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Sample records for achieve improved outcomes

  1. Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

    PubMed Central

    Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

    2015-01-01

    While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. PMID:26178332

  2. Achievement for All: improving psychosocial outcomes for students with special educational needs and disabilities.

    PubMed

    Humphrey, Neil; Lendrum, Ann; Barlow, Alexandra; Wigelsworth, Michael; Squires, Garry

    2013-04-01

    Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA) programme that was designed to improve outcomes for students with SEND through: (1) academic assessment, tracking and intervention, (2) structured conversations with parents, and (3) developing provision to improve wider outcomes (e.g. positive relationships). Using a quasi-experimental, pre-test-post-test control group design, we assessed the impact of AfA on teacher ratings of the behaviour problems, positive relationships and bullying of students with SEND over an 18-month period. Participants were 4758 students with SEND drawn from 323 schools across England. Our main impact analysis demonstrated that AfA had a significant impact on all three response variables when compared to usual practice. Hierarchical linear modelling of data from the intervention group highlighted a range of school-level contextual factors and implementation activities and student-level individual differences that moderated the impact of AfA on our study outcomes. The implications of our findings are discussed, and study strengths and limitations are noted. PMID:23380579

  3. Achievement for All: Improving Psychosocial Outcomes for Students with Special Educational Needs and Disabilities

    ERIC Educational Resources Information Center

    Humphrey, Neil; Lendrum, Ann; Barlow, Alexandra; Wigelsworth, Michael; Squires, Garry

    2013-01-01

    Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA)…

  4. Major Field Achievement Test in Business: Guidelines for Improved Outcome Scores--Part I

    ERIC Educational Resources Information Center

    McLaughlin, J. Patrick; White, Jason T.

    2007-01-01

    Outcomes measurements have always been an important part of proving to outside constituencies how you "measure up" to other schools with your business programs. A common nationally-normed exam that is used is the Major Field Achievement Test in Business from Educational Testing Services. Our paper discusses some guidelines that we are "pilot…

  5. Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?

    PubMed Central

    Bustreo, Flavia; Harding, April; Axelsson, Henrik

    2003-01-01

    The private sector exerts a significant and critical influence on child health outcomes in developing countries, including the health of poor children. This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector's influence on child health outcomes. This influence goes beyond service provision by private providers and nongovernmental organizations (NGOs). Pharmacies, drug sellers, private suppliers, and food producers also have an impact on the health of children. Many governments are experimenting with strategies to engage the private sector to improve child health. The article analyses some of the most promising strategies, and suggests that a number of constraints make it hard for policy-makers to emulate these approaches. Few experiences are clearly described, monitored, and evaluated. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of how to engage the private sector most effectively. The starting point should include the evaluation of the presence and potential of the private sector, including actors such as professional associations, producer organizations, community groups, and patients' organizations. PMID:14997241

  6. Schooling and Cognitive Achievements of Children in Morocco: Can the Government Improve Outcomes? World Bank Discussion Papers, No. 264.

    ERIC Educational Resources Information Center

    Khandker, Shahidur R.; And Others

    This paper uses data from the Morocco Living Standard Survey in an econometric investigation of the relative effectiveness of supply- and demand-side factors in determining educational outcomes. A wide range of factors are examined that may be responsible for differences in grade completion levels and achievement among sexes, regions, and urban…

  7. Achieving equity in HIV-treatment outcomes: can social protection improve adolescent ART-adherence in South Africa?

    PubMed Central

    Cluver, L. D.; Toska, E.; Orkin, F. M.; Meinck, F.; Hodes, R.; Yakubovich, A. R.; Sherr, L.

    2016-01-01

    ABSTRACT Low ART-adherence amongst adolescents is associated with morbidity, mortality and onward HIV transmission. Reviews find no effective adolescent adherence-promoting interventions. Social protection has demonstrated benefits for adolescents, and could potentially improve ART-adherence. This study examines associations of 10 social protection provisions with adherence in a large community-based sample of HIV-positive adolescents. All 10–19-year-olds ever ART-initiated in 53 government healthcare facilities in a health district of South Africa’s Eastern Cape were traced and interviewed in 2014–2015 (n = 1175 eligible). About 90% of the eligible sample was included (n = 1059). Social protection provisions were “cash/cash in kind”: government cash transfers, food security, school fees/materials, school feeding, clothing; and “care”: HIV support group, sports groups, choir/art groups, positive parenting and parental supervision/monitoring. Analyses used multivariate regression, interaction and marginal effects models in SPSS and STATA, controlling for socio-demographic, HIV and healthcare-related covariates. Findings showed 36% self-reported past-week ART non-adherence (<95%). Non-adherence was associated with increased opportunistic infections (p = .005, B .269, SD .09), and increased likelihood of detectable viral load at last test (>75 copies/ml) (aOR 1.98, CI 1.1–3.45). Independent of covariates, three social protection provisions were associated with reduced non-adherence: food provision (aOR .57, CI .42–.76, p < .001); HIV support group attendance (aOR .60, CI .40–.91, p < .02), and high parental/caregiver supervision (aOR .56, CI .43–.73, p < .001). Combination social protection showed additive benefits. With no social protection, non-adherence was 54%, with any one protection 39–41%, with any two social protections, 27–28% and with all three social protections, 18%. These results demonstrate that social protection provisions

  8. Achieving equity in HIV-treatment outcomes: can social protection improve adolescent ART-adherence in South Africa?

    PubMed

    Cluver, L D; Toska, E; Orkin, F M; Meinck, F; Hodes, R; Yakubovich, A R; Sherr, L

    2016-03-01

    Low ART-adherence amongst adolescents is associated with morbidity, mortality and onward HIV transmission. Reviews find no effective adolescent adherence-promoting interventions. Social protection has demonstrated benefits for adolescents, and could potentially improve ART-adherence. This study examines associations of 10 social protection provisions with adherence in a large community-based sample of HIV-positive adolescents. All 10-19-year-olds ever ART-initiated in 53 government healthcare facilities in a health district of South Africa's Eastern Cape were traced and interviewed in 2014-2015 (n = 1175 eligible). About 90% of the eligible sample was included (n = 1059). Social protection provisions were "cash/cash in kind": government cash transfers, food security, school fees/materials, school feeding, clothing; and "care": HIV support group, sports groups, choir/art groups, positive parenting and parental supervision/monitoring. Analyses used multivariate regression, interaction and marginal effects models in SPSS and STATA, controlling for socio-demographic, HIV and healthcare-related covariates. Findings showed 36% self-reported past-week ART non-adherence (<95%). Non-adherence was associated with increased opportunistic infections (p = .005, B .269, SD .09), and increased likelihood of detectable viral load at last test (>75 copies/ml) (aOR 1.98, CI 1.1-3.45). Independent of covariates, three social protection provisions were associated with reduced non-adherence: food provision (aOR .57, CI .42-.76, p < .001); HIV support group attendance (aOR .60, CI .40-.91, p < .02), and high parental/caregiver supervision (aOR .56, CI .43-.73, p < .001). Combination social protection showed additive benefits. With no social protection, non-adherence was 54%, with any one protection 39-41%, with any two social protections, 27-28% and with all three social protections, 18%. These results demonstrate that social protection provisions, particularly combinations of "cash

  9. Teleophthalmology: improving patient outcomes?

    PubMed Central

    Sreelatha, Omana Kesary; Ramesh, Sathyamangalam VenkataSubbu

    2016-01-01

    Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP). Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR), glaucoma, age-related macular degeneration (ARMD), and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time. Considering the improved quality of patient care and patient satisfaction reported for these telemedicine services, this review explores how teleophthalmology helps to improve patient outcomes. PMID:26929592

  10. Teleophthalmology: improving patient outcomes?

    PubMed

    Sreelatha, Omana Kesary; Ramesh, Sathyamangalam VenkataSubbu

    2016-01-01

    Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP). Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR), glaucoma, age-related macular degeneration (ARMD), and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients' assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time. Considering the improved quality of patient care and patient satisfaction reported for these telemedicine services, this review explores how teleophthalmology helps to improve patient outcomes. PMID:26929592

  11. Simulation: improving patient outcomes.

    PubMed

    Smith, Abi; Siassakos, Dimitrios; Crofts, Joanna; Draycott, Tim

    2013-06-01

    Effective training has been shown to improve perinatal care and outcome, decrease litigation claims and reduce midwifery sick leave. To be effective, training should be incentivised, in a realistic context, and delivered to inter-professional teams similar to those delivering actual care. Teamwork training is a useful addition, but it should be based on the characteristics of effective teamwork as derived from the study of frontline teams. Implementation of simulation and teamwork training is challenging, with constraints on staff time, facilities and finances. Local adoption and adaptation of effective programmes can help keep costs down, and make them locally relevant whilst maintaining effectiveness. Training programmes need to evolve continually in line with new evidence. To do this, it is vital to monitor outcomes and robustly evaluate programmes for their impact on patient care and outcome, not just on participants. PMID:23721770

  12. Enhanced loading regimen of teicoplanin is necessary to achieve therapeutic pharmacokinetics levels for the improvement of clinical outcomes in patients with renal dysfunction.

    PubMed

    Ueda, T; Takesue, Y; Nakajima, K; Ichiki, K; Doita, A; Wada, Y; Tsuchida, T; Takahashi, Y; Ishihara, M; Ikeuchi, H; Uchino, M; Kimura, T

    2016-09-01

    We evaluated the clinical efficacy and safety of teicoplanin according to the pharmacokinetics (PK) therapeutic level achieved in patients with renal dysfunction. Target trough concentration (Cmin) was ≥15-30 μg/ml which has been recommended in patients with normal renal function. Adult patients (estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2)) who were treated by teicoplanin were included in the study. We adopted two types of regimen for the initial 3 days: the conventional regimen, and the enhanced loading regimen (10 mg/kg twice daily on the 1st day, followed by 6.7-10 mg/kg once daily for the 2nd and 3rd days]. Two hundred and eighty-eight patients were evaluated for safety, and 106 patients with methicillin-resistant Staphylococcus aureus (MRSA) infections were evaluated for clinical efficacy. A significantly higher success rate was obtained in patients who achieved the target initial Cmin compared with those that did not (75.0 % vs 50.0 %, p = 0.008). In a multivariate analysis, initial Cmin ≥15 μg/ml was an independent factor for clinical success (adjusted odds ratio: 4.20, 95 % confidence interval: 1.34-13.15). In patients with 15-30 μg/ml of maximal Cmin during therapy, nephrotoxicity occurred in 13.1 %, and hepatotoxicity in 2.6 %, and these incidences were not significantly higher compared with those patients with <15 μg/ml. In conclusion, achievement of Cmin of 15-30 μg/ml without delay was necessary to improve clinical outcomes for the treatment by teicoplanin in patients with renal dysfunction. Further investigation is required regarding the optimal loading regimen to achieve the therapeutic levels in those patients. PMID:27278654

  13. Using optimal combination of teaching-learning methods (open book assignment and group tutorials) as revision exercises to improve learning outcome in low achievers in biochemistry.

    PubMed

    Rajappa, Medha; Bobby, Zachariah; Nandeesha, H; Suryapriya, R; Ragul, Anithasri; Yuvaraj, B; Revathy, G; Priyadarssini, M

    2016-07-01

    Graduate medical students of India are taught Biochemistry by didactic lectures and they hardly get any opportunity to clarify their doubts and reinforce the concepts which they learn in these lectures. We used a combination of teaching-learning (T-L) methods (open book assignment followed by group tutorials) to study their efficacy in improving the learning outcome. About 143 graduate medical students were classified into low (<50%: group 1, n = 23), medium (50-75%: group 2, n = 74), and high (>75%: group 3, n = 46) achievers, based on their internal assessment marks. After the regular teaching module on the topics "Vitamins and Enzymology", all the students attempted an open book assignment without peer consultation. Then all the students participated in group tutorials. The effects on the groups were evaluated by pre and posttests at the end of each phase, with the same set of MCQs. Gain from group tutorials and overall gain was significantly higher in the low achievers, compared to other groups. High and medium achievers obtained more gain from open book assignment, than group tutorials. The overall gain was significantly higher than the gain obtained from open book assignment or group tutorials, in all three groups. All the three groups retained the gain even after 1 week of the exercise. Hence, optimal use of novel T-L methods (open book assignment followed by group tutorials) as revision exercises help in strengthening concepts in Biochemistry in this oft neglected group of low achievers in graduate medical education. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(4):321-325, 2016. PMID:26891594

  14. The Economic Benefits of Closing Educational Achievement Gaps: Promoting Growth and Strengthening the Nation by Improving the Educational Outcomes of Children of Color

    ERIC Educational Resources Information Center

    Lynch, Robert G.; Oakford, Patrick

    2014-01-01

    Our nation is currently experiencing growing levels of income and wealth inequality, which are contributing to longstanding racial and ethnic gaps in education outcomes and other areas. This report quantifies the economic benefits of closing one of the most harmful racial and ethnic gaps: the educational achievement gap that exists between black…

  15. Postmastectomy Radiation Improves the Outcome of Patients With Locally Advanced Breast Cancer Who Achieve a Pathologic Complete Response to Neoadjuvant Chemotherapy

    SciTech Connect

    McGuire, Sean E.; Gonzalez-Angulo, Ana M.; Huang, Eugene H.; Tucker, Susan L.; Kau, S.-W.C.; Yu, T.-K.; Strom, Eric A.; Oh, Julia L.; Woodward, Wendy A.; Tereffe, Welela; Hunt, Kelly K.; Kuerer, Henry M.; Sahin, Aysegul A.; Hortobagyi, Gabriel N.; Buchholz, Thomas A. . E-mail: tbuchhol@mdanderson.org

    2007-07-15

    Purpose: The aim of this study was to investigate the role of postmastectomy radiation therapy in women with breast cancer who achieved a pathologic complete response (pCR) to neoadjuvant chemotherapy. Methods and Materials: We retrospectively identified 226 patients treated at our institution who achieved a pCR at surgery after receiving neoadjuvant chemotherapy. Of these, the 106 patients without inflammatory breast cancer who were treated with mastectomy were analyzed. The patients' clinical stages at diagnosis were I in 2%, II in 31%, IIIA in 30%, IIIB in 25%, and IIIC in 11% (American Joint Committee on Cancer 2003 system). Of the patients, 92% received anthracycline-based chemotherapy, and 38% also received a taxane. A total of 72 patients received postmastectomy radiation therapy, and 34 did not. The actuarial rates of local-regional recurrence (LRR) and survival of the two groups were compared using the log-rank test. Results: The median follow-up of surviving patients was 62 months. Use of radiation therapy did not affect the 10-year rates of LRR for patients with Stage I or II disease (the 10-year LRR rates were 0% for both groups). However, the 10-year LRR rate for patients with Stage III disease was significantly improved with radiation therapy (7.3% {+-} 3.5% with vs. 33.3% {+-} 15.7% without; p 0.040). Within this cohort, use of radiation therapy was also associated with improved disease-specific and overall survival. Conclusion: Postmastectomy radiation therapy provides a significant clinical benefit for breast cancer patients who present with clinical Stage III disease and achieve a pCR after neoadjuvant chemothearpy.

  16. Can Judges Improve Academic Achievement?

    ERIC Educational Resources Information Center

    Greene, Jay P.; Trivitt, Julie R.

    2008-01-01

    Over the last 3 decades student achievement has remained essentially unchanged in the United States, but not for a lack of spending. Over the same period a myriad of education reforms have been suggested and per-pupil spending has more than doubled. Since the 1990s the education reform attempts have frequently included judicial decisions to revise…

  17. Do Charter Schools Improve Student Achievement?

    ERIC Educational Resources Information Center

    Clark, Melissa A.; Gleason, Philip M.; Tuttle, Christina Clark; Silverberg, Marsha K.

    2015-01-01

    This article presents findings from a lottery-based study of the impacts of a broad set of 33 charter middle schools across 13 states on student achievement. To estimate charter school impacts, we compare test score outcomes of students admitted to these schools through the randomized admissions lotteries with outcomes of applicants who were not…

  18. Pancreatic cancer-improved care achievable

    PubMed Central

    Buanes, Trond A

    2014-01-01

    Pancreatic adenocarcinoma is one of the most aggressive cancers, and the decline in mortality observed in most other cancer diseases, has so far not taken place in pancreatic cancer. Complete tumor resection is a requirement for potential cure, and the reorganization of care in the direction of high patient-volume centers, offering multimodal treatment, has improved survival and Quality of Life. Also the rates and severity grade of complications are improving in high-volume pancreatic centers. One of the major problems worldwide is underutilization of surgery in resectable pancreatic cancer. Suboptimal investigation, follow up and oncological treatment outside specialized centers are additional key problems. New chemotherapeutic regimens like FOLFIRINOX have improved survival in patients with metastatic disease, and different adjuvant treatment options result in well documented survival benefit. Neoadjuvant treatment is highly relevant, but needs further evaluation. Also adjuvant immunotherapy, in the form of vaccination with synthetic K-Ras-peptides, has been shown to produce long term immunological memory in cytotoxic T-cells in long term survivors. Improvement in clinical outcome is already achievable and further progress is expected in the near future for patients treated with curative as well as palliative intention. PMID:25132756

  19. Improving Achievement in Gaelic. Improving Series

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2005

    2005-01-01

    The aim of this report is to provide an overview of the development of provision for Gaelic education in Scottish schools, 11 years on from the Inspectorate's last major review of the area. The report sets out to provide an update showing what progress has been achieved since that time, with a specific focus on pre-school, primary and secondary…

  20. Does Children's Academic Achievement Improve when Single Mothers Marry?

    ERIC Educational Resources Information Center

    Wagmiller, Robert L., Jr.; Gershoff, Elizabeth; Veliz, Philip; Clements, Margaret

    2010-01-01

    Promoting marriage, especially among low-income single mothers with children, is increasingly viewed as a promising public policy strategy for improving developmental outcomes for disadvantaged children. Previous research suggests, however, that children's academic achievement either does not improve or declines when single mothers marry. In this…

  1. Creating Effective Board-CEO Relationships and Fundraising to Achieve Successful Student Outcomes

    ERIC Educational Resources Information Center

    White, Frances L.

