Sample records for outcome measure results

  1. The Children's Performance Outcome Measures: Results after Six Months.

    ERIC Educational Resources Information Center

    Massey, Tom; Kershaw, Mary Ann; Armstrong, Mary; Shepard, Jennifer; Wir, Liang

    This report describes the implementation and first 6 months of data collection of the required performance outcome measures for children receiving mental health services in Florida, as required under Florida's 1994 Government Performance and Accountability Act. This summary is of data received from August 1996 to January 1997 and includes data for…

  2. Measuring Course Learning Outcomes

    ERIC Educational Resources Information Center

    Keshavarz, Mohsen

    2011-01-01

    Accreditation criteria of programs require effective learning outcomes, assessment with documented procedures, tools, results, and actions to close the assessment loop with broad faculty involvement. This article describes a methodology for providing quantitative measurement of a course's learning outcomes. The methodology uses a linkage matrix…

  3. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

    PubMed

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-09-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. PMID:22844983

  4. Are Children Improving? Results from Outcome Measurement in a Large Mental Health System

    Microsoft Academic Search

    Emily V. TraskAnn; Ann F. Garland

    Standardized outcome assessment was implemented in a large county mental health system. This study examines changes in children’s\\u000a emotional and behavioral problems after 6 months of treatment and identifies factors associated with treatment improvement.\\u000a Results from 3,215 youth indicated that externalizing and internalizing problems significantly decreased from intake to 6 months\\u000a and that ethnicity, gender, and age were associated with caregiver-reported changes

  5. Outcome measures in stapes surgery: postoperative results are independent from preoperative parameters.

    PubMed

    Koopmann, Mario; Weiss, Daniel; Savvas, Eleftherios; Rudack, Claudia; Stenner, Markus

    2014-06-01

    The aim of this study was to compare audiometric results before and after stapes surgery and identify potential prognostic factors to appropriately select patients with otosclerosis who will most likely benefit from surgery. We enrolled 126 patients with otosclerosis (162 consecutive ears) in our study who underwent stapes surgery between 2007 and 2012 at our institution. Preoperative and postoperative data including pure-tone audiometry, speech audiometry, stapedial reflex audiometry and surgical data were analyzed. The average preoperative air-bone gap (ABG) was 28.9 ± 8.6 dB. Male patients and patients older than 45 years of age had greater preoperative ABGs in comparison to females and younger patients. Postoperative ABGs were 11.2 ± 7.4 dB. The average ABG gain was 17.7 ± 11.1 dB. Preoperative audiometric data, age, gender and type of surgery did not influence the postoperative results. Stapes surgery offers predictable results independent from disease progression or patient-related factors. While absolute values of hearing improvement are instrumental in reflecting audiometric results of a cohort, relative values better reflect individual's audiometric data resembling the patient's benefit. PMID:24906841

  6. Outcome Measurement in Child Welfare.

    ERIC Educational Resources Information Center

    Maguar, Stephen; Moses, Beth S.

    1980-01-01

    The Child Welfare League of America surveyed the structured methods used by agencies to measure case outcome. The findings indicate a need to develop improved measures of effectiveness. Criteria for measures suitable to meet acountability requirements and problems in outcome measurement are discussed. (Author/RH)

  7. Lower limb orthopaedic surgery results in changes to coagulation and non-specific inflammatory biomarkers, including selective clinical outcome measures

    PubMed Central

    2013-01-01

    Background With an aging society and raised expectations, joint replacement surgery is likely to increase significantly in the future. The development of postoperative complications following joint replacement surgery (for example, infection, systemic inflammatory response syndrome and deep vein thrombosis) is also likely to increase. Despite considerable progress in orthopaedic surgery, comparing a range of biological markers with the ultimate aim of monitoring or predicting postoperative complications has not yet been extensively researched. The aim of this clinical pilot study was to test the hypothesis that lower limb orthopaedic surgery results in changes to coagulation, non-specific markers of inflammation (primary objective) and selective clinical outcome measures (secondary objective). Methods Test subjects were scheduled for elective total hip replacement (THR) or total knee replacement (TKR) orthopaedic surgery due to osteoarthritis (n?=?10). Platelet counts and D-dimer concentrations were measured to assess any changes to coagulation function. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured as markers of non-specific inflammation. Patients were monitored regularly to assess for any signs of postoperative complications, including blood transfusions, oedema (knee swelling), wound infection, pain and fever. Results THR and TKR orthopaedic surgery resulted in similar changes of coagulation and non-specific inflammatory biomarkers, suggestive of increased coagulation and inflammatory reactions postoperatively. Specifically, THR and TKR surgery resulted in an increase in platelet (P?=?0.013, THR) and D-dimer (P?=?0.009, TKR) concentrations. Evidence of increased inflammation was demonstrated by an increase in CRP and ESR (P???0.05, THR and TKR). Four patients received blood transfusions (two THR and two TKR patients), with maximal oedema, pain and aural temperatures peaking between days 1 and 3 postoperatively, for both THR and TKR surgery. None of the patients developed postoperative infections. Conclusions The most noticeable changes in biological markers occur during days 1 to 3 postoperatively for both THR and TKR surgery, and these may have an effect on such postoperative clinical outcomes as oedema, pyrexia and pain. This study may assist in understanding the postoperative course following lower limb orthopaedic surgery, and may help clinicians in planning postoperative management and patient care. PMID:24206644

  8. Measuring Inclusive Education Outcomes in Alberta, Canada

    ERIC Educational Resources Information Center

    Loreman, Tim

    2014-01-01

    This study details the results of a review of the academic and public sector literature on measuring inclusive education in large systems. It highlights some outcomes drawn from the international literature on inclusion that might be indicative of the presence and quality of inclusive education in an effort to develop a set of outcomes for…

  9. TEFTOM: A Promising General Trauma Expectation/Outcome Measure—Results of a Validation Study on Pan-American Ankle and Distal Tibia Trauma Patients

    PubMed Central

    Suk, Michael; Buckley, Richard E.; Paccola, Cleber A. J.; Lorich, Dean G.; Helfet, David L.; Hanson, Beate

    2013-01-01

    Background. In orthopedics, there is no instrument specifically designed to assess patients' expectations of their final surgery outcome in general trauma populations. We developed the Trauma Expectation Factor Trauma Outcome Measure (TEFTOM) to investigate the fulfilment of patients' expectations one year after surgery as a measure of general trauma surgical outcomes. The aim of this paper was to assess the psychometric characteristics of this new general trauma outcome measure. Methods. The questionnaire was tested in 201 ankle and distal tibia fracture patients scheduled for surgery. Patients were followed up for twelve months. The TEFTOM questionnaire was evaluated for its criterion validity, internal consistency, reproducibility, and responsiveness. Results. TOM showed good criterion validity against the American Academy of Orthopaedic Surgeons Foot and Ankle Scale (Pearson's correlation coefficient = 0.69–0.77). Internal consistency was acceptable for TEF (Cronbach's alpha = 0.65–0.76) and excellent for TOM (Cronbach's alpha = 0.76–0.85). Reproducibility was moderate to very good (intraclass coefficient correlation (ICC) ?0.67) for TEF and very good (ICC ?0.92) for TOM. TOM also proved to be responsive to changes in patients' condition over time (Wald test; P < 0.001). Conclusions. TEFTOM is a promising tool for measuring general trauma outcomes in terms of patients' expectation fulfilment that proved to be valid, internally consistent, reproducible, and responsive to change. PMID:24967116

  10. Measuring Gambling Outcomes Among College Students

    PubMed Central

    Neighbors, Clayton; Lostutter, Ty W.; Larimer, Mary E.; Takushi, Ruby Y.

    2006-01-01

    The present research describes the proposal and validation of three gambling outcome measures, the Gambling Quantity and Perceived Norms Scale (GQPN), the Gambling Problem Index (GPI), and the Gambling Readiness to Change Questionnaire (GRTC). The study consisted of 560 undergraduate college students who completed a survey including the newly constructed measures and other measures designed to assess convergent validity. Results confirmed good reliability and convergent validity of all three measures. Implications for evaluating efficacy of treatment and prevention interventions are detailed. PMID:12514914

  11. [Sifting through the results, a proposal for a new concept of outcome measurement. In connection with a series of 72 carpal tunnel endoscopic releases].

    PubMed

    Dubert, T; Kamoun, L

    2005-12-01

    We present a new concept in outcome measurement namely "sifting", which we demonstrate in a series of endoscopic carpal tunnel releases on 72 patients. Each patient is evaluated by considering three groups of criteria. The criteria in the first group are evaluated by the patients themselves (self-evaluation), those in the second group are evaluated by a medical observer (clinical examination) and those in the third group are evaluated by the community (socio-professional aspects). We consider that the global outcome result is good only if it is good at the same time from the point of view of the patient himself, from the point of view of the medical observer and from the point of view of the community. The originality of this "sifting" concept consists in sorting the global outcomes according to a principle of elimination. When the global outcome of each patient is passed through the sieve, this total result is considered as "poor" if only one of the three groups is noted as having a bad result. By applying this original principle to our series, we obtained 11 bad self-evaluated results (reduction in the preoperative DASH lower than 10), 6 bad clinical results (persistence of awkward paraesthesiae) and 1 bad socio-professional result (absence of return to work). After sifting all the patients the poor results represented 14 patients (19 %). It seems to us that this sifting principle represents an advance compared to existing evaluation forms, which do not independently consider these three points of view, and which provide a total score by means of arithmetic operations with arbitrary coefficients. PMID:16398103

  12. Outcome measures in inflammatory rheumatic diseases

    PubMed Central

    2009-01-01

    Inflammatory rheumatic diseases are generally multifaceted disorders and, therefore, measurement of multiple outcomes is relevant to most of these diseases. Developments in outcome measures in the rheumatic diseases are promoted by the development of successful treatments. Outcome measurement will increasingly deal with measurement of low levels of disease activity and avoidance of disease consequences. It is an advantage for patient management and knowledge transfer if the same outcomes are used in practice and in trials. Continuous measures of change are generally the most powerful and, therefore, are preferred as primary outcomes in trials. For daily clinical practice, outcome measures should reflect the patients' state and have to be easily derivable. The objective of this review is to describe recent developments in outcome measures for inflammatory rheumatic diseases for trials and clinical practice, with an emphasis on rheumatoid arthritis. PMID:19849821

  13. Objectively Measured Boar Sperm Motility Parameters Correlate With the Outcomes of On-Farm Inseminations: Results of Two Fertility Trials

    Microsoft Academic Search

    CLARE HOLT; WILLIAM V. HOLT; HARRY D. M. MOORE; C. B. REED; ROBERT M. CURNOCK

    1997-01-01

    Two fertility trials were undertaken to evaluate the re- lationship between boar semen quality and fertility (conception rate and litter size) after on-farm artificial insemination (Al). Trial 1 in- cluded 98 ejaculates from 27 boars, and trial 2 included 72 ejacu- lates from 26 boars. The semen quality was measured by computer- assisted semen analysis (CASA) using the Hobson Sperm

  14. Results of a two-year pilot study of clinical outcome measures in collagen VI- and laminin alpha2-related congenital muscular dystrophies.

    PubMed

    Meilleur, Katherine G; Jain, Minal S; Hynan, Linda S; Shieh, Ching-Yi; Kim, Eunice; Waite, Melissa; McGuire, Michelle; Fiorini, Courtney; Glanzman, Allan M; Main, Marion; Rose, Kristy; Duong, Tina; Bendixen, Roxanna; Linton, Melody M; Arveson, Irene C; Nichols, Carmel; Yang, Kelly; Fischbeck, Kenneth H; Wagner, Kathryn R; North, Kathryn; Mankodi, Ami; Grunseich, Christopher; Hartnett, Elizabeth J; Smith, Michaele; Donkervoort, Sandra; Schindler, Alice; Kokkinis, Angela; Leach, Meganne; Foley, A Reghan; Collins, James; Muntoni, Francesco; Rutkowski, Anne; Bönnemann, Carsten G

    2015-01-01

    Potential therapies are currently under development for two congenital muscular dystrophy (CMD) subtypes: collagen VI-related muscular dystrophy (COL6-RD) and laminin alpha 2-related dystrophy (LAMA2-RD). However, appropriate clinical outcome measures to be used in clinical trials have not been validated in CMDs. We conducted a two-year pilot study to evaluate feasibility, reliability, and validity of various outcome measures, particularly the Motor Function Measure 32, in 33 subjects with COL6-RD and LAMA2-RD. In the first year, outcome measures tested included: Motor Function Measure 32 (MFM32), forced vital capacity (FVC) percent predicted sitting, myometry, goniometry, 10-meter walk, Egen Klassification 2, and PedsQL(TM) Generic and Neuromuscular Cores. In the second year, we added the North Star Ambulatory Assessment (NSAA), Hammersmith Functional Motor Scale (HFMS), timed functional tests, Measure of Activity Limitations (ACTIVLIM), Quality of Upper Extremity Skills Test (QUEST), and Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue subscale. The MFM32 showed strong inter-rater (0.92) and internal consistency (0.96) reliabilities. Concurrent validity for the MFM32 was supported by large correlations (range 0.623-0.936) with the following: FVC, NSAA, HFMS, timed functional tests, ACTIVLIM, and QUEST. Significant correlations of the MFM32 were also found with select myometry measurements, mainly of the proximal extremities and domains of the PedsQL(TM) scales focusing on physical health and neuromuscular disease. Goniometry measurements were less reliable. The Motor Function Measure is reliable and valid in the two specific subtypes of CMD evaluated, COL6-RD and LAMA2-RD. The NSAA is useful as a complementary outcome measure in ambulatory individuals. Preliminary concurrent validity of several other clinical outcome measures was also demonstrated for these subtypes. PMID:25307854

  15. Understanding and measuring child welfare outcomes.

    PubMed

    D'Andrade, Amy; Osterling, Kathy Lemon; Austin, Michael J

    2008-01-01

    The new "Children's and Family Services Reviews" (CFSR) process focuses on the effectiveness of services to children and families by measuring client outcomes. This article reviews the research literature related to child welfare outcomes in order to provide a context for federal accountability efforts. It also summarizes the 2001 federal mandate to hold states accountable for child welfare outcomes and describes California's response to this mandate. Implications of the outcomes literature review and measurement problems in the CFSR process suggest CSFR measures do not always capture meaningful outcomes. Recommendations for change are made. PMID:19064447

  16. Measuring Program Outcomes: Using Retrospective Pretest Methodology

    Microsoft Academic Search

    CLARA C. PRATT; WILLIAM M. MCGUIGAN; APHRA R. KATZEV

    2001-01-01

    This study used longitudinal data from 307 mothers with firstborn infants participating in a home-visitation, child-abuse prevention program. A self-report measure of specific constructs the program hoped to affect showed that the retrospective pretest methodology produced a more legitimate assessment of program outcomes than did the traditional pretest-posttest methodology. Results showed that when response shift bias was present, traditional pretest-posttest

  17. Measuring program outcomes: using retrospective pretest methodology

    Microsoft Academic Search

    Clara C Pratt; William M McGuigan; Aphra R Katzev

    2000-01-01

    This study used longitudinal data from 307 mothers with firstborn infants participating in a home-visitation, child-abuse prevention program. A self-report measure of specific constructs the program hoped to affect showed that the retrospective pretest methodology produced a more legitimate assessment of program outcomes than did the traditional pretest-posttest methodology. Results showed that when response shift bias was present, traditional pretest-posttest

  18. Measuring Program Outcomes: Using Retrospective Pretest Methodology

    Microsoft Academic Search

    Clara C. Pratt; William M. McGuigan; Aphra R. Katzev

    2000-01-01

    This study used longitudinal data from 307 mothers with firstborn infants participating in a home-visitation, child-abuse prevention program. A self-report measure of specific constructs the program hoped to affect showed that the retrospective pretest methodology produced a more legitimate assessment of program outcomes than did the traditional pretest-posttest methodology. Results showed that when response shift bias was present, traditional pretest-posttest

  19. Measuring the General Education Outcomes: Practical Strategies.

    ERIC Educational Resources Information Center

    Peterson, Anne; And Others

    Prepared in an effort to more clearly define and measure general education outcomes at Columbus State Community College, in Ohio, this handbook describes outcomes and associated student behaviors and provides suggestions for assessing the outcomes. Following introductory materials, a list is provided of the college's six general education…

  20. Outcome measurement in forensic mental health research: an evaluation

    Microsoft Academic Search

    Jenny Yiend; Jemma C. Chambers; Tom Burns; Helen Doll; Seena Fazel; Asha Kaur; Lesley Sutton; Ray Fitzpatrick

    2011-01-01

    Measuring change resulting from healthcare interventions is critical to evaluating their usefulness. The choice of outcome measure is an important part of such evaluations and is driven by assumptions about what is likely to change and how best to capture this. Despite its importance, forensic mental health has paid little attention to determining which are the best measures of outcome.

  1. Health Outcome after Major Trauma: What Are We Measuring?

    PubMed Central

    Hoffman, Karen; Cole, Elaine; Playford, E. Diane; Grill, Eva; Soberg, Helene L.; Brohi, Karim

    2014-01-01

    Importance Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. Objective To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. Data Sources MEDLINE, EMBASE, and CINAHL (from 2006–2012) were searched for studies evaluating health outcome after traumatic injuries. Study selection and data extraction Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. Results 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Conclusion Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care. PMID:25051353

  2. Measures of social outcomes in disability research

    Microsoft Academic Search

    Marcel P. J. M. Dijkers; Gale Whiteneck; Rana El-Jaroudi

    2000-01-01

    ABSTRACT. Dijkers MPJM, Whiteneck G, El-Jaroudi R. Measures of social outcomes in disability research. Arch Phys Med Rehabil 2000;81 Suppl 2:S63-S80. Objectives: To describe instruments that have been developed to quantify (aspects of) social outcomes in research on persons with a disability, and to evaluate the clinimetric characteristics of some of the more prominent and promising measures. Data Sources: Literature

  3. Challenges in Measuring Outcomes Following Digital Replantation

    PubMed Central

    Sebastin, Sandeep J.; Chung, Kevin C.

    2013-01-01

    In the early period of replantation surgery, the emphasis was on digit survival. Subsequently, with better microsurgical techniques and instrumentation, the focus has shifted to function and in recent years to consideration of cost-effectiveness. Despite over 40 years of effort in refining digital replantation surgery, a rigorous evaluation of the outcomes of digital replantation has not been performed. This is because of the many confounding variables that influence outcome comparisons. These variables include the mechanism of injury (guillotine, crush, avulsion), the injury itself (total, near total, subtotal, partial amputation), and the surgical procedure (replantation, revascularization). In addition, the traditional outcome measures (two-point discrimination, range of motion, grip strength, or the ability to return to work) are reported inconsistently and vary widely among publications. All these factors make meaningful comparison of outcomes difficult. The recent emphasis on outcome research and cost-effectiveness necessitates a rethinking in the way we report outcomes of digital replantation. In this article, the authors summarize the challenges in assessing outcomes of digital replantation and explain the need to measure outcomes using rigorous clinical research designs that incorporate cost-effectiveness studies in the research protocol. PMID:24872766

  4. Measurement of Health Outcomes Following Tendon and Nerve Repair

    Microsoft Academic Search

    Joy C. MacDermid

    2005-01-01

    The World Health Organization's model of health suggests that tendon and nerve injury outcomes can be assessed in terms of impairment, activity limitations, and participation restrictions. A tendon injury results in impairment of motion and strength of affected digits. Literature on outcome of tendon surgery has focused on active motion. Recently developed devices can be used to measure strength impairments

  5. Use of health-related quality of life measures to predict health utility in postmenopausal osteoporotic women: results from the Multiple Outcomes of Raloxifene Evaluation study

    PubMed Central

    2013-01-01

    Background The aim of this study is to examine the associations between health utility (HU), health-related quality of life (HRQoL), and patient characteristics in postmenopausal osteoporotic (PMO) women. Methods Baseline data from a subsample of 1,245 participants of the Multiple Outcomes of Raloxifene Evaluation study, a randomized, placebo-controlled, multinational clinical trial to evaluate the safety and efficacy of raloxifene, were analyzed. The study cohort included 694 participants from non-European Union (non-EU) countries and 551 participants from EU countries. All participants with complete baseline HU and HRQoL assessments were included in the following analyses: 1) HU (HUI or EQ-5D) and HRQoL (QualEFFO or OPAQ and NHP) associations; 2) HU variability explained by HRQoL domains; and 3) the percentage of HU variability explained by statistically significant (p?Results Several domains were significantly associated with HU scores. HU variance was well explained (41% to 61%) by 4 to 6 (p?measures were significant predictors of HU. HRQoL and HU scores decreased with increased vertebral and non-vertebral fractures. PMID:24192207

  6. Association between Gender, Process of Care Measures, and Outcomes in ACS in India: Results from the Detection and Management of Coronary Heart Disease (DEMAT) Registry

    PubMed Central

    Pagidipati, Neha J.; Huffman, Mark D.; Jeemon, Panniyammakal; Gupta, Rajeev; Negi, Prakash; Jaison, Thannikot M.; Sharma, Satyavan; Sinha, Nakul; Mohanan, Padinhare; Muralidhara, B. G.; Bijulal, Sasidharan; Sivasankaran, Sivasubramonian; Puri, Vijay K.; Jose, Jacob; Reddy, K. Srinath; Prabhakaran, Dorairaj

    2013-01-01

    Background Studies from high-income countries have shown that women receive less aggressive diagnostics and treatment than men in acute coronary syndromes (ACS), though their short-term mortality does not appear to differ from men. Data on gender differences in ACS presentation, management, and outcomes are sparse in India. Methods and Results The Detection and Management of Coronary Heart Disease (DEMAT) Registry collected data from 1,565 suspected ACS patients (334 women; 1,231 men) from ten tertiary care centers throughout India between 2007–2008. We evaluated gender differences in presentation, in-hospital and discharge management, and 30-day death and major adverse cardiovascular event (MACE; death, re-hospitalization, and cardiac arrest) rates. Women were less likely to present with STEMI than men (38% vs. 55%, p<0.001). Overall inpatient diagnostics and treatment patterns were similar between men and women after adjustment for potential confounders. Optimal discharge management with aspirin, clopidogrel, beta-blockers, and statin therapy was lower for women than men, (58% vs. 65%, p?=?0.03), but these differences were attenuated after adjustment (OR?=?0.86 (0.62, 1.19)). Neither the outcome of 30-day mortality (OR?=?1.40 (0.62, 3.16)) nor MACE (OR?=?1.00 (0.67, 1.48)) differed significantly between men and women after adjustment. Conclusions ACS in-hospital management, discharge management, and 30-day outcomes did not significantly differ between genders in the DEMAT registry, though consistently higher treatment rates and lower event rates in men compared to women were seen. These findings underscore the importance of further investigation of gender differences in cardiovascular care in India. PMID:23637963

  7. Costs of measuring outcomes of acute hospital care in a longitudinal outcomes measurement system.

    PubMed

    Schneeweiss, Sebastian; Manstetten, Astrid; Wildner, Manfred; Sangha, Oliver; Liebetrau, Michael; Paeger, Axel

    2003-01-01

    It is widely acknowledged that the measurement of outcomes of care and the comparison of outcomes over time within health care providers and risk-adjusted comparisons among providers are important parts of improving quality and cost-effectiveness of care. However, few studies have assessed the costs of measuring outcomes of care. We sought to evaluate the personnel and financial resources spent for a prospective assessment of outcomes of acute hospital care by health professionals in internal medicine. The study included 15 primary care hospitals participating in a longitudinal outcomes measurement program and 2005 patients over an assessment period with an average duration of 6 months. Each hospital project manager participated in a previously-tested structured 30-minute telephone interview. Outcome measures include time spent by the individual job titles in implementing and running the outcomes measurement program. Job-title-specific times were used to calculate costs from the hospitals' perspective. One-time costs (2132 +/- 1352 Euros) and administrative costs (95 +/- 97 Euros per week) varied substantially. Costs per patient were fairly stable at around 20 Euros. We estimated that the total cost for each hospital to assess outcomes of care for accreditation (10 tracer diagnoses over 6 months) would be 9700 Euros and that continuous monitoring of outcomes (5 tracer diagnoses) would cost 12,400 Euros per year. This study suggests that outcomes of acute hospital care can be assessed with limited resources and that standardized training programs would reduce variability in overall costs. This study should help hospital decision makers to estimate the necessary funding for outcomes measurement initiatives. PMID:12583639

  8. General Outcome Measures for Verbal Operants

    ERIC Educational Resources Information Center

    Kubina, Richard M., Jr.; Wolfe, Pamela; Kostewicz, Douglas E.

    2009-01-01

    A general outcome measure (GOM) can be used to show progress towards a long-term goal. GOMs should sample domains of behavior across ages, be sensitive to change over time, be inexpensive and easy to use, and facilitate decision making. Skinner's (1957) analysis of verbal behavior may benefit from the development of GOM. To develop GOM, we…

  9. Applying Outcome Measurements: A Guide to Educational Outcome Measurements and Their Uses. Seminar No. 5.

    ERIC Educational Resources Information Center

    Glaser, Ezra

    This guide is essentially designed as a teaching aid for those who would inform planners, officials of educational ministries, school administrators, principals, and teachers about educational outcome measurements. In outline and graphic form, the guide presents topics for discussion in a seminar dealing with the application of outcome

  10. Measuring Program Outcomes: Using Retrospective Pretest Methodology.

    ERIC Educational Resources Information Center

    Pratt, Clara C.; McGuigan, William M.; Katsev, Aphra R.

    2000-01-01

    Used longitudinal data from 307 mothers of firstborn infants participating in a home-visitation, child abuse prevention program in a retrospective pretest methodology. Results shows that when response shift bias was present, the retrospective pretest methodology produced a more legitimate assessment of program outcomes than did the traditional…

  11. [Patient-reported outcomes: definition and measurement].

    PubMed

    Botturi, Davide; Rodella, Stefania

    2014-06-01

    The concept of "patient-reported outcomes" have been proposed by the Food and Drug Administration in the year 2000, in order to describe one of the different and potential sources of information on the drug's safety and effectiveness. It represents an "umbrella" term, which covers a multiplicity of meanings and primarily identifies a conceptual approach and a methodology specifically oriented to the patients' point of view on outcomes, instead of the traditional clinical and professional perspective. The patient-reported outcomes measures are frequently self-completed questionnaires. The measures can be classified in general and specific. The first one, general, relates to the assessment of the quality of life or the health status, in the general population or in subgroups with particular health problems (eg. SF-36 Health Survey, EQ-5D). The second one, specific, mainly relates to the assessment of particular types of symptoms (eg. pain, anxiety, fear, depression) and functions (eg. daily living activities), in population's subgroups with definite health problems, undergoing or not to a healthcare procedure (eg. Adult Asthma Quality of Life Questionnaire, Kidney Disease Quality of Life Instrument, Oxford Hip Score, Oxford Knee Score). For the selection of an instrument a series of criteria needs to be taken into account, among which the psychometric properties, the expert judgement, the interpretability, the acceptability, and the feasibility of the entire process. PMID:25002284

  12. Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes

    PubMed Central

    2014-01-01

    Background Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. Methods The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Results Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on outcomes not directly considered by the studies included in the analysis. Conclusions Accounting for the dependency between outcomes in a multivariate meta-analysis may or may not improve the precision of effect estimates from a network meta-analysis compared to analysing each outcome separately. PMID:25047164

  13. Comparative responsiveness of outcome measures for total knee arthroplasty

    PubMed Central

    Giesinger, K.; Hamilton, D.F.; Jost, B.; Holzner, B.; Giesinger, J.M.

    2014-01-01

    Summary Objective The aim of this study was to compare the responsiveness of various patient-reported outcome measures (PROMs) and clinician-reported outcomes following total knee arthroplasty (TKA) over a 2-year period. Methods Data were collected in a prospective cohort study of primary TKA. Patients who had completed Forgotten Joint Score-12 (FJS-12), Western Ontario and McMaster Universities (WOMAC) osteoarthritis (OA) index, EQ-5D, Knee Society Score and range of movement (ROM) assessment were included. Five time points were assessed: pre-operative, 2 months, 6 months, 1 year and 2 years post-operative. Results Data from 98 TKAs were available for analysis. Largest effect sizes (ES) for change from pre-operative to 2-month follow-up were observed for the Knee Society Score (KSS) Knee score (1.70) and WOMAC Total (?1.50). For the period from 6 months to 1 year the largest ES for change were shown by the FJS-12 (0.99) and the KSS Function Score (0.88). The EQ-5D showed the strongest ceiling effect at 1-year follow-up with 84.4% of patients scoring the maximum score. ES for the time from 1- to 2-year follow-up were largest for the FJS-12 (0.50). All other outcome measures showed ES equal or below 0.30. Conclusion Outcome measures differ considerably in responsiveness, especially beyond one year post-operatively. Joint-specific outcome measures are more responsive than clinician-reported or generic health outcome tools. The FJS-12 was the most responsive of the tools assessed; suggesting that joint awareness may be a more discerning measure of patient outcome than traditional PROMs. PMID:24262431

  14. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 2011-10-01 2011-10-01 false Diabetes outcome measurements. 410.146 Section...MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146...

  15. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 2013-10-01 2013-10-01 false Diabetes outcome measurements. 410.146 Section...MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146...

  16. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 2014-10-01 2014-10-01 false Diabetes outcome measurements. 410.146 Section...MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146...

  17. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 2012-10-01 2012-10-01 false Diabetes outcome measurements. 410.146 Section...MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146...

  18. 42 CFR 410.146 - Diabetes outcome measurements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 2010-10-01 2010-10-01 false Diabetes outcome measurements. 410.146 Section...MEDICAL INSURANCE (SMI) BENEFITS Outpatient Diabetes Self-Management Training and Diabetes Outcome Measurements § 410.146...

  19. The International Dermatology Outcome Measures Group: formation of patient-centered outcome measures in dermatology.

    PubMed

    Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W; Abernethy, April; Duffin, Kristina Callis; Bhushan, Reva; Garg, Amit; Merola, Joseph F; Maccarone, Mara; Christensen, Robin

    2015-02-01

    As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis, the group aims to create a tool considerate of patients and providers using the input of all relevant stakeholders in assessment of disease severity and response to treatment. Herein, we delineate the procedures through which consensus is being reached and the future directions of the project. PMID:25486914

  20. Outcome measurements in hand and upper limb surgery.

    PubMed

    Dubert, T

    2014-09-01

    Of marginal importance only 20 years ago, outcome measurement has become one of the most widely published topics in medical literature. The concept of global health is described by the International Classification of Function, Disability and Health. Today, the surgeon's perspective is no longer sufficient to evaluate global health condition of a patient. The patient cannot be reduced to an organ. Outcome measurement must take into consideration body structures and function (symptoms, organ function) as reviewed by a professional, the individual's functional health status in terms of activity and evaluated by the patient himself, and his participation in his social environment. These principles are now being applied to our specialty and it is essential to know them to be able to collect, analyze and publish valid results. This review article defines the rules for using clinical outcome tools, provides the most widely used clinical and self-evaluation forms for our specialty as well as instructions for their use. Global outcome is usually obtained by arithmetic addition of scores; which is a simple but questionable method. The sieving and radar charts can be used for a more comprehensible representation showing areas of relative strength and relative weakness on a graph, as well as depicting general overall performance. The reliability of data is also affected by declaration of conflicts of interest, negligence or fraud. The level of evidence is questionable as long as a data verification system is not implemented. PMID:24993591

  1. Outcomes 'out of africa': the selection and implementation of outcome measures for palliative care in Africa

    PubMed Central

    2012-01-01

    Background End-of-life care research across Africa is under-resourced and under-developed. A central issue in research in end-of-life care is the measurement of effects and outcomes of care on patients and families. Little is known about the experiences of health professionals' selection and implementation of outcome measures (OM) in clinical care, research, audit, or teaching in Africa. Methods An online survey was undertaken of those using outcome measures across the region, as part of the PRISMA project. A questionnaire addressing the use of OMs was developed for a similar survey in Europe and adapted for Africa. Participants were sampled through the contacts database of APCA. Invitation emails were sent out in January 2010 and reminders in February 2010. Results 168/301 invited contacts (56%) from 24 countries responded, with 78 respondents having previously used OM (65% in clinical practice, 12% in research and 23% for both). Main reasons for not using OM were a lack of guidance/training on using and analysing OM, with 49% saying that they would use the tools if this was provided. 40% of those using OM in clinical practice used POS, and 80% used them to assess, evaluate and monitor change. The POS was also the main tool used in research, with the principle criteria for use being validation in Africa, access to the tool and time needed to complete it. Challenges to the use of tools were shortage of time and resources, lack of guidance and training for the professionals, poor health status of patients and complexity of OM. Researchers also have problems analysing OM data. The APCA African POS was the most common version of the POS used, and was reported as a valuable tool for measuring outcomes. Respondents indicated the ideal outcome tool should be short, multi-dimensional and easy to use. Conclusion This was the first survey on professionals' views on OM in Africa. It showed that the APCA African POS was the most frequently OM used. Training and support are needed to help professionals utilise OM in palliative care, and OMs have an ongoing and important role in palliative care in Africa. PMID:22221932

  2. Measuring Outcomes in Urogynecologic Surgery: “Perspective is Everything” – A Review

    PubMed Central

    Parker-Autry, Candace Y.; Barber, Matthew D.; Kenton, Kimberly; Richter, Holly E.

    2013-01-01

    Over 10 years have passed since the first US National Institutes of Health consensus panel considered standardization of definitions of pelvic floor conditions and criteria utilized for reporting pelvic floor research study outcomes. The literature is replete with pelvic floor outcome studies; however, a consistent standardized approach to the evaluation of patients and characterization of outcomes is still needed. The purpose of this overview is to describe how the use of outcome measures have evolved over time and attempt to help readers utilize the best measures for their clinical and research needs. PMID:22930213

  3. Outcome as a Measure of Quality of Care in Oncology

    PubMed Central

    Burney, Ikram A; Al Moundhri, Mansour S; Rizvi, Azhar J; Ganguly, Shyam S; Al Abri, Rashid; Ashrafi, Rafi A

    2008-01-01

    Objectives: Measurement of outcomes is increasingly employed as an indicator of the quality of clinical care. The most commonly measured outcome in many clinical studies, especially in oncology, still remains the overall survival rate. Sultan Qaboos University Hospital (SQUH), Oman, is striving for excellence through quality management. In seeking continual improvement, quality measurement exercises have been initiated throughout the Hospital. We present the overall survival rate of four of the ten most common cancers diagnosed in Oman. Methods: The cancers included non-Hodgkin’s lymphoma (NHL), Hodgkin’s lymphoma (HL), breast cancer, and stomach cancer. The studies were all retrospective and had been conducted previously. For present purposes, only the overall survival was compared with studies both from the region, and with bench-mark studies. Results: For NHL, with a median follow-up of 8 months, the 2-year overall survival rate was 64%; 90% for low risk, 55% for intermediate risk, and 15% for high risk groups. For HL, the 5-year overall survival rate was 64%; 76% for low risk and 42% for high risk. For breast cancer, the 5-year survival rate was 67%; percentages were 88%, 75% and 59% for Groups I, II, and III respectively. For gastric cancer, the 5-year survival rate was 16.5 %; 24% for the non-metastatic group. Conclusion: The outcome of patients with early stages and fewer adverse prognostic factors is comparable to what has been reported in the international literature; however, the outcome is inferior for patients presenting with advanced stage disease and several adverse prognostic factors. PMID:21654954

  4. Generating Outcome Measurements: Economic and Societal. A Guide to Educational Outcomes Measurements and Their Uses. Seminar No. 4.

    ERIC Educational Resources Information Center

    Mushkin, Selma J.; Billings, Bradley B.

    This guide is essentially designed as a teaching aid for those who would inform planners, officials of educational ministires, school administrators, principals, and teachers about educational outcome measurements. In outline and graphic form, the guide presents topics for discussion in a seminar dealing with generating outcome measurements:…

  5. The Harmonizing Outcome Measures for Eczema (HOME) roadmap: a methodological framework to develop core sets of outcome measurements in dermatology.

    PubMed

    Schmitt, Jochen; Apfelbacher, Christian; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric L; Furue, Masutaka; Chalmers, Joanne; Williams, Hywel C

    2015-01-01

    Core outcome sets (COSs) are consensus-derived minimum sets of outcomes to be assessed in a specific situation. COSs are being increasingly developed to limit outcome-reporting bias, allow comparisons across trials, and strengthen clinical decision making. Despite the increasing interest in outcomes research, methods to develop COSs have not yet been standardized. The aim of this paper is to present the Harmonizing Outcomes Measures for Eczema (HOME) roadmap for the development and implementation of COSs, which was developed on the basis of our experience in the standardization of outcome measurements for atopic eczema. Following the establishment of a panel representing all relevant stakeholders and a research team experienced in outcomes research, the scope and setting of the core set should be defined. The next steps are the definition of a core set of outcome domains such as symptoms or quality of life, followed by the identification or development and validation of appropriate outcome measurement instruments to measure these core domains. Finally, the consented COS needs to be disseminated, implemented, and reviewed. We believe that the HOME roadmap is a useful methodological framework to develop COSs in dermatology, with the ultimate goal of better decision making and promoting patient-centered health care. PMID:25186228

  6. The Day-to-Day Acute Effect of Wake Therapy in Patients with Major Depression Using the HAM-D6 as Primary Outcome Measure: Results from a Randomised Controlled Trial

    PubMed Central

    Martiny, Klaus; Refsgaard, Else; Lund, Vibeke; Lunde, Marianne; Sørensen, Lene; Thougaard, Britta; Lindberg, Lone; Bech, Per

    2013-01-01

    Background This paper reports day-to-day data for from a one-week intervention phase, part of a 9-weeks randomised parallel study with patient having major depression (data from weekly visits have been reported). Wake therapy (sleep deprivation) has an established antidepressant effect with onset of action within hours. Deterioration on the following night’s sleep is, however, common, and we used daily light therapy and sleep time stabilisation as a preventive measure. In particular, we evaluated the day-to-day acute effect of and tolerance to sleep deprivation and examined predictors of response. Methods Patients were assessed at psychiatric inpatient wards. In the wake group (n?=?36), patients did three wake therapies in combination with light therapy each morning together with sleep time stabilisation. In the exercise group (n?=?38), patients did daily exercise. Hamilton subscale scores were primary outcome (not blinded), secondary outcome was self-assessment data from the Preskorn scale and sleep. Results Patients in the wake therapy group had an immediate, large, stable, and statistically significant better antidepressant effect than patients in the exercise group with response rates at day5 of 75.0%/25.1% and remission rates of 58.6%/6.0%, respectively. The response and remission rates were diminished at day8 with response rates of 41.9%/10.1% and remission rates of 19.4%/4.7%, respectively. Patients and ward personnel found the method applicable with few side effects. Positive diurnal variation (mood better in the evening) predicted a larger response to wake therapy. In the wake group napping on days after intervention predicted greater deterioration on day8. Conclusions The intervention induced an acute antidepressant response without relapse between wake nights but with a diminishing effect after intervention. Development is still needed to secure maintenance of response. Avoiding napping in the days after wake therapy is important. Trial Registration Clinical trials.gov NCT00149110 PMID:23840645

  7. A Binomial Test of Group Differences with Correlated Outcome Measures

    ERIC Educational Resources Information Center

    Onwuegbuzie, Anthony J.; Levin, Joel R.; Ferron, John M.

    2011-01-01

    Building on previous arguments for why educational researchers should not provide effect-size estimates in the face of statistically nonsignificant outcomes (Robinson & Levin, 1997), Onwuegbuzie and Levin (2005) proposed a 3-step statistical approach for assessing group differences when multiple outcome measures are individually analyzed within…

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

    ERIC Educational Resources Information Center

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

    2000-01-01

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

  9. Direct Measures for Course Outcomes Assessment for ABET Accreditation

    NSDL National Science Digital Library

    Gurocak, Hakan

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

  10. Reference Undulator Measurement Results

    SciTech Connect

    Wolf, Zachary; Levashov, Yurii; /SLAC; ,

    2011-08-18

    The LCLS reference undulator has been measured 22 times during the course of undulator tuning. These measurements provide estimates of various statistical errors. This note gives a summary of the reference undulator measurements and it provides estimates of the undulator tuning errors. We measured the reference undulator many times during the tuning of the LCLS undulators. These data sets give estimates of the random errors in the tuned undulators. The measured trajectories in the reference undulator are stable and straight to within {+-}2 {micro}m. Changes in the phase errors are less than {+-}2 deg between data sets. The phase advance in the cell varies by less than {+-}2 deg between data sets. The rms variation between data sets of the first integral of B{sub x} is 9.98 {micro}Tm, and the rms variation of the second integral of B{sub x} is 17.4 {micro}Tm{sup 2}. The rms variation of the first integral of B{sub y} is 6.65 {micro}Tm, and the rms variation of the second integral of B{sub y} is 12.3 {micro}Tm{sup 2}. The rms variation of the x-position of the fiducialized beam axis is 35 {micro}m in the final production run This corresponds to an rms uncertainty in the K value of {Delta}K/K = 2.7 x 10{sup -5}. The rms variation of the y-position of the fiducialized beam axis is 4 {micro}m in the final production run.

  11. Problem-based learning: measurable outcomes.

    PubMed

    Thomas, R E

    1997-09-01

    Problem-based learning (PBL) could potentially contribute to four key objectives in the education of doctors. (1) Motivating learning. Three studies show that students studying PBL problems choose fewer topics to study than those identified by the faculty, but one study of a critical care rotation showed that students were motivated to learn over a wider range of basic science topics than had been included in the basic science curriculum. (2) Developing clinical reasoning. One study compared methods of solving problems in PBL and conventional track curricula and suggested that PBL students work backwards from clinical information to theory, while conventional curriculum students tend to reason forward from theory. One study showed that computer searches provide knowledge for helping solve some PBL problems, and another study showed that specific knowledge in emergency medicine correlated with test scores. (3) Structuring knowledge in clinical contexts. A few studies show that PBL students perform less well on basic science examinations but better on clinical examinations. Educational outcomes, however, have been assessed quantitatively mainly by the U.S. National Boards of Medical Examiners Examinations or by clinical examinations with small samples. Only one study includes a power computation to assess type II error. There are no studies that examine how much variance occurs between PBL programmes in their curricular methods and outcomes. (4) Developing self learning skills. PBL students use a much wider range and number of resources than conventional track students. There is only one study comparing the knowledge of doctors trained by PBL and conventional curricula after the doctors have been in practice for a substantial number of years, and no studies of patient outcomes. Patient outcomes need to be assessed with randomized controlled trials, and sample sizes should be determined by power computations to avoid Type II error. Four possible methods of improving PBL would be to derive national and internationally accepted PBL curricula; to organize internationally accepted and psychometrically validated methods of evaluation; to develop attitudes among students and tutors to facilitate co-operative PBL teamwork; and to teach group process diagnostic skills. PMID:9488851

  12. Laparoscopic Versus Open Appendectomy: A Comparison of Primary Outcome Measures

    PubMed Central

    Khalil, Jawad; Muqim, Roohul; Rafique, Mohammad; Khan, Mansoor

    2011-01-01

    Background/Aim: The aim of the study was to compare laparoscopic and open appendectomy (OA) in terms of primary outcome measures. Study design: A randomized controlled trial. Place and duration of the study: Khyber Teaching Hospital, Peshawar, Pakistan, February 2008 to December 2009. Patients and Methods: A total of 160 patients were divided into two groups, A and B. Group A patients were subjected to laparoscopic appendectomy (LA), whereas Group B patients were subjected to OA. Data regarding age, gender, and primary outcome measures, such as hospital stay, operative duration, and postoperative complication, were recorded and analyzed. Percentages were calculated for categorical data, whereas numerical data were represented as mean ± SD. Chi-square test and t test were used to compare categorical and numerical variables, respectively. Probability ? 0.05 (P ? 0.05) was considered significant. Results: After randomization, 72 patients in group A and 75 patients in group B were analyzed. The mean age of patients in groups A and B was 23.09 ± 8.51 and 23.12 ± 10.42 years, respectively, (P = 0.981). The mean hospital stay was 1.52 ± 0.76 days in group A and 1.70 ± 1.06 days in group B (P = 0.294). The mean operative duration in group A and B were 47.54 ± 12.82 min and 31.36 ± 11.43 min, respectively (P < 0.001). Pain (overall level) was significantly less in group A compared with group B (P = 0.004). The two groups were comparable in terms of other postoperative complications, such as hematoma (P = 0.87), paralytic ileus (P = 0.086), urinary retention (P = 0.504), and wound infection (P = 0.134). Conclusion: LA is an equivalent procedure and not superior to OA in terms of primary outcome measures. PMID:21727728

  13. Health-related quality of life outcomes measures

    Microsoft Academic Search

    Elena M. Andresen; Allan R. Meyers

    2000-01-01

    ABSTRACT. Andresen EM, Meyers AR. Health-related quality of life outcomes measures. Arch Phys Med Rehabil 2000;81 Suppl 2:S30-S45. Objective: To review critically the features of measures of generic health-related quality of life (HRQOL) for disability outcomes research. Data Sources: A search of electronic databases, summary reviews, books, and government documents was performed. Comment and experiences from participants of a conference

  14. Directly measured secondhand smoke exposure and COPD health outcomes

    PubMed Central

    Eisner, Mark D; Balmes, John; Yelin, Edward H; Katz, Patricia P; Hammond, S Katherine; Benowitz, Neal; Blanc, Paul D

    2006-01-01

    Background Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD), secondhand smoke (SHS) exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL), and dyspnea measured at one year follow-up. Results The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9) and dyspnea (1.0 pts; 95% CI 0.4 to 1.7) after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054), disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063), and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p < 0.05), although the confidence intervals did not always exclude the no effect level. Conclusion Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking. PMID:16756671

  15. Definitions and outcome measures for mucous membrane pemphigoid: recommendations of an international panel of experts.

    PubMed

    Murrell, Dedee F; Marinovic, Branka; Caux, Frederic; Prost, Catherine; Ahmed, Razzaque; Wozniak, Katarzyna; Amagai, Masayuki; Bauer, Johann; Beissert, Stefan; Borradori, Luca; Culton, Donna; Fairley, Janet A; Fivenson, David; Jonkman, Marcel F; Marinkovich, M Peter; Woodley, David; Zone, John; Aoki, Valeria; Bernard, Philippe; Bruckner-Tuderman, Leena; Cianchini, Giuseppe; Venning, Vanessa; Diaz, Luis; Eming, Rudiger; Grando, Sergei A; Hall, Russell P; Hashimoto, Takashi; Herrero-González, Josep E; Hertl, Michael; Joly, Pascal; Karpati, Sarolta; Kim, Jaehwan; Chan Kim, Soo; Korman, Neil J; Kowalewski, Cezary; Lee, Sang Eun; Rubenstein, David R; Sprecher, Eli; Yancey, Kim; Zambruno, Giovanna; Zillikens, Detlef; Doan, Serge; Daniel, Benjamin S; Werth, Victoria P

    2015-01-01

    Mucous membrane pemphigoid encompasses a group of autoimmune bullous diseases with a similar phenotype characterized by subepithelial blisters, erosions, and scarring of mucous membranes, skin, or both. Although knowledge about autoimmune bullous disease is increasing, there is often a lack of clear definitions of disease, outcome measures, and therapeutic end points. With clearer definitions and outcome measures, it is possible to directly compare the results and data from various studies using meta-analyses. This consensus statement provides accurate and reproducible definitions for disease extent, activity, outcome measures, end points, and therapeutic response for mucous membrane pemphigoid and proposes a disease extent score, the Mucous Membrane Pemphigoid Disease Area Index. PMID:25443626

  16. Directly measured second hand smoke exposure and asthma health outcomes

    PubMed Central

    Eisner, M; Klein, J; Hammond, S; Koren, G; Lactao, G; Iribarren, C

    2005-01-01

    Background: Because they have chronic airway inflammation, adults with asthma could have symptomatic exacerbation after exposure to second hand smoke (SHS). Surprisingly, data on the effects of SHS exposure in adults with asthma are quite limited. Most previous epidemiological studies used self-reported SHS exposure which could be biased by inaccurate reporting. In a prospective cohort study of adult non-smokers recently admitted to hospital for asthma, the impact of SHS exposure on asthma health outcomes was examined. Methods: Recent SHS exposure during the previous 7 days was directly measured using a personal nicotine badge (n = 189) and exposure during the previous 3 months was estimated using hair nicotine and cotinine levels (n = 138). Asthma severity and health status were ascertained during telephone interviews, and subsequent admission to hospital for asthma was determined from computerised utilisation databases. Results: Most of the adults with asthma were exposed to SHS, with estimates ranging from 60% to 83% depending on the time frame and methodology. The highest level of recent SHS exposure, as measured by the personal nicotine badge, was related to greater asthma severity (mean score increment for highest tertile of nicotine level 1.56 points; 95% CI 0.18 to 2.95), controlling for sociodemographic covariates and previous smoking history. Moreover, the second and third tertiles of hair nicotine exposure during the previous month were associated with a greater baseline prospective risk of hospital admission for asthma (HR 3.73; 95% CI 1.04 to 13.30 and HR 3.61; 95% CI 1.0 to 12.9, respectively). Conclusions: Directly measured SHS exposure appears to be associated with poorer asthma outcomes. In public health terms, these results support efforts to prohibit smoking in public places. PMID:16192366

  17. IBADAN KNEE/HIP OSTEOARTHRITIS OUTCOME MEASURE: PROCESS OF DEVELOPMENT

    PubMed Central

    Odole, A.C.; Odunaiya, N.A.; Akinpelu, A.O.

    2013-01-01

    The development of instruments for the assessment of therapeutic intervention has been an age long practice. However, many of the published instruments do not have detailed information on how the instruments were developed. It is necessary for authors to provide detailed (step by step) information on how measuring scales/instruments are developed. The Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM) was developed as a Nigerian-environment and culture-friendly instrument for the assessment of the effectiveness of therapeutic interventions in individuals with osteoarthritis of the knee and/or hip. This article outlines the steps involved in developing an outcome measure using IKHOAM as a template. PMID:25161423

  18. Can a Future Choice Affect a Past Measurement's Outcome?

    E-print Network

    Yakir Aharonov; Eliahu Cohen; Avshalom C. Elitzur

    2015-06-20

    An EPR experiment is studied where each particle within the entangled pair undergoes a few weak measurements (WMs) along some pre-set spin orientations, with the outcomes individually recorded. Then the particle undergoes one strong measurement along an orientation chosen at the last moment. Bell-inequality violation is expected between the two final measurements within each EPR pair. At the same time, statistical agreement is expected between these strong measurements and the earlier weak ones performed on that pair. A contradiction seemingly ensues: (i) Bell's theorem forbids spin values to exist prior to the choice of the orientation measured; (ii) A weak measurement is not supposed to determine the outcome of a successive strong one; and indeed (iii) Almost no disentanglement is inflicted by the WMs; and yet (iv) The outcomes of weak measurements statistically agree with those of the strong ones, suggesting the existence of pre-determined values, in contradiction with (i). Although the conflict can be solved by mere mitigation of the above restrictions, the most reasonable resolution seems to be that of the Two-State-Vector Formalism (TSVF), namely, that the choice of the experimenter has been encrypted within the weak measurement's outcomes, even before the experimenters themselves know what their choice will be.

  19. A Consumer's Guide to Mental Health Treatment Outcome Measures.

    ERIC Educational Resources Information Center

    Pfeiffer, Steven I.; And Others

    A simple way of comparing the more widely used measures of the outcomes of mental health treatment is offered through this list of measures that includes both practical information and information about psychometric considerations. Each review contains information about the format, practicality (administration time and scoring), reliability,…

  20. OMERACT: An international initiative to improve outcome measurement in rheumatology

    Microsoft Academic Search

    Peter Tugwell; Maarten Boers; Peter Brooks; Lee Simon; Vibeke Strand; Leanne Idzerda

    2007-01-01

    OMERACT is the acronym for an international, informally organized network initiated in 1992 aimed at improving outcome measurement in rheumatology. Chaired by an executive committee, it organizes consensus conferences in a 2-yearly cycle that circles the globe. Data driven recommendations are prepared and updated by expert working groups. Recommendations include core sets of measures for most of the major rheumatologic

  1. Outcome measurement in clinical trials for Ulcerative Colitis: towards standardisation

    PubMed Central

    Cooney, Rachel M; Warren, Bryan F; Altman, Douglas G; Abreu, Maria T; Travis, Simon PL

    2007-01-01

    Clinical trials on novel drug therapies require clear criteria for patient selection and agreed definitions of disease remission. This principle has been successfully applied in the field of rheumatology where agreed disease scoring systems have allowed multi-centre collaborations and facilitated audit across treatment centres. Unfortunately in ulcerative colitis this consensus is lacking. Thirteen scoring systems have been developed but none have been properly validated. Most trials choose different endpoints and activity indices, making comparison of results from different trials extremely difficult. International consensus on endoscopic, clinical and histological scoring systems is essential as these are the key components used to determine entry criteria and outcome measurements in clinical trials on ulcerative colitis. With multiple new therapies under development, there is a pressing need for consensus to be reached. PMID:17592647

  2. Advances in diagnostics and outcome measures in peripheral neuropathies.

    PubMed

    Merkies, Ingemar S J; Faber, Catharina G; Lauria, Giuseppe

    2015-06-01

    Peripheral neuropathies are a group of acquired and hereditary disorders presenting with different distribution and nerve fiber class involvement. The overall prevalence is 2.4%, increasing to 8% in the elderly population. However, the frequency may vary depending on the underlying pathogenesis and association with systemic diseases. Distal symmetric polyneuropathy is the most common form, though multiple mononeuropathies, non-length dependent neuropathy and small fiber neuropathy can occur and may require specific diagnostic tools. The use of uniform outcome measures in peripheral neuropathies is important to improve the quality of randomized controlled trials, enabling comparison between studies. Recent developments in defining the optimal set of outcome measures in inflammatory neuropathies may serve as an example for other conditions. Diagnostic and outcome measure advances in peripheral neuropathies will be discussed. PMID:25703220

  3. Outcome measures in palliative care for advanced cancer patients: a review

    Microsoft Academic Search

    Julie Hearn; Irene J. Higginson

    Summary Information generated using outcome measures to measure the effectiveness of palliative care interventions is potentially invaluable. Depending on the measurement tool employed the results can be used to monitor clinical care, carry out comparative research, provide audit data or inform purchas- ing decisions. However, the data collected can only ever be as good as the method used to obtain

  4. Relation of executive functioning and social communication measures to functional outcomes following traumatic brain injury.

    PubMed

    Struchen, Margaret A; Clark, Allison N; Sander, Angelle M; Mills, Monique R; Evans, Gina; Kurtz, Diana

    2008-01-01

    Neuropsychologists are increasingly asked to provide recommendations regarding functional abilities based on test results, particularly within the rehabilitation setting. Yet, the empirical basis for making such recommendations is limited. The current study examines relationships between executive functioning and social communication measures and concurrently measured occupational and social integration outcomes. Participants were 121 individuals with traumatic brain injury (TBI) recruited from participants in a longitudinal study of outcome following TBI who had all received comprehensive brain injury rehabilitation. As part of a larger study designed to evaluate social communication abilities following TBI, participants completed measures of executive functioning, affect perception, perceived communication ability, and functional outcome. After adjusting for age, education, and performance on executive functioning measures, social communication performance accounted for a unique 5.6% of the variance in occupational outcomes and 7.9% of variance in social integration outcomes. Executive functioning performance accounted for a unique 13.3% of the variance in occupational functioning and 16.0% of explained variance in social integration. These results provide evidence of the value of executive functioning and social communication measures in the prediction of functional outcomes. Additionally, such results provide preliminary support for the addition of social communication measures to assessment of TBI in neuropsychological practice. PMID:18525140

  5. Quantum correlations cannot arise from measurements with limited number of outcomes

    E-print Network

    Matthias Kleinmann; Adan Cabello

    2015-06-02

    There is a tension in quantum theory between the existence of a widely accepted way to axiomatize the theory and the lack of similarly accepted intuitive principles from which the theory can be derived. This tension is present at the very definition of what measurements are admissible. The usual assumption is that all measurements which do not produce negative probabilities are valid measurements, irrespective of how many outcomes the measurement has. Here we show that this assumption is accessible to falsification by particular high-precision Bell-type experiments, which can exclude that all measurements are produced from measurements with a limited number of outcomes and classical measurements. Our analysis reveals that the results of previous experiments provide evidence that nature cannot be explained with the simplest of these modifications in which quantum measurements are limited to two or three outcomes. This supports standard quantum theory versus some natural and almost indistinguishable alternatives. Future experiments can also aim to exclude other alternatives such as quantum measurements with higher number of outcomes and more general non-signaling theories with a limited number of outcomes, possibly imposing universal constraints on the structure of measurements in any physical theory.

  6. Identification and Measurement of Career Education Outcomes: A Texas Model

    ERIC Educational Resources Information Center

    Arterbury, Elvis H.; And Others

    1976-01-01

    As part of a statewide assessment planning effort to establish career education in Texas, basic information was sought. Procedures used to find out what community members thought student development should be in terms of career education are described. The practicality and feasibility of measuring the student outcomes identified are discussed. (BP)

  7. Conceptualizing Outcome and Impact Measures for Intelligence Services

    ERIC Educational Resources Information Center

    Gainor, Rhiannon; Bouthillier, France

    2014-01-01

    Introduction: The purpose of this qualitative, exploratory study is to clarify ambiguous concepts in intelligence services literature specifically related to measurement of intelligence outcomes and impact. Method: Face to face interviews were held with five subject experts from various intelligence fields and countries regarding their…

  8. Differences Among Outcome Measures in Occupational Low Back Pain

    Microsoft Academic Search

    Sue A. Ferguson; William S. Marras; Deborah L. Burr

    2005-01-01

    The rate of recurrence in low back pain patients has been reported as high as 70%; therefore, it is believed that researchers have a poor understanding of low back pain recovery. To enhance our understanding of recovery, a large cross-sectional study was conducted to compare outcome measures of return to work, impairment of activities of daily living, pain symptoms, and

  9. Knowledge Retention as a Latent Outcome Measure in Distance Learning.

    ERIC Educational Resources Information Center

    Wisher, Robert A.; Curnow, Christina K.; Seidel, Robert J.

    2001-01-01

    Describes two experiments that investigated the retention of knowledge as a latent measure of learning outcome in video teletraining courses, one for air traffic controllers and one for military training. Discusses the merits of knowledge retention as a construct for examining initial evidence of learning, especially for training related to the…

  10. Nurse and Volunteer Competency Tools with Measurable Outcomes: Does Your Staff Measure Up?

    Microsoft Academic Search

    Marsha Magnusen Hughes; Karrie Bruegman-May

    1996-01-01

    The RN and Volunteer Clinical Competency Tools with Measurable Outcomes is a very practical, cost- effective tool for orientation and ongoing education. They provide a list of competencies that are then broken down into (1) subject, (2) content or learning options, and (3) measurable outcomes or evaluation mechanisms. These tools strive to facilitate productivity earlier, reduce turnover, decrease burnout, increase

  11. Unconditionally Secure Bit Commitment by Transmitting Measurement Outcomes

    E-print Network

    ,

    2011-01-01

    We propose a new unconditionally secure bit commitment scheme based on Minkowski causality and the properties of quantum information. The receiving party sends a number of randomly chosen BB84 qubits to the committer at a given point in space-time. The committer carries out measurements in one of the two BB84 bases, depending on the committed bit value, and transmits the outcomes securely at light speed in opposite directions to remote agents. These agents unveil the bit by returning the outcomes to adjacent agents of the receiver. The security proofs rely only on simple properties of quantum information and the impossibility of superluminal signalling.

  12. Unconditionally Secure Bit Commitment by Transmitting Measurement Outcomes

    E-print Network

    Adrian Kent

    2012-04-02

    We propose a new unconditionally secure bit commitment scheme based on Minkowski causality and the properties of quantum information. The receiving party sends a number of randomly chosen BB84 qubits to the committer at a given point in space-time. The committer carries out measurements in one of the two BB84 bases, depending on the committed bit value, and transmits the outcomes securely at light speed in opposite directions to remote agents. These agents unveil the bit by returning the outcomes to adjacent agents of the receiver. The security proofs rely only on simple properties of quantum information and the impossibility of superluminal signalling.

  13. PERFORMANCE METRICS: AN OVERVIEW OF ECOLOGICAL "OUTCOME" MEASUREMENT AT EPA

    EPA Science Inventory

    The terms "Accountability" and "Outcome" are becoming ubiquitous in government agencies. The impetus for demonstrating results from government-sponsored research and regulation comes from Congress (e.g., statutes like the Government Performance Results Act of 1993 and reports fro...

  14. Measure Once, Cut Twice – Adding Patient-Reported Outcome Measures to the Electronic Health Record for Comparative Effectiveness Research

    PubMed Central

    Wu, Albert W.; Kharrazi, Hadi; Boulware, L. Ebony; Snyder, Claire F.

    2013-01-01

    Objective This paper presents the current state of patient-reported outcome measures, and explains new opportunities for leveraging the recent adoption of electronic health records to expand the application of patient-reported outcomes in both clinical care and comparative effectiveness research. Study Design and Setting Historic developments of patient-reported outcome, electronic health record, and comparative effectiveness research are analyzed in two dimensions: patient-centeredness and digitization. We pose the question: “What needs to be standardized around the collection of patient-reported outcomes in electronic health records for comparative effectiveness research?” Results We identified three converging trends: the progression of patient-reported outcomes toward greater patient centeredness and electronic adaptation; the evolution of electronic health records into personalized and fully digitized solutions; the shift toward patient-oriented comparative effectiveness research. Related to this convergence, we propose an architecture for patient-reported outcome standardization that could serve as a first step toward a more comprehensive integration of patient-reported outcomes with electronic health record for both practice and research. Conclusion The science of patient-reported outcome measurement has matured sufficiently to be integrated routinely into electronic health records and other e-health solutions to collect data on an ongoing basis for clinical care and comparative effectiveness research. Further efforts and ideally coordinated efforts from various stakeholders are needed to refine the details of the proposed framework for standardization. PMID:23849145

  15. Novel mechanisms, treatments, and outcome measures in childhood sleep

    PubMed Central

    Colonna, Annalisa; Smith, Anna B.; Pal, Deb K.; Gringras, Paul

    2015-01-01

    Sleep disorders and sleep of insufficient duration and quality are on the increase due to changes in our lifestyle, particularly in children and adolescents. Sleep disruption is also more common in children with medical conditions, compounding their difficulties. Recent studies have focused on new mechanisms that explain how learning and cognitive performance depend on a good night’s sleep. Growing alongside this latest understanding is an innovative new field of non-drug interventions that improve sleep architecture, with resulting cognitive improvements. However, we need to rigorously evaluate such potentially popular and self-administered sleep interventions with equally state-of-the-art outcome measurement tools. Animated hand-held games, that incorporate embedded sleep-dependent learning tasks, promise to offer new robust methods of measuring changes in overnight learning. Portable computing technology has the potential to offer practical, inexpensive and reliable tools to indirectly assess the quality of sleep. They may be adopted in both clinical and educational settings, providing a unique way of monitoring the effect of sleep disruption on learning, leading also to a radical rethink of how we manage chronic diseases. PMID:26029140

  16. Novel mechanisms, treatments, and outcome measures in childhood sleep.

    PubMed

    Colonna, Annalisa; Smith, Anna B; Pal, Deb K; Gringras, Paul

    2015-01-01

    Sleep disorders and sleep of insufficient duration and quality are on the increase due to changes in our lifestyle, particularly in children and adolescents. Sleep disruption is also more common in children with medical conditions, compounding their difficulties. Recent studies have focused on new mechanisms that explain how learning and cognitive performance depend on a good night's sleep. Growing alongside this latest understanding is an innovative new field of non-drug interventions that improve sleep architecture, with resulting cognitive improvements. However, we need to rigorously evaluate such potentially popular and self-administered sleep interventions with equally state-of-the-art outcome measurement tools. Animated hand-held games, that incorporate embedded sleep-dependent learning tasks, promise to offer new robust methods of measuring changes in overnight learning. Portable computing technology has the potential to offer practical, inexpensive and reliable tools to indirectly assess the quality of sleep. They may be adopted in both clinical and educational settings, providing a unique way of monitoring the effect of sleep disruption on learning, leading also to a radical rethink of how we manage chronic diseases. PMID:26029140

  17. Clinical outcome data for symptomatic breast cancer: the breast cancer clinical outcome measures (BCCOM) project

    Microsoft Academic Search

    T Bates; O Kearins; I Monypenny; C Lagord; G Lawrence

    2009-01-01

    Background:Data collection for screen-detected breast cancer in the United Kingdom is fully funded, which has led to improvements in clinical practice. However, data on symptomatic cancer are deficient, and the aim of this project was to monitor the current practice.Methods:A data set was designed together with surrogate outcome measures to reflect best practice. Data from cancer registries initially required the

  18. Generating Outcome Measurements: Achievement and Attitudes. A Guide to Educational Outcome Measurements and Their Uses. Seminar No. 3.

    ERIC Educational Resources Information Center

    Mushkin, Selma J.; Billings, Bradley B.

    This guide is essentially designed as a teaching aid for those who would inform planners, officials of educational ministries, school administrators, principals, and teachers about educational outcome measurements. In outline and graphic form, the guide presents topics for discussion in a seminar dealing with how to obtain information on…

  19. Resolving the problem of definite outcomes of measurements

    E-print Network

    Art Hobson

    2015-06-25

    The core of the measurement problem, namely the problem of definite outcomes, remains unresolved. This paper shows that Josef Jauch's 1968 reduced density operator approach is the correct resolution, even though many have questioned it. In addition to Jauch's argument, a new argument based on the nonlocal entanglement between the quantum system and its measuring apparatus shows that the observed outcomes must be the definite reduced local states because of relativity's ban on instant signaling. Experiments in 1990 with entangled photon pairs provide insight into the entangled measurement state, showing it to be a superposition only of correlations, not of quantum state amplitudes. Nature's measurement strategy is to shift the superposition (the coherence) from the detected quantum system to the correlations between this system and its detector, allowing both system and detector to collapse locally into incoherent mixtures of definite outcomes while the global state maintains its unitary evolution. This resolution implies a revision of the standard eigenvalue-eigenstate link, but this neither alters nor contradicts other quantum principles. Three frequent objections to this resolution are rebutted.

