS. PMID:1322076
Background Prior to the antiretroviral (ARV) drug roll out in 2004, people living with HIV (PLHIV) in South Africa received disability grants when they were defined as "AIDS-sick". In the absence of available and effective medication, a diagnosis of AIDS portended disability. The disability grant is a critical component of South Africa's social security system, and plays an important role in addressing poverty among PLHIV. Given the prevalence of unemployment and poverty, disability grants ensure access to essential resources, like food, for PLHIV. Following the ARV roll out in South Africa, PLHIV experienced improved health that, in turn, affected their grant eligibility. Our aim is to explore whether PLHIV reduced or stopped treatment to remain eligible for the disability grant from the perspectives of both PLHIV and their doctors. Methods A mixed-methods design with concurrent triangulation was applied. We conducted: (1) in-depth semi-structured interviews with 29 PLHIV; (2) in-depth semi-structured interviews with eight medical doctors working in the public sector throughout the Cape Peninsula; (3) three focus group discussions with programme managers, stakeholders and community workers; and (4) a panel survey of 216 PLHIV receiving ARVs. Results Unemployment and poverty were the primary concerns for PLHIV and the disability grant was viewed as a temporary way out of this vicious cycle. Although loss of the disability grant significantly affected the well-being of PLHIV, they did not discontinue ARVs. However, in a number of subtle ways, PLHIV "tipped the scales" to lower the CD4 count without stopping ARVs completely. Grant criteria were deemed ad hoc, and doctors struggled to balance economic and physical welfare when assessing eligibility. Conclusions It is crucial to provide sustainable economic support in conjunction with ARVs in order to make "positive living" a reality for PLHIV. A chronic illness grant, a basic income grant or an unemployment grant could provide viable alternatives when the PLHIV are no longer eligible for a disability grant. PMID:22340659
Background The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. Methods A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. Results The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. Conclusions There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders. PMID:23110397
BORAH, BIJAN J.; BASU, ANIRBAN
The quantile regression (QR) framework provides a pragmatic approach in understanding the differential impacts of covariates along the distribution of an outcome. However, the QR framework that has pervaded the applied economics literature is based on the conditional quantile regression method. It is used to assess the impact of a covariate on a quantile of the outcome conditional on specific values of other covariates. In most cases, conditional quantile regression may generate results that are often not generalizable or interpretable in a policy or population context. In contrast, the unconditional quantile regression method provides more interpretable results as it marginalizes the effect over the distributions of other covariates in the model. In this paper, the differences between these two regression frameworks are highlighted, both conceptually and econometrically. Additionally, using real-world claims data from a large US health insurer, alternative QR frameworks are implemented to assess the differential impacts of covariates along the distribution of medication adherence among elderly patients with Alzheimer’s disease. PMID:23616446
Sullivan, Julie M.; Prasanna, Pataje G. S.; Grace, Marcy B.; Wathen, Lynne; Wallace, Rodney L.; Koerner, John F.; Coleman, C. Norman
Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual’s radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual’s dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a stand-alone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, we reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point. PMID:24162058
Wagner, Robert F.; Beiden, Sergey V.; Campbell, Gregory; Metz, Charles E.; Sacks, William M.
The dialog among investigators in academia, industry, NIH, and the FDA has grown in recent years on topics of historic interest to attendees of these SPIE sub-conferences on Image Perception, Observer Performance, and Technology Assessment. Several of the most visible issues in this regard have been the emergence of digital mammography and modalities for computer-assisted detection and diagnosis in breast and lung imaging. These issues appear to be only the "tip of the iceberg" foreshadowing a number of emerging advances in imaging technology. So it is timely to make some general remarks looking back and looking ahead at the landscape (or seascape). The advances have been facilitated and documented in several forums. The major role of the SPIE Medical Imaging Conferences i well-known to all of us. Many of us were also present at the Medical Image Perception Society and co-sponsored by CDRH and NCI in September of 2001 at Airlie House, VA. The workshops and discussions held at that conference addressed some critical contemporary issues related to how society - and in particular industry and FDA - approach the general assessment problem. A great deal of inspiration for these discussions was also drawn from several workshops in recent years sponsored by the Biomedical Imaging Program of the National Cancer Institute on these issues, in particular the problem of "The Moving Target" of imaging technology. Another critical phenomenon deserving our attention is the fact that the Fourth National Forum on Biomedical Imaging in Oncology was recently held in Bethesda, MD., February 6-7, 2003. These forums are presented by the National Cancer Institute (NCI), the Food and Drug Administration (FDA), the Centers for Medicare and Medicaid Services (CMS), and the National Electrical Manufacturers Association (NEMA). They are sponsored by the National Institutes of Health/Foundation for Advanced Education in the Sciences (NIH/FAES). These forums led to the development of the NCI"s Interagency Council on Biomedical Imaging in Oncology (ICBIO) about two and a half years ago. The purpose of the ICBIO is to assist developers of new imaging technologies for cancer screening and diagnosis to find a coherent way to interface with government agencies with responsibilities in these areas. A recent product of these activities was an overview paper written by the present authors and published this year in the Journal Academic Radiology (2). The paper includes a summary of some of the major developments in assessment methodology in recent years and includes several case studies from the public forum of the FDA"s Center for Devices & Radiological Health (CDRH). We will include a brief sketch of some of the key issues of that paper in this review.
AbouZahr, C.; Vaughan, J. P.
The use of the disability-adjusted life year (DALY) as the unit in which to calculate the burden of disease associated with reproductive ill-health has given rise to considerable debate. Criticisms include the failure to address the problem of missing and inadequate epidemiological data, inability to deal adequately with co-morbidities, and lack of transparency in the process of ascribing disability weights to sexual and reproductive health conditions. Many of these criticisms could be addressed within the current DALY framework and a number of suggestions to do so are made. These suggestions include: (1) developing an international research strategy to determine the incidence and prevalence of reproductive ill-health and diseases, including the risk of long-term complications; (2) undertaking a research strategy using case studies, population-based surveillance data and longitudinal studies to identify, evaluate and utilize more of the existing national data sources on sexual and reproductive health; (3) comprehensively mapping the natural history of sexual and reproductive health conditions--in males and in females--and their sequelae, whether physical or psychological; (4) developing valuation instruments that are adaptable for both chronic and acute health states, that reflect a range of severity for each health state and can be modified to reflect prognosis; (5) undertaking a full review of the DALY methodology to determine what changes may be made to reduce sources of methodological and gender bias. Despite the many criticisms of the DALY as a measurement unit, it represents a major conceptual advance since it permits the combination of life expectancy and levels of dysfunction into a single measure. Measuring reproductive ill-health by counting deaths alone is inadequate for a proper understanding of the dimensions of the problem because of the young age of many of the deaths associated with reproductive ill-health and the large component of years lived with disability from many of the associated conditions. PMID:10859859
Bijol, Vanesa; Byrne-Dugan, Cathryn J.; Hoenig, Melanie P.