    2011-01-01

    More and more accountability and successful educational outcomes are being demanded of colleges. Achieving successful outcomes requires strong and courageous leadership at all levels of the institution, but getting the faculty to improve teaching and learning outcomes very often requires a president/chief executive officer (CEO) who not only…

  2. Improving Student Achievement in Math and Science

    NASA Technical Reports Server (NTRS)

    Sullivan, Nancy G.; Hamsa, Irene Schulz; Heath, Panagiota; Perry, Robert; White, Stacy J.

    1998-01-01

    As the new millennium approaches, a long anticipated reckoning for the education system of the United States is forthcoming, Years of school reform initiatives have not yielded the anticipated results. A particularly perplexing problem involves the lack of significant improvement of student achievement in math and science. Three "Partnership" projects represent collaborative efforts between Xavier University (XU) of Louisiana, Southern University of New Orleans (SUNO), Mississippi Valley State University (MVSU), and the National Aeronautics and Space Administration (NASA), Stennis Space Center (SSC), to enhance student achievement in math and science. These "Partnerships" are focused on students and teachers in federally designated rural and urban empowerment zones and enterprise communities. The major goals of the "Partnerships" include: (1) The identification and dissemination of key indices of success that account for high performance in math and science; (2) The education of pre-service and in-service secondary teachers in knowledge, skills, and competencies that enhance the instruction of high school math and science; (3) The development of faculty to enhance the quality of math and science courses in institutions of higher education; and (4) The incorporation of technology-based instruction in institutions of higher education. These goals will be achieved by the accomplishment of the following objectives: (1) Delineate significant ?best practices? that are responsible for enhancing student outcomes in math and science; (2) Recruit and retain pre-service teachers with undergraduate degrees in Biology, Math, Chemistry, or Physics in a graduate program, culminating with a Master of Arts in Curriculum and Instruction; (3) Provide faculty workshops and opportunities for travel to professional meetings for dissemination of NASA resources information; (4) Implement methodologies and assessment procedures utilizing performance-based applications of higher order

  3. SOARing Into Strategic Planning: Engaging Nurses to Achieve Significant Outcomes.

    PubMed

    Wadsworth, Barbara; Felton, Fiona; Linus, Rita

    2016-01-01

    In 2013, a new system chief nursing officer engaged the nursing leaders and staff in an Appreciative Inquiry process utilizing strengths, opportunities, aspirations, and results (SOAR), and a Journey of Excellence to assess and understand the current environment. The ultimate goal was to engage all nurses in strategic planning and goal setting to connect their patient care to the system strategic initiatives. This work led to the creation of a nursing vision, a revised professional practice model and greater council alignment, resulting in significant positive change and ongoing advancement throughout the system. The shared decision-making structure was key to the process with a direct connection of each council's goals, leading to the successful achievement of 34 of the 36 goals in 2 years. This article outlines the process, tools, and staff engagement strategies used to achieve system-wide success. This methodology has improved the outcomes across the organization in both small and system-wide work groups. This work can easily be replicated and adapted to help disparate staffs brought together through mergers or acquisitions to become aligned as a new team. This process, model, and framework, provides structure and results in significant outcomes that recognizes and celebrates the work of individual entities while aligning future strategies and goals. PMID:27584888

  4. Social-Emotional Factors Affecting Achievement Outcomes Among Disadvantaged Students: Closing the Achievement Gap.

    PubMed

    Becker, Bronwyn E; Luthar, Suniya S

    2002-01-01

    Despite concentrated efforts at improving inferior academic outcomes among disadvantaged students, a substantial achievement gap between the test scores of these students and others remains (Jencks & Phillips, 1998; National Center for Education Statistics, 2000a, 2000b; Valencia & Suzuki, 2000). Existing research used ecological models to document social-emotional factors at multiple levels of influence that undermine academic performance. This article integrates ideas from various perspectives in a comprehensive and interdisciplinary model that will inform policy makers, administrators, and schools about the social-emotional factors that act as both risk and protective factors for disadvantaged students' learning and opportunities for academic success. Four critical social-emotional components that influence achievement performance (academic and school attachment, teacher support, peer values, and mental health) are reviewed. PMID:23255834

  5. Social–Emotional Factors Affecting Achievement Outcomes Among Disadvantaged Students: Closing the Achievement Gap

    PubMed Central

    Becker, Bronwyn E.; Luthar, Suniya S.

    2012-01-01

    Despite concentrated efforts at improving inferior academic outcomes among disadvantaged students, a substantial achievement gap between the test scores of these students and others remains (Jencks & Phillips, 1998; National Center for Education Statistics, 2000a, 2000b; Valencia & Suzuki, 2000). Existing research used ecological models to document social–emotional factors at multiple levels of influence that undermine academic performance. This article integrates ideas from various perspectives in a comprehensive and interdisciplinary model that will inform policy makers, administrators, and schools about the social–emotional factors that act as both risk and protective factors for disadvantaged students’ learning and opportunities for academic success. Four critical social–emotional components that influence achievement performance (academic and school attachment, teacher support, peer values, and mental health) are reviewed. PMID:23255834

  6. Science Achievement for All: Improving Science Performance and Closing Achievement Gaps

    NASA Astrophysics Data System (ADS)

    Jackson, Julie K.; Ash, Gwynne

    2012-11-01

    This article addresses the serious and growing need to improve science instruction and science achievement for all students. We will describe the results of a 3-year study that transformed science instruction and student achievement at two high-poverty ethnically diverse public elementary schools in Texas. The school-wide intervention included purposeful planning, inquiry science instruction, and contextually rich academic science vocabulary development. In combination, these instructional practices rapidly improved student-science learning outcomes and narrowed achievement gaps across diverse student populations.

  7. Improving Student Achievement through Character Education.

    ERIC Educational Resources Information Center

    Finck, Chip; Hansen, Cynthia; Jensen, Jane

    This report describes a program for improving moral character to increase academic achievement. Targeted population consisted of middle school students in a growing middle class community in a northern suburb of Chicago, Illinois. The problem, an absence of proper moral character, was documented through data collected from discipline referrals to…

  8. Handbook of Research on Improving Student Achievement.

    ERIC Educational Resources Information Center

    Cawelti, Gordon, Ed.

    This handbook is designed to identify classroom practices that research has shown to result in higher student achievement. The fundamental idea behind this book is that in order to succeed, efforts to improve instruction must foucs on the existing knowledge base about effective teaching and learning. The chapters are: (1) "Introduction" (Gordon…

  9. Improving Student Achievement Using Expert Learning Systems

    ERIC Educational Resources Information Center

    Green, Ronny; Smith, Bob; Leech, Don

    2004-01-01

    Both educators and the public are demanding improvements in student achievement and school performance. However, students meeting the highest college admission standards are increasingly selecting fields of study other than teaching. How can we increase teacher competence when many of our brightest teacher prospects are going into other fields?…

  10. Improving Student Achievement through Alternative Assessments.

    ERIC Educational Resources Information Center

    Durning, Jermaine; Matyasec, Maryann

    An attempt was made to improve students' academic grades and students' opinions of themselves as learners through the use of alternative assessments. The format of mastery learning using the direct instruction practice model was combined with performance-based assessment to increase achievement, self-esteem, and higher level thinking skills.…

  11. The Effectiveness of CASAs in Achieving Positive Outcomes for Children.

    ERIC Educational Resources Information Center

    Litzelfelner, Pat

    2000-01-01

    Evaluated effectiveness of court-appointed special advocates (CASAs) in achieving positive outcomes for children in the child welfare system, using data from court and CASA program files on 200 children. Found that CASAs may have reduced the number of placements and court continuances children experienced. More services were provided to children…

  12. Closing the achievement gap: the association of racial climate with achievement and behavioral outcomes.

    PubMed

    Mattison, Erica; Aber, Mark S

    2007-09-01

    This study investigated the relationship between school racial climate and students' self-reports of academic and discipline outcomes, including whether racial climate mediated and/or moderated the relationship between race and outcomes. Using the Racial Climate Survey-High School Version (M. Aber et al., unpublished), data were gathered from African American (n = 382) and European American students (n = 1456) regarding their perceptions of racial climate. About 18% of the respondents were low-income and approximately 50% were male. Positive perceptions of the racial climate were associated with higher student achievement and fewer discipline problems. Further, race moderated the relationship between racial climate and both achievement and discipline outcomes. Finally, racial differences in students' grades and discipline outcomes were associated with differences in perceptions of racial climate. Results suggest careful attention should be given to the racial climate of secondary schools, particularly for adolescents who perceive schools as unfair. PMID:17587175

  13. Using Chronic Pain Outcomes Data to Improve Outcomes.

    PubMed

    Mehta, Neel; Inturrisi, Charles E; Horn, Susan D; Witkin, Lisa R

    2016-06-01

    Standardization of care that is derived from analysis of outcomes data can lead to improvements in quality and efficiency of care. The outcomes data should be validated, standardized, and integrated into ongoing patient care with minimal burden on the patient and health care team. This article describes the organization and workflow of a chronic pain clinic registry designed to collect and analyze patient data for quality improvement and dissemination. Future efforts in using mobile technology and integrating patient-reported outcome data in the electronic health records have the potential to offer new and improved models of comprehensive pain management. PMID:27208717

  14. Does wound eversion improve cosmetic outcome?

    PubMed Central

    Kappel, Stefani; Kleinerman, Rebecca; King, Thomas H.; Sivamani, Raja; Taylor, Sandra; Nguyen, UyenThao; Eisen, Daniel B.

    2016-01-01

    Background Wound edge eversion has been hypothesized to improve aesthetic outcomes after cutaneous wound closure. Data supporting this assertion are sparse. Objective We sought to determine if wound eversion, achieved with interrupted subcuticular sutures, improves aesthetic outcome compared with planar closures. Methods We undertook a prospective, randomized, split-scar intervention in patients who underwent cutaneous surgery. Half of the wound was randomized to an everted or planar repair; the other side received the opposite one. At 3- and 6-month follow-up, both the patient and 2 blinded observers evaluated the wound using the Patient Observer Self-Assessment Scale (POSAS). Results The total observer POSAS score for the everted (13.59, 12.26) and planar (12.91, 12.98) sides did not differ significantly at 3 or 6 months, respectively. Similarly, there was not a significant difference in patient assessment between the everted (16.23, 12.84) and planar (15.07, 12.79) sides at 3 or 6 months, respectively. Finally, there was no significant difference between the 2 closure methods in terms of scar height or width at follow-up. Limitations This was a single-center trial, which used a validated but still subjective scar assessment instrument. Conclusion Wound eversion was not significantly associated with improved overall scar assessments by blinded observers or patient assessment. PMID:25619206

  15. Motivational Climates, Achievement Goals, and Physical Education Outcomes: A Longitudinal Test of Achievement Goal Theory

    ERIC Educational Resources Information Center

    Halvari, Hallgeir; Skjesol, Knut; Bagoien, Tor Egil

    2011-01-01

    The present research tested the longitudinal relations over a school-year between motivational climates, achievement goals, and five physical education outcomes, namely intrinsic motivation, perceived competence, positive attitude, exertion, and attendance in physical education. The results showed that students' mastery goals measured early in the…

  16. Conservation Covenants on Private Land: Issues with Measuring and Achieving Biodiversity Outcomes in Australia

    NASA Astrophysics Data System (ADS)

    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.

  17. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management…

  18. Getting to Outcomes: A Best Practice Process to Help Schools Achieve Desired Outcomes

    ERIC Educational Resources Information Center

    Maras, Melissa A.; Wandersman, Abe; Splett, Joni Williams; Flaspohler, Paul; Weist, Mark

    2012-01-01

    This article describes Getting to Outcomes (GTO), a 10-step framework for accountability designed to facilitate effective implementation of evidence-based programs and improvement of home-grown practices (Getting to Outcomes and GTO are trademarks registered by the University of South Carolina and RAND; Wandersman, Imm, Chinman, & Kaftarian, 1999,…

  19. Birth Outcomes and Academic Achievement in Childhood: A Population Record Linkage Study

    ERIC Educational Resources Information Center

    Moore, Elizabeth A.; Harris, Felicity; Laurens, Kristin R.; Green, Melissa J.; Brinkman, Sally; Lenroot, Rhoshel K.; Carr, Vaughan J.

    2014-01-01

    Poor academic performance during childhood predicts later adverse outcomes, and could be targeted for improvement if detected early. This study used population-based record linkage to examine the association between early life risk factors and academic achievement at two different stages of development using two different cohorts: a kindergarten…

  20. Orthogeriatric care: improving patient outcomes

    PubMed Central

    Tarazona-Santabalbina, Francisco José; Belenguer-Varea, Ángel; Rovira, Eduardo; Cuesta-Peredó, David

    2016-01-01

    Hip fractures are a very serious socio-economic problem in western countries. Since the 1950s, orthogeriatric units have introduced improvements in the care of geriatric patients admitted to hospital because of hip fractures. During this period, these units have reduced mean hospital stays, number of complications, and both in-hospital mortality and mortality over the middle term after hospital discharge, along with improvements in the quality of care and a reduction in costs. Likewise, a recent clinical trial has reported greater functional gains among the affected patients. Studies in this field have identified the prognostic factors present upon admission or manifesting themselves during admission and that increase the risk of patient mortality or disability. In addition, improved care afforded by orthogeriatric units has proved to reduce costs. Nevertheless, a number of management issues remain to be clarified, such as the optimum anesthetic, analgesic, and thromboprophylactic protocols; the type of diagnostic and therapeutic approach best suited to patients with cognitive problems; or the efficiency of the programs used in convalescence units or in home rehabilitation care. Randomized clinical trials are needed to consolidate the evidence in this regard. PMID:27445466

  1. Achieving better health care outcomes for children in foster care.

    PubMed

    Mekonnen, Robin; Noonan, Kathleen; Rubin, David

    2009-04-01

    This article reviews the challenges health care systems face as they attempt to improve health care outcomes for children in foster care. It discusses several of the promising health care strategies occurring outside the perimeter of child welfare and identifies some of the key impasses in working alongside efforts in child welfare reform. The authors posit that the greatest impasse in establishing a reasonable quality of health care for these children is placement instability, in which children move frequently among multiple homes and in and out of the child welfare system. The authors propose potential strategies in which efforts to improve placement stability can serve as a vehicle for multidisciplinary reform across the health care system. PMID:19358924

  2. [Challenges and Outcomes of the Process for Achieving Certification].

    PubMed

    Kadosaka, Yoshihiko; Suzuki, Reiko; Yoshika, Masamichi; Tsuta, Koji

    2016-02-01

    Clinical laboratory tests have been indispensable for medical services in recent years, and such a situation is associated with the offering of accurate test results by clinical laboratory units. A large number of facilities wishing to achieve ISO 15189 Certification follow preparatory procedures with support from consulting companies. However, in our facility, a limited budget did not allow us to use such services. As a solution, we participated in the Future Lab Session in OSAKA (FLS), a support group for the achievement of ISO 15189 Certification, when it was organized. Aiming to extensively cover and fulfill its responsibility for all processes, including clinical interpretations of the results obtained through patient preparation, in order to continuously offer high-quality test results to clinicians, our clinical laboratory unit underwent examination for certification, and consequently realized the necessity of third-party evaluation. The provision of laboratory services, fully complying with these standards, contributes to medical safety, in addition to accuracy improvement. Although the certification and its maintenance are costly, it is sufficiently cost-effective to achieve it, when focusing on improved efficiency and the enhanced quality and safety of medical services after work standardization. PMID:27311281

  3. Rethinking Ovarian Cancer: Recommendations for Improving Outcomes

    PubMed Central

    Vaughan, Sebastian; Coward, Jermaine I.; Bast Jr., Robert C.; Berchuck, Andy; Berek, Jonathan S.; Brenton, James D.; Coukos, George; Crum, Christopher C.; Drapkin, Ronny; Etemadmoghadam, Dariush; Friedlander, Michael; Gabra, Hani; Kaye, Stan B.; Lord, Chris J.; Lengyel, Ernst; Levine, Douglas A.; McNeish, Iain A.; Menon, Usha; Mills, Gordon B.; Nephew, Kenneth P.; Oza, Amit M.; Sood, Anil K.; Stronach, Euan A.; Walczak, Henning; Bowtell, David D.; Balkwill, Frances R.

    2012-01-01

    There have been major advances in our understanding of the cellular and molecular biology of the human malignancies collectively referred to as ovarian cancer. At a recent Helene Harris Memorial Trust meeting, an international group of researchers considered actions that should be taken to improve the outcome for women with ovarian cancer. Nine major recommendations are outlined in this Perspective. PMID:21941283

  4. Staff Development for Improving Student Outcomes.

    ERIC Educational Resources Information Center

    Asayesh, Gelareh

    1993-01-01

    Several educators highlight aspects of effective staff development programs that have resulted in improved student outcomes, agreeing that staff development is an important ingredient in the elusive formula of success. The article includes a list of eight examples of what experts say about staff development. (SM)

  5. Will Interventions Targeting Conscientiousness Improve Aging Outcomes?

    ERIC Educational Resources Information Center

    English, Tammy; Carstensen, Laura L.