  20. Outcome Measures of Triple Board Graduates, 1991-2003

    ERIC Educational Resources Information Center

    Warren, Marla J.; Dunn, David W.; Rushton, Jerry

    2006-01-01

    Objective: To describe program outcomes for the Combined Training Program in Child and Adolescent Psychiatry, Pediatrics, and Psychiatry (Triple Board Program). Method: All Triple Board Program graduates to date (1991-2003) were asked to participate in a 37-item written survey from February to April 2004. Results: The response rate was 80.7%. Most…

  1. Novel Outcome Measures for Clinical Trials in Cystic Fibrosis

    PubMed Central

    Tiddens, Harm AWM; Puderbach, Michael; Venegas, Jose G; Ratjen, Felix; Donaldson, Scott H; Davis, Stephanie D; Rowe, Steven M; Sagel, Scott D; Higgins, Mark; Waltz, David A

    2015-01-01

    Cystic fibrosis (CF) is a common inherited condition caused by mutations in the gene encoding the CF transmembrane regulator protein. With increased understanding of the molecular mechanisms underlying CF and the development of new therapies there comes the need to develop new outcome measures to assess the disease, its progression and response to treatment. As there are limitations to the current endpoints accepted for regulatory purposes, a workshop to discuss novel endpoints for clinical trials in CF was held in Anaheim, California in November 2011. The pros and cons of novel outcome measures with potential utility for evaluation of novel treatments in CF were critically evaluated. The highlights of the 2011 workshop and subsequent advances in technologies and techniques that could be used to inform the development of clinical trial endpoints are summarized in this review. Pediatr Pulmonol. © 2014 The Authors. Pediatric Pulmonology published by Wiley Periodicals, Inc. PMID:25641878

  2. Engaging the hearts and minds of clinicians in outcome measurement – the UK rehabilitation outcomes collaborative approach

    PubMed Central

    2012-01-01

    Purpose This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Key messages and implications Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) “needs” for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. Conclusions By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term. PMID:22506959

  3. Factors predicting work status 3?months after injury: results from the Prospective Outcomes of Injury Study

    PubMed Central

    Davie, Gabrielle; Ameratunga, Shanthi; Derrett, Sarah

    2012-01-01

    Objective Few studies examine predictors of work status following injury beyond injuries presenting to a hospital or emergency department. This paper examines the combined influences of socio-demographic, occupational, injury and pre-existing health and lifestyle factors as predictors of work status 3?months after hospitalised and non-hospitalised injury in a cohort of injured New Zealand workers. Design Prospective cohort study. Setting The Prospective Outcomes of Injury Study, New Zealand. Participants 2626 workforce active participants were identified from the Prospective Outcomes of Injury Study; 11 participants with missing outcome responses were excluded. Primary and secondary outcome measures The primary outcome of interest was ‘not working’ at the time of interview. Results 720 (27%) reported ‘not working’ 3?months after injury. The most important pre-injury predictors of not working following injury found by multidimensional modelling were as follows: low or unknown income, financial insecurity, physical work tasks, temporary employment, long week schedules, obesity, perceived threat to life and hospital admission. Contrary to expectations, workers reporting less frequent exercise pre-injury had lower odds of work absence. Pre-injury psychosocial and health factors were not associated with not working. Conclusion Certain pre-injury socio-demographic, physical work, work organisation, lifestyle and injury-related factors were associated with not working 3?months after injury. If these findings are confirmed, intervention strategies aimed at improving return to work should address multiple dimensions of both the worker and the workplace. PMID:22389359

  4. Unconditionally secure bit commitment by transmitting measurement outcomes.

    PubMed

    Kent, Adrian

    2012-09-28

    We propose a new unconditionally secure bit commitment scheme based on Minkowski causality and the properties of quantum information. The receiving party sends a number of randomly chosen Bennett-Brassard 1984 (BB84) qubits to the committer at a given point in space-time. The committer carries out measurements in one of the two BB84 bases, depending on the committed bit value, and transmits the outcomes securely at (or near) light speed in opposite directions to remote agents. These agents unveil the bit by returning the outcomes to adjacent agents of the receiver. The protocol's security relies only on simple properties of quantum information and the impossibility of superluminal signalling. PMID:23030073

  5. Quantum interferometry with binary-outcome measurements in the presence of phase diffusion

    E-print Network

    X. M. Feng; G. R. Jin; W. Yang

    2014-07-09

    Optimal measurement scheme with an efficient data processing is important in quantum-enhanced interferometry. Here we prove that for a general binary outcome measurement, the simplest data processing based on inverting the average signal can saturate the Cram\\'{e}r-Rao bound. This idea is illustrated by binary outcome homodyne detection, even-odd photon counting (i.e., parity detection), and zero-nonzero photon counting that have achieved super-resolved interferometric fringe and shot-noise limited sensitivity in coherent-light Mach-Zehnder interferometer. The roles of phase diffusion are investigated in these binary outcome measurements. We find that the diffusion degrades the fringe resolution and the achievable phase sensitivity. Our analytical results confirm that the zero-nonzero counting can produce a slightly better sensitivity than that of the parity detection, as demonstrated in a recent experiment.

  6. Quantum interferometry with binary-outcome measurements in the presence of phase diffusion

    E-print Network

    Feng, X M; Yang, W

    2014-01-01

    Optimal measurement scheme with an efficient data processing is important in quantum-enhanced interferometry. Here we prove that for a general binary outcome measurement, the simplest data processing based on inverting the average signal can saturate the Cram\\'{e}r-Rao bound. This idea is illustrated by binary outcome homodyne detection, even-odd photon counting (i.e., parity detection), and zero-nonzero photon counting that have achieved super-resolved interferometric fringe and shot-noise limited sensitivity in coherent-light Mach-Zehnder interferometer. The roles of phase diffusion are investigated in these binary outcome measurements. We find that the diffusion degrades the fringe resolution and the achievable phase sensitivity. Our analytical results confirm that the zero-nonzero counting can produce a slightly better sensitivity than that of the parity detection, as demonstrated in a recent experiment.

  7. Health outcomes in diabetics measured with Minnesota Community Measurement quality metrics

    PubMed Central

    Takahashi, Paul Y; St Sauver, Jennifer L; Finney Rutten, Lila J; Jacobson, Robert M; Jacobson, Debra J; McGree, Michaela E; Ebbert, Jon O

    2015-01-01

    Objective Our objective was to understand the relationship between optimal diabetes control, as defined by Minnesota Community Measurement (MCM), and adverse health outcomes including emergency department (ED) visits, hospitalizations, 30-day rehospitalization, intensive care unit (ICU) stay, and mortality. Patients and methods In 2009, we conducted a retrospective cohort study of empaneled Employee and Community Health patients with diabetes mellitus. We followed patients from 1 September 2009 until 30 June 2011 for hospitalization and until 5 January 2014 for mortality. Optimal control of diabetes mellitus was defined as achieving the following three measures: low-density lipoprotein (LDL) cholesterol <100 mg/mL, blood pressure <140/90 mmHg, and hemoglobin A1c <8%. Using the electronic medical record, we assessed hospitalizations, ED visits, ICU stays, 30-day rehospitalizations, and mortality. The chi-square or Wilcoxon rank-sum tests were used to compare those with and without optimal control. We used Cox proportional hazard models to estimate the associations between optimal diabetes mellitus status and each outcome. Results We identified 5,731 empaneled patients with diabetes mellitus; 2,842 (49.6%) were in the optimal control category. After adjustment, we observed that non-optimally controlled patients had higher risks for hospitalization (hazard ratio [HR] 1.11; 95% confidence interval [CI] 1.00–1.23), ED visits (HR 1.15; 95% CI 1.06–1.25), and mortality (HR 1.29; 95% CI 1.09–1.53) than diabetic patients with optimal control. No differences were observed in ICU stay or 30-day rehospitalization. Conclusion Diabetic patients without optimal control had higher risks of adverse health outcomes than those with optimal control. Patients with optimal control defined by the MCM were associated with decreased morbidity and mortality. PMID:25565873

  8. Technical Characteristics of General Outcome Measures (GOMs) in Reading for Students with Significant Cognitive Disabilities

    ERIC Educational Resources Information Center

    Wallace, Teri; Ticha, Renata; Gustafson, Kathy

    2010-01-01

    This study examined the technical characteristics of newly created general outcome measures (GOMs) in reading for students with significant cognitive disabilities. The participants were 31 students with significant cognitive disabilities, and the GOMs used produced reliable data. Early results establishing the validity of the GOMs suggest that…

  9. Similarities and differences between retrospective and pre–post measurements of outcome

    Microsoft Academic Search

    Christoph Flückiger; Daniel Regli; Klaus Grawe; Wolfgang Lutz

    2007-01-01

    In past years, various theoretical conceptualizations of therapeutic outcome have been proposed. Differences based on pre–post and retrospective measurements were found (Michalak et al., 2003). In the current study, a sample of 263 patients completed seven questionnaires pre- and posttreatment or retrospectively. The results were examined with explorative and confirmative factor analyses. The authors found high intercorrelations and internal consistency

  10. Patient-reported outcome measures in inflammatory bowel disease

    PubMed Central

    El-Matary, Wael

    2014-01-01

    Patient-reported outcome measures (PROMs) are increasingly used in both research and clinical health settings. With the recent development of United States Food and Drug Administration guidance on PROMs, more attention is being devoted to their role and importance in health care. Several methodological challenges in the development, validation and implementation of PROMs must be resolved to ensure their appropriate utilization and interpretation. The present review discusses recent developments and updates in PROMs, with specific focus on the area of inflammatory bowel disease. PMID:25390615

  11. Development of the FOCUS (Focus on the Outcomes of Communication under Six), a Communication Outcome Measure for Preschool Children

    ERIC Educational Resources Information Center

    Thomas-Stonell, Nancy L.; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter L.

    2010-01-01

    Aim: Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real-world changes in preschool children's communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived…

  12. CONCEPTUALIZATION AND MEASUREMENT OF PATIENT CHANGE DURING PSYCHOTHERAPY: DEVELOPMENT OF THE OUTCOME QUESTIONNAIRE AND YOUTH OUTCOME QUESTIONNAIRE

    Microsoft Academic Search

    M. GAWAIN WELLS; GARY M. BURLINGAME; MICHAEL J. LAMBERT; MATTHEW J. HOAG; CAROLEN A. HOPE

    1996-01-01

    The so-called age of accountability has been thrust upon psychotherapists by rising healthcare costs and the consequent growth of managed care. Accordingly, tracking psychotherapy outcomes is becoming a requirement for most practitioners. We suggest there is reason for optimism in accepting and employing treatment outcome measurement as an integral part of clinical practice. This article describes the construction and psychometric

  13. Early Antitoxin Treatment in Wound Botulism Results in Better Outcome

    Microsoft Academic Search

    Gregory Youngnam Chang; Gautam Ganguly

    2003-01-01

    Wound botulism in 7 heroin ‘skin poppers’ produced ophthalmoplegia and descending paralysis. Rapid recovery occurred in 2 who received the antitoxin within the fourth day of symptom onset. A poor outcome was seen in 4 who received the antitoxin after the eighth day of symptoms and 1 who did not receive the antitoxin. Early antitoxin administration is important in achieving

  14. Predicting Outcome in Behavioral Parent Training: Expected and Unexpected Results

    ERIC Educational Resources Information Center

    MacKenzie, Elizabeth P.; Fite, Paula J.; Bates, John E.

    2004-01-01

    This study examined the relationships among clinical utility and treatment outcome variables in Behavioral Parent Training (BPT). The sample included 21 mothers with 3-8 year-old children with significant externalizing behavior problems who received treatment for Oppositional Defiant Disorder. The primary aim was to relate two treatment…

  15. Children's Program Outcome Review Team: 2000 Evaluation Results.

    ERIC Educational Resources Information Center

    Wade, Patricia C.

    In its seventh year of evaluating children's services, the Children's Program Outcome Review Team (CPORT), under the direction of the Tennessee Commission on Children and Youth, continued to collect and analyze data to improve service delivery to children and families involved in state custody. The CPORT evaluation for 2000 collected and organized…

  16. Using Cross-Cultural Dimensions Exercises to Improve and Measure Learning Outcomes in International Business Courses

    ERIC Educational Resources Information Center

    Zainuba, Mohamed; Rahal, Ahmad

    2012-01-01

    This article proposes an approach for using cross-cultural dimensions exercises to improve and measure learning outcomes in international business courses. The following key issues are highlighted: (a) what are the targeted learning outcomes to be assessed, (b) how to measure the accomplishment of these learning outcomes, (c) the input measures

  17. Measures of attentional bias and relational responding are associated with behavioral treatment outcome for cocaine dependence

    PubMed Central

    Carpenter, Kenneth M.; Martinez, Diana; Vadhan, Nehal P.; Barnes-Holmes, Dermot; Nunes, Edward V.

    2012-01-01

    Background Psychosocial interventions for substance dependence have demonstrated efficacy. However, the mechanisms by which specific intervention strategies exert their effect have not been clearly identified. Objective This study investigated the prospective relationships between two psychological processes, an attentional bias towards cocaine stimuli and beliefs about the consequences of cocaine use, and treatment outcome. Method Twenty-five cocaine dependent participants enrolled in a 6-month outpatient treatment program that included voucher incentives for abstinence. All participants were asked to complete two implicit assessment procedures, a Drug Stroop protocol and an Implicit Relational Assessment Procedure (IRAP), as well as explicit measures of cocaine craving and the consequences of cocaine use, prior to beginning treatment. Pearson-correlation coefficients tested the prospective relationships between treatment outcome and the implicit and explicit assessments. Results Stronger implicit beliefs about the positive effects of cocaine use prior to treatment were associated with poorer treatment outcome when an escalating voucher incentive program was in place. Further, an attentional bias for cocaine-related stimuli was associated with better treatment outcome when an escalating voucher incentive program was removed. No association between cocaine use beliefs and treatment outcome was found when beliefs were measured with self-report instruments. Conclusions and Scientific Significance These findings highlight the potential utility of performance based measures for delineating the psychological mechanisms associated with variation in response to treatment for drug dependence. PMID:22220556

  18. Health Outcomes After Prostatectomy or Radiotherapy for Prostate Cancer: Results From the Prostate Cancer Outcomes Study

    Microsoft Academic Search

    Arnold L. Potosky; Julie Legler; Peter C. Albertsen; Janet L. Stanford; Frank D. Gilliland; Ann S. Hamilton; J. William Eley; Robert A. Stephenson; Linda C. Harlan

    Background: Radical prostatectomy and external beam ra- diotherapy are the two major therapeutic options for treat- ing clinically localized prostate cancer. Because survival is often favorable regardless of therapy, treatment decisions may depend on other therapy-specific health outcomes. In this study, we compared the effects of two treatments on urinary, bowel, and sexual functions and on general health- related quality-of-life

  19. Systematic review of outcome measures in trials of pediatric anaphylaxis treatment

    PubMed Central

    2014-01-01

    Background Considerable heterogeneity has been observed in the selection and reporting of disease-specific pediatric outcome measures in randomized controlled trials (RCTs). This makes interpretation of results and comparison across trials challenging. Outcome measures in pediatric anaphylaxis trials have never previously been systematically assessed. This systematic review (SR) identified and assessed outcome measures used in RCTs of anaphylaxis treatment in children. As a secondary objective, this SR assessed the evidence for current treatment modalities for anaphylaxis in the pediatric population. Methods We searched MEDLINE, EMBASE, The Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL from 2001 until December 2012. We also searched websites listing ongoing trials. We included randomized and controlled trials of anaphylaxis treatment in patients 0–18 years of age. Two authors independently assessed articles for inclusion. Results No published studies fulfilled the inclusion criteria. Conclusions There is an alarming absence of RCTs evaluating the treatments for anaphylaxis in children. High quality studies are needed and are possible to design, despite the severe and acute nature of this condition. Consensus about the selection and validation of appropriate outcome measures will enhance the quality of research and improve the care of children with anaphylaxis. Trial registration CRD42012002685 PMID:24950840

  20. Developing outcome measures for ambulatory care—An application to asthma and diabetes

    Microsoft Academic Search

    E. Mccoll; I. N. Steen; K. A. Meadows; A. Hutchinson; M. P. Eccles; J. Hewison; P. Fowler; S. M. Blades

    1995-01-01

    Increasing emphasis is now being placed on the assessment of patient outcomes, both in evaluating medical interventions and in quality assurance initiatives. Clinicians, purchasers, managers and researchers need outcome measures that are valid, reliable and responsive. This paper describes the theory and practice underlying the development of outcome measures for two chronic conditions, asthma and diabetes, for application in ambulatory

  1. Vision and vision-related outcome measures in multiple sclerosis.

    PubMed

    Balcer, Laura J; Miller, David H; Reingold, Stephen C; Cohen, Jeffrey A

    2015-01-01

    Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes assessment in clinical practice and therapeutic trials in multiple sclerosis. PMID:25433914

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

    PubMed Central

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

    2014-01-01

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

  3. Recommendations for the Use of Common Outcome Measures in Pediatric Traumatic Brain Injury Research

    E-print Network

    O'Toole, Alice J.

    Recommendations for the Use of Common Outcome Measures in Pediatric Traumatic Brain Injury Research injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup's recommendations address primary clinical research objectives including

  4. A SYSTEMATIC REVIEW OF OUTCOME TOOLS USED TO MEASURE LOWER LEG CONDITIONS

    PubMed Central

    Shultz, Susan; Olszewski, Amanda; Ramsey, Olivia; Schmitz, Michelle; Wyatt, Verrelle

    2013-01-01

    Background Context: A variety of self?report and physical performance?based outcome measures are commonly used to assess progress and recovery in the lower leg, ankle, and foot. A requisite attribute of any outcome measure is its ability to detect change in a condition, a construct known as “responsiveness”. There is a lack of consistency in how responsiveness is defined in all outcome measures. Purpose: The purpose of this study was to review the currently used recovery outcome measures for lower leg, ankle and foot conditions in order to determine and report recommended responsiveness values. Methods: A systematic literature search that included electronic searches of PubMed, CINAHL and SportDiscus as well extensive cross?referencing was performed in January, 2013. Studies were included if each involved: 1) a prospective, longitudinal study of any design; 2) any condition associated with the lower leg, ankle or foot; 3) a measure of responsiveness; and 4) was an acceptable type of outcome measure (eg. self?report, physical performance, or clinician report). The quality of the included articles was assessed by two independent authors using the responsiveness sub?component of the Consensus?based Standards for the selection of health Measurement Instruments (COSMIN). Results: Sixteen different studies met the inclusion criteria for this systematic review. The most commonly used outcome measures were the Foot and Ankle Ability Measure and the Lower Extremity Functional Scale. Responsiveness was calculated in a variety of methods including effect size, standardized response mean, minimal clinically important difference/importance, minimal detectable change, and minimal important change. Conclusion: Based on the findings of this systematic review there is a lack of consistency for reporting responsiveness among recovery measures used in the lower leg, ankle or foot studies. It is possible that the variability of conditions that involve the lower leg, ankle and foot contribute to the discrepancies found in reporting responsiveness values. Further research must be conducted in order to standardize reporting measures for responsiveness. Level of evidence: 2a PMID:24377070

  5. Cognitive and academic outcomes after pediatric liver transplantation: Functional Outcomes Group (FOG) results.

    PubMed

    Sorensen, L G; Neighbors, K; Martz, K; Zelko, F; Bucuvalas, J C; Alonso, E M

    2011-02-01

    This multicenter study examined prevalence of cognitive and academic delays in children following liver transplant (LT). One hundred and forty-four patients ages 5-7 and 2 years post-LT were recruited through the SPLIT consortium and administered the Wechsler Preschool and Primary Scale of Intelligence, 3rd Edition (WPPSI-III), the Bracken Basic Concept Scale, Revised (BBCS-R), and the Wide Range Achievement Test, 4th edition (WRAT-4). Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF). Participants performed significantly below test norms on intelligence quotient (IQ) and achievement measures (Mean WPPSI-III Full Scale IQ = 94.7 ± 13.5; WRAT-4 Reading = 92.7 ± 17.2; WRAT-4 Math = 93.1 ± 15.4; p < 0001). Twenty-six percent of patients (14% expected) had 'mild to moderate' IQ delays (Full Scale IQ = 71-85) and 4% (2% expected) had 'serious' delays (Full Scale IQ ? 70; p < 0.0001). Reading and/or math scores were weaker than IQ in 25%, suggesting learning disability, compared to 7% expected by CDC statistics (p < 0.0001). Executive deficits were noted on the BRIEF, especially by teacher report (Global Executive Composite = 58; p < 0.001). Results suggest a higher prevalence of cognitive and academic delays and learning problems in pediatric LT recipients compared to the normal population. PMID:21272236

  6. Cognitive and Academic Outcomes after Pediatric Liver Transplantation: Functional Outcomes Group (FOG) Results

    PubMed Central

    Sorensen, L.G.; Neighbors, K.; Martz, K.; Zelko, F.; Bucuvalas, J.C.; Alonso, E.M.

    2010-01-01

    This multi-center study examined prevalence of cognitive and academic delays in children following liver transplant (LT). 144 patients ages 5–7 and 2 years post-LT were recruited through the SPLIT consortium and administered the Wechsler Preschool and Primary Scale of Intelligence, 3rd Edition (WPPSI-III), the Bracken Basic Concept Scale, Revised (BBCS-R), and the Wide Range Achievement Test, 4th edition (WRAT-4). Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF). Participants performed significantly below test norms on intelligence quotient (IQ) and achievement measures (Mean WPPSI-III Full Scale IQ = 94.7± 13.5; WRAT-4 Reading = 92.7± 17.2; WRAT-4 Math = 93.1± 15.4; p<0001). 26% of patients (14% expected) had “mild to moderate” IQ delays (Full Scale IQ=71–85) and 4% (2% expected) had “serious” delays (Full Scale IQ ?70; p<0.0001). Reading and/or math scores were weaker than IQ in 25%, suggesting learning disability, compared to 7% expected by CDC(1) statistics (p<0.0001). Executive deficits were noted on the BRIEF, especially by teacher report (Global Executive Composite = 58; p<0.001). Results suggest a higher prevalence of cognitive and academic delays and learning problems in pediatric LT recipients compared to the normal population. PMID:21272236

  7. Measuring outcomes in orthopaedics: implementation of an outcomes program in an outpatient orthopaedic practice.

    PubMed

    Rodts, Mary F; Glanzman, Renée; Gray, Adam; Johnson, Randal; Viellieu, Dennis; Hachem, Fadi

    2014-01-01

    With increased demand to provide quality care for patients, orthopaedic practices will need to develop ways to efficiently collect and manage data to support the care that they provide. An outcomes management program must be efficient and consistent to provide good data. This article describes the implementation of an outcomes program at one large private orthopaedic practice within an academic medical setting. PMID:25401206

  8. Measuring Outcomes in Adult Weight Loss Studies That Include Diet and Physical Activity: A Systematic Review

    PubMed Central

    Millstein, Rachel A.

    2014-01-01

    Background. Measuring success of obesity interventions is critical. Several methods measure weight loss outcomes but there is no consensus on best practices. This systematic review evaluates relevant outcomes (weight loss, BMI, % body fat, and fat mass) to determine which might be the best indicator(s) of success. Methods. Eligible articles described adult weight loss interventions that included diet and physical activity and a measure of weight or BMI change and body composition change. Results. 28 full-text articles met inclusion criteria. Subjects, settings, intervention lengths, and intensities varied. All studies measured body weight (?2.9 to ?17.3?kg), 9 studies measured BMI (?1.1 to ?5.1?kg/m2), 20 studies measured % body fat (?0.7 to ?10.2%), and 22 studies measured fat mass (?0.9 to ?14.9?kg). All studies found agreement between weight or BMI and body fat mass or body fat % decreases, though there were discrepancies in degree of significance between measures. Conclusions. Nearly all weight or BMI and body composition measures agreed. Since body fat is the most metabolically harmful tissue type, it may be a more meaningful measure of health change. Future studies should consider primarily measuring % body fat, rather than or in addition to weight or BMI. PMID:25525513

  9. Content validity of patient-reported outcome measures: perspectives from a PROMIS meeting

    Microsoft Academic Search

    Susan MagasiGery; Gery Ryan; Dennis Revicki; William Lenderking; Ron D. Hays; Meryl Brod; Claire Snyder; Maarten Boers; David Cella

    Content validity of patient-reported outcome measures (PROs) has been a focus of debate since the 2006 publication of the\\u000a U.S. FDA Draft Guidance for Industry in Patient Reported Outcome Measurement. Under the auspices of the Patient Reported Outcomes\\u000a Measurement Information System (PROMIS) initiative, a working meeting on content validity was convened with leading PRO measurement\\u000a experts. Platform presentations and participant

  10. The impact of performance incentives on child health outcomes: results from a cluster randomized controlled trial in the Philippines.

    PubMed

    Peabody, John W; Shimkhada, Riti; Quimbo, Stella; Solon, Orville; Javier, Xylee; McCulloch, Charles

    2014-08-01

    Improving clinical performance using measurement and payment incentives, including pay for performance (or P4P), has, so far, shown modest to no benefit on patient outcomes. Our objective was to assess the impact of a P4P programme on paediatric health outcomes in the Philippines. We used data from the Quality Improvement Demonstration Study. In this study, the P4P intervention, introduced in 2004, was randomly assigned to 10 community district hospitals, which were matched to 10 control sites. At all sites, physician quality was measured using Clinical Performance Vignettes (CPVs) among randomly selected physicians every 6 months over a 36-month period. In the hospitals randomized to the P4P intervention, physicians received bonus payments if they met qualifying scores on the CPV. We measured health outcomes 4-10 weeks after hospital discharge among children 5 years of age and under who had been hospitalized for diarrhoea and pneumonia (the two most common illnesses affecting this age cohort) and had been under the care of physicians participating in the study. Health outcomes data collection was done at baseline/pre-intervention and 2 years post-intervention on the following post-discharge outcomes: (1) age-adjusted wasting, (2) C-reactive protein in blood, (3) haemoglobin level and (4) parental assessment of child's health using general self-reported health (GSRH) measure. To evaluate changes in health outcomes in the control vs intervention sites over time (baseline vs post-intervention), we used a difference-in-difference logistic regression analysis, controlling for potential confounders. We found an improvement of 7 and 9 percentage points in GSRH and wasting over time (post-intervention vs baseline) in the intervention sites relative to the control sites (P ? 0.001). The results from this randomized social experiment indicate that the introduction of a performance-based incentive programme, which included measurement and feedback, led to improvements in two important child health outcomes. PMID:24134922

  11. Transforming Course Evaluations into a Meaningful Measure of Student Outcomes Achievement

    ERIC Educational Resources Information Center

    McCullough, Christopher A.

    2008-01-01

    Over the past few years, the author had the good fortune to engage many faculty and administrators in conversations about student outcomes assessment. The author has discovered that many faculty and administrators associate course valuations with student outcomes assessment measures. He also found that no items about student learning outcomes are…

  12. Evaluation of test characteristics for outcome measures used in Raynaud's phenomenon clinical trials

    PubMed Central

    Gladue, Heather; Maranian, Paul; Paulus, Harold E.; Khanna, Dinesh

    2012-01-01

    Objective Randomized controlled trials (RCTs) in Raynaud's phenomenon (RP) have shown conflicting efficacy data. Also, there is no consensus on the outcome measures that should be used. Our objectives were: 1) assess the reliability of individual core set measures used in 3 RCTs; 2) evaluate the placebo response for individual core set measures; and 3) determine if a composite of individual core set measures will decrease the placebo response which may improve our ability to see treatment effects in future trials. Patients and Methods We analyzed core set measures from 249 patients in the placebo-treated groups from 3 RCTs. Core set measures analyzed included Raynaud's condition score (RCS), patient and physician assessment of RP, pain, numbness, and tingling during an RP attack, average number of attacks/day, and duration of attacks. ICC correlation coefficients were calculated during the run-in period to the RCTs. Results ICC coefficients of ?0.70 were observed for RCS, attack symptoms, and average attacks/day. A high placebo response rate was observed for all individual core measures except the duration of attacks. For the RCS, the placebo response ranged from 56% with >10% improvement to 20% with ?60% improvement. In contrast, placebo response rates of 10–20% were observed when several core set measures were combined to develop a composite score. Conclusions Outcome measures used in RP RCTs are associated with marked variability. Combination of outcome measures is associated with low placebo responses. Future studies are needed to assess if a composite score will be able to differentiate placebo from an effective agent. PMID:22972592

  13. Implementing patient reported outcome measures (PROMs) in palliative care - users' cry for help

    PubMed Central

    2011-01-01

    Background Patient-reported outcome measurement (PROM) plays an increasingly important role in palliative care. A variety of measures exists and is used in clinical care, audit and research. However, little is known about professionals' views using these measures. The aim of this study is to describe the use and experiences of palliative care professionals with outcome measures. Methods A web-based online survey was conducted in Europe and Africa. Professionals working in clinical care, audit and research in palliative care were invited to the survey via national palliative care associations and various databases. Invitation e-mails were sent with a link to the questionnaire. Results Overall participation rate 42% (663/1592), overall completion rate 59% (392/663). The majority of respondents were female (63.4%), mean age 46 years (SD 9). 68.1% respondents from Europe and 73.3% from Africa had experiences with outcome measures in palliative care. Non-users reported time constraints, burden, lack of training and guidance as main reasons. In clinical care/audit, assessment of patients' situation, monitoring changes and evaluation of services were main reasons for use. Choice of OMs for research was influenced by validity of the instrument in palliative care and comparability with international literature. Main problems were related to patient characteristics, staff, and outcome measures. Participants expressed the need for more guidance and training in the use of PROMs. Conclusions Professionals need more support for the use and implementation of PROMs in clinical practice and research through training and guidance in order to improve patient care. PMID:21507232

  14. Developing a General Outcome Measure of Growth in Social Skills for Infants and Toddlers

    Microsoft Academic Search

    Judith J. Carta; Charles R. Greenwood; Gayle J. Luze; Gabriel Cline; Susan Kuntz

    2004-01-01

    Proficiency in social interaction with adults and peers is an important outcome in early childhood. The development of an experimental measure for assessing growth in social skills in children birth to 3 years is described. Based on the general outcome measurement (GOM) approach (e.g., Deno, 1997), the measure is intended for use by early intervention practitioners to identify children having

  15. Body composition changes in pregnancy: measurement, predictors and outcomes.

    PubMed

    Widen, E M; Gallagher, D

    2014-06-01

    Prevalence of overweight and obesity has risen in the United States over the past few decades. Concurrent with this rise in obesity has been an increase in pregravid body mass index and gestational weight gain affecting maternal body composition changes in pregnancy. During pregnancy, many of the assumptions inherent in body composition estimation are violated, particularly the hydration of fat-free mass, and available methods are unable to disentangle maternal composition from fetus and supporting tissues; therefore, estimates of maternal body composition during pregnancy are prone to error. Here we review commonly used and available methods for assessing body composition changes in pregnancy, including: (1) anthropometry, (2) total body water, (3) densitometry, (4) imaging, (5) dual-energy X-ray absorptiometry, (6) bioelectrical impedance and (7) ultrasound. Several of these methods can measure regional changes in adipose tissue; however, most of these methods provide only whole-body estimates of fat and fat-free mass. Consideration is given to factors that may influence changes in maternal body composition, as well as long-term maternal and offspring outcomes. Finally, we provide recommendations for future research in this area. PMID:24667754

  16. Body composition changes in pregnancy: measurement, predictors and outcomes

    PubMed Central

    Widen, EM; Gallagher, D

    2014-01-01

    Prevalence of overweight and obesity has risen in the United States over the past few decades. Concurrent with this rise in obesity has been an increase in pregravid body mass index and gestational weight gain affecting maternal body composition changes in pregnancy. During pregnancy, many of the assumptions inherent in body composition estimation are violated, particularly the hydration of fat-free mass, and available methods are unable to disentangle maternal composition from fetus and supporting tissues; therefore, estimates of maternal body composition during pregnancy are prone to error. Here we review commonly used and available methods for assessing body composition changes in pregnancy, including: (1) anthropometry, (2) total body water, (3) densitometry, (4) imaging, (5) dual-energy X-ray absorptiometry, (6) bioelectrical impedance and (7) ultrasound. Several of these methods can measure regional changes in adipose tissue; however, most of these methods provide only whole-body estimates of fat and fat-free mass. Consideration is given to factors that may influence changes in maternal body composition, as well as long-term maternal and offspring outcomes. Finally, we provide recommendations for future research in this area. PMID:24667754

  17. Improving the Rank Precision of Population Health Measures for Small Areas with Longitudinal and Joint Outcome Models

    PubMed Central

    Athens, Jessica K.; Remington, Patrick L.; Gangnon, Ronald E.

    2015-01-01

    Objectives The University of Wisconsin Population Health Institute has published the County Health Rankings since 2010. These rankings use population-based data to highlight health outcomes and the multiple determinants of these outcomes and to encourage in-depth health assessment for all United States counties. A significant methodological limitation, however, is the uncertainty of rank estimates, particularly for small counties. To address this challenge, we explore the use of longitudinal and pooled outcome data in hierarchical Bayesian models to generate county ranks with greater precision. Methods In our models we used pooled outcome data for three measure groups: (1) Poor physical and poor mental health days; (2) percent of births with low birth weight and fair or poor health prevalence; and (3) age-specific mortality rates for nine age groups. We used the fixed and random effects components of these models to generate posterior samples of rates for each measure. We also used time-series data in longitudinal random effects models for age-specific mortality. Based on the posterior samples from these models, we estimate ranks and rank quartiles for each measure, as well as the probability of a county ranking in its assigned quartile. Rank quartile probabilities for univariate, joint outcome, and/or longitudinal models were compared to assess improvements in rank precision. Results The joint outcome model for poor physical and poor mental health days resulted in improved rank precision, as did the longitudinal model for age-specific mortality rates. Rank precision for low birth weight births and fair/poor health prevalence based on the univariate and joint outcome models were equivalent. Conclusion Incorporating longitudinal or pooled outcome data may improve rank certainty, depending on characteristics of the measures selected. For measures with different determinants, joint modeling neither improved nor degraded rank precision. This approach suggests a simple way to use existing information to improve the precision of small-area measures of population health. PMID:26098858

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

    PubMed Central

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

    2014-01-01

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

  19. The association of self-reported measures with poor training outcomes among male and female U.S. Navy recruits.

    PubMed

    Trone, Daniel W; Cipriani, Daniel J; Raman, Rema; Wingard, Deborah L; Shaffer, Richard A; Macera, Caroline A

    2013-01-01

    This prospective study evaluated the association of self-reported health habits and behaviors in 2,930 Navy recruits with poor training outcomes, defined as graduating late or separating from training. Although 17% of the men and 21% of the women had a poor training outcome, results suggest that some self-reported measures were associated with poor training outcomes. Men who did not run or jog at least 1 month before basic training or had a previous lower limb injury without complete recovery and women reporting the same or less physical activity compared with their same-age counterparts were more likely to have a poor training outcome. An important first step in decreasing poor training outcomes is encouraging incoming recruits to participate in physical activity and taking steps to identify and rehabilitate recruits who are not completely healed from a lower limb musculoskeletal injury before reporting to basic training. PMID:23356118

  20. The ACT College Outcome Measurement Project: A New Tool for Summative Evaluation of Nontraditional Postsecondary Education Programs?

    ERIC Educational Resources Information Center

    Ward, Eric F.; Pringle, Robert A.

    The American College Testing Program (ACT) developed tests as a result of the College Outcome Measures Project (COMP). These instruments were intended for evaluation of nontraditional and traditional postsecondary education programs. They measure skills rather than information. The study was designed to check on several aspects of use of the COMP…

  1. A Systematic Review of Outcome Measurements and Quality of Studies Evaluating Fixed Tooth-Supported Restorations

    PubMed Central

    Patel, Devangkumar Rajnikant; O'Brien, Tim; Petrie, Aviva; Petridis, Haralampos

    2014-01-01

    Purpose The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the assessment of the reporting of outcome measurements. Multiple hypotheses were generated to compare the effect of study type on different outcome modifiers and to compare the quality of publications before and after January 2005. Materials and Methods An electronic search was conducted using specific databases (MEDLINE via Ovid, EMBASE via Ovid, Cochrane Library) through July 2012. This was complemented by hand searching the past 10 years of issues of the Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Journal of Prosthodontics, and the International Journal of Prosthodontics. All experimental and observational clinical studies evaluating survival, success, failure, and complications of tooth-supported extracoronal fixed partial dentures, crowns, and onlays were included. No restrictions on age or follow-up time were placed. Results The electronic search generated 14,869 papers, of which 206 papers were included for full-text review. Hand-searching added 23 papers. Inclusion criteria were met by 182 papers and were included for the review. The majority were retrospective studies. Only 8 (4.4%) were randomized controlled trials. The majority of the studies measured survival and failure, and few studies recorded data on success; however, more than 60% of the studies failed to define survival, success, and failure. Many studies did not use any standardized criteria for assessment of the quality of the restorations and, when standardized criteria were used, they were modified, thereby not allowing for comparisons with other studies. There was an increase of 21.8% in the number of studies evaluating outcome measurements of all-ceramic restorations in past 8 years. Conclusions Prosthodontic literature presents with a reduced percentage of RCTs compared to other disciplines in dentistry. The overall quality of recording prosthodontic outcome measurements has not improved greatly in the past 8 years. PMID:24947268

  2. Measuring outcome in community-based rehabilitation services for people who have suffered traumatic brain injury: the Community Outcome Scale

    Microsoft Academic Search

    Philippa Stilwell; John Stilwell; Carol Hawley; Carol Davies

    1998-01-01

    Objective: To develop a way of measuring long-term outcomes after traumatic brain injury (TBI) that takes account of individual circumstances.Design: Reports by head-injured people and their families about problems and coping strategies were elicited via semi-structured interviews. Specially designed computer software was used to record problems and strengths and to measure their impact for the individual on four handicap dimensions.Setting:

  3. The concept of a toolbox of outcome measures for children with cerebral palsy: why, what, and how to use?

    PubMed

    Wright, F Virginia; Majnemer, Annette

    2014-08-01

    Accurate and well-targeted measurement of a child's abilities and participation in daily activities pre- and post-intervention is essential to understanding the effects of therapies provided by pediatric practitioners. There is growing interest in identification of outcome core sets for specified client groups. This article elaborates on the concepts to consider when selecting and interpreting measures from an outcomes toolbox for children with cerebral palsy. Principles discussed include use of self-report measures to open a dialogue with the child/parent; a holistic assessment approach to identify a child's challenges, strengths, and contextual factors that can influence functioning; links between measurement and heightened engagement of the child/family in the rehabilitation process and goals; and the need to plan the evaluation and dialogue aspects of the assessment process. If clinicians across the international rehabilitation community draw from the same toolbox, the end result could be a cohesive approach and common language to outcome measurement. PMID:24820336

  4. Targeted Estimation of Binary Variable Importance Measures with Interval-Censored Outcomes

    PubMed Central

    van der Laan, Mark J.; Page, Kimberly

    2015-01-01

    In most experimental and observational studies, participants are not followed in continuous time. Instead, data is collected about participants only at certain monitoring times. These monitoring times are random and often participant specific. As a result, outcomes are only known up to random time intervals, resulting in interval-censored data. In contrast, when estimating variable importance measures on interval-censored outcomes, practitioners often ignore the presence of interval censoring, and instead treat the data as continuous or right-censored, applying ad hoc approaches to mask the true interval censoring. In this article, we describe targeted minimum loss–based estimation (TMLE) methods tailored for estimation of binary variable importance measures with interval-censored outcomes. We demonstrate the performance of the interval-censored TMLE procedure through simulation studies and apply the method to analyze the effects of a variety of variables on spontaneous hepatitis C virus clearance among injecton drug users, using data from the “International Collaboration of Incident HIV and HCV in Injecting Cohorts” project. PMID:24637001

  5. The use of collaboration science to define consensus outcome measures: a telemental health case study.

    PubMed

    Mishkind, Matthew C; Doarn, Charles R; Bernard, Jordana; Shore, Jay H

    2013-06-01

    The purpose of this document is to provide an overview of a collaboration science process used to develop recommendations for the field of telemental health (TMH) in the selection of outcome measures that best reflect programmatic impacts. A common use of group development techniques in medicine is the development of clinical guidelines, which typically occurs using one of two methods: the nominal group or the Delphi method. Both processes have been faulted for limited transparency, reliability, and sustainability. Recommendations to improve the traditional process include making goals explicit, making disagreements transparent, and publicly displaying levels of agreement. A group of 26 TMH experts convened during the American Telemedicine Association's 2012 Fall Forum in New Orleans, LA to participate in a 1-day, interactive, consensus-building workshop to initiate the development of a shared lexicon of outcomes. The workshop method was designed to improve on traditional methods of guideline development by focusing on clarity of expectations, transparency, and timeliness of group development work. Results suggest that, compared with other traditional methods, the current process involved more people, occurred more rapidly, was more transparent, and resulted in a comparable deliverable. Recommendations for further process development, both within and external to TMH, as well as an initial overview of defined outcome measures are discussed. PMID:23590175

  6. RESNA Resource Guide for Assistive Technology Outcomes: Measurement Tools. Volume I.

    ERIC Educational Resources Information Center

    RESNA: Association for the Advancement of Rehabilitation Technology, Arlington, VA.

    This resource guide, the first of three volumes, lays out the fundamentals of outcome measurements for assistive technology. It includes the whys and hows of gathering data so that assistive technology practitioners can integrate outcomes measurement activities in their daily practice. Chapters include: (1) "Concepts and Rationale for…

  7. Measuring students’ transition into university and its association with learning outcomes

    Microsoft Academic Search

    Maria Pampaka; Julian Williams; Graeme Hutcheson

    2011-01-01

    Previously we showed how we measured pedagogy and revealed its association with learning outcomes of sixth-form college mathematics students. In this project we followed a similar approach to the study of university transition. We particularly sought to identify the students’ perceptions of the transitional experience, and measure the association with learning outcomes. We drew on longitudinal surveys of students entering

  8. The Impact of a "Healthy Youth" Learning Community on Student Learning Outcome Measures

    ERIC Educational Resources Information Center

    Butler, Karen L.; Dawkins, Phyllis Worthy

    2008-01-01

    Learning communities are becoming increasingly popular in the quest for enhancing student learning. The purpose of this study is to examine the impact of the "Healthy Youth" Learning Community on student learning outcome measures. In this study, the authors compared student learning outcome measures of students enrolled in those sections of HED…

  9. Lymph node density in oral cavity cancer: results of the International Consortium for Outcomes Research

    PubMed Central

    Patel, S G; Amit, M; Yen, T C; Liao, C T; Chaturvedi, P; Agarwal, J P; Kowalski, L P; Ebrahimi, A; Clark, J R; Cernea, C R; Brandao, S J; Kreppel, M; Zöller, J; Fliss, D; Fridman, E; Bachar, G; Shpitzer, T; Bolzoni, V A; Patel, P R; Jonnalagadda, S; Robbins, K T; Shah, J P; Gil, Z

    2013-01-01

    Background: Lymph node density (LND) has previously been reported to reliably predict recurrence risk and survival in oral cavity squamous cell carcinoma (OSCC). This multicenter international study was designed to validate the concept of LND in OSCC. Methods: The study included 4254 patients diagnosed as having OSCC. The median follow-up was 41 months. Five-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), locoregional control and distant metastasis rates were calculated using the Kaplan–Meier method. Lymph node density (number of positive lymph nodes/total number of excised lymph nodes) was subjected to multivariate analysis. Results: The OS was 49% for patients with LND?0.07 compared with 35% for patients with LND>0.07 (P<0.001). Similarly, the DSS was 60% for patients with LND?0.07 compared with 41% for those with LND>0.07 (P<0.001). Lymph node density reliably stratified patients according to their risk of failure within the individual N subgroups (P=0.03). A modified TNM staging system based on LND ratio was consistently superior to the traditional system in estimating survival measures. Conclusion: This multi-institutional study validates the reliability and applicability of LND as a predictor of outcomes in OSCC. Lymph node density can potentially assist in identifying patients with poor outcomes and therefore for whom more aggressive adjuvant treatment is needed. PMID:24064974

  10. Upper Extremity-Specific Measures of Disability and Outcomes in Orthopaedic Surgery

    PubMed Central

    Smith, Matthew V.; Calfee, Ryan P.; Baumgarten, Keith M.; Brophy, Robert H.; Wright, Rick W.

    2012-01-01

    Outcome measures may consist of simple questions or they may be more complex instruments that evaluate multiple interrelated domains that influence patient function. Outcome measures should be relevant to patients, easy to use, reliable, valid, and responsive to clinical changes. The Disabilities of the Arm, Shoulder and Hand score can be used to measure disability for any region of the upper limb. Joint and disease-specific outcome measures have been developed for the shoulder, the elbow, and the wrist and hand. Many of these measures would benefit from further research into their validity, reliability, and optimal applicability. PMID:22298061

  11. Review of patient-reported outcome measures in chronic hepatitis C

    PubMed Central

    2012-01-01

    Background Chronic hepatitis C (CHC) and its treatment are associated with a variety of patient-reported symptoms and impacts. Some CHC symptoms and impacts may be difficult to evaluate through objective clinical testing, and more easily measured through patient self-report. This literature review identified concepts raised by CHC patients related to symptoms, impacts, and treatment effects, and evaluated integration of these concepts within patient-reported outcome (PRO) measures. The goal of this work was to provide recommendations for incorporation of PRO measurement of concepts that are relevant to the CHC experience into CHC clinical trial design. Methods A three-tiered literature search was conducted. This included searches on concepts of importance, PRO measures used in clinical trials, and existing PRO measures. The PRO Concept Search focused on reviewing issues raised by CHC patients about CHC symptoms, disease impact, and treatment effects. The CHC Trials with PRO Endpoints Search reviewed clinical trials with PRO endpoints to assess differences between treatments over time. The PRO Measure Search reviewed existing PRO measures associated with the concepts of interest. Results This multi-tiered approach identified five key concepts of interest: depression/anxiety, fatigue, flu-like symptoms, cognitive function, insomnia. Comparing these five concepts of interest to the PRO measures in published CHC clinical trials showed that, while treatment of CHC may decrease health-related quality of life in a number of mental and physical domains, the PRO measures that were utilized in published clinical trials inadequately covered the concepts of interest. Further review of 18 existing PRO measures of the concepts of interest showed only four of the 18 were validated in CHC populations. Conclusions This review identified several gaps in the literature regarding assessment of symptoms and outcomes reported as important by CHC patients. Further research is needed to ensure that CHC clinical trials evaluate concepts that are important to patients and include measures that have evidence supporting content validity, reliability, construct validity, and responsiveness. PMID:22871087

  12. Recommendations for the Use of Common Outcome Measures in Pediatric Traumatic Brain Injury Research

    PubMed Central

    Wilde, Elisabeth A.; Anderson, Vicki A.; Bedell, Gary; Beers, Sue R.; Campbell, Thomas F.; Chapman, Sandra B.; Ewing-Cobbs, Linda; Gerring, Joan P.; Gioia, Gerard A.; Levin, Harvey S.; Michaud, Linda J.; Prasad, Mary R.; Swaine, Bonnie R.; Turkstra, Lyn S.; Wade, Shari L.; Yeates, Keith O.

    2012-01-01

    Abstract This article addresses the need for age-relevant outcome measures for traumatic brain injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup's recommendations address primary clinical research objectives including characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements (CDE) Workgroups, the Pediatric TBI Outcomes Workgroup adopted the standard three-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in pediatric TBI from each identified domain including academics, adaptive and daily living skills, family and environment, global outcome, health-related quality of life, infant and toddler measures, language and communication, neuropsychological impairment, physical functioning, psychiatric and psychological functioning, recovery of consciousness, social role participation and social competence, social cognition, and TBI-related symptoms. In the second tier, supplemental measures were recommended for consideration in TBI research focusing on specific topics or populations. In the third tier, emerging measures included important instruments currently under development, in the process of validation, or nearing the point of published findings that have significant potential to be superior to measures in the core and supplemental lists and may eventually replace them as evidence for their utility emerges. PMID:21644810

  13. Measuring Learning Outcomes in Higher Education: Motivation Matters

    ERIC Educational Resources Information Center

    Liu, Ou Lydia; Bridgeman, Brent; Adler, Rachel M.

    2012-01-01

    With the pressing need for accountability in higher education, standardized outcomes assessments have been widely used to evaluate learning and inform policy. However, the critical question on how scores are influenced by students' motivation has been insufficiently addressed. Using random assignment, we administered a multiple-choice test and an…

  14. Measuring Student Satisfaction from the Student Outcomes Survey. Technical Paper

    ERIC Educational Resources Information Center

    Fieger, Peter

    2012-01-01

    The Student Outcomes Survey is an annual national survey of vocational education and training (VET) students. Since 1995, participants have been asked to rate their satisfaction with different aspects of their training, grouped under three main themes: teaching, assessment, and generic skills and learning experiences. While the composition of the…

  15. Performance theory based outcome measurement in engineering education and training

    Microsoft Academic Search

    William E. Dillon; George V. Kondraske; Louis J. Everett; Richard A. Volz

    2000-01-01

    An approach is presented to improve engineering education that is based on new concepts of systems performance and classic feedback theory. An important aspect is the use of general systems performance theory (GSPT) to provide a performance model of the educational system and as a basis for the key outcome metrics: the volumes of performance capacity envelopes of individual students.

  16. Constructing a Consensus-based Prevention Outcome Measurement Instrument.

    ERIC Educational Resources Information Center

    Siegal, Harvey A.; Lane, D. Timothy; Falck, Russel S.; Wang, Jichuan; Carlson, Robert G.; Rahman, Ahmmed; Chambers, Deborah T.

    2001-01-01

    Describes Ohio's Prevention Evaluation Project (PEP), that developed a questionnaire to assess behavioral and attitudinal outcomes in primary drug abuse prevention programs targeting young people aged twelve to seventeen. One of PEP's principal achievements was the inclusion of community prevention program providers in the evaluation instrument…

  17. Environmental outcome-based management: Using environmental goals and measures in the Chesapeake Bay program

    SciTech Connect

    NONE

    1999-07-01

    Attention is focused on the following: Establishing Environmental Outcome-Based Management; Chesapeake Bay Program Environmental Indicators; Managing for Environmental Results; Future Directions; and Appendices.

  18. Outcome measures for clinical trials assessing treatment of cystic fibrosis lung disease

    PubMed Central

    VanDevanter, Donald R; Konstan, Michael W

    2015-01-01

    Cystic fibrosis (CF) is a complex genetic disease characterized by death from loss of lung function. Therapies target pathophysiologic changes associated with pulmonary disease progression. Although therapeutic mechanisms differ, efficacy demonstration is limited to a few accepted outcome measures, each with shortcomings that are becoming more pronounced as CF population health improves. Pulmonary function improvement (as forced expiratory volume in 1 s [FEV1]) and reduction of pulmonary exacerbation risk are commonly used outcomes. Changes in FEV1 decline rate, quality of life, linear growth and/or weight gain are less utilized outcomes. Validated outcomes tend to work best in subjects with more aggressive or advanced lung disease and less so in healthier subjects. Assays of effects on primary therapeutic targets have yet to be validated as surrogate measures of clinical efficacy. As CF population health improves, it will become increasingly difficult to employ current clinical outcome measures to demonstrate efficacy.

  19. Responsiveness of Health-Related Quality of Life Outcome Measures in Cardiac Rehabilitation: Comparison of Cardiac Rehabilitation Outcome Measures

    ERIC Educational Resources Information Center

    Hevey, David; McGee, Hannah M.; Horgan, John

    2004-01-01

    Assessment instruments that are not responsive to change are unsuitable as outcome tools in cardiac rehabilitation because they underestimate the psychosocial benefits of program attendance. Nine questionnaires were assessed for responsiveness with the standardized response mean (SRM). Questionnaires were allocated into 3 batteries, and each…

  20. The National Outcomes Measurement System for Pediatric Speech-Language Pathology

    ERIC Educational Resources Information Center

    Mullen, Robert; Schooling, Tracy

    2010-01-01

    Purpose: The American Speech-Language-Hearing Association's (ASHA's) National Outcomes Measurement System (NOMS) was developed in the late 1990s. The primary purpose was to serve as a source of data for speech-language pathologists (SLPs) who found themselves called on to provide empirical evidence of the functional outcomes associated with their…

  1. The Measure of Professorial Productivity: Using Student Learning Outcomes Criteria. ASHE Annual Meeting Paper.

    ERIC Educational Resources Information Center

    Bock, Marianne T.

    This paper considers the viability and applicability of student learning outcomes used as a measure of professorial productivity. While student learning outcomes need to be assessed in order to evaluate faculty productivity, examination of student learning as a concept reveals the difficulty of finding consensus on how to define it. The issue is…

  2. Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

    ERIC Educational Resources Information Center

    Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

    2003-01-01

    Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

  3. High Density Limit of the Distribution of the Outcome of Eeg-Measurements

    NASA Astrophysics Data System (ADS)

    Fichtner, K.-H.; Fichtner, L.; Freudenberg, W.; Ohya, M.

    2013-01-01

    Using EEG measurements one gets information on the densities of excited neurons located in the regions of the brain. Up to now there exist different hypothesises concerning the distribution of the random outcomes of EEG measurements. Using classical models for describing brain activities it turned out to be difficult to explain the observed properties of these outcomes. We will describe the distribution of the random outcomes of EEG measurements and certain conditional distributions in terms of a high density limit. These considerations are based on a quantum statistical model of the process of recognition that was developed in the last years (cf. [1] - [10]).

  4. Simulation as a New Tool to Establish Benchmark Outcome Measures in Obstetrics

    PubMed Central

    2015-01-01

    Background There are not enough clinical data from rare critical events to calculate statistics to decide if the management of actual events might be below what could reasonably be expected (i.e. was an outlier). Objectives In this project we used simulation to describe the distribution of management times as an approach to decide if the management of a simulated obstetrical crisis scenario could be considered an outlier. Design Twelve obstetrical teams managed 4 scenarios that were previously developed. Relevant outcome variables were defined by expert consensus. The distribution of the response times from the teams who performed the respective intervention was graphically displayed and median and quartiles calculated using rank order statistics. Results Only 7 of the 12 teams performed chest compressions during the arrest following the ‘cannot intubate/cannot ventilate’ scenario. All other outcome measures were performed by at least 11 of the 12 teams. Calculation of medians and quartiles with 95% CI was possible for all outcomes. Confidence intervals, given the small sample size, were large. Conclusion We demonstrated the use of simulation to calculate quantiles for management times of critical event. This approach could assist in deciding if a given performance could be considered normal and also point to aspects of care that seem to pose particular challenges as evidenced by a large number of teams not performing the expected maneuver. However sufficiently large sample sizes (i.e. from a national data base) will be required to calculate acceptable confidence intervals and to establish actual tolerance limits. PMID:26107661

  5. OSCR wave measurements-some preliminary results

    Microsoft Academic Search

    Lucy R. Wyatt; Louise J. Ledgard

    1996-01-01

    OSCR is an HF radar system that has been developed for high spatial resolution coastal surface current measurement. This paper describes preliminary results that demonstrate that wave measurement can be successfully obtained from suitably processed OSCR data. Comparisons with data from a WAVEC directional buoy are presented and show encouraging agreement. Some of the limitations to the measurement process are

  6. Conservation covenants on private land: issues with measuring and achieving biodiversity outcomes in Australia.

    PubMed

    Fitzsimons, James A; Carr, C Ben

    2014-09-01

    Conservation covenants and easements have become essential tools to secure biodiversity outcomes on private land, and to assist in meeting international protection targets. In Australia, the number and spatial area of conservation covenants has grown significantly in the past decade. Yet there has been little research or detailed policy analysis of conservation covenanting in Australia. We sought to determine how conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties, and factors inhibiting or contributing to measuring these outcomes. In addition, we also investigated the drivers and constraints associated with actually delivering the biodiversity outcomes, drawing on detailed input from covenanting programs. Although all conservation covenanting programs had the broad aim of maintaining or improving biodiversity in their covenants in the long term, the specific stated objectives of conservation covenanting programs varied. Programs undertook monitoring and evaluation in different ways and at different spatial and temporal scales. Thus, it was difficult to determine the extent Australian conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties on a national scale. Lack of time available to covenantors to undertake management was one of the biggest impediments to achieving biodiversity conservation outcomes. A lack of financial resources and human capital to monitor, knowing what to monitor, inconsistent monitoring methodologies, a lack of benchmark data, and length of time to achieve outcomes were all considered potential barriers to monitoring the biodiversity conservation outcomes of conservation covenants. PMID:25053159

  7. General Education Courses at the University of Botswana: Application of the Theory of Reasoned Action in Measuring Course Outcomes

    ERIC Educational Resources Information Center

    Garg, Deepti; Garg, Ajay K.

    2007-01-01

    This study applied the Theory of Reasoned Action and the Technology Acceptance Model to measure outcomes of general education courses (GECs) under the University of Botswana Computer and Information Skills (CIS) program. An exploratory model was validated for responses from 298 students. The results suggest that resources currently committed to…

  8. A Computerized Asthma Outcomes Measure Is Feasible for Disease Management.

    PubMed

    Turner-Bowker, Diane M; Saris-Baglama, Renee N; Anatchkova, Milena; Mosen, David M

    2010-04-01

    OBJECTIVE: To develop and test an online assessment referred to as the ASTHMA-CAT (computerized adaptive testing), a patient-based asthma impact, control, and generic health-related quality of life (HRQOL) measure. STUDY DESIGN: Cross-sectional pilot study of the ASTHMA-CAT's administrative feasibility in a disease management population. METHODS: The ASTHMA-CAT included a dynamic or static Asthma Impact Survey (AIS), Asthma Control Test, and SF-8 Health Survey. A sample of clinician-diagnosed adult asthmatic patients (N = 114) completed the ASTHMA-CAT. Results were used to evaluate administrative feasibility of the instrument and psychometric performance of the dynamic AIS relative to the static AIS. A prototype aggregate (group-level) report was developed and reviewed by care providers. RESULTS: Online administration of the ASTHMA-CAT was feasible for patients in disease management. The dynamic AIS functioned well compared with the static AIS in preliminary studies evaluating response burden, precision, and validity. Providers found reports to be relevant, useful, and applicable for care management. CONCLUSION: The ASTHMA-CAT may facilitate asthma care management. PMID:20852675

  9. Outcome Classification of Preschool Children With Autism Spectrum Disorders Using MRI Brain Measures

    Microsoft Academic Search

    Natacha Akshoomoff; Catherine Lord; Alan J. Lincoln; Rachel Y. Courchesne; Ruth A. Carper; Jeanne Townsend; Eric Courchesne

    2004-01-01

    ObjectiveTo test the hypothesis that a combination of magnetic resonance imaging (MRI) brain measures obtained during early childhood distinguish children with autism spectrum disorders (ASD) from typically developing children and is associated with functional outcome.

  10. Challenges in measuring outcomes for caregivers of people with mental health problems

    PubMed Central

    Zendjidjian, Xavier Y.; Boyer, Laurent

    2014-01-01

    Patient-reported outcomes (PROs) are increasingly important in health care and mental health research. Furthermore, caregivers become partners in care for patients with mental disorders, and health workers are more attentive to the expectations and needs of caregivers. A number of outcomes for caregivers are measured and used in daily practice in order to promote actions to improve health care systems and progress in research on the impact of mental disorders on their caregivers. This paper proposes an inventory of the different outcomes and different measurement tools used to assess the impact of disorders, raising a number of methodological and conceptual issues that limit the relevance of measurement tools and complicate their use. Finally, we propose some recommendations promoting the development of relevant outcome measures for caregivers and their integration into current systems of care. PMID:25152655

  11. A European consensus on outcome measures for psychosocial intervention research in dementia care

    Microsoft Academic Search

    E. Moniz-Cook; M. J. F. J. Vernooy-Dassen; R. Woods; F. Verhey; R. Chattat; M. DE Vugt; M. O’connell; J. Harrison; E. Vasse; R. M. Dröes

    2008-01-01

    Psychosocial intervention makes a vital contribution to dementia care. However, the lack of consensus about which outcome measures to use to evaluate effectiveness prevents meaningful comparisons between different studies and interventions. This study used an iterative collaborative, evidence-based approach to identify the best of currently available outcome measures for European psychosocial intervention research. This included consensus workshops, a web-based pan-European

  12. Outcome measures in chronic obstructive pulmonary disease (COPD): strengths and limitations

    PubMed Central

    2010-01-01

    Current methods for assessing clinical outcomes in COPD mainly rely on physiological tests combined with the use of questionnaires. The present review considers commonly used outcome measures such as lung function, health status, exercise capacity and physical activity, dyspnoea, exacerbations, the multi-dimensional BODE score, and mortality. Based on current published data, we provide a concise overview of the principles, strengths and weaknesses, and discuss open questions related to each methodology. Reviewed is the current set of markers for measuring clinically relevant outcomes with particular emphasis on their limitations and opportunities that should be recognized when assessing and interpreting their use in clinical trials of COPD. PMID:20565728

  13. Craniofacial Measurements of Donors and Recipients Correlate with Aesthetic Outcome in Virtual Face Transplantation

    PubMed Central

    S. Wallins, Joseph; Chandawarkar, Akash A.; Dobry, Allison; Diaz-Siso, J. Rodrigo; Bueno, Ericka M.; Caterson, Edward J.; Jania, Camille; Hevelone, Nathanael D.; Lipsitz, Stuart R.; Mukundan, Srinivasan

    2015-01-01

    Background: Face transplantation is an increasingly feasible option for patients with severe disfigurement. Donors and recipients are currently matched based on immune compatibility, skin characteristics, age, and gender. Aesthetic outcomes of the match are not always optimal and not possible to study in actual cases due to ethical and logistical challenges. We have used a reproducible and inexpensive three-dimensional virtual face transplantation (VFT) model to study this issue. Methods: Sixty-one VFTs were performed using reconstructed high-resolution computed tomography angiographs of male and female subjects aged 20–69 years. Twenty independent reviewers evaluated the level of disfigurement of the posttransplant models. Absolute differences in 9 soft-tissue measurements and 16 bony cephalometric measurements from each of the VFT donor and recipient pretransplant model pairs were correlated to the reviewers’ evaluation of disfigurement after VFT through a multivariate logistic regression model. Results: Five soft-tissue measurements and 3 bony measurements were predictive of the rating of disfigurement after VFT (odds ratio; 95% confidence interval): trichion-to-nasion facial height (1.106; 1.066–1.148), endocanthal width (1.096; 1.051–1.142), exocanthal width (1.067; 1.036–1.099), mouth/chelion width (1.064; 1.019–1.110), subnasale-to-menton facial height (1.029; 1.003–1.056), inner orbit width (1.039; 1.009–1.069), palatal plane/occlusal plane angle (1.148; 1.047–1.258), and sella-nasion/mandibular plane angle (1.079; 1.013–1.150). Conclusions: This study provides early evidence for the importance of soft-tissue and bony measurements in planning of facial transplantation. With future improvements to immunosuppressive regimens and increased donor availability, these measurements may be used as an additional criterion to optimize posttransplant outcomes. PMID:26090275

  14. An outcome-based learning model to identify emerging threats : experimental and simulation results.

    SciTech Connect

    Martinez-Moyano, I. J.; Conrad, S. H.; Andersen, D. F.; Decision and Information Sciences; SNL; Univ. at Albany

    2007-01-01

    The authors present experimental and simulation results of an outcome-based learning model as it applies to the identification of emerging threats. This model integrates judgment, decision making, and learning theories to provide an integrated framework for the behavioral study of emerging threats.

  15. Do intervention fidelity and dose influence outcomes? Results from the move to improve worksite physical activity program.

    PubMed

    Wilson, Mark G; Basta, Tania B; Bynum, Bethany H; DeJoy, David M; Vandenberg, Robert J; Dishman, Rod K

    2010-04-01

    The purpose of this paper is to evaluate the implementation of the Move to Improve worksite physical activity program using a four step framework that includes the following: (i) defining the active ingredients, (ii) using good methods to measure implementation, (iii) monitoring implementation and (iv) relating implementation to outcomes. The intervention active ingredients consisted of a goal setting behavior change program, a team competition and environmental supports. Intervention fidelity and dose were measured by surveys administered to site co-ordinators, team captains and employees. Implementation was monitored by the use of biweekly assessments that tracked individual physical activity levels and through weekly reports of the project director and site co-ordinators. Latent growth modeling was conducted to determine whether intervention outcomes were affected by site implementation (i.e. fidelity) and/or participation by employees (i.e. dose). Results showed high levels of intervention fidelity, moderate to high levels of intervention dose delivered and moderate levels of the intervention dose received. Level of implementation affected the degree of change in vigorous physical activity (Mean = 5.4 versus 2.2; chi(2) = 4.9, df = 1), otherwise outcome measures were unaffected by fidelity and dose. These findings suggest that practitioners should focus more energy assuring that the core components are fully implemented and be less concerned about the level of participation. PMID:19168573

  16. Evaluating Faculty Perceptions of Student Learning Outcomes: A Rasch Measurement Analysis

    ERIC Educational Resources Information Center

    Royal, Kenneth D.

    2010-01-01

    Background: The importance of assessing student learning outcomes has demanded attention from most everyone involved in the higher education enterprise, as accreditation and funding implications are often linked to the results. Faculty, however, are often critical of the assessment process because outcomes assessment is costly with regard to time,…

  17. The utility of the PedsQL™ Rheumatology Module as an outcome measure in juvenile fibromyalgia

    PubMed Central

    Joffe, Naomi E.; Lynch-Jordan, Anne; Ting, Tracy V.; Arnold, Lesley M.; Hashkes, Philip J.; Lovell, Daniel J.; Passo, Murray H.; Powers, Scott W.; Schikler, Kenneth N.; Kashikar-Zuck, Susmita

    2013-01-01

    Objective The PedsQL™ Rheumatology Module is currently the only available measure of disease-specific Quality of Life (QOL) for children and adolescents with juvenile fibromyalgia (JFM) but limited information has been published about the psychometric properties of the instrument specifically in JFM. The objective of this study was to assess the reliability, validity and sensitivity to change of the 5 scales (pain and hurt, daily activities, treatment, worry and communication) of the patient and parent-proxy versions of the PedsQL™ Rheumatology Module in the context of a randomized clinical trial in JFM. Methods The entire PedsQL™ Rheumatology Module was administered as a supplementary outcome measure at pre-treatment, post-treatment and 6-month follow-up assessments of 114 children and adolescents with JFM enrolled in a trial testing the efficacy of cognitive-behavioral therapy (CBT). Results Results indicated that internal consistency reliabilities for the scales were adequate to strong (Cronbach ?s 0.68 - 0.86). Parent-proxy and child reports on most scales (except for daily activities and communication) showed moderate correlations (Spearman rs 0.33-0.45). Support for construct validity was found based on comparing child and parent reports with other related measures of pain and functioning (Visual Analog Scale pain ratings and the Functional Disability Inventory). Finally, sensitivity to change was demonstrated by significant changes in 4/5 of the scales (excluding the daily activities scale) after treatment. Conclusion The PedsQL™ Rheumatology Module generally appears to have good utility for use in JFM patients but some caveats to interpretation of the specific scales in this population are discussed. Key words: PedsQL™ Rheumatology Module, quality of life, juvenile fibromyalgia, outcome measurement PMID:23686969

  18. Female College Students’ Media Use and Academic Outcomes: Results from a Longitudinal Cohort Study

    PubMed Central

    Walsh, Jennifer L.; Fielder, Robyn L.; Carey, Kate B.; Carey, Michael P.