Background Web-based formative assessment tools have become widely recognized in medical education as valuable resources for self-directed learning. Objectives To explore the educational value of formative assessment using online quizzes for kidney pathology learning in our renal pathophysiology course. Methods Students were given unrestricted and optional access to quizzes. Performance on quizzed and non-quizzed materials of those who used (‘quizzers’) and did not use the tool (‘non-quizzers’) was compared. Frequency of tool usage was analyzed and satisfaction surveys were utilized at the end of the course. Results In total, 82.6% of the students used quizzes. The greatest usage was observed on the day before the final exam. Students repeated interactive and more challenging quizzes more often. Average means between final exam scores for quizzed and unrelated materials were almost equal for ‘quizzers’ and ‘non-quizzers’, but ‘quizzers’ performed statistically better than ‘non-quizzers’ on both, quizzed (p=0.001) and non-quizzed (p=0.024) topics. In total, 89% of surveyed students thought quizzes improved their learning experience in this course. Conclusions Our new computer-assisted learning tool is popular, and although its use can predict the final exam outcome, it does not provide strong evidence for direct improvement in academic performance. Students who chose to use quizzes did well on all aspects of the final exam and most commonly used quizzes to practice for final exam. Our efforts to revitalize the course material and promote learning by adding interactive online formative assessments improved students’ learning experience overall. PMID:25833824
Zhang, Shixuan; Kriza, Christine; Kolominsky-Rabas, Peter L
The objective of this paper is to provide a systematic overview of the Chinese medical device registration processes, identify challenges and suggest how these can be addressed. In addition, the paper will outline the impact of new policies and regulations since the restructuring of the China FDA. A systematic review was performed for journal articles between the year of 2009 and 2013 in the following databases: PubMed, ScienceDirect and Zhongguozhiwang. The review has identified 184 papers which were potentially relevant. Seventeen articles were included in the review, which highlights the challenges and opportunities related to the medical device registration process. In order to understand the actual impact of the regulation environment and its policies including the lack of regulatory guidance regular assessment updates are crucial. The results of this paper are aimed at informing regulatory bodies, health policy decision makers, national and international Health Technology Assessment networks as well as medical devices manufacturers. PMID:25060514
Dixon, Brian E; Jabour, Abdulrahman M; Phillips, Erin O'Kelly; Marrero, David G
The aim of this study was to describe an integrated informatics approach to aggregating and displaying clinically relevant data that can identify problems with medication adherence and facilitate patient–provider communication about strategies to improve medication use. We developed a clinical dashboard within an electronic health record (EHR) system that uses data from three sources: the medical record, pharmacy claims, and a personal health record. The data are integrated to inform clinician–patient discussions about medication adherence. Whereas prior research on assessing patterns of medication adherence focused on a single approach using the EHR, pharmacy data, or patient-entered data, we present an approach that integrates multiple electronic data sources increasingly found in practice. Medication adherence is a complex challenge that requires patient and provider team input, necessitating an integrated approach using advanced EHR, clinical decision support, and patient-controlled technologies. Future research should focus on integrated strategies to provide patients and providers with the right combination of informatics tools to help them adequately address the challenge of adherence to complex medication therapies. PMID:24076751
Loue, Sana; Wilson-Delfosse, Amy; Limbach, Kristen
Physicians and other health care workers are increasingly being called upon to bridge the cultural differences that may exist between themselves and their patients. Adequate cross-cultural education is essential if existing health care disparities are to be reduced. We conducted a needs assessment to identify gaps in the cultural competence/sensitivity components of the undergraduate medical school curriculum at Case Western Reserve University School of Medicine. The 2011 study was designed (1) to assess how first and second year medical school students perceive the adequacy of the medical school curriculum with respect to issues of diversity and (2) the extent to which first and second year medical students believe that an understanding of issues relating to patient culture are important to the provision of effective patient care. Student perspectives were assessed through a web-based anonymous survey of all first year (n = 167) and all second year (n = 166) medical school students, two focus groups (total n = 14) and a Problem-based Case Inquiry Group exercise (n = 6), both with second year students. A substantial proportion of participating first and second year medical students do not believe that self-reflection regarding one's own cultural biases is important to one's performance as a physician, do not view an understanding of diverse patient cultural beliefs as important or very important in the provision of effective patient care, and are uncomfortable with and unsure about how to approach culture-related issues arising in patient care. The inclusion of specified elements-increased contact with diverse patients, more comprehensive resources, increased opportunities to practice communication skills and engage in self-reflection-may be critical to heighten student awareness of and comfort in interacting with diverse populations. Our findings are relevant to the development of medical school curricula designed to improve physician understanding of and responsiveness to diverse patient populations and efforts to reduce health disparities. PMID:25225077
Prathibha Varkey; Sudhakar Karlapudi; Steven Rose; Steve Swensen
Graduate medical education (GME) has traditionally focused on the diagnosis and management of disease with little attention devoted to patient safety and systems thinking. In this article, we describe the results of a needs assessment conducted to develop a patient safety curriculum for GME. Eight program directors, 10 patient safety experts, and 9 experts in education technology were interviewed for
Hein, Andreas; Steen, Enno-Edzard; Thiel, Andreas; Hülsken-Giesler, Manfred; Wist, Thorben; Helmer, Axel; Frenken, Thomas; Isken, Melvin; Schulze, Gisela C; Remmers, Hartmut
This article describes the results of field studies performed over a period between five months and 24 months. The objectives of these studies were to collect long-term real-life data to evaluate how these data can be mapped to items on standardized assessment tests and which presentation method is most suitable to inform caregivers about critical situations and changes in health or care needs. A Home-monitoring system which uses modern sensor technologies was developed for and used in these field studies. It was installed in living environments of seven people (three who were not in need of care, two in need of care, and two with mental disabilities). The data were generated by sensor data acquisition and questionnaire reporting. Four types of data analysis and representation were evaluated to support caregivers. Results show that sensor data can be used to determine information directly or indirectly, which can be mapped to relevant assessment items and presented with different degrees of granularity. It is also feasible to determine and present additional information of potential interest which cannot be directly mapped to any assessment item. Sensor data can also be displayed in a live view. This live data representation led to a decrease in the caregivers' workload when assessed according to the German version of the Perceived Stress Questionnaire. PMID:25148558
Zaorsky, Nicholas G.; Malatesta, Theresa M.; Den, Robert B.; Wuthrick, Evan; Ahn, Peter H.; Werner-Wasik, Maria; Shi, Wenyin; Dicker, Adam P.; Anne, P. Rani; Bar-Ad, Voichita [Department of Radiation Oncology, Jefferson Medical College, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States); Showalter, Timothy N., E-mail: email@example.com [Department of Radiation Oncology, Jefferson Medical College, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)
Purpose: Few medical students are given proper clinical training in oncology, much less radiation oncology. We attempted to assess the value of adding a radiation oncology clinical rotation to the medical school curriculum. Methods and Materials: In July 2010, Jefferson Medical College began to offer a 3-week radiation oncology rotation as an elective course for third-year medical students during the core surgical clerkship. During 2010 to 2012, 52 medical students chose to enroll in this rotation. The rotation included outpatient clinics, inpatient consults, didactic sessions, and case-based presentations by the students. Tests of students' knowledge of radiation oncology were administered anonymously before and after the rotation to evaluate the educational effectiveness of the rotation. Students and radiation oncology faculty were given surveys to assess feedback about the rotation. Results: The students' prerotation test scores had an average of 64% (95% confidence interval [CI], 61-66%). The postrotation test scores improved to an average of 82% (95% CI, 80-83%; 18% absolute improvement). In examination question analysis, scores improved in clinical oncology from 63% to 79%, in radiobiology from 70% to 77%, and in medical physics from 62% to 88%. Improvements in all sections but radiobiology were statistically significant. Students rated the usefulness of the rotation as 8.1 (scale 1-9; 95% CI, 7.3-9.0), their understanding of radiation oncology as a result of the rotation as 8.8 (95% CI, 8.5-9.1), and their recommendation of the rotation to a classmate as 8.2 (95% CI, 7.6-9.0). Conclusions: Integrating a radiation oncology clinical rotation into the medical school curriculum improves student knowledge of radiation oncology, including aspects of clinical oncology, radiobiology, and medical physics. The rotation is appreciated by both students and faculty.
Simon Darcy; Tracy Taylor
Research on disability and cultural life (the arts, leisure, recreation, sport and tourism) in the Australian context has largely been captured by medical approaches to disability. In contrast, this paper takes direction from social approaches to disability that place the experience of people with disabilities (PwD) at the centre of the research paradigm by examining this population’s human rights’ experiences.
Williams, Dorothy T.; Hershenson, David B.; Fabian, Ellen S.
Study found significant relationships between casual attributions of disabilities and the rehabilitation approach chosen. Attributions to fate correlated with accepting the disability as one's lot in life. Attributions to natural or medical causes correlated with choosing medical or retraining services; Attributions to societally imposed barriers…
Gleeson, Joseph G.