    2014-01-01

    The articles appearing in this special section discuss the role that conscientiousness may play in healthy aging. Growing evidence suggests that conscientious individuals live longer and healthier lives. However, the question remains whether this personality trait can be leveraged to improve long-term health outcomes. We argue that even though it…

  6. Paclitaxel improves outcome from traumatic brain injury

    PubMed Central

    Cross, Donna J.; Garwin, Gregory G.; Cline, Marcella M.; Richards, Todd L.; Yarnykh, Vasily; Mourad, Pierre D.; Ho, Rodney J.Y.; Minoshima, Satoshi

    2016-01-01

    Pharmacologic interventions for traumatic brain injury (TBI) hold promise to improve outcome. The purpose of this study was to determine if the microtubule stabilizing therapeutic paclitaxel used for more than 20 years in chemotherapy would improve outcome after TBI. We assessed neurological outcome in mice that received direct application of paclitaxel to brain injury from controlled cortical impact (CCI). Magnetic resonance imaging was used to assess injury-related morphological changes. Catwalk Gait analysis showed significant improvement in the paclitaxel group on a variety of parameters compared to the saline group. MRI analysis revealed that paclitaxel treatment resulted in significantly reduced edema volume at site-of-injury (11.92 ± 3.0 and 8.86 ± 2.2 mm3 for saline vs. paclitaxel respectively, as determined by T2-weighted analysis; p ≤ 0.05), and significantly increased myelin tissue preservation (9.45 ± 0.4 vs. 8.95 ± 0.3, p ≤ 0.05). Our findings indicate that paclitaxel treatment resulted in improvement of neurological outcome and MR imaging biomarkers of injury. These results could have a significant impact on therapeutic developments to treat traumatic brain injury. PMID:26086366

  7. Improving Education Outcomes in the Slovak Republic. OECD Economics Department Working Papers, No. 578

    ERIC Educational Resources Information Center

    Carey, David

    2007-01-01

    Improving education outcomes is vital for achieving convergence with GDP per capita levels in Western European countries and for reducing income inequality. While some education outcomes are favourable, such as the low secondary-school drop-out rate, others have room for improvement: education achievement is below the OECD average and strongly…

  8. Proven Strategies for Improving Learning & Achievement.

    ERIC Educational Resources Information Center

    Brown, Duane

    The purpose of this book is to give student support personnel tools that: (1) will be recognized by educators as directly related to enhancing academic performance; (2) can be used with confidence that they will have the desired impact on achievement; and (3) are culturally sensitive. Chapters contain detailed presentation of the technology as…

  9. Guidelines for Special Educators: Achieving Socially Valid Outcomes.

    ERIC Educational Resources Information Center

    Carpenter, C. Dale; Bloom, Lisa A.; Boat, Mary B.

    1999-01-01

    Suggests quality indicators for special-education practices that result in socially valid outcomes such as high self-esteem, self-determination, individual empowerment, and joy. Discusses social validity, criteria for determining socially valid outcomes, and practices that promote these outcomes. (Author/DB)

  10. Functional dysphonia: strategies to improve patient outcomes.

    PubMed

    Behlau, Mara; Madazio, Glaucya; Oliveira, Gisele

    2015-01-01

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

  11. Functional dysphonia: strategies to improve patient outcomes

    PubMed Central

    Behlau, Mara; Madazio, Glaucya; Oliveira, Gisele

    2015-01-01

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

  12. A multidisciplinary approach for improving outcomes.

    PubMed

    Sierchio, Grace P

    2003-01-01

    The healthcare environment has been impacted tremendously by higher patient acuity, cost-cutting measures, an increase in litigation, and increased expectations by an educated generation of healthcare consumers. This has led to the need to continually measure, assess, and improve quality. These activities must consider not only patient clinical outcomes, but also customer service ratings and financial outcomes. Quality improvement requires a collaborative approach to succeed, and the need to build a cohesive and effective multidisciplinary team is critical for positive outcomes. Strategies to build a culture of teamwork include incorporating total quality management principles into every level of the organization, seeking participation from every discipline and level of the organization, and recognizing employees for their efforts. Infusion nurses have an excellent opportunity to contribute their expertise to any multidisciplinary team that impacts the outcomes of infusion patients. In addition, team-building and quality improvement may prove to be excellent career moves for infusion nurses looking to further specialize their practice. PMID:12544365

  13. Reshaping Personnel Policies to Improve Student Achievement

    ERIC Educational Resources Information Center

    Koppich, Julia E.; Gerstein, Amy

    2007-01-01

    The "Getting Down to Facts" (GDTF) studies released in March 2007 offered a clear diagnosis of the issues facing California's education system. Now, as California moves beyond the facts and begins the search for ways to improve the performance of California schools and students, the state faces a critical policy dilemma. On the one hand, the…

  14. Strategic School Funding for Improved Student Achievement

    ERIC Educational Resources Information Center

    Chambers, Jay G.; Brown, James R.; Levin, Jesse; Jubb, Steve; Harper, Dorothy; Tolleson, Ray; Manship, Karen

    2010-01-01

    This article features Strategic School Funding for Results (SSFR) project, a new joint initiative of the American Institutes for Research (AIR) and Pivot Learning Partners (PLP) aimed at improving school finance, human resources, and management systems in large urban school districts. The goal of the project is to develop and implement more…

  15. Rethinking ovarian cancer: recommendations for improving outcomes.

    PubMed

    Vaughan, Sebastian; Coward, Jermaine I; Bast, Robert C; Berchuck, Andy; Berek, Jonathan S; Brenton, James D; Coukos, George; Crum, Christopher C; Drapkin, Ronny; Etemadmoghadam, Dariush; Friedlander, Michael; Gabra, Hani; Kaye, Stan B; Lord, Chris J; Lengyel, Ernst; Levine, Douglas A; McNeish, Iain A; Menon, Usha; Mills, Gordon B; Nephew, Kenneth P; Oza, Amit M; Sood, Anil K; Stronach, Euan A; Walczak, Henning; Bowtell, David D; Balkwill, Frances R

    2011-10-01

    There have been major advances in our understanding of the cellular and molecular biology of the human malignancies that are collectively referred to as ovarian cancer. At a recent Helene Harris Memorial Trust meeting, an international group of researchers considered actions that should be taken to improve the outcome for women with ovarian cancer. Nine major recommendations are outlined in this Opinion article. PMID:21941283

  16. Trading water to improve environmental flow outcomes

    NASA Astrophysics Data System (ADS)

    Connor, Jeffery D.; Franklin, Brad; Loch, Adam; Kirby, Mac; Wheeler, Sarah Ann

    2013-07-01

    As consumptive extractions and water scarcity pressures brought about by climate change increase in many world river basins, so do the risks to water-dependent ecological assets. In response, public or not for profit environmental water holders (EWHs) have been established in many areas and bestowed with endowments of water and mandates to manage water for ecological outcomes. Water scarcity has also increasingly spawned water trade arrangements in many river basins, and in many instances, EWHs are now operating in water markets. A number of EWHs, especially in Australia, begin with an endowment of permanent water entitlements purchased from irrigators. Such water entitlements typically have relatively constant interannual supply profiles that often do not match ecological water demand involving flood pulses and periods of drying. This article develops a hydrologic-economic simulation model of the Murrumbidgee catchment within the Murray-Darling Basin to assess the scope of possibilities to improve environmental outcomes through EWH trading on an annual water lease market. We find that there are some modest opportunities for EWHs to improve environmental outcomes through water trade. The best opportunities occur in periods of drought and for ecological outcomes that benefit from moderately large floods. We also assess the extent to which EWH trading in annual water leases may create pecuniary externalities via bidding up or down the water lease prices faced by irrigators. Environmental water trading is found to have relatively small impacts on water market price outcomes. Overall our results suggest that the benefits of developing EWH trading may well justify the costs.

  17. Secondary Student Motivation Orientations and Standards-Based Achievement Outcomes

    ERIC Educational Resources Information Center

    Meyer, Luanna H.; McClure, John; Walkey, Frank; Weir, Kirsty F.; McKenzie, Lynanne

    2009-01-01

    Background: Individual student characteristics such as competence motivation, achievement values, and goal orientations have been related in meaningful ways to task attainment. The standards-based National Certificate of Educational Achievement (NCEA) was developed in New Zealand with the intention of strengthening connections between student…

  18. Student Achievement Outcomes Comprehensive School Reform: A Canadian Case Study

    ERIC Educational Resources Information Center

    Ross, John A.; Scott, Garth; Sibbald, Timothy M.

    2012-01-01

    The authors conducted a third-party study of the student achievement effects of Struggling Schools, a user-generated approach to Comprehensive School Reform (CSR). The design was a quasiexperimental, pre-post matched sample (N = 180) with school as unit of analysis, drawing on 3 years of achievement data from standardized external assessments.…

  19. Longitudinal Outcomes for Mathematics Achievement for Students with Learning Disabilities

    ERIC Educational Resources Information Center

    Judge, Sharon; Watson, Silvana M. R.

    2011-01-01

    Using longitudinal data from the first 6 waves of the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), the authors examined mathematics achievement and growth trajectories by learning disability (LD) subgroups. The 2-level (time-student) growth curve model showed that lower levels of mathematics achievement were already evident at…

  20. Do marginal investments made by NHS healthcare commissioners in the UK produce the outcomes they hope to achieve? Observational study

    PubMed Central

    O'Cathain, Alicia; Sampson, Fiona; Strong, Mark; Pickin, Mark; Goyder, Elizabeth; Dixon, Simon

    2015-01-01

    Objective To investigate the effect of targeted marginal annual investments by local healthcare commissioners on the outcomes they expected to achieve with these investments. Design Controlled before and after study. Setting: 152 commissioning organisations (primary care trusts) in England. Methods National surveys of commissioning managers in 2009 and 2010 to identify: the largest marginal investments made in four key conditions/services (diabetes, coronary heart disease, chronic pulmonary airways disease and emergency and urgent care) in 2008/2009 and 2009/2010; the outcomes commissioners expected to achieve with these investments; and the processes commissioners used to develop these investments. Collation of routinely available data on outcomes commissioners expected from these investments over the period 2007/2008 to 2010/2011. Results 51% (77/152) of commissioners agreed to participate in the survey in 2009 and 60% (91/152) in 2010. Around half reported targeted marginal investments in each condition/service each year. Routine data on many of the outcomes they expected to achieve through these investments were not available. Also, commissioners expected some outcomes to be achieved beyond the time scale of our study. Therefore, only a limited number of outcomes of investments were tested. Outcomes included directly standardised emergency admission rates for the four conditions/services, and the percentage of patients with diabetes with glycated haemoglobin <7. There was no evidence that targeted marginal investments reduced emergency admission rates. There was evidence of an improvement in blood glucose management for diabetes for commissioners investing to improve diabetes care but this was compromised by a change in how the outcome was measured in different years. This investment was unlikely to be cost-effective. Conclusions Commissioners made marginal investments in specific health conditions and services with the aim of improving a wide range of outcomes

  1. Connecting Social Disorganization Theory to African-American Outcomes to Explain the Achievement Gap

    ERIC Educational Resources Information Center

    Madyun, Na'im H.

    2011-01-01

    African-American student achievement outcomes have been and continue to be a critical concern for education researchers. Much of the framing of African-American student outcomes centers on what is known as achievement gaps that exist between African-American and White students. Unfortunately, these gaps have remained roughly the same since the…

  2. Achieving Good Perioperative Outcomes After Pancreaticoduodenectomy in a Low-Volume Setting: A 25-Year Experience

    PubMed Central

    Chedid, Aljamir D.; Chedid, Marcio F.; Winkelmann, Leonardo V.; Filho, Tomaz J. M. Grezzana; Kruel, Cleber D. P.

    2015-01-01

    Perioperative mortality following pancreaticoduodenectomy has improved over time and is lower than 5% in selected high-volume centers. Based on several large literature series on pancreaticoduodenectomy from high-volume centers, some defend that high annual volumes are necessary for good outcomes after pancreaticoduodenectomy. We report here the outcomes of a low annual volume pancreaticoduodenectomy series after incorporating technical expertise from a high-volume center. We included all patients who underwent pancreaticoduodenectomy performed by a single surgeon (ADC.) as treatment for periampullary malignancies from 1981 to 2005. Outcomes of this series were compared to those of 3 high-volume literature series. Additionally, outcomes for first 10 cases in the present series were compared to those of all 37 remaining cases in this series. A total of 47 pancreaticoduodenectomies were performed over a 25-year period. Overall in-hospital mortality was 2 cases (4.3%), and morbidity occurred in 23 patients (48.9%). Both mortality and morbidity were similar to those of each of the three high-volume center comparison series. Comparison of the outcomes for the first 10 to the remaining 37 cases in this series revealed that the latter 37 cases had inferior mortality (20% versus 0%; P = 0.042), less tumor-positive margins (50 versus 13.5%; P = 0.024), less use of intraoperative blood transfusions (90% versus 32.4%; P = 0.003), and tendency to a shorter length of in-hospital stay (20 versus 15.8 days; P = 0.053). Accumulation of surgical experience and incorporation of expertise from high-volume centers may enable achieving satisfactory outcomes after pancreaticoduodenectomy in low-volume settings whenever referral to a high-volume center is limited. PMID:25875555

  3. On the Road to Success: How States Collaborate and Use Data to Improve Student Outcomes. A Working Paper by the Achieving the Dream Cross-State Data Work Group

    ERIC Educational Resources Information Center

    Baldwin, Chris; Borcoman, Gabriela; Chappell-Long, Cheryl; Coperthwaite, Corby A.; Glenn, Darrell; Hutchinson, Tony; Hughes, John; Jenkins, Rick; Jovanovich, Donna; Keller, Jonathan; Klimczak, Benjamin; Schneider, Bill; Stewart, Carmen; Stuart, Debra; Yeager, Michael

    2012-01-01

    Enrollment is rising across the nation's community colleges, but completion rates remain untenably low. Reformers are focusing on the importance of using comprehensive, high-quality data on student progress and completion to bring about change. A core tenet of Achieving the Dream: Community Colleges Count has been to embed a culture of…

  4. Students' Achievement Values, Goal Orientations, and Interest: Definitions, Development, and Relations to Achievement Outcomes

    ERIC Educational Resources Information Center

    Wigfield, Allan; Cambria, Jenna

    2010-01-01

    Students' achievement task values, goal orientations, and interest are motivation-related constructs which concern students' purposes and reasons for doing achievement activities. The authors review the extant research on these constructs and describe and compare many of the most frequently used measures of these constructs. They also discuss…

  5. Science Achievement for All: Improving Science Performance and Closing Achievement Gaps

    ERIC Educational Resources Information Center

    Jackson, Julie K.; Ash, Gwynne

    2012-01-01

    This article addresses the serious and growing need to improve science instruction and science achievement for all students. We will describe the results of a 3-year study that transformed science instruction and student achievement at two high-poverty ethnically diverse public elementary schools in Texas. The school-wide intervention included…

  6. Method to improve cosmetic outcome following craniotomy.

    PubMed

    Sato, S; Sato, M; Nishizawa, M; Oizumi, T; Hiwatari, M; Kajiwara, T; Ishikawa, M; Inamasu, G; Kawase, T

    2001-06-01

    This technical note describes a simple method for reducing the dead space created by craniotome due to the loss of bone dust and improving the cosmetic outcome following a craniotomy. After drilling the burr holes for the craniotomy, the bone between the holes is drilled away in a standard fashion except that multiple regions of about 1 cm in length are left intact. These intact regions are broken using a periosteal elevator and fixed like a bridge when the bone is replaced. The resulting bone flap is readily returned to its original position without making the dead space created by regular craniotomy. The amount of the dead space caused by losing the bone dust is reduced and a good cosmetic recovery is obtained. This technique is useful for both craniotomy and facial bone surgery, which requires cosmetic results. PMID:11428512

  7. Raising African American Student Achievement: California Goals, Local Outcomes

    ERIC Educational Resources Information Center

    EdSource, 2008

    2008-01-01

    Although academic performance is a concern, African American students represent less than 8 percent of California's K-12 students, and at times get lost in California policy debates about improving student performance. Findings of this study indicate that: (1) California's African American students are concentrated in relatively few counties and…

  8. Finishing the Job: Improving the Achievement of Vocational Students.

    ERIC Educational Resources Information Center

    Bottoms, Gene; Presson, Alice

    The Southern Regional Education Board (SREB)-State Vocational Education Consortium's commitment to higher standards for and greater achievement of vocational students has brought substantial gains in student performance. SREB's High Schools That Work (HSTW), a school improvement initiative, documents achievement gains by vocational students. Data…

  9. How Much Can Spatial Training Improve STEM Achievement?

    ERIC Educational Resources Information Center

    Stieff, Mike; Uttal, David

    2015-01-01

    Spatial training has been indicated as a possible solution for improving Science, Technology, Engineering, and Mathematics (STEM) achievement and degree attainment. Advocates for this approach have noted that the correlation between spatial ability and several measures of STEM achievement suggests that spatial training should focus on improving…

  10. Improvements in Interval Time Tracking and Effects on Reading Achievement

    ERIC Educational Resources Information Center

    Taub, Gordon E.; McGrew, Kevin S.; Keith, Timothy Z.

    2007-01-01

    This study examined the effect of improvements in timing/rhythmicity on students' reading achievement. 86 participants completed pre- and post-test measures of reading achievement (i.e., Woodcock-Johnson III, Comprehensive Test of Phonological Processing, Test of Word Reading Efficiency, and Test of Silent Word Reading Fluency). Students in the…

  11. Total Quality Management as a Philosophical and Organizational Framework To Achieve Outcomes-Based Education and Effective Schools.