    2013-01-01

    This longitudinal study describes women’s media use during their first year of college and examines associations between media use and academic outcomes. Female students (N = 483, Mage = 18.1 years) reported on their use of 11 media forms and their grade point average, academic behaviors, academic confidence, and problems affecting schoolwork. Allowing for multi-tasking, women reported nearly 12 hours of media use per day; use of texting, music, the Internet, and social networking was heaviest. In general, media use was negatively associated with academic outcomes after controlling for prior academics and demographics. Exceptions were newspaper reading and music listening, which were positively associated with academic outcomes. There were significant indirect effects of magazine reading and social networking on GPA via academic behaviors, confidence, and problems. Results show that female college students are heavy users of new media, and that some forms of media use may adversely impact academic performance. PMID:24505554

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

    SciTech Connect

    Gardner, B.H.; Snell, M.K.; Paulus, W.K. (Sandia National Labs., Albuquerque, NM (United States))

    1991-01-01

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

  20. Recent results from COMPASS muon scattering measurements

    SciTech Connect

    Capozza, Luigi [Irfu/SPhN - CEA Saclay, 91190 Gif-sur-Yvette (France); Collaboration: COMPASS Collaboration

    2012-10-23

    A sample of recent results in muon scattering measurements from the COMPASS experiment at CERN will be reviewed. These include high energy processes with longitudinally polarised proton and deuteron targets. High energy polarised measurements provide important constraints for studying the nucleon spin structure and thus permit to test the applicability of the theoretical framework of factorisation theorems and perturbative QCD. Specifically, latest results on longitudinal quark polarisation, quark helicity densities and gluon polarisation will be reviewed.

  1. Patient reported outcome measures for cardiac ablation procedures: a multicentre pilot to develop a new questionnaire

    PubMed Central

    Withers, Kathleen L.; White, Judith; Carolan-Rees, Grace; Patrick, Hannah; O'Callaghan, Peter; Murray, Stephen; Cunningham, David; Wood, Kathryn A.; Lencioni, Mauro; Griffith, Michael

    2014-01-01

    Aim To assess the feasibility of administering Patient Reported Outcomes Measures (PROMs) in patients treated with ablation for cardiac arrhythmias, and to conduct the first stage of development and testing of a new PROM tool. Methods and results A new tool was developed by a multidisciplinary team and tested alongside an adaptation of the patient perception of arrhythmia questionnaire (PPAQ) and EQ-5D-5L in a multicentre retrospective audit involving 791 consecutive cardiac arrhythmia patients treated with catheter ablation at three UK centres over 13 months. Data were recorded in the National Cardiac Rhythm Management Database, part of the National Institute for Cardiovascular Outcomes Research. The response rate was 71.9% (n = 569). Patients reported significant improvements across all outcomes and impacts, with reductions in symptoms of 51.7% (heart racing), 33.9% (fatigue) 31.8% (heart flutters), 43.5% (dizziness), 38.6% (breathlessness), 44.2% (chest pressure), 33.1% (trouble concentrating), 15.9% (headache), 28.3% (neck pressure), and 23.4% (fainting) (P < 0.001). The mean number of social days affected reduced by 7.49 days/month (P < 0.001); mean work/school days affected/month reduced by 6.26 (P < 0.001); mean GP/hospital visits reduced by 1.36 days/month (P < 0.001). The procedure met patient expectations in 72% of responders. Conclusions The high response rate suggests that the use of PROMs in this patient group is feasible, with rates equalling those of the National PROMs Programme. The results showed that patients experienced significant improvements in their quality of life following ablation, while feedback allowed the tools to be improved. Further work is required to validate these tools; however, the findings suggest that PROMs could be useful in the audit of ablation techniques. PMID:24627541

  2. Towards Graduate Medical Education (GME) Accountability: Measuring the Outcomes of GME Institutions

    PubMed Central

    Chen, Candice; Petterson, Stephen; Phillips, Robert L.; Mullan, Fitzhugh; Bazemore, Andrew; O'Donnell, Sarah D.

    2013-01-01

    Purpose Graduate medical education (GME) plays a key role in the U.S. health care workforce, defining its overall size and specialty distribution, and influencing physician practice locations. Medicare provides nearly $10 billion annually to support GME, and faces growing policymaker interest in creating accountability measures. The purpose of this study was to develop and test candidate GME outcome measures related to physician workforce. Method The authors performed a secondary analysis of data from the American Medical Association Physician Masterfile, National Provider Identifier file, Medicare claims, and National Health Service Corps, measuring the number and percentage of graduates from 2006 to 2008 practicing in high-need specialties and underserved areas aggregated by their U.S. GME program. Results Average overall primary care production rate was 25.2% for the study period, although this is an overestimate since hospitalists could not be excluded. Of 759 sponsoring institutions, 158 produced no primary care graduates, and 184 produced more than 80%. An average of 37.9% of Internal Medicine residents were retained in primary care, including hospitalists. Mean general surgery retention was 38.4%. Overall, 4.8% of graduates practiced in rural areas; 198 institutions produced no rural physicians, and 283 institutions produced no Federally Qualified Health Center or Rural Health Clinic physicians. Conclusions GME outcomes are measurable for most institutions and training sites. Specialty and geographic locations vary significantly. These findings can inform educators and policy-makers during a period of increased calls to align the GME system with national health needs. PMID:23752037

  3. Validity and responsiveness of the Core Outcome Measures Index (COMI) for the neck

    Microsoft Academic Search

    C. D. Fankhauser; U. Mutter; E. Aghayev; A. F. Mannion

    Purpose  Patient-orientated outcome questionnaires are essential to evaluate treatment success. To compare different treatments, hospitals,\\u000a and surgeons, standardised questionnaires are required. The present study examined the validity and responsiveness of the\\u000a Core Outcome Measurement Index for neck pain (COMI-neck), a short, multidimensional outcome instrument.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Questionnaires were completed by patients with degenerative problems of the cervical spine undergoing cervical disc arthroplasty\\u000a before

  4. A Two-Stage Estimation of Hospital Performance Using Mortality Outcome Measures: An Application Using Victorian Hospital Data

    Microsoft Academic Search

    Chew Lian Chua; Alfons Palangkaraya; Jongsay Yong

    2008-01-01

    This paper proposes a method of deriving a hospital quality performance indicator using mortality outcome measures. The method aggregates any number of mortality outcome measures observed over several years into a single indicator. We begin with the supposition that there exists an abstract quality index which drives all observed mortality outcomes in each hospital. This abstract index is not directly

  5. Research Choices for Measuring Outcome of High School Groups.

    ERIC Educational Resources Information Center

    Baldwin, Cynthia L.; And Others

    1988-01-01

    Assessed the efficacy of four group evaluation methods used to examine change in high school students' attitudes after participation in a drug abuse prevention group counseling treatment, including pre- and posttreatment measurement with a Likert scale or an open-ended questionnaire, and a case study approach. Discusses the relative merits of…

  6. Beyond Brain Mapping: Using Neural Measures to Predict Real-World Outcomes.

    PubMed

    Berkman, Elliot T; Falk, Emily B

    2013-02-01

    One goal of social science in general, and of psychology in particular, is to understand and predict human behavior. Psychologists have traditionally used self-report measures and performance on laboratory tasks to achieve this end. However, these measures are limited in their ability to predict behavior in certain contexts. We argue that current neuroscientific knowledge has reached a point where it can complement other existing psychological measures in predicting behavior and other important outcomes. This brain-as-predictor approach integrates traditional neuroimaging methods with measures of behavioral outcomes that extend beyond the immediate experimental session. Previously, most neuroimaging experiments focused on understanding basic psychological processes that could be directly observed in the laboratory. However, recent experiments have demonstrated that brain measures can predict outcomes (e.g., purchasing decisions, clinical outcomes) over longer timescales in ways that go beyond what was previously possible with self-report data alone. This approach can be used to reveal the connections between neural activity in laboratory contexts and longer-term, ecologically valid outcomes. We describe this approach and discuss its potential theoretical implications. We also review recent examples of studies that have used this approach, discuss methodological considerations, and provide specific guidelines for using it in future research. PMID:24478540

  7. Decoding Learning Gains: Measuring Outcomes and the Pivotal Role of the Major and Student Backgrounds

    Microsoft Academic Search

    2009-01-01

    Throughout the world, interest in gauging learning outcomes at all levels of education has grown considerably over the past decade. In higher education, measuring “learning outcomes†is viewed by many stakeholders as a relatively new method to judge the “value added†of colleges and universities. The potential to accurately measure learning gains is also viewed as a diagnostic tool for

  8. “Summary measure” statistic for assessing the outcome of treatment trials in relapsing-remitting multiple sclerosis

    Microsoft Academic Search

    Clarence Liu; Alain Li Wan Po; Lance D Blumhardt

    1998-01-01

    OBJECTIVESTo review the outcome measures commonly used in phase III treatment trials of relapsing-remitting multiple sclerosis and to introduce a method of data analysis which is clinically appropriate for the often reversible disability in this type of multiple sclerosis.METHODSThe conventional end point measures for disability change are inadequate and potentially misleading. Those using the disability difference between study entry and

  9. ICF components of corresponding outcome measures in flexor tendon rehabilitation – a systematic review

    Microsoft Academic Search

    Renée Oltman; Gudrun Neises; Daniel Scheible; Gerhard Mehrtens; Christian Grüneberg

    2008-01-01

    BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) delivers a holistic approach to health conditions. The objective of the present study is to provide an overview of flexor tendon rehabilitation outcome measures with respect to ICF components. Furthermore, it aims to investigate to which extent current assessments measure aspects of health according to these components primarily focussing on

  10. Universal health outcome measures for older persons with multiple chronic conditions.

    PubMed

    2012-12-01

    Older adults with multiple chronic conditions (MCCs) require considerable health services and complex care. Because the persistence and progression of diseases and courses of treatments affect health status in multiple dimensions, well-validated universal outcome measures across diseases are needed for research, clinical care, and administrative purposes. An expert panel meeting held by the National Institute on Aging in September 2011 recommends that older persons with MCCs complete a brief initial composite measure that includes general health; pain; fatigue; and physical health, mental health, and social role function, along with gait speed measurement. Suitable composite measures include the Medical Outcomes Study 8 (SF-8) and 36 (SF-36) -item Short-Form Survey and the Patient Reported Outcomes Measurement Information System 29-item Health Profile. Based on responses to items in the initial measure, short follow-on measures should be selectively targeted to symptom burden, depression, anxiety, and daily activities. Persons unable to walk a short distance to assess gait speed should be assessed using a physical function scale. Remaining gaps to be considered for measure development include disease burden, cognitive function, and caregiver burden. Routine outcome assessment of individuals with MCCs could facilitate system-based care improvement and clinical effectiveness research. PMID:23194184

  11. Gender Disparities in HIV Treatment Outcomes Following Release From Jail: Results From a Multicenter Study

    PubMed Central

    Meyer, Jaimie P.; Zelenev, Alexei; Wickersham, Jeffrey A.; Williams, Chyvette T.; Teixeira, Paul A.; Altice, Frederick L.

    2014-01-01

    Objectives. We assessed gender differences in longitudinal HIV treatment outcomes among HIV-infected jail detainees transitioning to the community. Methods. Data were from the largest multisite prospective cohort study of HIV-infected released jail detainees (n?=?1270)—the Enhancing Linkages to HIV Primary Care and Services in Jail Setting Initiative, January 2008 and March 2011, which had 10 sites in 9 states. We assessed baseline and 6-month HIV treatment outcomes, stratifying by gender. Results. Of 867 evaluable participants, 277 (31.9%) were women. Compared with men, women were more likely to be younger, non-Hispanic White, married, homeless, and depressed, but were similar in recent alcohol and heroin use. By 6 months postrelease, women were significantly less likely than men to experience optimal HIV treatment outcomes, including (1) retention in care (50% vs 63%), (2) antiretroviral therapy prescription (39% vs 58%) or optimal antiretroviral therapy adherence (28% vs 44%), and (3) viral suppression (18% vs 30%). In multiple logistic regression models, women were half as likely as men to achieve viral suppression. Conclusions. HIV-infected women transitioning from jail experience greater comorbidity and worse HIV treatment outcomes than men. Future interventions that transition people from jail to community-based HIV clinical care should be gender-specific. PMID:24432878

  12. Treatment outcome of adult patients with Burkitt lymphoma: results using the LMB protocol in Korea

    Microsoft Academic Search

    Moon Ki Choi; Hyun Jung Jun; Sung Yoon Lee; Kyung Ha Kim; Do Hyoung Lim; Kihyun Kim; Young Hyeh Ko; Won Seog Kim; Seok Jin Kim

    2009-01-01

    Burkitt lymphoma (BL) is a rare subtype of adult non-Hodgkin lymphoma, so studies on the outcome of adult BL, especially in\\u000a Asian patients, are scarce. We report our results using the LMB protocol on Korean adult BL patients. Thirty-eight newly diagnosed\\u000a BL patients were treated with the LMB protocol; 29 males and nine females with a median age of 47 years

  13. Evaluating the impact of California's full service partnership program using a multidimensional measure of outcomes.

    PubMed

    Brown, Timothy Tyler; Hong, Juliette S; Scheffler, Richard M

    2014-05-01

    This study evaluates the impact of California's full-service partnership (FSP) program using a multidimensional measure of outcomes. The FSP program is a key part of California's 2005 Mental Health Services Act. Secondary data were collected from the Consumer Perception Survey, the Client and Service Information System, and the Data Collection and Reporting System, all data systems which are maintained by the California Department of Mental Health. The analytic sample contained 39,681 observations of which 588 were FSP participants (seven repeated cross-sections from May 2005 to May 2008). We performed instrumental variables (IV) limited information maximum likelihood and IV Tobit analyses. The marginal monthly improvement in outcomes of services for FSP participants was approximately 3.5 % higher than those receiving usual care with the outcomes of the average individual in the program improving by 33.4 %. This shows that the FSP program is causally effective in improving outcomes among the seriously mentally ill. PMID:23456598

  14. Can Research Design Explain Variation in Head Start Research Results? A Meta-Analysis of Cognitive and Achievement Outcomes

    ERIC Educational Resources Information Center

    Shager, Hilary M.; Schindler, Holly S.; Magnuson, Katherine A.; Duncan, Greg J.; Yoshikawa, Hirokazu; Hart, Cassandra M. D.

    2013-01-01

    This study explores the extent to which differences in research design explain variation in Head Start program impacts. We employ meta-analytic techniques to predict effect sizes for cognitive and achievement outcomes as a function of the type and rigor of research design, quality and type of outcome measure, activity level of control group, and…

  15. Demystifying Results-Based Performance Measurement.

    ERIC Educational Resources Information Center

    Jorjani, Hamid

    Many evaluators are convinced that Results-based Performance Measurement (RBPM) is an effective tool to improve service delivery and cost effectiveness in both public and private sectors. Successful RBPM requires self-directed and cross-functional work teams and the supporting infrastructure to make it work. There are many misconceptions and…

  16. Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: Why we should measure them all

    PubMed Central

    2014-01-01

    Introduction Regular reporting of health inequalities is essential to monitoring progress of efforts to reduce health inequalities. While reporting of population health became increasingly common, reporting of a subpopulation group breakdown of each indicator of the health of the population is rarely a standard practice. This study reports education-, sex-, and race-related inequalities in four health outcomes in each of the selected 93 counties in the United States in a systematic and comparable manner. Methods This study is a cross-sectional analysis of large, publicly available data, 2008, 2009, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) Selected Metropolitan/Micropolitan Area Risk Trends (SMART) and 2008, 2009, and 2010 United States Birth Records from the National Vital Statistics System. The study population is American adults older than 25 years of age residing in the selected 93 counties, representing about 30% of the US population, roughly equally covering all geographic regions of the country. Main outcome measures are: (1) Attribute (group characteristic)-specific inequality: education-, sex-, or race-specific inequality in each of the four health outcomes (poor or fair health, poor physical health days, poor mental health days, and low birthweight) in each county; (2) Overall inequality: the average of these three attribute-specific inequalities for each health outcome in each county; and (3) Summary inequality in total morbidity: the weighted average of the overall inequalities across the four health outcomes in each county. Results The range of inequality across the counties differed considerably by health outcome; inequality in poor or fair health had the widest range and the highest median among inequalities in all health outcomes. In more than 70% of the counties, education-specific inequality was the largest in all health outcomes except for low birthweight. Conclusions It is feasible to extend population health reporting to include reporting of a subpopulation group breakdown of each indicator of the health of the population at a small jurisdictional level using publicly available data. No single group characteristic or health outcome represents the whole picture of health inequalities in a population. Examining multiple group characteristics and outcomes in a comparable manner is essential in reporting health inequalities. PMID:24927805

  17. Recent results from tokamak divertor plasma measurements

    SciTech Connect

    Allen, S.L.

    1996-05-01

    New diagnostics have been developed to address key divertor physics questions, including: target plate heat flux reduction by radiation, basic edge transport issues, and plasma wall interactions (PWI) such as erosion. A system of diagnostics measures the target plate heat flux (imaging IR thermography) and particle flux (probes, pressure and Penning gauges, and visible emission arrays). Recently, T{sub e},n{sub e}, and P{sub e} (electron pressure) have been measured in 2-D with divertor Thomson Scattering. During radiative divertor operation T{sub e} is less than 2 eV, indicating that new atomic processes are important. Langmuir probes measure higher T{sub e} in some cases. In addition, the measured P{sub e} near the separatrix at the target plate is lower than the midplane pressure, implying radial momentum transport. Bolometer arrays, inverted with reconstruction algorithms, provide the 2-D core and divertor radiation profiles. Spectroscopic measurements identify the radiating species and provide information on impurity transport; both absolute chordal measurements and tomographic reconstructions of images are used. Either intrinsic carbon or an inert species (e.g., injected Ne) are usually observed, and absolute particle inventories are obtained. Computer codes are both benchmarked with the experimental data and provide important consistency checks. Several techniques are used to measure fundamental plasma transport and fluctuations, including probes and reflectometry. PWI issues are studied with in-situ coupons and insertable samples (DiMES). Representative divertor results from DIII-D with references to results on other tokamaks will be presented.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  20. Measuring public health practice and outcomes in chronic disease: a call for coordination.

    PubMed

    Porterfield, Deborah S; Rogers, Todd; Glasgow, LaShawn M; Beitsch, Leslie M

    2015-04-01

    A strategic opportunity exists to coordinate public health systems and services researchers' efforts to develop local health department service delivery measures and the efforts of divisions within the Centers for Disease Control and Prevention's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) to establish outcome indicators for public health practice in chronic disease. Several sets of outcome indicators developed by divisions within NCCDPHP and intended for use by state programs can be tailored to assess outcomes of interventions within smaller geographic areas or intervention settings. Coordination of measurement efforts could potentially allow information to flow from the local to the state to the federal level, enhancing program planning, accountability, and even subsequent funding for public health practice. PMID:25689196

  1. The Medical Outcomes Study. An application of methods for monitoring the results of medical care

    Microsoft Academic Search

    Alvin R. Tarlov; Ware John E. Jr; Sheldon Greenfield; Eugene C. Nelson; Edward Perrin; Michael Zubkoff

    1989-01-01

    The Medical Outcomes Study was designed to (1) determine whether variations in patient outcomes are explained by differences in system of care, clinician specialty, and clinicians' technical and interpersonal styles and (2) develop more practical tools for the routine monitoring of patient outcomes in medical practice. Outcomes included clinical end points; physical, social, and role functioning in everyday living; patients'

  2. Health economics research into supporting carers of people with dementia: A systematic review of outcome measures

    PubMed Central

    2012-01-01

    Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups. Generic measures may not be sensitive enough to fully capture the QoL effects for certain populations, such as carers, so there is a need to consider additional outcome measures, which are preference based where possible to enable cost-effectiveness analysis to be undertaken. This paper reviews outcome measures commonly used in health services research and health economics research involving carers of people with dementia. An electronic database search was conducted in PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment database. Studies were eligible for inclusion if they included an outcome measure for carers of people with dementia. 2262 articles were identified. 455 articles describing 361 studies remained after exclusion criteria were applied. 228 outcome measures were extracted from the studies. Measures were categorised into 44 burden measures, 43 mastery measures, 61 mood measures, 32 QoL measures, 27 social support and relationships measures and 21 staff competency and morale measures. The choice of instrument has implications on funding decisions; therefore, researchers need to choose appropriate instruments for the population being measured and the type of intervention undertaken. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be underestimated, and hence interventions which may appear to be beneficial to participants are not deemed cost-effective and are not funded. If this is the case, it is essential that additional outcome measures which detect changes in broader QoL are included, whilst still retaining preference based utility measures such as EQ-5D to allow QALY calculation for comparability with other interventions. PMID:23181515

  3. Interaction between Maternal Obesity and 1-Hour Glucose Challenge Test Results on Maternal and Perinatal Outcomes.

    PubMed

    Subramaniam, Akila; Jauk, Victoria C; Tita, Alan; Harper, Lorie M

    2015-07-01

    Objective?The objective of this study was to examine the relationship between positive glucose challenge test (GCT) values and perinatal outcomes stratified by maternal body mass index (BMI). Study Design?Retrospective cohort of singleton gestations with a GCT performed at >20 weeks and documented BMI at entry to care. Subjects were classified by GCT level and BMI. Primary outcomes included large for gestational age (LGA), macrosomia, shoulder dystocia, and pregnancy-induced hypertension. Cochran-Armitage tests for trend and logistic regression were used to compare the GCT categories. Results?A total of 14,525 women met enrollment criteria-8,521 with a GCT?outcome. However, for subjects with BMI???25 kg/m(2), the risk of LGA for a GCT 130 to 134 mg/dL was increased, but not at GCT of 135 to 139 mg/dL (p?outcomes primarily in women with a BMI???25 kg/m(2). Women with a BMI???25 kg/m(2) and a GCT 135 to 140 mg/dL appear to have less risk of LGA than women with GCT 130 to 134 mg/dL, suggesting a possible effect of diagnosing and treating gestational diabetes mellitus in this group. PMID:25545448

  4. Using an integrated COC index and multilevel measurements to verify the care outcome of patients with multiple chronic conditions

    PubMed Central

    2012-01-01

    Background The increasing prevalence of multiple chronic conditions has accentuated the importance of coordinating and integrating health care services. Patients with better continuity of care (COC) have a lower utilization rate of emergency department (ED) services, lower hospitalization and better care outcomes. Previous COC studies have focused on the care outcome of patients with a single chronic condition or that of physician-patient relationships; few studies have investigated the care outcome of patients with multiple chronic conditions. Using multi-chronic patients as subjects, this study proposes an integrated continuity of care (ICOC) index to verify the association between COC and care outcomes for two scopes of chronic conditions, at physician and medical facility levels. Methods This study used a dataset of 280,840 subjects, obtained from the Longitudinal Health Insurance Database (LHID 2005), compiled by the National Health Research Institutes, of the National Health Insurance Bureau of Taiwan. Principal Component Analysis (PCA) was used to integrate the indices of density, dispersion and sequence into ICOC to measure COC outcomes - the utilization rate of ED services and hospitalization. A Generalized Estimating Equations model was used to verify the care outcomes. Results We discovered that the higher the COC at medical facility level, the lower the utilization rate of ED services and hospitalization for patients; by contrast, the higher the COC at physician level, the higher the utilization rate of ED services (odds ratio?>?1; Exp(?)?=?2.116) and hospitalization (odds ratio?>?1; Exp(?)?=?1.688). When only those patients with major chronic conditions with the highest number of medical visits were considered, it was found that the higher the COC at both medical facility and physician levels, the lower the utilization rate of ED services and hospitalization. Conclusions The study shows that ICOC is more stable than single indices and it can be widely used to measure the care outcomes of different chronic conditions to accumulate empirical evidence. Concentrated care of multi-chronic patients by a single physician often results in unsatisfactory care outcomes. This highlights the need for referral mechanisms and integration of specialties inside or outside medical facilities, in order to optimize patient-centered care. PMID:23157982

  5. Social and behavioral research in genomic sequencing: approaches from the Clinical Sequencing Exploratory Research Consortium Outcomes and Measures Working Group.

    PubMed

    Gray, Stacy W; Martins, Yolanda; Feuerman, Lindsay Z; Bernhardt, Barbara A; Biesecker, Barbara B; Christensen, Kurt D; Joffe, Steven; Rini, Christine; Veenstra, David; McGuire, Amy L

    2014-10-01

    The routine use of genomic sequencing in clinical medicine has the potential to dramatically alter patient care and medical outcomes. To fully understand the psychosocial and behavioral impact of sequencing integration into clinical practice, it is imperative that we identify the factors that influence sequencing-related decision making and patient outcomes. In an effort to develop a collaborative and conceptually grounded approach to studying sequencing adoption, members of the National Human Genome Research Institute's Clinical Sequencing Exploratory Research Consortium formed the Outcomes and Measures Working Group. Here we highlight the priority areas of investigation and psychosocial and behavioral outcomes identified by the Working Group. We also review some of the anticipated challenges to measurement in social and behavioral research related to genomic sequencing; opportunities for instrument development; and the importance of qualitative, quantitative, and mixed-method approaches. This work represents the early, shared efforts of multiple research teams as we strive to understand individuals' experiences with genomic sequencing. The resulting body of knowledge will guide recommendations for the optimal use of sequencing in clinical practice. PMID:24625446

  6. Treatment effects model for assessing disease management: measuring outcomes and strengthening program management.

    PubMed

    Wendel, Jeanne; Dumitras, Diana

    2005-06-01

    This paper describes an analytical methodology for obtaining statistically unbiased outcomes estimates for programs in which participation decisions may be correlated with variables that impact outcomes. This methodology is particularly useful for intraorganizational program evaluations conducted for business purposes. In this situation, data is likely to be available for a population of managed care members who are eligible to participate in a disease management (DM) program, with some electing to participate while others eschew the opportunity. The most pragmatic analytical strategy for in-house evaluation of such programs is likely to be the pre-intervention/post-intervention design in which the control group consists of people who were invited to participate in the DM program, but declined the invitation. Regression estimates of program impacts may be statistically biased if factors that impact participation decisions are correlated with outcomes measures. This paper describes an econometric procedure, the Treatment Effects model, developed to produce statistically unbiased estimates of program impacts in this type of situation. Two equations are estimated to (a) estimate the impacts of patient characteristics on decisions to participate in the program, and then (b) use this information to produce a statistically unbiased estimate of the impact of program participation on outcomes. This methodology is well-established in economics and econometrics, but has not been widely applied in the DM outcomes measurement literature; hence, this paper focuses on one illustrative application. PMID:15966781

  7. Deconstructing Therapy Outcome Measurement with Rasch Analysis of a Measure of General Clinical Distress: The Symptom Checklist-90-Revised

    ERIC Educational Resources Information Center

    Elliott, Robert; Fox, Christine M.; Beltyukova, Svetlana A.; Stone, Gregory E.; Gunderson, Jennifer; Zhang, Xi

    2006-01-01

    Rasch analysis was used to illustrate the usefulness of item-level analyses for evaluating a common therapy outcome measure of general clinical distress, the Symptom Checklist-90-Revised (SCL-90-R; Derogatis, 1994). Using complementary therapy research samples, the instrument's 5-point rating scale was found to exceed clients' ability to make…

  8. Development of an Outcome Measurement Tool for a Teen Parent Wraparound Program

    ERIC Educational Resources Information Center

    Fries, Derrick; Carney, Karen J.; Blackman-Urteaga, Laura; Savas, Sue Ann

    2012-01-01

    This article chronicles the search for and development of an outcome measurement tool for teen parents receiving community-based wraparound services. The criteria for selecting functional assessment tools available in the literature is presented along with the barriers experienced in using two of these well-cited tools. The rationale for in-house…

  9. The rheumatoid foot: a systematic literature review of patient-reported outcome measures

    Microsoft Academic Search

    Steven Walmsley; Anita E Williams; Mike Ravey; Andrea Graham

    2010-01-01

    BACKGROUND: The foot is often the first area of the body to be systematically affected by rheumatoid arthritis. The multidimensional consequences of foot problems for patients can be subjectively evaluated using patient-reported outcome measures (PROMs). However, there is currently no systematic review which has focused specifically upon the PROMs available for the foot with rheumatoid arthritis. The aim of this

  10. Relationships between self-report and cognitive measures of hearing aid outcome

    PubMed Central

    Ng, Elaine Hoi Ning; Rudner, Mary; Lunner, Thomas; Rönnberg, Jerker

    2013-01-01

    This present study examined the relationship between cognitive measures and self-report hearing aid outcome. A sentence-final word identification and recall (SWIR) test was used to investigate how hearing aid use may relate to experienced explicit cognitive processing. A visually based cognitive test battery was also administered. To measure self-report hearing aid outcome, the International Outcome Inventory – Hearing Aids (IOI-HA) and the Speech, Spatial and Qualities of Hearing Scale (SSQ) were employed. Twenty-six experienced hearing aid users (mean age of 59 years) with symmetrical moderate-to-moderately severe sensorineural hearing loss were recruited. Free recall performance in the SWIR test correlated negatively with item 3 of IOI-HA, which measures residual difficulty in adverse listening situations. Cognitive abilities related to verbal information processing were correlated positively with self-reported hearing aid use and overall success. The present study showed that reported residual difficulty with hearing aid may relate to experienced explicit processing in difficult listening conditions, such that individuals with better cognitive capacity tended to report more remaining difficulty in challenging listening situations. The possibility of using cognitive measures to predict hearing aid outcome in real life should be explored in future research.

  11. Outcome of therapy for sexually abused children: A repeated measures study

    Microsoft Academic Search

    John Briere

    1995-01-01

    The outcome of abuse-focused treatment was examined in a sample of 105 sexually abused children, 71 of whom completed 3 months of treatment or longer. Symptom change was measured with the Trauma Symptom Checklist for Children (TSCC; Briere, in press) and the Children's Depression Inventory (CDI; Kovacs, 1983, 1992), administered at 3 month intervals. The CDI and all TSCC scales

  12. National Outcome Measures for Early Childhood Development: Development of an Indicator-Based Reporting Framework

    ERIC Educational Resources Information Center

    Australian Institute of Health and Welfare, 2011

    2011-01-01

    The Council of Australian Governments released the National Early Childhood Development Strategy, Investing in the Early Years in July 2009 (COAG 2009). One of the key reform priorities in the strategy is to build better information and a solid evidence base, and establishing national outcome measures for early childhood development has been…

  13. Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting

    Microsoft Academic Search

    R. Harper; J. E. Brazier; J. C. Waterhouse; S. J. Walters; N. M. Jones; P. Howard

    1997-01-01

    BACKGROUND: To assist clinicians and researchers in choosing outcome measures for patients with chronic obstructive pulmonary disease attending routine outpatient clinics, a comparative assessment was undertaken of four questionnaires designed to reflect the patients' perception of their physical and emotional health in terms of their feasibility, validity, reliability, and responsiveness to health change. METHODS: Two condition specific questionnaires, the St

  14. Side Effects of Minocycline Treatment in Patients with Fragile X Syndrome and Exploration of Outcome Measures

    ERIC Educational Resources Information Center

    Utari, Agustini; Chonchaiya, Weerasak; Rivera, Susan M.; Schneider, Andrea; Hagerman, Randi J.; Faradz, Sultana M. H.; Ethell, Iryna M.; Nguyen, Danh V.

    2010-01-01

    Minocycline can rescue the dendritic spine and synaptic structural abnormalities in the fragile X knock-out mouse. This is a review and preliminary survey to document side effects and potential outcome measures for minocycline use in the treatment of individuals with fragile X syndrome. We surveyed 50 patients with fragile X syndrome who received…

  15. Different Tests, Different Answers: The Stability of Teacher Value-Added Estimates across Outcome Measures

    ERIC Educational Resources Information Center

    Papay, John P.

    2011-01-01

    Recently, educational researchers and practitioners have turned to value-added models to evaluate teacher performance. Although value-added estimates depend on the assessment used to measure student achievement, the importance of outcome selection has received scant attention in the literature. Using data from a large, urban school district, I…

  16. Stimulus, Task, and Learning Effects on Measures of Temporal Resolution: Implications for Predictors of Language Outcome

    ERIC Educational Resources Information Center

    Smith, Nicholas A.; Trainor, Laurel J.; Gray, Kellie; Plantinga, Judy A.; Shore, David I.

    2008-01-01

    Purpose: Some studies find that temporal processing ability predicts language outcome whereas other studies do not. Resolution of this debate is hindered by the variety of temporal measures used, nonsensory loading of the tasks, and differential amounts of practice across studies. The goal of this study was to examine the effects of stimulus…

  17. Development of a multiple sclerosis functional composite as a clinical trial outcome measure

    Microsoft Academic Search

    Gary R. Cutter; Monika L. Baier; Richard A. Rudick; Diane L. Cookfair; Jill S. Fischer; John Petkau; Karl Syndulko; Brian G. Weinshenker; Jack P. Antel; Christian Confavreux; George W. Ellison; Fred Lublin; Aaron E. Miller; Stephen M. Rao; Stephen Reingold; Alan Thompson; Ernest Willoughby

    1999-01-01

    Summary The primary clinical outcome measure for evaluating multiple sclerosis in clinical trials has been Kurtzke's expanded disability status scale (EDSS). New therapies appear to favourably impact the course of multiple sclerosis and render continued use of placebo control groups more difficult. Consequently, future trials are likely to compare active treatment groups which will most probably require increased sample sizes

  18. Preliminary results of radiation measurements on EURECA

    NASA Technical Reports Server (NTRS)

    Benton, E. V.; Frank, A. L.

    1995-01-01

    The eleven-month duration of the EURECA mission allows long term radiation effects to be studied similarly to those of the Long Duration Exposure Facility (LDEF). Basic data can be generated for projections of crew doses and electronic and computer reliability on spacecraft missions. A radiation experiment has been designed for EURECA which uses passive integrating detectors to measure average radiation levels. The components include a Trackoscope, which employs fourteen plastic nuclear track detector (PNTD) stacks to measure the angular dependence of LET (greater than or equal to 6 keV/microns) radiation. Also included are TLD's for total absorbed doses, thermal/resonance neutron detectors (TRND's) for low energy neutron fluences and a thick PNTD stack for depth dependence measurements. LET spectra are derived from the PNTD measurements. Preliminary TLD results from seven levels within the detector array show that integrated doses inside the flight canister varied from 18.8 plus or minus 0.6 cGy to 38.9 plus or minus 1.2 cGy. The TLD's oriented toward the least shielded direction averaged 53 percent higher in dose than those oriented away from the least shielded direction (minimum shielding toward the least shielded direction varied from 1.13 to 7.9 g/cm(exp 2), Al equivalent). The maximum dose rate on EURECA (1.16 mGy/day) was 37 percent of the maximum measured on LDEF and dose rates at all depths were less than measured on LDEF. The shielding external to the flight canister covered a greater solid angle about the canister than in the LDEF experiments.

  19. Preliminary results of radiation measurements on EURECA

    NASA Technical Reports Server (NTRS)

    Benton, E. V.; Frank, A. L.

    1995-01-01

    The eleven-month duration of the EURECA mission allows long-term radiation effects to be studied similarly to those of the Long Duration Exposure Facility (LDEF). Basic data can be generated for projections to crew doses and electronic and computer reliability on spacecraft missions. A radiation experiment has been designed for EURECA which uses passive integrating detectors to measure average radiation levels. The components include a Trackoscope, which employs fourteen plastic nuclear track detector (PNTD) stacks to measure the angular dependence of high LET (greater than or equal to 6 keV/micro m) radiation. Also included are TLD's for total absorbed doses, thermal/resonance neutron detectors (TRND's) for low energy neutron fluences and a thick PNTD stack for depth dependence measurements. LET spectra are derived from the PNTD measurements. Preliminary TLD results from seven levels within the detector array show that integrated does inside the flight canister varied from 18.8 +/- 0.6 cGy to 38.9 +/- 1.2 cGy. The TLD's oriented toward the least shielded direction averaged 53% higher in dose than those oriented away from the least shielded direction (minimum shielding toward the least shielded direction varied from 1.13 to 7.9 g/cm(exp 2), Al equivalent). The maximum dose rate on EURECA (1.16 mGy/day) was 37% of the maximum measured on LDEF and dose rates at all depths were less than measured on LDEF. The shielding external to the flight canister covered a greater solid angle about the canister than the LDEF experiments.

  20. Comparing frailty measures in their ability to predict adverse outcome among older residents of assisted living

    PubMed Central

    2012-01-01

    Background Few studies have directly compared the competing approaches to identifying frailty in more vulnerable older populations. We examined the ability of two versions of a frailty index (43 vs. 83 items), the Cardiovascular Health Study (CHS) frailty criteria, and the CHESS scale to accurately predict the occurrence of three outcomes among Assisted Living (AL) residents followed over one year. Methods The three frailty measures and the CHESS scale were derived from assessment items completed among 1,066 AL residents (aged 65+) participating in the Alberta Continuing Care Epidemiological Studies (ACCES). Adjusted risks of one-year mortality, hospitalization and long-term care placement were estimated for those categorized as frail or pre-frail compared with non-frail (or at high/intermediate vs. low risk on CHESS). The area under the ROC curve (AUC) was calculated for select models to assess the predictive accuracy of the different frailty measures and CHESS scale in relation to the three outcomes examined. Results Frail subjects defined by the three approaches and those at high risk for decline on CHESS showed a statistically significant increased risk for death and long-term care placement compared with those categorized as either not frail or at low risk for decline. The risk estimates for hospitalization associated with the frailty measures and CHESS were generally weaker with one of the frailty indices (43 items) showing no significant association. For death and long-term care placement, the addition of frailty (however derived) or CHESS significantly improved on the AUC obtained with a model including only age, sex and co-morbidity, though the magnitude of improvement was sometimes small. The different frailty/risk models did not differ significantly from each other in predicting mortality or hospitalization; however, one of the frailty indices (83 items) showed significantly better performance over the other measures in predicting long-term care placement. Conclusions Using different approaches, varying degrees of frailty were detected within the AL population. The various approaches to defining frailty were generally more similar than dissimilar with regard to predictive accuracy with some exceptions. The clinical implications and opportunities of detecting frailty in more vulnerable older adults require further investigation. PMID:22978265

  1. Evaluation and outcomes of women with a breast lump and a normal mammogram result

    Microsoft Academic Search

    Jennifer S. Haas; Celia P. Kaplan; Phyllis Brawarsky; Karla Kerlikowske

    2005-01-01

    BACKGROUND: Many women experience a breast lump. Clinical guidelines suggest that a normal mammogram result alone is not adequate to\\u000a exclude a diagnosis of cancer.\\u000a \\u000a \\u000a OBJECTIVE: To examine the characteristics of women with a breast lump and a normal mammogram that were associated with receiving further\\u000a evaluation, and to examine cancer outcomes.\\u000a \\u000a \\u000a \\u000a \\u000a DESIGN: Observational cohort.\\u000a \\u000a \\u000a \\u000a \\u000a PARTICIPANTS: Women aged 35 to

  2. Theoretical framework and methodological development of common subjective health outcome measures in osteoarthritis: a critical review.

    PubMed

    Pollard, Beth; Johnston, Marie; Dixon, Diane

    2007-01-01

    Subjective measures involving clinician ratings or patient self-assessments have become recognised as an important tool for the assessment of health outcome. The value of a health outcome measure is usually assessed by a psychometric evaluation of its reliability, validity and responsiveness. However, psychometric testing involves an accumulation of evidence and has recognised limitations. It has been suggested that an evaluation of how well a measure has been developed would be a useful additional criteria in assessing the value of a measure. This paper explored the theoretical background and methodological development of subjective health status measures commonly used in osteoarthritis research. Fourteen subjective health outcome measures commonly used in osteoarthritis research were examined. Each measure was explored on the basis of their i) theoretical framework (was there a definition of what was being assessed and was it part of a theoretical model?) and ii) methodological development (what was the scaling strategy, how were the items generated and reduced, what was the response format and what was the scoring method?). Only the AIMS, SF-36 and WHOQOL defined what they were assessing (i.e. the construct of interest) and no measure assessed was part of a theoretical model. None of the clinician report measures appeared to have implemented a scaling procedure or described the rationale for the items selected or scoring system. Of the patient self-report measures, the AIMS, MPQ, OXFORD, SF-36, WHOQOL and WOMAC appeared to follow a standard psychometric scaling method. The DRP and EuroQol used alternative scaling methods. The review highlighted the general lack of theoretical framework for both clinician report and patient self-report measures. This review also drew attention to the wide variation in the methodological development of commonly used measures in OA. While, in general the patient self-report measures had good methodological development, the clinician report measures appeared less well developed. It would be of value if new measures defined the construct of interest and, that the construct, be part of theoretical model. By ensuring measures are both theoretically and empirically valid then improvements in subjective health outcome measures should be possible. PMID:17343739

  3. Aquarius Third Stokes Parameter Measurements: Initial Results

    NASA Technical Reports Server (NTRS)

    Utku, Cuneyt; Vine, David M Le; Abraham, S.; Piepmeier, J.

    2012-01-01

    The Aquarius/SAC-D observatory was launched on June 10, 2011 and the Aquarius instrument has been collecting data continuously since late August. One of the unique features of the L-band radiometers comprising Aquarius is the presence of a polarimetric channel to measure the third Stokes parameter. The purpose is to provide a measure of Faraday rotation, which can be important for remote sensing at L-band, especially in the case of remote sensing of salinity which requires high precision. Initial results are presented here showing a reasonable agreement between retrieved and modeled Faraday rotation and also the "noisy" behavior at land-water boundaries and other mixed scenes predicted by theory.

  4. MEASURING AND IMPROVING RESPIRATORY OUTCOMES IN CYSTIC FIBROSIS LUNG DISEASE: OPPORTUNITIES AND CHALLENGES TO THERAPY

    PubMed Central

    Zemanick, Edith T.; Harris, J. Kirk; Conway, Steven; Konstan, Michael W.; Marshall, Bruce; Quittner, Alexandra L.; Retsch-Bogart, George; Saiman, Lisa; Accurso, Frank J.

    2010-01-01

    Cystic fibrosis (CF) is a life-shortening disease with significant morbidity. Despite overall improvements in survival, patients with CF experience frequent pulmonary exacerbations and declining lung function, which often accelerates during adolescence. New treatments target steps in the pathogenesis of lung disease, such as the basic defect in CF (CF Transmembrane Conductance Regulator [CFTR]), pulmonary infections, inflammation, and mucociliary clearance. These treatments offer hope but also present challenges to patients, clinicians, and researchers. Comprehensive assessment of efficacy is critical to identify potentially beneficial treatments. Lung function and pulmonary exacerbation are the most commonly used outcome measures in CF clinical research. Other outcome measures under investigation include measures of CFTR function; biomarkers of infection, inflammation, lung injury and repair; and patient-reported outcomes. Molecular diagnostics may help elucidate the complex CF airway microbiome. As new treatments are developed for patients with CF, efforts should be made to balance treatment burden with quality of life. This review highlights emerging treatments, obstacles to optimizing outcomes, and key future directions for research. PMID:19833563

  5. Relationship Between 1-Hour Glucose Challenge Test Results and Perinatal Outcomes

    PubMed Central

    Figueroa, Dana; Landon, Mark B.; Mele, Lisa; Spong, Catherine Y.; Ramin, Susan M.; Casey, Brian; Wapner, Ronald J.; Varner, Michael W.; Thorp, John M.; Sciscione, Anthony; Catalano, Patrick; Harper, Margaret; Saade, George; Caritis, Steve N.; Sorokin, Yoram; Peaceman, Alan M.; Tolosa, Jorge E.

    2014-01-01

    Objective To estimate the relationship between 1-hour 50 gm glucose challenge test (GCT) values and perinatal outcomes. Methods This was a secondary analysis of data from a multicenter treatment trial of mild gestational diabetes mellitus (GDM). Women with GCT 135199 mg/dL completed a 3-hour oral glucose tolerance test (OGTT). Mild GDM was defined as fasting glucose less than 95 mg/dL and two or more abnormal OGTT values: 1-hour 180 mg/dL or more; 2-hour 155 mg/dL or more; 3-hour 140 mg/dL or more. Our study included untreated women with GCT 135–139 mg/dL, GCT 140–199 mg/dL, and a comparison group with GCT less than 120 mg/dL. Primary outcomes included a perinatal composite (stillbirth, neonatal death, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and birth trauma), large for gestational age (LGA, birth weight above the 90th percentile based on gender and race specific norms) and macrosomia (greater than 4,000gm). Results There were 436 women with GCT less than120 mg/dL and 1,403 with GCT 135 mg/dL or more (GCT 135–139, n=135; 140–199, n=1,268). The composite perinatal outcome occurred in 25.6% of those with GCT less than 120 mg/dL compared with 21.1% for GCT 135–139 mg/dL, and 35.3% for GCT 140–199 mg/dL. Rates of LGA by group were 6.6%, 6.8% and 12.4%, respectively. Rates of macrosomia by group were 7.8%, 6.1% and 12.1%, respectively. Compared with GCT less than 120 mg/dL, the adjusted odds ratios (OR) (95% confidence intervals [CI]) for GCT values of 140–199 mg/dL were 1.48 (1.14–1.93) for the composite outcome, 1.97 (1.29–3.11) for LGA, and 1.61(1.07–2.49) for macrosomia. For GCT values 135–139 mg/dL, adjusted ORs and 95% CIs were 0.75 (0.45–1.21), 1.04 (0.44–2.24) and 0.75 (0.30–1.66), respectively. The subcategories with GCT values 140–144 mg/dL and 145–149 mg/dL were also associated with an increase in selected outcomes when compared with those with GCT less than 120 mg/dL. Conclusions Glucose challenge test values of 135–139 mg/dL were not associated with adverse outcomes compared with GCT less than 120 mg/dL; however, GCT values 140 mg/dL or more were associated with an increase in odds of the composite perinatal outcome, LGA and macrosomia. PMID:23812458

  6. Recommendations for a Core Outcome Set for Measuring Standing Balance in Adult Populations: A Consensus-Based Approach

    PubMed Central

    Sibley, Kathryn M.; Howe, Tracey; Lamb, Sarah E.; Lord, Stephen R.; Maki, Brian E.; Rose, Debra J.; Scott, Vicky; Stathokostas, Liza; Straus, Sharon E.; Jaglal, Susan B.

    2015-01-01

    Background Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice. Objective To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults. Methodology A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria. Data sources The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS. Results Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations. Limitations Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate. Conclusions The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally. PMID:25768435

  7. Precision Results on ?13: Measurements and Implications

    NASA Astrophysics Data System (ADS)

    Napolitano, Jim

    2012-10-01

    Over the past decade, terrestrial experiments have proven that neutrino oscillations explain the solar neutrino problem and the atmospheric neutrino anomaly. These phenomena rely on neutrino mixing between the first and second, and second and third, neutrino generations, respectively. However, other experiments put limits on mixing between the first and third generations, and suggested a rather small mixing angle ?13. In March 2012 the Daya Bay Reactor Neutrino Experiment reported a conclusive measurement of ?13, with a larger value than generally expected. This result was consistent with some earlier indications of a nonzero ?13 from T2K, MINOS, KamLAND, and Double Chooz, and was soon confirmed by RENO. This talk will present updated results from Daya Bay and other experiments, and discuss consequences for the next generation of neutrino experiments, in the US and abroad.

  8. Using discrete choice experiments to estimate a preference-based measure of outcome—An application to social care for older people

    Microsoft Academic Search

    Mandy Ryan; Ann Netten; Diane Skåtun; Paul Smith

    2006-01-01

    This paper reports the results of a study that used discrete choice experiment (DCE) methodology to estimate quality weights for a of social care outcome measure. To reflect different states of need, a five-dimensional profile measure was developed. Experimental design techniques were used to derive a sample of states for which preferences were elicited. The DCE approach was employed to

  9. Clinical validity of outcome pain measures in naturally occurring canine osteoarthritis

    PubMed Central

    2012-01-01

    Background The conceptual validity of kinetic gait analysis and disability outcome assessment methods has guided their use in the assessment of pain caused by osteoarthritis (OA). No consensus on the best clinical methods for pain evaluation in canine OA exists, particularly, when evaluating treatments where a smaller treatment effect is anticipated than with pharmacological pain killers. This study thus aimed at determining the technical validity of some clinical endpoints on OA pain in dogs using the green-lipped mussel (GLM)-enriched diet. Twenty-three adult dogs with clinical OA completed the prospective controlled study. All the dogs were fed a balanced diet over a 30-day control period followed by a GLM-enriched diet over a 60-day period. The kinetic gait analysis parameter (PVFBW, peak vertical force adjusted for body weight change), electrodermal activity (EDA), and a standardized multifactorial pain questionnaire (MFQ) were performed on day (D) 0 (inclusion), D30 (start) and D90 (end). The owners completed a client-specific outcome measures (CSOM) instrument twice a week. Motor activity (MA) was continuously recorded in seven dogs using telemetered accelerometric counts. We hypothesized that these methods would produce convergent results related to diet changes. A Type I error of 0.05 was adjusted to correct for the multiplicity of the primary clinical endpoints. Results Neither the EDA nor the MFQ were found reliable or could be validated. Changes in the PVFBW (Padj?=?0.0004), the CSOM (Padj?=?0.006) and the MA intensity (Padj?=?0.02) from D0 to D90 suggested an effect of diet(s). Only the PVFBW clearly increased after the GLM-diet (Padj?=?0.003). The CSOM exhibited a negative relationship with the PVFBW (P?=?0.02) and MA duration (P?=?0.02). Conclusions The PVFBW exhibited the best technical validity for the characterization of the beneficial effect of a GLM-enriched diet. The CSOM and MA appeared less responsive following a GLM-diet, but these measures appeared complementary to gait analysis. Apparently, the CSOM provides the capacity to rely on pain OA assessment influenced by both lameness quantification (PVFBW) and physical functioning (MA). PMID:22963751

  10. Assessing methods for measurement of clinical outcomes and quality of care in primary care practices

    PubMed Central

    2012-01-01

    Purpose To evaluate the appropriateness of potential data sources for the population of performance indicators for primary care (PC) practices. Methods This project was a cross sectional study of 7 multidisciplinary primary care teams in Ontario, Canada. Practices were recruited and 5-7 physicians per practice agreed to participate in the study. Patients of participating physicians (20-30) were recruited sequentially as they presented to attend a visit. Data collection included patient, provider and practice surveys, chart abstraction and linkage to administrative data sets. Matched pairs analysis was used to examine the differences in the observed results for each indicator obtained using multiple data sources. Results Seven teams, 41 physicians, 94 associated staff and 998 patients were recruited. The survey response rate was 81% for patients, 93% for physicians and 83% for associated staff. Chart audits were successfully completed on all but 1 patient and linkage to administrative data was successful for all subjects. There were significant differences noted between the data collection methods for many measures. No single method of data collection was best for all outcomes. For most measures of technical quality of care chart audit was the most accurate method of data collection. Patient surveys were more accurate for immunizations, chronic disease advice/information dispensed, some general health promotion items and possibly for medication use. Administrative data appears useful for indicators including chronic disease diagnosis and osteoporosis/ breast screening. Conclusions Multiple data collection methods are required for a comprehensive assessment of performance in primary care practices. The choice of which methods are best for any one particular study or quality improvement initiative requires careful consideration of the biases that each method might introduce into the results. In this study, both patients and providers were willing to participate in and consent to, the collection and linkage of information from multiple sources that would be required for such assessments. PMID:22824551

  11. Drug-resistant focal sleep related epilepsy: results and predictors of surgical outcome.

    PubMed

    Losurdo, Anna; Proserpio, Paola; Cardinale, Francesco; Gozzo, Francesca; Tassi, Laura; Mai, Roberto; Francione, Stefano; Castana, Laura; Lo Russo, Giorgio; Casaceli, Giuseppe; Sartori, Ivana; Della Marca, Giacomo; Cossu, Massimo; Nobili, Lino

    2014-07-01

    In this study we report the results of surgery in a large population of patients affected by drug-resistant focal sleep related epilepsy (SRE) and the identified prognostic factors. We conducted a retrospective analysis of a case series of 955 patients operated on for drug-resistant focal epilepsy from 1997 to 2009. Ninety-five patients with focal SRE and a follow-up of at least 2 years were identified. Presurgical, surgical and histopathological variables were analyzed. Risk of seizures recurrence was assessed by univariate and multivariate analysis. Mean age at epilepsy onset was 5.6 ± 4.9 years. MRI revealed a focal abnormality in 78.9% of cases. Sixty-two percent of patients required a Stereo-EEG investigation. The cortical resection involved the frontal lobe in 61.1% of cases, while in 38.9% an extrafrontal resection was performed. Focal cortical dysplasia (FCD) type II was the most frequent histopathological finding. Mean postoperative follow-up was 82.3 months. Seventy-three patients (76.8%) were in Engel's class I. At univariate analysis, variables associated with a favorable outcome were: absence of Stereo-EEG investigation; positive MRI; complete removal of the epileptogenic zone (EZ); presence of FCD type II and FCD type IIb. A diagnosis of FCD type I was associated with postoperative recurrence of seizures. Multivariate analysis identified the complete removal of the EZ and FCD type I as independent predictors of a favorable and unfavorable outcome respectively. SRE can frequently originate outside the frontal lobe and a favorable surgical outcome is achieved in three-fourths of cases independently from the location of the EZ. PMID:24679947

  12. Therapeutic Alliance and Outcome of Psychotherapy: Historical Excursus, Measurements, and Prospects for Research

    PubMed Central

    Ardito, Rita B.; Rabellino, Daniela

    2011-01-01

    This paper proposes a historical excursus of studies that have investigated the therapeutic alliance and the relationship between this dimension and outcome in psychotherapy. A summary of how the concept of alliance has evolved over time and the more popular alliance measures used in literature to assess the level of alliance are presented. The proposal of a therapeutic alliance characterized by a variable pattern over the course of treatment is also examined. The emerging picture suggests that the quality of the client–therapist alliance is a reliable predictor of positive clinical outcome independent of the variety of psychotherapy approaches and outcome measures. In our opinion, with regard to the relationship between the therapeutic alliance and outcome of psychotherapy, future research should pay special attention to the comparison between patients’ and therapists’ assessments of the therapeutic alliance. This topic, along with a detailed examination of the relationship between the psychological disorder being treated and the therapeutic alliance, will be the subject of future research projects. PMID:22028698

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

    PubMed

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

    2015-04-01

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

  14. The Ohio Scales Youth Form: Expansion and Validation of a Self-Report Outcome Measure for Young Children

    ERIC Educational Resources Information Center

    Dowell, Kathy A.; Ogles, Benjamin M.

    2008-01-01

    We examined the validity and reliability of a self-report outcome measure for children between the ages of 8 and 11. The Ohio Scales Problem Severity scale is a brief, practical outcome measure available in three parallel forms: Parent, Youth, and Agency Worker. The Youth Self-Report form is currently validated for children ages 12 and older. The…

  15. Outcome Rating Scale and Session Rating Scale in Psychological Practice: Clinical Utility of Ultra-Brief Measures

    ERIC Educational Resources Information Center

    Campbell, Alistair; Hemsley, Samantha

    2009-01-01

    The validity and reliability of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) were evaluated against existing longer measures, including the Outcome Questionnaire-45, Working Alliance Inventory, Depression Anxiety Stress Scale-21, Quality of Life Scale, Rosenberg Self-Esteem Scale and General Self-efficacy Scale. The measures

  16. Shifting management of a community volunteer system for improved child health outcomes: results from an operations research study in Burundi

    PubMed Central

    2015-01-01

    Background Community-based strategies that foster frequent contact between caregivers of children under five and provide credible sources of health information are essential to improve child survival. Care Groups are a community-based implementation strategy for the delivery of social and behavior change interventions. This study assessed if supervision of Care Group activities by Ministry of Health (MOH) personnel could achieve the same child health outcomes as supervision provided by specialized non-governmental organization (NGO) staff. Methods The study was a pretest-posttest quasi-experimental design implemented in Burundi. A total of 45 MOH-led Care Groups with 478 Care Group Volunteers (CGVs) were established in the intervention area; and 50 NGO-led Care Groups with 509 CGVs were formed in the comparison area. Data were collected from 593 and 700 mothers of children 0-23 months at baseline and endline, respectively. Pearson’s chi-squared test and difference-in-difference analysis assessed changes in 40 child health and nutrition outcomes. A qualitative process evaluation was also conducted midway through the study. Results The MOH-led Care Group model performed at least as well as the NGO-led model in achieving specific child health and nutrition outcomes. Mothers of children 0-23 months in the intervention and comparison sites reported similar levels of knowledge and practices for 38 of 40 dependent variables measured in the study, and these results remained unchanged after accounting for differences in the indicator values at baseline. Process monitoring data confirmed that the MOH-led Care Group model and the NGO-led Care Group model were implemented with similar intervention strength. Conclusions The study demonstrated that behavior change interventions traditionally led by NGOs can be implemented through the existing MOH systems and achieve similar results, thereby increasing the potential for sustainable child health outcomes. Future research on the MOH-led Care Group model is required to systematically document all inputs and monetary costs borne by the MOH to implement the model. PMID:26062624

  17. Microinvasive cervical adenocarcinoma (FIGO stage 1A tumors): results of surgical staging and outcome analysis.

    PubMed

    Ceballos, Katherine M; Shaw, Danielle; Daya, Dean

    2006-03-01

    Although studies suggest that microinvasive cervical adenocarcinoma has an excellent prognosis, none has reported treatment-related complications and many have lacked detailed measurement criteria. Our study looks at the rate of lymph node metastases and outcome, including complications, in patients with FIGO 1A1 and 1A2 adenocarcinomas of the cervix. Invasion was strictly defined, and the method of measurement was standardized. Villoglandular, papillary serous and clear cell carcinomas were excluded, as were tumors in which invasion exceeded 7 mm in width or 5 mm in thickness, with tumor thickness measured from the basement membrane of the overlying endocervical or ectocervical surface to the deepest focus of invasive tumor. A mean follow-up of 54 months (range, 5-159 months) was available for 31 of 32 (97%) patients. A total of 29 of 32 patients underwent hysterectomies, 2 patients had radical trachelectomies, and 1 patient was treated by cone biopsy. One patient received adjuvant radiotherapy. A total of 27 of 32 patients had bilateral pelvic lymph node dissections, and no lymph node metastases were identified. No recurrences have been reported to date. One patient died of metastatic ovarian carcinoma 82 months after her diagnosis of cervical carcinoma. Two of 27 (7%) patients have chronic leg edema secondary to lymph node dissection. Given the excellent prognosis of this tumor, the absence of lymph node metastases and a lymph node dissection complication rate of 7%, less radical surgery should be considered in this low-risk patient population. PMID:16538058

  18. Potential outcome measures and trial design issues for multiple system atrophy.

    PubMed

    May, Susanne; Gilman, Sid; Sowell, B Brooke; Thomas, Ronald G; Stern, Matthew B; Colcher, Amy; Tanner, Caroline M; Huang, Neng; Novak, Peter; Reich, Stephen G; Jankovic, Joseph; Ondo, William G; Low, Phillip A; Sandroni, Paola; Lipp, Axel; Marshall, Frederick J; Wooten, Frederick; Shults, Clifford W

    2007-12-01

    Multiple system atrophy (MSA) is a neurodegenerative disorder exhibiting a combination of parkinsonism, cerebellar ataxia, and autonomic failure. A disease-specific scale, the Unified Multiple System Atrophy Rating Scale (UMSARS), has been developed and validated to measure progression of MSA, but its use as an outcome measure for therapeutic trials has not been evaluated. On the basis of twelve months of follow-up from an observational study of 67 patients with probable MSA, we evaluated three disease-specific scores: Activities of Daily Living, Motor Examination, and a combined score from the UMSARS and two general health scores, the Physical Health and Mental Health scores of the SF-36 health survey, for their use as outcome measures in a therapeutic trial. We discuss related design issues and provide sample size estimates. Scores based on the disease-specific UMSARS seemed to be equal or superior to scores based on the SF-36 health survey. They appeared to capture disease progression, were well correlated and required the smallest sample size. The UMSARS Motor Examination score exhibited the most favorable characteristics as an outcome measure for a therapeutic trial in MSA with 1 year of follow-up. PMID:17914727

  19. Risk of retinal detachment following cataract extraction: results from the International Cataract Surgery Outcomes Study.

    PubMed Central

    Norregaard, J C; Thoning, H; Andersen, T F; Bernth-Petersen, P; Javitt, J C; Anderson, G F

    1996-01-01

    AIMS: To estimate the risk of retinal detachment (RD) following cataract extraction in Denmark, and to compare the risk with that following cataract extraction in the USA, and with that in a sample of Danish patients who did not have ocular surgery. METHODS: A sample was created from the administrative Danish Hospital Register and included 19,252 patients who underwent first eye cataract surgery between 1985 and 1987, and who were 50 years of age or older. The patients were then followed for 4-6 years using the register data. The design and definition of events were identical to the US National Study of Cataract Outcomes. RESULTS: In Denmark a 4 year cumulative risk of hospitalisation for RD of 0.93% (95% confidence interval (CI) 0.71-1.16) was observed following an extracapsular cataract extraction with a lens implant. A similar cumulative risk of RD was reported from the US study. Thus, no difference in outcomes concerning risk of RD was shown between Denmark and the USA. In a multivariate analysis younger age, male sex, and intracapsular cataract extraction were all associated with higher risk of postoperative RD. A reference group of 7636 people not undergoing any ocular surgery was created and the incidence of RD in this group was calculated. During the sixth year following cataract surgery, the incidence of RD in the cataract group was still 7.5 (95% CI 1.6-22.0) times higher than that observed in the reference group. PMID:8949710

  20. Salvage Radical Prostatectomy: Outcome Measured by Serum Prostate Specific Antigen Levels

    Microsoft Academic Search

    Eamonn Rogers; Makoto Ohori; Vahan S. Kassabian; Thomas M. Wheeler; Peter T. Scardino

    1995-01-01

    We reviewed our experience with salvage radical prostatectomy for locally recurrent cancer in 40 patients to assess the current complication rate and the results using prostate specific antigen (PSA) as an indicator of treatment outcome and to identify better criteria for the selection of appropriate candidates for this operation. Most recurrent cancers were detected by digital rectal examination (26 patients)

  1. Results of dosimetric measurements in space missions.

    PubMed

    Reitz, G; Beaujean, R; Heilmann, C; Kopp, J; Leicher, M; Strauch, K

    1998-01-01

    Detector packages consisting of plastic nuclear track detectors, nuclear emulsions, and theromoluminescence detectors were exposed at different locations inside the space laboratory Spacelab and at the astronauts' body and in different sections of the MIR space station. Total dose, particle fluence rate and linear energy transfer (LET) spectra of heavy ions, number of nuclear disintegrations and fast neutron fluence rates were determined of each exposure. The dose equivalent received by the Payload specialists (PSs) were calculated from the measurements, they range from 190 microSv d-1 to 770 microSv d-1. Finally, a preliminary investigation of results from a particle telescope of two silicon detectors, first used in the last BIORACK mission on STS 76, is reported. PMID:11542777

  2. 26 CFR 801.6 - Business results measures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 false Business results measures. 801...REVENUE SERVICE § 801.6 Business results measures. (a) In general. The business results measures will...enforcement results are data, statistics,...

  3. Quality of life as an outcome measure in the treatment of alcohol dependence

    PubMed Central

    Srivastava, Shruti; Bhatia, Manjeet S.

    2013-01-01

    Background: Quality of life has emerged as an important treatment outcome measure for alcohol dependence whose natural course comprises of remission and relapse. Materials and Methods: The purpose of this study was to examine the prospective change in Quality of life (QoL) in 56 patients aged 18-45 years of alcohol dependence over a three months’ period and compare it with QoL of 150 age- and gender- matched healthy controls using WHOQoL-BREF. Severity of alcohol dependence and drinking parameters were assessed. Results: Significant improvement in QoL of patients of alcohol dependence over three months’ abstinence. The physical, psychological, social, and environment domains of QoL in alcohol dependence subjects were significantly lower before treatment initiation than the healthy controls. Alcoholic liver disease emerged as a predictor of improvement in psychological and social domains of QoL. Conclusion: The study confirms poor quality of life in patients of alcohol dependence before intervention. The regular follow-up with the family members in out-patient setting enables the patients achieve complete abstinence, thereby improving their quality of life. PMID:24459373

  4. Primary outcome indices in illicit drug dependence treatment research: systematic approach to selection and measurement of drug use end-points in clinical trials

    PubMed Central

    Donovan, Dennis M.; Bigelow, George E.; Brigham, Gregory S.; Carroll, Kathleen M.; Cohen, Allan J.; Gardin, John G.; Hamilton, John A.; Huestis, Marilyn A.; Hughes, John R.; Lindblad, Robert; Marlatt, G. Alan; Preston, Kenzie L.; Selzer, Jeffrey A.; Somoza, Eugene C.; Wakim, Paul G.; Wells, Elizabeth A.