CERTIFICATION OF HEALTH CARE PROVIDER FOR EMPLOYEE'S PREGNANCY DISABILITY California Pregnancy to a disability resulting from her pregnancy, childbirth, or related medical condition which may qualify to submit a timely, complete, and sufficient medical certification to support your request for pregnancy
Silva, Cláudia Susana Rosa Correia da Rocha E; Silva, Filipe Miguel Glória E; Martins, Maria Isabel Pavão
Reading disabilities are one of the most significant causes of school failure and may result from different causes and cognitive processes. A comprehensive battery of neuropsychological tests was applied to a control group of 102 children (46 girls, 56 boys) with no history of learning disabilities and 32 children (13 girls, 19 boys) with poor reading achievement (PRA) to characterize their cognitive profile. A principal component analysis of the cognitive measures was undertaken to identify cognitive domains. Age-adjusted normative data were computed from controls for verbal and visuospatial abilities, psychomotor skills, executive functions, and a total score. Significant differences were found between the 2 groups. Although single tests could not identify children with PRA, measures of oral and written language, immediate and working memory, calculation, and verbal learning discriminated the 2 groups. A logistic regression model using these factors allowed us to identify 91.2% of healthy children and 96.9% of children with PRA. PRA may result from different patterns of cognitive difficulties, and it is more common in children with oral language and working-memory deficits. Wide-range cognitive testing is necessary to identify strong and weak areas to plan personalized intervention programs. PMID:25117206
Waller, Ed; Wilkinson, Diana
After a radiological dispersal device (RDD) event, it is possible for radionuclides to enter the human body through inhalation, ingestion, and skin and wound absorption. From a health physics perspective, it is important to know the magnitude of the intake to perform dosimetric assessments. From a medical perspective, removal of radionuclides leading to dose aversion (hence risk reduction) is of high importance. The efficacy of medical decorporation strategies is extremely dependent upon the time of treatment delivery after intake. The "golden hour," or more realistically 3-4 h, is optimal when attempting to increase removal of radionuclides from extracellular fluids prior to cellular incorporation. To assist medical first response personnel in making timely decisions regarding appropriate treatment delivery modes, it is desirable to have a software tool that compiles existing radionuclide decorporation therapy data and allows a user to perform simple diagnosis leading to optimized decorporation treatment strategies. In its most simple application, the software is a large database of radionuclide decorporation strategies and treatments. The software can also be used in clinical interactive mode, in which the user inputs the radionuclide, estimated activity, route of intake and time since exposure. The software makes suggestions as to the urgency of treatment (i.e., triage) and the suggested therapy. Current developments include risk assessment which impacts the potential risk of delivered therapy and resource allocation of therapeutic agents. The software, developed for the Canadian Department of National Defence (DND), is titled MEDECOR (MEdical DECORporation). The MEDECOR tool was designed for use on both personal digital assistant and laptop computer environments. The tool was designed using HTML/Jscript, to allow for ease of portability amongst different computing platforms. This paper presents the features of MEDECOR, results of testing at a major NATO exercise, and future development of this tool into MEDECOR2. PMID:20838103
Can You Know Me Better? An Exploratory Study Combining Behavioural and Physiological Measurements for an Objective Assessment of Sensory Responsiveness in a Child with Profound Intellectual and Multiple Disabilities
Lima, Mariely; Silva, Karine; Magalhaes, Ana; Amaral, Isabel; Pestana, Helena; de Sousa, Liliana
Background: Sensory assessment of individuals with profound intellectual and multiple disabilities (PIMD) can be difficult for several reasons, including the idiosyncratic reactions that these individuals exhibit to environmental stimuli. This case report presents a combination of behavioural and physiological measurements aimed at providing an…
The report defines and characterizes types of medical waste, discusses the impacts of burning medical waste on combustor emissions, and outlines important handling and operating considerations. Facility-specific design, handling, and operating practiced are also discussed for mun...
The Commissioner of Social Security will conduct a demonstration project to test how certain altered resources counting rules might apply in the SSI program. The SSI program is authorized by title XVI of the Social Security Act (the Act). The rules which will be tested are those that apply to the treatment of cash received and conserved to pay for medical or social services. Cash which is received for the purposes of payment for medical or social services is not counted as income to the beneficiary when received. If cash received for medical or social services which is not a reimbursement for these services already paid for by the beneficiary is conserved, it is not counted as a resource for the calendar month following the month of receipt, so long as it remains separately identifiable from other resources of the individual. Beginning with the second calendar month following the month of receipt, cash received for the payment of medical or social services becomes a countable resource used in the determination of SSI eligibility. The Health Care Financing Administration of the Department of Health and Human Services (DHHS) is collaborating with the States of Arkansas, Florida, New Jersey and New York and with the National Program Office at the University of Maryland's Center on Aging, the Robert Wood Johnson Foundation, the Office of the Assistant Secretary for Planning and Evaluation of the DHHS, the National Council on Aging and Mathematica Policy Research (the evaluator) on a demonstration project to provide greater autonomy to the consumers of personal assistance services. Personal assistance services are help with the basic activities of daily living, including bathing, dressing, transferring, toileting, and eating, and/or instrumental activities of daily living such as housekeeping, meal preparation, shopping, laundry, money management and medication management. Consumers of personal assistance services who participate in this demonstration will be empowered by purchasing the services they require (including medical and social services) to perform the activities of daily living. In order to accomplish the objective of the demonstration project, cash allowances and information services will be provided directly to persons with disabilities to enable them to choose and purchase services from providers which they feel would best meet their needs. Medicaid is the predominant source of public financing for personal assistance services programs for the aged, blind and disabled. The demonstration which will permit the States of Arkansas, Florida, New Jersey and New York to waive certain requirements under title XIX of the Act to participate in this "Cash and Counseling" demonstration is within the authority granted to the Secretary of Health and Human Services (HHS) by section 1115 of the Act. Medicaid beneficiaries who participate in this demonstration will be given cash to purchase the services they need from traditional and nontraditional providers as they deem appropriate. Counseling will be available for these beneficiaries to assist them in effective use of funds allotted for personal assistance services. Many of the Medicaid beneficiaries who participate in the Cash and Counseling demonstration will be SSI beneficiaries or belong to coverage groups using eligibility methodologies related to those of the SSI program under title XIX of the Act. The Commissioner of Social Security wishes to test the appropriateness of current SSI rules which require counting cash received for the purchase of medical or social services as resources if retained for more than one month after the month of receipt. The test will also be used to assist the Secretary of HHS in testing the possibility of providing greater autonomy to the consumers of personal assistance services by empowering them to purchase the services they require (including medical and social services) to perform their activities of daily living. (ABSTRACT TRUNCATED) PMID:10185853
Rogers, Mary E.; Creed, Peter A.; Searle, Judy
The demands placed on medical trainees by the different specialty training programs are important considerations when choosing a medical specialty. To understand these demands, 193 junior doctors completed a web-based survey, and: (a) ranked medical specialties according to perceived level of training difficulty (incorporating entry difficulty,…
S Schneeweiss; J J Gagne; R J Glynn; M Ruhl; J A Rassen
Comparative-effectiveness research (CER) aims to produce actionable evidence regarding the effectiveness and safety of medical products and interventions as they are used outside of controlled research settings. Although CER evidence regarding medications is particularly needed shortly after market approval, key methodological challenges include (i) potential bias due to channeling of patients to the newly marketed medication because of various patient-,
Newsome, L. R.