    ERIC Educational Resources Information Center

    Valesky, Thomas C.; And Others

    The educational establishment is under a great deal of pressure to improve and to prove to its critics that it has done so. This paper develops three concepts to support its thesis: effective schools, the change process, and outcomes-based education (OBE). To achieve effective schools, major change must take place. Yet change is not easy for…

  12. Can Probiotics Improve Your Surgical Outcomes?

    PubMed

    Ward, Tina; Nichols, Misty; Nutter, Julie

    2016-01-01

    Despite ongoing advances in medical technology, postoperative infections and infectious complications continue to be a significant cause of morbidity and mortality. Surgical trauma and prophylactic antibiotics disrupt the balance of the intestinal microbiota and barrier function of the gut, potentiating an enhanced inflammatory response and further immune system depression. With the increasing costs of health care and emergence of multidrug-resistant bacteria, alternative approaches must be explored. Many clinical studies have demonstrated that the use of probiotics, prebiotics, or a combination of both (synbiotics) as a part of innovative strategies can improve outcomes of elective abdominal and gastrointestinal surgical procedures. It has been demonstrated that probiotics play a role in gut barrier improvement and immunomodulation. However, it is evident that additional research is needed including larger, multicenter, randomized controlled trials to validate the safety and efficacy of their use in surgical patients. The purpose of this article is to discuss background of probiotic use in abdominal/gastrointestinal surgery, risk and benefits, clinical relevance for health care providers, and further implications for research. PMID:27254237

  13. Improving Outcomes for Pulmonary Vascular Disease

    PubMed Central

    Robbins, Ivan M.; Blaisdell, Carol J.; Abman, Steven H.

    2012-01-01

    Recognizing the importance of improving lung health through lung disease research, the National Heart, Lung, and Blood Institute (NHLBI) convened a workshop of multidisciplinary experts for the following purpose: (1) to review the current scientific knowledge underlying the basis for treatment of adults and children with pulmonary vascular diseases (PVDs); (2) to identify gaps, barriers, and emerging scientific opportunities in translational PVD research and the means to capitalize on these opportunities; (3) to prioritize new research directions that would be expected to affect the clinical course of PVDs; and (4) to make recommendations to the NHLBI on how to fill identified gaps in adult and pediatric PVD clinical research. Workshop participants reviewed experiences from previous PVD clinical trials and ongoing clinical research networks with other lung disorders, including acute respiratory distress syndrome, chronic obstructive lung disease, and idiopathic pulmonary fibrosis, as well. Bioinformatics experts discussed strategies for applying cutting-edge health information technology to clinical studies. Participants in the workshop considered approaches in the following broad concept areas: (1) improved phenotyping to identify potential subjects for appropriate PVD clinical studies; (2) identification of potential new end points for assessing key outcomes and developing better-designed PVD clinical trials; and (3) the establishment of priorities for specific clinical research needed to advance care of patients with various subsets of PVDs from childhood through adulthood. This report provides a summary of the objectives and recommendations to the NHLBI concentrating on clinical research efforts that are needed to better diagnose and treat PVDs. PMID:22335936

  14. Interdisciplinary ICU Cardiac Arrest Debriefing Improves Survival Outcomes

    PubMed Central

    Wolfe, Heather; Zebuhr, Carleen; Topjian, Alexis A.; Nishisaki, Akira; Niles, Dana E.; Meaney, Peter A.; Boyle, Lori; Giordano, Rita T.; Davis, Daniela; Priestley, Margaret; Apkon, Michael; Berg, Robert A.; Nadkarni, Vinay M.; Sutton, Robert M.

    2014-01-01

    Objective In-hospital cardiac arrest is an important public health problem. High-quality resuscitation improves survival but is difficult to achieve. Our objective is to evaluate the effectiveness of a novel, interdisciplinary, postevent quantitative debriefing program to improve survival outcomes after in-hospital pediatric chest compression events. Design, Setting, and Patients Single-center prospective interventional study of children who received chest compressions between December 2008 and June 2012 in the ICU. Interventions Structured, quantitative, audiovisual, interdisciplinary debriefing of chest compression events with front-line providers. Measurements and Main Results Primary outcome was survival to hospital discharge. Secondary outcomes included survival of event (return of spontaneous circulation for ≥ 20 min) and favorable neurologic outcome. Primary resuscitation quality outcome was a composite variable, termed “excellent cardiopulmonary resuscitation,” prospectively defined as a chest compression depth ≥ 38 mm, rate ≥ 100/min, ≤ 10% of chest compressions with leaning, and a chest compression fraction > 90% during a given 30-second epoch. Quantitative data were available only for patients who are 8 years old or older. There were 119 chest compression events (60 control and 59 interventional). The intervention was associated with a trend toward improved survival to hospital discharge on both univariate analysis (52% vs 33%, p = 0.054) and after controlling for confounders (adjusted odds ratio, 2.5; 95% CI, 0.91–6.8; p = 0.075), and it significantly increased survival with favorable neurologic outcome on both univariate (50% vs 29%, p = 0.036) and multivariable analyses (adjusted odds ratio, 2.75; 95% CI, 1.01–7.5; p = 0.047). Cardiopulmonary resuscitation epochs for patients who are 8 years old or older during the debriefing period were 5.6 times more likely to meet targets of excellent cardiopulmonary resuscitation (95% CI, 2.9–10

  15. Improving Alcohol Withdrawal Outcomes in Acute Care

    PubMed Central

    Melson, Jo; Kane, Michelle; Mooney, Ruth; McWilliams, James; Horton, Terry

    2014-01-01

    Context Excessive alcohol consumption is the nation’s third leading cause of preventable deaths. If untreated, 6% of alcohol-dependent patients experience alcohol withdrawal, with up to 10% of those experiencing delirium tremens (DT), when they stop drinking. Without routine screening, patients often experience DT without warning. Objective: Reduce the incidence of alcohol withdrawal advancing to DT, restraint use, and transfers to the intensive care unit (ICU) in patients with DT. Design: In October 2009, the alcohol withdrawal team instituted a care management guideline used by all disciplines, which included tools for screening, assessment, and symptom management. Data were obtained from existing datasets for three quarters before and four quarters after implementation. Follow-up data were analyzed and showed a great deal of variability in transfers to the ICU and restraint use. Percentage of patients who developed DT showed a downward trend. Main Outcome Measures: Incidence of alcohol withdrawal advancing to DT and, in patients with DT, restraint use and transfers to the ICU. Results: Initial data revealed a decrease in percentage of patients with alcohol withdrawal who experienced DT (16.4%–12.9%). In patients with DT, restraint use decreased (60.4%–44.4%) and transfers to the ICU decreased (21.6%–15%). Follow-up data indicated a continued downward trend in patients with DT. Changes were not statistically significant. Restraint use and ICU transfers maintained postimplementation levels initially but returned to preimplementation levels by third quarter 2012. Conclusion: Early identification of patients for potential alcohol withdrawal followed by a standardized treatment protocol using symptom-triggered dosing improved alcohol withdrawal management and outcomes. PMID:24867561

  16. Using AMLO to Improve the Quality of Teacher Education Outcomes

    ERIC Educational Resources Information Center

    Al-Shammari, Zaid

    2012-01-01

    This study aims to find ways to improve learning outcomes in teacher education courses by using an Analysis Model for Learning Outcomes (AMLO). It addresses the improvement of the quality of teacher education by analyzing learning outcomes and implementing curriculum modifications related to specific learning objectives and their effects on…

  17. Do Student Achievement Outcomes Differ across Teacher Preparation Programs? An Analysis of Teacher Education in Louisiana

    ERIC Educational Resources Information Center

    Gansle, Kristin A.; Noell, George H.; Burns, Jeanne M.

    2012-01-01

    Achievement outcomes for students taught by recent program completers of Louisiana's teacher preparation programs (TPPs) are examined using hierarchical linear modeling of State student achievement data in English language arts, reading, mathematics, science, and social studies. The current year's achievement in each content area is predicted…

  18. Boredom in Achievement Settings: Exploring Control-Value Antecedents and Performance Outcomes of a Neglected Emotion

    ERIC Educational Resources Information Center

    Pekrun, Reinhard; Goetz, Thomas; Daniels, Lia M.; Stupnisky, Robert H.; Perry, Raymond P.

    2010-01-01

    The linkages of achievement-related boredom with students' appraisals and performance outcomes were examined in a series of 5 exploratory, cross-sectional, and predictive investigations. Studies 1 and 2 assessed students' boredom in a single achievement episode (i.e., state achievement boredom); Studies 3, 4, and 5 focused on their habitual…

  19. Individual Differences in Achievement Goals: A Longitudinal Study of Cognitive, Emotional, and Achievement Outcomes

    ERIC Educational Resources Information Center

    Daniels, Lia M.; Haynes, Tara L.; Stupnisky, Robert H.; Perry, Raymond P.; Newall, Nancy E.; Pekrun, Reinhard

    2008-01-01

    Within achievement goal theory debate remains regarding the adaptiveness of certain combinations of goals. Assuming a multiple-goals perspective, we used cluster analysis to classify 1002 undergraduate students according to their mastery and performance-approach goals. Four clusters emerged, representing different goal combinations: high…

  20. An Action Plan for Improving Mediocre or Stagnant Student Achievement

    ERIC Educational Resources Information Center

    Redmond, Kimberley B.

    2013-01-01

    Although all of the schools in the target school system adhere to a school improvement process, achievement scores remain mediocre or stagnant within the overseas school in Italy that serves children of United States armed service members. To address this problem, this study explored the target school's improvement process to discover how…

  1. Professional Learning Communities That Initiate Improvement in Student Achievement

    ERIC Educational Resources Information Center

    Royer, Suzanne M.

    2012-01-01

    Quality teaching requires a strong practice of collaboration, an essential building block for educators to improve student achievement. Researchers have theorized that the implementation of a professional learning community (PLC) with resultant collaborative practices among teachers sustains academic improvement. The problem addressed specifically…

  2. Achieving the Desired Transformation: Thoughts on Next Steps for Outcomes-Based Medical Education.

    PubMed

    Holmboe, Eric S; Batalden, Paul

    2015-09-01

    Since the introduction of the outcomes-based medical education (OBME) movement, progress toward implementation has been active but challenging. Much of the angst and criticism has been directed at the approaches to assessment that are associated with outcomes-based or competency frameworks, particularly defining the outcomes. In addition, these changes to graduate medical education (GME) are concomitant with major change in health care systems--specifically, changes to increase quality and safety while reducing cost. Every sector, from medical education to health care delivery and financing, is in the midst of substantial change and disruption.The recent release of the Institute of Medicine's report on the financing and governance of GME highlights the urgent need to accelerate the transformation of medical education. One source of continued tension within the medical education community arises from the assumption that the much-needed increases in value and improvement in health care can be achieved by holding the current educational structures and architecture of learning in place while concomitantly withdrawing resources. The authors of this Perspective seek to reframe the important and necessary debate surrounding the current challenges to implementing OBME. Building on recent change and service theories (e.g., Theory U and coproduction), they propose several areas of redirection, including reexamination of curricular models and greater involvement of learners, teachers, and regulators in cocreating new training models, to help facilitate the desired transformation in medical education. PMID:26083400

  3. Emerging technologies for the detection of melanoma: achieving better outcomes

    PubMed Central

    Herman, Cila

    2012-01-01

    Every year around 2.5–3 million skin lesions are biopsied in the US, and a fraction of these – between 50,000 and 100,000 – are diagnosed as melanoma. Diagnostic instruments that allow early detection of melanoma are the key to improving survival rates and reducing the number of unnecessary biopsies, the associated morbidity, and the costs of care. Advances in technology over the past 2 decades have enabled the development of new, sophisticated test methods, which are currently undergoing laboratory and small-scale clinical testing. This review highlights and compares some of the emerging technologies that hold the promise of melanoma diagnosis at an early stage of the disease. The needs for detection at different levels (patient, primary care, specialized care) are discussed, and three broad classes of instruments are identified that are capable of satisfying these needs. Technical and clinical requirements on the diagnostic instruments are introduced to aid the comparison and evaluation of new technologies. White- and polarized-light imaging, spatial and spectroscopic multispectral methods, quantitative thermographic imaging, confocal microscopy, Optical Coherence Tomography (OCT), and Terahertz (THZ) imaging methods are highlighted in light of the criteria identified in the review. Based on the properties, possibilities, and limitations of individual methods, those best suited for a particular setting are identified. Challenges faced in development and wide-scale application of novel technologies are addressed. PMID:23204850

  4. Do microfractures improve high tibial osteotomy outcome?

    PubMed

    Pascale, Walter; Luraghi, Simone; Perico, Laura; Pascale, Valerio

    2011-07-01

    The aim of this study was to determine if microfractures improve the outcome of high tibial osteotomy in patients with medial compartmental osteoarthritis in genu varum. Forty patients presenting with Outerbridge grade III and IV chondropathies on the femoral and/or the tibial joint surface underwent high tibial osteotomy with Puddu plates (Arthrex, Inc, Naples, Florida) for primary medial compartment osteoarthritis in genu varum at our institution. Patients were randomly assigned to either the high tibial osteotomy plus microfractures group (A; n=20) or the high tibial osteotomy alone group (B; n=20). Final assessment was conducted 5 years postoperatively, including clinical response measured by the International Knee Documentation Committee (IKDC), Lysholm score, and patient satisfaction score. All patients were blinded to the treatment received and followed the same rehabilitation protocol. A statistically significant improvement between pre- and postoperative values was observed for Lysholm and IKDC scores in both groups, without any statistically significant difference between them. Regarding the satisfaction score, there were no differences between the 2 groups in terms of preoperative self-assessment (P>.05), whereas postoperative subjective satisfaction at 5-year follow-up was significantly higher in group A than in group B (P=.0036).Our study results provide further evidence that medial tibial osteotomy is an effective surgical option for treating a varus knee associated with medial degenerative arthritis in patients wishing to continue accustomed levels of physical activity. In particular, patient satisfaction was higher among those who underwent the combined treatment involving high tibial osteotomy to correct femorotibial angle and microfractures. PMID:21717984

  5. Improving maternal nutrition for better pregnancy outcomes.

    PubMed

    Nnam, N M

    2015-11-01

    Much has been learned during the past several decades about the role of maternal nutrition in the outcome of pregnancy. While the bulk of the data is derived from animal models, human observations are gradually accumulating. There is need to improve maternal nutrition because of the high neonatal mortality rate especially in developing countries. The author used a conceptual framework which took both primary and secondary factors into account when interpreting study findings. Nutrition plays a vital role in reducing some of the health risks associated with pregnancy such as risk of fetal and infant mortality, intra-uterine growth retardation, low birth weight and premature births, decreased birth defects, cretinism, poor brain development and risk of infection. Adequate nutrition is essential for a woman throughout her life cycle to ensure proper development and prepare the reproductive life of the woman. Pregnant women require varied diets and increased nutrient intake to cope with the extra needs during pregnancy. Use of dietary supplements and fortified foods should be encouraged for pregnant women to ensure adequate supply of nutrients for both mother and foetus. The author concludes that nutrition education should be a core component of Mother and Child Health Clinics and every opportunity should be utilised to give nutrition education on appropriate diets for pregnant women. PMID:26264457

  6. Motivational tools to improve probationer treatment outcomes

    PubMed Central

    Taxman, Faye S.; Walters, Scott T.; Sloas, Lincoln B.; Lerch, Jennifer; Rodriguez, Mayra

    2015-01-01

    Background Motivational interviewing (MI) is a promising practice to increase motivation, treatment retention, and reducing recidivism among offender populations. Computer-delivered interventions have grown in popularity as a way to change behaviors associated with drug and alcohol use. Methods/Design Motivational Assistance Program to Initiate Treatment (MAPIT) is a three arm, multisite, randomized controlled trial, which examines the impact of Motivational Interviewing (MI), a Motivational Computer Program (MC), and Supervision as Usual (SAU) on addiction treatment initiation, engagement, and retention. Secondary outcomes include drug/alcohol use, probation progress, recidivism (i.e., criminal behavior) and HIV/AIDS testing and treatment among probationers. Participant characteristics are measured at baseline, 2, and 6 months after assignment. The entire study will include 600 offenders, with each site recruiting 300 offenders (Baltimore City, Maryland and Dallas, Texas). All participants will go through standard intake procedures for probation and participate in probation requirements as usual. After standard intake, participants will be recruited and screened for eligibility. Discussion The results of this clinical trial will fill a gap in knowledge about ways to motivate probationers to participate in addiction treatment and HIV care. This randomized clinical trial is innovative in the way it examines the use of in-person vs. technological approaches to improve probationer success. Trial Registration NCT01891656 PMID:26009023

  7. Estimating the population benefit of radiotherapy: using demand models to estimate achievable cancer outcomes.

    PubMed

    Hanna, T P; Shafiq, J

    2015-02-01

    The measurement of population benefits is important for priority setting, economic evaluation and quality improvement. It also informs advocacy. In this article, the use of demand models to estimate the achievable benefit of cancer therapy is reviewed. Achievable benefit refers to the treatment benefit achievable under optimal conditions. The population benefit of radiotherapy has been used as an example. Demand models provide a means of estimating the optimal proportion of patients with treatment indications when guidelines are followed. They may be used to estimate achievable benefit. The choice of end point should reflect the range of benefits associated with the treatment of interest. In some cases, further model development is needed if a pre-existing demand model is used. The benefit of treatment for each indication is estimated using a systematic review process. The highest level of evidence is used to define the benefit for each indication. In cases where multiple sources of the same level and quality of evidence exist, a meta-analysis is carried out. Population-based effectiveness data sources are considered, but three major challenges to their use are: (i) generalisability of the observed outcomes, (ii) data resolution and (iii) confounding and bias. The population benefit determined from this process describes the population proportion achieving a benefit due to the use of guideline-based treatment, compared with no use of that treatment. Sensitivity analysis provides a means for modelling the effect of model uncertainties. The predominant uncertainty is most often due to uncertainty in indication proportion. Preference-sensitive treatment decisions are a common example. The described approach to estimating the achievable benefit of cancer therapy is robust to model uncertainties, rapidly adaptable and is transparent. However, estimates rely on the quality of model data sources and may be affected by model assumptions. Models should be developed for a