    2012-01-01

    Aims Clinical trials test the safety and efficacy of behavioral and pharmacological interventions in drug-dependent individuals. However, there is no consensus about the most appropriate outcome(s) to consider in determining treatment efficacy or on the most appropriate methods for assessing selected outcome(s). We summarize the discussion and recommendations of treatment and research experts, convened by the US National Institute on Drug Abuse, to select appropriate primary outcomes for drug dependence treatment clinical trials, and in particular the feasibility of selecting a common outcome to be included in all or most trials. Methods A brief history of outcomes employed in prior drug dependence treatment research, incorporating perspectives from tobacco and alcohol research, is included. The relative merits and limitations of focusing on drug-taking behavior, as measured by self-report and qualitative or quantitative biological markers, are evaluated. Results Drug-taking behavior, measured ideally by a combination of self-report and biological indicators, is seen as the most appropriate proximal primary outcome in drug dependence treatment clinical trials. Conclusions We conclude that the most appropriate outcome will vary as a function of salient variables inherent in the clinical trial, such as the type of intervention, its target, treatment goals (e.g. abstinence or reduction of use) and the perspective being taken (e.g. researcher, clinical program, patient, society). It is recommended that a decision process, based on such trial variables, be developed to guide the selection of primary and secondary outcomes as well as the methods to assess them. PMID:21781202

  5. Comparison of Single-Level and Multiple-Level Outcomes of Total Disc Arthroplasty: 24-Month Results

    PubMed Central

    Ritter-Lang, Karsten; Gössel, Lutz; Dreßler, Nadine

    2015-01-01

    Background Low back pain is one of the most prevalent problems in industrialized countries, affecting as many as 80% of all adults at some time in their lives. Among the significant contributors to low back pain is degenerative disc disease (DDD). Although fusion has been well accepted for treatment of DDD, high rates of complications and stress to adjacent segments remain a concern. Lumbar total disc replacement (TDR) was developed with a goal of preserving motion and avoiding various fusion-related complications, but the relative merits of single vs. multiple level arthroplasty remain unclear. Methods This is a multi-center, single arm, prospective post-market registry of the M6-L, consisting of consecutive patients presenting with lumbar DDD who agreed to participate. This paper reports on those patients who have completed at least 24 months of followup to date. Clinical outcome measures include the Oswestry Disability Index (ODI) and back and leg Visual Analogue Scales (VAS). Radiographic analysis of disc angle and range of motion (ROM) was also performed. Results Results for 83 patients comprising 121 implants in two cohorts (49 single level (SL), 34 multiple levels (ML)) are reported. Both cohorts experienced significant improvement at 24 months including significant decreases in ODI and VAS. Relative to SL procedures, ML procedures demonstrated either comparable results, or results that trended favorably towards the ML procedures. Index and global ROM at 24 months were not significantly different between the two cohorts, while the disc angles were larger in the SL cohort regardless of index level. Conclusions This is the first study to report clinical and radiographic outcomes of TDR with the M6-L in SL vs ML procedures with two years of followup. The results suggest initial device safety and effectiveness when used for the treatment of lumbar degenerative disc disease at one or more levels. PMID:26056629

  6. Estimates of success in patients with sciatica due to lumbar disc herniation depend upon outcome measure

    Microsoft Academic Search

    Anne Julsrud Haugen; Lars Grøvle; Jens Ivar Brox; Bård Natvig; Anne Keller; Dag Soldal; Margreth Grotle

    The objectives were to estimate the cut-off points for success on different sciatica outcome measures and to determine the\\u000a success rate after an episode of sciatica by using these cut-offs. A 12-month multicenter observational study was conducted\\u000a on 466 patients with sciatica and lumbar disc herniation. The cut-off values were estimated by ROC curve analyses using Completely recovered or Much

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

    PubMed Central

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

    2015-01-01

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

  8. Worker productivity outcome measures: OMERACT filter evidence and agenda for future research.

    PubMed

    Tang, Kenneth; Boonen, Annelies; Verstappen, Suzanne M M; Escorpizo, Reuben; Luime, Jolanda J; Lacaille, Diane; Fautrel, Bruno; Bosworth, Ailsa; Cifaldi, Mary; Gignac, Monique A M; Hofstetter, Cathy; Leong, Amye; Montie, Pam; Petersson, Ingemar F; Purcaru, Oana; Bombardier, Claire; Tugwell, Peter S; Beaton, Dorcas E

    2014-01-01

    The objective of the Outcome Measures in Rheumatology (OMERACT) Worker Productivity working group is to identify worker productivity outcome measures that meet the requirements of the OMERACT filter. At the OMERACT 11 Workshop, we focused on the at-work limitations/productivity component of worker productivity (i.e., presenteeism) - an area with diverse conceptualization and instrumentation approaches. Various approaches to quantify at-work limitations/productivity (e.g., single-item global and multi-item measures) were examined, and available evidence pertaining to OMERACT truth, discrimination, and feasibility were presented to conference participants. Four candidate global measures of presenteeism were put forth for a plenary vote to determine whether current evidence meets the OMERACT filter requirements. Presenteeism globals from the Work Productivity and Activity Impairment Questionnaire (72% support) and Rheumatoid Arthritis-specific Work Productivity Survey (71% support) were endorsed by conference participants; however, neither the presenteeism global item from the Health and Work Performance Questionnaire nor the Quantity and Quality method achieved the level of support required for endorsement at the present time. The plenary was also asked whether the central item from the Work Ability Index should also be considered as a candidate measure for potential endorsement in the future. Of participants at the plenary, 70% supported this presenteeism global measure. Progress was also made in other areas through discussions at individual breakout sessions. Topics examined include the merits of various multi-item measures of at-work limitations/productivity, methodological issues related to interpretability of outcome scores, and approaches to appraise and classify contextual factors of worker productivity. Feedback gathered from conference participants will inform the future research agenda of the working group. PMID:24128774

  9. A two-stage estimation of hospital quality using mortality outcome measures: an application using hospital administrative data.

    PubMed

    Chua, Chew Lian; Palangkaraya, Alfons; Yong, Jongsay

    2010-12-01

    This paper proposes a method of deriving a quality indicator for hospitals using mortality outcome measures. The method aggregates any number of mortality outcomes into a single indicator via a two-stage procedure. In the first stage, mortality outcomes are risk-adjusted using a system of seemingly unrelated regression equations. These risk-adjusted mortality rates are then aggregated into a single quality indicator in the second stage via weighted least squares. This method addresses the dimensionality problem in measuring hospital quality, which is multifaceted in nature. In addition, our method also facilitates further analyses of determinants of hospital quality by allowing the resulting quality estimates be associated with hospital characteristics. The method is applied to a sample of heart-disease episodes extracted from hospital administrative data from the state of Victoria, Australia. Using the quality estimates, we show that teaching hospitals and large regional hospitals provide higher quality of care than other hospitals and this superior performance is related to hospital case-load volume. PMID:19937614

  10. The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings

    PubMed Central

    Cavaletti, G.; Cornblath, D. R.; Merkies, I. S. J.; Postma, T. J.; Rossi, E.; Frigeni, B.; Alberti, P.; Bruna, J.; Velasco, R.; Argyriou, A. A.; Kalofonos, H. P.; Psimaras, D.; Ricard, D.; Pace, A.; Galiè, E.; Briani, C.; Dalla Torre, C.; Faber, C. G.; Lalisang, R. I.; Boogerd, W.; Brandsma, D.; Koeppen, S.; Hense, J.; Storey, D.; Kerrigan, S.; Schenone, A.; Fabbri, S.; Valsecchi, M. G.; Mazzeo, A.; Pace, A.; Pessino, A.; Schenone, A.; Toscano, A.; Argyriou, A.A.; Brouwer, B.; Frigeni, B.; Piras, B.; Briani, C.; Dalla Torre, C.; Dominguez Gonzalez, C.; Faber, C. G.; Tomasello, C.; Binda, D.; Brandsma, D.; Cortinovis, D.; Psimaras, D.; Ricard, D.; Storey, D.; Cornblath, D.R.; Galiè, E.; Lindeck Pozza, E.; Rossi, E.; Vanhoutte, E.K.; Lanzani, F.; Pastorelli, F.; Altavilla, G.; Cavaletti, G.; Granata, G.; Kalofonos, H.P.; Ghignotti, I.; Merkies, I.S.J.; Bruna, J.; Hense, J.; Heimans, J.J.; Mattavelli, L.; Padua, L.; Reni, L.; Bakkers, M.; Boogerd, M.; Campagnolo, M.; Cazzaniga, M.; Eurelings, M.; Leandri, M.; Lucchetta, M.; Penas Prado, M.; Russo, M.; Valsecchi, M.G.; Piatti, M.L.; Alberti, P.; Bidoli, P.; Grant, R.; Plasmati, R.; Velasco, R.; Lalisang, R.I.; Meijer, R.J.; Fabbri, S.; Dorsey, S. G.; Galimberti, S.; Kerrigan, S.; Koeppen, S.; Postma, T.J.; Boogerd, W.; Grisold, W.

    2013-01-01

    Background Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating and dose-limiting complication of cancer treatment. Thus far, the impact of CIPN has not been studied in a systematic clinimetric manner. The objective of the study was to select outcome measures for CIPN evaluation and to establish their validity and reproducibility in a cross-sectional multicenter study. Patients and methods After literature review and a consensus meeting among experts, face/content validity were obtained for the following selected scales: the National Cancer Institute-Common Toxicity Criteria (NCI-CTC), the Total Neuropathy Score clinical version (TNSc), the modified Inflammatory Neuropathy Cause and Treatment (INCAT) group sensory sumscore (mISS), the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and CIPN20 quality-of-life measures. A total of 281 patients with stable CIPN were examined. Validity (correlation) and reliability studies were carried out. Results Good inter-/intra-observer scores were obtained for the TNSc, mISS, and NCI-CTC sensory/motor subscales. Test–retest values were also good for the EORTC QLQ-C30 and CIPN20. Acceptable validity scores were obtained through the correlation among the measures. Conclusion Good validity and reliability scores were demonstrated for the set of selected impairment and quality-of-life outcome measures in CIPN. Future studies are planned to investigate the responsiveness aspects of these measures. PMID:22910842

  11. A two?stage estimation of hospital quality using mortality outcome measures: an application using hospital administrative data

    Microsoft Academic Search

    Chew Lian Chua; Alfons Palangkaraya; Jongsay Yong

    2010-01-01

    This paper proposes a method of deriving a quality indicator for hospitals using mortality outcome measures. The method aggregates any number of mortality outcomes into a single indicator via a two-stage procedure. In the first stage, mortality outcomes are risk?adjusted using a system of seemingly unrelated regression equations. These risk?adjusted mortality rates are then aggregated into a single quality indicator

  12. Using the California Q-sort Measure of Life History Strategy to Predict Sexual Behavioral Outcomes.

    PubMed

    Dunkel, Curtis S; Summerville, Lauren A; Mathes, Eugene W; Kesserling, Sean N

    2015-08-01

    The validity of the California Q-set measure of life history (LH) strategy was examined by conducting secondary analyses on longitudinal data that included the Q-sort measure of LH strategy at multiple ages (base year N = 106) and six measures of reproductive behavior. LH strategy Q-sort ratings showed stability from ages 14-23. Additionally, the ratings were found to be good prospective and age concurrent predictors of six reproductive behaviors. LH strategy as rated at age 14 was found to be a significant predictor of age of sexual debut, number of sexual partners, frequency of intercourse, number of abortions, age at birth of first child, and likelihood for having contracted venereal disease as measured up to age 32. Future research should test the further utility of the measure focusing on ways to reduce its cumbersomeness without reducing its ability to predict behavioral outcomes. PMID:25515585

  13. Developing a patient-centered outcome measure for complementary and alternative medicine therapies I: defining content and format

    PubMed Central

    2011-01-01

    Background Patients receiving complementary and alternative medicine (CAM) therapies often report shifts in well-being that go beyond resolution of the original presenting symptoms. We undertook a research program to develop and evaluate a patient-centered outcome measure to assess the multidimensional impacts of CAM therapies, utilizing a novel mixed methods approach that relied upon techniques from the fields of anthropology and psychometrics. This tool would have broad applicability, both for CAM practitioners to measure shifts in patients' states following treatments, and conventional clinical trial researchers needing validated outcome measures. The US Food and Drug Administration has highlighted the importance of valid and reliable measurement of patient-reported outcomes in the evaluation of conventional medical products. Here we describe Phase I of our research program, the iterative process of content identification, item development and refinement, and response format selection. Cognitive interviews and psychometric evaluation are reported separately. Methods From a database of patient interviews (n = 177) from six diverse CAM studies, 150 interviews were identified for secondary analysis in which individuals spontaneously discussed unexpected changes associated with CAM. Using ATLAS.ti, we identified common themes and language to inform questionnaire item content and wording. Respondents' language was often richly textured, but item development required a stripping down of language to extract essential meaning and minimize potential comprehension barriers across populations. Through an evocative card sort interview process, we identified those items most widely applicable and covering standard psychometric domains. We developed, pilot-tested, and refined the format, yielding a questionnaire for cognitive interviews and psychometric evaluation. Results The resulting questionnaire contained 18 items, in visual analog scale format, in which each line was anchored by the positive and negative extremes relevant to the experiential domain. Because of frequent informant allusions to response set shifts from before to after CAM therapies, we chose a retrospective pretest format. Items cover physical, emotional, cognitive, social, spiritual, and whole person domains. Conclusions This paper reports the success of a novel approach to the development of outcome instruments, in which items are extracted from patients' words instead of being distilled from pre-existing theory. The resulting instrument, focused on measuring shifts in patients' perceptions of health and well-being along pre-specified axes, is undergoing continued testing, and is available for use by cooperating investigators. PMID:22206345

  14. [Final results from four clinical studies in the field of cardiovascular diseases integrated in the "Mattoni del SSN - Mattone Outcome" Project].

    PubMed

    D'Errigo, Paola; Seccareccia, Fulvia; Rosato, Stefano; Maraschini, Alice; Badoni, Gabriella; Perucci, Carlo Alberto; Fusco, Danilo; D'Ovidio, Mariangela; Stafoggia, Massimo; Barone, Anna Patrizia

    2011-12-01

    Observational outcome studies represent a valid approach to evaluating comparative treatment effectiveness in real populations. The main objective of outcome research is to underline what works and what does not work in the field of health assistance. In 2004 the Italian Ministry of Health launched the Project "Mattone Misura dell'Outcome" aimed at assessing the introduction of procedures and methods for the systematic evaluation of outcomes in the national health system. A new experience, the PROGRESSI program (PROGRamma ESiti per SIVeAS e LEA), started in 2008 with the aim to further develop the methodologies for outcome evaluation. In this Supplement the final results from four clinical studies named "Sperimentazioni dell'area cardiovascolare del Progetto Mattoni" are presented. These studies started between 2005 and 2007 and their main objectives were to evaluate: --the contribution of information from current informative systems and clinical studies in risk-adjustment methodologies; --the advisability of introducing some clinical items in current informative systems to improve outcome estimates; --the goodness of follow-up procedures from current informative systems; and --the role of disease registries in the validation of comparative evaluation measures. The four studies were designed as voluntary prospective multicentre studies. Results concerning the characteristics of the enrolled populations as well as the risk-adjustment models built using information from current informative systems and/or clinical information are presented. As expected, each study produced specific remarks both in terms of clinical findings and contribution of different informative systems to the risk-adjustment models. In general, models built with information from both current informative systems and clinical information show the best performance. Findings from these analyses will provide the public health system with suitable indications to improve statistical methodologies for outcome estimates. PMID:22158390

  15. Dynamic patient data bases: the foundation of an integrated approach to outcome measures for the healthcare professionals.

    PubMed

    Kwok, H K; Stevens, N

    1995-01-01

    In recent years there has been a tremendous need among healthcare professionals to assess the effectiveness, efficiency, and appropriateness of the patient care services being provided through criteria-based outcome and program evaluation. Although the need for a tool which could evaluate the effectiveness of patient care is widely recognized, such an undertaking has been severely limited due to the lack of any automated means to collect and analyze patient data on a routine, continuous basis within a clinical setting. We have developed and implemented at Mineral Springs Hospital, Banff, Alberta an integrated and automated hospital information system that not only continuously collects administrative, financial, and patient data, but also contains an intelligent component for automated outcome measure and program evaluation. The system collects various non-duplicated data elements from each routine work process within the facility on a continuous basis. Through the creation of a dynamic patient database, data is transformed into information--a powerful decision support tool. The system provides flexible user-defined reports in patient-specific resource utilization, direct and/or indirect specific financial costs, result reporting of each intervention, service provided and user-defined criteria-based outcome, and program evaluation. The system design incorporates expert rules, dynamic data entry forms, quantitative models, and user-defined access control. Using information derived from the dynamic common database, managers and front-line clinicians can easily evaluate and modify management decisions or careplans on a macro or micro level. An external review is planned to evaluate whether the system has helped the assessment of effectiveness, efficiency and appropriateness of healthcare services being provided at the hospital. The fundamental concept behind the system design is that the patient is the center of activity for data collection. The system provides the answers to the 5 W's (who, what, where, when, and why) together with intervention and service result reports. A dynamic common patient database is the center of the system and is accessible to all with proper authorization. Common data elements are collected from routine work flow without extra data entry and this information is subsequently shared. Data collection is a continuous process. We believe that every process is the outcome of another sub-process or event. The design of the dynamic patient database incorporates patient-specific costing and outcome evaluation, user-defined flexible data entry forms, user-defined access control, outcome evaluation rules and information semantic rules. Such a patient database would provide the flexibility needed to accommodate diverse methodologies to evaluate outcomes whether it they be medical, cost, access and/or other combination of measures. The system was developed on a PC-based Network technology, using FOXPRO (XBase) as the database development tool incorporating advanced technology such as distributed processing and fault tolerant computing. We chose PC-based technology because it is economical, having relatively low maintenance costs and requires no major dependency on vendors. The developed system produces patient-specific reports with many dimensions. The reports are user-defined. The system reports general data, CMG, RGN, LOS, Expected LOS, and other user-defined demographic data. Resource utilization, financial costs, and result reportings are produced together with rule-based outcome assessments of any type of measures, including, but not limited to, pre-set functional/health goals, user satisfaction, clinicianUs text or codified comments etc. It provides the framework for continually capturing data at a practical, work-flow level. The incorporation of a dynamic patient database as the driving forece of an integrated, rule-based administration, financial and patient data system will provdie the tools for healthcar PMID:8591238

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

    PubMed Central

    Agarwala, Sanjay; Mohrir, Ganesh; Moonot, Pradeep

    2014-01-01

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

  17. Measuring the impact of medical research: moving from outputs to outcomes.

    PubMed

    Weiss, Anthony P

    2007-02-01

    Billions of dollars are spent every year to support medical research, with a substantial percentage coming from charitable foundations. To justify these expenditures, some measure of the return on investment would be useful, particularly one aligned with the intended ultimate outcome of this scientific effort: the amelioration of disease. The current mode of reporting on the success of medical research is output based, with an emphasis on measurable productivity. This approach falls short in many respects and may be contributing to the well-described efficacy-effectiveness gap in clinical care. The author argues for an outcomes-based approach and describes the steps involved, using an adaptation of the logic model. A shift in focus to the outcomes of our work would provide our founders with clearer mission-central return-on-investment feedback, would make explicit the benefits of science to an increasingly skeptical public, and would serve as a compass to guide the scientific community in playing a more prominent role in reducing the efficacy-effectiveness gap. While acknowledging the enormous complexity involved with the implementation of this approach on a large scale, the author hopes that this essay will encourage some initial steps toward this aim and stimulate further discussion of this concept. PMID:17267781

  18. Recent results on Electroweak measurements from ATLAS

    NASA Astrophysics Data System (ADS)

    Benekos, Nektarios Chr.

    2015-05-01

    ATLAS measurements of multiboson production processes involving combinations of W,Z and isolated photons are summarized. Measurements using data at 7 TeV and at 8 TeV are presented. The measurements are performed using leptonic decay modes, including the invisible decay Z ? v v?, as well as semileptonic channels. Measurements of single and diboson production in association with two forward jets is sensitive to electroweak vector boson fusion and scattering processes. An observation of the electroweak production of the Z boson and an evidence of same sign WW production are reported.

  19. Measuring Outcomes in Mental Health Services for Older People: An Evaluation of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+)

    ERIC Educational Resources Information Center

    Gee, Susan B.; Croucher, Matthew J.; Beveridge, John

    2010-01-01

    The Health of the Nation Outcome Scales (HoNOS) family of measures is routinely used in mental health services in the New Zealand, Australia, and the United Kingdom. However, the psychometric properties of the HoNOS65+ for elderly people have not been extensively evaluated. The aim of the present study was to examine the validity, reliability, and…

  20. Extreme ultraviolet BRDF measurements: instrumentation and results

    Microsoft Academic Search

    Michael P. Newell; Ritva A. Keski-Kuha

    1996-01-01

    The lack of measured surface scatter data at extreme ultraviolet (EUV) wavelengths has been commented upon by a number of authors. The need for such data arises primarily in the area of stray light design and analysis. Most stray light software requires knowledge of the bidirectional reflectance distribution (BRDF) for relevant surfaces. Without this measured data, quantitative assessment of stray

  1. Outcomes Assessment.

    ERIC Educational Resources Information Center

    Claxton, Charles; And Others

    1987-01-01

    Seven characteristics of an effective outcomes assessment program are identified: Outcomes assessment is a curricular rather than a measurement issue, yields information useful to decision-makers in gauging the quality of the curriculum, institutional purpose drives decisions on how outcomes are assessed, etc. (MLW)

  2. Measuring patient-reported outcomes: moving beyond misplaced common sense to hard science

    PubMed Central

    2011-01-01

    Interest in the patient's views of his or her illness and treatment has increased dramatically. However, our ability to appropriately measure such issues lags far behind the level of interest and need. Too often such measurement is considered to be a simple and trivial activity that merely requires the application of common sense. However, good quality measurement of patient-reported outcomes is a complex activity requiring considerable expertise and experience. This review considers the most important issues related to such measurement in the context of chronic disease and details how instruments should be developed, validated and adapted for use in additional languages. While there is often consensus on how best to undertake these activities, there is generally little evidence to support such accord. The present article questions these orthodox views and suggests alternative approaches that have been shown to be effective. PMID:21756344

  3. Extreme ultraviolet BRDF measurements: instrumentation and results

    NASA Astrophysics Data System (ADS)

    Newell, Michael P.; Keski-Kuha, Ritva A. M.

    1996-11-01

    The lack of measured surface scatter data at extreme ultraviolet (EUV) wavelengths has been commented upon by a number of authors. The need for such data arises primarily in the area of stray light design and analysis. Most stray light software requires knowledge of the bidirectional reflectance distribution (BRDF) for relevant surfaces. Without this measured data, quantitative assessment of stray light effects is difficult, making the confident prediction of instrument performance almost impossible. The Goddard EUV scatterometer was designed to perform such measurements, and the geometry, important design issues, and performance are discussed. This instrument is capable of plane-of-incidence BRDF measurements at EUV wavelengths between 58.1 nm and 121.6 nm, with a lower measurement limit of approximately 10-5 sr-1, and is able to accommodate angles of incidence between 10 and 75 degrees. The scatterometer can measure scatter to within 1.5 degrees of the specular beam, and the scatter angle can be measured to within 0.1 degree. BRDF data is presented for the commonly used visible-diffuser material white Spectralon SRS-99 at 121.6 nm; and for common baffle surfaces Martin Black, black Spectralon SRS-02, and an evaporated Cu black at wavelengths of 58.4 nm and 121.6 nm and angles of incidence of 15 degrees and 45 degrees. The BRDF distribution of a 3000 line/mm Al diffraction grating is also presented.

  4. Higher Chest Wall Dose Results in Improved Locoregional Outcome in Patients Receiving Postmastectomy Radiation

    SciTech Connect

    Panoff, Joseph E.; Takita, Cristiane [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Hurley, Judith [Department of Medicine, Division of Hematology and Oncology, Miller School of Medicine, University of Miami, Miami, Florida (United States); Department of Surgery, Division of Surgical Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Reis, Isildinha M. [Department of Epidemiology and Public Health and Sylvester Division of Biostatistics, University of Miami Miller School of Medicine, Miami, Florida (United States); Sylvester Division of Biostatistics and Bioinformatics Core, University of Miami Miller School of Medicine, Miami, Florida (United States); Zhao, Wei [Sylvester Division of Biostatistics and Bioinformatics Core, University of Miami Miller School of Medicine, Miami, Florida (United States); Rodgers, Steven E. [Department of Medicine, Division of Hematology and Oncology, Miller School of Medicine, University of Miami, Miami, Florida (United States); Department of Surgery, Division of Surgical Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Gunaseelan, Vijayalakshmi [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Wright, Jean L., E-mail: Jwright3@med.miami.edu [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States)

    2012-03-01

    Purpose: Randomized trials demonstrating decreased locoregional recurrence (LRR) and improved overall survival (OS) in women receiving postmastectomy radiation therapy (PMRT) used up to 50 Gy to the chest wall (CW), but in practice, many centers boost the CW dose to {>=}60 Gy, despite lack of data supporting this approach. We evaluated the relationship between CW dose and clinical outcome. Methods and Materials: We retrospectively reviewed medical records of 582 consecutively treated patients who received PMRT between January 1999 and December 2009. We collected data on patient, disease, treatment characteristics, and outcomes of LRR, progression-free survival (PFS) and OS. Results: Median follow-up from the date of diagnosis was 44.7 months. The cumulative 5-year incidence of LRR as first site of failure was 6.2%. CW dose for 7% (43 patients) was {<=}50.4 Gy (range, 41.4-50.4 Gy) and 93% received >50.4 Gy (range, 52.4-74.4 Gy). A CW dose of >50.4 Gy vs. {<=}50.4 Gy was associated with lower incidence of LRR, a 60-month rate of 5.7% (95% confidence interval [CI], 3.7-8.2) vs. 12.7% (95% CI, 4.5-25.3; p = 0.054). Multivariate hazard ratio (HR) for LRR controlling for race, receptor status, and stage was 2.62 (95% CI, 1.02-7.13; p = 0.042). All LRR in the low-dose group occurred in patients receiving 50 to 50.4 Gy. Lower CW dose was associated with worse PFS (multivariate HR, 2.73; 95% CI, 1.64-4.56; p < 0.001) and OS (multivariate HR, 3.88; 95% CI, 2.16-6.99; p < 0.001). Conclusions: The addition of a CW boost above 50.4 Gy resulted in improved locoregional control and survival in this cohort patients treated with PMRT for stage II-III breast cancer. The addition of a CW boost to standard-dose PMRT is likely to benefit selected high-risk patients. The optimal technique, target volume, and patient selection criteria are unknown. The use of a CW boost should be studied prospectively, as has been done in the setting of breast conservation.

  5. Mercury in fish and adverse reproductive outcomes: results from South Carolina

    PubMed Central

    2014-01-01

    Background Mercury is a metal with widespread distribution in aquatic ecosystems and significant neurodevelopmental toxicity in humans. Fish biomonitoring for total mercury has been conducted in South Carolina (SC) since 1976, and consumption advisories have been posted for many SC waterways. However, there is limited information on the potential reproductive impacts of mercury due to recreational or subsistence fish consumption. Methods To address this issue, geocoded residential locations for live births from the Vital Statistics Registry (1995–2005, N?=?362,625) were linked with spatially interpolated total mercury concentrations in fish to estimate potential mercury exposure from consumption of locally caught fish. Generalized estimating equations were used to test the hypothesis that risk of low birth weight (LBW, <2,500 grams) or preterm birth (PTB, <37 weeks clinical gestation) was greater among women living in areas with elevated total mercury in fish, after adjustment for confounding. Separate analyses estimated term LBW and PTB risks using residential proximity to rivers with fish consumption advisories to characterize exposure. Results Term LBW was more likely among women residing in areas in the upper quartile of predicted total mercury in fish (odds ratio [OR]?=?1.04; 95% confidence interval [CI]: 1.00-1.09) or within 8 kilometers of a river with a ‘do not eat’ fish advisory (1.05; 1.00-1.11) compared to the lowest quartile, or rivers without fish consumption restrictions, respectively. When stratified by race, risks for term LBW or PTB were 10-18% more likely among African-American (AA) mothers living in areas with the highest total fish mercury concentrations. Conclusions To our knowledge, this is the first study to examine the relationship between fish total mercury concentrations and adverse reproductive outcomes in a large population-based sample that included AA women. The ecologic nature of exposure assessment in this study precludes causal inference. However, the results suggest a need for more detailed investigations to characterize patterns of local fish consumption and potential dose–response relationships between mercury exposure and adverse reproductive outcomes, particularly among AA mothers. PMID:25127892

  6. Do intervention fidelity and dose influence outcomes? Results from the Move to Improve worksite physical activity program

    Microsoft Academic Search

    Mark G. Wilson; Tania B. Basta; Bethany H. Bynum; David M. DeJoy; Robert J. Vandenberg; Rod K. Dishman

    2009-01-01

    The purpose of this paper is to evaluate the implementation of the Move to Improve worksite physical activity program using a four step framework that includes the following: (i) de- fining the active ingredients, (ii) using good methods to measure implementation, (iii) mon- itoring implementation and (iv) relating imple- mentation to outcomes. The intervention active ingredients consisted of a goal

  7. Surgical versus Non-Operative Treatment for Lumbar Disc Herniation: Four-Year Results for the Spine Patient Outcomes Research Trial (SPORT)

    PubMed Central

    Weinstein, James N.; Lurie, Jon D.; Tosteson, Tor D.; Tosteson, Anna N. A.; Blood, Emily; Abdu, William A.; Herkowitz, Harry; Hilibrand, Alan; Albert, Todd; Fischgrund, Jeffrey

    2009-01-01

    Study Design Concurrent prospective randomized and observational cohort study. Objectives To assess the 4-year outcomes of surgery vs. non-operative care. Background Although randomized trials have demonstrated small short-term differences in favor of surgery, long-term outcomes comparing surgical to non-operative treatment remain controversial. Methods Surgical candidates with imaging-confirmed lumbar intervertebral disc herniation meeting SPORT eligibility criteria enrolled into prospective randomized (501 participants) and observational cohorts (743 participants) at 13 spine clinics in 11 US states. Interventions were standard open discectomy versus usual non-operative care. Main outcome measures were changes from baseline in the SF-36 Bodily Pain (BP) and Physical Function (PF) scales and the modified Oswestry Disability Index (ODI - AAOS/Modems version) assessed at 6 weeks, 3 and 6 months, and annually thereafter. Results Non-adherence to treatment assignment caused the intent-to-treat analyses to underestimate the treatment effects. In the 4-year combined as-treated analysis, those receiving surgery demonstrated significantly greater improvement in all the primary outcome measures (mean change Surgery vs. Non-operative; treatment effect; 95% CI): BP (45.6 vs. 30.7; 15.0; 11.8 to 18.1), PF (44.6 vs. 29.7; 14.9; 12.0 to 17.8) and ODI (?38.1 vs. ?24.9; ?13.2; ?15.6 to ?10.9). The percent working was similar between the surgery and non-operative groups, 84.4% vs. 78.4% respectively. Conclusion In a combined as-treated analysis at 4 years, patients who underwent surgery for a lumbar disc herniation achieved greater improvement than non-operatively treated patients in all primary and secondary outcomes except work status. Trial Registration Spine Patient Outcomes Research Trial (SPORT): Intervertebral Disc Herniation; #NCT00000410; http://www.clinicaltrials.gov/ct/show/NCT00000410?order=2 PMID:19018250

  8. The Effect of Ethical Signals on Recruitment Outcomes: Two Studies with Convergent Results 

    E-print Network

    Degrassi, Sandra W.

    2010-10-12

    The applicant decision making process is a complex one. During the recruitment process, signals from the organization provide information to the candidates and affect important recruitment outcomes. Ethics is one area the organization can utilize...

  9. The Effect of Ethical Signals on Recruitment Outcomes: Two Studies with Convergent Results

    E-print Network

    Degrassi, Sandra W.

    2010-10-12

    The applicant decision making process is a complex one. During the recruitment process, signals from the organization provide information to the candidates and affect important recruitment outcomes. Ethics is one area the organization can utilize...

  10. Terminated Trials in the ClinicalTrials.gov Results Database: Evaluation of Availability of Primary Outcome Data and Reasons for Termination

    PubMed Central

    Williams, Rebecca J.; Tse, Tony; DiPiazza, Katelyn; Zarin, Deborah A.

    2015-01-01

    Background Clinical trials that end prematurely (or “terminate”) raise financial, ethical, and scientific concerns. The extent to which the results of such trials are disseminated and the reasons for termination have not been well characterized. Methods and Findings A cross-sectional, descriptive study of terminated clinical trials posted on the ClinicalTrials.gov results database as of February 2013 was conducted. The main outcomes were to characterize the availability of primary outcome data on ClinicalTrials.gov and in the published literature and to identify the reasons for trial termination. Approximately 12% of trials with results posted on the ClinicalTrials.gov results database (905/7,646) were terminated. Most trials were terminated for reasons other than accumulated data from the trial (68%; 619/905), with an insufficient rate of accrual being the lead reason for termination among these trials (57%; 350/619). Of the remaining trials, 21% (193/905) were terminated based on data from the trial (findings of efficacy or toxicity) and 10% (93/905) did not specify a reason. Overall, data for a primary outcome measure were available on ClinicalTrials.gov and in the published literature for 72% (648/905) and 22% (198/905) of trials, respectively. Primary outcome data were reported on the ClinicalTrials.gov results database and in the published literature more frequently (91% and 46%, respectively) when the decision to terminate was based on data from the trial. Conclusions Trials terminate for a variety of reasons, not all of which reflect failures in the process or an inability to achieve the intended goals. Primary outcome data were reported most often when termination was based on data from the trial. Further research is needed to identify best practices for disseminating the experience and data resulting from terminated trials in order to help ensure maximal societal benefit from the investments of trial participants and others involved with the study. PMID:26011295

  11. Heart rate variability measured early in patients with evolving acute coronary syndrome and 1-year outcomes of rehospitalization and mortality

    PubMed Central

    Harris, Patricia R E; Stein, Phyllis K; Fung, Gordon L; Drew, Barbara J

    2014-01-01

    Objective This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS). Background Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. Methods Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with ?18 hours of sinus rhythm were selected for HRV analysis (number [N] =193). Time domain, frequency domain, and nonlinear HRV were examined. Survival analysis was performed. Results During the 1-year follow-up, 94 patients were event-free, 82 were readmitted, and 17 died. HRV was altered in relation to outcomes. Predictors of rehospitalization included increased normalized high frequency power, decreased normalized low frequency power, and decreased low/high frequency ratio. Normalized high frequency >42 ms2 predicted rehospitalization while controlling for clinical variables (hazard ratio [HR] =2.3; 95% confidence interval [CI] =1.4–3.8, P=0.001). Variables significantly associated with death included natural logs of total power and ultra low frequency power. A model with ultra low frequency power <8 ms2 (HR =3.8; 95% CI =1.5–10.1; P=0.007) and troponin >0.3 ng/mL (HR =4.0; 95% CI =1.3–12.1; P=0.016) revealed that each contributed independently in predicting mortality. Nonlinear HRV variables were significant predictors of both outcomes. Conclusion HRV measured close to the ACS onset may assist in risk stratification. HRV cut-points may provide additional, incremental prognostic information to established assessment guidelines, and may be worthy of additional study. PMID:25143740

  12. An overview of animal models of pain: disease models and outcome measures

    PubMed Central

    Gregory, N; Harris, AL; Robinson, CR; Dougherty, PM; Fuchs, PN; Sluka, KA

    2013-01-01

    Pain is ultimately a perceptual phenomenon. It is built from information gathered by specialized pain receptors in tissue, modified by spinal and supraspinal mechanisms, and integrated into a discrete sensory experience with an emotional valence in the brain. Because of this, studying intact animals allows the multidimensional nature of pain to be examined. A number of animal models have been developed, reflecting observations that pain phenotypes are mediated by distinct mechanisms. Animal models of pain are designed to mimic distinct clinical diseases to better evaluate underlying mechanisms and potential treatments. Outcome measures are designed to measure multiple parts of the pain experience including reflexive hyperalgesia measures, sensory and affective dimensions of pain and impact of pain on function and quality of life. In this review we discuss the common methods used for inducing each of the pain phenotypes related to clinical pain syndromes, as well as the main behavioral tests for assessing pain in each model. PMID:24035349

  13. Betting on the Outcomes of Measurements: A Bayesian Theory of Quantum Probability

    E-print Network

    I. Pitowsky

    2002-08-18

    We develop a systematic approach to quantum probability as a theory of rational betting in quantum gambles. In these games of chance the agent is betting in advance on the outcomes of several (finitely many) incompatible measurements. One of the measurements is subsequently chosen and performed and the money placed on the other measurements is returned to the agent. We show how the rules of rational betting imply all the interesting features of quantum probability, even in such finite gambles. These include the uncertainty principle and the violation of Bell's inequality among others. Quantum gambles are closely related to quantum logic and provide a new semantics to it. We conclude with a philosophical discussion on the interpretation of quantum mechanics.

  14. Moving beyond Mindfulness: Defining Equanimity as an Outcome Measure in Meditation and Contemplative Research

    PubMed Central

    Gard, Tim; Hoge, Elizabeth A.; Hölzel, Britta K.; Kerr, Catherine; Lazar, Sara W.; Olendzki, Andrew; Vago, David R.

    2014-01-01

    In light of a growing interest in contemplative practices such as meditation, the emerging field of contemplative science has been challenged to describe and objectively measure how these practices affect health and well-being. While “mindfulness” itself has been proposed as a measurable outcome of contemplative practices, this concept encompasses multiple components, some of which, as we review here, may be better characterized as equanimity. Equanimity can be defined as an even-minded mental state or dispositional tendency toward all experiences or objects, regardless of their origin or their affective valence (pleasant, unpleasant, or neutral). In this article we propose that equanimity be used as an outcome measure in contemplative research. We first define and discuss the inter-relationship between mindfulness and equanimity from the perspectives of both classical Buddhism and modern psychology and present existing meditation techniques for cultivating equanimity. We then review psychological, physiological, and neuroimaging methods that have been used to assess equanimity, either directly or indirectly. In conclusion, we propose that equanimity captures potentially the most important psychological element in the improvement of well-being, and therefore should be a focus in future research studies. PMID:25750687

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

    PubMed

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

    2015-03-18

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

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

    PubMed Central

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

    2015-01-01

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

  17. The influence of central review on outcome associations in childhood malignant gliomas: Results from the CCG-945 experience1

    Microsoft Academic Search

    Ian F. Pollack; James M. Boyett; Allan J. Yates; Peter C. Burger; Floyd H. Gilles; Richard L. Davis; Jonathan L. Finlay

    2003-01-01

    To examine the influence of the pathology review mech- anism on the results of analyses of therapeutic efficacy and biological prognostic correlates for pediatric high- grade gliomas, we evaluated the effects of using single- expert review or consensus review, as alternatives to insti- tutional classification, in determining outcome results of a large randomized trial. The study group was the ran-

  18. Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

    PubMed Central

    Chalmers, JR; Schmitt, J; Apfelbacher, C; Dohil, M; Eichenfield, LF; Simpson, EL; Singh, J; Spuls, P; Thomas, KS; Admani, S; Aoki, V; Ardeleanu, M; Barbarot, S; Berger, T; Bergman, JN; Block, J; Borok, N; Burton, T; Chamlin, SL; Deckert, S; DeKlotz, CC; Graff, LB; Hanifin, JM; Hebert, AA; Humphreys, R; Katoh, N; Kisa, RM; Margolis, DJ; Merhand, S; Minnillo, R; Mizutani, H; Nankervis, H; Ohya, Y; Rodgers, P; Schram, ME; Stalder, JF; Svensson, A; Takaoka, R; Teper, A; Tom, WL; von Kobyletzki, L; Weisshaar, E; Zelt, S; Williams, HC

    2014-01-01

    Summary This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6–7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting participants (31 of whom were dermatologists). Significant progress was made on the domain of clinical signs. Without reference to any named scales, it was agreed that the intensity and extent of erythema, excoriation, oedema/papulation and lichenification should be included in the core outcome measure for the scale to have content validity. The group then discussed a systematic review of all scales measuring the clinical signs of eczema and their measurement properties, followed by a consensus vote on which scale to recommend for inclusion in the core outcome set. Research into the remaining three domains was presented, followed by discussions. The symptoms group and quality of life groups need to systematically identify all available tools and rate the quality of the tools. A definition of long-term control is needed before progress can be made towards recommending a core outcome measure. What's already known about this topic? Many different scales have been used to measure eczema, making it difficult to compare trials in meta-analyses and hampering improvements in clinical practice. HOME core outcome measures must pass the OMERACT (Outcome Measures in Rheumatology) filter of truth (validity), discrimination (sensitivity to change and responsiveness) and feasibility (ease of use, costs, time to perform and interpret). It has been previously agreed as part of the consensus process that four domains should be measured by the core outcomes: clinical signs, patient-reported symptoms, long-term control and health-related quality of life. What does this study add? Progress was made towards developing a core outcome set for measuring eczema in clinical trials. The group established the essential items to be included in the outcome measure for the clinical signs of eczema and was able to recommend a scale for the core set. The remaining three domains of patient-reported symptoms, long-term control and health-related quality of life require further work and meetings to determine the core outcome measures. PMID:24980543

  19. Superiority of amniotic fluid index over amniotic fluid pocket measurement for predicting bad fetal outcome.

    PubMed

    Youssef, A A; Abdulla, S A; Sayed, E H; Salem, H T; Abdelalim, A M; Devoe, L D

    1993-04-01

    Semiquantitative amniotic fluid volume (AFV) determination is a component of the fetal biophysical profile (BPP). To assess decreased AVF we did BPPs of 174 fetuses within 1 week of delivery. Two methods were used: measurement of the single largest vertical pocket (oligohydramnios = depth < 1 cm) and the four-quadrant amniotic fluid index (AFI) (oligohydramnios = AFI < or = 5 cm). AFV, as determined by each method, was related to measures of fetal outcome (perinatal mortality, fetal distress, Apgar score, meconium-stained amniotic fluid, and intrauterine growth retardation [IUGR]). The AFI was more sensitive in predicting mortality (87.5%) and the following measures of perinatal morbidity: low 5-minute Apgar score (88.8%), fetal distress during labor (86.6%), meconium-stained amniotic fluid (63.6%), and the presence of IUGR (79.4%). The sensitivity of amniotic fluid pocket measurement of < 1 cm was 75%, 72.2%, 66.6%, 47.7%, and 55.8%, respectively, for the same measures. Using the AFI instead of a single pocket measurement in BPP assessment increased the sensitivity and positive predictive value of the BPP from 64.7% to 76.4% and from 45.8% to 68.4%, respectively. Our data suggest that qualitative AFV measurement using the AFI is superior to that of the single largest pocket in multiple component fetal biophysical testing. PMID:8465220

  20. Interpersonal contribution to outcome: The relation of interpersonal distress and symptomatic improvement as a result of psychotherapy.

    PubMed

    Hardy, Amanda O; Tracey, Terence J G; Glidden-Tracey, Cynthia; Hess, Timothy R; Rohlfing, Jessica E

    2011-01-01

    The study utilized a 32-item brief measure of interpersonal problems (IIP) to examine interpersonal distress in relation to symptomology and treatment outcome as assessed by the Outcome Questionnaire-45 (OQ-45). The study included a community sample of 210 individuals receiving psychotherapy at a mental health training facility. A number of significant correlations were found between interpersonal distresses with symptomology. The highest correlations were found between levels of general interpersonal distress and symptoms relating to psychiatric and social distress at the onset of therapy; in general the IIP did not differentiate between symptomology types. The study failed to replicate previous research indicating a relation between facets of interpersonal problems with treatment outcome. PMID:20589619

  1. Cerebellar Alterations and Gait Defects as Therapeutic Outcome Measures for Enzyme Replacement Therapy in ?-Mannosidosis

    PubMed Central

    Damme, Markus; Stroobants, Stijn; Walkley, Steven U.; Lüllmann-Rauch, Renate; D`Hooge, Rudi; Fogh, Jens; Saftig, Paul; Lübke, Torben; Blanz, Judith

    2011-01-01

    ?-Mannosidosis is a rare lysosomal storage disease with accumulation of undegraded mannosyl-linked oligosaccharides in cells throughout the body, most notably in the CNS. This leads to a broad spectrum of neurological manifestations, including progressive intellectual impairment, disturbed motor functions and cerebellar atrophy. To develop therapeutic outcome measures for enzyme replacement therapy (ERT) that could be used for human patients, a gene knockout model of ?-mannosidosis in mice was analyzed for CNS pathology and motor deficits. In the cerebellar molecular layer, ?-mannosidosis mice display clusters of activated Bergman glia, infiltration of phagocytic macrophages and accumulation of free cholesterol and gangliosides (GM1), notably in regions lacking Purkinje cells. ?-mannosidosis brain lysates also displayed increased expression of Lamp1 and hyperglycosylation of the cholesterol binding protein NPC2. Detailed assessment of motor function revealed age-dependent gait defects in the mice that resemble the disturbed motor function in human patients. Short-term ERT partially reversed the observed cerebellar pathology with fewer activated macrophages and astrocytes but unchanged levels of hyperglycosylated NPC2, gangliosides and cholesterol. The present study demonstrates cerebellar alterations in ?-mannosidosis mice that relate to the motor deficits and pathological changes seen in human patients and can be used as therapeutic outcome measures. PMID:21157375

  2. The 6-minute walk test as a new outcome measure in Duchenne muscular dystrophy.

    PubMed

    McDonald, Craig M; Henricson, Erik K; Han, Jay J; Abresch, R Ted; Nicorici, Alina; Elfring, Gary L; Atkinson, Leone; Reha, Allen; Hirawat, Samit; Miller, Langdon L

    2010-04-01

    Walking abnormalities are prominent in Duchenne muscular dystrophy (DMD). We modified the 6-minute walk test (6MWT) for use as an outcome measure in patients with DMD and evaluated its performance in 21 ambulatory boys with DMD and 34 healthy boys, ages 4 to 12 years. Boys with DMD were tested twice, approximately 1 week apart; controls were tested once. The groups had similar age, height, and weight. All tests were completed. Boys who fell recovered rapidly from falls without injury. Mean +/- SD [range] 6-minute walk distance (6MWD) was lower in boys with DMD than in controls (366 +/- 83 [125-481] m vs. 621 +/- 68 [479-754] m; P < 0.0001; unpaired t-test). Test-retest correlation for boys with DMD was high (r = 0.91). Stride length (R(2) = 0.89; P < 0.0001) was the major determinant of 6MWD for both boys with DMD and controls. A modified 6MWT is feasible and safe, documents disease-related limitations on ambulation, is reproducible, and offers a new outcome measure for DMD natural history and therapeutic trials. PMID:19941337

  3. Adolescent Outcome Measures in the NLSY97 Family Process Data Set: Variation by Race and Socioeconomic Conditions

    Microsoft Academic Search

    Erin K. Holmes; Hinckley A. Jones-Sanpei; Randal D. Day

    2009-01-01

    This study uses nationally representative data from the National Longitudinal Surveys of Youth 1997 to analyze adolescent outcome indexes (delinquency, substance use, and emotional and behavior problems) by gender, race, household income, and family structure. Results from analysis of variance show that family structure is correlated with better adolescent outcomes, even after controlling for gender, race, and household income. For

  4. Communicating the results of randomized clinical trials: do patients understand multidimensional patient-reported outcomes?

    PubMed

    McNair, Angus G K; Brookes, Sara T; Davis, Christopher R; Argyropoulos, Miltiadis; Blazeby, Jane M

    2010-02-10

    PURPOSE Evidence suggests that patient-reported outcomes (PROs) from randomized trials in oncology may not influence clinical decision making and patient choice. Reasons for this are currently unclear and little is known about patients' interpretation of PROs. This study assessed patients' understanding of multidimensional PROs in a graphical format. PATIENTS AND METHODS Semistructured interviews in which patients interpreted a series of graphs depicting simple, then multiple different hypothetical PROs associated with two treatments with identical chances of survival were audio recorded. The interviewer and a blinded observer (listening to audio recordings) scored patients' understanding of the graphs. Logistic regression examined the associations between patient understanding of the graphs and clinical and sociodemographic details. Results One hundred thirty-two patients with esophageal and gastric cancer were interviewed and 115 understood the first two graphs depicting different PROs of two treatments (87%; 95% CI,81 to 93). Simultaneous interpretation of adverse and beneficial treatment effects was achieved by 74 (66%; 95% CI, 57 to 75). Graphs showing complex, longitudinal data were correctly interpreted by 97 (73%; 95% CI, 66 to 81) and 108 (81%; 95% CI, 75 to 88), respectively. Univariable analyses demonstrated associations between patient understanding and patient age, educational level, and cancer site (P < or = .02 for all); however, in a multivariable model each of these associations was attenuated. CONCLUSION Most patients understand graphical multidimensional PROs, although a smaller majority were able to interpret more complex, or simultaneous, presentations. Additional work is needed to define methods for communicating clinical and PRO data from trials to allow patients to make informed treatment choices. PMID:20065187

  5. Functional health outcomes as a measure of health care quality for Medicare beneficiaries.

    PubMed Central

    Bierman, A S; Lawrence, W F; Haffer, S C; Clancy, C M

    2001-01-01

    OBJECTIVE: the Medicare Health Outcomes Survey (HOS), a new quality measure in the Health Plan Employer Data and Information Set, is designed to assess physical and mental functional health outcomes of Medicare beneficiaries enrolled in Medicare+Choice organizations. We discuss the rationale for the HOS measure together with methodologic challenges in its use and interpretation, using descriptive data from the baseline Medicare HOS to illustrate some of these challenges. DATA SOURCES/STUDY DESIGN: The 1999 Cohort 2 Medicare HOS baseline data were used for a cross-sectional descriptive analysis. A random sample of 1,000 beneficiaries from each health plan with a Medicare+Choice contract was surveyed (N = 156,842; 282 organizations included in these analyses) . PRINCIPAL FINDINGS: The HOS measure is designed to assess a previously unmeasured dimension of quality. Plan-level variation was seen across all baseline measures of sociodemographic characteristics and illness burden. At the individual level socioeconomic position as measured by educational attainment was strongly associated with functional status. The least educated beneficiaries had the highest burden of illness on all measures examined, and there was a consistent and significant gradient in health and functional status across all levels of education. In analyses stratified by race and ethnicity, socioeconomic gradients in f un ct ion persist ed. CONCLUSIONS Despite limitations, by focusing at t en t ion on the need to improve functional health out comes among elderly Medicare beneficiaries enrolled in Medicare+Choice, the HOS can serve as an important new tool to support efforts to improve health care quality. The HOS provides valuable information at the federal, state, and health plan levels that can be used to identify, prioritize, and evaluate quality improvement interventions and monitor progress for the program overall as well as for vulnerable subgroups. To interpret the HOS as a quality measure individual-and plan-level differences in functional status and illness burden, as well as methodologic issues in health status measurement, need to be recognized and addressed. PMID:16148963

  6. Three Measures of Forest Fire Smoke Exposure and Their Associations with Respiratory and Cardiovascular Health Outcomes in a Population-Based Cohort

    PubMed Central

    Brauer, Michael; MacNab, Ying C.; Kennedy, Susan M.

    2011-01-01

    Background: During the summer of 2003 numerous fires burned in British Columbia, Canada. Objectives: We examined the associations between respiratory and cardiovascular physician visits and hospital admissions, and three measures of smoke exposure over a 92-day study period (1 July to 30 September 2003). Methods: A population-based cohort of 281,711 residents was identified from administrative data. Spatially specific daily exposure estimates were assigned to each subject based on total measurements of particulate matter (PM) ? 10 ?m in aerodynamic diameter (PM10) from six regulatory tapered element oscillating microbalance (TEOM) air quality monitors, smoke-related PM10 from a CALPUFF dispersion model run for the study, and a SMOKE exposure metric for plumes visible in satellite images. Logistic regression with repeated measures was used to estimate associations with each outcome. Results: The mean (± SD) exposure based on TEOM-measured PM10 was 29 ± 31 ?g/m3, with an interquartile range of 14–31 ?g/m3. Correlations between the TEOM, smoke, and CALPUFF metrics were moderate (0.37–0.76). Odds ratios (ORs) for a 30-?g/m3 increase in TEOM-based PM10 were 1.05 [95% confidence interval (CI), 1.03–1.06] for all respiratory physician visits, 1.16 (95% CI, 1.09–1.23) for asthma-specific visits, and 1.15 (95% CI, 1.00–1.29) for respiratory hospital admissions. Associations with cardiovascular outcomes were largely null. Conclusions: Overall we found that increases in TEOM-measured PM10 were associated with increased odds of respiratory physician visits and hospital admissions, but not with cardiovascular health outcomes. Results indicating effects of fire smoke on respiratory outcomes are consistent with previous studies, as are the null results for cardiovascular outcomes. Some agreement between TEOM and the other metrics suggests that exposure assessment tools that are independent of air quality monitoring may be useful with further refinement. PMID:21659039

  7. Goals, Motivation for, and Outcomes of Personal Learning through Networks: Results of a Tweetstorm

    ERIC Educational Resources Information Center

    Sie, Rory L. L.; Pataraia, Nino; Boursinou, Eleni; Rajagopal, Kamakshi; Margaryan, Anoush; Falconer, Isobel; Bitter-Rijpkema, Marlies; Littlejohn, Allison; Sloep, Peter B.

    2013-01-01

    Recent developments in the use of social media for learning have posed serious challenges for learners. The information overload that these online social tools create has changed the way learners learn and from whom they learn. An investigation of learners' goals, motivations and expected outcomes when using a personal learning network is…

  8. Outcomes of cardiac surgery in patients age ?80 years: results from the National Cardiovascular Network

    Microsoft Academic Search

    Karen P Alexander; Kevin J Anstrom; Lawrence H Muhlbaier; Ralph D Grosswald; Peter K Smith; Robert H Jones; Eric D Peterson

    2000-01-01

    OBJECTIVESThe purpose of this study was to evaluate characteristics and outcomes of patients age ?80 undergoing cardiac surgery.BACKGROUNDPrior single-institution series have found high mortality rates in octogenarians after cardiac surgery. However, the major preoperative risk factors in this age group have not been identified. In addition, the additive risks in the elderly of valve replacement surgery at the time of

  9. Reassuring results with regard to the effect of donor nephrectomy on cardiovascular outcomes

    Microsoft Academic Search

    Martin J Landray; Christopher G Winearls; Richard Haynes

    2009-01-01

    This article discusses the conclusions of a retrospective cohort study reported by Garg et al. on behalf of the Donor Nephrectomy Outcomes Research (DONOR) Network. This study compared the incidence of cardiovascular events in a cohort of kidney donors with that in a matched control population, to establish whether living kidney donation is associated with increased cardiovascular risk. Garg et

  10. The Effectiveness of Substance Abuse Treatment in Illinois: Results of the Illinois Statewide Treatment Outcomes Project

    E-print Network

    Illinois at Chicago, University of

    Treatment Outcomes Project September, 2001 Maria Bruni, Ph.D., Director of Research and Evaluation Beth Center (Outpatient) Peoria #12;Human Service Center White Oaks Knolls for Men Peoria Human Service Center (Women's Residential) Peoria Lake County Health Department & Community Health Center Women's Residential

  11. Interrater Reliability of the Outcomes and Assessment Information Set: Results from the Field.

    ERIC Educational Resources Information Center

    Madigan, Elizabeth A.; Fortinsky, Richard H.

    2004-01-01

    The Outcomes and Assessment Information Set (OASIS) is now used extensively for regulatory, reimbursement, research, and clinical purposes in home health care. However, little is known about the interrater reliability of OASIS items based on assessments from home-health-agency clinicians. Therefore, we evaluated OASIS item interrater reliability…

  12. Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: Results from the Bipolar CHOICE trial

    PubMed Central

    Bobo, William V.; Reilly-Harrington, Noreen A.; Ketter, Terence A.; Brody, Benjamin D.; Kinrys, Gustavo; Kemp, David E.; Shelton, Richard C.; McElroy, Susan L.; Sylvia, Louisa G.; Kocsis, James H.; McInnis, Melvin G.; Friedman, Edward S.; Singh, Vivek; Tohen, Mauricio; Bowden, Charles L.; Deckersbach, Thilo; Calabrese, Joseph R.; Thase, Michael E.; Nierenberg, Andrew A.; Rabideau, Dustin J.; Schoenfeld, David A.; Faraone, Stephen V.; Kamali, Masoud

    2014-01-01

    Background Little is known about the longer-term effects of adjunctive benzodiazepines on symptom response during treatment in patients with bipolar disorders. Methods The study sample consisted of 482 patients with bipolar I or II disorder enrolled in a 6-month, randomized, multi-site comparison of lithium- and quetiapine-based treatment. Changes in clinical measures (BISS total and subscales, CGI-BP, and CGI-Efficacy Index) were compared between participants who did and did not receive benzodiazepine treatment at baseline or during follow-up. Selected outcomes were also compared between patients who did and did not initiate benzodiazepines during follow-up using stabilized inverse probability weighted analyses. Results Significant improvement in all outcome measures occurred within each benzodiazepine exposure group. Benzodiazepine users (at baseline or during follow-up) experienced significantly less improvement in BISS total, BISS irritability, and CGI-BP scores than did benzodiazepine non-users. There were no significant differences in these measures between patients who did and did not initiate benzodiazepines during follow-up in the weighted analyses. There was no significant effect of benzodiazepine use on any outcome measure in patients with comorbid anxiety or substance use disorders. Limitations This is a secondary analysis of data from a randomized effectiveness trial that was not designed to address differential treatment response according to benzodiazepine use. Conclusions Adjunctive benzodiazepines may not significantly affect clinical outcome in lithium- or quetiapine-treated patients with bipolar I or II disorder over 6 months, after controlling for potential confounding factors. PMID:24751304

  13. Patient-reported outcome measures: an on-line system empowering patient choice.

    PubMed

    Wilson, J; Arshad, F; Nnamoko, N; Whiteman, A; Ring, J; Roy, B

    2014-01-01

    An innovative web-based system was developed to allow patient-reported outcome measures (PROMs) to be easily administered. Stakeholders guided the design and implementation. The software gives patients access to their current and previous scores. This pilot study focused on patients undergoing arthroscopic subacromial decompression, evaluated using the Oxford shoulder score (OSS). Patients showing good improvement in their OSS were offered the choice to return for routine follow-up clinic appointments, or continue rehabilitation, reassured by their improved score. Thirty-six of 117 patients were eligible. Thirty of these (83%) were opted to avoid further clinics. PROMs 2.0 can be used for any medical intervention with a validated PROM. Evolution and refinement is ongoing. Funding has been granted for 12 primary and secondary healthcare trusts to implement PROMs 2.0. Further work is needed to assess economic impact, patient views and satisfaction with the process. PMID:24013090

  14. Feasibility of 4 patient-reported outcome measures in a registry setting

    PubMed Central

    2012-01-01

    Background and purpose Feasibility is an important parameter when choosing which patient-reported outcomes (PRO) to use in a study. We assessed the feasibility of PROs in a hip registry setting. Methods Primary total hip arthroplasty (THA) patients (n = 5,747) who had been operated on 1–2, 5–6, or 10–11 years previously were randomly selected from the Danish Hip Arthroplasty Register and sent 2 PRO questionnaires: 1 generic (EuroQoL-5D or SF-12 health survey) and 1 disease-specific (hip dysfunction and osteoarthritis outcome score (HOOS) or Oxford 12-item hip score). We compared response rates, floor and ceiling effects, missing items, and the need for manual validation of forms. Results 4,784 patients (mean age 71 years, 57% females) were included (83%). The response rates ranged from 82–84%. Statistically significantly different floor and ceiling effects ranged from 0% to 0.5% and from 6.1% to 46%, respectively. Missing items ranged from 1.2% to 3.4%, and 0.8–4.3% required manual validation (p < 0.009). A hypothetical repeat study found that group sizes from 51 to 1,566 are needed for subgroup analysis, depending on descriptive factor and choice of PRO. Interpretation All 4 PROs fulfilled a priori set criteria, with the exception of ceiling effects. The high ceiling effects were attributed to postoperative administration and good outcome for THA. We conclude that all 4 PROs are appropriate for administration in a hip registry. PMID:22900909

  15. Measuring and predicting long-term outcomes in older survivors of critical illness.

    PubMed

    Baldwin, M R

    2015-06-01

    Older adults (age ?65 years) now initially survive what were previously fatal critical illnesses, but long-term mortality and disability after critical illness remain high. Most studies show that the majority of deaths among older ICU survivors occur during the first 6 to 12 months after hospital discharge. Less is known about the relationship between critical illness and subsequent cause of death, but longitudinal studies of ICU survivors of pneumonia, stroke, and those who require prolonged mechanical ventilation suggest that many debilitated older ICU survivors die from recurrent infections and sepsis. Recent studies of older ICU survivors have created a new standard for longitudinal critical care outcomes studies with a systematic evaluation of pre-critical illness comorbidities and disability and detailed assessments of physical and cognitive function after hospital discharge. These studies show that after controlling for pre-morbid health, older ICU survivors experience large and persistent declines in cognitive and physical function after critical illness. Long-term health-related quality-of-life studies suggest that some older ICU survivors may accommodate to a degree of physical disability and still report good emotional and social well-being, but these studies are subject to survivorship and proxy-response bias. In order to risk-stratify older ICU survivors for long-term (6-12 months) outcomes, we will need a paradigm shift in the timing and type of predictors measured. Emerging literature suggests that the initial acuity of critical illness will be less important, whereas prehospitalization estimates of disability and frailty, and, in particular, measures of comorbidity, frailty, and disability near the time of hospital discharge will be essential in creating reliable long-term risk-prediction models. PMID:24923682

  16. Preference based outcome measures for economic evaluation of drug interventions: quality adjusted life years (QALYs) versus healthy years equivalents (HYEs).

    PubMed

    Mehrez, A; Gafni, A

    1992-05-01

    Decisions about medical treatment and health programmes involve both technical and value judgements. For the purpose of performing an economic appraisal of different health interventions (including drug interventions), a single global score is essential as the measure of outcome. This measure should enable us to compare different interventions that affect both duration and quality of life at different levels of effect. This article provides a short but critical overview of the most commonly used measure of outcome in such cases--the quality adjusted life years (QALY). We describe the measure and discuss its limitations. More specifically we discuss problems stemming from the fact that QALYs do not fully reflect individual preferences and the fact that different (not necessarily comparable) methods of measurement can be used to generate the weights. We also discuss the issue of the equity implications of the methods used to aggregate the QALY values of individuals to arrive at a community health outcome measure. Our conclusion is that the use of QALY does not coincide with achieving the stated goal of economic evaluations (i.e. efficient allocation of resources to enable maximisation of the health of the community for any given level of resources). An alternative measure of outcome--the healthy years equivalent (HYE), which does not suffer from many of the major limitations associated with the QALY measure--is described and discussed. PMID:10146998

  17. Long-term, Clinical and Echocardiographic Results After Successful Mitral Balloon Valvotomy and Predictors of Long-term Outcome

    Microsoft Academic Search

    Mohamed Eid Fawzy; Hesham Hegazy; Mohamed Shoukri

    2005-01-01

    Aims To assess the long-term outcome of mitral balloon valvotomy (MBV) and identify predictors of rest- enosis- and event-free survival. Methods and results We report the immediate and long-term clinical and echocardiographic results in 493 patients, mean age 31+ 11, who underwent successful MBV and were followed-up for 0.5-15 years (median 5+ 3) with clinical and echocardiographic examination. After MBV,

  18. Patient-reported outcome measures in psoriasis: the good, the bad and the missing!

    PubMed

    Kitchen, H; Cordingley, L; Young, H; Griffiths, C E M; Bundy, C

    2015-05-01

    As a long-term condition, psoriasis demands significant personal and professional input for optimal self-management. Low levels of well-being and high levels of psychological distress in patients with psoriasis are associated with reduced resources for self-care. Patient-reported outcome (PRO) measures can be used to assess physical, social and psychological functioning in order to guide treatment. In this article, we systematically reviewed the development and validation of existing PRO measures. PubMed (Medline), PsycINFO and CINAHL were searched systematically using predefined search terms. The search was limited to articles in the English language relating to human subjects. Articles were selected for full review through explicit inclusion/exclusion criteria. PRO measures were critically reviewed in accordance with the published guidelines and theory on the development and validation of PROs. The search identified 967 abstracts; 71 of these articles met the criteria for full review. In these 71 articles, 45 PRO measures were found: 16 were specific to psoriasis, 21 assessed other dermatological conditions and eight were developed for generic nondermatological health conditions. The review revealed several limitations of the existing measures, including: (i) a composite structure assessing multiple, poorly-defined concepts; (ii) a lack of evidence for face and content validity; (iii) a failure to include both patient and clinician perspectives and requirements and (iv) a lack of evidence regarding the feasibility and acceptability for patients and physicians. No single PRO measure with adequate evidence of validity, reliability and sensitivity to change captures patient well-being in psoriasis. A valid, sensitive, specific and acceptable PRO that assesses the full impact of psoriasis on well-being is needed for the comprehensive clinical management of psoriasis. PMID:25677764

  19. Interviewing to develop Patient-Reported Outcome (PRO) measures for clinical research: eliciting patients' experience.

    PubMed

    Brédart, Anne; Marrel, Alexia; Abetz-Webb, Linda; Lasch, Kathy; Acquadro, Catherine

    2014-01-01

    Patient-reported outcome (PRO) measures must provide evidence that their development followed a rigorous process for ensuring their content validity. To this end, the collection of data is performed through qualitative interviews that allow for the elicitation of in-depth spontaneous reports of the patients' experiences with their condition and/or its treatment. This paper provides a review of qualitative research applied to PRO measure development. A clear definition of what is a qualitative research interview is given as well as information about the form and content of qualitative interviews required for developing PRO measures. Particular attention is paid to the description of interviewing approaches (e.g., semi-structured and in-depth interviews, individual vs. focus group interviews). Information about how to get prepared for a qualitative interview is provided with the description of how to develop discussion guides for exploratory or cognitive interviews. Interviewing patients to obtain knowledge regarding their illness experience requires interpersonal and communication skills to facilitate patients' expression. Those skills are described in details, as well as the skills needed to facilitate focus groups and to interview children, adolescents and the elderly. Special attention is also given to quality assurance and interview training. The paper ends on ethical considerations since interviewing for the development of PROs is performed in a context of illness and vulnerability. Therefore, it is all the more important that, in addition to soliciting informed consent, respectful interactions be ensured throughout the interview process. PMID:24499454

  20. Depression symptom clusters and their predictive value for treatment outcomes: results from an individual patient data meta-analysis of duloxetine trials.

    PubMed

    Schacht, Alexander; Gorwood, Philip; Boyce, Philip; Schaffer, Ayal; Picard, Hernan

    2014-06-01

    We evaluated individual patient data from phase II to IV clinical trials of duloxetine in major depressive disorder (MDD) (34 studies, 13,887 patients). Our goal was to identify clusters of patients with similar depressive symptom patterns at baseline, as measured by the 17-item Hamilton Depression Rating Scale (HAMD-17), and to investigate their respective predictive value of outcomes as measured by the HAMD-17 total score. Five clusters were identified at baseline: 1) "Lack of insight"; 2) "Sleep/sexual/somatic"; 3) "Typical MDD"; 4) "Gastrointestinal/weight loss"; and 5) "Mild MDD". However, it should be noted that cluster descriptors are not mutually exclusive. Analyses of the HAMD-17 total score results over time were performed using the 18 randomized placebo and/or actively controlled studies representing 6723 patients. At the end of acute treatment (ranging from 4 to 36 weeks), different levels of effect sizes for active therapy (64.5% duloxetine) vs. placebo were detected by cluster. In 3 out of 5 clusters (representing about 80% of the patients), the effect size was significantly different from 0, in favor of active therapy. The effect size was largest in those clusters with severe somatic symptoms ("Sleep/sexual/somatic" cluster [-0.4170], and "Gastrointestinal/weight loss" cluster [-0.338]). In conclusion, our cluster analysis identified 5 clinically relevant MDD patient clusters with specific mean treatment outcomes. Identification of MDD clusters may help to improve outcomes by adapting MDD treatment to particular clinical profiles. PMID:24572681

  1. Can MR Measurement of Renal Artery Flow and Renal Volume Predict the Outcome of Percutaneous Transluminal Renal Angioplasty?