A study examined the pattern and organization of services for disabled persons in New Zealand. As of 1981, there were between 250,000 and 280,000 disabled persons in New Zealand. The Accident Compensation Act of 1972 provides compensation for up to 80 percent of previous earnings, medical and dental treatment costs, and rehabilitation and training…
Peach, H; Charlton, J R
A survey in a London borough showed that 15% of adults living at home were restricted in one or more areas of their lives because of illness. A sample of these adults aged 25 to 75 years was interviewed using a validated medical questionnaire, and the severity of their restrictions was also assessed using a separate instrument. Many symptoms were found which had not been reported to a doctor and many were not being treated. When the disability scores were regressed on symptoms classified as reported to a doctor, unreported, or absent, with a few exceptions it was the reported symptoms that were significantly associated with disability. Similarly, when symptoms were classified as treated (by doctor or respondent), untreated, or absent, treated symptoms were associated with disability. Some disabling symptoms were similar to the effects, mainly adverse, of commonly prescribed drugs, and these symptoms were reported more frequently by respondents taking the possible offending drug than by those not taking the drug. It appears that making general practitioners aware of unreported and untreated symptoms among their 25 to 75 year old patients will not reduce the overall level of disability in the community. However, the iatrogenic component of disability needs to be studied further. PMID:2940310
von Lengerke, Thomas; Kursch, Angelika; Lange, Karin
In the model medical curriculum HannibaL at Hannover Medical School (MHH, Hannover, Germany), communication skills in taking case histories and disclosing diagnoses (breaking bad news) are assessed through an objective structured clinical examination (OSCE). This is part of the examinations which at the MHH represent the equivalent to the First Part of the Medical Examinations. The second year doctor-patient communication course preparing for these examinations was evaluated during the 2009/10 academic year. Using questionnaires specific to the learning objectives, learning needs were assessed, pre-post comparisons of self-assessed competencies were performed and key teaching methods were evaluated (5-point Likert scales, “5”=fully agree). At T0 (start of the course) 267 students participated (response rate: 93.7%), of which 180 filled out the T1 questionnaire during the last session of the course (67.4%). Within-subject analyses of variance and paired t-tests were conducted. The highest learning needs were found for the “to show how”-items regarding history taking and disclosing diagnoses (M=4.4). The T1-T0 comparisons showed the greatest improvements for history taking (“to know how”: mean difference = +1.7, “to show how”: +1.8, p<.0001 as with all tests) and the “to know how”-item regarding the disclosure of diagnoses (+1.6), followed by the “to show how”-items on disclosing a diagnosis (+1.4), shared decision making (+1.2), self-assessing one’s own strengths/weaknesses (+1.0) and confidently approaching new patients (+0.7). Students with T0 values of 1 or 2 on the respective scales improved on average by 2.2 points across all items, students with the value of 3 by 1.1, and from 4 or 5 by 0.1. Methodically, the use of simulated patients was rated the most helpful (M=4.8, 87% with the scale value 5). This doctor-patient communication course is associated with substantial improvements regarding all key learning objectives. Regarding methods, the deployed simulated patients (2-4 per 10-student-course group in 3 of the 7 course sessions, respectively) were rated the most helpful. The present evaluation calls for both further development of the doctor-patient communication curriculum at the MHH and joint activities across medical schools, which are discussed at the end of the paper. PMID:22205912
Valdovinos, M. G.; Zarcone, J. R.; Hellings, J. A.; Kim, G.; Schroeder, S. R.
Within the scope of a double-blind, placebo-controlled, crossover medication study, the Diagnostic Assessment of the Severely Handicapped-II (DASH-II) was evaluated as a measurement for determining the effectiveness of the medication risperidone in treating the problem behaviour of 21 people with intellectual disabilities (ID). Participants…
Background To date, our ability to accurately identify patients at high risk from suicidal behaviour, and thus to target interventions, has been fairly limited. This study examined a large pool of factors that are potentially associated with suicide risk from the comprehensive electronic medical record (EMR) and to derive a predictive model for 1–6 month risk. Methods 7,399 patients undergoing suicide risk assessment were followed up for 180 days. The dataset was divided into a derivation and validation cohorts of 4,911 and 2,488 respectively. Clinicians used an 18-point checklist of known risk factors to divide patients into low, medium, or high risk. Their predictive ability was compared with a risk stratification model derived from the EMR data. The model was based on the continuation-ratio ordinal regression method coupled with lasso (which stands for least absolute shrinkage and selection operator). Results In the year prior to suicide assessment, 66.8% of patients attended the emergency department (ED) and 41.8% had at least one hospital admission. Administrative and demographic data, along with information on prior self-harm episodes, as well as mental and physical health diagnoses were predictive of high-risk suicidal behaviour. Clinicians using the 18-point checklist were relatively poor in predicting patients at high-risk in 3 months (AUC 0.58, 95% CIs: 0.50 – 0.66). The model derived EMR was superior (AUC 0.79, 95% CIs: 0.72 – 0.84). At specificity of 0.72 (95% CIs: 0.70-0.73) the EMR model had sensitivity of 0.70 (95% CIs: 0.56-0.83). Conclusion Predictive models applied to data from the EMR could improve risk stratification of patients presenting with potential suicidal behaviour. The predictive factors include known risks for suicide, but also other information relating to general health and health service utilisation. PMID:24628849
Background Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system. Methods A custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12?months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan’s?year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. Results ICCs were generated for Taiwan’s?year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. Conclusion We recommend using the ICC to annually assess a nation’s?year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system. PMID:22587736
Frank, E.; McLendon, L.; Denniston, M.; Fitzmaurice, D.; Hertzberg, V.; Elon, L.
Abstract and Introduction Abstract Context/Objectives We surveyed fourth-year medical students in the Class of 2003 at Emory University School of Medicine, Atlanta, Georgia, about various personal and clinical practices. We were especially interested in the frequency that these seniors reported of talking with patients about nutrition, weight, exercise, alcohol, and cigarette smoking. Because the validity of our findings about these counseling practices was limited by our having only self-reported data from seniors' questionnaires, we developed a standardized patient (SP) examination to test the relationship between what students reported on the questionnaires and how they actually performed with SPs. Design/Setting/Main Outcome Measures As part of a lengthy questionnaire, 88 senior medical students answered these 5 separated questions: “With a typical general medicine patient, how often do you actually talk to patients about: (1) nutrition; (2) exercise/physical activity; (3) weight; (4) smoking cessation (among smokers); and (5) alcohol? (never/rarely, sometimes, usually/always).” As part of their internal medicine subinternship final exam, students clinically assessed 4 SP cases with predetermined risk factors (poor diet, exercise, alcohol, and/or cigarette-smoking habits). Results For every risk factor, the proportion of SPs actually counseled was higher for those students who self-reported discussing that risk factor more frequently with their patients. Additionally, the odds of counseling an SP for any risk factor were significantly higher (odds ratio = 1.76-2.80, P < .05) when students reported more frequent counseling. Conclusion Student self-reports regarding patient counseling may be useful when resources are limited, and the purpose is to grossly and anonymously distinguish between higher and lower performers. Introduction We surveyed Emory University School of Medicine (Atlanta, Georgia) medical students in the Class of 2003 on 3 occasions (first-year orientation, entry to wards, and senior year). Among many questionnaire items about students' personal and clinical practices, we were especially interested in the frequency that they reported as seniors of talking to patients about nutrition, exercise, alcohol, and cigarette smoking. However, the validity of our findings about these counseling practices was limited by the self-reported nature of these data. Prior publications on the relationship between students' self-report and their actual performance with standardized patients (SPs) are limited. The few prior studies that have been conducted correlating physicians'/medical students' self-reports and their clinical performance have been generally (although not strongly) positive, finding that clinician underreporting[1,2] of performance may be more common than overreporting. Given the limitations of previous studies, we developed an SP program to test the relationship between what students reported on the questionnaires and what they actually did with SPs. PMID:16369307
Witters, Donald; Bassen, Howard; Guag, Joshua; Addissie, Bisrat; LaSorte, Nickolas; Rafai, Hazem
This paper describes research and testing of a representative group of high priority body worn and implantable personal medical electronic devices (PMEDs) for exposure to millimeter wave (MMW) advanced imaging technology (AIT) security systems used at airports. The sample PMEDs included in this study were implantable cardiac pacemakers, ICDs, neurostimulators and insulin pumps. These PMEDs are designed and tested for susceptibility to electromagnetic interference (EMI) under the present standards for medical device electromagnetic compatibility (EMC). However, the present standards for medical equipment do not address exposure to the much higher frequency fields that are emitted by MMW security systems. Initial AIT emissions measurements were performed to assess the PMED and passenger exposures. Testing protocols were developed and testing methods were tailored to the type of PMED. In addition, a novel exposure simulation system was developed to allow controlled EMC testing without the need of the MMW AIT system. Methodology, test results, and analysis are presented, along with an assessment of the human exposure and risks for PMED users. The results on this study reveal no effects on the medical devices from the exposure to the MMW security system. Furthermore, the human exposure measurements and analysis showed levels well below applicable standard, and the risks for PMED users and others we assessed to be very low. These findings apply to the types of PMEDs used in the study though these findings might suggest that the risks for other, similar PMEDs would likely be similar.