  8. Improving Outcomes for Workers with Mental Retardation

    ERIC Educational Resources Information Center

    Fornes, Sandra; Rocco, Tonette S.; Rosenberg, Howard

    2008-01-01

    This research presents an analysis of factors predicting job retention, job satisfaction, and job performance of workers with mental retardation. The findings highlight self-determination as a critical skill in predicting the three important employee outcomes. The study examined a hypothesized job retention model and the outcome of the three…

  9. Does Cooperative Learning Improve Student Learning Outcomes?

    ERIC Educational Resources Information Center

    Yamarik, Steven

    2007-01-01

    What is the effect of small-group learning on student learning outcomes in economic instruction? In spring 2002 and fall 2004, the author applied cooperative learning to one section of intermediate macroeconomics and taught another section using a traditional lecture format. He identified and then tracked measures of student learning outcomes.…

  10. Does Providing Transition Services Early Enable Students with ASD to Achieve Better Vocational Outcomes as Adults?

    ERIC Educational Resources Information Center

    Cimera, Robert Evert; Burgess, Sloane; Wiley, Andrew

    2013-01-01

    This study investigated whether receiving transition services early (i.e., by age 14) promoted better vocational outcomes than receiving transition services later (i.e., by age 16) for young adults with ASD. To do this, the outcomes achieved by two matched groups were examined--453 young adults from states requiring transition services be…

  11. Early diagnosis improves outcomes in hepatitis C.

    PubMed

    Miller, Michael H; Dillon, John F

    2015-11-01

    Chronic hepatitis C (HCV) infection affects 0.8-1.0% of the UK population, with up to 70% having ongoing chronic infection. HCV is curable but if left untreated can progress to end stage liver disease and potentially hepatocellular carcinoma. HCV management options have changed dramatically over the past five years, with improvement in cure rates and tolerability; cure rates of more than 90% can now be achieved. The main risk factors for acquiring HCV infection in the UK are injecting drug use and sharing drug using equipment. Other risk factors include receipt of blood products in the UK before 1991; tattooing or acupuncture with non-sterile equipment; medical procedures; needlestick injuries and contact with blood from an infected person. Acute hepatitis C infection has mild symptoms only and is likely to go undiagnosed. The estimated diagnosis rate in England is 35%, suggesting that 65% of the total HCV-positive population remains undiagnosed. The most common method of detecting HCV is case finding in high- risk groups. Those who test positive for HCV antibodies should be tested for persisting viral presence through HCV PCR testing - a positive result confirms active infection. GPs can play a major role in identifying those at risk of the disease, which includes patients with known risk factors and those with unexplained abnormal liver function tests, providing information and arranging testing. Patients with confirmed active HCV infection should be referred to the local specialist hepatology or infectious disease service in accordance with locally agreed pathways. PMID:26753270

  12. Student-Level Analysis of Year 1 (2003-2004) Achievement Outcomes for Tennessee Charter Schools

    ERIC Educational Resources Information Center

    Ross, Steven M.; McDonald, Aaron J.; Gallagher, Brenda McSparrin

    2005-01-01

    This report presents student-level achievement results for the four charter schools that began operation in Tennessee during the 2003-04 academic year. To conduct a rigorous and valid analysis of student achievement outcomes at these schools, we employed a matched program-control design at the student level, whereby each charter school student was…

  13. The Relationships between Teacher Empowerment, Teachers' Sense of Responsibility for Student Outcomes, and Student Achievement.

    ERIC Educational Resources Information Center

    Martin, Barbara N.; Crossland, Barbara J.

    Relationships between the level of teachers' perceived empowerment, the degree of teachers' perceived responsibility for student outcomes, and student achievement were studied with 271 elementary school teachers. The Responsibility for Student Achievement Scale (RSA) (T. Guskey, 1981) and the School Participant Empowerment Scales (SPES) (P. Short…

  14. Improving the Teaching of Economics: Achievements and Aspirations.

    ERIC Educational Resources Information Center

    Bach, G. L.; Kelley, Allen C.

    Achievements and possible future projects of the American Economic Association's Committee on Economic Education (CEE), whose goal is to improve teaching in college and university economics, are discussed. The Teacher Training Program (TTP) was established by the CEE in the 1970's to develop programs to train economic educators. To date the…

  15. Using Students' Cultural Heritage to Improve Academic Achievement in Writing

    ERIC Educational Resources Information Center

    Mendez, Gilbert

    2006-01-01

    This article discusses an approach to teaching used at Calexico Unified School District, a California-Mexican border high school, by a group of teachers working to make teaching and learning more relevant to Chicano and Mexican students' lives and to improve their academic achievement in writing. An off-shoot of a training program for English…

  16. Improving Students' Social Skills and Achievement through Cooperative Learning.

    ERIC Educational Resources Information Center

    Caparos, Jennifer; Cetera, Colleen; Ogden, Lynn; Rossett, Kathryn

    This action research project evaluated a program designed to increase the use of appropriate social skills and improve academic achievement. The targeted population was comprised of first through third graders in four separate communities located in northeast Illinois. Evidence of the problem included teacher observational checklists denoting…

  17. Using Site-Based Budgeting To Improve Student Achievement.

    ERIC Educational Resources Information Center

    Warden, Christina

    2002-01-01

    Advances the use of school-based budgeting to improve student achievement. Describes four steps to implementing school-based budgeting: Access the current situation, set priorities and make decisions, plan action steps and benchmarks, and analyze choices and build the budget. Includes case study of the implementation of school-based budgeting at…

  18. Systems Thinking: A Skill to Improve Student Achievement

    ERIC Educational Resources Information Center

    Thornton, Bill; Peltier, Gary; Perreault, George

    2004-01-01

    This article examines how schools can avoid barriers to systems thinking in relation to improving student achievement. It then illustrates common errors associated with non-systems thinking and recommends solutions. Educators who understand that schools are complex interdependent social systems can move their organizations forward. Unfortunately,…

  19. New Directions in Social Psychological Interventions to Improve Academic Achievement

    ERIC Educational Resources Information Center

    Wilson, Timothy D.; Buttrick, Nicholas R.

    2016-01-01

    Attempts to improve student achievement typically focus on changing the educational environment (e.g., better schools, better teachers) or on personal characteristics of students (e.g., intelligence, self-control). The 6 articles in this special issue showcase an additional approach, emanating from social psychology, which focuses on students'…

  20. Understanding the Change Styles of Teachers to Improve Student Achievement

    ERIC Educational Resources Information Center

    Bigby, Arlene May Green

    2009-01-01

    The topic of this dissertation is the understanding of teacher change styles to improve student achievement. Teachers from public schools in a state located in the northern plains were surveyed regarding their Change Styles (preferred approaches to change) and flexibility scores. The results were statistically analyzed to determine if there were…

  1. Improving Student Achievement through the Use of Music Strategies.

    ERIC Educational Resources Information Center

    Brogla-Krupke, Cheryl

    This report describes a program to improve student achievement through the use of music strategies. The targeted population was fifth-grade students in a small Iowa community. The absence of music integration into the social studies area was observed through data that displayed the lack of motivation and in-depth learning by the students. Analysis…

  2. Hypothermia improves outcome from cardiac arrest.

    PubMed

    Bernard, S A

    2005-12-01

    Out-of-hospital cardiac arrest is common and patients who are initially resuscitated by ambulance officers and transported to hospital are usually admitted to the intensive care unit (ICU). In the past, the treatment in the ICU consisted of supportive care only, and most patients remained unconscious due to the severe anoxic neurological injury. It was this neurological injury rather than cardiac complications that caused the high rate of morbidity and mortality. However, in the early 1990's, a series of animal experiments demonstrated convincingly that mild hypothermia induced after return of spontaneous circulation and maintained for several hours dramatically reduced the severity of the anoxic neurological injury. In the mid-1990's, preliminary human studies suggested that mild hypothermia could be induced and maintained in post-cardiac arrest patients without an increase in the rate of cardiac or other complications. In the late 1990's, two prospective, randomised, controlled trials were conducted and the results confirmed the animal data that mild hypothermia induced after resuscitation and maintained for 12 - 24 hours dramatically improved neurological and overall outcomes. On the basis of these studies, mild hypothermia was endorsed in 2003 by the International Liaison Committee on Resuscitation as a recommended treatment for comatose patients with an initial cardiac rhythm of ventricular fibrillation. However, the application of this therapy into routine clinical critical care practice has been slow. The reasons for this are uncertain, but may relate to the relative complexity of the treatment, unfamiliarity with the pathophysiology of hypothermia, lack of clear protocols and/or uncertainty of benefit in particular patients. Therefore, recent research in this area has focused on the development of feasible, inexpensive techniques for the early, rapid induction of mild hypothermia after cardiac arrest. Currently, the most promising strategy is a rapid

  3. Evaluating Practice: Does It Improve Treatment Outcome?

    ERIC Educational Resources Information Center

    Slonim-Nevo, Vered; Anson, Yonatan

    1998-01-01

    Single-case design methodology is evaluated for its effect on treatment outcomes. Participants were juvenile delinquents treated by probation officers with social work degrees in Israel. A quasi-experimental design used measures of the functioning of participants in several settings as dependent variables. Results are presented and discussed. (EMK)

  4. Preparing the patient for surgery to improve outcomes.

    PubMed

    Levett, Denny Z H; Edwards, Mark; Grocott, Mike; Mythen, Monty

    2016-06-01

    The time between contemplation of surgery and the procedure offers a window of opportunity to optimize patients' nutritional, functional and psychological state prior to surgery. Traditionally, preoperative pathways have focused on the underlying disease process and 'fitness for surgery' with physical pre-assessment and risk counselling late in the pathway when little time is available to intervene. With an increasingly elderly and co-morbid surgical population, early physiological assessment and multidisciplinary collaborative decision-making is increasingly important. Multimodal prehabilitation programmes may improve surgical outcome, facilitating rapid recovery from surgery and limiting post-operative functional dependence. Patient education and engagement is important if compliance with behavioural change is to be achieved and maintained. To date, there has been evidence supporting preoperative exercise training, smoking cessation, reduction in alcohol intake, anaemia management and psychosocial support. Further research is needed to identify the most effective elements of these complex preoperative interventions, as well as their optimum timing and duration. PMID:27396803

  5. Mini incision open pyeloplasty - Improvement in patient outcome

    PubMed Central

    Singh, Vishwajeet; Garg, Manish; Sharma, Pradeep; Sinha, Rahul Janak; Kumar, Manoj

    2015-01-01

    ABSTRACT Purpose: To assess the subjective and objective outcomes of mini-incision dismembered Anderson-Hynes pyeloplasty in the treatment of primary ureteropelvic junction obstruction (UPJO). Materials and Methods: Between January 2008 to January 2013, Anderson-Hynes pyeloplasty was performed in 71 patients diagnosed with primary UPJO. Small subcostal muscle splitting incision was used in all cases. Sixteen patients with renal calculi underwent concomitant pyelolithotomy. Subjective outcome was assessed using visual pain analogue score (VAS). For objective assessment, the improvement in differential renal function (DRF) and radio-tracer wash out time (T1/2) on Tc-99m DTPA scan and decrease in hydronephrosis (HDN) on renal ultrasound (USG) and urography (IVU) were assessed. Results: Mean incision length was 5.2 cm. The average operating time and postoperative hospital stay was 63 (52-124) minutes and 2.5 (2–6) days respectively. Concomitant renal calculi were successfully removed in all the patients. Overall complication rates were 8.4% and overall success rate was 98.6% at median follow-up of 16 months. There was significant improvement in pain score (p=0.0001) and significant decrease in HDN after the procedure. While preoperative mean T1/2 was 26.7±6.4 minutes, postoperative half-time decreased to 7.8±4.2 minutes at 6 months and to 6.7±3.3 minutes at 1 year. Mean pre-operative DRF was 26.45% and it was 31.38% and 33.19% at 6 months and 1 year respectively. Conclusions: Mini-incision pyeloplasty is a safe and effective technique with combined advantage of high success rates of standard open pyeloplasty with decreased morbidity of laparoscopic approach. Excellent functional and objective outcomes can be achieved without extra technical difficulty. PMID:26689518

  6. Professional Development of Preceptors Improves Nurse Outcomes.

    PubMed

    Cotter, Elizabeth; Dienemann, Jacqueline

    2016-01-01

    This hospital preceptor program includes processes to recruit, select, and provide ongoing evaluation of preceptor function. After volunteering, candidates are chosen by peer vote. A blended training program includes online, commercially available modules and nursing professional development practitioner-led sessions that engage preceptors in reflection and problem-solving. Preceptor education allows nurses to further develop their skills over 2 years. Formal evaluation found that preceptors gained efficiency in their role with low turnover rate and positive patient outcomes. PMID:27434318

  7. How regional trauma systems improve outcomes.

    PubMed

    Cole, Elaine

    2015-10-01

    Management of severely injured patients is complex and requires organised, expert care. Regionalised trauma systems are relatively new in the UK and aim to deliver optimal, timely care to injured patients at the most appropriate location. This article discusses the drivers, organisation, processes and outcomes of regionalised trauma care. It also describes the challenges and benefits of working within a trauma system to enable emergency practitioners to reflect on their roles in contemporary trauma care. PMID:26451941

  8. Longitudinal Outcomes of Start Time Delay on Sleep, Behavior, and Achievement in High School

    PubMed Central

    Thacher, Pamela V.; Onyper, Serge V.

    2016-01-01

    Study Objectives: To establish whether sleep, health, mood, behavior, and academics improved after a 45-minute delay in high school start time, and whether changes persisted longitudinally. Methods: We collected data from school records and student self-report across a number of domains at baseline (May 2012) and at two follow-up time points (November 2012 and May 2013), at a public high school in upstate New York. Students enrolled during academic years (AY) 2011–2012 and 2012–2013 completed the Pittsburgh Sleep Quality Index; the DASS-21; the “Owl-Lark” Scale; the Daytime Sleepiness Index; and a brief self-report of health. Reports from school records regarding attendance, tardiness, disciplinary violations, and academic performance were collected for AY 2010–2011 through 2013–2014. Results: Students delayed but did not extend their sleep period; we found lasting improvements in tardiness and disciplinary violations after the start-time delay, but no changes to other variables. At the first follow-up, students reported 20 minutes longer sleep, driven by later rise times and stable bed times. At the second follow-up, students maintained later rise times but delayed bedtimes, returning total sleep to baseline levels. A delay in rise time, paralleling the delay in the start time that occurred, resulted in less tardiness and decreased disciplinary incidents, but larger improvements to sleep patterns may be necessary to affect health, attendance, sleepiness, and academic performance. Conclusions: Later start times improved tardiness and disciplinary issues at this school district. A delay in start time may be a necessary but not sufficient means to increase sleep time and may depend on preexisting individual differences. Commentary: A commentary on this article appears in this issue on page 267. Citation: Thacher PV, Onyper SV. Longitudinal outcomes of start time delay on sleep, behavior, and achievement in high school. SLEEP 2016;39(2):271–281. PMID

  9. Weaving a Stronger Fabric for Improved Outcomes

    ERIC Educational Resources Information Center

    Lobry de Bruyn, Lisa; Prior, Julian; Lenehan, Jo

    2014-01-01

    Purpose: To explain how training and education events (TEEs) can be designed to increase the likelihood of achieving behavioural objectives. Approach: The approach combined both a quantitative review of evaluation surveys undertaken at the time of the TEE, and qualitative telephone interviews with selected attendees (2025% of the total population…

  10. Project ELI: Improving Early Literacy Outcomes

    ERIC Educational Resources Information Center

    Young, Robin Miller; Chandler, Lynette K.; Shields, LuAnn; Laubenstein, Pam; Butts, Jill; Black, Kristine

    2008-01-01

    Early childhood and elementary-level educators are engaging in conversations about how to coordinate their efforts to develop fluent readers. There is evidence that key early literacy skills that are predictive of subsequent literacy achievement in kindergarten and first grade can be taught to preschool-age children. Moreover, early childhood…

  11. Improving outcomes in anaesthesiology education on research.

    PubMed

    Nagle, Pamela C

    2011-12-01

    For more than 30 years in the United States, we have been lamenting the fate of the clinician-scientist in anaesthesiology. In the past 5 years, attention to the issues has escalated and a number of new training pathways have emerged. This chapter summarizes programs which have innovative curricula, analyzes current research needs and discusses the limited studies in regards to best practices for research training in graduate medical education. It also proposes further development of residency research curricula through the application of basic educational concepts and explores funding issues and resources that remain relevant to all faculty and departments training the residents. We hope the ideas proposed here will promote the academic caliber of our profession; however, much more data and outcomes research needs to be done to determine our best practices for the future. PMID:22099917

  12. Improved Cardiovascular Disease Outcomes in Older Adults

    PubMed Central

    Forman, Daniel E.; Alexander, Karen; Brindis, Ralph G.; Curtis, Anne B.; Maurer, Mathew; Rich, Michael W.; Sperling, Laurence; Wenger, Nanette K.