    SciTech Connect

    Binkert, Christoph A.; Debatin, Jorg F. [Department of Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zuerich (Switzerland); Schneider, Ernst [Department of Internal Medicine, Angiology Division, University Hospital Zurich, Raemistrasse 100, CH-8091 Zuerich (Switzerland); Hodler, Juerg [Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zuerich (Switzerland); Ruehm, Stefan G. [Department of Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen (Germany); Schmidt, Michaela [Department of Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zuerich (Switzerland); Hoffmann, Ulrich [Department of Internal Medicine, Angiology Division, University Hospital Zurich, Raemistrasse 100, CH-8091 Zuerich (Switzerland)

    2001-07-15

    Purpose: Predicting therapeutic benefit from percutaneous transluminal renal angioplasty (PTRA) in patients with renal artery stenosis (RAS) remains difficult. This study investigates whether magnetic resonance (MR)-based renal artery flow measurements relative to renal parenchymal volume can predict clinical outcome following PTRA.Methods: The data on 23 patients (13 men, 10 women; age range 47-82 years, mean age 64 years) were analyzed. The indication for treatment was hypertension (n = 18) or renal insufficiency (n = 5). Thirty-four cases of RAS were identified: bilateral disease was manifest in 11 and unilateral disease in 12 patients. The MR imaging protocol included a breath-hold, cardiac-gated cine phase-contrast sequence for renal flow measurement and a fast multiplanar spoiled gradient-echo sequence for renal volume measurement. MR measurements were performed on the day prior to and the day following PTRA. Clinical success was defined as (a) a reduction in diastolic blood pressure > 15% or (b) a reduction in serum creatinine > 20%. Kidneys were categorized as normal volume or low volume. A renal flow index (RFI) was calculated by dividing the renal flow (ml/min) by the renal volume (cm{sup 3}).Results: Clinical success was observed in 11 patients. Twelve patients did not benefit from angioplasty. Normal kidney volume was seen in 10 of 11 responders and in 8 of 12 nonresponders, resulting in a sensitivity of 91%, specificity of 33%, a positive predictive value (PPV) of 56% and a negative predictive value (NPV) of 80%. A RFI below a threshold of 1.5 ml/min/cm{sup 3} predicted successful outcome with 100% sensitivity, 33% specificity, 58% PPV, and 100% NPV. The combination of normal renal volume and a RFI below 1.5 ml/min/cm{sup 3} identified PTRA responders with a sensitivity of 91%, a specificity of 67%, a PPV of 71%, and a NPV of 89%. PTRA resulted in a greater increase in renal flow in responders compared with nonresponders (p < 0.001).Conclusion: A combination of cine phase-contrast MR renal flow and parenchymal volume measurements enables identification of patients benefiting from PTRA with a high sensitivity and NPV, but only moderate specificity and PPV.

  2. Polycyclic aromatic hydrocarbons (PAHs) as determinants of various anthropometric measures of birth outcome.

    PubMed

    Al-Saleh, Iman; Alsabbahen, Ammar; Shinwari, Neptune; Billedo, Grisellhi; Mashhour, Abdullah; Al-Sarraj, Yaser; Mohamed, Gamal El Din; Rabbah, Abdullah

    2013-02-01

    Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental contaminants that are known to induce oxidative stress. There have been several reports about the link between PAH exposure and complications in pregnancy. This cross-sectional study was conducted to: (1) measure the levels of benzo(a)anthracene (BaA), chrysene (Ch), benzo(b)fluoranthene (BbF), benzo(a)pyrene (BaP), and dibenzo(a,h)anthracene (DBahA) in placentas and maternal and -umbilical cord blood obtained at delivery from 1578 women between June 2005 and 2006 in the area of Al-Kharj, Saudi Arabia; (2) assess their influence on various anthropometric measures of birth outcome taking into consideration the carcinogenic properties of these PAHs; and (3) determine the degree of PAH-related oxidative DNA damage and birth outcome. Among the five tested PAHs, only BaP was carcinogenic; therefore, the levels of the other four probable or possible carcinogenic PAHs (BaA, Ch, BaF, and DBahA) were summed as ?4-PAHs. Levels of 1-hydroxypyrene (1-HP) were determined in maternal urine samples as a biomarker of PAH internal dose. Urinary cotinine (COT) was measured as an index of smoking. The following markers of oxidative stress were selected: malondialdehyde (MDA) in cord (C-MDA) and maternal (M-MDA) serum and 8-hydroxy-2-deoxyguanosine (8-OHdG) in maternal urine. None of the tested PAHs was found in maternal or cord blood. However, all five PAH compounds were detected in placentas; Ch was the highest (6.582 ?g/kg dry wt.), and BaA was the lowest (0.236 ?g/kg dry wt.). The mean concentration of urinary 1-HP found in this study was 0.216 ± 0.856 ?g/g Cr. After adjusting for gestational age and other confounding variables, regression models revealed an inverse relationship between placental weight, cord length and placental BaP. A similar trend was observed between cord length and ?4-PAHs in placental tissues. Urinary 1-HP, though, cannot be used as an unequivocal biomarker of PAH exposure, but it can be an appropriate indicator of exposure to environmental tobacco smoke (ETS). The data demonstrate that ETS exposure (as measured by urinary COT) may adversely affect birth outcome as shown by reduced head circumference, birth weight, and birth length, as well as increased cephalization index. The positive relationship between 8-OHdG levels and 1-HP in urine provides evidence of an oxidative stress mechanism. Although this study provides no direct evidence of an association between PAH exposure and DNA damage, increased oxidative stress in the form of lipid peroxidation significantly affected various birth measures. Therefore, there is a need for studies regarding PAH exposure and its associated biological effects to determine the extent of potential fetal damage as well as possible long-term effects, such as cancer. PMID:23314068

  3. A comparison of the readability of two patient-reported outcome measures used to evaluate foot surgery.

    PubMed

    Alvey, James; Palmer, Simon; Otter, Simon

    2012-01-01

    Measuring the outcome of surgical intervention is an integral part of modern-day healthcare provision. The increasing requirement to monitor patient-reported outcomes highlights the need for patients to be able to read and understand health outcomes questionnaires. The present study compared the readability of 2 commonly used, validated, foot surgery outcome questionnaires (the Foot Health Status Questionnaire and the Manchester-Oxford Foot Questionnaire) using the Flesch Reading Ease score and the Flesch-Kincaid grade level score. The Manchester-Oxford Foot Questionnaire had a significantly greater (p < .003) score for reading ease and a significantly lower reading grade score (p < .005) than the Foot Health Status Questionnaire. These findings suggest the Manchester-Oxford Foot Questionnaire is a more suitable instrument in terms of readability and comprehension for a greater proportion of the population undergoing hallux valgus surgery. PMID:22554926

  4. Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures.

    PubMed

    Deighton, Jessica; Croudace, Tim; Fonagy, Peter; Brown, Jeb; Patalay, Praveetha; Wolpert, Miranda

    2014-01-01

    There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures' psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against standards of feasibility and psychometric credibility in relation to use for practice and policy. PMID:24834111

  5. Application of the OMERACT filter to measures of core outcome domains in recent clinical studies of acute gout

    PubMed Central

    Taylor, William J; Redden, David; Dalbeth, Nicola; Schumacher, H Ralph; Edwards, N Lawrence; Simon, Lee S; John, Markus R; Essex, Margaret N; Watson, Douglas J; Evans, Robert; Rome, Keith; Singh, Jasvinder A

    2014-01-01

    Objective To determine the extent to which instruments that measure core outcome domains in acute gout fulfil the OMERACT filter requirements of truth, discrimination and feasibility. Methods Patient-level data from four randomised controlled trials of agents designed to treat acute gout and one observational study of acute gout were analysed. For each available measure construct validity, test-retest reliability, within-group change using effect size, between-group change using the Kruskall-Wallis statistic and repeated measures generalised estimating equations were assessed. Floor and ceiling effects were also assessed and MCID was estimated. These analyses were presented to participants at OMERACT 11 to help inform voting for possible endorsement. Results There was evidence for construct validity and discriminative ability for 3 measures of pain (0 to 4 Likert, 0 to 10 numeric rating scale, 0 to 100 mm visual analogue scale). Likewise, there appears to be sufficient evidence for a 4-point Likert scale to possess construct validity and discriminative ability for physician assessment of joint swelling and joint tenderness. There was some evidence for construct validity and within-group discriminative ability for the Health Assessment Questionnaire as a measure of activity limitations, but not for discrimination between groups allocated to different treatment. Conclusions There is sufficient evidence to support measures of pain (using Likert, numeric rating scale or visual analogue scales), joint tenderness and swelling (using Likert scale) as fulfilling the requirements of the OMERACT filter. Further research on a measure of activity limitations in acute gout clinical trials is required. PMID:24429178

  6. Measurement of costs and scales for outcome evaluation in health economic studies of Parkinson's disease.

    PubMed

    Dodel, Richard; Jönsson, Bengt; Reese, Jens Peter; Winter, Yaroslav; Martinez-Martin, Pablo; Holloway, Robert; Sampaio, Cristina; R?ži?ka, Evžen; Hawthorne, Graeme; Oertel, Wolfgang; Poewe, Werner; Stebbins, Glenn; Rascol, Oliver; Goetz, Christopher G; Schrag, Anette

    2014-02-01

    Health economic studies in Parkinson's disease (PD) have become increasingly common in recent years. Because several methodologies and instruments have been used to assess cost and outcomes in PD, the Movement Disorder Society (MDS) commissioned a Task Force to assess their properties and make recommendations regarding their use. A systematic literature review was conducted to explore the use of those instruments in PD and to determine which should be selected for this review. We assessed approaches to evaluate cost of illness (COI), cost effectiveness, and cost utilities, which include the use of direct (standard gamble, time trade-off. and visual analogue scales) and indirect instruments to measure health status and utilities. No validated instruments/models were identified for the evaluation of COI or cost-effectiveness in patients with PD; therefore, no instruments in this group are recommended. Among utility instruments, only a few of these outcome instruments have been used in the PD population, and only limited psychometric data are available for these instruments with respect to PD. Because psychometric data for further utility instruments in conditions other than PD already exist, the standard gamble and time trade-off methods and the EQ-5D (a European quality-of-life health states instrument) and Health Utility Index instruments met the criteria for scales that are "recommended (with limitations)," but only the EQ-5D has been assessed in detail in PD patients. The MDS Task Force recommends further study of these instruments in the PD population to establish core psychometric properties. For the assessment of COI, the Task Force considers the development of a COI instrument specifically for PD, like that available for Alzheimer's disease. PMID:23861335

  7. Synthesis and review: delivering on conservation promises: the challenges of managing and measuring conservation outcomes

    NASA Astrophysics Data System (ADS)

    Adams, Vanessa M.; Game, Edward T.; Bode, Michael

    2014-08-01

    Growing threats and limited resources have always been the financial realities of biodiversity conservation. As the conservation sector has matured, however, the accountability of conservation investments has become an increasingly debated topic, with two key topics being driven to the forefront of the discourse: understanding how to manage the risks associated with our conservation investments and demonstrating that our investments are making a difference through evidence-based analyses. A better understanding of the uncertainties associated with conservation decisions is a central component of managing risks to investments that is often neglected. This focus issue presents both theoretical and applied approaches to quantifying and managing risks. Furthermore, transparent and replicable approaches to measuring impacts of conservation investments are noticeably absent in many conservation programs globally. This focus issue contains state of the art conservation program impact evaluations that both demonstrate how these methods can be used to measure outcomes as well as directing future investments. This focus issue thus brings together current thinking and case studies that can provide a valuable resource for directing future conservation investments.

  8. Early Outcome After Off-Pump Versus On-Pump Coronary Bypass Surgery Results From a Randomized Study

    Microsoft Academic Search

    Diederik van Dijk; Arno P. Nierich; Erik W. L. Jansen; Hendrik M. Nathoe; Willem J. L. Suyker; Jan C. Diephuis; Wim-Jan van Boven; Cornelius Borst; Erik Buskens; Diederick E. Grobbee; Etienne O. Robles de Medina

    Background—The use of cardiopulmonary bypass during coronary artery bypass surgery (CABG) has been associated with substantial morbidity. The recent introduction of cardiac stabilizers facilitates CABG without cardiopulmonary bypass (off-pump CABG), but it is unknown whether cardiac outcome after off-pump surgery is similar to that for the on-pump procedure. Methods and Results—In a multicenter trial, 281 patients (mean age 61 years,

  9. Factors Influencing Consumer Outcome Monitoring in Implementation of Evidence-Based Practices: Results from the National EBP Implementation Project

    Microsoft Academic Search

    Doug Marty; Charlie Rapp; Greg McHugo; Rob Whitley

    2008-01-01

    Objective This study reports participating agencies use of a single fidelity dimension, Outcome Monitoring, during the 2-year National\\u000a EBP Implementation Project. Method The study involved an emerging theme qualitative approach for analyzing the implementation of fidelity achieved for five\\u000a EBPs in 49 sites across eight states. Results Twenty-seven percent of the sites reached a high level of implementation fidelity. Conclusion

  10. Gender Differences in 1-Year Clinical Characteristics and Outcomes after Stroke: Results from the China National Stroke Registry

    PubMed Central

    Wang, Chunxue; Yao, Xiaomei; Zhao, Xingquan; Wang, Yilong; Li, Hao; Liu, Gaifen; Wang, Anxin; Wang, Yongjun

    2013-01-01

    Background Previous reports have shown inconsistent results on clinical outcomes between women and men after stroke, and little is known about gender differences on outcomes in Chinese post-stroke patients. The aim of this study was to explore whether there were gender differences on clinical characteristics and outcomes in Chinese patients after ischemic stroke by using the data from the China National Stroke Registry (CNSR). Methods and Findings Out of 12,415 consecutively recruited patients with acute ischemic stroke in the CNSR from 2007 to 2008, 11,560 (93.1%) patients were followed up for 12 months. Their clinical characteristics and outcomes on death, recurrence, and dependency were recorded. The multivariate logistic regression was performed to determine whether there were gender differences in these outcomes. Women were older than men at baseline (67.9 vs. 64.0 years, P<0.001). Women had a higher mortality, recurrence rate, and dependency rate at 3, 6, and 12 months than men, but after adjusting for age, history of diabetes, pre-stroke dependency, stroke severity, in-hospital complications, and other confounders, there were no statistically significant differences in gender on mortality and recurrence rate at 3, 6, and 12 months; and dependency rate at 3, and 6 months. However, the dependency rate at 12 months remained significantly higher in women (odds ratio, 1.24; 95% confidence interval, 1.06 to 1.45). Conclusions There are many differences in clinical characteristics between women and men after ischemic stroke in China. Compared with men, women are more dependent at 12 months after stroke. This difference still exists after controlling the potential confounders. PMID:23418571

  11. The impact of chronic migraine: The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study methods and baseline results

    PubMed Central

    Serrano, Daniel; Buse, Dawn C; Reed, Michael L; Marske, Valerie; Fanning, Kristina M; Lipton, Richard B

    2015-01-01

    Background Longitudinal migraine studies have rarely assessed headache frequency and disability variation over a year. Methods The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study is a cross-sectional and longitudinal Internet study designed to characterize the course of episodic migraine (EM) and chronic migraine (CM). Participants were recruited from a Web-panel using quota sampling in an attempt to obtain a sample demographically similar to the US population. Participants who passed the screener were assessed every three months with the Core (baseline, six, and 12 months) and Snapshot (months three and nine) modules, which assessed headache frequency, headache-related disability, treatments, and treatment satisfaction. The Core also assessed resource use, health-related quality of life, and other features. One-time cross-sectional modules measured family burden, barriers to medical care, and comorbidities/endophenotypes. Results Of 489,537 invitees, we obtained 58,418 (11.9%) usable returns including 16,789 individuals who met ICHD-3 beta migraine criteria (EM (<15 headache days/mo): n?=?15,313 (91.2%); CM (?15 headache days/mo): n?=?1476 (8.8%)). At baseline, all qualified respondents (n?=?16,789) completed the Screener, Core, and Barriers to Care modules. Subsequent modules showed some attrition (Comorbidities/Endophenotypes, n?=?12,810; Family Burden (Proband), n?=?13,064; Family Burden (Partner), n?=?4022; Family Burden (Child), n?=?2140; Snapshot (three months), n?=?9741; Core (six months), n?=?7517; Snapshot (nine months), n?=?6362; Core (12 months), n?=?5915). A total of 3513 respondents (21.0%) completed all modules, and 3626 (EM: n?=?3303 (21.6%); CM: n?=?323 (21.9%)) completed all longitudinal assessments. Conclusions The CaMEO Study provides cross-sectional and longitudinal data that will contribute to our understanding of the course of migraine over one year and quantify variations in headache frequency, headache-related disability, comorbidities, treatments, and familial impact. PMID:25304766

  12. Defining the Prize: From Agreed-Upon Outcomes to Results-Based Accountability. A Matter of Commitment: Community Collaboration Guidebook Series. Guidebook 2.

    ERIC Educational Resources Information Center

    Bruner, Charles

    This guidebook discusses the importance of building consensus in establishing outcomes for community reform to improve the well-being of children and youth, their families, and neighborhoods and communities. The guide is grounded in the premise that community collaboratives have the capacity to develop a set of measurable outcome indicators and…

  13. Rates, management, and outcome of rivaroxaban bleeding in daily care: results from the Dresden NOAC registry.

    PubMed

    Beyer-Westendorf, Jan; Förster, Kati; Pannach, Sven; Ebertz, Franziska; Gelbricht, Vera; Thieme, Christoph; Michalski, Franziska; Köhler, Christina; Werth, Sebastian; Sahin, Kurtulus; Tittl, Luise; Hänsel, Ulrike; Weiss, Norbert

    2014-08-01

    Worldwide, rivaroxaban is increasingly used for stroke prevention in atrial fibrillation and treatment of venous thromboembolism, but little is known about rivaroxaban-related bleeding complications in daily care. Using data from a prospective, noninterventional oral anticoagulation registry of daily care patients (Dresden NOAC registry), we analyzed rates, management, and outcome of rivaroxaban-related bleeding. Between October 1, 2011, and December 31, 2013, 1776 rivaroxaban patients were enrolled. So far, 762 patients (42.9%) reported 1082 bleeding events during/within 3 days after last intake of rivaroxaban (58.9% minor, 35.0% of nonmajor clinically relevant, and 6.1% major bleeding according to International Society on Thrombosis and Haemostasis definition). In case of major bleeding, surgical or interventional treatment was needed in 37.8% and prothrombin complex concentrate in 9.1%. In the time-to-first-event analysis, 100-patient-year rates of major bleeding were 3.1 (95% confidence interval 2.2-4.3) for stroke prevention in atrial fibrillation and 4.1 (95% confidence interval 2.5-6.4) for venous thromboembolism patients, respectively. In the as-treated analysis, case fatality rates of bleeding leading to hospitalizations were 5.1% and 6.3% at days 30 and 90 after bleeding, respectively. Our data indicate that, in real life, rates of rivaroxaban-related major bleeding may be lower and that the outcome may at least not be worse than that of major vitamin K antagonist bleeding, and probably better. This trial was registered at www.clinicaltrials.gov as identifier #NCT01588119. PMID:24859362

  14. Treatment outcome measures for randomized controlled trials of antibiotic treatment for acute bacterial skin and skin structure infections in the emergency department setting.

    PubMed

    Quirke, Michael; Wakai, Abel

    2015-01-01

    Acute bacterial skin and skin structure infections (ABSSSIs), which include cellulitis, abscesses, and wound infections, are among the most commonly encountered conditions in emergency departments (EDs) internationally. Primarily, as a result of the recent epidemic of community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) in North America, ED attendances and hospital admissions secondary to ABSSSIs have increased significantly. First-line antibiotic drug therapies for ABSSSIs have therefore changed to take account of CA-MRSA and the threat of evolving antibiotic resistance. Prior to 2010, randomized controlled trials (RCTs) of antibiotic therapy for ABSSSI used broad trial inclusion criteria and utilized investigator-determined clinical resolution, 7 to 14 days after the end of therapy, as the primary outcome measure. In order to produce more objective, reproducible, and quantifiable primary outcome measures, the US Food and Drug Administration (FDA) Center for Drug Evaluation and Research and a multidisciplinary consortium convened by the Foundation for the National Institutes of Health (FNIH) issued significantly changed trial guidance criteria. The currently recommended primary outcome measure is an assessment of greater than 20% reduction in the area of erythema, edema, or induration from baseline, measured at 48 to 72 h after randomization and initiation of drug treatment. In contrast, the European Medicines Agency (EMA) still recommends measurement of clinical resolution at a later time period. We discuss the evolution of changes to trial guidance criteria issued by the FDA since 1998 and the potential difficulties of implementing the recommended primary outcome measured at an earlier time point in RCTs of outpatient antibiotic treatment performed in the ED setting. PMID:26034514

  15. Research Challenges: Implementing Standardized Outcome Measures in a Decentralized, Community-Based Residential Treatment Program

    ERIC Educational Resources Information Center

    Butler, Linda S.; Little, Liza; Grimard, Andre R.

    2009-01-01

    With residential treatment services under pressure to produce outcome data, the process of executing research in such settings presents considerable challenges. This paper describes how a large, decentralized, community-based residential treatment program in southern and central Maine designed and implemented a research outcome process study using…

  16. Understanding Program Monitoring: The Relationships among Outcomes, Indicators, Measures, and Targets. REL 2014-011

    ERIC Educational Resources Information Center

    Malone, Nolan; Mark, Lauren; Narayan, Krishna

    2014-01-01

    This guide offers educators, program managers, administrators, and researchers a resource for building capacity for monitoring program outcomes. It provides concise definitions of program monitoring components and a framework for assessing program progress. Examples demonstrate the relationships among program components: outcomes, indicators,…

  17. Outcome Measurement Using Naturalistic Language Samples: A Feasibility Pilot Study Using Language Transcription Software and Speech and Language Therapy Assistants

    ERIC Educational Resources Information Center

    Overton, Sarah; Wren, Yvonne

    2014-01-01

    The ultimate aim of intervention for children with language impairment is an improvement in their functional language skills. Baseline and outcome measurement of this is often problematic however and practitioners commonly resort to using formal assessments that may not adequately reflect the child's competence. Language sampling,…

  18. The use of two common palliative outcome measures in clinical care and research: a systematic review of POS and STAS.

    PubMed

    Bausewein, C; Le Grice, C; Simon, St; Higginson, Ij

    2011-06-01

    The Palliative Care Outcome Scale (POS) and the Support Team Assessment Schedule (STAS) are outcome measures assessing quality of care in palliative care patients. This review aims to appraise their use in clinical care and research. Five electronic databases were searched (February 2010) for original papers describing the validation or use of POS and/or STAS. Of the 83 papers included, 43 studies were on POS, 39 on STAS and one study using both. Eight STAS studies validated the original version, four an adaptation; 20 studies applied the STAS in another culture and 19 in other languages. POS papers reported included: 14 adapted POS versions, 12 translations of the POS and 15 studies of use in different cultures. Both measures have been used in cancer, HIV/AIDS and in mixed groups. POS has also been applied in neurological, kidney, pulmonary and heart disease. Both tools were used in different areas such as the evaluation of care or interventions, description of symptom prevalence and implementation of outcome measures in clinical practice. Overall, they seem to be well accepted tools for outcome measurement in palliative care, both in clinical care and research. PMID:21464119

  19. Intelligibility as a Clinical Outcome Measure Following Intervention with Children with Phonologically Based Speech-Sound Disorders

    ERIC Educational Resources Information Center

    Lousada, M.; Jesus, Luis M. T.; Hall, A.; Joffe, V.

    2014-01-01

    Background: The effectiveness of two treatment approaches (phonological therapy and articulation therapy) for treatment of 14 children, aged 4;0-6;7 years, with phonologically based speech-sound disorder (SSD) has been previously analysed with severity outcome measures (percentage of consonants correct score, percentage occurrence of phonological…

  20. Designing Reading Comprehension Assessments for Reading Interventions: How a Theoretically Motivated Assessment Can Serve as an Outcome Measure

    ERIC Educational Resources Information Center

    O'Reilly, Tenaha; Weeks, Jonathan; Sabatini, John; Halderman, Laura; Steinberg, Jonathan

    2014-01-01

    When designing a reading intervention, researchers and educators face a number of challenges related to the focus, intensity, and duration of the intervention. In this paper, we argue there is another fundamental challenge--the nature of the reading outcome measures used to evaluate the intervention. Many interventions fail to demonstrate…

  1. Psychological Versus Generic Critical Thinking as Predictors and Outcome Measures in a Large Undergraduate Human Development Course

    ERIC Educational Resources Information Center

    Williams, Robert L.; Oliver, Renee; Stockdale, Susan

    2004-01-01

    This study examines the differential status of psychological critical thinking and generic critical thinking as predictors of test performance and as outcome measures in a large human development course. Psychological critical thinking proved to be the better predictor of test performance and more responsive to instructional procedures in the…

  2. Feedback Consequences and Steps Toward Implementation: A Guide to Educational Outcome Measurements and Their Uses. Seminar No. 6.

    ERIC Educational Resources Information Center

    Mushkin, Selma J.; Billings, Bradley B.

    This guide is essentially designed as a teaching aid for those who would inform planners, officials of educational ministries, school administrators, principals, and teachers about educational outcome measurements. In outline and graphic form, the guide presents topics for discussion in a seminar dealing with feedback consequences and steps toward…

  3. Toward Improved Spectral Measures of /s/: Results From Adolescents

    E-print Network

    theoretically driven acoustic measures of /s/ that reflect aerodynamic and articulatory conditions. The measures of relative spectral energies in low- (550­3000 Hz), mid- (3000­7000 Hz), and high-frequency regions (7000 were also obtained to permit comparison with existing work. Results: Spectral balance measures in low

  4. 26 CFR 801.6 - Business results measures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...and a fraud referral. Examples of data that are not tax enforcement results include a quantity measure and data derived from a quality review...Records of tax enforcement results are data, statistics, compilations of...

  5. 26 CFR 801.6 - Business results measures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...and a fraud referral. Examples of data that are not tax enforcement results include a quantity measure and data derived from a quality review...Records of tax enforcement results are data, statistics, compilations of...

  6. 26 CFR 801.6 - Business results measures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...and a fraud referral. Examples of data that are not tax enforcement results include a quantity measure and data derived from a quality review...Records of tax enforcement results are data, statistics, compilations of...

  7. 26 CFR 801.6 - Business results measures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...and a fraud referral. Examples of data that are not tax enforcement results include a quantity measure and data derived from a quality review...Records of tax enforcement results are data, statistics, compilations of...

  8. Population-Based Stroke Atlas for Outcome Prediction: Method and Preliminary Results for Ischemic Stroke from CT

    PubMed Central

    Nowinski, Wieslaw L.; Gupta, Varsha; Qian, Guoyu; Ambrosius, Wojciech; Kazmierski, Radoslaw

    2014-01-01

    Background and Purpose Knowledge of outcome prediction is important in stroke management. We propose a lesion size and location-driven method for stroke outcome prediction using a Population-based Stroke Atlas (PSA) linking neurological parameters with neuroimaging in population. The PSA aggregates data from previously treated patients and applies them to currently treated patients. The PSA parameter distribution in the infarct region of a treated patient enables prediction. We introduce a method for PSA calculation, quantify its performance, and use it to illustrate ischemic stroke outcome prediction of modified Rankin Scale (mRS) and Barthel Index (BI). Methods The preliminary PSA was constructed from 128 ischemic stroke cases calculated for 8 variants (various data aggregation schemes) and 3 case selection variables (infarct volume, NIHSS at admission, and NIHSS at day 7), each in 4 ranges. Outcome prediction for 9 parameters (mRS at 7th, and mRS and BI at 30th, 90th, 180th, 360th day) was studied using a leave-one-out approach, requiring 589,824 PSA maps to be analyzed. Results Outcomes predicted for different PSA variants are statistically equivalent, so the simplest and most efficient variant aiming at parameter averaging is employed. This variant allows the PSA to be pre-calculated before prediction. The PSA constrained by infarct volume and NIHSS reduces the average prediction error (absolute difference between the predicted and actual values) by a fraction of 0.796; the use of 3 patient-specific variables further lowers it by 0.538. The PSA-based prediction error for mild and severe outcomes (mRS?=?[2]–[5]) is (0.5–0.7). Prediction takes about 8 seconds. Conclusions PSA-based prediction of individual and group mRS and BI scores over time is feasible, fast and simple, but its clinical usefulness requires further studies. The case selection operation improves PSA predictability. A multiplicity of PSAs can be computed independently for different datasets at various centers and easily merged, which enables building powerful PSAs over the community. PMID:25121979

  9. Developing an outcome measure for excessive saliva management in MND and an evaluation of saliva burden in Sheffield.

    PubMed

    McGeachan, Alexander J; Hobson, Esther V; Shaw, Pamela J; McDermott, Christopher J

    2015-03-01

    There are few studies providing evidence to guide the management of oropharyngeal secretion problems in motor neuron disease (MND). There is a lack of a suitable outcome measure for evaluating management strategies. We applied several potential outcome measures for assessing excessive secretions to patients with MND who attended the Sheffield Care and Research Centre for Motor Neurone Disease between 21 November 2012 and 15 May 2013. These measures were the CSS-MND, a symptom rating scale, and the Drool and Wipe quotient, which were designed to semi-objectively measure patients' drooling. Of the 143 patients seen in clinic during the study period, 58 had symptoms of excessive secretions, and of whom 50 agreed to participate in the study. Semi-objective measures failed to effectively identify patients complaining of secretion problems. The CSS-MND had a relatively low internal consistency (Cronbach's alpha 0.539; n = 50); however, analysis of the inter-item correlations suggested the appearance of low internal consistency was because the scale was measuring a variety of saliva related symptoms that did not necessarily influence each other. The scale correlated well with patient reported symptom impact (r = 0.673, n = 50). In conclusion, the CSS-MND would be a useful outcome measure in studies assessing the management of oropharyngeal secretion problems. PMID:25225845

  10. Use of patient-reported outcomes to measure symptoms and health related quality of life in the clinic.

    PubMed

    Gilbert, Alexandra; Sebag-Montefiore, David; Davidson, Susan; Velikova, Galina

    2015-03-01

    There is increasing interest in the use of patient-reported outcomes (PROs) in routine practice in cancer care to measure symptoms and health related quality of life (HRQOL). PROs are designed to capture the patient's perspective of their care and treatment, and complement the traditional clinical outcomes of survival and toxicity assessment. Integrating routine collection and feedback of PROs has been found to improve care for patients on both an individual level, through improved communication and management of symptoms, and at an organizational level, by enabling aggregation of data to compare performance. This article reviews the benefits and challenges of introducing patient-reported assessments into routine clinical practice. Methods for choosing a questionnaire; collection and presentation of results; timing and frequency of administration as well as clinician training methods to aid the ability of clinicians to integrate the use of PROs into their own practice are described. Electronic PRO capture and integration with electronic health records seems to provide the most effective method for seamless integration into existing patient care pathways. Case studies from our own practice illustrate the issues raised. Electronic methods enabling immediate collection, scoring and interpretation of the data, as well as real-time data capture, email alert systems and individualized, online self-management advice may enable severe symptoms to be managed in a more timely manner. Evaluation methods are described to establish the effectiveness of the PRO intervention. Engaging stakeholders throughout the process of initial consultation and development, during delivery and evaluation is key to success. Future work needs to focus on the effectiveness of PROs in longer-term follow-up of patients in routine care and the relationship between the PRO severity grading and clinician severity grading using the Common Terminology Criteria of Adverse Events (CTCAE). PMID:25448486

  11. A methodology for successfully producing global translations of patient reported outcome measures for use in multiple countries.

    PubMed

    Two, Rebecca; Verjee-Lorenz, Aneesa; Clayson, Darren; Dalal, Mehul; Grotzinger, Kelly; Younossi, Zobair M

    2010-01-01

    The production of accurate and culturally relevant translations of patient reported outcome (PRO) measures is essential for the success of international clinical trials. Although there are many reports in publication regarding the translation of PRO measures, the techniques used to produce single translations for use in multiple countries (global translations) are not well documented. This article addresses this apparent lack of documentation and presents the methodology used to create global translations of the Chronic Liver Disease Questionnaire-Hepatitis C Virus (CLDQ-HCV). The challenges of creating a translation for use in multiple countries are discussed, and the criteria for a global translation project explained. Based on a thorough translation and linguistic validation methodology including a concept elaboration, multiple forward translations, two back translations, reviews by in-country clinicians and the instrument developer, pilot testing in each target country and multiple sets of proofreading, the key concept of the global translation methodology is consistent international harmonization, achieved through the involvement of linguists from each target country at every stage of the process. This methodology enabled the successful resolution of the translation issues encountered, and resulted in consistent translations of the CLDQ-HCV that were linguistically and culturally appropriate for all target countries. PMID:19695006

  12. Current practice in primary total hip replacement: results from the National Hip Replacement Outcome Project.

    PubMed Central

    Best, A. J.; Fender, D.; Harper, W. M.; McCaskie, A. W.; Oliver, K.; Gregg, P. J.

    1998-01-01

    As part of the National Study of Primary Hip Replacement Outcome, 402 consultant orthopaedic surgeons from three regions were contacted by postal questionnaire which covered all aspects of total hip replacement (THR). There was a 70% response rate of which 71 did not perform hip surgery, a further 33 refused to take part, leaving 181 valid responses. Preoperative assessment clinics were used by 89% of surgeons, but anaesthetists and rehabilitation services were rarely involved at this stage. Of respondents, 99% used routine thromboprophylaxis, with 79% using a combination of mechanical and chemical methods. Of surgeons, 84% routinely used stockings, whereas 95.5% used chemical prophylaxis, 63% employed low molecular weight heparins. Theatre facilities were shared with other surgical specialties by 6% of surgeons and 18% regularly used body exhaust suits for THR. Antibiotic loaded cement was used by 69% of surgeons, the majority (65%) used a single brand of normal viscosity cement with 9% using reduced viscosity formulations. Modern cementing techniques were commonly used at least in part, 87% used a cement gun and 94% a cement restrictor for femoral cementing. On the acetabulum, 47% pressurised the cement. In all, 36 different femoral stems and 35 acetabular cups were in routine use, but the majority of surgeons (55%) used Charnley type prostheses. Of the surgeons, 57% performed only cemented THR, while 3% exclusively used uncemented THR. Of consultants, 21% followed up their patients to 5 years, the majority discharge patients within the first year. Of concern is a large proportion of surgeons using low molecular weight heparins despite a lack of evidence with regard to reducing fatal pulmonary embolism, and also the small number of surgeons using prostheses of unproven value. Third generation cementing techniques have yet to be fully adopted. The introduction of a national hip register could help to resolve some of these issues. PMID:9849338

  13. The construct of internalization: conceptualization, measurement, and prediction of smoking treatment outcome

    Microsoft Academic Search

    G. SCOTT ACTON; JEFFREY D. KUNZ; MARK WILSON; SHARON M. HALL

    2005-01-01

    Background. Depression symptoms and diagnoses are associated with failure to quit smoking in most studies, but not all. Method. A new measure of internalization (i.e. symptoms of depression or anxiety, or poor mood) was created to investigate whether internalization would predict smoking cessation in 549 smokers from three randomized clinical trials with inconsistent findings. Results. Predicted item locations based on

  14. Developing a patient-centered outcome measure for complementary and alternative medicine therapies II: Refining content validity through cognitive interviews

    PubMed Central

    2011-01-01

    Background Available measures of patient-reported outcomes for complementary and alternative medicine (CAM) inadequately capture the range of patient-reported treatment effects. The Self-Assessment of Change questionnaire was developed to measure multi-dimensional shifts in well-being for CAM users. With content derived from patient narratives, items were subsequently focused through interviews on a new cohort of participants. Here we present the development of the final version in which the content and format is refined through cognitive interviews. Methods We conducted cognitive interviews across five iterations of questionnaire refinement with a culturally diverse sample of 28 CAM users. In each iteration, participant critiques were used to revise the questionnaire, which was then re-tested in subsequent rounds of cognitive interviews. Following all five iterations, transcripts of cognitive interviews were systematically coded and analyzed to examine participants' understanding of the format and content of the final questionnaire. Based on this data, we established summary descriptions and selected exemplar quotations for each word pair on the final questionnaire. Results The final version of the Self-Assessment of Change questionnaire (SAC) includes 16 word pairs, nine of which remained unchanged from the original draft. Participants consistently said that these stable word pairs represented opposite ends of the same domain of experience and the meanings of these terms were stable across the participant pool. Five pairs underwent revision and two word pairs were added. Four word pairs were eliminated for redundancy or because participants did not agree on the meaning of the terms. Cognitive interviews indicate that participants understood the format of the questionnaire and considered each word pair to represent opposite poles of a shared domain of experience. Conclusions We have placed lay language and direct experience at the center of questionnaire revision and refinement. In so doing, we provide an innovative model for the development of truly patient-centered outcome measures. Although this instrument was designed and tested in a CAM-specific population, it may be useful in assessing multi-dimensional shifts in well-being across a broader patient population. PMID:22206409

  15. Revealing the popularity of traditional medicine in light of multiple recourses and outcome measurements from a user's perspective in Ghana.

    PubMed

    Sato, Azusa

    2012-12-01

    Traditional medicine is known to be popular in sub-Saharan Africa, where over 80% have reported its utilization. It is claimed to be easily accessible, affordable, available and acceptable, but little is known about at which stage of treatment-seeking individuals turn to traditional medicines and the resulting satisfaction once used. This is due to a paucity of quantitative demand data on how many recourses of care people take for one episode of illness, whether individuals use traditional medicines as a secondary option to orthodox medicines, and if used, how satisfied they are with results. This study presents descriptive data from fieldwork carried out on 772 households in two regions of Ghana to ascertain actions taken for self-reported episodes of acute and previously diagnosed chronic diseases. Quantitative results that show by looking merely at first recourse, use of traditional medicines is fairly low, but once second recourses are accounted for there is a doubling and tripling of incidence of traditional medicine use for acute and chronic diseases, respectively. A commonly used patient-reported outcome measurement, the EuroQol 5 Dimension (EQ5D), is used to measure satisfaction before and after traditional medicine use, to reveal significantly positive changes. The study shows that whilst individuals are highly satisfied with traditional medicine, it is more often the second recourse of treatment with a revealed preference for orthodox medicines as a first recourse. This suggests that research is needed to investigate why individuals turn to traditional medicine only as a second recourse and to clarify the insufficiencies of orthodox treatment. Policies which guide individuals to take the most efficient recourses for given symptoms, and further exploration of key reasons behind high levels of satisfaction following utilization, are encouraged. PMID:22345671

  16. A worksite vitality intervention to improve older workers' lifestyle and vitality-related outcomes: results of a randomised controlled trial

    PubMed Central

    Strijk, Jorien E; Proper, Karin I; van Mechelen, Willem

    2012-01-01

    Objective To evaluate the effectiveness of a worksite vitality intervention on vigorous physical activity (VPA), fruit intake, aerobic capacity, mental health and need for recovery after work among older hospital workers (ie, 45?years and older). Methods The 6-month intervention was evaluated using a randomised controlled trial design. Workers who were randomised to the intervention group (n=367; control: n=363) received the Vital@Work intervention containing (1) a Vitality Exercise Program (VEP) combined with (2) three visits to Personal Vitality Coach. The VEP consisted of a weekly yoga session, a weekly workout session and weekly unsupervised aerobic exercising. Free fruit was provided at the VEP. Data on the outcome measures were collected (ie, year 2009–2010) at baseline (n=730) and 6?months of follow-up after baseline (n=575) using questionnaires, accelerometers and 2?km walk tests. Effects were analysed according to the intention-to-treat principle with complete cases (n=575) and imputed data (n=730) using linear regression analyses. Additional analyses were performed for high yoga and workout compliance (ie, >mean number of sessions). Results Effects were found for sports activities (?=40.4?min/week, 95% CI 13.0 to 67.7) and fruit intake (?=2.7 pieces/week, 95% CI 0.07 to 4.7) and were stronger for workers with high compliance to yoga (sport: ?=49.6?min/week, 95% CI 13.9 to 85.2; fruit: ?=3.8 pieces/week, 95% CI 1.1 to 6.4) and workout sessions (sport: ?=72.9?min/week, 95% CI 36.1 to 109.8; fruit: ?=4.0 pieces/week, 95% CI 1.1 to 6.4). The intervention group lowered their need for recovery, when compared to controls (?=?3.5, 95% CI ?6.4 to ?0.54), with stronger effects for high workout compliance (?=?5.3, 95% CI ?9.3 to ?1.3). No effects were found on VPA, aerobic capacity or mental health. Conclusions Implementation of worksite yoga and workout facilities and minimal fruit interventions should be considered by employers to promote transitions into healthier lifestyles and thereby health. PMID:22268128

  17. Delays in receiving obstetric care and poor maternal outcomes: results from a national multicentre cross-sectional study

    PubMed Central

    2014-01-01

    Background The vast majority of maternal deaths in low-and middle-income countries are preventable. Delay in obtaining access to appropriate health care is a fairly common problem which can be improved. The objective of this study was to explore the association between delay in providing obstetric health care and severe maternal morbidity/death. Methods This was a multicentre cross-sectional study, involving 27 referral obstetric facilities in all Brazilian regions between 2009 and 2010. All women admitted to the hospital with a pregnancy-related cause were screened, searching for potentially life-threatening conditions (PLTC), maternal death (MD) and maternal near-miss (MNM) cases, according to the WHO criteria. Data on delays were collected by medical chart review and interview with the medical staff. The prevalence of the three different types of delays was estimated according to the level of care and outcome of the complication. For factors associated with any delay, the PR and 95%CI controlled for cluster design were estimated. Results A total of 82,144 live births were screened, with 9,555 PLTC, MNM or MD cases prospectively identified. Overall, any type of delay was observed in 53.8% of cases; delay related to user factors was observed in 10.2%, 34.6% of delays were related to health service accessibility and 25.7% were related to quality of medical care. The occurrence of any delay was associated with increasing severity of maternal outcome: 52% in PLTC, 68.4% in MNM and 84.1% in MD. Conclusions Although this was not a population-based study and the results could not be generalized, there was a very clear and significant association between frequency of delay and severity of outcome, suggesting that timely and proper management are related to survival. PMID:24886330

  18. Development of outcome measures for large-vessel vasculitis for use in clinical trials: opportunities, challenges, and research agenda.

    PubMed

    Direskeneli, Haner; Aydin, Sibel Z; Kermani, Tanaz A; Matteson, Eric L; Boers, Maarten; Herlyn, Karen; Luqmani, Raashid A; Neogi, Tuhina; Seo, Philip; Suppiah, Ravi; Tomasson, Gunnar; Merkel, Peter A

    2011-07-01

    Giant cell (GCA) and Takayasu's arteritis (TAK) are 2 forms of large-vessel vasculitis (LVV) that involve the aorta and its major branches. GCA has a predilection for the cranial branches, while TAK tends to affect the extracranial branches. Both disorders may also cause nonspecific constitutional symptoms. Although some clinical features are more common in one or the other disorder and the ages of initial presentation differ substantially, there is enough clinical and histopathologic overlap between these disorders that some investigators suggest GCA and TAK may be 2 processes within the spectrum of a single disease. There have been few randomized therapeutic trials completed in GCA, and none in TAK. The lack of therapeutic trials in LVV is only partially explained by the rarity of these diseases. It is likely that the lack of well validated outcome measures for LVV and uncertainties regarding trial design contribute to the paucity of trials for these diseases. An initiative to develop a core set of outcome measures for use in clinical trials of LVV was launched by the international OMERACT Vasculitis Working Group in 2009 and subsequently endorsed by the OMERACT community at the OMERACT 10 meeting. Aims of this initiative include: (1) to review the literature and existing data related to outcome assessments in LVV; (2) to obtain the opinion of experts and patients on disease content; and (3) to formulate a research agenda to facilitate a more data-based approach to outcomes development. PMID:21724719

  19. Perspectives from health, social care and policy stakeholders on the value of a single self-report outcome measure across long-term conditions: a qualitative study

    PubMed Central

    Hunter, Cheryl; Fitzpatrick, Ray; Jenkinson, Crispin; Darlington, Anne-Sophie Emma; Coulter, Angela; Forder, Julien E; Peters, Michele

    2015-01-01

    Objectives To explore the views of a range of stakeholders regarding whether patient-reported outcome measures (PROMs) can be developed to measure key attributes of long-term conditions (LTCs) care in England, and the potential value of a single generic measure. Design Qualitative semistructured interview study, analysed using a framework approach. Participants and setting Interviews with 31 stakeholders from primary care, secondary care, social care, policy and patient-focused voluntary organisations in England. Results There was broad support for a single PROM that could be used to measure outcomes for patients with any LTCs in any health or social care setting. Interviewees identified three desired uses for a PROM: to improve the quality of individual care; to increase people's engagement in their own care; and to monitor the performance of services. Interviewees felt that a PROM for LTCs should incorporate a mixture of traditional and non-traditional domains, such as functioning, empowerment and social participation, and be codesigned with patients and professional end-users. Stakeholders emphasised the need for a PROM to be feasible for practical implementation at the individual clinical level as a first priority. A number of concerns and potential problems were identified in relation to the application and interpretation of an LTC PROM. Conclusions This study has demonstrated support for a single self-report outcome measure that reflects the priorities of people with LTCs, if such a measure can be shown to be meaningful and useful at the individual level. People with LTCs and professional end-users in health and social care should be involved in the development and evaluation of such a measure. PMID:25991448

  20. DS2000+ Outcomes Measurement and Reporting Module Recommendations for Domains, Data Elements, and Instruments Report from the Technical Expert Workgroup 1

    Microsoft Academic Search

    Josh Koerner; Denise McHugh; Sarah Minden; Deborah Nelson; Steve Onken; Dee Roth; Greg Teague

    Workgroups of behavioral health stakeholders—consumers, family members, providers, state mental health agencies, and managed behavioral health care organizations—recommended domains and data elements for measuring outcomes in behavioral health. These were reviewed by a technical expert workgroup (TEW) that recommended they be reduced in number; this task was carried out by TEW members with expertise in the content of outcomes measurement

  1. Asthma Outcomes: Pulmonary Physiology

    PubMed Central

    Tepper, Robert S.; Wise, Robert S.; Covar, Ronina; Irvin, Charles G.; Kercsmar, Carolyn M.; Kraft, Monica; Liu, Mark C.; O’Connor, George T.; Peters, Stephen P.; Sorkness, Ronald; Togias, Alkis

    2014-01-01

    Background Outcomes of pulmonary physiology have a central place in asthma clinical research. Objective At the request of National Institutes of Health (NIH) institutes and other federal agencies, an expert group was convened to provide recommendations on the use of pulmonary function measures as asthma outcomes that should be assessed in a standardized fashion in future asthma clinical trials and studies to allow for cross-study comparisons. Methods Our subcommittee conducted a comprehensive search of PubMed to identify studies that focused on the validation of various airway response tests used in asthma clinical research. The subcommittee classified the instruments as core (to be required in future studies), supplemental (to be used according to study aims and in a standardized fashion), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results A list of pulmonary physiology outcomes that applies to both adults and children older than 6 years was created. These outcomes were then categorized into core, supplemental, and emerging. Spirometric outcomes (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], and FEV1/FVC) are proposed as core outcomes for study population characterization, for observational studies, and for prospective clinical trials. Bronchodilator reversibility and pre- and post-bronchodilator FEV1 also are core outcomes for study population characterization and observational studies. Conclusions The subcommittee considers pulmonary physiology outcomes of central importance in asthma and proposes spirometric outcomes as core outcomes for all future NIH-initiated asthma clinical research. PMID:22386510

  2. Magnetic Measurement Results in the AGS Cold Snake HSD601

    E-print Network

    Ohta, Shigemi

    Magnetic Measurement Results in the AGS Cold Snake HSD601 (a.k.a. DSM101) Animesh Jain in the Cold Snake (HSD601) · Integral dipole field in the main helical magnet: ­ Full excitation curve using Animesh Jain, BNL 3 Measurements in the Cold Snake (Contd.) · Axial scans using 51 mm long coil: ­ 67

  3. A Guide to Strategically Planning Training and Measuring Results.

    ERIC Educational Resources Information Center

    Office of Personnel Management, Washington, DC.

    A four-step approach to implementing a training program and measuring results for government agencies was developed in response to an executive order to federal agencies to provide effective training and performance measures in their annual budgets. Step one is the analysis of established goals to identify training requirements. Suggested…

  4. Child welfare outcomes for youth in care as a result of parental death or parental incarceration.

    PubMed

    Shaw, Terry V; Bright, Charlotte Lyn; Sharpe, Tanya L

    2015-04-01

    Every day, in the United States, children are removed from their homes and placed into state supervised out-of-home care because of concerns around their safety. These children enter care as a result of child abuse, child neglect, abandonment or some other reasons. Lost in most discussions of out-of-home care is the role that parental incarceration and parental death have on the trajectory of children through the child welfare system. In order to address this gap in the literature, the present study aims to compare youth in foster care as a result of parental death or youth in foster care as a result of parental incarceration with youth in care because of child maltreatment in terms of the length of time to achieve permanency. Holding all other variables constant, entering care as a result of parental death more than doubled the average time to exit (HR=2.32, SE=0.22), and these youth were significantly less likely to exit to permanency when compared to children entering care for other maltreatment reasons (OR=0.35, SE=0.24). Entering care as a result of parental incarceration led to a 24% longer time to exit (HR=1.24, SE=0.09) compared to children entering care for other maltreatment reasons. Findings suggest that a one-size-fits-all approach to policy and practice may not be useful to identifying permanent placements for children entering care as a result of parental death or incarceration. PMID:25641050

  5. Methods and results of boundary layer measurements on a glider

    NASA Technical Reports Server (NTRS)

    Nes, W. V.

    1978-01-01

    Boundary layer measurements were carried out on a glider under natural conditions. Two effects are investigated: the effect of inconstancy of the development of static pressure within the boundary layer and the effect of the negative pressure difference in a sublaminar boundary layer. The results obtained by means of an ion probe in parallel connection confirm those results obtained by means of a pressure probe. Additional effects which have occurred during these measurements are briefly dealt with.

  6. Ultrasound-guided Interdigital Neuroma Injections: Short-term Clinical Outcomes after a Single Percutaneous Injection—Preliminary Results

    PubMed Central

    Adler, Ronald S.; Ciavarra, Gina A.; Pavlov, Helene

    2006-01-01

    Purpose To describe the procedure of ultrasound-guided Morton’s neuroma and recurrent stump neuroma injections and early clinical outcomes after a single injection. Materials and Methods Retrospective review of 44 percutaneous ultrasound-guided neuroma injections in 24 patients who had completed clinical outcomes questionnaires. A 10-point pain scale [scale of 1 (no pain) to 10 (severe pain)] in a 7-day pain log format was distributed to patients at the time percutaneous neuroma injection was performed. Results Neuromas were clearly visualized with sonography as hypoechoic nodules and were distinguishable from other causes of forefoot pain, such as metatarsophalangeal joint synovitis and intermetatarsal bursae. The sizes of the neuromas injected ranged between 4 and 19 mm. Postinjection, all neuromas displayed increased echogenicity and/or the appearance of fluid surrounding it, confirming localization of the therapeutic mixture. We arbitrarily subdivided the pain ratings into symptomatic (greater than 4) and asymptomatic (less than or equal to 4) for statistical analysis. Average pain level pre injection was 5.2 and average pain level was 3.7 at 7 days post single injection, with 62% of the initially symptomatic patients asymptomatic on day 7 (p?results. PMID:18751769

  7. Promoting equal developmental opportunity and outcomes among America's children and youth: results from the National Promises Study.

    PubMed

    Scales, Peter C; Benson, Peter L; Moore, Kristin A; Lippman, Laura; Brown, Brett; Zaff, Jonathan F

    2008-03-01

    Building on a developmental framework positing five types of assets or inputs needed for children's development, referred to as promises, we investigated the extent to which American children and youth experience the five Promises articulated by the America's Promise Alliance. These are: (1) Caring Adults, (2) Safe Places and Constructive Use of Time, (3) A Healthy Start, (4) Effective Education, and (5) Opportunities to Make a Difference. Data came from a nationally representative poll designed to assess these five resources and involved more than 4,000 teenagers and their parents. Results showed that only a minority of young people experienced rich developmental nourishment (having 4-5 of the Promises). Males, older adolescents, adolescents of color, and adolescents from families with less education and lower parental annual incomes were significantly less likely to experience sufficient developmental opportunities and were also less likely to experience desirable developmental outcomes. However, among those young people who reported experiencing 4-5 Promises, the great majority of demographic differences in developmental outcomes were either eliminated or significantly reduced. The results suggest that increasing children's experience of these Promises would reduce developmental inequalities among America's young people. EDITORS' STRATEGIC IMPLICATIONS: Longitudinal studies with representative samples will be necessary to further validate this approach and study causal contributions of assets, but this integration of Positive Youth Development frameworks holds great promise for theory, practice, and policy. PMID:18373201

  8. Characterizing the relationship between fMRI derived measures and clinical outcomes in vascular lesion patients

    PubMed Central

    Regner, Michael F.; Young, Brittany M.; Radtke, Andrew; Pankratz, Joshua; Holdsworth, Ryan L.; Baniulis, Dovile; Kornder, Nicole K.; Voss, Jed; Austin, Benjamin P.; Moritz, Chad; Meyerand, Elizabeth M.; Prabhakaran, Vivek

    2013-01-01

    Background and Purpose Functional magnetic resonance imaging (fMRI) has proven to be an effective component of pretreatment planning in patients harboring a variety of different brain lesions. Our group has recently reported significant relationships concerning distances between brain tumor border and area of functional activation (Lesion-to-Activation-Distance; LAD) with regard to patient morbidity and mortality. This study further examines the relationship between LAD, focusing on a host of vascular lesions, and pre- and posttreatment morbidity. Materials and Methods This study included a sample population (n=106) of patients with vascular lesions, primarily arteriovenous malformations (AVM) and cavernomas. These patients underwent pretreatment fMRI-based motor mapping (n=72) or language mapping (n=84). The impact of LAD and other variables derived from the patient medical record were analyzed with respect to functional deficits in terms of morbidity (weakness and/or aphasia). Results In patients with no pretreatment deficits, there was trend for a significant relationship between Wernicke's area LAD and posttreatment language deficits. In patients with or without pretreatment deficits, a trend toward significance was observed between sensorimotor LAD and posttreatment motor deficits. Additionally, lesion type (AVMs or cavernomas) impacted posttreatment deficits with more patients with cavernomas showing posttreatment language deficits than patients with AVMs. This difference was however not observed for posttreatment motor deficits. Conclusion These findings suggest that the proximity of a vascular lesion to sensorimotor and language areas is a relevant parameter in estimating patient prognosis in the peri-operative period. Additionally, vascular lesion type and existence of pretreatment deficits play a significant role in outcomes. PMID:23544414

  9. Student Learning Outcomes Committee 2009 (revised 12-29-09) Department/Program Assessment Results Report

    E-print Network

    Gallo, Linda C.

    in response to last year's results. The Human Resource Management (HRM) specialization started as a new program in the Management Department in Fall 2008. The HRM specialization is housed under the Management Management (HRM), the goal is to provide a foundation of all areas of human resources with an emphasis

  10. Results of Prevention of REStenosis with Tranilast and its Outcomes (PRESTO) trial

    Microsoft Academic Search

    D. R. Holmes; J. R. Granett; J. J. Popma; P. J. Fitzgerald; D. Fischman; J. J. Ferguson; A. M. Lincoff; S. Goldberg; J. A. Brinker; R. Chan; B. R. Davis; M. Poland; A. M. Zeiher; J. T. Willerson; S. B. King; L. M. Shapiro; M. Savage; J. M. Lablanche; J. E. Tcheng; L. Grip; P. W. J. C. Serruys

    2002-01-01

    BACKGROUND: Restenosis after percutaneous coronary intervention (PCI) is a major problem affecting 15% to 30% of patients after stent placement. No oral agent has shown a beneficial effect on restenosis or on associated major adverse cardiovascular events. In limited trials, the oral agent tranilast has been shown to decrease the frequency of angiographic restenosis after PCI. METHODS AND RESULTS: In

  11. Developing outcome measures for pediatric mitochondrial disorders: which complaints and limitations are most burdensome to patients and their parents?

    PubMed

    Koene, Saskia; Wortmann, Saskia B; de Vries, Maaike C; Jonckheere, An I; Morava, Eva; de Groot, Imelda J M; Smeitink, Jan A M

    2013-01-01

    Since some drug intervention effects are only experienced by the patient, organizations such as the Food and Drug Administration prefer clinically meaningful outcome measures. Here, we evaluated which symptoms and limitations in daily life are most burdensome to pediatric patients with mitochondrial disorders and their parents, using two questionnaires. In a study of 78 patients, the most burdensome complaints included fatigue, behavior and speech disturbances, epilepsy and muscle weakness and a high degree of limitations in daily activities was found. Importantly, there was a discrepancy between what symptoms metabolic pediatricians estimated would be most burdensome compared to the patients'/caretakers' opinion. To include feasible and relevant outcome measures in intervention studies, the experience and opinions of patients and caretakers should therefore be heard. PMID:23164801

  12. Item Banks for Alcohol Use from the Patient-Reported Outcomes Measurement Information System (PROMIS): Use, Consequences, and Expectancies

    PubMed Central

    Pilkonis, Paul A.; Yu, Lan; Colditz, Jason; Dodds, Nathan; Johnston, Kelly L.; Maihoefer, Catherine; Stover, Angela M.; Daley, Dennis C.; McCarty, Dennis

    2012-01-01

    Background We report on the development and calibration of item banks for alcohol use, negative and positive consequences of alcohol use, and negative and positive expectancies regarding drinking as part of the Patient-Reported Outcomes Measurement Information System (PROMIS). Methods Comprehensive literature searches yielded an initial bank of more than 5,000 items from over 200 instruments. After qualitative item analysis (including focus groups and cognitive interviewing), 141 items were included in field testing. Items for alcohol use and consequences were written in a first-person, past-tense format with a 30-day time frame and 5 response options reflecting frequency. Items for expectancies were written in a third-person, present-tense format with no time frame specified and 5 response options reflecting intensity. The calibration sample included 1,407 respondents, 1,000 from the general population (ascertained through an internet panel) and 407 from community treatment programs participating in the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN). Results Final banks of 37, 31, 20, 11, and 9 items (108 total items) were calibrated for alcohol use, negative consequences, positive consequences, negative expectancies, and positive expectancies, respectively, using item response theory (IRT). Seven-item static short forms were also developed from each item bank. Conclusions Test information curves showed that the PROMIS item banks provided substantial information in a broad range of severity, making them suitable for treatment, observational, and epidemiological research. PMID:23206377

  13. Mapping of the EQ-5D index from clinical outcome measures and demographic variables in patients with coronary heart disease

    Microsoft Academic Search

    Kimberley A Goldsmith; Matthew T Dyer; Martin J Buxton; Linda D Sharples

    2010-01-01

    BACKGROUND: The EuroQoL 5D (EQ-5D) is a questionnaire that provides a measure of utility for cost-effectiveness analysis. The EQ-5D has been widely used in many patient groups, including those with coronary heart disease. Studies often require patients to complete many questionnaires and the EQ-5D may not be gathered. This study aimed to assess whether demographic and clinical outcome variables, including

  14. Using Early Change to Predict Outcome in Cognitive Behaviour Therapy: Exploring Timeframe, Calculation Method, and Differences of Disorder-Specific versus General Measures

    PubMed Central

    Schibbye, Peter; Ghaderi, Ata; Ljótsson, Brjánn; Hedman, Erik; Lindefors, Nils; Rück, Christian; Kaldo, Viktor

    2014-01-01

    Early change can predict outcome of psychological treatment, especially in cognitive behavior therapy. However, the optimal operationalization of “early change” for maximizing its predictive ability, and differences in predictive ability of disorder-specific versus general mental health measures has yet to be clarified. This study aimed to investigate how well early change predicted outcome depending on the week it was measured, the calculation method (regression slope or simple subtraction), the type of measures used, and the target disorder. During 10–15 weeks of internet-based cognitive behavior therapy for depression, social anxiety disorder, or panic disorder, weekly ratings were collected through both disorder-specific measures and general measures (Outcome Questionnaire-45 (OQ-45) and Clinical Outcomes in Routine Evaluation-10 (CORE-10)). With outcome defined as the disorder-specific measure, change at week four was the optimal predictor. Slope and subtraction methods performed equally well. The OQ-45 explained 18% of outcome for depression, 14% for social anxiety disorder, and 0% for panic disorder. Corresponding values for CORE-10 were 23%, 29%, and 25%. Specific measures explained 41%, 43%, and 34% respectively: this exceeded the ability of general measures also when they predicted themselves. We conclude that a simple calculation method with a disorder-specific measure at week four seems to provide a good choice for predicting outcome in time-limited cognitive behavior therapy. PMID:24959666

  15. MEASURING SUCESS: HOW CENSUSATSCHOOL ENGAGES CANADIAN STUDENTS IN ACTIVE LEARNING OUTCOMES

    Microsoft Academic Search

    Mary Townsend

    2006-01-01

    This paper examines the experiential process of statistical learning involved in Statistics Canada's Census at School project. It profiles students' learning outcomes and the contribution of classroom teachers, pre-service teachers, school boards and senior management of Statistics Canada in the project's success. NEW EXPECTATIONS FOR STUDENT LEARNING The Information age demands the teaching and learning of new skills in data

  16. Development of Student Service-Learning Course Survey (SSLCS) to Measure Service-Learning Course Outcomes

    Microsoft Academic Search

    Yan Wang; Feifei Ye; Golden Jackson; Robert Rodgers; Susan Jones

    2005-01-01

    Service-learning courses focus on both service experience and academic learning. Academic content is covered in both the classroom and the service experience, and the service experiences are reflected upon and processed in the classroom. Based on educational values, potential outcomes can be classified as development of personal competence, interpersonal relationship, and perception of community service as a responsibility of charity

  17. An Analysis of State Data Collection Protocols for Measuring Postschool Outcomes for Students with Disabilities

    ERIC Educational Resources Information Center

    Gerber, Paul J.; Batalo, Cecilia G.; De Arment, Serra T.

    2014-01-01

    Indicator 14 is a federal accountability initiative that attempts to generate data on the outcomes of students with disabilities 1 year after leaving high school. Currently, there are only two areas, postsecondary education/training and employment, mandated for examination. Ultimately, the data are used to develop specific goals for 6-year State…

  18. Child Protection and Child Outcomes: Measuring the Effects of Foster Care

    Microsoft Academic Search

    Joseph J. Doyle

    2007-01-01

    Little is known about the effects of placing children who are abused or neglected into foster care. This paper uses the placement tendency of child protection investigators as an instrumental variable to identify causal effects of foster care on long-term outcomes—including juvenile delinquency, teen motherhood, and employment— among children in Illinois where a rotational assignment process effectively randomizes families to

  19. Using Action Verbs as Learning Outcomes: Applying Bloom's Taxonomy in Measuring Instructional Objectives in Introductory Psychology

    ERIC Educational Resources Information Center

    Nevid, Jeffrey S.; McClelland, Nate

    2013-01-01

    We used a set of action verbs based on Bloom's taxonomy to assess learning outcomes in two college-level introductory psychology courses. The action verbs represented an acronym, IDEA, comprising skills relating to identifying, defining or describing, evaluating or explaining, and applying psychological knowledge. Exam performance demonstrated…

  20. Using CAS Standards to Measure Learning Outcomes of Student Affairs Preparation Programs

    ERIC Educational Resources Information Center

    Young, Dallin George; Janosik, Steven M.

    2007-01-01

    A majority of recent graduates from master's level student affairs preparation programs report having a clear understanding of 58 of 60 foundational learning outcomes derived from the Council for the Advancement of Standards in Higher Education (CAS) guidelines. While there were only two significant differences between self-reported learning of…

  1. Core Outcome Measures in Effectiveness Trials http://www.comet-initiative.org/home

    E-print Network

    Applebaum, David

    MRC North West Hub for Trials Methodology Research University of Liverpool #12;Acknowledgments between the groups · Selection of appropriate outcomes is crucial · `Clinical trials are only as credible target recruitment) Stopped early Never started Submitted Interim analysis Other e.g. poor recruitment

  2. School Context and Educational Outcomes: Results from a Quasi-Experimental Study

    PubMed Central

    Casciano, Rebecca; Massey, Douglas S.

    2013-01-01

    In this study we draw on data from a quasi-experimental study to test whether moving into a subsidized housing development in an affluent suburb yields educational benefits to the children of residents, compared to the educations they would have received had they not moved into the development. Results suggest that resident children experienced a significant improvement in school quality compared with a comparison group of students whose parents also had applied for residence. Parents who were residents of the development also displayed higher levels of school involvement compared with the comparison group of non-resident parents, and their children were exposed to significantly lower levels of school disorder and violence within school and spent more time reading outside of school. Living in the development did not influence GPA directly, but did indirectly increase GPA by increasing the time residents spent reading outside of school. PMID:25342878

  3. What are outcomes?

    PubMed

    Mullins, C D; Baldwin, R; Perfetto, E M

    1996-01-01

    Understanding the important aspects of measuring outcomes will prepare pharmacists for changes in the marketplace and help them to assess the results of studies that will appear in subsequent issues of the Journal of the American Pharmaceutical Association and the research journals of other health services professions. In any evaluation of quality, all three quality measures (structure, process, and outcomes) must be considered. No one measure, in isolation, can describe the quality of care provided. Thus, the best patient care will come from health care practitioners who document structure, process, and outcomes and who evaluate these measures to provide appropriate care. The pharmacist cannot dispense prescriptions or provide pharmaceutical care without a pharmacy, drug inventory, or patient profiles, all of which are important structural inputs. The pharmacist takes a medication history, monitors the drug regimen, and counsels the patient on the appropriate way to use the treatment, all vital process activities. The objective of these inputs and actions is to improve the health status of the patient. Outcomes, therefore, are the intended endpoints of care, and occasional unintended effects (e.g., adverse drug reactions) as well. The future of pharmacy rests on demonstrating the positive effect of pharmaceutical care on patient outcomes. Pharmacists have always been part of the system of checks and balances in health care delivery. As the provision of health services changes, opportunities to assess the process and structure of care and to document patient outcomes will increase. Pharmacists are well positioned to intervene in patient care, but if they do not demonstrate the value of pharmacy services, they will face competition from alternative providers. Some have even suggested less expensive alternatives to having pharmacists dispense medications. Pharmacists must establish that their role goes beyond dispensing to include cognitive services such as compliance programs, screening services, glucose monitoring, and disease management programs. Pharmacists must document their role and its effects on patient outcomes. PMID:8835440

  4. Relationship between Learning Outcomes and Online Accesses

    ERIC Educational Resources Information Center

    Suanpang, Pannee; Petocz, Peter; Reid, Anna

    2004-01-01

    This paper reports on a study carried out in Thailand investigating the relationship between students' use of an e-learning system and their learning outcomes in a course on Business Statistics. The results show a clear relationship between accesses to the e-learning system, as measured by number of "hits", and outcomes, as measured by final…

  5. [Treatment and outcome of Crohn's disease without initial complications. Results of a retrospective, multicenter Tunisian study].