Ojeleye, Oluwagbemileke; Avery, Anthony J; Boyd, Matthew J
Aims To evaluate the ability of electronic patient medication record (ePMR) systems used in community pharmacies in England to detect and alert users about clinical hazards, errors and other safety problems. Methods Between September 2012 and November 2012, direct on-site observational data about the performance of ePMR systems were collected from nine sites. Twenty-eight scenarios were developed by consensus agreement between a general practitioner and two community pharmacists. Each scenario was entered into the ePMR system, and the results obtained from the assessment of six unique systems in nine sites, in terms of the presence or absence of an alert, were recorded onto a prespecified form. Results None of the systems produced the correct responses for all of the 28 scenarios tested. Only two systems provided an alert to penicillin sensitivity. No dose or frequency check was observed when processing a prescription for methotrexate. One system did not warn about nonsuitability of aspirin prescribed to a child of 14 years of age. In another system, it was not possible to record a patient's pregnancy status. None of the six systems provided any warning for diclofenac overdose, high initiation dose of morphine sulfate or significant dose increase. Only one of the systems did not produce any spurious alerts. Conclusions The performance of the ePMR systems tested was variable and suboptimal. The findings suggest the need for minimum specifications and standards for ePMR systems to ensure consistency of performance. PMID:24528252
Pozarowska, Dorota; Pozarowski, Piotr; Darzynkiewicz, Zbigniew
Background The long-term-treatment of glaucoma with topical medications is associated with side effects involving cornea damage. We examined the effect of glaucoma topical medications (bimatoprost, travoprost, latanoprost, timolol, betaxolol, dorzolamide, brinzolamide, brimonidine) on growth of cells of three human epithelial corneal lines. Methods The cells were cultured in 8-chamber slides, treated with different concentrations of the medications, and fixed at 24, 48, and 72 h. Cell number on slides to estimate viability and growth curves, frequency of apoptosis (FLICA and caspase-3 activation probes), and proliferation (BrdU incorporation assay) were measured by laser scanning cytometry (LSC). Results Depending on concentration all examined medications induced cell necrosis or apoptosis and suppressed proliferation. Significant variability in proliferation and apoptosis was observed within the same cultures depending on local cell density, with cells in high density areas being more resistant. The data indicate that commonly used topical medications exert cytostatic and cytotoxic effects in cultures of corneal cells and suggest that caution should be exercised in their use, particularly, when the corneal diseases are accompanied by cell proliferation and regeneration, in long-term-treatment. Conclusions The present approach of using LSC makes it possible to assess and compare cytostatic and cytotoxic effects of different topical medications on the respective target cells. PMID:19834965
Gehlhar, Kirsten; Klimke-Jung, Kathrin; Stosch, Christoph; Fischer, Martin R.
Objectives: As a fundamental element of medical practice, clinical reasoning should be cultivated in courses of study in human medicine. To date, however, no conclusive evidence has been offered as to what forms of teaching and learning are most effective in achieving this goal. The Diagnostic Thinking Inventory (DTI) was developed as a means of measuring knowledge-unrelated components of clinical reasoning. The present pilot study examines the adequacy of this instrument in measuring differences in the clinical reasoning of students in varying stages of education in three curricula of medical studies. Methods: The Diagnostic Thinking Inventory (DTI) comprises 41 items in two subscales (“Flexibility in Thinking” and “Structure of Knowledge in Memory”). Each item contains a statement or finding concerning clinical reasoning in the form of a stem under which a 6-point scale presents opposing conclusions. The subjects are asked to assess their clinical thinking within this range. The German-language version of the DTI was completed by 247 student volunteers from three schools and varying clinical semesters. In a quasi-experimental design, 219 subjects from traditional and model courses of study in the German state of North Rhine-Westphalia took part. Specifically, these were 5th, 6th and 8th semester students from the model course of study at Witten/Herdecke University (W/HU), from the model (7th and 9th semester) and traditional (7th semester) courses of study at the Ruhr University Bochum (RUB) and from the model course of study (9th semester) at the University of Cologne (UoC). The data retrieved were quantitatively assessed. Results: The reliability of the questionnaire in its entirety was good (Cronbach’s alpha between 0.71 and 0.83); the reliability of the subscales ranged between 0.49 and 0.75. The different groups were compared using the Mann-Whitney test, revealing significant differences among semester cohorts within a school as well as between students from similar academic years in different schools. Among the participants from the model course of study at the W/HU, scores increased from the 5th to the 6th semester and from the 5th to the 9th semester. Among individual cohorts at RUB, no differences could be established between model and traditional courses of study or between 7th and 9th semester students in model courses of study. Comparing all participating highest semester students, the 8th semester participants from the W/HU achieved the highest scores – significantly higher than those of 9th semester RUB students or 9th semester UoC students. Scores from the RUB 9th semester participants were significantly higher than those of the 9th semester UoC participants. Discussion: The German-language version of the DTI measures self-assessed differences in diagnostic reasoning among students from various semesters and different model and traditional courses of study with satisfactory reliability. The results can be used for discussion in the context of diverse curricula. The DTI is therefore appropriate for further research that can then be correlated with the different teaching method characteristics and outcomes of various curricula. PMID:24872858
Boyce, Alison M.; Tosi, Laura L.; Paul, Scott M.
Fractures are a frequent source of morbidity in children with disabling conditions. The assessment of bone density in this population is challenging, because densitometry is influenced by dynamic forces affecting the growing skeleton and may be further confounded by positioning difficulties and surgical hardware. First-line treatment for pediatric osteoporosis involves conservative measures, including optimizing the management of underlying conditions, maintaining appropriate calcium and vitamin D intake, encouraging weight-bearing physical activity, and monitoring measurements of bone mineral density. Bisphosphonates are a class of medications that increase bone mineral density by inhibiting bone resorption. Although bisphosphonates are commonly prescribed for treatment of adult osteoporosis, their use in pediatric patients is controversial because of the lack of long-term safety and efficacy data. PMID:24368091
Guillot, Martin; Gravel, Pierre; Gauthier, Marie-Lou; Leblond, Hugues; Tremblay, Maurice; Rossignol, Serge; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; de Guise, Jacques A; Troncy, Eric
The objectives of this pilot study were to develop a video fluoroscopy kinematics method for the assessment of the coxofemoral joint in cats with and without osteoarthritis (OA)-associated disability. Two non-OA cats and four cats affected by coxofemoral OA were evaluated by video fluoroscopy. Video fluoroscopic images of the coxofemoral joints were captured at 120 frames/s using a customized C-arm X-ray system while cats walked freely on a treadmill at 0.4 m/s. The angle patterns over time of the coxofemoral joints were extracted using a graphic user interface following four steps: (i) correction for image distortion; (ii) image denoising and contrast enhancement; (iii) frame-to-frame anatomical marker identification; and (iv) statistical gait analysis. Reliability analysis was performed. The cats with OA presented greater intra-subject stride and gait cycle variability. Three cats with OA presented a left-right asymmetry in the range of movement of the coxofemoral joint angle in the sagittal plane (two with no overlap of the 95% confidence interval, and one with only a slight overlap) consistent with their painful OA joint, and a longer gait cycle duration. Reliability analysis revealed an absolute variation in the coxofemoral joint angle of 2º-6º, indicating that the two-dimensional video fluoroscopy technique provided reliable data. Improvement of this method is recommended: variability would likely be reduced if a larger field of view could be recorded, allowing the identification and tracking of each femoral axis, rather than the trochanter landmarks. The range of movement of the coxofemoral joint has the potential to be an objective marker of OA-associated disability. PMID:24907140
Wilson, Mark A.
for Faculty Development, who will inform the department chair and the Assistant Dean for Academic by the physician. 2. The faculty member should forward the FMLA certification form to the physician who should's medical file (kept confidentially in Human Resources). The completed form should indicate the physician
Chard, Melissa; Roulin, Jean-Luc; Bouvard, Martine
Background: The use of common psychological assessment tools is invalidated with persons with PIMD. The aim of this study was to test the feasibility of using a visual habituation procedure with a group of adults with PIMD, to develop a new theoretical and practical framework for the assessment of cognitive abilities. Methods: To test the…
van der Meer, Larah; Sigafoos, Jeff; O'Reilly, Mark F.; Lancioni, Giulio E.