    2016-01-01

    Longevity is increasing and the population of older adults is growing. The biology of aging is conducive to cardiovascular disease (CVD), such that prevalence of coronary artery disease, heart failure, valvular heart disease, arrhythmia and other disorders are increasing as more adults survive into old age.  Furthermore, CVD in older adults is distinctive, with management issues predictably complicated by multimorbidity, polypharmacy, frailty and other complexities of care that increase management risks (e.g., bleeding, falls, and rehospitalization) and uncertainty of outcomes.  In this review, state-of-the-art advances in heart failure, acute coronary syndromes, transcatheter aortic valve replacement, atrial fibrillation, amyloidosis, and CVD prevention are discussed.  Conceptual benefits of treatments are considered in relation to the challenges and ambiguities inherent in their application to older patients. PMID:26918183

  13. Improved Cardiovascular Disease Outcomes in Older Adults.

    PubMed

    Forman, Daniel E; Alexander, Karen; Brindis, Ralph G; Curtis, Anne B; Maurer, Mathew; Rich, Michael W; Sperling, Laurence; Wenger, Nanette K

    2016-01-01

    Longevity is increasing and the population of older adults is growing. The biology of aging is conducive to cardiovascular disease (CVD), such that prevalence of coronary artery disease, heart failure, valvular heart disease, arrhythmia and other disorders are increasing as more adults survive into old age.  Furthermore, CVD in older adults is distinctive, with management issues predictably complicated by multimorbidity, polypharmacy, frailty and other complexities of care that increase management risks (e.g., bleeding, falls, and rehospitalization) and uncertainty of outcomes.  In this review, state-of-the-art advances in heart failure, acute coronary syndromes, transcatheter aortic valve replacement, atrial fibrillation, amyloidosis, and CVD prevention are discussed.  Conceptual benefits of treatments are considered in relation to the challenges and ambiguities inherent in their application to older patients. PMID:26918183

  14. Improving STEM Student Learning Outcomes with GIS

    NASA Astrophysics Data System (ADS)

    Montgomery, W. W.

    2013-12-01

    Longitudinal data collection initiated a decade ago as part of a successful NSF-CCLI grant proposal has resulted in a large - and growing - sample (200+) of students who report on their perceptions of self-improvement in Technology, Critical Thinking, and Quantitative Reasoning proficiencies upon completion of an introductory (200-level) GIS course at New Jersey City University, a Hispanic-Serving and Minority Institution in Jersey City, NJ. Results from student satisfaction surveys indicate that, not surprisingly, 80% of respondents report improved confidence in Technology Literacy. Critical Thinking proficiency is judged to be significantly improved by 60% of respondents. On the other hand, Quantitative Reasoning proficiency confidence is improved in only 30% of students. This latter finding has prompted the instructor to search for more easily recognizable (to the student) ways of embedding quantitative reasoning into the course, as it is obvious to any GIS professional that there is an enormous amount of quantitative reasoning associated with this technology. A second post-course questionnaire asks students to rate themselves in these STEM proficiency areas using rubrics. Results mirror those from the self-satisfaction surveys. On a 5-point Likkert scale, students tend to see themselves improving about one letter grade on average in each proficiency area. The self-evaluation rubrics are reviewed by the instructor and are judged to be accurate for about 75% of the respondents.

  15. The effects of physical activity and physical fitness on children's achievement and cognitive outcomes: a meta-analysis.

    PubMed

    Fedewa, Alicia L; Ahn, Soyeon

    2011-09-01

    It is common knowledge that physical activity leads to numerous health and psychological benefits. However; the relationship between children's physical activity and academic achievement has been debated in the literature. Some studies have found strong, positive relationships between physical activity and cognitive outcomes, while other studies have reported small, negative associations. This study was a comprehensive, quantitative synthesis of the literature, using a total of 59 studies from 1947 to 2009 for analysis. Results indicated a significant and positive effect of physical activity on children's achievement and cognitive outcomes, with aerobic exercise having the greatest effect. A number of moderator variables were also found to play a significant role in this relationship. Findings are discussed in light of improving children's academic performance and changing school-based policy. PMID:21957711

  16. Working together to achieve the best outcomes for equine health and welfare.

    PubMed

    2016-03-19

    Gill Harris reports from this year's National Equine Forum where a key theme was the importance of collaboration and effective communication in achieving the best outcomes for the health and welfare of the horse and the future of equestrianism in the UK. PMID:26993448

  17. A Comparison of Mathematics Achievement Outcomes among Three Instruction Programs for Pacific Island Elementary Students

    ERIC Educational Resources Information Center

    Bernardo, Jonathan Christian Amor

    2013-01-01

    The purpose of this study was to compare the mathematics achievement outcomes of 3rd grade students from some Pacific Island elementary schools that use 1 of 3 different modes of instruction: Direct Instruction (DI), Success for All (SFA), and noncomprehensive school reform (non-CSR). The need for this research stems from the large proportion of…

  18. The Role of Teachers' Support in Predicting Students' Motivation and Achievement Outcomes in Physical Education

    ERIC Educational Resources Information Center

    Zhang, Tao; Solmon, Melinda A.; Gu, Xiangli

    2012-01-01

    Examining how teachers' beliefs and behaviors predict students' motivation and achievement outcomes in physical education is an area of increasing research interest. Guided by the expectancy-value model and self-determination theory, the major purpose of this study was to examine the predictive strength of teachers' autonomy, competence, and…

  19. Discrepancies between Student Perception and Achievement of Learning Outcomes in a Flipped Classroom

    ERIC Educational Resources Information Center

    Van Sickle, Jenna

    2016-01-01

    In a college algebra course that used flipped/inverted pedagogy, students achieved learning outcomes at a significantly higher rate, as evidenced by results on the final exam. At the same time, student perception on a number of measures decreased significantly, including how interested students were in the course and whether the instructor…

  20. Exposure to Childhood Sexual and Physical Abuse and Subsequent Educational Achievement Outcomes

    ERIC Educational Resources Information Center

    Boden, Joseph M.; Horwood, L. John; Fergusson, David M.

    2007-01-01

    Objective: This paper examined the relationship between exposure to sexual and physical abuse (CSA and CPA) in childhood and later educational achievement outcomes in late adolescence and early adulthood in a birth cohort of over 1,000 children studied to age 25. Method: Retrospective data on CSA and CPA were gathered at ages 18 and 21 and used to…

  1. Family Background and Academic Achievement: Does Self-Efficacy Mediate Outcomes?

    ERIC Educational Resources Information Center

    Weiser, Dana A.; Riggio, Heidi R.

    2010-01-01

    Research indicates both family background and self-efficacy influence academic outcomes; however, family background also impacts self-efficacy development. The purpose of the current study was to establish whether self-efficacy mediates the relationship between family background and academic achievement. Results indicated family background…

  2. Emotional Design in Multimedia: Does Gender and Academic Achievement Influence Learning Outcomes?

    ERIC Educational Resources Information Center

    Kumar, Jeya Amantha; Muniandy, Balakrishnan; Yahaya, Wan Ahmad Jaafar Wan

    2016-01-01

    This study was designed as a preliminary study (N = 33) to explore the effects of gender and academic achievement (Cumulative Grade Point Average-CGPA) on polytechnic students' learning outcomes when exposed to Multimedia Learning Environments (MLE) designed to induce emotions. Three designs namely positive (PosD), neutral (NeuD) and negative…

  3. Role of Video Games in Improving Health-Related Outcomes

    PubMed Central

    Primack, Brian A.; Carroll, Mary V.; McNamara, Megan; Klem, Mary Lou; King, Brandy; Rich, Michael O.; Chan, Chun W.; Nayak, Smita

    2012-01-01

    Context Video games represent a multibillion-dollar industry in the U.S. Although video gaming has been associated with many negative health consequences, it may also be useful for therapeutic purposes. The goal of this study was to determine whether video games may be useful in improving health outcomes. Evidence acquisition Literature searches were performed in February 2010 in six databases: the Center on Media and Child Health Database of Research, MEDLINE, CINAHL, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials. Reference lists were hand-searched to identify additional studies. Only RCTs that tested the effect of video games on a positive, clinically relevant health consequence were included. Study selection criteria were strictly defined and applied by two researchers working independently. Study background information (e.g., location, funding source), sample data (e.g., number of study participants, demographics), intervention and control details, outcomes data, and quality measures were abstracted independently by two researchers. Evidence synthesis Of 1452 articles retrieved using the current search strategy, 38 met all criteria for inclusion. Eligible studies used video games to provide physical therapy, psychological therapy, improved disease self-management, health education, distraction from discomfort, increased physical activity, and skills training for clinicians. Among the 38 studies, a total of 195 health outcomes were examined. Video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 46% of clinician skills outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. Study quality was generally poor; for example, two thirds (66%) of studies had follow-up periods of <12 weeks, and only 11% of studies blinded researchers. Conclusions There is potential promise for video games to improve

  4. Improving Learning Outcome Using Six Sigma Methodology

    ERIC Educational Resources Information Center

    Tetteh, Godson A.

    2015-01-01

    Purpose: The purpose of this research paper is to apply the Six Sigma methodology to identify the attributes of a lecturer that will help improve a student's prior knowledge of a discipline from an initial "x" per cent knowledge to a higher "y" per cent of knowledge. Design/methodology/approach: The data collection method…

  5. Does Children’s Academic Achievement Improve when Single Mothers Marry?

    PubMed Central

    Wagmiller, Robert L.; Gershoff, Elizabeth; Veliz, Philip; Clements, Margaret

    2011-01-01

    Promoting marriage, especially among low-income single mothers with children, is increasingly viewed as a promising public policy strategy for improving developmental outcomes for disadvantaged children. Previous research suggests, however, that children’s academic achievement either does not improve or declines when single mothers marry. In this paper, we argue that previous research may understate the benefits of mothers’ marriages to children from single-parent families because (1) the short-term and long-term developmental consequences of marriage are not adequately distinguished and (2) child and family contexts in which marriage is likely to confer developmental advantages are not differentiated from those that do not. Using multiple waves of data from the ECLS-K, we find that single mothers’ marriages are associated with modest but statistically significant improvements in their children’s academic achievement trajectories. However, only children from more advantaged single-parent families benefit from their mothers’ marriage. PMID:21611134

  6. Targeting Pannexin1 Improves Seizure Outcome

    PubMed Central

    Santiago, Marcelo F.; Veliskova, Jana; Patel, Naman K.; Lutz, Sarah E.; Caille, Dorothee; Charollais, Anne; Meda, Paolo; Scemes, Eliana

    2011-01-01

    Imbalance of the excitatory neurotransmitter glutamate and of the inhibitory neurotransmitter GABA is one of several causes of seizures. ATP has also been implicated in epilepsy. However, little is known about the mechanisms involved in the release of ATP from cells and the consequences of the altered ATP signaling during seizures. Pannexin1 (Panx1) is found in astrocytes and in neurons at high levels in the embryonic and young postnatal brain, declining in adulthood. Panx1 forms large-conductance voltage sensitive plasma membrane channels permeable to ATP that are also activated by elevated extracellular K+ and following P2 receptor stimulation. Based on these properties, we hypothesized that Panx1 channels may contribute to seizures by increasing the levels of extracellular ATP. Using pharmacological tools and two transgenic mice deficient for Panx1 we show here that interference with Panx1 ameliorates the outcome and shortens the duration of kainic acid-induced status epilepticus. These data thus indicate that the activation of Panx1 in juvenile mouse hippocampi contributes to neuronal hyperactivity in seizures. PMID:21949881

  7. The Social Responsibility Performance Outcomes Model: Building Socially Responsible Companies through Performance Improvement Outcomes.

    ERIC Educational Resources Information Center

    Hatcher, Tim

    2000-01-01

    Considers the role of performance improvement professionals and human resources development professionals in helping organizations realize the ethical and financial power of corporate social responsibility. Explains the social responsibility performance outcomes model, which incorporates the concepts of societal needs and outcomes. (LRW)

  8. Implementing change: involving employees to improve outcomes.

    PubMed

    Wick, Jeannette Y

    2014-11-01

    Increasingly, pharmacy workplaces are larger organizations that rely on policy and clinical guidelines to direct professional practice. Often, cost-cutting, profit-making, service-improving, and process-streamlining ideas are needed but difficult to identify or implement. By involving employees more closely in the change process using participative management (PM), managers reap tremendous reward. PM focuses on employee collaboration to develop and implement consistent, effective policies and procedures. This process recognizes employees' creative, emotional and intellectual needs and often improves the organization's public face as well. In addition, consumers perceive this approach to be socially responsible management. Managers can implement PM in a number of ways, applying it to problems or processes. PM has some pitfalls, but overall, if the workplace culture adapts to accommodate its principles, PM usually provides numerous benefits for organizations, their employees, and their customers. PMID:25369185

  9. Innovative strategies to improve diabetes outcomes in disadvantaged populations.

    PubMed

    Ruddock, J S; Poindexter, M; Gary-Webb, T L; Walker, E A; Davis, N J

    2016-06-01

    Diabetes disproportionately affects disadvantaged populations. Eighty percent of deaths directly caused by diabetes occurred in low- and middle-income countries. In high-income countries, there are marked disparities in diabetes control among racial/ethnic minorities and those with low socio-economic status. Innovative, effective and cost-effective strategies are needed to improve diabetes outcomes in these populations. Technological advances, peer educators and community health workers have expanded methodologies to reach, educate and monitor individuals with diabetes. In the present manuscript we review the outcomes of these strategies, and describe the barriers to and facilitators of these approaches for improving diabetes outcomes. PMID:27194172

  10. Nutrition and Chronic Wounds: Improving Clinical Outcomes.

    PubMed

    Molnar, Joseph A; Vlad, Lucian G; Gumus, Tuna

    2016-09-01

    There is increasing awareness that chronic wound healing is very dependent on the patient's nutritional status, but there are no clearly established and accepted assessment protocols or interventions in clinical practice. Much of the data used as guidelines for chronic wound patients are extrapolated from acutely wounded trauma patients, but the 2 groups are very different patient populations. While most trauma patients are young, healthy, and well-nourished before injury, the chronic wound patient is usually old, with comorbidities and frequently malnourished. We suggest the assumption that all geriatric wound patients are malnourished until proved otherwise. Evaluation should include complete history and physical and a formal nutritional evaluation should be obtained. Laboratory studies can be used in conjunction with this clinical information to confirm the assessment. While extensive studies are available in relation to prevention and treatment of pressure ulcers and perioperative nutrition, less is known of the effect of nutritional deficits and supplementation of the diabetic foot ulcer and venous stasis ulcer patient. This does not necessarily mean that nutritional support of these patients is not helpful. In the pursuit of wound healing, we provide systemic support of cardiac and pulmonary function and cessation of smoking, improve vascular inflow, improve venous outflow, decrease edema, and treat with hyperbaric oxygen. If we address all of these other conditions, why would we not wish to support the most basic of organismal needs in the form of nutrition? PMID:27556777

  11. Effective pain management and improvements in patients' outcomes and satisfaction.

    PubMed

    Glowacki, Diane

    2015-06-01

    Adequate pain management is a compelling and universal requirement in health care. Despite considerable advancements, the adverse physiological and psychological implications of unmanaged pain remain substantially unresolved. Ineffective pain management can lead to a marked decrease in desirable clinical and psychological outcomes and patients' overall quality of life. Effective management of acute pain results in improved patient outcomes and increased patient satisfaction. Although research and advanced treatments in improved practice protocols have documented progressive improvements in management of acute and postoperative pain, little awareness of the effectiveness of best practices persists. Improved interventions can enhance patients' attitudes to and perceptions of pain. What a patient believes and understands about pain is critical in influencing the patient's reaction to the pain therapy provided. Use of interdisciplinary pain teams can lead to improvements in patients' pain management, pain education, outcomes, and satisfaction. PMID:26033099

  12. The Role of Self-Efficacy, Task Value, and Achievement Goals in Predicting Learning Strategies, Task Disengagement, Peer Relationship, and Achievement Outcome

    ERIC Educational Resources Information Center

    Liem, Arief Darmanegara; Lau, Shun; Nie, Youyan

    2008-01-01

    Adopting a combination of expectancy-value and achievement goal theories, this study examined the role of self-efficacy, task value, and achievement goals in students' learning strategies, task disengagement, peer relationship, and English achievement outcome. A sample of 1475 Year-9 students participated in the study. A structural equation model…

  13. Improving outcomes in patients with psoriasis.

    PubMed

    Tidman, Michael J

    2013-01-01

    Psoriasis is a heterogeneous inflammatory disorder that targets the skin and joints. It affects 1.3-2% of the population. The diagnosis of plaque psoriasis is usually straightforward, a helpful diagnostic clue is the tendency for silver scales to appear after gentle scratching of a lesion. Stress, streptococcal infection and drugs including beta-blockers, antimalarials and lithium may precipitate or exacerbate psoriasis. Psoriasis, especially when severe, predisposes to metabolic syndrome, and patients with psoriasis are at increased risk of ischaemic heart disease, hypertension, stroke, type 2 diabetes and hyperlipidaemia. Additionally, psoriasis sufferers appear at increased risk of uveitis, inflammatory boweldisease, lymphoma, non-melanoma skin cancer, COPD and venous thromboembolism. Psoriasis should be assessed on the basis of: severity, impact on physical, psychological and social wellbeing, symptoms of arthritis and the presence of comorbidities. Poor response to topical therapy may be as much to do with lack of compliance as with lack of efficacy. The number of treatments each day should be kept to a minimum, and patients should be reviewed after four weeks when initiating or changing topical therapy to improve adherence to treatment and assess response. The majority of patients with psoriasis can be managed in primary care, although specialist care may be necessary at some point in up to 60% of cases. Patients with erythrodermic or generalised pustular psoriasis should be referred for a same day dermatological opinion, and if psoriatic arthritis is suspected, early referral for a rheumatological opinion is recommended. PMID:23469725