    PubMed

    Cheikh, Imed; Ben Ammar, Ahmed; Essid, Mejda; Azzouz, Messadak; Ettahri, Nabil; Krichene, Mohamed; Bouzaidi, Slim; Ennajar, Taoufik

    2002-04-01

    The purpose of this study was to estimate and achieve the factors that have an influence on the evolution of the Chron's disease. This study was done in 124 patients reaching the diagnosis of Chron's disease between 1988 and 1997. The evolution of this disease was achieved in 87 patients. The Chron's disease was inactive among 31 patients (35-6%)--with discontinous evolution in 42 patients (48.3%) and active chronic in 14 patients (16-1%). The active chronic form of Chron's disease was twice more frequent among the smokers and the patients with age above 40 years--but this difference has no statistical significance. The indication of surgical treatment was realised in 21 patients and it takes place as result of failure of medical treatment in 16 patients (76-2%)--an abcess in 2 patents (9-5%) and iatrogenic perforation in 1 patient (4-8%). The age-sexe-smoke--the intensity of the initial attack and the nature of the treatment had no influence in the need of the surgical interfference. The Chron's disease showed the less severe evolution in this study--the age above 40 years and the consumption of smoke increased the frequency of active chronic form. PMID:12416354

  6. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results From a Two-Year Randomized Trial

    PubMed Central

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2013-01-01

    Objective To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method Early course schizophrenia outpatients (N = 58) were randomly assigned to Cognitive Enhancement Therapy (CET) or an Enriched Supportive Therapy (EST) control and treated for two years. Comprehensive data on cognition and employment were collected annually. Results Individuals treated with CET were significantly more likely to be competitively employed, had greater earnings from employment, and were more satisfied with their employment status by the end of treatment compared to EST recipients. Mediator analyses revealed that improvements in both social and non-social cognition mediated the CET effects on employment. Conclusion CET can help facilitate employment in early schizophrenia, by addressing the cognitive impairments that limit functioning in the disorder. Inclusion of cognitive rehabilitation in social work practice can support more optimal functional recovery from schizophrenia. PMID:23885163

  7. Clinical Evaluation of a Mobile Sensor-Based Gait Analysis Method for Outcome Measurement after Knee Arthroplasty

    PubMed Central

    Calliess, Tilman; Bocklage, Raphael; Karkosch, Roman; Marschollek, Michael; Windhagen, Henning; Schulze, Mareike

    2014-01-01

    Clinical scores and motion-capturing gait analysis are today's gold standard for outcome measurement after knee arthroplasty, although they are criticized for bias and their ability to reflect patients' actual quality of life has been questioned. In this context, mobile gait analysis systems have been introduced to overcome some of these limitations. This study used a previously developed mobile gait analysis system comprising three inertial sensor units to evaluate daily activities and sports. The sensors were taped to the lumbosacral junction and the thigh and shank of the affected limb. The annotated raw data was evaluated using our validated proprietary software. Six patients undergoing knee arthroplasty were examined the day before and 12 months after surgery. All patients reported a satisfactory outcome, although four patients still had limitations in their desired activities. In this context, feasible running speed demonstrated a good correlation with reported impairments in sports-related activities. Notably, knee flexion angle while descending stairs and the ability to stop abruptly when running exhibited good correlation with the clinical stability and proprioception of the knee. Moreover, fatigue effects were displayed in some patients. The introduced system appears to be suitable for outcome measurement after knee arthroplasty and has the potential to overcome some of the limitations of stationary gait labs while gathering additional meaningful parameters regarding the force limits of the knee. PMID:25171119

  8. Use of Local {sup 111}In-Capromab Pendetide Scan Results to Predict Outcome After Salvage Radiotherapy for Prostate Cancer

    SciTech Connect

    Koontz, Bridget F. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Duke Prostate Center, Duke University Medical Center, Durham, NC (United States)], E-mail: koont005@mc.duke.edu; Mouraviev, Vladimir [Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Department of Surgery, Division of Urologic Surgery, Duke University Medical Center, Durham, NC (United States); Johnson, Jeffrey L. [Duke Cancer Center Biostatistics, Duke University Medical Center, Durham, NC (United States); Mayes, Janice; Chen, Stephanie H. [Department of Surgery, Division of Urologic Surgery, Duke University Medical Center, Durham, NC (United States); Wong, Terence Z. [Department of Radiology, Duke University Medical Center, Durham, NC (United States); Anscher, Mitchell S. [Department of Radiation Oncology, Virginia Commonwealth University School of Medicine, Richmond, VA (United States); Sun, Leon; Moul, Judd; Polascik, Thomas J. [Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Department of Surgery, Division of Urologic Surgery, Duke University Medical Center, Durham, NC (United States)

    2008-06-01

    Purpose: The {sup 111}In-capromab pendetide scan (ProstaScint; Cytogen Corp., Princeton NJ) is approved by the Food and Drug Administration to evaluate increasing prostate-specific antigen (PSA) levels after radical prostatectomy. This study evaluated the role of prostate bed {sup 111}In-capromab pendetide scan findings to predict response to salvage radiotherapy (RT). Methods and Materials: Forty patients who had PSA recurrence after radical prostatectomy and a {sup 111}In-capromab pendetide scan immediately before salvage prostate bed RT (median, 66 Gy) were identified from the Duke Prostate Center database. Patients with distant uptake of capromab pendetide or long-term androgen deprivation therapy were excluded. Median follow-up after salvage RT was 2.7 years. Patient demographic, clinical, and pathologic characteristics; PSA values; and {sup 111}In-capromab pendetide scan results were retrospectively analyzed. A PSA failure after salvage RT was defined as PSA level greater than 0.2 ng/ml. Data were combined with other published results in a secondary pooled analysis of 106 patients. Results: {sup 111}In-Capromab pendetide findings included 20 patients with negative scan results and 20 with locally positive scan results. Two-year progression-free survival rates were 60% for patients with a negative scan result and 74% for those with a locally positive scan result (p = 0.49). Combined analysis did not show a difference in outcome based on local {sup 111}In-capromab pendetide scan result. Conclusion: For patients without distant signal detected by using {sup 111}In-capromab pendetide scan, patients with locally positive scan findings did not have statistically different progression-free survival than those with a negative scan result, suggesting that salvage RT may be successful in patients with either a locally positive or negative {sup 111}In-capromab pendetide scan result.

  9. HOMs Simulation and Measurement Results of IHEP02 Cavity

    E-print Network

    Zheng, Hongjuan; Zhao, Tongxian; Gao, Jie

    2015-01-01

    In cavities, there exists not only the fundamental mode which is used to accelerate the beam but also higher order modes (HOMs). The higher order modes excited by beam can seriously affect beam quality, especially for the higher R/Q modes. This paper reports on measured results of higher order modes in the IHEP02 1.3GHz low-loss 9-cell superconducting cavity. Using different methods, Qe of the dangerous modes passbands have been got. The results are compared with TESLA cavity results. R/Q of the first three passbands have also been got by simulation and compared with the results of TESLA cavity.

  10. HOMs Simulation and Measurement Results of IHEP02 Cavity

    E-print Network

    Hongjuan Zheng; Jiyuan Zhai; Tongxian Zhao; Jie Gao

    2015-02-06

    In cavities, there exists not only the fundamental mode which is used to accelerate the beam but also higher order modes (HOMs). The higher order modes excited by beam can seriously affect beam quality, especially for the higher R/Q modes. This paper reports on measured results of higher order modes in the IHEP02 1.3GHz low-loss 9-cell superconducting cavity. Using different methods, Qe of the dangerous modes passbands have been got. The results are compared with TESLA cavity results. R/Q of the first three passbands have also been got by simulation and compared with the results of TESLA cavity.

  11. 'Painting a path to wellness': correlations between participating in a creative activity group and improved measured mental health outcome.

    PubMed

    Caddy, L; Crawford, F; Page, A C

    2012-05-01

    Responding to a call for quantitative outcome evidence about the therapeutic relationship between creative activity and mental health, this study examined the mental health outcomes of inpatients participating in art- and craft-based creative therapies at a private psychiatric hospital over a 5-year period. The creative activity group sample (n= 403) improved from admission to discharge across four different psychometric measures with moderate to strong mean effect sizes. Reductions from pre- to post-treatment in both self-reported and clinician-rated symptoms are clearly demonstrated for the creative activity group participant sample. Research findings establish that participation in creative activity has potential benefits for people experiencing mental health problems. PMID:22074391

  12. Outcome measures to evaluate new technology for tonsillectomy: preliminary experience with Coblation

    NASA Astrophysics Data System (ADS)

    Shah, Udayan K.; Puchalski, Robert; Briggs, Marianne; Chiavacci, Rosetta; Galinkin, Jeffrey

    2001-05-01

    Evaluating the benefits of new surgical technologies does not end with the observation of successful instrument-to- tissue interaction. The impact of new technologies in medicine today is also gauged by improvements in patients' daily activities and performance. We present our outcomes assessment tool for judging the value of applying a novel tonsillectomy technique, plasma- mediated ablation using Coblation technology. Plasma- mediated ablation (PMA) achieves soft tissue resection in the oropharynx by energizing protons to break bonds. Less heat is released, allowing for less thermal injury, and possibly less pain, than with tonsillectomy performed using electrocautery alone. Children undergoing tonsillectomy by PMA, were evaluated using our outcomes-based scale, which asked families to report the degree of interruption of normal activities for the patient and their family during the post-tonsillectomy recovery period. A preliminary review of several outcomes assessments exemplify the benefits and limitations of this tool. The tracking of valuable data is weighed against the limitations of a short time course relative to the duration of disability, and a poor response rate. Future work aims to improve this data collection tool to allow application to other new technologies in otolaryngology.

  13. Validity of patient-reported swallowing and speech outcomes in relation to objectively measured oral function among patients treated for oral or oropharyngeal cancer.

    PubMed

    Rinkel, R N P M; Verdonck-de Leeuw, I M; de Bree, R; Aaronson, N K; Leemans, C R

    2015-04-01

    The objective of this study was to test the construct validity of the patient-reported outcomes Swallowing Quality of Life Questionnaire (SWAL-QOL) and Speech Handicap Index (SHI) in relation to objectively measured oral function among patients treated for oral or oropharyngeal cancer. The study sample consisted of patients treated for oral or oropharyngeal cancer. Outcome measures were the SWAL-QOL and the SHI, and the Functional Rehabilitation Outcomes Grade (FROG), a test to measure oral and shoulder function. Spearman's rank correlation coefficient was used to test associations between the SHI and SWAL-QOL scales, and the FROG scales. During a study period of 3 months, 38 patients (21 males, 17 females; mean age 54 years) were included who visited the outpatient clinic for follow-up care 6-155 months after surgical treatment (n = 14) or combined surgery and radiotherapy (n = 24) for oral (n = 21) or oropharyngeal cancer (n = 17). Most SWAL-QOL and SHI scales (except the SWAL-QOL Fatigue scale) correlated significantly with one or more FROG oral function scales. None of the SWAL-QOL and SHI scales correlated significantly with the FROG shoulder function scale. These results support the construct validity of the SWAL-QOL and SHI questionnaires for assessing speech and swallowing problems in daily life that are moderately but significantly related to oral function. A multidimensional assessment protocol is recommended for use in clinical practice and for research purposes for measuring oral function and swallowing- and speech-related problems in daily life among head and neck cancer patients. PMID:25622807

  14. Intensive-Phase Treatment Outcomes among Hospitalized Multidrug-Resistant Tuberculosis Patients: Results from a Nationwide Cohort in Nigeria

    PubMed Central

    Oladimeji, Olanrewaju; Isaakidis, Petros; Obasanya, Olusegun J.; Eltayeb, Osman; Khogali, Mohammed; Van den Bergh, Rafael; Kumar, Ajay M. V.; Hinderaker, Sven Gudmund; Abdurrahman, Saddiq T.; Lawson, Lovett; Cuevas, Luis E.

    2014-01-01

    Background Nigeria is faced with a high burden of Human Immunodeficiency Virus (HIV) infection and multidrug-resistant tuberculosis (MDR-TB). Treatment outcomes among MDR-TB patients registered across the globe have been poor, partly due to high loss-to-follow-up. To address this challenge, MDR-TB patients in Nigeria are hospitalized during the intensive-phase(IP) of treatment (first 6–8 months) and are provided with a package of care including standardized MDR-TB treatment regimen, antiretroviral therapy (ART) and cotrimoxazole prophylaxis (CPT) for HIV-infected patients, nutritional and psychosocial support. In this study, we report the end-IP treatment outcomes among them. Methods In this retrospective cohort study, we reviewed the patient records of all bacteriologically-confirmed MDR-TB patients admitted for treatment between July 2010 and October 2012. Results Of 162 patients, 105(65%) were male, median age was 34 years and 28(17%) were HIV-infected; all 28 received ART and CPT. Overall, 138(85%) were alive and culture negative at the end of IP, 24(15%) died and there was no loss-to-follow-up. Mortality was related to low CD4-counts at baseline among HIV-positive patients. The median increase in body mass index among those documented to be underweight was 2.6 kg/m2 (p<0.01) and CD4-counts improved by a median of 52 cells/microL among the HIV-infected patients (p<0.01). Conclusions End-IP treatment outcomes were exceptional compared to previously published data from international cohorts, thus confirming the usefulness of a hospitalized model of care. However, less than five percent of all estimated 3600 MDR-TB patients in Nigeria were initiated on treatment during the study period. Given the expected scale-up of MDR-TB care, the hospitalized model is challenging to sustain and the national TB programme is contemplating to move to ambulatory care. Hence, we recommend using both ambulatory and hospitalized approaches, with the latter being reserved for selected high-risk groups. PMID:24722139

  15. Precision Reactor e Spectrum Measurements: Recent Results and PROSPECTs

    E-print Network

    described largely by reactor thermal power 6 HFIR Core/Containment Spent HFIR fuel elements LEU FissionPrecision Reactor e Spectrum Measurements: Recent Results and PROSPECTs Bryce Littlejohn Illinois Institute of Technology November 24, 2014 Daya Bay Antineutrino Spectrum PROSPECT Collaboration at HFIR #12

  16. Developmental Test of Visual–Motor Integration (VMI): An Effective Outcome Measure for Handwriting Interventions for Kindergarten, First-Grade, and Second-Grade Students?

    PubMed Central

    Moskowitz, Beverly; Paoletti, Andrew; Brusilovskiy, Eugene; Zylstra, Sheryl Eckberg; Murray, Tammy

    2015-01-01

    We determined whether a widely used assessment of visual–motor skills, the Beery–Buktenica Developmental Test of Visual–Motor Integration (VMI), is appropriate for use as an outcome measure for handwriting interventions. A two-group pretest–posttest design was used with 207 kindergarten, first-grade, and second-grade students. Two well-established handwriting measures and the VMI were administered pre- and postintervention. The intervention group participated in the Size Matters Handwriting Program for 40 sessions, and the control group received standard instruction. Paired and independent-samples t tests were used to analyze group differences. The intervention group demonstrated significant improvements on the handwriting measures, with change scores having mostly large effect sizes. We found no significant difference in change scores on the VMI, t(202) = 1.19, p = .23. Results of this study suggest that the VMI may not detect changes in handwriting related to occupational therapy intervention. PMID:26114468

  17. Developmental Test of Visual-Motor Integration (VMI): An Effective Outcome Measure for Handwriting Interventions for Kindergarten, First-Grade, and Second-Grade Students?

    PubMed

    Pfeiffer, Beth; Moskowitz, Beverly; Paoletti, Andrew; Brusilovskiy, Eugene; Zylstra, Sheryl Eckberg; Murray, Tammy

    2015-01-01

    We determined whether a widely used assessment of visual-motor skills, the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), is appropriate for use as an outcome measure for handwriting interventions. A two-group pretest-posttest design was used with 207 kindergarten, first-grade, and second-grade students. Two well-established handwriting measures and the VMI were administered pre- and postintervention. The intervention group participated in the Size Matters Handwriting Program for 40 sessions, and the control group received standard instruction. Paired and independent-samples t tests were used to analyze group differences. The intervention group demonstrated significant improvements on the handwriting measures, with change scores having mostly large effect sizes. We found no significant difference in change scores on the VMI, t(202) = 1.19, p = .23. Results of this study suggest that the VMI may not detect changes in handwriting related to occupational therapy intervention. PMID:26114468

  18. Outcome of resonant voice therapy for female teachers with voice disorders: perceptual, physiological, acoustic, aerodynamic, and functional measurements.

    PubMed

    Chen, Sheng Hwa; Hsiao, Tzu-Yu; Hsiao, Li-Chun; Chung, Yu-Mei; Chiang, Shu-Chiung

    2007-07-01

    Teachers have a high percentage of voice problems. For voice disordered teachers, resonant voice therapy is hypothesized to reduce voice problems. No research has been done on the physiological, acoustic, and aerodynamic effects of resonant voice therapy for school teachers. The purpose of this study is to investigate resonant voice therapy outcome from perceptual, physiological, acoustic, aerodynamic, and functional aspects for female teachers with voice disorders. A prospective study was designed for this research. The research subjects were 24 female teachers in Taipei. All subjects received resonant voice therapy in groups of 4 subjects, 90 minutes per session, and 1 session per week for 8 weeks. The outcome of resonant voice therapy was assessed from auditory perceptual judgment, videostroboscopic examination, acoustic measurements, aerodynamic measurements, and functional measurements before and after therapy. After therapy the severity of roughness, strain, monotone, resonance, hard attack, and glottal fry in auditory perceptual judgments, the severity of vocal fold pathology, mucosal wave, amplitude, and vocal fold closure in videostroboscopic examinations, phonation threshold pressure, and the score of physical scale in the Voice Handicap Index were significantly reduced. The speaking Fo, maximum range of speaking Fo, and maximum range of speaking intensity were significantly increased after therapy. No significant change was found in perturbation and breathiness measurements after therapy. Resonant voice therapy is effective for school teachers and is suggested as one of the therapy approaches in clinics for this population. PMID:16581227

  19. DWPF STARTUP FRIT VISCOSITY MEASUREMENT ROUND ROBIN RESULTS

    SciTech Connect

    Crum, Jarrod V.; Edwards, Tommy B.; Russell, Renee L.; Workman, Phyllis J.; Schweiger, Michael J.; Schumacher, Ray F.; Smith, Donald E.; Peeler, David K.; Vienna, John D.

    2012-07-31

    A viscosity standard is needed to replace the National Institute of Standards and Technology (NIST) glasses currently being used to calibrate viscosity measurement equipment. The current NIST glasses are either unavailable or less than ideal for calibrating equipment to measure the viscosity of high-level waste glasses. This report documents the results of a viscosity round robin study conducted on the Defense Waste Processing Facility (DWPF) startup frit. DWPF startup frit was selected because its viscosity-temperature relationship is similar to most DWPF and Hanford high-level waste glass compositions. The glass underwent grinding and blending to homogenize the large (100 lb) batch. Portions of the batch were supplied to the laboratories (named A through H) for viscosity measurements following a specified temperature schedule with a temperature range of 1150 C to 950 C and with an option to measure viscosity at lower temperatures if their equipment was capable of measuring at the higher viscosities. Results were used to fit the Vogel-Tamman-Fulcher and Arrhenius equations to viscosity as a function of temperature for the entire temperature range of 460 C through 1250 C as well as the limited temperature interval of approximately 950 C through 1250 C. The standard errors for confidence and prediction were determined for the fitted models.

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  2. Intravascular Ultrasound Guidance Improves Angiographic and Clinical Outcome of Stent Implantation for Long Coronary Artery Stenoses Final Results of a Randomized Comparison With Angiographic Guidance (TULIP Study)

    Microsoft Academic Search

    Pranobe V. Oemrawsingh; Gary S. Mintz; Martin J. Schalij; Aeilko H. Zwinderman; J. Wouter Jukema

    2010-01-01

    Background—Long coronary lesions treated with stents have a poor outcome. This study compared the 6-month outcome of stent implantation for long lesions in patients randomized to intravascular ultrasound (IVUS; n73) or angiographic guidance (n71). Methods and Results—Stenoses 20 mm in length and a reference diameter that permitted a stent diameter 3 mm were eligible. Primary end points were 6-month minimal

  3. Hypoxic Prostate/Muscle PO{sub 2} Ratio Predicts for Outcome in Patients With Localized Prostate Cancer: Long-Term Results

    SciTech Connect

    Turaka, Aruna [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Buyyounouski, Mark K., E-mail: mark.buyyounouski@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Hanlon, Alexandra L. [School of Nursing, University of Pennsylvania, Philadelphia, PA (United States); Horwitz, Eric M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Greenberg, Richard E. [Department of Surgery, Fox Chase Cancer Center, Philadelphia, PA (United States); Movsas, Benjamin [Department of Radiation Oncology, Henry Ford Hospital, Detroit, MI (United States)

    2012-03-01

    Purpose: To correlate tumor oxygenation status with long-term biochemical outcome after prostate brachytherapy. Methods and Materials: Custom-made Eppendorf PO{sub 2} microelectrodes were used to obtain PO{sub 2} measurements from the prostate (P), focused on positive biopsy locations, and normal muscle tissue (M), as a control. A total of 11,516 measurements were obtained in 57 men with localized prostate cancer immediately before prostate brachytherapy was given. The Eppendorf histograms provided the median PO{sub 2}, mean PO{sub 2}, and % <5 mm Hg or <10 mm Hg. Biochemical failure (BF) was defined using both the former American Society of Therapeutic Radiation Oncology (ASTRO) (three consecutive raises) and the current Phoenix (prostate-specific antigen nadir + 2 ng/mL) definitions. A Cox proportional hazards regression model evaluated the influence of hypoxia using the P/M mean PO{sub 2} ratio on BF. Results: With a median follow-up time of 8 years, 12 men had ASTRO BF and 8 had Phoenix BF. On multivariate analysis, P/M PO{sub 2} ratio <0.10 emerged as the only significant predictor of ASTRO BF (p = 0.043). Hormonal therapy (p = 0.015) and P/M PO{sub 2} ratio <0.10 (p = 0.046) emerged as the only independent predictors of the Phoenix BF. Kaplan-Meier freedom from BF for P/M ratio <0.10 vs. {>=}0.10 at 8 years for ASTRO BF was 46% vs. 78% (p = 0.03) and for the Phoenix BF was 66% vs. 83% (p = 0.02). Conclusions: Hypoxia in prostate cancer (low mean P/M PO{sub 2} ratio) significantly predicts for poor long-term biochemical outcome, suggesting that novel hypoxic strategies should be investigated.

  4. Toward improved spectral measures of /s/: Results from adolescents

    PubMed Central

    Koenig, Laura L.; Shadle, Christine H.; Preston, Jonathan L.; Mooshammer, Christine R.

    2014-01-01

    Purpose To introduce theoretically-driven acoustic measures of /s/ that reflect aerodynamic and articulatory conditions. The measures were evaluated by assessing whether they revealed expected changes over time and labiality effects, along with possible gender differences suggested by past work. Method Productions of /s/ were extracted from various speaking tasks from typically-speaking adolescents (6 boys; 6 girls). Measures were made of relative spectral energies in low- (550–3000 Hz), mid- (3000–7000 Hz), and high-frequency regions (7000–11025 Hz); the mid-frequency amplitude peak; and temporal changes in these parameters. Spectral moments were also obtained to permit comparison with existing work. Results Spectral balance measures in low–mid and mid–high frequency bands varied over the time course of /s/, capturing the development of sibilance at mid-fricative along with showing some effects of gender and labiality. The mid-frequency spectral peak was significantly higher in non-labial contexts, and in girls. Temporal variation in the mid-frequency peak differentiated ±labial contexts while normalizing over gender. Discussion The measures showed expected patterns, supporting their validity. Comparison of these data with studies of adults suggests some developmental patterns that call for further study. The measures may also serve to differentiate some cases of typical and misarticulated /s/. PMID:23785194

  5. Electric filed measurements onboard satellites - method, instrumentation and recent results

    NASA Astrophysics Data System (ADS)

    Korepanov, Valery

    2015-04-01

    The electric field measurements in the conductive media, such as ground, water and space plasma, are one of the most complicated metrological tasks from the point of view of proper measurement method application. This is because the electric field sensors are always interacting with the surrounding medium and the parasitic potential is formed at this. In the result, the measured value consists of the sum of useful and parasitic signals; by this the signal-to-noise ratio is mostly below unity. To overcome these problems, special high demands are made to the electric sensor parameters, especially to its equal form and surface homogeneity. These are analyzed in the report and the ways to fulfill them are discussed. The successful examples of DC electric field measurements in space plasma are given. But if only AC component is necessary to measure, the problem becomes much easier to overcome and even the sensors with non-uniform surface may be used. Some examples of AC electric field measurements during recent space missions are given and main peculiarities of sensors installation onboard the satellites are discussed. The possible sensor arrangement for future spatial mission onboard cubesat is also discussed. This work is supported by EC Framework 7 funded project 607197 (SEAM).

  6. Bowel Perfusion Measured with Dynamic Contrast-enhanced Ultrasound Predicts Treatment Outcome in Patients with Crohn's Disease

    PubMed Central

    Saevik, Fredrik; Hausken, Trygve; Ødegaard, Svein; Gilja, Odd H.

    2014-01-01

    Background: To improve management of patients with Crohn's disease (CD), objective measurements of the degree of local inflammation in the gastrointestinal wall are needed. Increased microvessel density and perfusion are typical features of acute inflammation and can be estimated with contrast-enhanced ultrasound (CEUS). The aim of the study was to investigate whether CEUS can provide prognostic information about patients treated medically for an acute exacerbation of CD. Methods: Fourteen patients with CD who received medical treatment for acute exacerbation with systemic steroids or tumor necrosis factor–? inhibitors were prospectively recruited. The patients were examined with clinical scoring, blood tests, and CEUS at time 0, 1, 3, and 12 months after initiation of the treatment. Outcome was treatment efficacy or treatment failure defined as change in medical treatment after 1 month or later. The perfusion analysis was performed with a commercially available software program that analyzes the contrast intensity in a selected area, fits the data to a standardized time-intensity curve, and derives several relative perfusion parameters. Results: Six of the 14 patients had treatment failure during the study period. There was a significant difference between the groups for peak contrast enhancement (P = 0.013), rate of wash-in (P = 0.020) and wash-out (P = 0.008), and the area under the time-intensity curve in the wash-in phase (0.013) at the examination 1 month after the start of treatment. Conclusions: Perfusion analysis of the intestinal wall with CEUS 1 month after starting treatment in patients with CD can provide prognostic information regarding treatment efficacy. PMID:25185684

  7. Ranking of physiotherapeutic evaluation methods as outcome measures of stifle functionality in dogs

    PubMed Central

    2013-01-01

    Background Various physiotherapeutic evaluation methods are used to assess the functionality of dogs with stifle problems. Neither validity nor sensitivity of these methods has been investigated. This study aimed to determine the most valid and sensitive physiotherapeutic evaluation methods for assessing functional capacity in hind limbs of dogs with stifle problems and to serve as a basis for developing an indexed test for these dogs. A group of 43 dogs with unilateral surgically treated cranial cruciate ligament deficiency and osteoarthritic findings was used to test different physiotherapeutic evaluation methods. Twenty-one healthy dogs served as the control group and were used to determine normal variation in static weight bearing and range of motion. The protocol consisted of 14 different evaluation methods: visual evaluation of lameness, visual evaluation of diagonal movement, visual evaluation of functional active range of motion and difference in thrust of hind limbs via functional tests (sit-to-move and lie-to-move), movement in stairs, evaluation of hind limb muscle atrophy, manual evaluation of hind limb static weight bearing, quantitative measurement of static weight bearing of hind limbs with bathroom scales, and passive range of motion of hind limb stifle (flexion and extension) and tarsal (flexion and extension) joints using a universal goniometer. The results were compared with those from an orthopaedic examination, force plate analysis, radiographic evaluation, and a conclusive assessment. Congruity of the methods was assessed with a combination of three statistical approaches (Fisher’s exact test and two differently calculated proportions of agreeing observations), and the components were ranked from best to worst. Sensitivities of all of the physiotherapeutic evaluation methods against each standard were calculated. Results Evaluation of asymmetry in a sitting and lying position, assessment of muscle atrophy, manual and measured static weight bearing, and measurement of stifle passive range of motion were the most valid and sensitive physiotherapeutic evaluation methods. Conclusions Ranking of the various physiotherapeutic evaluation methods was accomplished. Several of these methods can be considered valid and sensitive when examining the functionality of dogs with stifle problems. PMID:23566355

  8. Diabetes self-management education improves quality of care and clinical outcomes determined by a diabetes bundle measure

    PubMed Central

    Brunisholz, Kimberly D; Briot, Pascal; Hamilton, Sharon; Joy, Elizabeth A; Lomax, Michael; Barton, Nathan; Cunningham, Ruthann; Savitz, Lucy A; Cannon, Wayne

    2014-01-01

    Purpose The purpose of this study was to determine the impact of diabetes self-management education (DSME) in improving processes and outcomes of diabetes care as measured by a five component diabetes bundle and HbA1c, in individuals with type 2 diabetes mellitus (T2DM). Methods A retrospective analysis was performed for adult T2DM patients who received DSME training in 2011–2012 from an accredited American Diabetes Association center at Intermountain Healthcare (IH) and had an HbA1c measurement within the prior 3 months and 2–6 months after completing their first DSME visit. Control patients were selected from the same clinics as case-patients using random number generator to achieve a 1 to 4 ratio. Case and control patients were included if 1) pre-education HbA1c was between 6.0%–14.0%; 2) their main provider was a primary care physician; 3) they met the national Healthcare Effectiveness Data and Information Set criteria for inclusion in the IH diabetes registry. The IH diabetes bundle includes retinal eye exam, nephropathy screening or prescription of angiotensin converting enzyme or angiotensin receptor blocker; blood pressure <140/90 mmHg, LDL <100 mg/dL, HbA1c <8.0%. Results DSME patients had a significant difference in achievement of the five element IH diabetes bundle and in HbA1c % compared to those without DSME. After adjusting for possible confounders in a multivariate logistic regression model, DSME patients had a 1.5 fold difference in improvement in their diabetes bundle and almost a 3 fold decline in HbA1c compared to the control group. Conclusion Standardized DSME taught within an IH American Diabetes Association center is strongly associated with a substantial improvement in patients meeting all five elements of a diabetes bundle and a decline in HbA1c beyond usual care. Given the low operating cost of the DSME program, these results strongly support the value adding benefit of this program in treating T2DM patients. PMID:25473293

  9. Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims: draft guidance

    PubMed Central

    2006-01-01

    This guidance describes how the FDA evaluates patient-reported outcome (PRO) instruments used as effectiveness endpoints in clinical trials. It also describes our current thinking on how sponsors can develop and use study results measured by PRO instruments to support claims in approved product labeling (see appendix point 1). It does not address the use of PRO instruments for purposes beyond evaluation of claims made about a drug or medical product in its labeling. By explicitly addressing the review issues identified in this guidance, sponsors can increase the efficiency of their endpoint discussions with the FDA during the product development process, streamline the FDA's review of PRO endpoint adequacy, and provide optimal information about the patient's perspective of treatment benefit at the time of product approval. A PRO is a measurement of any aspect of a patient's health status that comes directly from the patient (i.e., without the interpretation of the patient's responses by a physician or anyone else). In clinical trials, a PRO instrument can be used to measure the impact of an intervention on one or more aspects of patients' health status, hereafter referred to as PRO concepts, ranging from the purely symptomatic (response of a headache) to more complex concepts (e.g., ability to carry out activities of daily living), to extremely complex concepts such as quality of life, which is widely understood to be a multidomain concept with physical, psychological, and social components. Data generated by a PRO instrument can provide evidence of a treatment benefit from the patient perspective. For this data to be meaningful, however, there should be evidence that the PRO instrument effectively measures the particular concept that is studied. Generally, findings measured by PRO instruments may be used to support claims in approved product labeling if the claims are derived from adequate and well-controlled investigations that use PRO instruments that reliably and validly measure the specific concepts at issue. The glossary defines many of the terms used in this guidance. In particular, the term instrument refers to the actual questions or items contained in a questionnaire or interview schedule along with all the additional information and documentation that supports the use of these items in producing a PRO measure (e.g., interviewer training and instructions, scoring and interpretation manual). The term conceptual framework refers to how items are grouped according to subconcepts or domains (e.g., the item walking without help may be grouped with another item, walking with difficulty, within the domain of ambulation, and ambulation may be further grouped into the concept of physical ability). FDA's guidance documents, including this guidance, do not establish legally enforceable responsibilities. Instead, guidance documents describe the Agency's current thinking on a topic and should be viewed only as recommendations, unless specific regulatory or statutory requirements are cited. The use of the word should in Agency guidance documents means that something is suggested or recommended but not required. First publication of the Draft Guidance by the Food and Drug Administration- February 2006. PMID:17034633

  10. Process-of-Care Measures as Predictors of Client Outcome Among a Methamphetamine-Dependent Sample at 12- and 36-Month Follow-ups

    PubMed Central

    Rawson, Richard A.; Gonzales, Rachel; Greenwell, Lisa; Chalk, Mady

    2014-01-01

    This study examines the utility of several process-of-care performance measures (initiation, engagement, retention, and monitoring of drug use during treatment) as predictors of methamphetamine (MA) use outcomes at 12- and 36-month follow-ups. MA-dependent individuals (n = 871) participated in a randomized, controlled trial of outpatient psychosocial treatment from 1999–2002 and completed 12- and 36-month follow-up interviews. This sample included a treatment-as-usual group (n = 436) and a 16-week Matrix treatment (n = 435) group. Significant associations were observed between select process-of-care measures and MA use outcomes at both follow-ups. While correlational analyses showed an association between MA abstinence at follow-up and enhanced treatment engagement and retention, mixed logistic regression analyses indicated that sustained abstinence from MA during outpatient treatment was the strongest predictor of testing negative for MA use at both follow-ups. Results suggest that monitoring client drug use during treatment may be a useful process-of-care measure with MA-dependent users. PMID:23210383

  11. The Incidence, Management, and Outcome of Penetrating Bladder Injuries in Civilians Resultant from Armed Conflict in Baghdad 2005-2006

    PubMed Central

    Petros, Firas G.; Santucci, Richard A.; Al-Saigh, Naimet K.

    2009-01-01

    The purpose of this paper is to review the diagnosis, treatment, and outcomes of penetrating bladder injuries suffered by civilians in the Iraqi war zone. Materials and Methods. All civilian trauma cases received alive at Al-Yarmouk Teaching Hospital from January 2005 to August 2006 were reviewed for the presence of bladder injury. Results. 533 cases of penetrating abdominal trauma were identified, of which 177 (33%) involved the genitourinary (GU) system and 64 (12%) involved the bladder. Most (70%) were young males, and most (55%) had grade IV injuries. Associated injuries occurred in 63/64 (98%) of patients. 3 patients had missed bladder injuries, and all of these had complications related to their missed injury. Bladder-related complications occurred in 11% of cases, and mortality in 13%, all due to extravesical injuries. Conclusions. Penetrating bladder injury among civilians in Baghdad war zone resulted in 64 cases in 18 months. The initial detection rate is very high (98%), and after primary repair, lasting complications are rare. Morbidities from missed injuries were severe hematuria and vesicorectal fistula. However, (3%) of vesicorectal fistulae healed spontaneously with prolonged bladder drainage. Associated injuries are the rule in penetrating bladder injury patients, and must be diligently investigated and treated. PMID:19360111

  12. The incidence, management, and outcome of penetrating bladder injuries in civilians resultant from armed conflict in Baghdad 2005-2006.

    PubMed

    Petros, Firas G; Santucci, Richard A; Al-Saigh, Naimet K

    2009-01-01

    The purpose of this paper is to review the diagnosis, treatment, and outcomes of penetrating bladder injuries suffered by civilians in the Iraqi war zone. Materials and Methods. All civilian trauma cases received alive at Al-Yarmouk Teaching Hospital from January 2005 to August 2006 were reviewed for the presence of bladder injury. Results. 533 cases of penetrating abdominal trauma were identified, of which 177 (33%) involved the genitourinary (GU) system and 64 (12%) involved the bladder. Most (70%) were young males, and most (55%) had grade IV injuries. Associated injuries occurred in 63/64 (98%) of patients. 3 patients had missed bladder injuries, and all of these had complications related to their missed injury. Bladder-related complications occurred in 11% of cases, and mortality in 13%, all due to extravesical injuries. Conclusions. Penetrating bladder injury among civilians in Baghdad war zone resulted in 64 cases in 18 months. The initial detection rate is very high (98%), and after primary repair, lasting complications are rare. Morbidities from missed injuries were severe hematuria and vesicorectal fistula. However, (3%) of vesicorectal fistulae healed spontaneously with prolonged bladder drainage. Associated injuries are the rule in penetrating bladder injury patients, and must be diligently investigated and treated. PMID:19360111

  13. Measurement results of DIPIX pixel sensor developed in SOI technology

    NASA Astrophysics Data System (ADS)

    Ahmed, Mohammed Imran; Arai, Yasuo; Idzik, Marek; Kapusta, Piotr; Miyoshi, Toshinobu; Turala, Michal

    2013-08-01

    The development of integration type pixel detectors presents interest for physics communities because it brings optimization of design, simplicity of production-which means smaller cost, and reduction of detector material budget. During the last decade a lot of research and development activities took place in the field of CMOS Silicon-On-Insulator (SOI) technology resulting in improvement in wafer size, wafer resistivity and MIM capacitance. Several ideas have been tested successfully and are gradually entering into the application phase. Some of the novel concepts exploring SOI technology are pursued at KEK; several prototypes of dual mode integration type pixel (DIPIX) have been recently produced and described. This report presents initial test results of some of the prototypes including tests obtained with the infrared laser beams and Americium (Am-241) source. The Equivalent Noise Charge (ENC) of 86 e - has been measured. The measured performance demonstrates that SOI technology is a feasible choice for future applications.

  14. ASIA impairment scale conversion in traumatic SCI: is it related with the ability to walk? A descriptive comparison with functional ambulation outcome measures in 273 patients

    Microsoft Academic Search

    J. J. van Middendorp; A. J. F. Hosman; M. H. Pouw; H. van de Meent; JJ van Middendorp

    2009-01-01

    Study design:Prospective multicenter longitudinal cohort study.Objectives:To determine the relationship between improvements of the American Spinal Injury Association\\/International Spinal Cord Society (ASIA\\/ISCoS) neurological standard scale (AIS) outcome measure and improvements of functional ambulatory outcome measures in patients with traumatic spinal cord injury (SCI).Setting:European multicenter study of human SCI (EM-SCI).Methods:In 273 eligible patients with traumatic SCI, acute (0–15 days) and chronic phase

  15. A 10-year review of quality improvement monitoring in pain management: Recommendations for standardized outcome measures

    Microsoft Academic Search

    Debra B. Gordon; Teresa A. Pellino; Christine Miaskowski; Jeanette Adams McNeill; Judith A. Paice; Daniel Laferriere; Marilyn Bookbinder

    2002-01-01

    Quality measurement in health care is complex and in a constant state of evolution. Different approaches are necessary depending on the purpose of the measurement (e.g., accountability, research, improvement). Recent changes in health care accreditation standards are driving increased attention to measurement of the quality of pain management for improvement purposes. The purpose of this article is to determine what

  16. Qualitative Development of a Patient-Reported Outcome Symptom Measure in Diarrhea-Predominant Irritable Bowel Syndrome

    PubMed Central

    Marquis, P; Lasch, K E; Delgado-Herrera, L; Kothari, S; Lembo, A; Lademacher, C; Spears, G; Nishida, A; Tesler, Waldman L; Piault, E; Rosa, K; Zeiher, B

    2014-01-01

    OBJECTIVES: Despite a documented clinical need, no patient reported outcome (PRO) symptom measure meeting current regulatory requirements for clinically relevant end points is available for the evaluation of treatment benefit in diarrhea-predominant IBS (IBS-D). METHODS: Patients (N=113) with IBS-D participated in five study phases: (1) eight concept elicitation focus groups (N=34), from which a 17-item IBS-D Daily Symptom Diary and four-item IBS-D Symptom Event Log (Diary and Event Log) were developed; (2) one-on-one cognitive interviews (N=11) to assess the instrument's comprehensiveness, understandability, appropriateness, and readability; (3) four data triangulation focus groups (N=32) to confirm the concepts elicited; (4) two hybrid (concept elicitation and cognitive interview) focus groups (N=16); and (5) two iterative sets of one-on-one cognitive interviews (N=20) to further clarify the symptoms of IBS-D and debrief a revised seven-item Diary and four-item Event Log. RESULTS: Of thirty-six concepts initially identified, 22 were excluded because they were not saturated, not clinically relevant, not critical symptoms of IBS-D, considered upper GI symptoms, or too broad or vaguely defined. The remaining concepts were diarrhea, immediate need (urgency), bloating/pressure, frequency of bowel movements, cramps, abdominal/stomach pain, gas, completely emptied bowels/incomplete evacuation, accidents, bubbling in intestines (bowel sounds), rectal burning, stool consistency, rectal spasm, and pain while wiping. The final instrument included a daily diary with separate items for abdominal and stomach pain and an event log with four items completed after each bowel movement as follows: (1) a record of the bowel movement/event and an assessment of (2) severity of immediacy of need/bowel urgency, (3) incomplete evacuation, and (4) stool consistency (evaluated using the newly developed Astellas Stool Form Scale). Based on rounds of interviews and clinical input, items considered secondary or nonspecific to IBS-D (rectal burning, bubbling in intestines, spasms, and pain while wiping) were excluded. CONCLUSIONS: The IBS-D Symptom Diary and Event Log represent a rigorously developed PRO instrument for the measurement of the IBS-D symptom experience from the perspective of the patient. Its content validity has been supported, and future work should evaluate the instrument's psychometric properties. PMID:24964994

  17. Objectively-assessed outcome measures: a translation and cross-cultural adaptation procedure applied to the Chedoke McMaster Arm and Hand Activity Inventory (CAHAI)

    PubMed Central

    2010-01-01

    Background Standardised translation and cross-cultural adaptation (TCCA) procedures are vital to describe language translation, cultural adaptation, and to evaluate quality factors of transformed outcome measures. No TCCA procedure for objectively-assessed outcome (OAO) measures exists. Furthermore, no official German version of the Canadian Chedoke Arm and Hand Activity Inventory (CAHAI) is available. Methods An eight-step for TCCA procedure for OAO was developed (TCCA-OAO) based on the existing TCCA procedure for patient-reported outcomes. The TCCA-OAO procedure was applied to develop a German version of the CAHAI (CAHAI-G). Inter-rater reliability of the CAHAI-G was determined through video rating of CAHAI-G. Validity evaluation of the CAHAI-G was assessed using the Chedoke-McMaster Stroke Assessment (CMSA). All ratings were performed by trained, independent raters. In a cross-sectional study, patients were tested within 31 hours after the initial CAHAI-G scoring, for their motor function level using the subscales for arm and hand of the CMSA. Inpatients and outpatients of the occupational therapy department who experienced a cerebrovascular accident or an intracerebral haemorrhage were included. Results Performance of 23 patients (mean age 69.4, SD 12.9; six females; mean time since stroke onset: 1.5 years, SD 2.5 years) have been assessed. A high inter-rater reliability was calculated with ICCs for 4 CAHAI-G versions (13, 9, 8, 7 items) ranging between r = 0.96 and r = 0.99 (p < 0.001). Correlation between the CAHAI-G and CMSA subscales for hand and arm was r = 0.74 (p < 0.001) and r = 0.67 (p < 0.001) respectively. Internal consistency of the CAHAI-G for all four versions ranged between ? = 0.974 and ? = 0.979. Conclusions The TCCA-OAO procedure was validated regarding its feasibility and applicability for objectively-assessed outcome measures. The resulting German CAHAI can be used as a valid and reliable assessment for bilateral upper limb performance in ADL in patients after stroke. PMID:21114807

  18. Results of ozone measurements in Northern Germany: A case study

    NASA Technical Reports Server (NTRS)

    Schmidt, Manfred

    1994-01-01

    At most of the German ozone recording stations which have records over a sufficiently long period, the results of the summer months of 1989 showed the highest values since the beginning of the measurements. One of the reasons for this phenomenon was the high duration of sunshine in that summer; for example, in Potsdam near Berlin in May 1989 the sunshine duration was the highest in May since the beginning of the records in 1893. For that reason we selected this summer for a case study. The basis for the study was mainly the ozone measuring stations of the network of Lower Saxony and the Federal Office of Environment (Umweltbundesamt). The results of these summer measurements point to intense sources of ozone, probably in form of gaseous precursors, in the Middle German industrial areas near Leipzig and Halle and in Northwestern Czechoslovakia, with coal-mining, chemical and petrochemical industries, coking plants and others. The maps of average ozone concentrations, number or days with high ozone maxima, ozone-windroses of the stations, etc., suggest that these areas could be a main source of precursors and of photochemical ozone production in summer smog episodes in Central Europe. Stations on the North Sea coast, at which early ozone measurements were made by our institute in 1973/74 are compared with similarly located stations of the Lower Saxon network in 1989 and the results show a reversal of the ozone-windroses. In 1973/74, the highest ozone concentrations were correlated with wind directions from the sea while in 1989 these concentrations were correlated with directions from the continent. In the recent years, photochemical ozone production on the continent is probably predominant, while in former years the higher ozone content of the maritime subpolar air masses has been explained by stratospheric-tropospheric exchange.

  19. Comparison of ablation stake measurements and Airborne Laser Scanning results

    NASA Astrophysics Data System (ADS)

    Rieg, Lorenzo; Galos, Stephan; Klug, Christoph; Sailer, Rudolf

    2014-05-01

    Ablation measurements using ablation stakes are a well-established method in glaciology, which sees a lot of use. However, ablation stakes cannot always be installed and read at a sufficient number of points on a glacier or on multiple glaciers, due to limited personnel and financial capacities or because of inaccessible areas due to dangerous zones (crevasses, rock falls, avalanches) or remote terrain. Furthermore, ablation stakes only enable measurements of surface melt, whereas basal or internal melt processes as well as surface change related to glacier dynamics cannot be measured. Multi temporal Airborne laser scanning (ALS) can provide high resolution and very accurate topographic information for the whole glacier area, which allows the calculation of the difference in surface height and therefore - if the density profile is known or can be estimated - the determination of the local mass balance, including processes like basal melt at least to a certain degree. To gain a better understanding of the differences between ablation stake readings and differential ALS data at the stake locations, the results of both methods have been compared in detail. At Langenferner, a glacier in the Italian Eastern Alps, where mass balance measurements have been carried out since 2004, three ALS campaigns have been conducted at the end of the hydrological year in 2005, 2010 and 2013. There are about 30 ablation stakes installed at the glacier, which have been read during or very close to the time of the flight campaigns. The ablation measurements are then compared to the surface differences calculated from ALS data at the locations of the ablation stakes. To take the movement of the stakes due to glacier dyanmics into account, the position of the stakes has been measured with a differential GPS.

  20. Outcomes from treatment of necrotizing soft-tissue infections: results from the National Surgical Quality Improvement Program database

    Microsoft Academic Search

    Megan K. Mills; Iris Faraklas; Cherisse Davis; Gregory J. Stoddard; Jeffrey Saffle

    2010-01-01

    BackgroundNecrotizing soft-tissue infections (NSTIs) are a group of uncommon, rapidly progressive, potentially fatal disorders. The National Surgical Quality Improvement Program (NSQIP) Registry was used to determine current data on the incidence, treatment, and outcomes of NSTIs.

  1. Electrical axes of TESLA-type cavities (Theoretical background, development of measurement equipment, measurement results)

    E-print Network

    - 1 - Electrical axes of TESLA-type cavities (Theoretical background, development of measurement equipment, measurement results) Anton Labanc, MHF-SL, DESY, January 2008 Abstract Cells in TESLA cavities. A short overview was already published at the TESLA Report 2007-01. This paper brings more details about

  2. Outcome of alloanergized haploidentical bone marrow transplantation after ex vivo costimulatory blockade: results of 2 phase 1 studies

    PubMed Central

    Davies, Jeff K.; Gribben, John G.; Brennan, Lisa L.; Yuk, Dongin; Nadler, Lee M.

    2008-01-01

    We report the outcomes of 24 patients with high-risk hematologic malignancies or bone marrow failure (BMF) who received haploidentical bone marrow transplantation (BMT) after ex vivo induction of alloantigen-specific anergy in donor T cells by allostimulation in the presence of costimulatory blockade. Ninety-five percent of evaluable patients engrafted and achieved full donor chimerism. Despite receiving a median T-cell dose of 29 ×106/kg, only 5 of 21 evaluable patients developed grade C (n = 4) or D (n = 1) acute graft-versus-host disease (GVHD), with only one attributable death. Twelve patients died from treatment-related mortality (TRM). Patients reconstituted T-cell subsets and immunoglobulin levels rapidly with evidence of in vivo expansion of pathogen-specific T cells in the early posttransplantation period. Five patients reactivated cytomegalovirus (CMV), only one of whom required extended antiviral treatment. No deaths were attributable to CMV or other viral infections. Only 1 of 12 evaluable patients developed chronic GVHD. Eight patients survive disease-free with normal performance scores (median follow-up, 7 years). Thus, despite significant early TRM, ex vivo alloanergization can support administration of large numbers of haploidentical donor T cells, resulting in rapid immune reconstitution with very few viral infections. Surviving patients have excellent performance status and a low rate of chronic GVHD. PMID:18617635

  3. Issues in defining and measuring veteran community reintegration: proceedings of the Working Group on Community Reintegration, VA Rehabilitation Outcomes Conference, Miami, Florida.

    PubMed

    Resnik, Linda; Bradford, Daniel W; Glynn, Shirley M; Jette, Alan M; Johnson Hernandez, Caitlin; Wills, Sharon

    2012-01-01

    In January 2010, the Department of Veterans Affairs (VA) Rehabilitation Research and Development Service convened a State of the Art (SOTA) conference to advance the field of outcome measurement for rehabilitation-related studies. This article reports on the proceedings of the SOTA Working Group on Community Reintegration. We explored the use of the International Classification of Health, Disability, and Functioning as a theoretical framework for measuring community reintegration; identified key dimensions of community reintegration that could and/or should be measured; discussed challenges in measuring community reintegration; suggested steps to enhance community reintegration measurement; proposed future research that focuses on outcomes measures for community reintegration and the study of community reintegration outcomes; and made policy recommendations that would facilitate community reintegration research within the VA. PMID:22492341

  4. Surgical versus Non-Operative Treatment for Lumbar Spinal Stenosis Four-Year Results of the Spine Patient Outcomes Research Trial (SPORT)

    PubMed Central

    Weinstein, James N.; Tosteson, Tor D.; Lurie, Jon D.; Tosteson, Anna; Blood, Emily; Herkowitz, Harry; Cammisa, Frank; Albert, Todd; Boden, Scott D.; Hilibrand, Alan; Goldberg, Harley; Berven, Sigurd; An, Howard

    2012-01-01

    Study Design Randomized trial and concurrent observational cohort study Objective To compare 4 year outcomes of surgery to non-operative care for spinal stenosis. Summary of Background Data Surgery for spinal stenosis has been shown to be more effective compared to non-operative treatment over two years, but longer-term data have not been analyzed. Methods Surgical candidates from 13 centers in 11 U.S. states with at least 12 weeks of symptoms and confirmatory imaging were enrolled in a randomized cohort (RC) or observational cohort (OC). Treatment was standard decompressive laminectomy or standard non-operative care. Primary outcomes were SF-36 bodily pain (BP) and physical function (PF) scales and the modified Oswestry Disability index (ODI) assessed at 6 weeks, 3 months, 6 months and yearly up to 4 years. Results 289 patients enrolled in the RC and 365 patients enrolled in the OC. An as-treated analysis combining the RC and OC and adjusting for potential confounders found that the clinically significant advantages for surgery previously reported were maintained through 4 years, with treatment effects (defined as mean change in surgery group minus mean change in non-op group) for BP 12.6 (95% CI, 8.5 to 16.7); PF 8.6 (95% CI, 4.6 to 12.6); and ODI ?9.4 (95% CI, ?12.6, to ?6.2). Early advantages for surgical treatment for secondary measures such as bothersomeness, satisfaction with symptoms and self-rated progress also were maintained. Conclusions Patients with symptomatic spinal stenosis treated surgically compared to those treated non-operatively maintain substantially greater improvement in pain and function through four years. PMID:20453723

  5. Development and results of a questionnaire to measure carer satisfaction after stroke

    Microsoft Academic Search

    P Pound; P Gompertz; S Ebrahim

    1993-01-01

    STUDY OBJECTIVE--To develop a carer satisfaction questionnaire for use as an outcome measure in stroke, to test the measure for reliability and validity, and to survey levels of carer satisfaction with services for stroke patients. DESIGN--Postal survey of carer satisfaction with stroke services was carried out using the questionnaire we developed and tested. Internal consistency was tested and construct validation

  6. Feasibility of Using the Patient-Reported Outcomes Measurement Information System in Academic Health Centers: Case Series Design on Pain Reduction After Chiropractic Care

    PubMed Central

    Burke, Jeanmarie R.

    2014-01-01

    Objective The purpose of this study was to test the utility of Patient-Reported Outcomes Measurement Information System (PROMIS) as a resource for collecting data on patient-reported outcomes (PRO) within academic health centers at a chiropractic college; and, to describe changes in PRO following pragmatic chiropractic care incorporating instrument-assisted soft tissue mobilization (IASTM) on pain symptoms. Methods This was a pre-post intervention design without a control group (case series) involving 25 patients (14 females and 11 males; 40.5 ± 16.39 years, range 20-70 years) who completed their chiropractic care and their baseline and post-treatment pain assessments. The pragmatic chiropractic care intervention included both spinal manipulation and IASTM to treat pain symptoms. PRO’s were collected using PROMIS to measure pain behavior, pain interference and pain intensity. Results The average pre-post assessment interval was 33 ± 22.5 days (95% CI, 23-42 days). The durations of treatments ranged from one week to 10 weeks. The median number of IASTM treatments was six. Pre-post decreases in T-scores for pain behavior and pain interference were 55.5 to 48.4 and 57.7 to 48.4, respectively (P < .05). Only 12 patients had a baseline T-score for pain intensity greater than 50. The pre-post decrease in pain intensity T-scores for these 12 patients was from 53.4 to 40.9. Conclusion Within the limitations of a case series design, these data provide initial evidence on the utility of PROMIS instruments for clinical and research outcomes in chiropractic patients. PMID:25225465

  7. EARLINET correlative measurements for CALIPSO: First intercomparison results

    NASA Astrophysics Data System (ADS)

    Pappalardo, Gelsomina; Wandinger, Ulla; Mona, Lucia; Hiebsch, Anja; Mattis, Ina; Amodeo, Aldo; Ansmann, Albert; Seifert, Patric; Linné, Holger; Apituley, Arnoud; Alados Arboledas, Lucas; Balis, Dimitris; Chaikovsky, Anatoli; D'Amico, Giuseppe; de Tomasi, Ferdinando; Freudenthaler, Volker; Giannakaki, Elina; Giunta, Aldo; Grigorov, Ivan; Iarlori, Marco; Madonna, Fabio; Mamouri, Rodanthi-Elizabeth; Nasti, Libera; Papayannis, Alexandros; Pietruczuk, Aleksander; Pujadas, Manuel; Rizi, Vincenzo; Rocadenbosch, Francesc; Russo, Felicita; Schnell, Franziska; Spinelli, Nicola; Wang, Xuan; Wiegner, Matthias

    2010-01-01

    A strategy for European Aerosol Research Lidar Network (EARLINET) correlative measurements for Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) has been developed. These EARLINET correlative measurements started in June 2006 and are still in progress. Up to now, more than 4500 correlative files are available in the EARLINET database. Independent extinction and backscatter measurements carried out at high-performance EARLINET stations have been used for a quantitative comparison with CALIPSO level 1 data. Results demonstrate the good performance of CALIPSO and the absence of evident biases in the CALIPSO raw signals. The agreement is also good for the distribution of the differences for the attenuated backscatter at 532 nm ((CALIPSO-EARLINET)/EARLINET (%)), calculated in the 1-10 km altitude range, with a mean relative difference of 4.6%, a standard deviation of 50%, and a median value of 0.6%. A major Saharan dust outbreak lasting from 26 to 31 May 2008 has been used as a case study for showing first results in terms of comparison with CALIPSO level 2 data. A statistical analysis of dust properties, in terms of intensive optical properties (lidar ratios, Ångström exponents, and color ratios), has been performed for this observational period. We obtained typical lidar ratios of the dust event of 49 ± 10 sr and 56 ± 7 sr at 355 and 532 nm, respectively. The extinction-related and backscatter-related Ångström exponents were on the order of 0.15-0.17, which corresponds to respective color ratios of 0.91-0.95. This dust event has been used to show the methodology used for the investigation of spatial and temporal representativeness of measurements with polar-orbiting satellites.

  8. Associations among Measures of Engagement with KP.Org and Clinical Outcomes

    ERIC Educational Resources Information Center

    Sobko, Heather J.

    2011-01-01

    Introduction. The purpose of this retrospective cohort study was to examine patterns of use of an electronic personal health record among adults diagnosed with diabetes, hypertension or hyperlipidemia. Intermediate behavioral measures (medication possession ratios) and physiological measures of metabolic control for diabetes (hemoglobinA1c),…

  9. Survival Outcomes in Resected Extrahepatic Cholangiocarcinoma: Effect of Adjuvant Radiotherapy in a Surveillance, Epidemiology, and End Results Analysis

    SciTech Connect

    Vern-Gross, Tamara Z. [Department of Radiation Oncology, Wake Forest University Baptist Medical Center, Winston-Salem, NC (United States); Shivnani, Anand T., E-mail: Anand.Shivnani@usoncology.com [Department of Radiation Oncology, Baylor-Irving Cancer Center, Irving, TX (United States); Chen, Ke [Department of Mathematical Sciences, University of Texas-Dallas, Richardson, TX (United States); Lee, Christopher M. [Department of Radiation Oncology, Cancer Care Northwest, Spokane, WA (United States); Tward, Jonathan D. [Department of Radiation Oncology, Huntsman Cancer Center, University of Utah, Salt Lake City, UT (United States); MacDonald, O. Kenneth [Department of Radiation Oncology, Mayo Clinic, Rochester, MN (United States); Crane, Christopher H. [Department of Radiation Oncology, M.D. Anderson Cancer Center, Houston, TX (United States); Talamonti, Mark S. [Department of Surgery, Northshore University Healthsystem, Evanston, IL (United States); Munoz, Louis L. [Department of Radiation Oncology, Texas Cancer Center at Medical City Dallas, Dallas, TX (United States); Small, William [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (United States)

    2011-09-01

    Purpose: The benefit of adjuvant radiotherapy (RT) after surgical resection for extrahepatic cholangiocarcinoma has not been clearly established. We analyzed survival outcomes of patients with resected extrahepatic cholangiocarcinoma and examined the effect of adjuvant RT. Methods and Materials: Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program between 1973 and 2003. The primary endpoint was the overall survival time. Cox regression analysis was used to perform univariate and multivariate analyses of the following clinical variables: age, year of diagnosis, histologic grade, localized (Stage T1-T2) vs. regional (Stage T3 or greater and/or node positive) stage, gender, race, and the use of adjuvant RT after surgical resection. Results: The records for 2,332 patients were obtained. Patients with previous malignancy, distant disease, incomplete or conflicting records, atypical histologic features, and those treated with preoperative/intraoperative RT were excluded. Of the remaining 1,491 patients eligible for analysis, 473 (32%) had undergone adjuvant RT. After a median follow-up of 27 months (among surviving patients), the median overall survival time for the entire cohort was 20 months. Patients with localized and regional disease had a median survival time of 33 and 18 months, respectively (p < .001). The addition of adjuvant RT was not associated with an improvement in overall or cause-specific survival for patients with local or regional disease. Conclusion: Patients with localized disease had significantly better overall survival than those with regional disease. Adjuvant RT was not associated with an improvement in long-term overall survival in patients with resected extrahepatic bile duct cancer. Key data, including margin status and the use of combined chemotherapy, was not available through the SEER database.

  10. Measuring interdisciplinary research and education outcomes in the Vienna Doctoral Programme on Water Resource Systems

    NASA Astrophysics Data System (ADS)

    Carr, Gemma; Loucks, Daniel Pete; Blaschke, Alfred Paul; Bucher, Christian; Farnleitner, Andreas; Fürnkranz-Prskawetz, Alexia; Parajka, Juraj; Pfeifer, Norbert; Rechberger, Helmut; Wagner, Wolfgang; Zessner, Matthias; Blöschl, Günter

    2015-04-01

    The interdisciplinary postgraduate research and education programme - the Vienna Doctoral Programme on Water Resource Systems - was initiated in 2009. To date, 35 research students, three post-docs and ten faculty members have been engaged in the Programme, from ten research fields (aquatic microbiology, hydrology, hydro-climatology, hydro-geology, mathematical economics, photogrammetry, remote sensing, resource management, structural mechanics, and water quality). The Programme aims to develop research students with the capacity to work across the disciplines, to conduct cutting edge research and foster an international perspective. To do this, a variety of mechanisms are adopted that include research cluster groups, joint study sites, joint supervision, a basic study programme and a research semester abroad. The Programme offers a unique case study to explore if and how these mechanisms lead to research and education outcomes. Outcomes are grouped according to whether they are tangible (publications with co-authors from more than one research field, analysis of graduate profiles and career destinations) or non-tangible (interaction between researchers, networks and trust). A mixed methods approach that includes bibliometric analysis combined with interviews with students is applied. Bibliometric analysis shows that as the Programme has evolved the amount of multi-disciplinary work has increased (32% of the 203 full papers produced by the programme's researchers have authors from more than one research field). Network analysis to explore which research fields collaborate most frequently show that hydrology plays a significant role and has collaborated with seven of the ten research fields. Hydrology researchers seem to interact the most strongly with other research fields as they contribute understanding on water system processes. Network analysis to explore which individuals collaborate shows that much joint work takes place through the five research cluster groups (water resource management, land-surface processes, Hydrological Open Air Laboratory, water and health, modelling and risk). Student interviews highlight that trust between colleagues and supervisors, and the role of spaces for interaction (joint study sites, cluster group meetings, shared offices etc.) are important for joint work. Graduate analysis shows that students develop skills and confidence to work across disciplines through collaborating on their doctoral research. Working collaboratively during the doctorate appears to be strongly correlated with continuing to work in this way after graduation.

  11. Data Collection Strategies and Measurement Tools for Assessing Academic and Therapeutic Outcomes in Recovery Schools

    PubMed Central

    Botzet, Andria M.; McIlvaine, Patrick W.; Winters, Ken C.; Fahnhorst, Tamara; Dittel, Christine

    2014-01-01

    Accurate evaluation and documentation of the efficacy of recovery schools can be vital to the continuation and expansion of these beneficial resources. A very limited data set currently exists that examines the value of specific schools established to support adolescents and young adults in recovery; additional research is necessary. The following article outlines the methodology utilized in a current quasi-experimental study evaluating both academic and therapeutic outcomes of adolescents attending recovery high schools as compared to traditional (non-recovery-based) high schools. The developmental considerations in assessing adolescents in recovery and their parents is delineated in this article, which underscores the need for extensive knowledge of adolescent substance abuse and other mental health issues. In addition, sensitivity around privacy among adolescents, parents, schools, and health providers is highlighted, as well as the validity of assessment. Key assessment strategies, including protocol of recruitment and interviewing techniques, are also presented along with a list of parent and adolescent assessment instruments and their corresponding interpretive variables. Protocol recommendations for future research are also outlined. PMID:25018573

  12. Standardization of outcome measures in clinical trials of pharmacological treatment for abdominal aortic aneurysm.

    PubMed

    Wang, Xing Li; Thompson, Matt M; Dole, William P; Dalman, Ronald L; Zalewski, Andrew

    2012-10-01

    An abdominal aortic aneurysm (AAA) is a common aortic wall disease with an increased prevalence in the elderly population (4-8% for those aged >65 years). Many AAAs are slow growing and remain insidious. Current standard of care for patients with small AAAs (<49 mm) is surveillance, with interventional therapy (open surgical repair or endovascular aneurysm repair) recommended for large (>50-55 mm), rapidly growing (>10 mm/year) or symptomatic AAAs. Although open surgical repair or endovascular aneurysm repair are effective, significant short- and long-term postoperative morbidity and mortality occurs. Currently, there is no pharmacological treatment specific for AAA; the need for the development of targeted pharmacological therapies based on clinically relevant and feasible outcomes acceptable to the medical community, regulatory agencies and third-party payers is high. A consensus on such end points will be critical to accelerating the development of pharmacological agents to prevent formation, arrest the expansion and reduce the rupture risk of AAA. PMID:23113642

  13. The impact of measuring patient-reported outcomes in clinical practice: a systematic review of the literature

    Microsoft Academic Search

    J. M. Valderas; A. Kotzeva; M. Espallargues; G. Guyatt; C. E. Ferrans; M. Y. Halyard; D. A. Revicki; T. Symonds; A. Parada; J. Alonso

    2008-01-01

    Objective  The purpose of this paper is to summarize the best evidence regarding the impact of providing patient-reported outcomes (PRO)\\u000a information to health care professionals in daily clinical practice.\\u000a \\u000a \\u000a \\u000a Methods  Systematic review of randomized clinical trials (Medline, Cochrane Library; reference lists of previous systematic reviews;\\u000a and requests to authors and experts in the field).\\u000a \\u000a \\u000a \\u000a Results  Out of 1,861 identified references published between 1978

  14. Recent Results of TMD Measurements from Jefferson Lab Hall A

    SciTech Connect

    Jiang, Xiaodong [LANL

    2013-10-01

    This slide-show presents results on transverse momentum distributions. The presentation covers: target single-spin asymmetry (SSA) (in parity conserving interactions); • Results of JLab Hall A polarized {sup 3}He target TMD measurement; • Semi-­?inclusive deep-inelastic scattering channels (E06-010); • Target single-spin asymmetry A{sub UT}, Collins and Sivers SSA on neutron; • Double-spin asymmetry A{sub LT}, extract TMD g{sub 1T} on neutron; • Inclusive channels SSA (E06-010, E05-015, E07-013) • Target SSA: inclusive {sup 3}He(e,e’) quasi-elastic scattering; • Target SSA: inclusive {sup 3}He(e,e’) deep inelastic-elastic scattering; • New SIDIS experiments planned in Hall-A for JLab-12 GeV.