We synthesized studies that assessed preference for using different augmentative and alternative communication (AAC) options. Studies were identified via systematic searches of electronic databases, journals, and reference lists. Studies were evaluated in terms of: (a) participants, (b) setting, (c) communication options assessed, (d) design, (e)…
Rogers, Richard; Gillard, Nathan D.; Wooley, Chelsea N.; Ross, Colin A.
Research on feigned mental disorders indicates that severe psychopathology coupled with significant trauma histories often complicate feigning determinations, resulting in inaccuracies on otherwise effective measures. As part of malingering assessments, the Personality Assessment Inventory (PAI) is often used because of its excellent validation…
Backstein, R; Peters, W; Neligan, P
A retrospective analysis of 812 patients admitted to the Ross Tilley Burn Centre between 1984 and 1992 resulted in 37 cases of burn injuries which were directly related to premorbid disabilities. The majority of these burns (83.8 per cent) occurred in the patient's home, most commonly as scald injuries in the bath tub, the shower, or following hot water spills. Nineteen patients were male, 17 were female. The median age was 58 years. Six patients had spinal cord disorders: four had traumatic cord damage, two had spina bifida. Six patients had seizure disorders. Five of these patients had been taking anti-seizure medications, but all had subtherapeutic blood levels on admission to hospital. Two patients had diabetes mellitus with peripheral neuropathies. Thirteen patients had four miscellaneous neurological disorders, including: tardive dyskinesia (two), CVA (four), Parkinson's disease (two), Alzheimer's disease (two), cerebral palsy (one), multiple sclerosis (one) and blindness (one). Three patients had a diagnosis of syncope. Two patients had emphysema, and four were morbidly obese. The average length of stay (LOS) for the disabled patients was 27.6 days for a median burn size of 10 per cent body surface area (BSA), compared to an average LOS for the general population of 25.7 days for a larger median burn size of 21 per cent BSA. The mortality rate was also much higher in the disabled population (22.2 per cent vs. 6.0 per cent). Most of these burn injuries were preventable. A series of burn prevention guidelines is presented, in an attempt to reduce the incidence of these burn injuries in disabled patients. PMID:8507362
Poscia, Andrea; Cambieri, Andrea; Tucceri, Chiara; Ricciardi, Walter; Volpe, Massimo
In the actual economic context, with increasing health needs, efficiency and efficacy represents fundamental keyword to ensure a successful use of the resources and the best health outcomes. Together, the medical record, completely and correctly compiled, is an essential tool in the patient diagnostic and therapeutic path, but it's becoming more and more essential for the administrative reporting and legal claims. Nevertheless, even if the improvement of medical records quality and of hospital stay appropriateness represent priorities for every health organization, they could be difficult to realize. This study aims to present the methodology and the preliminary results of a training and improvement process: it was carried out from the Hospital Management of a third level Italian teaching hospital through audit cycles to actively involve their health professionals. A self assessment process of medical records quality and hospital stay appropriateness (inpatients admission and Day Hospital) was conducted through a retrospective evaluation of medical records. It started in 2012 and a random sample of 2295 medical records was examined: the quality assessment was performed using a 48-item evaluation grid modified from the Lombardy Region manual of the medical record, while the appropriateness of each days was assessed using the Italian version of Appropriateness Evaluation Protocol (AEP) - 2002ed. The overall assessment was presented through departmental audit: the audit were designed according to the indication given by the Italian and English Ministry of Health to share the methodology and the results with all the involved professionals (doctors and nurses) and to implement improvement strategies that are synthesized in this paper. Results from quality and appropriateness assessment show several deficiencies, due to 40% of minimum level of acceptability not completely satisfied and to 30% of inappropriateness between days of hospitalization. Furthermore, there are great discrepancies among departments and among Care Units: the higher problems are centered in DHs, which are generally lacking on both profiles. Finally, our audit model, that could be considered a good project according the NHS (score of 20/25), has allowed to involve in 34 editions 480 professionals of different care Unit which are satisfied and stimulated to keep going in continuous improvement of the quality and appropriateness with these arrangements. The tools used in the project have proven their value for measuring the minimum quality of healthcare documentation and organizational appropriateness: furthermore, the audit has been shown as an effective methodology for their introduction because it ensures their acceptability among the staff and creates the basis for a rapid and quantifiable improvement that, through the promotion of accountability and transparency, could support the risk management activities and ensure greater efficiency in hospitalization. PMID:26057172
National Council on Disability, Washington, DC.
The National Council on Disability (NCD) held a National Summit on Disability Policy on April 27-29, 1996 at which 300 grassroots disability leaders gathered to discuss how to achieve independence in the next decade. Following an analysis of disability demographics and disability rights and culture, disability policy is assessed in 11 areas:…
Anuj, Mittal; Rajasekar, Vedapriya Dande; Krishnagopal, Lavanya
Context: Our country India is having 919.17 million cell phone users; currently this is the second largest number of cell phone users after China. The youth spend a good amount on talk time and purchasing cell phone handsets. Discarding of cell phone is another issue which needs attention because of generation of e-wastes, which leads to environmental pollution. Aim: To assess economic burden and practice of cell phone disposal among medical students. Methodology: It is a cross-sectional study where self filled questionnaire were given to randomly chosen students. Results: Out of total 311 participants, 133 were males and 178 were females. Mean monthly expenditure of students was Rs. 2787. Out of 311 students only 2 (0.64%) boys were not using cell phones. It was observed that boys are more inclined towards cell phone than girls, as number of previous handsets, money spent on buying handsets and therefore average monthly costs of handsets were significantly higher among boys than girls. Most common reason for frequent changing of handsets was that they were outdated (46.14%). 47.13% of handsets were disposed by exchanging or giving to somebody for use, but 36.57% of handsets were lying waste or thrown away. Conclusion: As noticed that a good amount of money was spent on cell phones, students and parents should be counseled regarding cost effective use of cell phone. An effort should be made to dispose off handset in environment friendly way, which can be done by creating awareness about collection centers and strengthening collection chain. PMID:23730640
Purohit, Geetanjali; Nair, Sandhya Pillai; Patel, Bhavita; Rawal, Yash; Shah, R. M.
Introduction: Obesity is a condition in which excess body fat accumulates, which leads to various adverse effects on health, particularly cardiovascular diseases (CVDs), which reduce life expectancy and/or increase health problems. Fast food consumption is one of the factors which have been reported as a cause of obesity. Body mass index (BMI) is used to assess obesity and overweight, which can be calculated by using the formula, weight in kg, divided by square of height in metres. Aim: This study focused on the relationship of body mass index with fast food consumption, associated soft drink consumption and physical activity. Methods: Descriptive cross-sectional study was conducted in Department of Biochemistry, SBKS MI and RC, and Sumandeep Vidyapeeth. This study was approved by the ethical review board .One hundred and forty seven medical students from 1st year MBBS course were included in this study. Self-structured questionnaire was used, which contained several data like information on age, height, weight, education level. The formula used for calculating BMI was, weight in kg, divided by square of height in metres (Kg/m2). Results: In our study, out of 147 students, a total of 138 students (more than 90%) used to have fast food. Among these, a total of 47 students (34.05%) were pre-obese and obese. Out of 147 students, 87 students (59.18%) were in normal weight range, while 13 (8.84%) students were underweight. Statistical Analysis: Data was compiled in an Excel worksheet and it was analyzed for percentages and proportions. Chi-square and Pearson’s correlation test were also applied wherever they were applicable and Alpha error was set at a 5% level. Conclusion: In our study, a significant relationship was found between BMI and fast food consumption, less physical activity, and intake of soft drinks. PMID:24995170
Shively, R. J.