  14. Vitamin d and rehabilitation: improving functional outcomes.

    PubMed

    Shinchuk, Leonid M; Shinchuk, Leonid; Holick, Michael F

    2007-06-01

    Vitamin D inadequacy is pandemic among rehabilitation patients in both inpatient and outpatient settings. Male and female patients of all ages and ethnic backgrounds are affected. Vitamin D deficiency causes osteopenia, precipitates and exacerbates osteoporosis, causes the painful bone disease osteomalacia, and worsens proximal muscle strength and postural sway. Vitamin D inadequacy can be prevented by sensible sun exposure and adequate dietary intake with supplementation. Vitamin D status is determined by measurement of serum 25-hydroxyvitamin D. The recommended healthful serum level is between 30 and 60 ng/mL. 25-Hydroxyvitamin D levels of >30 ng/mL are sufficient to suppress parathyroid hormone production and to maximize the efficiency of dietary calcium absorption from the small intestine. This can be accomplished by ingesting 1000 IU of vitamin D(3) per day, or by taking 50,000 IU of vitamin D(2) every 2 weeks. Vitamin D toxicity is observed when 25-hydroxyvitamin D levels exceed 150 ng/mL. Identification and treatment of vitamin D deficiency reduces the risk of vertebral and nonvertebral fractures by improving bone health and musculoskeletal function. Vitamin D deficiency and osteomalacia should be considered in the differential diagnosis of patients with musculoskeletal pain, fibromyalgia, chronic fatigue syndrome, or myositis. There is a need for better education of health professionals and the general public regarding the optimization of vitamin D status in the care of rehabilitation patients. PMID:17507730

  15. Improving the Outcome of Acute Pancreatitis.

    PubMed

    Bruno, Marco J

    2016-01-01

    Acute pancreatitis (AP) is the most common indication for hospital admission and its incidence is rising. It has a variable prognosis, which is mainly dependent upon the development of persistent organ failure and infected necrotizing pancreatitis. In the past few years, based on large-scale multicenter randomized trials, some novel insights regarding clinical management have emerged. In patients with infected pancreatic necrosis, a step-up approach of percutaneous catheter drainage followed by necrosectomy only when the patient does not improve, reduces new-onset organ failure and prevents the need for necrosectomy in about a third of patients. A randomized pilot study comparing surgical to endoscopic necrosectomy in patients with infected necrotizing pancreatitis showed a striking reduction of the pro-inflammatory response following endoscopic necrosectomy. These promising results have recently been tested in a large multicenter randomized trial whose results are eagerly awaited. Contrary to earlier data from uncontrolled studies, a large multicenter randomized trial comparing early (within 24 h) nasoenteric tube feeding compared with an oral diet after 72 h, did not show that early nasoenteric tube feeding was superior in reducing the rate of infection or death in patients with AP at high risk for complications. Although early ERCP does not have a role in the treatment of predicted mild pancreatitis, except in the case of concomitant cholangitis, it may ameliorate the disease course in patients with predicted severe pancreatitis. Currently, a large-scale randomized study is underway and results are expected in 2017. PMID:27336312

  16. Guidance on feedback of outcome data to improve performance in vascular surgery.

    PubMed

    Li, Mimi M; Shalhoub, Joseph; Davies, Alun H; Maruthappu, Mahiben

    2016-08-01

    Feedback of performance data is a well-established method of performance improvement in the health-care setting, although guidance has been limited in the context of surgical performance. This article outlines how optimal feedback can be achieved using surgeon outcome data. PMID:27487059

  17. Improving Education Outcomes in Germany. OECD Economics Department Working Papers, No. 611

    ERIC Educational Resources Information Center

    Carey, David

    2008-01-01

    Improving education outcomes is important for Germany's long-term economic performance and social cohesion. While student achievement is above the OECD average in science and at the OECD average in reading and mathematics according to the 2006 OECD PISA study, weaker students tend to do badly by international comparison and socio-economic and/or…

  18. The Paradox of Reducing Class Size and Improving Learning Outcomes

    ERIC Educational Resources Information Center

    Hattie, John

    2005-01-01

    This paper addresses four questions: What are the effects of reducing class size? How important are these effects? How can we explain these effects? and How can we improve the outcomes when class sizes are reduced? A major aim is to provide directions for resolving the paradox as to "Why reducing class size has not led to major improvements in…

  19. Improving Rural Cancer Patients' Outcomes: A Group-Randomized Trial

    ERIC Educational Resources Information Center

    Elliott, Thomas E.; Elliott, Barbara A.; Regal, Ronald R.; Renier, Colleen M.; Haller, Irina V.; Crouse, Byron J.; Witrak, Martha T.; Jensen, Patricia B.

    2004-01-01

    Significant barriers exist in the delivery of state-of-the-art cancer care to rural populations. Rural providers' knowledge and practices, their rural health care delivery systems, and linkages to cancer specialists are not optimal; therefore, rural cancer patient outcomes are less than achievable. Purpose: To test the effects of a strategy…

  20. School Factors Explaining Achievement on Cognitive and Affective Outcomes: Establishing a Dynamic Model of Educational Effectiveness

    ERIC Educational Resources Information Center

    Creemers, Bert; Kyriakides, Leonidas

    2010-01-01

    The dynamic model of educational effectiveness defines school level factors associated with student outcomes. Emphasis is given to the two main aspects of policy, evaluation, and improvement in schools which affect quality of teaching and learning at both the level of teachers and students: a) teaching and b) school learning environment. Five…

  1. Using a Triad Leadership Model at the System Level to Achieve Outcomes.

    PubMed

    Batcheller, Joyce

    2016-06-01

    Nurses must partner with physicians and other health professionals in redesigning healthcare. What do nurse executives need to learn to participate and lead as part of a highly functioning executive triad? In this column, a former system chief nursing officer will share personal experiences and highlights of outcomes that were improved. PMID:27214330

  2. Premature ovarian insufficiency: how to improve reproductive outcome?

    PubMed

    Ben-Nagi, J; Panay, N

    2014-06-01

    Premature ovarian insufficiency (POI) is a life-changing condition that affects women in their reproductive age. The condition is not necessarily permanent but is associated with intermittent and unpredictable ovarian activity. Hence, spontaneous pregnancies have been reported to be 5-10%. However, pregnancy in patients with POI is still unlikely and rare. Although, there are reviews on POI in the literature, there is a lack of reports which focus on how to improve the reproductive outcome of these women who wish to conceive spontaneously or use assisted conception with their own oocytes. We found that there is no conclusive evidence of which treatment is optimal for women with POI who wish to conceive using their own gametes. However, one could surmise that it is important to lower gonadotropin levels into the physiological range before embarking on any treatment, even if natural conception is the only choice for the woman/couple. In the future, multi-center, randomized, double-blind, placebo-controlled trials should be carried out, which may entail recruitment of patients from various centers nationally and internationally to increase the sample size and therefore achieve a powered study. This may standardize the treatment of women with POI who wish to conceive and ultimately have their biological child. PMID:24341612

  3. Improving periodontal outcomes: merging clinical and behavioral science.

    PubMed

    Wilder, Rebecca S; Bray, Kimberly S

    2016-06-01

    New data indicate that periodontal diseases are much more prevalent than previously thought, which means that there are large numbers of patients who will need to be diagnosed and treated for periodontal disease in a general dental practice. Oral hygiene procedures performed by patients between office visits are important for gingival health. No particular type of toothbrush has consistently been shown to have superior plaque-removal ability over another. Although studies on powered brushes have shown evidence for efficacy of biofilm removal and increased patient compliance, they are of short duration, making evaluation of long-term effects difficult to achieve. Interdental cleaning with dental floss can be effective but it is technique-sensitive. Interdental brushes have been shown to be superior to floss in plaque index scores, but not in gingival inflammation reduction. A systematic review of oral irrigation reported a beneficial adjunctive effect on bleeding and gingival indices and pocket depth. Antimicrobials in mouthrinses and toothpastes have shown significant reductions in plaque and gingivitis when used correctly. Even though it is considered essential for patients to utilize biofilm-removal techniques on a frequent basis, studies on adherence show that approximately 30-60% of health information is forgotten within 1 h, and 50% of health recommendations are not followed. Incorporating psychosocial aspects of behavioral change, including well-established counseling strategies, such as motivational interviewing, may elicit improved patient outcomes. PMID:27045431

  4. Outcomes of patients with myelodysplastic syndromes who achieve stable disease after treatment with hypomethylating agents.

    PubMed

    Nazha, Aziz; Sekeres, Mikkael A; Garcia-Manero, Guillermo; Barnard, John; Al Ali, Najla H; Roboz, Gail J; Steensma, David P; DeZern, Amy E; Zimmerman, Cassie; Jabbour, Elias J; Zell, Katrina; List, Alan F; Kantarjian, Hagop M; Maciejewski, Jaroslaw P; Komrokji, Rami S

    2016-02-01

    Treatment with hypomethylating agents (HMAs) improves overall survival (OS) in patients who achieve a response of stable disease (SD) or better (complete remission [CR], partial remission [PR], or hematologic improvement [HI]). It is not well established if patients who achieve SD at 4-6 months of therapy should be offered different therapies to optimize their response or continue with the same regimen. Clinical data were obtained from the MDS Clinical Research Consortium database. SD was defined as no evidence of progression and without achievement of any other responses. Of 291 patients treated with AZA or DAC, 55% achieved their best response (BR) at 4-6 months. Among patients with SD at 4-6 months, 29 (20%) achieved a better response at a later treatment time point. Younger patients with lower bone marrow blast percentages, and intermediate risk per IPSS-R were more likely to achieve a better response (CR, PR, or HI) after SD at 4-6 months. Patients with SD who subsequently achieved CR had superior OS compared to patients who remained with SD (28.1 vs. 14.4 months, respectively, p=.04). In conclusion, patients treated with HMAs who achieves CR after a SD status had longer survival with continuous treatment after 6 months. PMID:26777537

  5. Outcomes of patients with myelodysplastic syndromes who achieve stable disease after treatment with hypomethylating agents

    PubMed Central

    Nazha, Aziz; Sekeres, Mikkael A.; Garcia-Manero, Guillermo; Barnard, John; Al Ali, Najla H.; Roboz, Gail J.; Steensma, David P.; DeZern, Amy E.; Zimmerman, Cassie; Jabbour, Elias J.; Zell, Katrina; List, Alan F.; Kantarjian, Hagop M.; Maciejewski, Jaroslaw P.; Komrokji, Rami S.

    2016-01-01

    Treatment with hypomethylating agents (HMAs) improves overall survival (OS) in patients who achieve a response of stable disease (SD) or better (complete remission [CR], partial remission [PR], or hematologic improvement [HI]). It is not well established if patients who achieve SD at 4–6 months of therapy should be offered different therapies to optimize their response or continue with the same regimen. Clinical data were obtained from the MDS Clinical Research Consortium database. SD was defined as no evidence of progression and without achievement of any other responses. Of 291 patients treated with AZA or DAC, 55% achieved their best response (BR) at 4–6 months. Among patients with SD at 4–6 months, 29 (20%) achieved a better response at a later treatment time point. Younger patients with lower bone marrow blast percentages, and intermediate risk per IPSS-R were more likely to achieve a better response (CR, PR, or HI) after SD at 4–6 months. Patients with SD who subsequently achieved CR had superior OS compared to patients who remained with SD (28.1 vs. 14.4 months, respectively, p =.04). In conclusion, patients treated with HMAs who achieves CR after a SD status had longer survival with continuous treatment after 6 months. PMID:26777537

  6. Lean Participative Process Improvement: Outcomes and Obstacles in Trauma Orthopaedics

    PubMed Central

    New, Steve; Hadi, Mohammed; Pickering, Sharon; Robertson, Eleanor; Morgan, Lauren; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter

    2016-01-01

    Objectives To examine the effectiveness of a “systems” approach using Lean methodology to improve surgical care, as part of a programme of studies investigating possible synergy between improvement approaches. Setting A controlled before-after study using the orthopaedic trauma theatre of a UK Trust hospital as the active site and an elective orthopaedic theatre in the same Trust as control. Participants All staff involved in surgical procedures in both theatres. Interventions A one-day “lean” training course delivered by an experienced specialist team was followed by support and assistance in developing a 6 month improvement project. Clinical staff selected the subjects for improvement and designed the improvements. Outcome Measures We compared technical and non-technical team performance in theatre using WHO checklist compliance evaluation, “glitch count” and Oxford NOTECHS II in a sample of directly observed operations, and patient outcome (length of stay, complications and readmissions) for all patients. We collected observational data for 3 months and clinical data for 6 months before and after the intervention period. We compared changes in measures using 2-way analysis of variance. Results We studied 576 cases before and 465 after intervention, observing the operation in 38 and 41 cases respectively. We found no significant changes in team performance or patient outcome measures. The intervention theatre staff focused their efforts on improving first patient arrival time, which improved by 20 minutes after intervention. Conclusions This version of “lean” system improvement did not improve measured safety processes or outcomes. The study highlighted an important tension between promoting staff ownership and providing direction, which needs to be managed in “lean” projects. Space and time for staff to conduct improvement activities are important for success. PMID:27124012

  7. Does aggregate school-wide achievement mediate fifth grade outcomes for former early childhood education participants?

    PubMed

    Curenton, Stephanie M; Dong, Nianbo; Shen, Xiangjin

    2015-07-01

    This study used a multilevel mediation model to test the theory that former early childhood education (ECE) attendees' 5th grade achievement is mediated by the aggregate school-wide achievement of their elementary school. Aggregate school-wide achievement was defined as the percentage of 5th graders in a school who were at/above academic proficiency in reading or math. Research questions were: (a) Do ECE program participants have better achievement at 5th grade compared with their matched peers who did not participate in an ECE program?; and (b) Is the association between ECE attendance and 5th grade academic performance mediated by school-wide achievement? Results indicated that children who attended prekindergarten (pre-K) and child care outperformed their matched peers who had not attended ECE programs; conversely, those children who did not attend ECE actually outperformed their Head Start counterparts. Mediation analyses indicated that aggregate school-wide achievement at 5th grade partially mediated the association between former ECE attendance and 5th grade performance; however, these mediated effects were small. Overall, the size of the total effects of ECE and the 5th grade academic outcomes were consistent with prior studies. This research confirms the long-term effects of pre-K and child care until 5th grade. PMID:26098581

  8. Pre-operative Thresholds for Achieving Meaningful Clinical Improvement after Arthroscopic Treatment of Femoroacetabular Impingement

    PubMed Central

    Nwachukwu, Benedict U.; Fields, Kara G.; Nawabi, Danyal H.; Kelly, Bryan T.; Ranawat, Anil S.

    2016-01-01

    sagittal CEA was the only variable maintaining significance (p = 0.032). Conclusion: We used a large prospective hip arthroscopy database to identify pre-operative patient outcome score thresholds predictive of meaningful post-operative outcome improvement after arthroscopic FAI treatment. This is the largest reported hip arthroscopy cohort to define MCID and the first to do so for iHOT-33. The HOS-ADL may have the best predictive ability for achieving MCID after hip arthroscopy. Patients with relatively high pre-operative ADL, quality of life and functional status appear to have a high chance for achieveing MCID up to our defined thresholds. Hip dysplasia is an important outcome modifier. The findings of this study may be useful for managing preoperative expectation for patients undergoing arthroscopic FAI surgery.

  9. Efforts to Improve Perinatal Outcomes for Women Enrolled in Medicaid.

    PubMed

    Daniel-Robinson, Lekisha; Cha, Stephen; Lillie-Blanton, Marsha

    2015-08-01

    Improving women's health and perinatal health outcomes is a high priority for Medicaid, the jointly financed federal-state health coverage program. The authorities provided by the Affordable Care Act give Medicaid new resources and opportunities to improve coverage and perinatal care. Given that the Medicaid program currently covers almost half of all births in the United States, the Centers for Medicare and Medicaid Services, working in partnership with states and other stakeholders, is using new and existing authorities to improve birth outcomes. Quality measurement, quality-improvement projects, and expanded models of care underscore the major quality approach of the center. As an outgrowth of an expert panel that included membership of several state Medicaid medical directors, Medicaid providers, and consumer representatives, the Centers for Medicare and Medicaid Services' Center for Medicaid and CHIP Services launched the Maternal and Infant Health Initiative, which aims to increase postpartum visit rates and the use of effective contraception among women covered by Medicaid. This Initiative provides focus on key opportunities and strategies to improve the rate, measurement, timing, and content of postpartum visits. Additionally, a focus on contraception will serve to improve pregnancy planning and spacing and prevent unintended pregnancy. As the Initiative evolves, the Center for Medicaid and CHIP Services plans to identify policy, service delivery, and reimbursement policies to advance the Initiative's goals and improve outcomes for women covered by Medicaid. PMID:26241435

  10. From Headline to Hard Grind: The Importance of Understanding Public Administration in Achieving Health Outcomes

    PubMed Central

    O’Flynn, Janine

    2016-01-01

    Many public policy programs fail to translate ambitious headlines to on-the-ground action. The reasons for this are many and varied, but for public administration and management scholars a large part of the gap between ambition and achievement is the challenge associated with the operation of the machinery of government itself, and how it relates to the other parties that it relies on to fulfill these outcomes. In their article, Carey and Friel set out key reasons why public health scholars should seek to better understand important ideas in public administration. In commenting on their contribution, I draw out two critical questions that are raised by this discussion: (i) what are boundaries and what forms do they take? and (ii) why work across boundaries? Expanding on these key questions extends the points made by Carey and Friel on the importance of understanding public administration and will better place public health scholars and practitioners to realise health outcomes.

  11. Surgical treatment achieves better outcome in severe traumatic pericallosal aneurysm: case report and literature review

    PubMed Central

    Sui, Mingxing; Mei, Qiyong; Sun, Kehua

    2015-01-01

    Traumatic pericallosal aneurysm (TPA) is typically seldom yet potentially lethal. Because of its rarity, also complicated by the unpredictable delayed-onset, TPA is more difficult to be diagnosed promptly. Due to the sporadic reports and diverse opinions on the priority of surgical treatment, a consensus about effective management of TPA has not been reached. Here we report a 55 year-old male patient with TPA, who received an emergent craniotomy to clip the pseudoaneurysm and remove the hematoma under intense intracranial pressure (ICP) monitoring. A satisfactory clinical outcome was achieved at a 3-month follow-up. Thereafter, a review was conducted to evaluate the outcomes of different managing modalities. PMID:25932088

  12. Breast center's redesign improves outcomes, cuts costs, attracts MCOs.

    PubMed

    1997-07-01

    Slashing breast cancer screening costs and improving outcomes: Implementing an innovative multidisciplinary approach to diagnosing breast cancer and narrowing its team to dedicated "breast specialists" has helped this community hospital's breast center win more MCO contracts--despite its location in the shadow of a world-renowned center. Here's how the new program works. PMID:10175553

  13. Evidence that Smaller Schools Do Not Improve Student Achievement

    ERIC Educational Resources Information Center

    Wainer, Howard; Zwerling, Harris L.