  15. Relationship between midweek training measures of testosterone and cortisol concentrations and game outcome in professional rugby union matches.

    PubMed

    Gaviglio, Christopher M; Cook, Christian J

    2014-12-01

    The aim of this study was to assess the response of salivary-free testosterone and cortisol concentrations across selected midweek skill-based training sessions and their association with subsequent match outcome 3 days later. Twenty-two rugby union players were assessed for salivary-free testosterone and cortisol concentrations before and after a midweek training session over 6 consecutive weeks. The relative percentage change (response) in the testosterone and cortisol concentration and the testosterone to cortisol (T/C) ratio was also determined. Game-day analysis consisted of prematch testosterone concentrations and match outcome. Data were pooled across the winning (n = 3) and losing (n = 3) outcomes. The midweek pretraining T/C ratio was significantly lower (p < 0.01) before a win than a loss and the increase in the pre- to post-T/C ratio before a win was significant (p < 0.001). The increase in the pre- to post-testosterone concentration before a win was also shown to be significant (p < 0.01). However, the relative changes in testosterone before games that were won were not statistically different to that of games lost (p > 0.01). Significant relationships were also demonstrated between game-day pre-testosterone concentrations and the midweek cortisol response (r = -0.90, p = 0.01) and midweek T/C ratio response (r = 0.90, p = 0.01). In conclusion, a midweek measurement of the T/C ratio against a skill-based training session seems to show some potential as an early indicator of subsequent successfully executed performances in competitive rugby union. If this work is subsequently validated, further monitoring of midweek hormone concentrations in response to a mixed psychological-physical training session may assist with assessing competitive readiness leading up to competition. PMID:24936894

  16. LDEF: Dosimetric measurement results (AO 138-7 experiment)

    NASA Technical Reports Server (NTRS)

    Bourrieau, J.

    1992-01-01

    One of the objectives of the AO 138-7 experiment on board the LDEF was a total dose measurement with Thermo Luminescent Detectors (TLD 100). Two identical cases, both including 5 TLDs inside various aluminum shields, are exposed to the space environment in order to obtain the absorbed dose profile induced. Radiation fluence received during the total mission length was computed, taking into account the trapped particles (solar maximum and solar minimum periods) and the cosmic rays; due to the magnetospheric shielding, the solar proton fluences are negligible on the LDEF orbit. The total dose induced by these radiations inside a semi-infinite plane shield of Al are computed with radiation transport codes. TLD reading are performed after flight; due to the mission duration increase, a post-flight calibration was necessary in order to cover the range of the flight induced dose. The results obtained, similar (+ or - 30 pct.) in both cases, are compared with the dose profile computation. In practice, these LDEF results, with less than a factor 1.4 between measurements and forecasts, reinforce the validity of the computation methods and models used for the long term evaluation of space radiation intensity on low inclination Earth orbits.

  17. Fan Noise Source Diagnostic Test: LDV Measured Flow Field Results

    NASA Technical Reports Server (NTRS)

    Podboy, Gary C.; Krupar, Martin J.; Hughes, Christopher E.; Woodward, Richard P.

    2003-01-01

    Results are presented of an experiment conducted to investigate potential sources of noise in the flow developed by two 22-in. diameter turbofan models. The R4 and M5 rotors that were tested were designed to operate at nominal take-off speeds of 12,657 and 14,064 RPMC, respectively. Both fans were tested with a common set of swept stators installed downstream of the rotors. Detailed measurements of the flows generated by the two were made using a laser Doppler velocimeter system. The wake flows generated by the two rotors are illustrated through a series of contour plots. These show that the two wake flows are quite different, especially in the tip region. These data are used to explain some of the differences in the rotor/stator interaction noise generated by the two fan stages. In addition to these wake data, measurements were also made in the R4 rotor blade passages. These results illustrate the tip flow development within the blade passages, its migration downstream, and (at high rotor speeds) its merging with the blade wake of the adjacent (following) blade. Data also depict the variation of this tip flow with tip clearance. Data obtained within the rotor blade passages at high rotational speeds illustrate the variation of the mean shock position across the different blade passages.

  18. Clinical Outcome after the Use of a New Craniocaudal Expandable Implant for Vertebral Compression Fracture Treatment: One Year Results from a Prospective Multicentric Study

    PubMed Central

    Noriega, David; Krüger, Antonio; Ardura, Francisco; Hansen-Algenstaedt, Nils; Hassel, Frank; Barreau, Xavier; Beyerlein, Jörg

    2015-01-01

    The purpose of this prospective multicentric observational study was to confirm the safety and clinical performance of a craniocaudal expandable implant used in combination with high viscosity PMMA bone cement for the treatment of vertebral compression fractures. Thirty-nine VCFs in 32 patients were treated using the SpineJack minimally invasive surgery protocol. Outcome was determined by using the Visual Analogue Scale for measuring pain, the Oswestry Disability Index for scoring functional capacity, and the self-reporting European Quality of Life scores for the quality of life. Safety was evaluated by reporting all adverse events. The occurrence of cement leakages was assessed by either radiographs or CT scan or both. Statistically significant improvements were found regarding pain, function, and quality of life. The global pain score reduction at 1 year was 80.9% compared to the preoperative situation and the result of the Oswestry Disability Index showed a decrease from 65.0% at baseline to 10.5% at 12 months postoperatively. The cement leakage rate was 30.8%. No device- or surgery-related complications were found. This observational study demonstrates promising and persistent results consisting of immediate and sustained pain relief and durable clinical improvement after the procedure and throughout the 1-year follow-up period. PMID:25667929

  19. Astronaut Preflight Cardiovascular Variables Associated with Vascular Compliance are Highly Correlated with Post-Flight Eye Outcome Measures in the Visual Impairment Intracranial Pressure (VIIP) Syndrome Following Long Duration Spaceflight

    NASA Technical Reports Server (NTRS)

    Otto, Christian; Ploutz-Snyder, R.

    2015-01-01

    The detection of the first VIIP case occurred in 2005, and adequate eye outcome measures were available for 31 (67.4%) of the 46 long duration US crewmembers who had flown on the ISS since its first crewed mission in 2000. Therefore, this analysis is limited to a subgroup (22 males and 9 females). A "cardiovascular profile" for each astronaut was compiled by examining twelve individual parameters; eleven of these were preflight variables: systolic blood pressure, pulse pressure, body mass index, percentage body fat, LDL, HDL, triglycerides, use of anti-lipid medication, fasting serum glucose, and maximal oxygen uptake in ml/kg. Each of these variables was averaged across three preflight annual physical exams. Astronaut age prior to the long duration mission, and inflight salt intake was also included in the analysis. The group of cardiovascular variables for each crew member was compared with seven VIIP eye outcome variables collected during the immediate post-flight period: anterior-posterior axial length of the globe measured by ultrasound and optical biometry; optic nerve sheath diameter, optic nerve diameter, and optic nerve to sheath ratio- each measured by ultrasound and magnetic resonance imaging (MRI), intraocular pressure (IOP), change in manifest refraction, mean retinal nerve fiber layer (RNFL) on optical coherence tomography (OCT), and RNFL of the inferior and superior retinal quadrants. Since most of the VIIP eye outcome measures were added sequentially beginning in 2005, as knowledge of the syndrome improved, data were unavailable for 22.0% of the outcome measurements. To address the missing data, we employed multivariate multiple imputation techniques with predictive mean matching methods to accumulate 200 separate imputed datasets for analysis. We were able to impute data for the 22.0% of missing VIIP eye outcomes. We then applied Rubin's rules for collapsing the statistical results across our 200 multiply imputed data sets to assess the canonical correlation between the eye outcomes and the twelve astronaut cardiovascular variables available for all 31 subjects. Results: A highly significant canonical correlation was observed among the canonical solutions (p<.00001), with an average best canonical correlation of.97. The results suggest a strong association between astronauts' measures of cardiovascular health and the seven eye outcomes of the VIIP syndrome used in this analysis. Furthermore, the "joint test" revealed a significant difference in cardiovascular profile between male and female astronauts (Prob > F = 0.00001). Overall, female astronauts demonstrated a significantly healthier cardiovascular status. Individually, the female astronauts had significantly healthier profiles on seven of twelve cardiovascular variables than the men (p values ranging from <0.0001 to <0.05). Male astronauts did not demonstrate significantly healthier values on any of the twelve cardiovascular variables measured

  20. Four converging measures of temporal discounting and their relationships with intelligence, executive functions, thinking dispositions, and behavioral outcomes

    PubMed Central

    Basile, Alexandra G.; Toplak, Maggie E.

    2015-01-01

    Temporal discounting is the tendency to devalue temporally distant rewards. Past studies have examined the k-value, the indifference point, and the area under the curve as dependent measures on this task. The current study included these three measures and a fourth measure, called the interest rate total score, which differentiated good from poor choices. The interest rate total score was based on scoring only those items in which the delayed choice should be preferred given the expected return based on simple interest rates. In addition, associations with several individual difference measures were examined including intelligence, executive functions (inhibition, working memory, and set-shifting), thinking dispositions [Need for Cognition and Consideration of Future Consequences (CFCs)] and engagement in substance use and gambling behavior. A staircase temporal discounting task was examined in a sample of 99 university students. Replicating previous studies, temporal discounting increased with longer delays to reward and decreased with higher reward magnitudes. A hyperbolic function accounted for more variance in temporal discounting than an exponential function. Reaction time at the indifference point was significantly longer than at the other choice points. The four dependent measures of temporal discounting were all significantly correlated and were also significantly associated with our individual difference measures. That is, the tendency to wait for a larger delayed reward on all of the temporal discounting measures was associated with higher intelligence, higher executive functions, and more CFCs. Associations between our measures of temporal discounting and outcomes related to substance use and gambling behavior were modest in our university sample. PMID:26097462

  1. Four converging measures of temporal discounting and their relationships with intelligence, executive functions, thinking dispositions, and behavioral outcomes.

    PubMed

    Basile, Alexandra G; Toplak, Maggie E

    2015-01-01

    Temporal discounting is the tendency to devalue temporally distant rewards. Past studies have examined the k-value, the indifference point, and the area under the curve as dependent measures on this task. The current study included these three measures and a fourth measure, called the interest rate total score, which differentiated good from poor choices. The interest rate total score was based on scoring only those items in which the delayed choice should be preferred given the expected return based on simple interest rates. In addition, associations with several individual difference measures were examined including intelligence, executive functions (inhibition, working memory, and set-shifting), thinking dispositions [Need for Cognition and Consideration of Future Consequences (CFCs)] and engagement in substance use and gambling behavior. A staircase temporal discounting task was examined in a sample of 99 university students. Replicating previous studies, temporal discounting increased with longer delays to reward and decreased with higher reward magnitudes. A hyperbolic function accounted for more variance in temporal discounting than an exponential function. Reaction time at the indifference point was significantly longer than at the other choice points. The four dependent measures of temporal discounting were all significantly correlated and were also significantly associated with our individual difference measures. That is, the tendency to wait for a larger delayed reward on all of the temporal discounting measures was associated with higher intelligence, higher executive functions, and more CFCs. Associations between our measures of temporal discounting and outcomes related to substance use and gambling behavior were modest in our university sample. PMID:26097462

  2. Evaluation of the sample needed to accurately estimate outcome-based measurements of dairy welfare on farm.

    PubMed

    Endres, M I; Lobeck-Luchterhand, K M; Espejo, L A; Tucker, C B

    2014-06-01

    Dairy welfare assessment programs are becoming more common on US farms. Outcome-based measurements, such as locomotion, hock lesion, hygiene, and body condition scores (BCS), are included in these assessments. The objective of the current study was to investigate the proportion of cows in the pen or subsamples of pens on a farm needed to provide an accurate estimate of the previously mentioned measurements. In experiment 1, we evaluated cows in 52 high pens (50 farms) for lameness using a 1- to 5-scale locomotion scoring system (1 = normal and 5 = severely lame; 24.4 and 6% of animals were scored ? 3 or ? 4, respectively). Cows were also given a BCS using a 1- to 5-scale, where 1 = emaciated and 5 = obese; cows were rarely thin (BCS ? 2; 0.10% of cows) or fat (BCS ? 4; 0.11% of cows). Hygiene scores were assessed on a 1- to 5-scale with 1 = clean and 5 = severely dirty; 54.9% of cows had a hygiene score ? 3. Hock injuries were classified as 1 = no lesion, 2 = mild lesion, and 3 = severe lesion; 10.6% of cows had a score of 3. Subsets of data were created with 10 replicates of random sampling that represented 100, 90, 80, 70, 60, 50, 40, 30, 20, 15, 10, 5, and 3% of the cows measured/pen. In experiment 2, we scored the same outcome measures on all cows in lactating pens from 12 farms and evaluated using pen subsamples: high; high and fresh; high, fresh, and hospital; and high, low, and hospital. For both experiments, the association between the estimates derived from all subsamples and entire pen (experiment 1) or herd (experiment 2) prevalence was evaluated using linear regression. To be considered a good estimate, 3 criteria must be met: R(2)>0.9, slope = 1, and intercept = 0. In experiment 1, on average, recording 15% of the pen represented the percentage of clinically lame cows (score ? 3), whereas 30% needed to be measured to estimate severe lameness (score ? 4). Only 15% of the pen was needed to estimate the percentage of the herd with a hygiene score ? 3, whereas 30% to estimate the prevalence of severe hock lesions. Estimating very thin and fat cows required that 70 to 80% of the pen be measured. In experiment 2, none of the pen subsamples met our criteria for accurate estimates of herd prevalence. In conclusion, we found that both a higher percentage of the pen must be sampled to generate accurate values for relatively rare parameters and that the population measured plays an important role in prevalence estimates. PMID:24657083

  3. Outcomes Following Iodine-125 Monotherapy for Localized Prostate Cancer: The Results of Leeds 10-Year Single-Center Brachytherapy Experience

    SciTech Connect

    Henry, Ann M., E-mail: Ann.Henry@leedsth.nhs.u [Department of Clinical Oncology, St. James's Institute of Oncology, St. James's University Hospital, Leeds (United Kingdom); Al-Qaisieh, Bashar [Department of Medical Physics, St. James's Institute of Oncology, St. James's University Hospital, Leeds (United Kingdom); Gould, Kathy [Department of Clinical Oncology, St. James's Institute of Oncology, St. James's University Hospital, Leeds (United Kingdom); Bownes, Peter [Department of Medical Physics, St. James's Institute of Oncology, St. James's University Hospital, Leeds (United Kingdom); Smith, Jonathan; Carey, Brendan [Department of Clinical Radiology, St. James's Institute of Oncology, St. James's University Hospital, Leeds (United Kingdom); Bottomley, David; Ash, Dan [Department of Clinical Oncology, St. James's Institute of Oncology, St. James's University Hospital, Leeds (United Kingdom)

    2010-01-15

    Purpose: This study reports the 10-year experience of permanent brachytherapy monotherapy at a single UK center. Methods and Materials: Between March 1995 and September 2004, 1,298 patients underwent trans-rectal ultrasound (TRUS) planned transperineal brachytherapy delivering 145 Gy using I-125. No patient received supplemental external beam; 44.2% received neoadjuvant hormones. In 688, CT postimplant dosimetry was available. Outcome data were analyzed in terms of overall survival (OS), disease specific survival (DSS), and PSA relapse-free survival (PSA-RFS). Results: The mean age was 62.9 (range, 34-83) years. Median follow-up was 4.9 years (range, 2.03-11.7 years). OS and DSS were 85% and 95%, respectively, at 10 years. Twenty-one patients died from prostate cancer (1.6%) and 34 (2.5%) from unrelated causes. Seventy-four (5.7%) developed evidence of clinical failure. Overall PSA-RFS was 79.9% and 72.1% at 10 years (American Society for Therapeutic Radiology and Oncology [ASTRO] and Nadir+2 definitions, respectively). Higher presenting PSA or Gleason score and use of neoadjuvant hormones were associated with an increased risk of biochemical failure (p <0.01). Biochemical control was achieved in 86.4%, 76.7%, and 60.6% (ASTRO) and 72.3%, 73.5%, and 57.6% (Nadir+2) of patients in low-, intermediate-, and high-risk groups, respectively. Biochemical control was achieved in 88% of patients with D{sub 90} >=140 Gy and in 78% of patients with D{sub 90} <140 Gy (p <0.01). Conclusions: I-125 brachytherapy alone achieved excellent rates of medium-term biochemical control in both low- and selected intermediate-risk localized prostate cancer patients. Postimplant dosimetry improved with experience and longer follow-up, confirming the relationship of D{sub 90} with biochemical control.

  4. The hyperglycemia and adverse pregnancy outcome (HAPO) study: can we use the results as a basis for change?

    PubMed

    Coustan, Donald R; Lowe, Lynn P; Metzger, Boyd E

    2010-03-01

    At present the diagnosis of gestational diabetes uses differing criteria in different parts of the world, with none being based on pregnancy outcome. Different glucose loads (50, 75 or 100 grams) are recommended, rather than the standard 75 gram load utilized worldwide in nonpregnant individuals. The HAPO study was designed to determine what level of glucose intolerance, short of diabetes, is associated with an excess of adverse perinatal outcomes. On a 75 gram, 2-hour OGTT each of the 3 values is significantly and continuously related to various adverse outcomes, and no inflection point is evident. Consequently an international group of interested experts is developing recommendations for diagnostic criteria for GDM which, it is hoped, will be adopted world wide. PMID:20059445

  5. Ultrasound-guided Interdigital Neuroma Injections: Short-term Clinical Outcomes after a Single Percutaneous Injection—Preliminary Results

    Microsoft Academic Search

    Carolyn M. Sofka; Ronald S. Adler; Gina A. Ciavarra; Helene Pavlov

    2007-01-01

    Purpose  To describe the procedure of ultrasound-guided Morton’s neuroma and recurrent stump neuroma injections and early clinical\\u000a outcomes after a single injection.\\u000a \\u000a \\u000a \\u000a Materials and Methods  Retrospective review of 44 percutaneous ultrasound-guided neuroma injections in 24 patients who had completed clinical outcomes\\u000a questionnaires. A 10-point pain scale [scale of 1 (no pain) to 10 (severe pain)] in a 7-day pain log format was

  6. Revised Tumor and Node Categorization for Rectal Cancer Based on Surveillance, Epidemiology, and End Results and Rectal Pooled Analysis Outcomes

    PubMed Central

    Gunderson, Leonard L.; Jessup, John Milburn; Sargent, Daniel J.; Greene, Frederick L.; Stewart, Andrew

    2010-01-01

    Purpose The sixth edition of the American Joint Committee on Cancer (AJCC) rectal cancer staging subdivided stage II into IIA (T3N0) and IIB (T4N0) and stage III into IIIA (T1-2N1M0), IIIB (T3-4N1M0), and IIIC (anyTN2M0). Subsequent analyses supported revised substaging of stage III as a result of improved survival with T1-2N2 versus T3-4N2 and survival of T4N1 more similar to T3-4N2 than T3N1. The AJCC Hindgut Taskforce sought population-based validation that depth of invasion interacts with nodal status to affect survival. Methods Surveillance, Epidemiology, and End Results (SEER) population-based data from January 1992 to December 2004 for 35,829 patients with rectal cancer were compared with rectal pooled analysis data (3,791 patients). T4N0 cancers were stratified by tumors that perforate visceral peritoneum (T4a) versus tumors that invade or are adherent to adjacent organs or structures (T4b). N1 and N2 were stratified by number of positive nodes as follows: N1a/N1b (one v two to three nodes) and N2a/N2b (four to six v ? seven nodes). Five-year observed and relative survival rates were obtained for each TN category. Results SEER rectal cancer analyses confirm that T1-2N2 cancers have better prognosis than T3-4N2, T4bN1 have similar prognosis to T4N2, T1-2N1 have similar prognosis to T2N0/T3N0, and T1-2N2a have similar prognosis to T2N0/T3N0 (T1N2a) or T4aN0 (T2N2a). Prognosis for T4a lesions is better than T4b by N category. The number of positive nodes affects prognosis. Conclusion This SEER population-based rectal cancer analysis validates the rectal pooled analyses and supports the shift of T1-2N2 lesions from IIIC to IIIA or IIIB and T4bN1 from IIIB to IIIC. SEER outcomes support subdividing T4, N1, and N2 and revised substaging of stages II and III. Survival by TN category suggests a complex biologic interaction between depth of invasion and nodal status. PMID:19949015

  7. LDEF: Dosimetric measurement results (AO 138-7 experiment)

    NASA Technical Reports Server (NTRS)

    Bourrieau, J.

    1993-01-01

    One of the objectives of the AO 138-7 experiment on board the Long Duration Exposure Facility (LDEF) was a total dose measurement with Thermo Luminescent Detectors (TLD 100). Two identical packages, both of them including five TLD's inside various aluminum shields, are exposed to the space environment in order to obtain the absorbed dose profile. Radiation fluence received during the total mission length was computed, taking into account the trapped particles (AE8 and AP8 models during solar maximum and minimum periods) and the cosmic rays; due to the magnetospheric shielding the solar proton fluences are negligible on the LDEF orbit. The total dose induced by these radiations inside a semi infinite plane shield of aluminum are computed with the radiation transport codes available at DERTS. The dose profile obtained is in good agreement with the evaluation by E.V. Benton. TLD readings are performed after flight; due to the mission duration increase a post flight calibration was necessary in order to cover the range of the in flight induced dose. The results obtained, similar (plus or minus 30 percent) for both packages, are compared with the dose profile computation. For thick shields it seems that the measurements exceed the forecast (about 40 percent). That can be due to a cosmic ray and trapped proton contributions coming from the backside (assumed as perfectly shielded by the LDEF structure in the computation), or to an underestimate of the proton or cosmic ray fluences. A fine structural shielding analysis should be necessary in order to determine the origin of this slight discrepancy between forecast and in flight measurements. For the less shielded dosimeters, mainly exposed to the trapped electron flux, a slight overestimation of the dose (less than 40 percent) appears. Due to the dispersion of the TLD's response, this cannot be confirmed. In practice these results obtained on board LDEF, with less than a factor 1.4 between measurements and forecast, reinforce the validity of the computation methods and models used for the long term evaluation of the radiation levels (flux and dose) encountered in space on low inclination and altitude Earth orbits.

  8. A two-stage estimation of hospital quality of care using mortality outcome measures: An application using Victorian hospital Data

    Microsoft Academic Search

    C. l. Chua; Alfons Palangkaraya; Jongsay Yong

    Abstract Inferring hospital quality of care using mortality outcomes: An empirical approach using Victorian Hospital Data We propose a method,of deriving a quality indicator for hospitals using mortality outcome

  9. Using a Brief Parent-Report Measure to Track Outcomes for Children and Teens with Internalizing Disorders.

    PubMed

    Kamin, Hayley S; McCarthy, Alyssa E; Abel, Madelaine R; Jellinek, Michael S; Baer, Lee; Murphy, J Michael

    2014-12-01

    The Pediatric Symptom Checklist (PSC) is a widely-used, parent-completed measure of children's emotional and behavioral functioning. Previous research has shown that the PSC and its subscales are generally responsive to patient progress over the course of psychiatric treatment. In this naturalistic study, we examined the performance and utility of the five-item PSC Internalizing Subscale (PSC-IS) as an assessment of routine treatment in outpatient pediatric psychiatry. Parents and clinicians of 1,593 patients aged 17 or younger completed standardized measures at intake and three-month follow-up appointments. Comparisons between PSC-IS scores and clinician-reported diagnoses, internalizing symptoms, and overall functioning showed acceptable levels of agreement. Change scores on the PSC-IS were also larger among patients with internalizing diagnoses than those with non-internalizing diagnoses. As a brief measure of internalizing symptoms, the PSC may be particularly useful to mental health clinicians treating youth with depression and anxiety as a quality assurance or treatment outcome measure. PMID:25476666

  10. Further Evidence of the Utility and Validity of a Measure of Outcome for Children and Adolescents

    ERIC Educational Resources Information Center

    Turchik, Jessica A.; Karpenko, Veronika; Ogles, Benjamin M.

    2007-01-01

    The "Ohio Youth Problems, Functioning, and Satisfaction Scales" (Ohio Scales) are a recently developed set of measures designed to be a brief, practical assessment of changes in behavior over time in children and adolescents. The authors explored the convergent validity of the Ohio Scales by examining the relationship between the scales and…

  11. Real Impact Solutions for Better Measurement and Improved Outcomes Microsoft Dynamics AX 2012 for

    E-print Network

    Bernstein, Phil

    their mission with a powerful enterprise resource planning (ERP) solution purposely built for better measurement and faculty, keeping pace with institutional policy changes, planning carefully, and effectively delivering. The powerful Microsoft Dynamics AX 2012 solution helps you manage finances, procurement, HR, funds, endowments

  12. Neurocognitive Deficits and Functional Outcome in Schizophrenia: Are We Measuring the “Right Stuff”?

    Microsoft Academic Search

    Michael Foster Green; Robert S. Kern; David L. Braff; Jim Mintz

    2000-01-01

    There has been a surge of interest in the functional consequences of neurocognitive deficits in schizophrenia. The published literature in this area has doubled in the last few years. In this paper, we will attempt to confirm the conclusions from a previous review that certain neurocognitive domains (secondary verbal memory, immediate memory, executive functioning as measured by card sorting, and

  13. Measuring a broad spectrum of clinically relevant outcomes after experimental spinal cord injury

    Microsoft Academic Search

    Jacqueline C. Bresnahan; Yvette S. Nout

    Measuring recovery of function after central nervous system injury is an important aspect of experimental models of brain and spinal cord injury. Our laboratory has been focused on developing models, especially for spinal cord injury, for many years. The purpose of the models is to mimic the neurological condition in humans and to provide a test ground for evaluating treatments

  14. Accuracy of the DIBELS Oral Reading Fluency Measure for Predicting Third Grade Reading Comprehension Outcomes

    ERIC Educational Resources Information Center

    Roehrig, Alysia D.; Petscher, Yaacov; Nettles, Stephen M.; Hudson, Roxanne F.; Torgesen, Joseph K.

    2008-01-01

    We evaluated the validity of DIBELS ("Dynamic Indicators of Basic Early Literacy Skills") ORF ("Oral Reading Fluency") for predicting performance on the "Florida Comprehensive Assessment Test" (FCAT-SSS) and "Stanford Achievement Test" (SAT-10) reading comprehension measures. The usefulness of previously established ORF risk-level cutoffs [Good,…

  15. Computer-Based Collaborative Knowledge Mapping To Measure Team Processes and Team Outcomes.

    ERIC Educational Resources Information Center

    O'Neil, Harold F., Jr.; Chung, Gregory K. W. K.; Herl, Howard E.

    The feasibility and validity of using a computer-based networked collaborative knowledge mapping system to measure teamwork skills was examined. Student groups (10 groups of 3 ninth graders each) were assessed with the system twice in the academic year, once in the fall and once the following spring. The study focused on the nature of the…

  16. What is the most relevant standard of success in assisted reproduction?: no single outcome measure is satisfactory when evaluating success in assisted reproduction; both twin births and singleton births should be counted as successes.

    PubMed

    Dickey, Richard P; Sartor, Belinda M; Pyrzak, Roman

    2004-04-01

    The 2002 recommendation of the consensus meeting of the European Society of Human Reproduction and Embryology (ESHRE) that the outcome measure of assisted reproductive technology (ART) and non-ART should be 'singleton live birth rate' could profoundly effect the ability of infertility patients to become pregnant. We reviewed published reports and new data concerning elective single embryo transfer (eSET) vs. double embryo transfer (DET) and the outcome of twin pregnancies in the United States, as well as recommendations of other Societies concerning number of embryos to transfer and methods used to measure ART success. We found that no single outcome measure of ART is ideal. Mandatory eSET would result in 42%-70% fewer births compared to DET. Infertility treatments account for only 12% of all twin pregnancies and 4% of all premature births in the United States. Twin and singleton births due to ART do not occur earlier than spontaneously conceived twins and singletons unless they started as triplet and higher order pregnancies. Multiple outcome measures are necessary when evaluating ART success. Twin as well as singleton births should be counted as ART successes. The essential aim of infertility treatment should be a healthy low order (singleton or twin) birth. PMID:15016781

  17. A computer-based measure of resultant achievement motivation.

    PubMed

    Blankenship, V

    1987-08-01

    Three experiments were conducted to develop a computer-based measure of individual differences in resultant achievement motivation (RAM) on the basis of level-of-aspiration, achievement motivation, and dynamics-of-action theories. In Experiment 1, the number of atypical shifts and greater responsiveness to incentives on 21 trials with choices among easy, intermediate, and difficult levels of an achievement-oriented game were positively correlated and were found to differentiate the 62 subjects (31 men, 31 women) on the amount of time they spent at a nonachievement task (watching a color design) 1 week later. In Experiment 2, test-retest reliability was established with the use of 67 subjects (15 men, 52 women). Point and no-point trials were offered in blocks, with point trials first for half the subjects and no-point trials first for the other half. Reliability was higher for the atypical-shift measure than for the incentive-responsiveness measure and was higher when points were offered first. In Experiment 3, computer anxiety was manipulated by creating a simulated computer breakdown in the experimental condition. Fifty-nine subjects (13 men, 46 women) were randomly assigned to the experimental condition or to one of two control conditions (an interruption condition and a no-interruption condition). Subjects with low RAM, as demonstrated by a low number of typical shifts, took longer to choose the achievement-oriented task, as predicted by the dynamics-of-action theory. The difference was evident in all conditions and most striking in the computer-breakdown condition. A change of focus from atypical to typical shifts is discussed. PMID:3625473

  18. Teaching Note--Educating Public Health Social Work Professionals: Results from an MSW/MPH Program Outcomes Study

    ERIC Educational Resources Information Center

    Ruth, Betty J.; Marshall, Jamie Wyatt; Velásquez, Esther E. M.; Bachman, Sara S.

    2015-01-01

    Dual-degree programs in public health and social work continue to proliferate, yet there has been little research on master's of social work (MSW)/master's of public health (MPH) graduates. The purpose of this study was to describe and better understand the self-reported professional experiences, identities, roles, and outcomes

  19. Investigating the Influences of Class Size and Class Mix on Special Education Student Outcomes: Phase One Results.

    ERIC Educational Resources Information Center

    Keith, Patricia B.; And Others

    This study investigated students with specific learning disabilities (SLD), serious emotional disturbances (SED), and educable mental retardation (EMR) to determine if class size and class mix influence educational outcomes. A total of 110 students in 12 classrooms were included in the sample, which included classes with waivers (classes out of…

  20. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results from a 2-Year Randomized Trial

    ERIC Educational Resources Information Center

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2011-01-01

    Objective: To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method: Early course schizophrenia outpatients (N = 58) were randomly assigned to cognitive enhancement therapy (CET) or an enriched supportive therapy (EST) control and…

  1. The first geocenter estimation results using GPS measurements

    NASA Technical Reports Server (NTRS)

    Malla, R. P.; Wu, S. C.

    1990-01-01

    The center of mass of the Earth is the natural and unambiguous origin of a geocentric satellite dynamical system. A geocentric reference frame assumes that the origin of its coordinate axes is at the geocenter, in which all relevant observations and results can be referred and in which geodynamic theories or models for the dynamic behavior of Earth can be formulated. In practice, however, a kinematically obtained terrestrial reference frame may assume an origin other than the geocenter. A fast and accurate method of determining origin offset from the geocenter is highly desirable. Global Positioning System (GPS) measurements, because of their abundance and broad distribution, provide a powerful tool to obtain this origin offset in a short period of time. Two effective strategies have been devised. Data from the first Central and South America (Casa Uno) global GPS experiment were studied to demonstrate the ability of recovering the geocenter location with present-day GPS satellites and receivers.

  2. [Antituberculous measures according to the results of Mantoux test].

    PubMed

    Guse?nov, G K; Mamaev, I A; Abdulaeva, Z K

    2003-01-01

    Analyzing the results of Mantoux tests with 2 TE made 7 times for 5 years in 750-850 schoolchildren of the settlement of Sulak has demonstrated that the infection rates are on the increase on the one hand, and, due to material and transport problems, the proportion of examinees from a risk group decreases to 10-30% of those to be examined, on the other hand. The authors suggest that the remaining unexamined children should undergo chemotherapy with 2-3 antituberculosis drugs for 3 months so as to perform an examination when the first opportunity occurs. They propose to examine the coverage of children, except for children and adolescents with a hyperergic and increasing reactions and those with a highly positive (15-16 mm) Mantoux test. An algorithm for implementation of the above measures is offered. PMID:12652976

  3. Marital status and colon cancer outcomes in US Surveillance, Epidemiology and End Results registries: Does marriage affect cancer survival by gender

    E-print Network

    Martinez, Tony R.

    and prostate cancer [7­16], and all but a few studies [9,16] find statistically significant survival benefitsMarital status and colon cancer outcomes in US Surveillance, Epidemiology and End Results registries: Does marriage affect cancer survival by gender and stage? Li Wang a, *, Sven E. Wilson b , David

  4. Evaluating Curricular Influence on Preparation for Practice, Career Outcomes, and Job Satisfaction: Results from an Alumni Survey of a 40-Year Rehabilitation and Mental Health Counseling Program

    ERIC Educational Resources Information Center

    Smith, Tammy Jorgensen; Reid, Joan A.; Henry, Ryan G.; Dixon, Charlotte G.; Wright, Tennyson J.

    2013-01-01

    Alumni of a Council on Rehabilitation Education (CORE)-accredited graduate rehabilitation counselor education (RCE) program were surveyed to evaluate career outcomes, job satisfaction, licensure and certification rates, client populations served, and RCE program satisfaction and effectiveness. Results indicate a high level of satisfaction with the…

  5. A Systematic Review of Studies That Aim to Determine Which Outcomes to Measure in Clinical Trials in Children

    Microsoft Academic Search

    Ian Sinha; Leanne Jones; Rosalind L. Smyth; Paula R. Williamson

    2008-01-01

    Background In clinical trials the selection of appropriate outcomes is crucial to the assessment of whether one intervention is better than another. Selection of inappropriate outcomes can compromise the utility of a trial. However, the process of selecting the most suitable outcomes to include can be complex. Our aim was to systematically review studies that address the process of selecting

  6. The Association between Serum Biomarkers and Disease Outcome in Influenza A(H1N1)pdm09 Virus Infection: Results of Two International Observational Cohort Studies

    PubMed Central

    Davey, Richard T.; Lynfield, Ruth; Dwyer, Dominic E.; Losso, Marcello H.; Cozzi-Lepri, Alessandro; Wentworth, Deborah; Lane, H. Clifford; Dewar, Robin; Rupert, Adam; Metcalf, Julia A.; Pett, Sarah L.; Uyeki, Timothy M.; Bruguera, Jose Maria; Angus, Brian; Cummins, Nathan; Lundgren, Jens; Neaton, James D.

    2013-01-01

    Background Prospective studies establishing the temporal relationship between the degree of inflammation and human influenza disease progression are scarce. To assess predictors of disease progression among patients with influenza A(H1N1)pdm09 infection, 25 inflammatory biomarkers measured at enrollment were analyzed in two international observational cohort studies. Methods Among patients with RT-PCR-confirmed influenza A(H1N1)pdm09 virus infection, odds ratios (ORs) estimated by logistic regression were used to summarize the associations of biomarkers measured at enrollment with worsened disease outcome or death after 14 days of follow-up for those seeking outpatient care (FLU 002) or after 60 days for those hospitalized with influenza complications (FLU 003). Biomarkers that were significantly associated with progression in both studies (p<0.05) or only in one (p<0.002 after Bonferroni correction) were identified. Results In FLU 002 28/528 (5.3%) outpatients had influenza A(H1N1)pdm09 virus infection that progressed to a study endpoint of complications, hospitalization or death, whereas in FLU 003 28/170 (16.5%) inpatients enrolled from the general ward and 21/39 (53.8%) inpatients enrolled directly from the ICU experienced disease progression. Higher levels of 12 of the 25 markers were significantly associated with subsequent disease progression. Of these, 7 markers (IL-6, CD163, IL-10, LBP, IL-2, MCP-1, and IP-10), all with ORs for the 3rd versus 1st tertile of 2.5 or greater, were significant (p<0.05) in both outpatients and inpatients. In contrast, five markers (sICAM-1, IL-8, TNF-?, D-dimer, and sVCAM-1), all with ORs for the 3rd versus 1st tertile greater than 3.2, were significantly (p?.002) associated with disease progression among hospitalized patients only. Conclusions In patients presenting with varying severities of influenza A(H1N1)pdm09 virus infection, a baseline elevation in several biomarkers associated with inflammation, coagulation, or immune function strongly predicted a higher risk of disease progression. It is conceivable that interventions designed to abrogate these baseline elevations might affect disease outcome. PMID:23468921

  7. Point of maximum width: a new measure for anthropometric outcomes in patients with sagittal synostosis.

    PubMed

    Gangopadhyay, Noopur; Shah, Manjool; Skolnick, Gary B; Patel, Kamlesh B; Naidoo, Sybill D; Woo, Albert S

    2014-07-01

    The esthetic success of sagittal synostosis reconstruction is measured by cephalic index (CI). This limited measure does not fully account for the abnormal head shape in sagittal synostosis. In this retrospective study, we investigate a new objective measure, point of maximum width (PMW) of the skull from a vertex view, to determine where the head is widest for children with sagittal synostosis as compared with normal controls. Preoperative computed tomography (CT) scans of 27 children with sagittal synostosis and 14 postoperative CT scans at least 8 months after surgery were obtained. Normal CT scans were matched for age, sex, and race. Three-dimensional renderings were standardized for orientation. Mean (SE) PMW in patients with sagittal synostosis was 53% (1%) compared with 57% (1%) in controls (P < 0.001). Mean (SE) CI in patients with sagittal synostosis was 66.8% (0.8%) compared with 83.3% (1.0%) in controls (P < 0.001). The correlation between PMW and CI was weak in both controls (r2 = 0.002, P = 0.824) and uncorrected cases (r2 = 0.083, P = 0.145). After surgical correction, both CI and PMW significantly improved. Mean (SE) PMW in patients after surgical release of sagittal synostosis was 58% (1%) compared with 58% (1%) in controls (P = 0.986). The PMW is not a surrogate for CI but is a novel, valid measure of skull shape, which aids in quantifying the widest region of the skull. It is significantly more anterior in children with sagittal synostosis and exhibits a consistent posterior shift along the cranium after surgery, showing no difference compared with healthy children. PMID:25006901

  8. POINT OF MAXIMUM WIDTH: A NEW MEASURE FOR ANTHROPOMETRIC OUTCOMES IN PATIENTS WITH SAGITTAL SYNOSTOSIS

    PubMed Central

    Gangopadhyay, Noopur; Shah, Manjool; Skolnick, Gary B; Patel, Kamlesh B; Naidoo, Sybill D; Woo, Albert S

    2014-01-01

    The aesthetic success of sagittal synostosis reconstruction is measured by cephalic index (CI). This limited measure does not fully account for the abnormal head shape in sagittal synostosis. In this retrospective study, we investigate a new objective measure, point of maximum width (PMW) of the skull from a vertex view, to determine where the head is widest for children with sagittal synostosis as compared to normal controls. Preoperative CT scans of 27 children with sagittal synostosis and 14 postoperative CT scans at least 8 months after surgery were obtained. Normal CT scans were matched for age, gender, and race. Three-dimensional renderings were standardized for orientation. Average PMW in patients with sagittal synostosis was 53% ± 1% compared to 57% ± 1% in controls (p<0.001). Average CI in patients with sagittal synostosis was 66.8% ± 0.8% compared to 83.3% ± 1.0% in controls (p<0.001). The correlation between PMW and CI was weak in both controls (R2=0.002, p=0.824) and uncorrected cases (R2=0.083, p=0.145). After surgical correction, both CI and PMW significantly improved. Average PMW in patients after surgical release of sagittal synostosis was 58% ± 1% compared to 58% ± 1% in controls (p=0.986). PMW is not a surrogate for CI but is a novel, valid measure of skull shape, which aids in quantifying the widest region of the skull. PMW is significantly more anterior in children with sagittal synostosis and exhibits a consistent posterior shift along the cranium after surgery, showing no difference compared to healthy children. PMID:25006901

  9. Apparent Diffusion Coefficient on Magnetic Resonance Imaging in Pons and in Corona Radiata and Relation with the Neurophysiologic Measurement and the Outcome in Very Preterm Infants

    Microsoft Academic Search

    Tuula Kaukola; Marja Perhomaa; Leena Vainionpää; Uolevi Tolonen; Jukka Jauhiainen; Eija Pääkkö; Mikko Hallman

    2010-01-01

    Background: New imaging techniques allow a detailed visualization of the brain and the findings possibly correlate with neurophysiologic measurements and neurosensory and motor outcomes. Postnatal clinical factors known to associate with neurologic disabilities may contribute to brain abnormalities not visible to the naked eye. Objectives: We evaluated whether quantitative measurement of organized water diffusion on MR imaging, apparent diffusion coefficient

  10. Content comparison of haemophilia specific patient-rated outcome measures with the international classification of functioning, disability and health (ICF, ICF-CY)

    PubMed Central

    2010-01-01

    Background Patient-Reported Outcomes (PROs) are considered important outcomes because they reflect the patient's experience in clinical trials. PROs have been included in the field of haemophilia only recently. Purpose Comparing the contents of PROs measures used in haemophilia, based on the ICF/ICF-CY as frame of reference. Methods Haemophilia-specific PROs for adults and children were selected on the grounds of international accessibility. The content of the selected instruments were examined by linking the concepts within the items of these instruments to the ICF/ICF-CY. Results Within the 5 selected instruments 365 concepts were identified, of which 283 concepts were linked to the ICF/ICF CY and mapped into 70 different categories. The most frequently used categories were "b152: Emotional functions" and "e1101: Drugs". Conclusions The present paper provides an overview on current PROs in haemophilia and facilitates the selection of appropriate instruments for specific purposes in clinical and research settings. This work was made possible by the grant of the European Murinet Project (Multidisciplinary Research Network on Health and Disability in Europe). PMID:21108796

  11. Magnetic Resonance Imaging Measures of Brain Structure to Predict Antidepressant Treatment Outcome in Major Depressive Disorder

    PubMed Central

    Korgaonkar, Mayuresh S.; Rekshan, William; Gordon, Evian; Rush, A. John; Williams, Leanne M.; Blasey, Christine; Grieve, Stuart M.

    2014-01-01

    Background Less than 50% of patients with Major Depressive Disorder (MDD) reach symptomatic remission with their initial antidepressant medication (ADM). There are currently no objective measures with which to reliably predict which individuals will achieve remission to ADMs. Methods 157 participants with MDD from the International Study to Predict Optimized Treatment in Depression (iSPOT-D) underwent baseline MRIs and completed eight weeks of treatment with escitalopram, sertraline or venlafaxine-ER. A score at week 8 of 7 or less on the 17 item Hamilton Rating Scale for Depression defined remission. Receiver Operator Characteristics (ROC) analysis using the first 50% participants was performed to define decision trees of baseline MRI volumetric and connectivity (fractional anisotropy) measures that differentiated non-remitters from remitters with maximal sensitivity and specificity. These decision trees were tested for replication in the remaining participants. Findings Overall, 35% of all participants achieved remission. ROC analyses identified two decision trees that predicted a high probability of non-remission and that were replicated: 1. Left middle frontal volume < 14 · 8 mL & right angular gyrus volume > 6 · 3 mL identified 55% of non-remitters with 85% accuracy; and 2. Fractional anisotropy values in the left cingulum bundle < 0 · 63, right superior fronto-occipital fasciculus < 0 · 54 and right superior longitudinal fasciculus < 0 · 50 identified 15% of the non-remitters with 84% accuracy. All participants who met criteria for both decision trees were correctly identified as non-remitters. Interpretation Pretreatment MRI measures seem to reliably identify a subset of patients who do not remit with a first step medication that includes one of these commonly used medications. Findings are consistent with a neuroanatomical basis for non-remission in depressed patients. Funding Brain Resource Ltd is the sponsor for the iSPOT-D study (NCT00693849).

  12. Development of a conceptual model evaluating the humanistic and economic burden of Crohn's disease: implications for patient-reported outcomes measurement and economic evaluation.

    PubMed

    Gater, Adam; Kitchen, Helen; Heron, Louise; Pollard, Catherine; Håkan-Bloch, Jonas; Højbjerre, Lise; Hansen, Brian Bekker; Strandberg-Larsen, Martin

    2015-08-01

    The primary objective of this review is to develop a conceptual model for Crohn's disease (CD) outlining the disease burden for patients, healthcare systems and wider society, as reported in the scientific literature. A search was conducted using MEDLINE, PsycINFO, EconLit, Health Economic Evaluation Database and Centre for Reviews and Dissemination databases. Patient-reported outcome (PRO) measures widely used in CD were reviewed according to the US FDA PRO Guidance for Industry. The resulting conceptual model highlights the characterization of CD by gastrointestinal disturbances, extra-intestinal and systemic symptoms. These symptoms impact physical functioning, ability to complete daily activities, emotional wellbeing, social functioning, sexual functioning and ability to work. Gaps in conceptual coverage and evidence of reliability and validity for some PRO measures were noted. Review findings also highlight the substantial direct and indirect costs associated with CD. Evidence from the literature confirms the substantial burden of CD to patients and wider society; however, future research is still needed to further understand burden from the perspective of patients and to accurately understand the economic burden of disease. Challenges with existing PRO measures also suggest the need for future research to refine or develop new measures. PMID:25985850

  13. The effects of compounded bioidentical transdermal hormone therapy on hemostatic, inflammatory, immune factors; cardiovascular biomarkers; quality-of-life measures; and health outcomes in perimenopausal and postmenopausal women.

    PubMed

    Stephenson, Kenna; Neuenschwander, Pierre F; Kurdowska, Anna K

    2013-01-01

    Menopause impacts 25 million women world wide each year, and the World Health Organization estimates 1.2 billion women will be postmenopausal by 2030. Menopause has been associated with symptoms of hot flashes, night sweats, dysphoric mood, sleep disturbance, and conditions of cardiovascular disease, depression, osteoporosis, osteoarthritis, depression, dementia, and frailty. Conventional hormone replacement therapy results in increased thrombotic events, and an increased risk of breast cancer and dementia as evidenced in large prospective clinical trials including Heart and Estrogen/Progestin Replacement Study I and the Women's Health Initiative. A possible mechanism for these adverse events is the unfavorable net effects of conjugated equine estrogens and medroxyprogesterone acetate on the hemostatic balance and inflammatory and immune factors. Physiologic sex steroid therapy with transdermal delivery for peri/postmenopausal women may offer a different risk/benefit profile, yet long-term studies of this treatment model are lacking. The objective of this study was to examine the long-term effects of compounded bioidentical transdermal sex steroid therapy including estriol, estradiol, progesterone, DHEA, and testosterone on cardiovascular biomarkers, hemostatic, inflammatory, immune signaling factors; quality-of-life measures; and health outcomes in peri/postmenopausal women within the context of a hormone restoration model of care. A prospective, cohort, closed-label study received approval from the Human Subjects Committee. Recruitment from outpatient clinics at an academic medical center and the community at large resulted in three hundred women giving signed consent. Seventy-five women who met strict inclusion/exclusion criteria were enrolled. Baseline hormone evaluation was performed along with baseline experimental measures. Following this, women received compounded transdermal bioidentical hormone therapy of BiEst (80%Estriol/20%Estradiol), and/or Progesterone for eight weeks to meet established physiologic reference ranges for the luteal phase in premenopausal women. The luteal phase hormone ratios were selected based on animal and epidemiologic studies demonstrating favorable outcomes related to traumatic, ischemic, or neuronal injury. Follow-up testing was performed at eight weeks and adjustment to hormone regimens were made including addition of androgens of DHEA and Testosterone if indicated. Experimental subjects were monitored for 36 months. Baseline, 2-month, and annual values were obtained for: blood pressure, body mass index, fasting glucose, Homeostasis Metabolic Assessment of Insulin Resistance (HOMA-IR), fasting triglycerides, total Factor VII, Factor VIII, fibrinogen, Antithrombin III, Plasminogen Activator Inhibitor1(PAL-1), C-reactive protein (CRP), Interleukin-6 (IL-6), Matrix Metalloproteinase-9 (MMP-9), Tumor Necrosis Factor-alpha (TNF), Insulin-like Growth Factor (IGF-1), and sex steroid levels. Psychosocial measures included: Greene Climacteric Scale, Visual Analog Pain Scale, Hamilton Anxiety Scale, Hamilton Depression Scale, Holmes Rahe Stress Scale, Job Strain, and Home Strain. Health outcome measures included the number of prescribed medications used, number of co-morbidities, and endometrial thickness in postmenopausal women with intact uteri. Subjects receiving compounded transdermal bioidentical hormone therapy showed significant favorable changes in: Greene Climacteric Scale scores, Hamilton Anxiety Scale, Hamilton Depression Scale, Visual Analog Pain Scale, fasting glucose, fasting triglycerides, MMP-9, C-reactive Protein, fibrinogen, Factor VII, Factor VIII, Insulin-Like Growth Factor 1, and health outcomes of co-morbidities and a number of prescribed medications. Antithrombin III levels were significantly decreased at 36 months. All other measures did not exhibit significant effects. Administration of compounded transdermal bioidentical hormone therapy in doses targeted to physiologic reference ranges administered in a daily dose significantly relieved menopausal symptoms in peri/po

  14. Collaborative Outcome Measurement: Development of the Nationally Standardized Minimum Data Set

    ERIC Educational Resources Information Center

    Stephens, Barry C.; Kirchner, Corinne; Orr, Alberta L.; Suvino, Dawn; Rogers, Priscilla

    2009-01-01

    This article discusses the challenging process of developing a common data set for independent living programs serving older adults who are visually impaired. The three-year project, which included collaborative efforts among many stakeholders that encompass diverse program models, resulted in the development of the Internet-based Nationally…

  15. Palivizumab prophylaxis of respiratory syncytial virus disease in 2000-2001: results from The Palivizumab Outcomes Registry.

    PubMed

    Parnes, Curt; Guillermin, Judith; Habersang, Rolf; Nicholes, Peggy; Chawla, Vijay; Kelly, Tammy; Fishbein, Judith; McRae, Patty; Goessler, Mary; Gatti, Antoinette; Calcagno, John A; Eki, Cheryl; Harris, Kristen A; Joyave, Joseph; McFarland, Kathy; Protter, Paul; Sullivan, Mary; Stanford, Allan; Lovett, Nancy; Ortiz, Marisol; Rojas, Sharon; Cyrus, Scott; Cyrus, Janell; Cohen, Stuart; Buchin, Debbie; Riordan, Linda; Zuniga, Monica; Shah, Rupa; Minard, Carmen; Quintin, Arden; Douglas, Glenda; van Houten, John; Freutner, Sharyn; Chartrand, Stephen; Nowatzke, Patsy; Romero, Jose; Rhodes, Torunn; Benoit, Michelle; Walter, Emmanuel; Walker, Leslie; DeBonnett, Laurie; Cross, Mia; Free, Teresa; Martin, Sharman; Shank, Karen; Guedes, Ben; Atkinson, Lee Ann; Halpin, George J; Rouse, Kathy; Hand, Ivan; Geiss, Donna; Marshall, James R; Burleson, Lois; Boland, Jim; Seybold, Kelsey; Hunter, Vicki; Unfer, Susan; Schmucker, Jackie; Gley, Margaret; Marcus, Michael; Thompson, Patricia; Milla, Paulino; Young, Connie; Zanni, Robert; Zinno, Virginia; Fetter-Zarzeka, Alexandra; Busey, Amanda; Sokunbi, Modupe A; Airington, Sherrie; Richard, Nancy; Muraligopal, Vellore; Lewis, Stephanie; Weber, F Thomas; Giordano, Beverly P; Linehan, Denise; Roach, Jane; Davis, Randle; Rzepka, Andrew A; Booth, Teri; Smeltzer, David; Walsh, Jeanne; Arispe, Emilio; Rowley, Rhonda; Bolling, Christopher; Botts, Tanya; Haskett, Kateri; Raby, Deana; Batiz, Evelyn; Gelfand, Andrew; Farrell, Lynn; Butler, Stephen; Colby, Linda; Schochet, Peter; Bentler, Julie; Hirsch, David; Wilkinson, Lisa; Aaronson, Allen; Bennett, Eleanora; Wingate, Julie; Quinn, Dawn; Komendowski, Katherine; Deckard, Marcia; Frogel, Michael; Nerwen, Cliff; Copenhaver, Steven; Prater, Michele; Wolsztein, Jacob; Mackey, Kristine; Benbow, Marshall; Naranjo, Marisela; Hensley, Sandra; Hayes, Cindy; Sadeghi, Hossein; Lawson, Sally May; McCall, Mark; Combs, Karla; Ledbetter, Joel; Sarnosky, Karen; Swafford, Cathy; Speer, Michael; Barton, Wendy J; Mink, J W; Lemm, Dianne; Hudak, Mark; Case, Elizabeth; Rowen, Judith; Fuentes, Sandra; Pane, Carly; Richardson, Leslie; Chavarria, Cesar; Cassino, Deanne; Ghaffari, Kourosh; Carroll, Carol; Lee, Haesoon; Guclu, Lydia; Johnson, Christopher; Blum, Valerie; Boron, Marnie L; Sorrentino, Mark; Hirsch, Robert L; Van Veldhuisen, Paul C; Smith, Carol

    2003-06-01

    The objective of the Registry was to characterize the population of infants receiving prophylaxis for respiratory syncytial virus (RSV) disease by describing the patterns and scope of usage of palivizumab in a cross section of US infants. RSV hospitalization outcomes were also described. The Palivizumab (Synagis, MedImmune, Inc., 25 West Watkins Mill Road, Gaithersburg, MD 20878) Outcomes Registry was a prospective multicenter survey conducted at 63 sites. Demographics, injection history, and RSV hospitalization outcomes were collected on 2,116 infants receiving palivizumab. Infants were enrolled in the Registry between September 1, 2000-March 1, 2001, at the time of their first injection. Infants born at less than 32 weeks of gestation accounted for 47% of infants enrolled, and those between 32-35 weeks accounted for 45%; approximately 8% were greater than 35 weeks of gestation. Lower RSV hospitalization rates were observed in infants who had greater adherence to regularly scheduled injections. Nearly one-half of all hospitalizations occurred within the first and second injection intervals, suggesting the importance of early RSV protection. The confirmed RSV hospitalization rate of all infants in the Registry was 2.9%; the rate was 5.8% in infants with chronic lung disease of infancy, and 2.1% in premature infants without chronic lung disease. In conclusion, these data support the continued effectiveness of palivizumab prophylaxis for severe RSV lower respiratory tract disease in a large cohort of high-risk infants from geographically diverse pediatric offices and clinics. The Palivizumab Outcomes Registry provides an opportunity to assess palivizumab utilization and clinical effectiveness in the US. PMID:12746948

  16. Abciximab or Eptifibatide in Percutaneous Coronary Intervention: In-Hospital Outcomes and Costs and Six-Month Results

    Microsoft Academic Search

    Brett C. Burgess; Shafik Hanna-Moussa; Kala Ramasamy; Diana Sigler; Shukri David

    2002-01-01

      Inhibition of platelet aggregation with glycoprotein (GP) IIb-IIIa receptor blockers has been shown to reduce ischemic complications\\u000a in patients with acute coronary syndromes (ACS) and in those undergoing percutaneous coronary intervention (PCI) in multiple\\u000a placebo-controlled, randomized clinical trials. The effect of pharmacologic and cost differences between abciximab and eptifibatide,\\u000a the only GP IIb-IIIa inhibitors indicated for PCI, on clinical outcomes

  17. Treatment Outcomes in Black and White Children With Cancer: Results From the SEER Database and St Jude Children's Research Hospital, 1992 Through 2007

    PubMed Central

    Pui, Ching-Hon; Pei, Deqing; Pappo, Alberto S.; Howard, Scott C.; Cheng, Cheng; Sandlund, John T.; Furman, Wayne L.; Ribeiro, Raul C.; Spunt, Sheri L.; Rubnitz, Jeffrey E.; Jeha, Sima; Hudson, Melissa M.; Kun, Larry E.; Merchant, Thomas E.; Kocak, Mehmet; Broniscer, Alberto; Metzger, Monika L.; Downing, James R.; Leung, Wing; Evans, William E.; Gajjar, Amar

    2012-01-01

    Purpose Treatment outcome for black patients with cancer has been significantly worse than for their white counterparts. We determined whether recent improved treatment had narrowed the gap in outcome between black and white pediatric patients. Patients and Methods In a parallel comparison, we analyzed survival by disease category between black and white patients with childhood cancer registered in one of the 17 cancer registries of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program or treated at St Jude Children's Research Hospital, which provides comprehensive treatment to all patients regardless of their ability to pay, from 1992 to 2000 and from 2001 to 2007. Results Analysis of the SEER data indicated that in both study periods, black patients had significantly poorer rates of survival than did white patients, with the exception of a few types of cancer. Despite significantly improved treatment outcomes for patients who were treated from 2001 to 2007, the racial difference in survival has actually widened for acute myeloid leukemia and neuroblastoma. By contrast, in the cohorts treated at St Jude Children's Research Hospital, there were no significant differences in survival between black and white patients in either study period, regardless of the cancer type. Importantly, the outcome of treatment for acute lymphoblastic leukemia, acute myeloid leukemia, and retinoblastoma has improved in parallel for both races during the most recent study period. Conclusion With equal access to comprehensive treatment, black and white children with cancer can achieve the same high cure rates. PMID:22547602

  18. Determining issues of importance for the evaluation of quality of life and patient-reported outcomes in breast cancer: results of a survey of 1072 patients.

    PubMed

    Hollen, Patricia J; Msaouel, Pavlos; Gralla, Richard J

    2015-06-01

    Identifying key issues for patients is central to assessing treatment for cancer, especially when evaluating health-related quality of life (QL) and patient-reported outcomes (PROs). This study was conducted to provide enhanced content validity support by incorporating the views of a large number of patients with breast cancer. This methodological study used an anonymous, cross-sectional, electronic web-based survey of 1072 patients with a diagnosis of breast cancer. Patients ranked the importance of 21 issues on a 5-point scale. Issues included general, physical, functional, psychosocial, and summative items. Analysis was also performed by four key factors (age group, time since diagnosis, adjuvant treatment or not, and tumor extent). All of the top five issues rated as either "very important" or "important" were global issues-rather than symptoms-such as maintaining quality of life (ranked in these two highest categories by 99 % of patients), maintaining independence (97 %), and ability to perform normal activities (97 %). The abilities to concentrate and to be able to sleep (97 and 96 %, respectively) were ranked above specific breast cancer symptoms. Specific symptoms included within the top ten highest ranked items were fatigue, depression, anxiety, shortness of breath, and pain. This is the largest analysis of evidence-based data determining support for content validity for QL and PROs provided by patients with breast cancer. While symptoms are important to patients, the survey also demonstrates that PRO measures that only evaluate symptoms are not fully responding to patient-expressed needs. These results provide confidence in the content of quality of life measures for large groups of patients with breast cancer, including the new Breast Cancer Symptom Scale (BCSS) questionnaire. PMID:25981897

  19. Early results from ISEE-A electric field measurements

    NASA Technical Reports Server (NTRS)

    Heppner, J. P.; Maynard, N. C.; Aggson, T. L.

    1978-01-01

    In the solar wind and in middle latitude regions of the magnetosphere, spacecraft sheath fields obscure the ambient field under low plasma flux conditions such that valid measurements are confined to periods of moderately intense flux. Initial results show: (1) that the DC electric field is enhanced by roughly a factor of two in a narrow region at the front, increasing B, edge of the bow shock, (2) that scale lengths for large changes in E at the subsolar magnetopause are considerably shorter than scale lengths associated with the magnetic structure of the magnetopause, and (3) that the transverse distribution of B-aligned E-fields between the outer magnetosphere and ionospheric levels must be highly complex to account for the random turbulent appearance of the magnetospheric fields and the lack of corresponding time-space variations at ionospheric levels. Spike-like, non-oscillatory, fields lasting less than 0.2 seconds are occasionally seen at the bow shock and at the magnetopause and also intermittently appear in magnetosheath and plasma sheet regions under highly variable field conditions.

  20. Results from the LADCP measurements conducted in the Eurasian Arctic

    NASA Astrophysics Data System (ADS)

    Goszczko, Ilona; Pnyushkov, Andrey; Polyakov, Igor; Rember, Robert; Thurnherr, Andreas M.

    2015-04-01

    Preliminary results from 114 dual headed LADCP (Lowered Acoustic Doppler Current Profiler) measurements performed during the NABOS (Nansen and Amundsen Basin Observational System) 2013 cruise in the Eurasian Basin of the Arctic Ocean are discussed. Calculated horizontal magnetic field strength for that specific study area and cruise time span equals to 1500-4200 nT which is a critically low value. This affected the heading usability of instruments' compasses, thereby making the obtained ocean currents velocities and directions difficult to assess. Additional data post-processing performed with the LDEO Software (Version IX_9) and dedicated Matlab routines have so far allowed to obtain reasonable velocity profiles only in several cases (with additional information from the SeaBird 911plus CTD, GPS and bottom tracking). Thus, doubts concerning the feasibility of compasses, confirmed by difficulties encountered previously in similar polar locations, rise the necessity of providing an additional heading source which should be mounted together with the Teledyne RDI instruments to gain an unquestionable velocity field.

  1. SWSA 6 interim corrective measures environmental monitoring: FY 1990 results

    SciTech Connect

    Ashwood, T.L.; Spalding, B.P.

    1991-07-01

    This report presents the results and conclusions from a multifaceted monitoring effort associated with the high-density polyethylene caps installed in Solid Waste Storage Area (SWSA) 6 at Oak Ridge National Laboratory (ORNL) as an interim corrective measure (ICM). The caps were installed between November 1988 and June 1989 to meet Resource Conservation and Recovery Act (RCRA) requirements for closure of those areas of SWSA 6 that had received RCRA-regulated wastes after November 1980. Three separate activities were undertaken to evaluate the performance of the caps: (1) wells were installed in trenches to be covered by the caps, and water levels in these intratrench wells were monitored periodically; (2) samples were taken of the leachate in the intratrench wells and were analyzed for a broad range of radiological and chemical contaminants; and (3) water levels in wells outside the trenches were monitored periodically. With the exception of the trench leachate sampling, each of these activities spanned the preconstruction, construction, and postconstruction periods. Findings of this study have important implications for the ongoing remedial investigation in SWSA 6 and for the design of other ICMs. 51 figs., 2 tabs.

  2. Invariant Measures for Dissipative Dynamical Systems: Abstract Results and Applications

    NASA Astrophysics Data System (ADS)

    Chekroun, Mickaël D.; Glatt-Holtz, Nathan E.

    2012-12-01

    In this work we study certain invariant measures that can be associated to the time averaged observation of a broad class of dissipative semigroups via the notion of a generalized Banach limit. Consider an arbitrary complete separable metric space X which is acted on by any continuous semigroup { S( t)} t ? 0. Suppose that { S( t)} t ? 0 possesses a global attractor {{A}}. We show that, for any generalized Banach limit LIM T ? ? and any probability distribution of initial conditions {{m}_0}, that there exists an invariant probability measure {{m}}, whose support is contained in {{A}}, such that intX \\varphi(x) d{m}(x) = \\underset{t rightarrow infty}LIM1/T int_0^T int_X \\varphi(S(t) x) d{m}_0(x) dt, for all observables ? living in a suitable function space of continuous mappings on X. This work is based on the framework of Foias et al. (Encyclopedia of mathematics and its applications, vol 83. Cambridge University Press, Cambridge, 2001); it generalizes and simplifies the proofs of more recent works (Wang in Disc Cont Dyn Syst 23(1-2):521-540, 2009; Lukaszewicz et al. in J Dyn Diff Eq 23(2):225-250, 2011). In particular our results rely on the novel use of a general but elementary topological observation, valid in any metric space, which concerns the growth of continuous functions in the neighborhood of compact sets. In the case when { S( t)} t ? 0 does not possess a compact absorbing set, this lemma allows us to sidestep the use of weak compactness arguments which require the imposition of cumbersome weak continuity conditions and thus restricts the phase space X to the case of a reflexive Banach space. Two examples of concrete dynamical systems where the semigroup is known to be non-compact are examined in detail. We first consider the Navier-Stokes equations with memory in the diffusion terms. This is the so called Jeffery's model which describes certain classes of viscoelastic fluids. We then consider a family of neutral delay differential equations, that is equations with delays in the time derivative terms. These systems may arise in the study of wave propagation problems coming from certain first order hyperbolic partial differential equations; for example for the study of line transmission problems. For the second example the phase space is {X= C([-tau,0],{R}^n)}, for some delay ? > 0, so that X is not reflexive in this case.

  3. Developing clinical performance measures based on the Dialysis Outcomes Quality Initiative Clinical Practice Guidelines: process, outcomes, and implications 1,2 1 The analyses on which this publication is based were performed under Contract No. 500-99WA02, entitled “Utilization and Quality Control Peer Review Organization for the State of Washington,” sponsored by the Centers for Medicare and Medicaid Services, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. 2 The authors assume full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Centers for Medicare and Medicaid Services, which has encouraged identification of quality improvement pro

    Microsoft Academic Search

    Jonathan R. Sugarman; Pamela R. Frederick; Diane L. Frankenfield; William F. Owen; William M. McClellan

    2003-01-01

    Background:The National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) Clinical Practice Guidelines established a widely accepted set of recommendations for high-quality dialysis care. To enhance the End-Stage Renal Disease Core Indicators Project, an ongoing effort to assess and improve dialysis care in the United States, the Centers for Medicare and Medicaid Services (CMS) commissioned a project to develop clinical performance measures

  4. Balloon Intercomparison Campaigns: Results of remote sensing measurements of HCl

    Microsoft Academic Search

    C. B. Farmer; B. Carli; A. Bonetti; M. Carlotti; B. M. Dinelli; H. Fast; W. F. J. Evans; N. Louisnard; C. Alamichel; W. Mankin; M. Coffey; I. G. Nolt; D. G. Murcray; A. Goldman; G. M. Stokes; D. W. Johnson; W. A. Traub; K. V. Chance; R. Zander; G. Roland; L. Delbouille

    1990-01-01

    All of the techniques used to measure stratospheric HCl during the two BIC campaigns involved high resolution infrared spectroscopy. The balloon-borne instruments included five different spectrometers, three operating in the solar absorption mode and two in emission (at distinctly different wavelengths). Ground-based and aircraft correlative measurements were made close to the balloon locations, again by near-infrared spectroscopy.