The Emergency Medical Service (EMS) industry has been the subject of several television and newspaper articles (Harvey and Jensen, 1987) which emphasized the negative aspects, (e.g., fatalities and high accident rates), rather than the life saving services performed. Until recently, the accident rate of the EMS industry has been five times as high as that of other civil helicopters. This high accident rate has been coupled with the dramatic rise in the number of programs. The industry has built from a single service at its inception in 1972, to over 180 in 1987 (Spray, 1987), to the point that 93 percent of the contiguous U.S. is now covered by some type of EMS service. These factors prompted the National Transportation Safety Board (NTSB) to study the accidents that occurred between May 11, 1978 and December 3, 1986 (NTSB, 1988). The NTSB report concluded that 'Sound pilot judgment is central to safe flight operations.' They further stated that '... factors unique to EMS helicopter operations--such as the influence of the mission itself, program competition, and EMS program management perspectives--can drastically influence pilot judgment during the EMS mission.' One of the most difficult decisions that a pilot must make is whether to accept or decline a mission. A pre-flight risk assessment system (SAFE) was developed at NASA-Ames Research Center for civil EMS operations to aid pilots in making this decision objectively. The ability of the SAFE system to predict mission risk profiles was tested at an EMS facility. The results of this field study demonstrated that the usefulness of SAFE was highly dependent on the type of mission flown. SAFE is now being modified so that it can 'learn' with each mission flown. For example, after flying a mission to a particular site, an EMS pilot would input information about this mission into the system, such as new buildings, wires, or approach procedures. Then, the next time a pilot flew a similar mission or one to the same area, this additional information would be taken into account in computing a risk assessment.
Shemesh, Eyal; Yehuda, Rachel; Rockmore, Lori; Shneider, Benjamin L.; Emre, Sukru; Bartell, Abraham S.; Schmeidler, James; Annunziato, Rachel A.; Stuber, Margaret L.; Newcorn, Jeffrey H.
Objective: Self-report measures of depression may be inaccurate when applied to medically ill children because of the overlap between medical and psychiatric symptoms. The American Academy of Pediatrics endorses the use of self-reports as diagnostic aids (used in patients who are suspected of having an emotional problem by their pediatricians).…
Alain Beaulieu; Henk Venter; Doug Priestley; Dion Marson; Collin Stockwell
In this paper, we present the design of two smart sensors that were developed for deployment within a body worn wireless network of medical devices. Ambulatory and remote monitoring of biomedical signals have gained importance in the last decade as medical institutions try to reduce costs by discharging patients earlier while still requiring various levels of monitoring. Most of the
Christopher T. Shen; Mark C. Tsai; Paul Yock; Kenneth L. Melmon
Medical device development involves interdisciplinary knowledge of engineering and the life sciences. In order to maintain a competitive advantage in the medical device industry, design engineers require extensive and detailed knowledge of engineering and biomedical technology. This underscores the need for continual self-education with the most current technical information. Inadequate access to biomedical information during the design process may have
Carney, Patricia A.; Bar-on, Miriam E.; Grayson, Martha S.; Klein, Martin; Cochran, Nan; Eliassen, M. Scottie; Gambert, Steven R.; Gupta, Krishan L.; Labrecque, Mary C.; Munson, Paul J.; Nierenberg, David W.; O'Donnell, Joseph F.; Whitehurst-Cook, Michelle; Willett, Rita M.
Funded by the Generalist Physician Initiative, Dartmouth Medical School (New Hampshire), Virginia Commonwealth University, and New York Medical College adopted early community-based training models for longitudinal clinical experiences. The three programs, the methods used to evaluate an aspect of the program, lessons learned about early clinical…
Song, Hyuksoon S.; Kalet, Adina L.; Plass, Jan L.
We developed a Self-Regulation Measure for Computer-based learning (SRMC) tailored toward medical students, by modifying Zimmerman's Self-Regulated Learning Interview Schedule (SRLIS) for K-12 learners. The SRMC's reliability and validity were examined in 2 studies. In Study 1, 109 first-year medical students were asked to complete the SRMC.…
Zvi D. Gellis
Depressive symptoms are highly prevalent among medically ill homebound elderly and are associated with significant functional decline, lower quality of life, and increased health care utilization. Despite this, depression is generally underdiagnosed and undertreated among medically ill homebound older adults. The objective of this study was to determine the validity of a brief depression measure (CES-D) and examine the nature
Government reports, campaigning groups and parents all value the goal that families with disabled children should live 'ordinary lives'. Yet evidence of the impact of childhood disability on finances, housing, relationships, family life and mental health all points to barriers that families face to achieving this. With numbers of disabled children rising significantly, increasing numbers of families are living with disabled children and experiencing a life that feels very far from ordinary. Support services, both within health and the local authority, may use a medical model of disability that fails to acknowledge some of these challenges. This paper aims to raise awareness of some of the issues faced by families with disabled children and argues for a more holistic, social model of disability that takes account of the needs of the whole family when considering support needs, not only the needs of the disabled child.This has the potential to reduce the social and practical cost of supporting disabled children, improve outcomes for the whole family, and enable families to enjoy their children within a family life that feels something much closer to'ordinary'. PMID:20441096
GURUPRASAD P. AITHAL; HEATHER THORNES; ANANDAPURAM D. DWARAKANATH; ANDREW R. TANNER
The aim of this study was to measure serum carbohydrate-deficient transferrin (CDT) in consecutive patients attending a general medical clinic with a range of alcohol intakes to determine its value in assessing such intake. Eighty-one consecutive patients (42 male, 39 female) aged 20-85 years (median = 49.5 years) attending an out-patient clinic were selected for the study. Each patient completed
Viviane Bernardo; Monica Parente Ramos; Helio Plapler; Luiz Francisco Poli De Figueiredo; Helena B. Nader; Meide Silva Anção; Carl P. Von Dietrich; Daniel Sigulem
In order to increase the number of practical and discussion classes offered to students in the traditional-curriculum scenario, while decreasing the lecture-based ones and to create an online community to share knowledge on surgery, we developed and assessed the first online course for undergraduate medical students on experimental surgery at the Federal University of Sao Paulo-UNIFESP, Brazil. The purposes of
National Council on the Handicapped, Washington, DC.
As one of a series of topic papers assessing federal laws and programs affecting persons with disabilities, this paper describes the major components of a comprehensive program to prevent disabilities, including programs to maximize health care, programs to maximize educational growth and sound psychological development, and programs for public…
Personality traits such as adventurousness and an active, external orientation may both predispose persons to traumatic injury and assist them in adjustment to disabilities resulting from such injury. Using the Eysenck Personality Inventory (EPI) and the Derogatis Symptom Checklist (SCL-90), personality and level of distress were assessed for 111 rehabilitation patients with either traumatic or nontraumatic disabilities associated with either
Steele, Marcee M.
Students with learning disabilities (LD) frequently take general education science classes because their disabilities are very mild. Sometimes, however, it is difficult for students with LD to succeed in the classes and pass the related high-stakes assessments mandated by No Child Left Behind (NCLB). In this article, the author reviews typical LD…
disability documentation from a medical professional licensed or certified to diagnose and treat. Statement regarding the current or planned use of medication, assistive devices, or other rehabilitativePhysical Disability Documentation Guidelines for Service Eligibility In order to establish
...Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.42 Complete medical examination of injury cases. The importance of complete medical...
...Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.42 Complete medical examination of injury cases. The importance of complete medical...
...Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Musculoskeletal System § 4.42 Complete medical examination of injury cases. The importance of complete medical...
Teschke, Rolf; Wolff, Albrecht; Frenzel, Christian; Schwarzenboeck, Alexander; Schulze, Johannes; Eickhoff, Axel
Causality assessment of suspected drug induced liver injury (DILI) and herb induced liver injury (HILI) is hampered by the lack of a standardized approach to be used by attending physicians and at various subsequent evaluating levels. The aim of this review was to analyze the suitability of the liver specific Council for International Organizations of Medical Sciences (CIOMS) scale as a standard tool for causality assessment in DILI and HILI cases. PubMed database was searched for the following terms: drug induced liver injury; herb induced liver injury; DILI causality assessment; and HILI causality assessment. The strength of the CIOMS lies in its potential as a standardized scale for DILI and HILI causality assessment. Other advantages include its liver specificity and its validation for hepatotoxicity with excellent sensitivity, specificity and predictive validity, based on cases with a positive reexposure test. This scale allows prospective collection of all relevant data required for a valid causality assessment. It does not require expert knowledge in hepatotoxicity and its results may subsequently be refined. Weaknesses of the CIOMS scale include the limited exclusion of alternative causes and qualitatively graded risk factors. In conclusion, CIOMS appears to be suitable as a standard scale for attending physicians, regulatory agencies, expert panels and other scientists to provide a standardized, reproducible causality assessment in suspected DILI and HILI cases, applicable primarily at all assessing levels involved. PMID:24653791
Leam A. Craig; Roger B. Hutchinson
While the literature on the assessment, treatment and management of non-learning disabled sexual offenders is well established, it is only in recent years that researchers and clinicians have focused on sexual offenders with learning disabilities. In contrast to mainstream sex offender treatment programmes, there are few evaluated community-based treatment programmes for sexual offenders with learning disabilities, and of the small
Ali, Madiha; Asim, Hamna; Edhi, Ahmed Iqbal; Hashmi, Muhammad Daniyal; Khan, Muhammad Shahjahan; Naz, Farah; Qaiser, Kanza Noor; Qureshi, Sidra Masud; Zahid, Mohammad Faizan; Jehan, Imtiaz
Introduction Stress among medical students induced by academic pressures is on the rise among the student population in Pakistan and other parts of the world. Our study examined the relationship between two different systems employed to assess academic performance and the levels of stress among students at two different medical schools in Karachi, Pakistan. Methods A sample consisting of 387 medical students enrolled in pre-clinical years was taken from two universities, one employing the semester examination system with grade point average (GPA) scores (a tiered system) and the other employing an annual examination system with only pass/fail grading. A pre-designed, self-administered questionnaire was distributed. Test anxiety levels were assessed by The Westside Test Anxiety Scale (WTAS). Overall stress was evaluated using the Perceived Stress Scale (PSS). Results There were 82 males and 301 females while four did not respond to the gender question. The mean age of the entire cohort was 19.7±1.0 years. A total of 98 participants were from the pass/fail assessment system while 289 were from the GPA system. There was a higher proportion of females in the GPA system (85% vs. 59%; p<0.01). Students in the pass/fail assessment system had a lower score on the WTAS (2.4±0.8 vs. 2.8±0.7; p=0.01) and the PSS (17.0±6.7 vs. 20.3±6.8; p<0.01), indicating lower levels of test anxiety and overall stress than in students enrolled in the GPA assessment system. More students in the pass/fail system were satisfied with their performance than those in the GPA system. Conclusion Based on the present study, we suggest governing bodies to revise and employ a uniform assessment system for all the medical colleges to improve student academic performance and at the same time reduce stress levels. Our results indicate that the pass/fail assessment system accomplishes these objectives. PMID:26112353
Shaw, Stan F.; Keenan, Walter R.; Madaus, Joseph W.; Banerjee, Manju
Disability documentation has been an ongoing challenge for Office for Students with Disabilities personnel. Initial lack of consistency and inadequate documentation data resulted in the promulgation of detailed documentation guidelines in the 1990s. Discontinuity between approaches to transition assessment and disability documentation in secondary…
Martinez Escobar, Marisol; Juhnke, Bethany; Hisley, Kenneth; Eliot, David; Winer, Eliot
The dramatic rise of digital medical imaging has allowed medical personnel to see inside their patients as never before. Many software products are now available to view this data in various 2D and 3D formats. This also raises many basic research questions on spatial perception for humans viewing these images. The work presented here attempts to answer the question: How would adding the stereopsis depth cue affect relative position tasks in a medical context? By designing and conducting a study to isolate the benefits between monoscopic 3D and stereoscopic 3D displays in a relative position task, the following hypothesis was tested: stereoscopic 3D displays are beneficial over monoscopic 3D displays for relative position judgment tasks in a medical visualization setting. The results show that stereoscopic condition yielded a higher score than the monoscopic condition, but the results were not always statistically significant.
Espitia, Noberto Francisco
The purpose of this study was to measure the competency of problem solving skills of fourth-year veterinary students. The study identified two primary objectives, (a) define clinical competency for fourth-year veterinary medical students, and (b...
Espitia, Noberto Francisco
The purpose of this study was to measure the competency of problem solving skills of fourth-year veterinary students. The study identified two primary objectives, (a) define clinical competency for fourth-year veterinary medical students, and (b...
Jackson, Terry L.
There is a significant need to address the academic outcomes of students with emotional and behavioral disabilities (EBD). Of the 13 federal disability categories under which a student can be classified to receive special education services, students with EBD have the highest dropout rate, the highest failure rate, and pose the most behavioral…
Watkins, J.; Espie, C. A.; Curtice, L.; Mantala, K.; Corp, A.; Foley, J.
Background: Epilepsy is common in people with intellectual disability, yet clinicians and researchers seldom obtain information directly from the client. The development and preliminary validation of a novel measure for use with people with mild to moderate intellectual disabilities is described. Methods: Focus group methods (6 groups; 24…
Sideridis, Georgios; Padeliadu, Susana
The purpose of the present studies was to provide the means to create brief versions of instruments that can aid the diagnosis and classification of students with learning disabilities and comorbid disorders (e.g., attention-deficit/hyperactivity disorder). A sample of 1,108 students with and without a diagnosis of learning disabilities took part…
Lori A Paine; Beryl J Rosenstein; J Bryan Sexton; Paula Kent; Christine G Holzmueller; Peter J Pronovost
ObjectivesTo describe the authors' hospital-wide efforts to improve safety climate at a large academic medical centre.Design and settingA prospective cohort study used multiple interventions to improve hospital-wide safety climate. 144 clinical units in an urban academic medical centre are included in this analysis.InterventionsThe comprehensive unit-based safety programme included steps to identify hazards, partner units with a senior executive to fix
Lori A Paine; Beryl J Rosenstein; J Bryan Sexton; Paula Kent; Christine G Holzmueller; Peter J Pronovost
ObjectivesTo describe the authors' hospital-wide efforts to improve safety climate at a large academic medical centre.Design and settingA prospective cohort study used multiple interventions to improve hospital-wide safety climate. 144 clinical units in an urban academic medical centre are included in this analysis.InterventionsThe comprehensive unit-based safety programme included steps to identify hazards, partner units with a senior executive to fix
Berry, B S; Devapitchai, K S; Raju, M S
To assess the level of awareness about the different provisions of the persons with Disability Act (1995) among the health care professionals, 201 health care professionals dealing with the disabled persons from different parts of India were interviewed using structured interview checklist. The data were analysed through statistical package of social sciences software. Chi-square test were applied on the variables and the Pvalues were ascertained. The results show that 48.3% knew about administration hierarchy, 53.7% of respondents were aware of the free education available for the disabled, 68.5% were aware of the employment scheme, 62.7% about poverty alleviation schemes, 59.2% know about the traveling benefits, 56.2% of professionals were aware of the benefits for people with low vision. Only 29.9% of respondents knew about provisions to overcome architectural barriers. 43.8% of them knew about the least disability percentage whereas only 28.4% were aware of research and manpower schemes. Regarding affirmative action, 32.17% told correctly and 52.7% of the professionals responded correctly with respectto non- discrimination schemes. The level of awareness among the professionals working in rural regions is lower with regard to administration hierarchy and poverty alleviation schemes. Informations regarding disabled friendly environments and research and manpower development were found to be low among respondents of all professions which need to be effectively intervened. Gender did not show any influence with respect to the components of the act. The study showed that there is an ample need for educational interventions among the health care professionals in all socio-demography. Inclusion of PWD Act in the curriculum of medical schools as a topic in conferences and workshops for health care professionals are suggested. PMID:20329362