  5. Measuring weight outcomes for obesity intervention strategies: the case of a sugar-sweetened beverage tax.

    PubMed

    Lin, Biing-Hwan; Smith, Travis A; Lee, Jonq-Ying; Hall, Kevin D

    2011-12-01

    Taxing unhealthy foods has been proposed as a means to improve diet and health by reducing calorie intake and raising funds to combat obesity, particularly sugar-sweetened beverages (SSBs). A growing number of studies have examined the effects of such food taxes, but few have estimated the weight-loss effects. Typically, a static model of 3500 calories for one pound of body weight is used, and the main objective of the study is to demonstrate its bias. To accomplish the objective, we estimate income-segmented beverage demand systems to examine the potential effects of a SSB tax. Elasticity estimates and a hypothetical 20 percent effective tax rate (or about 0.5 cent per ounce) are applied to beverage intake data from a nationally representative survey, and we find an average daily reduction of 34-47 calories among adults and 40-51 calories among children. The tax-induced energy reductions are translated into weight loss using both static and dynamic calorie-to-weight models. Results demonstrate that the static model significantly overestimates the weight loss from reduced energy intake by 63 percent in year one, 346 percent in year five, and 764 percent in year 10, which leads to unrealistic expectations for obesity intervention strategies. The tax is estimated to generate $5.8 billion a year in revenue and is found to be regressive, although it represents about 1 percent of household food and beverage spending. PMID:21940223

  6. Humoral response to catumaxomab correlates with clinical outcome: Results of the pivotal phase II/III study in patients with malignant ascites

    PubMed Central

    Ott, Marion G; Marmé, Frederik; Moldenhauer, Gerhard; Lindhofer, Horst; Hennig, Michael; Spannagl, Rolf; Essing, Mirko M; Linke, Rolf; Seimetz, Diane

    2012-01-01

    The trifunctional antibody catumaxomab is a targeted immunotherapy for the intraperitoneal treatment of malignant ascites. In a Phase II/III trial in cancer patients (n = 258) with malignant ascites, catumaxomab showed a clear clinical benefit vs. paracentesis and had an acceptable safety profile. Human antimouse antibodies (HAMAs), which could be associated with beneficial humoral effects and prolonged survival, may develop against catumaxomab as it is a mouse/rat antibody. This post hoc analysis investigated whether there was a correlation between the detection of HAMAs 8 days after the fourth catumaxomab infusion and clinical outcome. HAMA-positive and HAMA-negative patients in the catumaxomab group and patients in the control group were analyzed separately for all three clinical outcome measures (puncture-free survival, time to next puncture and overall survival) and compared to each other. There was a strong correlation between humoral response and clinical outcome: patients who developed HAMAs after catumaxomab showed significant improvement in all three clinical outcome measures vs. HAMA-negative patients. In the overall population in HAMA-positive vs. HAMA-negative patients, median puncture-free survival was 64 vs. 27 days (p < 0.0001; HR 0.330), median time to next therapeutic puncture was 104 vs. 46 days (p = 0.0002; HR 0.307) and median overall survival was 129 vs. 64 days (p = 0.0003; HR 0.433). Similar differences between HAMA-positive and HAMA-negative patients were seen in the ovarian, nonovarian and gastric cancer subgroups. In conclusion, HAMA development may be a biomarker for catumaxomab response and patients who developed HAMAs sooner derived greater benefit from catumaxomab treatment. PMID:21702044

  7. Effectiveness of Telebehavioral Health Program Nurse Case Managers (NCM): Data Collection Tools and the Process for NCM-Sensitive Outcome Measures.

    PubMed

    Carlson, Judy; Cohen, Roslyn; Bice-Stephens, Wynona

    2014-01-01

    As a part of our nation's pursuit of improvements in patient care outcomes, continuity of care, and cost containment, the case manager has become a vital member on interdisciplinary teams and in health care agencies. Telebehavioral health programs, as a relatively new method of delivering behavioral health care, have recently begun to incorporate case management into their multidisciplinary teams. To determine the efficacy and efficiency of healthcare programs, program managers are charged with the determination of the outcomes of the care rendered to patient populations. However, programs that use telehealth methods to deliver care have unique structures in place that impact ability to collect outcome data. A military medical center that serves the Pacific region developed surveys and processes to distribute, administer, and collect information about a telehealth environment to obtain outcome data for the nurse case manager. This report describes the survey development and the processes created to capture nurse case manager outcomes. Additionally, the surveys and processes developed in this project for measuring outcomes may be useful in other settings and disciplines. PMID:25830797

  8. Annual Average Ambient Particulate Matter Exposure Estimates, Measured Home Particulate Matter, and Hair Nicotine are Associated with Respiratory Outcomes in Adults with Asthma

    PubMed Central

    Balmes, John R.; Cisternas, Miriam; Quinlan, Patricia J.; Trupin, Laura; Lurmann, Fred W.; Katz, Patricia P.; Blanc, Paul D.

    2014-01-01

    Background While exposure to outdoor particulate matter (PM) has been associated with poor asthma outcomes, few studies have investigated the combined effects of outdoor and indoor PM (including secondhand tobacco smoke). Objective To examine the associations between PM and asthma outcomes. Methods We analyzed data from a cohort of adults with asthma and rhinitis (n=302; 82% both conditions; 13% asthma only; 5% rhinitis alone) including measures of home PM, tobacco smoke exposure (hair nicotine and self-report), ambient PM from regional monitoring, distance to roadway, and season (wet or dry). The outcomes of interest were frequent respiratory symptoms and forced expiratory volume in 1 second (FEV1) below the lower limit of normal (NHANES reference values). Multivariable regression analyses examined the associations (Odds Ratio [OR] and 95% Confidence Interval [95%CI]) between exposures and these outcomes, adjusted by sociodemographic characteristics. Results In adjusted analyses of each exposure, the highest tertile of home PM and season of interview were associated with increased odds for more frequent respiratory symptoms (OR=1.64 95%CI: [1.00, 2.69] and OR = 1.66 95%CI: [1.09, 2.51]). The highest tertile of hair nicotine was significantly associated with FEV1 below the lower limit of normal (OR=1.80 95%CI: [1.00, 3.25]). In a model including home PM, ambient PM, and hair nicotine, and season, only two associations remained strong: hair nicotine with FEV1 below the lower limit of normal and season of measurement (dry, April-October) with increased respiratory symptoms (OR=1.85 95%CI: [1.00, 3.41] and OR = 1.54 95%CI: [1.0, 2.37]). When that model was stratified by sex, the highest tertiles of ambient PM and hair nicotine were associated with FEV1 below the lower limit of normal among women (OR=2.23 95%CI: [1.08, 4.61] and OR=2.90 95% CI: [1.32, 6.38]), but not men. The highest tertile of hair nicotine was also associated with increased respiratory symptoms in women but not men (OR=2.38 95% CI: [1.26, 4.49]). When stratified by age, the middle quartile of ambient PM and the highest hair nicotine tertile were associated with increased respiratory symptoms (OR=2.07 95%CI: [1.01, 4.24] and OR=2.55 95%CI: [1.21,5.36]) in those under 55 but not in the older stratum. Conclusions Exposure to PM from both home and ambient sources is associated with increased symptoms and lower lung function in adults with asthma, although these associations vary by type of PM, the respiratory outcome studied, sex and age. PMID:24528996

  9. The development of a patient-reported outcome measure for assessing nighttime symptoms of chronic obstructive pulmonary disease

    PubMed Central

    2013-01-01

    Background The assessment of symptoms of chronic obstructive pulmonary disease (COPD) is important for monitoring and managing the disease and for evaluating outcomes of interventions. COPD patients experience symptoms during the day and night, and symptoms experienced at night often disturb sleep. The aim of this paper is to describe methods used to develop a patient-reported outcome (PRO) instrument for evaluating nighttime symptoms of COPD, and to document evidence for the content validity of the instrument. Methods Literature review and clinician interviews were conducted to inform discussion guides to explore patients’ nighttime COPD symptom experience. Data from focus groups with COPD patients was used to develop a conceptual framework and the content of a new PRO instrument. Patient understanding of the new instrument was assessed via cognitive interviews with COPD patients. Results The literature review confirmed that there is no instrument with evidence of content validity currently available to assess nighttime symptoms of COPD. Additionally, the literature review and clinician interviews suggested the need to understand patients’ experience of specific symptoms in order to evaluate nighttime symptoms of COPD. Analyses of patient focus group data (N = 27) supported saturation of concepts and aided in development of a conceptual framework. Items were generated using patients’ terminology to collect data on concepts in the framework including the occurrence and severity of COPD symptoms, use of rescue medication at night, and nocturnal awakening. Response options were chosen to reflect concepts that were salient to patients. Subsequent cognitive interviewing with ten COPD patients demonstrated that the items, response options, recall period, and instructions were understandable, relevant, and interpreted as intended. Conclusions A new PRO instrument, the Nighttime Symptoms of COPD Instrument (NiSCI), was developed with documented evidence of content validity. The NiSCI is ready for empirical testing, including item reduction and evaluation of psychometric properties. PMID:23799883

  10. Ecological Validity and Clinical Utility of Patient-Reported Outcomes Measurement Information System (PROMIS®) instruments for detecting premenstrual symptoms of depression, anger, and fatigue

    PubMed Central

    Junghaenel, Doerte U.; Schneider, Stefan; Stone, Arthur A.; Christodoulou, Christopher; Broderick, Joan E.

    2014-01-01

    Objective This study examined the ecological validity and clinical utility of NIH Patient Reported-Outcomes Measurement Information System (PROMIS®) instruments for anger, depression, and fatigue in women with premenstrual symptoms. Methods One-hundred women completed daily diaries and weekly PROMIS assessments over 4 weeks. Weekly assessments were administered through Computerized Adaptive Testing (CAT). Weekly CATs and corresponding daily scores were compared to evaluate ecological validity. To test clinical utility, we examined if CATs could detect changes in symptom levels, if these changes mirrored those obtained from daily scores, and if CATs could identify clinically meaningful premenstrual symptom change. Results PROMIS CAT scores were higher in the pre-menstrual than the baseline (ps < .0001) and post-menstrual (ps < .0001) weeks. The correlations between CATs and aggregated daily scores ranged from .73 to .88 supporting ecological validity. Mean CAT scores showed systematic changes in accordance with the menstrual cycle and the magnitudes of the changes were similar to those obtained from the daily scores. Finally, Receiver Operating Characteristic (ROC) analyses demonstrated the ability of the CATs to discriminate between women with and without clinically meaningful premenstrual symptom change. Conclusions PROMIS CAT instruments for anger, depression, and fatigue demonstrated validity and utility in premenstrual symptom assessment. The results provide encouraging initial evidence of the utility of PROMIS instruments for the measurement of affective premenstrual symptoms. PMID:24630180

  11. Does Participation in Home-delivered Meals Programs Improve Outcomes for Older Adults?: Results of a Systematic Review

    PubMed Central

    Campbell, Anthony D.; Godfryd, Alice; Buys, David R.; Locher, Julie L.

    2015-01-01

    Participation in home-delivered meals programs may contribute to the health and independence of older adults living in the community, especially those who are food insecure or those who are making transitions from acute, subacute, and chronic care settings to the home. The purpose of this study was to conduct a comprehensive and systematic review of ALL studies related to home-delivered meals in order to shed light on the state of the science. A complete review of articles appearing in PubMed using the Keyword “Meal” was conducted; and titles, abstracts, and full-texts were screened for relevance. Included in this review are 80 articles. Most studies are descriptive and do not report on outcomes. Frequently reported outcomes included nutritional status based upon self-reported dietary intake. Additionally, most studies included in this review are cross-sectional, have a small sample size, and/or are limited to a particular setting or participant population. More rigorous research is needed to: 1) gain insight into why so few eligible older adults access home-delivered meals programs, 2) support expansion of home-delivered meals to all eligible older adults, 3) better identify what home-delivered meals models alone and in combination with other services works best and for whom, and 4) better target home-delivered meals programs where and when resources are scarce. PMID:26106985

  12. Acute Achilles Tendon RuptureA Randomized, Controlled Study Comparing Surgical and Nonsurgical Treatments Using Validated Outcome Measures

    Microsoft Academic Search

    Katarina Nilsson-Helander; Karin Grävare Silbernagel; Roland Thomeé; Eva Faxén; Nicklas Olsson; Bengt I. Eriksson; Jon Karlsson

    2010-01-01

    Background: There is no consensus regarding the optimal treatment for patients with acute Achilles tendon rupture. Few randomized controlled studies have compared outcomes after surgical or nonsurgical treatment with both groups receiving early mobilization.Purpose: This study was undertaken to compare outcomes of patients with acute Achilles tendon rupture treated with or without surgery using early mobilization and identical rehabilitation protocols.Study

  13. Binge eating and weight loss outcomes in overweight and obese individuals with type 2 diabetes: Results from the Look AHEAD trial

    PubMed Central

    Gorin, Amy A.; Niemeier, Heather M.; Hogan, Patricia; Coday, Mace; Davis, Cralen; DiLillo, Vicki G.; Gluck, Marci E.; Wadden, Thomas A.; West, Delia S.; Williamson, Donald; Yanovski, Susan Z.

    2009-01-01

    Context Binge eating (BE) is common in overweight and obese individuals with type 2 diabetes yet little is known about how BE affects weight loss in this population. Objective To determine whether BE was related to 1-year weight losses in overweight and obese individuals with type 2 diabetes participating in an ongoing clinical trial. Design and Setting Look AHEAD is a randomized controlled trial examining the long-term effect of intentional weight loss on CVD in overweight and obese adults with type 2 diabetes. Participants Overweight and obese individuals, 45–76 years old, with type 2 diabetes (n=5145). Interventions Participants were randomly assigned to an intensive lifestyle intervention (ILI) or to enhanced usual care (DSE). Main outcome measures At baseline and 1-year, participants had their weight measured and completed a fitness test and self-report measures of BE and dietary intake. Four groups were created based on BE status at baseline and 1-year (Yes/Yes, No/No, Yes/No, No/Yes). Analyses controlled for baseline differences between binge eaters and non-binge eaters. Results Most individuals (85.4%) did not report BE at baseline or 1-year, 7.5% reported BE only at baseline, 3.7% reported BE at both times, and 3.4% reported BE only at 1-year, with no differences between ILI and DSE conditions (p=.14). Across ILI and DSE, greater weight losses were observed in participants who stopped BE at 1-year (5.3±.4 kg) and in those who reported no BE at either time point (4.8±.1 kg) than in those who continued to BE (3.1±.6 kg) and those who began BE at 1-year (3.0±.6 kg) (p=.0003). Post hoc analyses suggested these differences were due to changes in caloric intake. Conclusions Overweight and obese individuals with type 2 diabetes who stop binge eating appear just as successful at weight loss as non-binge eaters after one year of treatment. PMID:19047532

  14. Magnetic Measurement Results of the LCLS Undulator Quadrupoles

    SciTech Connect

    Anderson, Scott; Caban, Keith; Nuhn, Heinz-Dieter; Reese, Ed; Wolf, Zachary; /SLAC; ,

    2011-08-18

    This note details the magnetic measurements and the magnetic center fiducializations that were performed on all of the thirty-six LCLS undulator quadrupoles. Temperature rise, standardization reproducibility, vacuum chamber effects and magnetic center reproducibility measurements are also presented. The Linac Coherent Light Source (LCLS) undulator beam line has 33 girders, each with a LCLS undulator quadrupole which focuses and steers the beam through the beam line. Each quadrupole has main quadrupole coils, as well as separate horizontal and vertical trim coils. Thirty-six quadrupoles, thirty-three installed and three spares were, manufactured for the LCLS undulator system and all were measured to confirm that they met requirement specifications for integrated gradient, harmonics and for magnetic center shifts after current changes. The horizontal and vertical dipole trims of each quadrupole were similarly characterized. Each quadrupole was also fiducialized to its magnetic center. All characterizing measurements on the undulator quads were performed with their mirror plates on and after a standardization of three cycles from -6 to +6 to -6 amps. Since the undulator quadrupoles could be used as a focusing or defocusing magnet depending on their location, all quadrupoles were characterized as focusing and as defocusing quadrupoles. A subset of the undulator quadrupoles were used to verify that the undulator quadrupole design met specifications for temperature rise, standardization reproducibility and magnetic center reproducibility after splitting. The effects of the mirror plates on the undulator quadrupoles were also measured.

  15. Does self-regulation and autonomic regulation have an influence on survival in breast and colon carcinoma patients? results of a prospective outcome study

    PubMed Central

    2011-01-01

    Background Cancer Related Fatigue (CRF) and circadian rhythm have a great impact on the quality of life (HRQL) of patients with breast (BC) and colon cancer (CRC). Other patient related outcomes in oncology are measured by new instruments focusing on adaptive characteristics such as sense of coherence or self-regulation, which could be more appropriate as a prognostic tool than classical HRQL. The aim of this study was to assess the association of autonomic regulation (aR) and self-regulation (SR) with survival. Methods 146 cancer patients and 120 healthy controls took part in an initial evaluation in 2000/2001. At a median follow up of 5.9 years later, 62 of 95 BC, 17 of 51 CRC patients, and 85 of 117 healthy controls took part in the follow-up study. 41 participants had died. For the follow-up evaluation, participants were requested to complete the standardized aR and SR questionnaires. Results On average, cancer patients had survived for 10.1 years with the disease. Using a Cox proportional hazard regression with stepwise variables such as age, diagnosis group, Charlson co-morbidity index, body mass index (BMI)) aR and SR. SR were identified as independent parameters with potential prognostic relevance on survival While aR did not significantly influence survival, SR showed a positive and independent impact on survival (OR = 0.589; 95%-CI: 0.354 - 0.979). This positive effect persisted significantly in the sensitivity analysis of the subgroup of tumour patients and in the subscale 'Achieve satisfaction and well-being' and by tendency in the UICC stages nested for the different diagnoses groups. Conclusions Self-regulation might be an independent prognostic factor for the survival of breast and colon carcinoma patients and merits further prospective studies. PMID:21961625

  16. Validity and internal consistency of a Yoruba version of the Ibadan knee/hip osteoathritis outcome measure (Yoruba IKHOAM).

    PubMed

    Odole, A C; Akinpelu, A O; Bamgboye, E A

    2006-09-01

    The Ibadan Knee Hip osteoarthritis Outcome measure (IKHOAM) was developed for patients with Knee/Hip Osteoarthritis in the Nigerian and similar environments. The Yoruba Version was developed to encourage its use in the Southwestern region of Nigeria. The IKHOAM was translated into Yoruba in four separate processes of translation, back translation, committee review and pre-testing. It was administered to a cohort of 164 outpatients with symptomatic OA of the knee and or Hip who attended physiotherapy units in selected hospitals from Southwestern region of Nigeria. The IKHOAM (English Version) was correlated with the Yoruba version and Visual analogue scale (VAS). The Validity of the Yoruba IKHOAM was found to be satisfactory and comparable to the original version (r = 0.67, p = 0.005) for the criterion-related validity and r = -0.31 (p = 0.005) for construct validity. The items in the Yoruba IKHOAM correlated well with each other with Cronbach's alpha coefficient ranging between 0.69 and 0.99. The correlation on the different parts of the Yoruba IKHOAM was satisfactory (alpha = 0.52-0.87). The Yoruba IKHOAM like the original version is a reliable consistent and valid instrument that can be considered for use in the Nigeria environment for evidence based quality healthcare promotion in Knee/Hip OA patients. PMID:17312744

  17. Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

    PubMed Central

    Coluccia, Anna; Ferretti, Fabio; Pozza, Andrea

    2014-01-01

    Purpose The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE) questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course. Patients and methods The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26) receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s ?. Factor invariance was assessed through multigroup analyses. Results Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (?=0.95). Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No significant difference emerged on patient-centeredness between male and female outpatients. Conclusion The HSOPE questionnaire seemed to be a tool with high acceptability and excellent psychometric properties to measure patient-centeredness as a unidimensional construct. Limitations and implications for future research are discussed. PMID:25228826

  18. Moment independent importance measures: new results and analytical test cases.

    PubMed

    Borgonovo, Emanuele; Castaings, William; Tarantola, Stefano

    2011-03-01

    Moment independent methods for the sensitivity analysis of model output are attracting growing attention among both academics and practitioners. However, the lack of benchmarks against which to compare numerical strategies forces one to rely on?ad hoc?experiments in estimating the sensitivity measures. This article introduces a methodology that allows one to obtain moment independent sensitivity measures analytically. We illustrate the procedure by implementing four test cases with different model structures and model input distributions. Numerical experiments are performed at increasing sample size to check convergence of the sensitivity estimates to the analytical values. PMID:21070300

  19. Result of storage term measurements at a sandy grassland site

    NASA Astrophysics Data System (ADS)

    Pintér, Krisztina; Barcza, Zoltán; Balogh, János; Nagy, Zoltán

    2015-04-01

    Eddy covariance (EC) technique is common technique to investigate fluxes over ecosystems. In the past 20 years the focus was on the carbon dioxide (CO2) budget of ecosystems measured as net ecosystem exchange (NEE). Night underestimation of fluxes is a frequent problem, addressed by several EC studies. When the turbulence is low the accumulation of CO2 close to the ground can be significant, so the storage term (rate of change of storage, RCS) has to be taken into account. In the case of tall vegetation storage measurements are routinely done, but in the case of short vegetation it is often neglected based on the assumption that its positive values after sunset and negative values at dawn extinguish each other when calculating daily and yearly sums. The EC system at the sandy grassland (Bugacpuszta, Hungary) was complemented by a 5-level (0.2, 0.5, 1, 2 and 4m) concentration profile measuring system and the storage term was calculated from the profile at half-hourly intervals. RCS was also calculated using only the concentration measurements of the EC system assuming linear concentration profile between the surface and the level of the measurement (linear approach). When comparing the uncorrected and the corrected (profile method) half-hourly fluxes storage correction did not affect the daytime NEE values (slope=1.0084, const=-0.0053, R2=0.9922) and had only a minor effect on the measured Reco values (slope=0.9577, const=0.0066, R2=0.9173). Yearly sums were calculated for the first whole year (August, 2013 - July, 2014) of the concentration profile measurement. Application of the linear approach storage correction enhanced the sink (more negative NEE) by 12 gC m-2 year-1 as compared to the uncorrected yearly sum. On the other hand, the use of storage terms calculated from the concentration profile measurements increased the sink activity by 54 gC m-2 year-1. Considering this more than 4 fold difference, concentration profiling should also be considered in case of grasslands when calculating storage. Acknowledgement: Present work was supported by OTKA-PD 105944.

  20. 48 CFR 1511.011-80 - Data standards for the transmission of laboratory measurement results.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...transmission of laboratory measurement results. 1511.011-80...transmission of laboratory measurement results. The contracting...the contract requires the electronic transmission of environmental measurements from laboratories to...

  1. 48 CFR 1511.011-80 - Data standards for the transmission of laboratory measurement results.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...transmission of laboratory measurement results. 1511.011-80...transmission of laboratory measurement results. The contracting...the contract requires the electronic transmission of environmental measurements from laboratories to...

  2. 48 CFR 1511.011-80 - Data standards for the transmission of laboratory measurement results.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...transmission of laboratory measurement results. 1511.011-80...transmission of laboratory measurement results. The contracting...the contract requires the electronic transmission of environmental measurements from laboratories to...

  3. 40 CFR 761.316 - Interpreting PCB concentration measurements resulting from this sampling scheme.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 false Interpreting PCB concentration measurements resulting from this sampling... § 761.316 Interpreting PCB concentration measurements resulting from this sampling...the portion is based on the surface concentration measured in that sample. If the...

  4. Surgical Treatment for Non-Small Cell Lung Cancer in Patients on Hemodialysis due to Chronic Kidney Disease: Clinical Outcome and Intermediate-Term Results

    PubMed Central

    Park, Byung Jo; Shin, Sumin; Kim, Hong Kwan; Choi, Yong Soo; Kim, Jhingook; Shim, Young Mog

    2015-01-01

    Background Patients on dialysis undergoing surgery belong to a high-risk group. Only a few studies have evaluated the outcome of major thoracic surgical procedures in dialysis patients. We evaluated the outcomes of pulmonary resection for non-small cell lung cancer (NSCLC) in patients on hemodialysis (HD). Methods Between 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses. Results The median duration of HD before surgery was 55.0 months. Five patients underwent lobectomy and two patients underwent wedge resection. Postoperative morbidity occurred in three patients, including pulmonary edema combined with pneumonia, cerebral infarction, and delirium. There were no instances of in-hospital mortality, although one patient died of intracranial bleeding 15 days after discharge. During follow-up, three patients (one patient with pathologic stage IIB NSCLC and two patients with pathologic stage IIIA NSCLC) experienced recurrence and died as a result of the progression of the cancer, while the remaining three patients (with pathologic stage I NSCLC) are alive with no evidence of disease. Conclusion Surgery for NSCLC in HD patients can be performed with acceptable perioperative morbidity. Good medium-term survival in patients with pathologic stage I NSCLC can also be expected. Pulmonary resection seems to be the proper treatment option for dialysis patients with stage I NSCLC.

  5. Combinations of motor measures more strongly predict adverse health outcomes in old age: the rush memory and aging project, a community-based cohort study

    PubMed Central

    2011-01-01

    Objective Motor impairment in old age is a growing public-health concern, and several different constructs have been used to identify motor impairments in older people. We tested the hypothesis that combinations of motor constructs more strongly predict adverse health outcomes in older people. Methods In total, 949 people without dementia, history of stroke or Parkinson's disease, who were participating in the Rush Memory and Aging Project (a longitudinal community-based cohort study), underwent assessment at study entry. From this, three constructs were derived: 1) physical frailty based on grip strength, timed walk, body mass index and fatigue; 2) Parkinsonian Signs Score based on the modified motor section of the Unified Parkinson's Disease Rating Scale; and 3) a motor construct, based on nine strength measures and nine motor performances. Disability and cognitive status were assessed annually. A series of Cox proportional-hazards models, controlling for age, sex and education, were used to examine the association of each of these three constructs alone and in various combinations with death, disability and Alzheimer's disease (AD). Results All three constructs were related (mean r = 0.50, all P < 0.001), and when considered individually in separate proportional-hazards models, were associated with risk of death, incident disability and AD. However, when considered together, combinations of these constructs more strongly predicted adverse health outcomes. Conclusions Physical frailty, parkinsonian signs score and global motor score are related constructs that capture different aspects of motor function. Assessments using several motor constructs may more accurately identify people at the highest risk of adverse health consequences in old age. PMID:21507235

  6. Characterizing the Joint Effect of Diverse Test-Statistic Correlation Structures and Effect Size on False Discovery Rates in a Multiple-Comparison Study of Many Outcome Measures

    NASA Technical Reports Server (NTRS)

    Feiveson, Alan H.; Ploutz-Snyder, Robert; Fiedler, James

    2011-01-01

    In their 2009 Annals of Statistics paper, Gavrilov, Benjamini, and Sarkar report the results of a simulation assessing the robustness of their adaptive step-down procedure (GBS) for controlling the false discovery rate (FDR) when normally distributed test statistics are serially correlated. In this study we extend the investigation to the case of multiple comparisons involving correlated non-central t-statistics, in particular when several treatments or time periods are being compared to a control in a repeated-measures design with many dependent outcome measures. In addition, we consider several dependence structures other than serial correlation and illustrate how the FDR depends on the interaction between effect size and the type of correlation structure as indexed by Foerstner s distance metric from an identity. The relationship between the correlation matrix R of the original dependent variables and R, the correlation matrix of associated t-statistics is also studied. In general R depends not only on R, but also on sample size and the signed effect sizes for the multiple comparisons.

  7. Surveillance for asymptomatic recurrence in resected stage III colon cancer: does it result in a more favorable outcome?

    PubMed Central

    Lim, Howard; Peixoto, Renata D’Alpino

    2015-01-01

    Background Evidence from dated and moderate quality trials supports a modest survival benefit for intensive surveillance in resected colon cancer (CC). This study evaluates surveillance in a modern population-based cohort of stage III CC patients (pts). Methods Records of pts who initiated oxaliplatin-based adjuvant chemotherapy (AC) for stage III CC between 2006-2011 at the British Columbia Cancer Agency (BCCA) were reviewed. Kaplan-Meier and log rank test were generated to investigate whether diagnosis of recurrence based on symptoms was associated with worse overall survival (OS). OS1 and OS2 were measured from date of recurrence or date of initial surgery, respectively. Results Of 635 pts who received AC for stage III CC, 175 pts (27.5%) recurred and 118 (18.6%) died at a median follow-up of 67.7 months. Recurrences were detected by surveillance in 149 pts (41% by CEA elevation and 44% by abnormal imaging), and symptoms in 26 pts (15%). Patients with surveillance-detected recurrences had a shorter median relapse-free survival (RFS) (18.5 vs. 25.3 months, HR 1.82, P<0.001), and longer median OS1 (28.5 vs. 6.5 months, HR 0.37, P<0.001). However, median OS2 was not significantly different (50.9 vs. 39.1 months, HR 0.66, P=0.091). Pts with surveillance-detected recurrence received more potentially curative metastasectomy (39% vs. 7%, P=0.002) and chemotherapy (70% vs. 50%, P=0.03). Conclusions In this modern population-based cohort study, the OS impact of detecting asymptomatic recurrences in stage III CC is unclear. However, pts with asymptomatic recurrences were more likely to receive potentially curative metastasectomy and chemotherapy. PMID:26029453

  8. Baseline depression severity as a predictor of single and combination antidepressant treatment outcome: Results from the CO-MED Trial

    PubMed Central

    Friedman, Edward S.; Davis, Lori L.; Zisook, Sidney; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; Rush, A. John

    2011-01-01

    The objective of this manuscript is to report associations between baseline depressive severity and (1) baseline sociodemographic and clinical characteristics, (2) treatment outcomes, and (3) differential outcomes for three treatment groups. Six hundred and sixty-five outpatients with nonpsychotic, major depressive disorder were prospectively randomized to treatment with either a selective serotonin reuptake inhibitor (SSRI) monotherapy (escitalopram plus placebo) or one of two antidepressant medication combinations (bupropion-sustained release plus escitalopram, or venlafaxine-extended release plus mirtazapine). For purposes of these analyses, participants were divided into four groups based on baseline severity by the 16-item Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR16) total score: mild (0–10) [N=81], moderate (11–15) [N=238], severe (16–20) [N=260] and very severe (21–27) [N=67]. Treatment outcomes at 12 and 28 weeks were compared among the four severity groups. A history of childhood neglect and/or abuse was strongly associated with the severity of adult depression (1/2 of participants in the very severy group versus 1/5–1/4 of those in the mild group reported abuse and/or neglect). The degree of suicidality (e.g., 15/.4% of the very severe group ever attempted suicide versus none in the mild group), the number of suicide attempts (e.g., mean of .41 +/? 1.99 suicide attempts in the severe group versus o.o +/?0.0 in the mild group) and severity of suicidality (e.g., 9.2% of participants in very severe group had a plan or made a gesture versus 5.6% in moderate group and none in the mild group) were increased in more severe groups. Participants with a greater baseline depressive severity reported significantly more psychiatric comorbitities (e..g. [at p < 0.05] increased rates of agoraphobia, bulimia, generalized anxiety, hypocondriasis, panic disorder, post-traumatic stress disorder, social phobia and somatoform disorder, with 23.9 % of participants in the very severe group having reported four or more psychiatric disorders versus 1.2% of the mild group). Combination medication treatments were no more effective in treating severe depressions than was SSRI monotherapy. Remission (61.7% of participants in the mild group achieved remission versus 28.4% in the very severe group) is more difficult to achieve in more severe groups than is response (48.8% of participants in the mild group achieved response versus 58.2% in the very severe group) (p < 0.03) . These data may help us to understand the impact of baseline features on antidepressant medication effectiveness and to inform the personalization of depression treatment across the spectrum of depressive severity. PMID:21920711

  9. Baseline depression severity as a predictor of single and combination antidepressant treatment outcome: results from the CO-MED trial.

    PubMed

    Friedman, Edward S; Davis, Lori L; Zisook, Sidney; Wisniewski, Stephen R; Trivedi, Madhukar H; Fava, Maurizio; Rush, A John

    2012-03-01

    The objective of this manuscript is to report associations between baseline depressive severity and (1) baseline sociodemographic and clinical characteristics, (2) treatment outcomes, and (3) differential outcomes for three treatment groups. Six hundred and sixty-five outpatients with nonpsychotic, major depressive disorder were prospectively randomized to treatment with either a selective serotonin reuptake inhibitor (SSRI) monotherapy (escitalopram plus placebo) or one of two antidepressant medication combinations (bupropion-sustained release plus escitalopram, or venlafaxine-extended release plus mirtazapine). For purposes of these analyses, participants were divided into four groups based on baseline severity by the 16-item Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR(16)) total score: mild (0-10) [N=81], moderate (11-15) [N=238], severe (16-20) [N=260] and very severe (21-27) [N=67]. Treatment outcomes at 12 and 28weeks were compared among the four severity groups. A history of childhood neglect and/or abuse was strongly associated with the severity of adult depression (1/2 of participants in the very severe group versus 1/5-1/4 of those in the mild group reported abuse and/or neglect). The degree of suicidality (e.g., 15/.4% of the very severe group ever attempted suicide versus none in the mild group), the number of suicide attempts (e.g., mean of .41±1.99 suicide attempts in the severe group versus 0.0±0.0 in the mild group) and severity of suicidality (e.g., 9.2% of participants in very severe group had a plan or made a gesture versus 5.6% in moderate group and none in the mild group) were increased in more severe groups. Participants with a greater baseline depressive severity reported significantly more psychiatric comorbidities (e.g. [at p<.05] increased rates of agoraphobia, bulimia, generalized anxiety, hypocondriasis, panic disorder, post-traumatic stress disorder, social phobia and somatoform disorder, with 23.9% of participants in the very severe group having reported four or more psychiatric disorders versus 1.2% of the mild group). Combination medication treatments were no more effective in treating severe depressions than was SSRI monotherapy. Remission (61.7% of participants in the mild group achieved remission versus 28.4% in the very severe group) is more difficult to achieve in more severe groups than is response (48.8% of participants in the mild group achieved response versus 58.2% in the very severe group) (p<.03). These data may help us to understand the impact of baseline features on antidepressant medication effectiveness and to inform the personalization of depression treatment across the spectrum of depressive severity. PMID:21920711

  10. LIVER X RECEPTOR ALPHA GENE POLYMORPHISMS AND VARIABLE CARDIOVASCULAR OUTCOMES IN PATIENTS TREATED WITH ANTIHYPERTENSIVE THERAPY: RESULTS FROM THE INVEST-GENES STUDY

    PubMed Central

    Price, Elvin T.; Pacanowski, Michael A.; Martin, Michael A.; Cooper-DeHoff, Rhonda M.; Pepine, Carl J.; Zineh, Issam; Johnson, Julie A.

    2011-01-01

    BACKGROUND/AIMS Liver X receptor-? (LXRA) is a nuclear receptor that regulates genes important in cholesterol homeostasis and inflammation. Several single nucleotide polymorphisms (SNPs) in the LXRA gene have been previously associated with metabolic phenotypes (dyslipidemia and elevated BMI). Metabolic dysregulation is a major contributor to coronary disease; therefore, we assessed LXRA in INVEST-GENES, a genetic-substudy of a large clinical trial in patients with hypertension and coronary artery disease. METHODS Seven tag SNPs in the LXRA gene region (NR1H3) were selected for study: rs11039149, rs12221497, rs2279238, rs7120118, rs326213, rs11039159 and rs10501321. 1059 subjects were genotyped from the INVEST-GENES case-control set (Verapamil-SR or Atenolol based treatment strategies), comprised of 297 cases frequency matched approximately 2.5:1 with event-free controls by sex and race. The primary outcome was defined as first occurrence of all-cause death, nonfatal MI, or nonfatal stroke. Adjusted odds ratios (OR) were calculated using logistic regression. RESULTS Three of the seven SNPs were associated with significant effects on the primary outcome in Non-Blacks. The variant G allele of rs11039149 and the variant A allele of rs12221497 were associated with reduced risk of experiencing the primary outcome (OR: 0.62, CI: 0.45-0.85, P=0.003 and OR: 0.60, CI: 0.39-0.91, P=0.016 respectively). The rs2279238 genotype was associated with a significant increase in risk for the primary outcome (OR: 1.42, CI: 1.03-1.95, P=0.03). Furthermore, there was a significant genotype-treatment strategy interaction for carriers of the variant T allele of rs2279238 (OR for Verapamil SR strategy compared to Atenolol: 2.86, CI: 1.50-5.46, P=0.0015). Diplotype analyses revealed that the SNPs are rarely co-inherited and support the directionally opposite effects of the SNPs on the primary outcome. CONCLUSIONS LXRA genotypes were associated with variable risk for cardiovascular outcomes and pharmacogenetic effect in INVEST-GENES. These novel findings suggest LXRA is a genetic/pharmacogenetic target that should be further explored. PMID:21562465

  11. Outcomes of Influenza A(H1N1)pdm09 Virus Infection: Results from Two International Cohort Studies

    PubMed Central

    Lynfield, Ruth; Davey, Richard; Dwyer, Dominic E.; Losso, Marcelo H.; Wentworth, Deborah; Cozzi-Lepri, Alessandro; Herman-Lamin, Kathy; Cholewinska, Grazyna; David, Daniel; Kuetter, Stefan; Ternesgen, Zelalem; Uyeki, Timothy M.; Lane, H. Clifford; Lundgren, Jens; Neaton, James D.

    2014-01-01

    Background Data from prospectively planned cohort studies on risk of major clinical outcomes and prognostic factors for patients with influenza A(H1N1)pdm09 virus are limited. In 2009, in order to assess outcomes and evaluate risk factors for progression of illness, two cohort studies were initiated: FLU 002 in outpatients and FLU 003 in hospitalized patients. Methods and Findings Between October 2009 and December 2012, adults with influenza-like illness (ILI) were enrolled; outpatients were followed for 14 days and inpatients for 60 days. Disease progression was defined as hospitalization and/or death for outpatients, and hospitalization for >28 days, transfer to intensive care unit (ICU) if enrolled from general ward, and/or death for inpatients. Infection was confirmed by RT-PCR. 590 FLU 002 and 392 FLU 003 patients with influenza A (H1N1)pdm09 were enrolled from 81 sites in 17 countries at 2 days (IQR 1–3) and 6 days (IQR 4–10) following ILI onset, respectively. Disease progression was experienced by 29 (1 death) outpatients (5.1%; 95% CI: 3.4–7.2%) and 80 inpatients [death (32), hospitalization >28 days (43) or ICU transfer (20)] (21.6%; 95% CI: 17.5–26.2%). Disease progression (death) for hospitalized patients was 53.1% (26.6%) and 12.8% (3.8%), respectively, for those enrolled in the ICU and general ward. In pooled analyses for both studies, predictors of disease progression were age, longer duration of symptoms at enrollment and immunosuppression. Patients hospitalized during the pandemic period had a poorer prognosis than in subsequent seasons. Conclusions Patients with influenza A(H1N1)pdm09, particularly when requiring hospital admission, are at high risk for disease progression, especially if they are older, immunodeficient, or admitted late in infection. These data reinforce the need for international trials of novel treatment strategies for influenza infection and serve as a reminder of the need to monitor the severity of seasonal and pandemic influenza epidemics globally. Trial Registration ClinicalTrials.gov Identifiers: FLU 002- NCT01056354, FLU 003- NCT01056185. PMID:25004134

  12. Early working memory as a racially and ethnically neutral measure of outcome in extremely preterm children at 18-22 months

    PubMed Central

    Lowe, Jean R.; Duncan, Andrea Freeman; Bann, Carla M.; Fuller, Janell; Hintz, Susan R.; Das, Abhik; Higgins, Rosemary D.; Watterberg, Kristi L.

    2013-01-01

    Background Difficulties with executive function has been found in preterm children, resulting in difficulties with learning and school performance. Aim This study evaluated the relationship of early working memory as measured by object permanence items to the cognitive and language scores on the Bayley Scales-III in a cohort of children born extremely preterm. Study Design Logistic regression models were conducted to compare object permanence scores derived from the Bayley Scales-III by race/ethnicity and maternal education, controlling for medical covariates. Subjects Extremely preterm toddlers (526), who were part of a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network's multi-center study, were evaluated at 18-22 months corrected age. Outcome Measures Object permanence scores derived from the Bayley Developmental Scales were compared by race/ethnicity and maternal education, controlling for medical covariates. Results There were no significant differences in object permanence mastery and scores among the treatment groups after controlling for medical and social variables, including maternal education and race/ethnicity. Males and children with intraventricular hemorrhage, retinopathy of prematurity, and bronchopulmonary dysplasia were less likely to demonstrate object permanence mastery and had lower object permanence scores. Children who attained object permanence mastery had significantly higher Bayley Scales-III cognitive and language scores after controlling for medical and socio-economic factors. Conclusions Our measure of object permanence is free of influence from race, ethnic and socio-economic factors. Adding this simple task to current clinical practice could help detect early executive function difficulties in young children. PMID:23993309

  13. Combining accelerator and reactor measurements of ? 13: the first result

    NASA Astrophysics Data System (ADS)

    Machado, P. A. N.; Minakata, H.; Nunokawa, H.; Funchal, R. Zukanovich

    2012-05-01

    The lepton mixing angle ? 13, the only unknown angle in the standard three-flavor neutrino mixing scheme, is finally measured by the recent reactor and accelerator neutrino experiments. We perform a combined analysis of the data coming from T2K, MINOS, Double Chooz, Daya Bay and RENO experiments and find sin2 2 ? 13 = 0.096 ± 0.013(±0.040) at 1 ? (3 ?) CL and that the hypothesis ? 13 = 0 is now rejected at a significance level of 7.7 ?. We also discuss the near future expectation on the precision of the ? 13 determination by using expected data from these ongoing experiments.

  14. Liver Stiffness Measurement among Patients with Chronic Hepatitis B and C: Results from a 5-Year Prospective Study

    PubMed Central

    Christiansen, Karen M.; Mössner, Belinda K.; Hansen, Janne F.; Jarnbjer, Erik F.; Pedersen, Court; Christensen, Peer B.

    2014-01-01

    Liver stiffness measurement (LSM) is widely used to evaluate liver fibrosis, but longitudinal studies are rare. The current study was aimed to monitor LSM during follow-up, and to evaluate the association of LSM data with mortality and liver-related outcomes. We included all patients with chronic viral hepatitis and valid LSM using Fibroscan. Information about liver biopsy, antiviral treatment, and clinical outcome was obtained from medical records and national registers. The study included 845 patients: 597 (71%) with hepatitis C virus (HCV), 235 (28%) with hepatitis B virus (HBV) and 13 (2%) with dual infection. The initial LSM distribution (<7/7–9.9/10–16.9/?17 kPa) was 58%/16%/14%/12%. Among patients with initial LSM values of 7–9.9 kPa, 60% of HCV patients and 83% of HBV patients showed LSM values of <7 kPa at the latest follow-up. Progression rates (defined as >20% and >2 kPa increase, with one measure >7 kPa) were 3.4/100 person years (PY) for HCV and 1.5/100 PY for HBV infected patients. Patients with LSM values of ?17 kPa had the same liver-related complication incidence as patients with biopsy-proven cirrhosis (11.1 versus 12.1/100 PY). Thirteen liver-related deaths occurred among HCV patients (0.6/100 PY), but none among HBV patients. Among patients who died of liver-related causes, all but one had baseline LSM values of ?17 kPa. Overall, patients with LSM values <17 kPa were not associated with adverse outcomes. In contrast, LSM values ?17 kPa were associated with significant risk of liver-related problems. The results of the current study suggest that clinical decisions should not be taken based on a single LSM measurement. PMID:25369038

  15. Effect of combination treatment on patient-related outcome measures in benign prostatic hyperplasia: clinical utility of dutasteride and tamsulosin

    PubMed Central

    Djavan, Bob; Dianat, Seyed Saeid; Kazzazi, Amir

    2011-01-01

    Background: Benign prostatic hyperplasia, the fourth most commonly diagnosed medical condition in the elderly, is a major underlying cause of lower urinary tract symptoms in men. Medical therapy is usually the first therapeutic option. Combination therapy is increasingly used for better symptom relief and outcome. Methods: We searched the literature using the MEDLINE database for the efficacy of combination therapy in men with benign prostatic hyperplasia in terms of symptom improvement and impact on quality of life. Results: Combination therapy with dutasteride and tamsulosin not only provides better symptom improvement and improved urinary flow rate, but is also associated with a more favorable impact on quality of life and patient satisfaction with treatment than monotherapy. Combination therapy also reduces the risk of events related to disease progression, such as acute urinary retention and benign prostatic hyperplasia-related surgery. Conclusion: Combination therapy with dutasteride and tamsulosin is highly efficacious as medical therapy for benign prostatic hyperplasia in patients with moderate-to-severe lower urinary tract symptoms. PMID:22915969

  16. Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes

    PubMed Central

    2011-01-01

    Background There is increasing attention, globally and in countries, to monitoring and addressing the health systems and human resources inputs, processes and outputs that impede or facilitate progress towards achieving the Millennium Development Goals for maternal and child health. We reviewed the situation of human resources for health (HRH) in 68 low- and middle-income countries that together account for over 95% of all maternal and child deaths. Methods We collected and analysed cross-nationally comparable data on HRH availability, distribution, roles and functions from new and existing sources, and information from country reviews of HRH interventions that are associated with positive impacts on health services delivery and population health outcomes. Results Findings from 68 countries demonstrate availability of doctors, nurses and midwives is positively correlated with coverage of skilled birth attendance. Most (78%) of the target countries face acute shortages of highly skilled health personnel, and large variations persist within and across countries in workforce distribution, skills mix and skills utilization. Too few countries appropriately plan for, authorize and support nurses, midwives and community health workers to deliver essential maternal, newborn and child health-care interventions that could save lives. Conclusions Despite certain limitations of the data and findings, we identify some key areas where governments, international partners and other stakeholders can target efforts to ensure a sufficient, equitably distributed and efficiently utilized health workforce to achieve MDGs 4 and 5. PMID:21702913

  17. Patient-reported outcome labeling claims and measurement approach for metastatic castration-resistant prostate cancer treatments in the United States and European Union

    PubMed Central

    2014-01-01

    Background Metastatic castration-resistant prostate cancer (mCRPC) and its treatment significantly affect health-related quality of life (HRQOL). Our objectives were to evaluate and compare patient-reported outcome (PRO) claims granted by the Food and Drug Administration (FDA) and European Medicines Agency (EMA) for 5 recently approved mCRPC treatments and to examine key characteristics, development, and measurement properties of the PRO measures supporting these claims against current regulatory standards. Methods Five products approved for treatment of mCRPC by the FDA and the EMA (2010–2013) were examined: enzalutamide, abiraterone, sipuleucel-T, cabazitaxel, and radium Ra 223 dichloride. United States (US) drug approval packages and European Public Assessment Reports were reviewed. PRO claims in the US labels and European Summaries of Product Characteristics and supporting measures were identified. For PRO measures supporting claims, a targeted literature review was conducted to identify information on key characteristics and measurement properties; this information was compared against FDA PRO guidance criteria. Results Nine PRO “claims” were granted across 4 of 5 products reviewed. The EMA granted more claims (7 claims—4 for pain, 3 for HRQOL) than the FDA (2 claims, both for pain). The Brief Pain Inventory–Short Form (BPI-SF) worst pain item supported most pain claims and was the only measure supporting US claims. EMA pain claims were supported by BPI-SF worst pain (n?=?2) and average pain (n?=?1) items and the McGill Pain Questionnaire Present Pain Intensity component (n?=?1). EMA HRQOL claims were supported by the Functional Assessment of Cancer Therapy–Prostate Module (n?=?2) and the EuroQol 5 Dimensions with visual analogue scale (n?=?1). Pain and prostate cancer–specific HRQOL measures supporting claims met US regulatory standards for construct validity, reliability, and responsiveness; these properties were strongest for the BPI-SF worst pain item. Only the BPI-SF worst pain item has documented content validity in mCRPC. Conclusions PRO label claims were commonly granted across the mCRPC products reviewed. Among the measures reviewed, only the BPI-SF worst pain item supported US label claims. The BPI-SF worst pain item is recommended for pain assessment for the evaluation of new mCRPC treatments. PMID:24989428

  18. Left atrial appendage closure-indications, techniques, and outcomes: results of the European Heart Rhythm Association Survey.

    PubMed

    Pison, Laurent; Potpara, Tatjana S; Chen, Jian; Larsen, Torben B; Bongiorni, Maria Grazia; Blomström-Lundqvist, Carina

    2015-04-01

    The purpose of this EP Wire was to assess the indications, techniques, and outcomes of left atrial appendage occlusion (LAAO) in Europe. Thirty-three European centres, all members of the European Heart Rhythm Association electrophysiology (EP) research network, responded to this survey by completing the questionnaire. The major indication for LAAO (94%) was the prevention of stroke in patients at high thrombo-embolic risk (CHA2DS2-VASc ? 2) and contraindications to oral anticoagulants (OACs). Twenty-one (64%) of the responding centres perform LAAO in their own institution and 80% implanted 30 or less LAAO devices in 2014. Two-dimensional transoesophageal echocardiography was the preferred imaging technique to visualize LAA before, during, and after LAAO in 79, 58, and 62% of the participating centres, respectively. Following LAAO, 49% of the centres prescribe vitamin K antagonists or novel OACs. Twenty-five per cent of the centres combine LAAO with pulmonary vein isolation. The periprocedural complications included death (range, 0-3%), ischaemic or haemorrhagic stroke (0-25%), tamponade (0-25%), and device embolization (0-20%). In conclusion, this EP Wire has demonstrated that LAAO is most commonly employed in patients at high thrombo-embolic risk in whom OAC is contraindicated. The technique is not yet very widespread and the complication rates remain significant. PMID:25833883

  19. The clinical management and outcome of term premature rupture of membrane in East China: results from a retrospective multicenter study

    PubMed Central

    Xia, Hexia; Li, Xilian; Li, Xiaotian; Liang, Huan; Xu, Huan

    2015-01-01

    In this study, we investigated the management of term premature rupture of membranes (PROM) and maternal-fetal outcomes in East China. Between January and December 2012, the term delivery data for 111390 pregnant women was retrospectively analyzed. The subjects were divided into two groups: those women who had term PROM (PROM Group, n=13927) and those who did not (Control Group, n=94341). The general patient characteristics, the mode of delivery, and the maternal and fetal complications were recorded. Statistical analysis was completed using the Student’s t-test and ?2-test. The incidence of term PROM in East China is approximately 12.5%. The maternal demographic and obstetric characteristics were similar between the two groups. Patients in the PROM group had a higher incidence of bacterial vaginitis (BV), chlamydia trachomatis (CT) infection, postpartum hemorrhage, and cesarean section deliveries. Infants in the PROM group experienced higher rates of infection, asphyxia, and jaundice. There was a high cesarean section rate, and further efforts are needed to increase the vaginal delivery rate for women with term PROM.

  20. Predicting blood pressure outcomes using single-item physician-administered measures: a retrospective pooled analysis of observational studies in Belgium

    PubMed Central

    Villa, Lorenzo; Sun, Diana; Denhaerynck, Kris; Vancayzeele, Stefaan; Brié, Heidi; Hermans, Christine; Aerts, Ann; Levengood, Michael; MacDonald, Karen; Abraham, Ivo

    2015-01-01

    Background Patient adherence is often not monitored because existing methods of evaluating adherence are either burdensome or do not accurately predict treatment outcomes. Aim To examine whether two simple, single-item physician-administered measures of patient adherence to antihypertensive medication are predictive of blood pressure outcomes. Design and setting Retrospective database analysis of patients with hypertension treated in Belgian primary care. Method Using pooled data from five observational studies, a sample was identified of 9725 patients who were assessed using two single-item physician-administered measures of adherence to antihypertensive medication: the first item of the Basel Assessment of Adherence Scale (BAAS) and the Visual Analogue Scale (VAS). These two assessment tools were administered by GPs during regular appointments with patients. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and combined SBP/DBP were measured at baseline and at 90 days. Results BAAS-identified adherent patients achieved lower mean SBP and DBP compared with non-adherent patients at 90 days (P<0.001), and had odds ratios of achieving blood pressure control of 0.66 (95% confidence intervals (CI) = 0.61 to 0.73, P<0.001) for SBP, 0.69 (95% CI = 0.62 to 0.76, P<0.001) for DBP, and 0.65 (95% CI = 0.59 to 0.72, P<0.001) for combined SBP/DBP. For VAS-identified adherent patients, the odds ratios of achieving blood pressure control were 0.93 (95% CI = 0.86 to 1.00, P<0.001) for SBP, 0.79 (95% CI = 0.73 to 0.85, P<0.001) for DBP, and 0.91 (95% CI = 0.84 to 0.99, P<0.001) for combined SBP/DBP. Conclusions The first item of the BAAS and the VAS are independent predictors of blood pressure control. These methods can be integrated seamlessly into routine clinical practice by allowing GPs to quickly evaluate a patient’s adherence and tailor treatment recommendations accordingly. PMID:25548319

  1. Results you can rely on Insights into NSZD Rate Measurements

    E-print Network

    Illinois at Urbana-Champaign, University of

    Leik, and Keith Wooburne/TRC Scott MacDonald/BNSF Railway University of Illinois, Urbana ­ Champaign;Results you can rely on Kennett MO ­ Q1 Results Sample Location CO2 Flux Rate (GPAY) TRC-CO2-05 MW-17 819 TRC-CO2-01 MW-18 1,220 TRC-CO2-02 MW-12 738 TRC-CO2-03 480 TRC-CO2-04 NW of MW-12 2,083 Average

  2. Results of model intercomparison : predicted vs. measured system performance.

    SciTech Connect

    Stein, Joshua S.

    2010-10-01

    This is a blind modeling study to illustrate the variability expected between PV performance model results. Objectives are to answer: (1) What is the modeling uncertainty; (2) Do certain models do better than others; (3) How can performance modeling be improved; and (4) What are the sources of uncertainty? Some preliminary conclusions are: (1) Large variation seen in model results; (2) Variation not entirely consistent across systems; (3) Uncertainty in assigning derates; (4) Discomfort when components are not included in database - Is there comfort when the components are in the database?; and (5) Residual analysis will help to uncover additional patterns in the models.

  3. Results of induced atmosphere measurements from the Apollo program

    Microsoft Academic Search

    R. J. Naumann

    1974-01-01

    Experiments on Apollo missions 15, 16, and 17 were utilized in an attempt to learn about the induced environment in the vicinity of manned spacecraft. Photographic sequences were examined to obtain scattered light data from the spacecraft-generated particulates during quiescence periods and after liquid dumps. The results allowed estimates of the obscuration factor and the clearing times after dumps. It

  4. Dynamic model of the electrorheological fluid based on measurement results

    NASA Astrophysics Data System (ADS)

    Krivenkov, K.; Ulrich, S.; Bruns, R.

    2013-02-01

    To develop modern applications for vibration decoupling based on electrorheological fluids with suitable control strategies, an appropriate mathematical model of the ERF is necessary. The devices mostly used have annular-shape electrorheological valves. This requires the use of flow channels to measure the static and dynamic properties of the electrorheological fluids in similar flow conditions. Particularly for the identification of the dynamic behavior of the fluids, the influences of the non-electrorheological properties on the overall system must be taken into account. In this contribution three types of parameters with several nonlinear dependencies for the mapping of the static and dynamic properties of the ERF are considered: electro-rheological, hydraulic and electrical. The mathematical model introduced can precisely demonstrate the static and dynamic behavior of the electrorheological fluid and can be used for the future design of real systems for vibration decoupling or other systems with high dynamic requirements.

  5. Measuring the results in B2C e-commerce

    Microsoft Academic Search

    Lucía Melián-Alzola; Víctor Padrón-Robaina

    2007-01-01

    Purpose – The purpose of this paper is to analyze the role and importance of results in B2C e-commerce from the customer's perspective, together with impact on overall perceived quality and customer attitudes. Design\\/methodology\\/approach – The data base for this study was obtained from a sample of 191 individuals who had purchased on the internet and the techniques used in

  6. Decoding Learning Gains: Measuring Outcomes and the Pivotal Role of the Major and Student Backgrounds. SERU Project and Consortium Research Paper. Research & Occasional Paper Series: CSHE.5.09

    ERIC Educational Resources Information Center

    Thomas, Gregg; Douglass, John Aubrey

    2009-01-01

    Throughout the world, interest in gauging learning outcomes at all levels of education has grown considerably over the past decade. In higher education, measuring "learning outcomes" is viewed by many stakeholders as a relatively new method to judge the "value added" of colleges and universities. The potential to accurately measure learning gains…

  7. LEO Atomic Oxygen Measurements: Experiment Design and Preliminary Results

    NASA Astrophysics Data System (ADS)

    Roberts, G. T.; Chambers, A. R.; White, C. B.

    2009-01-01

    Recently two University of Southampton flight experiments intended to measure the LEO atomic oxygen (AO) flux or fluence have been launched. The first forms part of the Southampton Transient Oxygen and Radiation Monitor (STORM) instrument package that is included as part of the European Materials Exposure and Degradation Experiment on EuTEF (MEDET) module now residing on the external pay load facility of the Columbus laboratory on the International Space Station (ISS). The atomic oxygen detectors on STORM comprise screen-printed thick films of a carbon-polymer resistive ink and also thin sputtered films of zinc oxide. The second is a relatively simple experiment package comprising thick-film carbon-polymer sensors similar to those on STORM; this experiment is currently being flown on the Canadian CanX-2 nano-satellite mission. The design and mode of operation of both types of AO sensor will be described and the current status of both of these experiments will be reviewed.

  8. Comparative Value of Four Measures of Retention in Expert Care in Predicting Clinical Outcomes and Health Care Utilization in HIV Patients

    PubMed Central

    Reveles, Kelly R.; Juday, Timothy R.; Labreche, Matthew J.; Mortensen, Eric M.; Koeller, Jim M.; Seekins, Daniel; Oramasionwu, Christine U.; Bollinger, Mary; Copeland, Laurel A.; Jones, Xavier; Frei, Christopher R.

    2015-01-01

    This study compared the ability of four measures of patient retention in HIV expert care to predict clinical outcomes. This retrospective study examined Veterans Health Administration (VHA) beneficiaries with HIV (ICD-9-CM codes 042 or V08) receiving expert care (defined as HIV-1 RNA viral load and CD4 cell count tests occurring within one week of each other) at VHA facilities from October 1, 2006, to September 30, 2008. Patients were ?18 years old and continuous VHA users for at least 24 months after entry into expert care. Retention measures included: Annual Appointments (?2 appointments annually at least 60 days apart), Missed Appointments (missed ?25% of appointments), Infrequent Appointments (>6 months without an appointment), and Missed or Infrequent Appointments (missed ?25% of appointments or >6 months without an appointment). Multivariable nominal logistic regression models were used to determine associations between retention measures and outcomes. Overall, 8,845 patients met study criteria. At baseline, 64% of patients were virologically suppressed and 37% had a CD4 cell count >500 cells/mm3. At 24 months, 82% were virologically suppressed and 46% had a CD4 cell count >500 cells/mm3. During follow-up, 13% progressed to AIDS, 48% visited the emergency department (ED), 28% were hospitalized, and 0.3% died. All four retention measures were associated with virologic suppression and antiretroviral therapy initiation at 24 months follow-up. Annual Appointments correlated positively with CD4 cell count >500 cells/mm3. Missed Appointments was predictive of all primary and secondary outcomes, including CD4 cell count ?500 cells/mm3, progression to AIDS, ED visit, and hospitalization. Missed Appointments was the only measure to predict all primary and secondary outcomes. This finding could be useful to health care providers and public health organizations as they seek ways to optimize the health of HIV patients. PMID:25794182

  9. Introduction Main result Manner of proof Usable hyperbolicity and SRB measures

    E-print Network

    Climenhaga, Vaughn

    Introduction Main result Manner of proof Usable hyperbolicity and SRB measures Vaughn Climenhaga result Manner of proof 1 Introduction and classical results Definition of SRB measure Examples, known and otherwise 2 Main result Existence of an SRB measure Maps on the boundary of Axiom A: Slowdown, no shear Maps

  10. Child Welfare Outcomes 1998: Annual Report

    NSDL National Science Digital Library

    2000-01-01

    This report is the first in a series of annual reports from the Department of Health and Human Services required by the Adoption and Safe Families Act of 1997 (ASFA). The report "presents data on State performance in meeting the needs of children and families who come into contact with the child welfare system, focusing specifically on the "outcomes, or results, for these children." It also examines the condition of child welfare programs nationwide, presents data measuring outcomes, and offers findings and conclusions.

  11. Outcomes in Registered, Ongoing Randomized Controlled Trials of Patient Education

    PubMed Central

    Pino, Cécile; Boutron, Isabelle; Ravaud, Philippe

    2012-01-01

    Background With the increasing prevalence of chronic noncommunicable diseases, patient education is becoming important to strengthen disease prevention and control. We aimed to systematically determine the extent to which registered, ongoing randomized controlled trials (RCTs) evaluated an educational intervention focus on patient-important outcomes (i.e., outcomes measuring patient health status and quality of life). Methods On May 6, 2009, we searched for all ongoing RCTs registered in the World Health Organization International Clinical Trials Registry platform. We used a standardized data extraction form to collect data and determined whether the outcomes assessed were 1) patient-important outcomes such as clinical events, functional status, pain, or quality of life or 2) surrogate outcomes, such as biological outcome, treatment adherence, or patient knowledge. Principal Findings We selected 268 of the 642 potentially eligible studies and assessed a random sample of 150. Patient-important outcomes represented 54% (178 of 333) of all primary outcomes and 46% (286 of 623) of all secondary outcomes. Overall, 69% of trials (104 of 150) used at least one patient-important outcome as a primary outcome and 66% (99 of 150) as a secondary outcome. Finally, for 31% of trials (46 of 150), primary outcomes were only surrogate outcomes. The results varied by medical area. In neuropsychiatric disorders, patient important outcomes represented 84% (51 of 61) of primary outcomes, as compared with 54% (32 of 59) in malignant neoplasm and 18% (4 of 22) in diabetes mellitus trials. In addition, only 35% assessed the long-term impact of interventions (i.e., >6 months). Conclusions There is a need to improve the relevance of outcomes and to assess the long term impact of educational interventions in RCTs. PMID:22916183

  12. How outcomes are defined in clinical trials of mechanically ventilated adults and children.

    PubMed

    Blackwood, Bronagh; Clarke, Mike; McAuley, Danny F; McGuigan, Peter J; Marshall, John C; Rose, Louise

    2014-04-15

    Systematic reviews have considerable potential to provide evidence-based data to aid clinical decision-making. However, there is growing recognition that trials involving mechanical ventilation lack consistency in the definition and measurement of ventilation outcomes, creating difficulties in combining data for meta-analyses. To address the inconsistency in outcome definitions, international standards for trial registration and clinical trial protocols published recommendations, effectively setting the "gold standard" for reporting trial outcomes. In this Critical Care Perspective, we review the problems resulting from inconsistent outcome definitions and inconsistent reporting of outcomes (outcome sets). We present data highlighting the variability of the most commonly reported ventilation outcome definitions. Ventilation outcomes reported in trials over the last 6 years typically fall into four domains: measures of ventilator dependence; adverse outcomes; mortality; and resource use. We highlight the need, first, for agreement on outcome definitions and, second, for a minimum core outcome set for trials involving mechanical ventilation. A minimum core outcome set would not restrict trialists from measuring additional outcomes, but would overcome problems of variability in outcome selection, measurement, and reporting, thereby enhancing comparisons across trials. PMID:24512505

  13. Echocardiographic measurement methods for left ventricular linear dimensions in children result in predictable variations in results.

    PubMed

    Kutty, Shelby; Russell, David; Li, Ling; Hasan, Rimsha; Peng, Qinghai; Frommelt, Peter C; Danford, David A

    2014-02-01

    Precise quantification of left ventricular (LV) cavity dimensions assumes great importance in clinical cardiology. Pediatric guidelines recommend the left parasternal short axis (PSA) imaging plane for measuring LV cavity dimensions, while measuring from the long axis (PLA) plane is the convention in adult echocardiography. We sought to compare measurements obtained by two-dimensional (2D) and M-mode (MM) techniques in the two imaging planes. Healthy subjects were prospectively recruited for research echocardiography. Complete 2D, spectral and color flow Doppler examinations were performed in a non-sedated state. All subjects had structurally and functionally normal hearts. LV cavity dimensions were obtained in PLA and PSA views using 2D and MM yielding four measurement sets for each subject: PLA direct 2D; PLA 2D-guided MM, PSA direct 2D, PSA 2D-guided MM. A commercially available ultrasound system (Vivid E9, GE) was used and data stored digitally for subsequent analysis (EchoPAC BT11, GE). Acquisition and measurements were made by a single observer from at least three consecutive cardiac cycles, and averaged for each of the four categories. The study cohort consisted of 114 subjects (mean age 9 years, range 1-18; mean BSA 1.1 m(2), range 0.42-2.6). The smallest estimate of LV end-diastolic dimension (LVED) was obtained by PLA 2D, with larger estimates by PLA MM, PSA 2D, and PSA MM. Largest estimates of LV end-systolic dimension (LVES) are by 2D methods, with smaller estimates by both MM techniques. The smallest shortening fraction (SF) was by PLA 2D; other methods yielded larger SF. Temporal resolution is limited in 2D methodology and may account for the smaller LVED, larger LVES and smaller SF observed. Long axis methodology may predispose to off-center or non-perpendicular data acquisition and the potential for dimensional underestimation, particularly in diastole. Consistency in method for assessment of LV dimensions in children is an important factor for serial comparisons. PMID:24322889

  14. Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance

    PubMed Central

    2014-01-01

    Background Despite overall progress in treatment of autoimmune diseases, patients with systemic lupus erythematosus (SLE) experience many inflammatory symptoms representing an unmet medical need. This study aimed to create a conceptual model of the humani