    2006-01-01

    If more small schools than "expected" are among the high achievers, then creating more small schools would raise achievement across the board, many proponents of small schools have argued. In this article, the authors challenge the faulty logic of such inferences. Many claims have been made about the advantages of smaller schools. One is that,…

  14. Connections between Teacher Perceptions of School Effectiveness and Student Outcomes in Idaho's Low-Achieving Schools. REL 2014-012

    ERIC Educational Resources Information Center

    Scott, Caitlin; Parsley, Danette

    2014-01-01

    Policymakers and practitioners frequently use teacher surveys to inform decisions on school improvement efforts in low-achieving schools. There is little empirical evidence on how the results of these surveys relate to student outcomes. This study provides information on how perception data from a teacher survey in Idaho is correlated with three…

  15. Challenges to the Development and Implementation of Public Policies to Achieve Animal Welfare Outcomes

    PubMed Central

    Rose, Margaret

    2011-01-01

    Simple Summary Many countries have enacted legislation to protect animals. In the 1800's the primary concern was to protect animals from cruelty but more recent legislative changes also seek to ensure that human beings uphold a duty of care towards those animals for which they are responsible. Today animal welfare concerns all aspects of our interaction with other animals. Although, the diversity of views in society can present challenges, the whole community needs to be engaged in the development and implementation of policies and initiatives so as to achieve sustainable improvements in animal welfare. Abstract Although there is a long-established tradition of concern for the welfare of animals, it was not until the mid 1800's that governments sought to enact legislation to protect animals from cruelty. In the 1950's, questions concerning animal welfare re-emerged and in the ensuing years have been an on-going focus of government activities. These developments occurred against a backdrop of significant social change but there are important differences in what now underpins and informs these considerations. In the formulation and implementation of public policies, governments look for a course of action that represents and protects the interests of the community; the process may be challenging with competing interests but the final determination seeks a middle ground that best meets the needs and interests of the community as a whole. When policy development concerns our relationship with other animals, the complexity of this relationship presents particular challenges not only to the formulation of policies but also to the evaluation of outcomes. Notably, the depth of feelings and diversity of views in our community reflect the complex social, cultural and personal dimensions of this relationship. The use of animals for scientific purposes remains one of the most contentious animal welfare issues primarily because when animals are used for these purposes, accepted

  16. Improving outcome for mental disorders by enhancing memory for treatment.

    PubMed

    Harvey, Allison G; Lee, Jason; Smith, Rita L; Gumport, Nicole B; Hollon, Steven D; Rabe-Hesketh, Sophia; Hein, Kerrie; Dolsen, Michael R; Haman, Kirsten L; Kanady, Jennifer C; Thompson, Monique A; Abrons, Deidre

    2016-06-01

    Patients exhibit poor memory for treatment. A novel Memory Support Intervention, derived from basic science in cognitive psychology and education, is tested with the goal of improving patient memory for treatment and treatment outcome. Adults with major depressive disorder (MDD) were randomized to 14 sessions of cognitive therapy (CT)+Memory Support (n = 25) or CT-as-usual (n = 23). Outcomes were assessed at baseline, post-treatment and 6 months later. Memory support was greater in CT+Memory Support compared to the CT-as-usual. Compared to CT-as-usual, small to medium effect sizes were observed for recall of treatment points at post-treatment. There was no difference between the treatment arms on depression severity (primary outcome). However, the odds of meeting criteria for 'response' and 'remission' were higher in CT+Memory Support compared with CT-as-usual. CT+Memory Support also showed an advantage on functional impairment. While some decline was observed, the advantage of CT+Memory Support was evident through 6-month follow-up. Patients with less than 16 years of education experience greater benefits from memory support than those with 16 or more years of education. Memory support can be manipulated, may improve patient memory for treatment and may be associated with an improved outcome. PMID:27089159

  17. Purchasing population health: aligning financial incentives to improve health outcomes.

    PubMed Central

    Kindig, D A

    1998-01-01

    OBJECTIVE: To review the concept of population health, including its definition, measurement, and determinants, and to suggest an approach for aligning financial incentives toward this goal. DATA SOURCE, STUDY DESIGN, DATA EXTRACTION. Literature review, policy analysis PRINCIPAL FINDINGS: The article presents the argument that a major reason for our slow progress toward health outcome improvement is that there is no operational definition of population health and that financial incentives are not aligned to this goal. Current attempts at process measures as indicators of quality or outcome are not adequate for the task. It is suggested that some measure of health-adjusted life expectancy be adopted for this purpose, and that integrated delivery systems and other agents responsible for nonmedical determinants be rewarded for improvement in this measure. This will require the development of an investment portfolio across the determinants of health based on relative marginal return to health, with horizontal integration strategies across sectoral boundaries. A 20-year three-phase development strategy is proposed, including components of research and acceptance, integrated health system implementation, and cross-sectoral integration. CONCLUSIONS: The U.S. healthcare system is a $1 trillion industry without a definition of its product. Until population outcome measures are developed and rewarded for, we will not solve the twenty-first century challenge of maximizing health outcome improvement for the resources available. Images Figure 1 PMID:9618669

  18. What Works Clearinghouse Quick Review: "KIPP Middle Schools: Impacts on Achievement and Other Outcomes, Final Report"

    ERIC Educational Resources Information Center

    What Works Clearinghouse, 2013

    2013-01-01

    This study examined whether attending a Knowledge is Power Program (KIPP) middle school improved students' reading, math, social studies, and science achievement for up to 4 years following enrollment. The study reported that students attending KIPP middle schools scored statistically significantly higher than matched students on all of the state…

  19. Learning science in a cooperative setting: Academic achievement and affective outcomes

    NASA Astrophysics Data System (ADS)

    Lazarowitz, Reuven; Hertz-Lazarowitz, Rachel; Baird, J. Hugh

    A learning unit in earth science was taught to high school students, using a jigsaw-group mastery learning approach. The sample consisted of 73 students in the experimental group and 47 students who learned the topic in an individualized mastery learning approach. The study lasted 5 weeks. Pretests and posttests on academic achievement and affective outcomes were administered. Data were treated with an analysis of covariance. The results show that students of the experimental group achieved significantly higher on academic outcomes, both normative and objective scores. On the creative essay test, the differences in number of ideas and total essay score were not significant between the groups, although the mean scores for number of words were higher for the individualized mastery learning group. On the affective domain, jigsaw-group mastery learning students scored significantly higher on self-esteem, number of friends, and involvement in the classroom. No differences were found in cohesiveness, cooperation, competition, and attitudes toward the subject learned. The results are discussed through the evaluation and comparison of the two methods of instruction used in this study.The cooperative learning movement began in junior high schools as part of the desegregation process, aiming at facilitating positive ethnic relations and increasing academic achievement and social skills among diverse students (Aronson, Stephan, Sikes, Blaney, & Snapp, 1978; Sharan & Hertz-Lazarowitz, 1980; Slavin, 1980). However, elementary teachers quickly recognized the potential of cooperative methods, and such methods were adopted freely in elementary schools before becoming widespread on the junior and senior high level. It has only been during the past few years that application of cooperative learning has been studied extensively with these older students.Cooperative learning methods generally involve heterogeneous groups working together on tasks that are deliberately structured to

  20. Healthcare systems engineering: an interdisciplinary approach to achieving continuous improvement.

    PubMed

    Wu, Bin; Klein, Cerry; Stone, Tamara T

    2006-01-01

    This paper argues that a systems approach can significantly enhance healthcare improvement efforts in patient safety, service quality and healthcare cost containment. The application of systems thinking to healthcare improvement encompasses three key principles: the systems perspective of healthcare processes, structured problem solving and the closed loop of continuous system improvement. These are encapsulated in a conceptual framework of continuous system improvement, which includes a reference architecture model and an analysis and design process model. Combined into a closed-loop, this framework allows users to understand and appropriately apply relevant functions, issues and analytical techniques. Practical applications of the framework are presented. PMID:18048245

  1. Improving Literacy Outcomes for Years 5-8 Boys

    ERIC Educational Resources Information Center

    Mercer, Kelly

    2011-01-01

    This paper reports on a small action research project carried out by a Special Education Needs Coordinator (SENCO) in a small rural, full primary school in New Zealand. It focused on improving the literacy outcomes for Years 5-8 boys in the school by way of a boys'-only writing group. Results show that the boys'-only learning group had a positive…

  2. Music as intervention: a notable endeavor to improve patient outcomes.

    PubMed

    White, J M

    2001-03-01

    Music interventions have been used in medicine and nursing throughout history. Music therapy is an easy-to-administer, relatively inexpensive, noninvasive intervention that has been used to reduce heart rate, blood pressure, myocardial oxygen consumption, gastrointestinal function, anxiety, and pain. A review of theoretic and empirical base for the use of music therapy to improve patient outcomes in a variety of areas of clinical practice is presented. Implications for practice and future research are suggested. PMID:11342404

  3. Partnering through Training and Practice to Achieve Performance Improvement

    ERIC Educational Resources Information Center

    Lyons, Paul R.

    2010-01-01

    This article presents a partnership effort among managers, trainers, and employees to spring to life performance improvement using the performance templates (P-T) approach. P-T represents a process model as well as a method of training leading to performance improvement. Not only does it add to our repertoire of training and performance management…

  4. Capacity Building for a School Improvement Program, Achievement Directed Leadership.

    ERIC Educational Resources Information Center

    Graeber, Anna O.; And Others

    This report describes and evaluates efforts to enhance school districts' capacity to implement and institutionalize the monitoring and management system for an instructional leadership program called Achievement Directed Leadership (ADL). Chapter one introduces the report's methodology, limitations, and structure. Chapter two first states the…

  5. Improving Secondary School Students' Achievement using Intrinsic Motivation

    ERIC Educational Resources Information Center

    Albrecht, Erik; Haapanen, Rebecca; Hall, Erin; Mantonya, Michelle

    2009-01-01

    This report describes a program for increasing students' intrinsic motivation in an effort to increase academic achievement. The targeted population consisted of secondary level students in a middle to upper-middle class suburban area. The students of the targeted secondary level classes appeared to be disengaged from learning due to a lack of…

  6. Does Video-Autotutorial Instruction Improve College Student Achievement?

    ERIC Educational Resources Information Center

    Fisher, K. M.; And Others

    1977-01-01

    Compares student achievement in an upper-division college introductory course taught by the video-autotutorial method with that in two comparable courses taught by the lecture-discussion method. Pre-post tests of 623 students reveal that video-autotutorial students outperform lecture/discussion participants at all ability levels and that in…

  7. Middle School Practices Improve Student Achievement in High Poverty Schools.

    ERIC Educational Resources Information Center

    Mertens, Steven B.; Flowers, Nancy

    2003-01-01

    Examined how interdisciplinary team practices and classroom instructional practices affected student achievement in high poverty middle schools in Arkansas, Louisiana, and Mississippi. Found that when the combined effects of family poverty level, teaming and common planning time, and duration of teaming were considered, there was a relationship…

  8. Helping Students Improve Academic Achievement and School Success Behavior

    ERIC Educational Resources Information Center

    Brigman, Greg; Campbell, Chari

    2003-01-01

    This article describes a study evaluating the impact of school-counselor-led interventions on student academic achievement and school success behavior. A group counseling and classroom guidance model called student success skills (SSS) was the primary intervention. The focus of the SSS model was on three sets of skills identified in several…

  9. Instruction and Achievement in Chicago Elementary Schools. Improving Chicago's Schools.

    ERIC Educational Resources Information Center

    Smith, Julia B.; Lee, Valerie E.; Newmann, Fred M.

    This study focused on the link between different forms of instruction and learning in Chicago, Illinois, elementary schools. It used teachers' survey reports about their instruction in the 1997-1997 school year and linked these reports with achievement gains. The study tested the common assumption that the nature of standardized assessments…

  10. An Effective Way to Improve Mathematics Achievement in Urban Schools

    ERIC Educational Resources Information Center

    Kim, Taik

    2010-01-01

    The local Gaining Early Awareness and Readiness for Undergraduate Programs (GEARUP) partnership serves 11 K-8 schools with the lowest achievement scores and the highest poverty rates in a large Midwestern urban district. Recently, GEARUP launched a specially designed teaching program, Mathematics Enhancement Group (MEG), for underachievers in…

  11. Learning science in a cooperative setting: Academic achievement and affective outcomes

    NASA Astrophysics Data System (ADS)

    Lazarowitz, Reuven; Hertz-Lazarowitz, Rachel; Baird, J. Hugh

    A learning unit in earth science was taught to high school students, using a jigsaw-group mastery learning approach. The sample consisted of 73 students in the experimental group and 47 students who learned the topic in an individualized mastery learning approach. The study lasted 5 weeks. Pretests and posttests on academic achievement and affective outcomes were administered. Data were treated with an analysis of covariance. The results show that students of the experimental group achieved significantly higher on academic outcomes, both normative and objective scores. On the creative essay test, the differences in number of ideas and total essay score were not significant between the groups, although the mean scores for number of words were higher for the individualized mastery learning group. On the affective domain, jigsaw-group mastery learning students scored significantly higher on self-esteem, number of friends, and involvement in the classroom. No differences were found in cohesiveness, cooperation, competition, and attitudes toward the subject learned. The results are discussed through the evaluation and comparison of the two methods of instruction used in this study.The cooperative learning movement began in junior high schools as part of the desegregation process, aiming at facilitating positive ethnic relations and increasing academic achievement and social skills among diverse students (Aronson, Stephan, Sikes, Blaney, & Snapp, 1978; Sharan & Hertz-Lazarowitz, 1980; Slavin, 1980). However, elementary teachers quickly recognized the potential of cooperative methods, and such methods were adopted freely in elementary schools before becoming widespread on the junior and senior high level. It has only been during the past few years that application of cooperative learning has been studied extensively with these older students.Cooperative learning methods generally involve heterogeneous groups working together on tasks that are deliberately structured to

  12. Student achievement outcomes in a scaling urban standards-based science reform

    NASA Astrophysics Data System (ADS)

    Geier, Robert R.

    This work examines the effects on achievement of a multifaceted reform supporting standards based science teaching in urban middle schools. Several project-based inquiry science curriculum units were introduced to the Detroit public schools, supported by aligned professional development, learning technologies, and administrative policy. The units scaled to over 20,000 students in 26 schools over 6 years, producing unique large-scale longitudinal achievement data on curriculum reform. Chapters include a review of achievement studies on scaling reforms, an examination of the impact of the inquiry curriculum units on state standardized test results, and an investigation of the effect of scaling and teacher experience on student learning. Two cohorts of 7th and 8th graders that participated in the curricula are compared with the remainder of the district population using state standardized test results. Both the initial (n = 760) and scaled up (n = 1,043) cohorts show higher science content understanding and process skills, and significantly higher pass rates. The effect does not attenuate with scaling, is greater for students who experience an inquiry curriculum in both 7th and 8th grade, and reduces the gender gap in achievement for urban African-American boys. Scaling effects as the curriculum innovation matured over 4--6 years are examined using pretest/posttest assessments for two curricula involving 6,396 and 5,043 students respectively. There is no attenuation in student achievement as the innovation scales and outside support fades. Student achievement shows significant gains in the first two years of curriculum enactment, before reaching a stable plateau. By contrast, individual teachers show yearly improvement in student achievement on average as they gain experience with curricula. The absence of a plateau suggests that stability of teacher staffing and administrative support for reform are important for maintaining and improving achievement. Together, the

  13. Improving patient outcomes with technology and social media in paediatric diabetes

    PubMed Central

    Ng, Sze May

    2015-01-01

    The UK has the highest number of children and young people with diagnosed Type 1 diabetes mellitus (T1DM) in Europe, but the lowest numbers attaining good diabetes control (1, 2). Novel strategies and incorporation of digital strategies were identified in the team for development to improve overall patient care and outcomes in our population of children and young people with T1DM. Within a dual-site integrated care organisation, 3 digital initiatives were proposed from 2012-2013 to 1) establish Facebook communications with parents/patients, 2) to implement an electronic diabetes information management system (using Twinkle.Net) and 3) to undertake routine uploading of blood glucose meters and insulin pumps (using DIASEND®) with the aim to improve outcomes in paediatric diabetes care. Key objectives for the three initiatives were aimed to optimise the following outcomes: • Reduce HbA1c levels • Decrease emergency admissions, reduce diabetes-related complications and minimise the length of hospital stays • Improve patient satisfaction and communication • Improve efficiencies with mandatory audit submissions • Empower patients, parents, and the multidisciplicnary team with accurate, real-time information. These digital initiatives showed effective use of technology and social media in achieving significant improvements in all the outcomes within the objectives. PMID:26734405

  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. Organizational management practices for achieving software process improvement

    NASA Technical Reports Server (NTRS)

    Kandt, Ronald Kirk

    2004-01-01

    The crisis in developing software has been known for over thirty years. Problems that existed in developing software in the early days of computing still exist today. These problems include the delivery of low-quality products, actual development costs that exceed expected development costs, and actual development time that exceeds expected development time. Several solutions have been offered to overcome out inability to deliver high-quality software, on-time and within budget. One of these solutions involves software process improvement. However, such efforts often fail because of organizational management issues. This paper discusses business practices that organizations should follow to improve their chances of initiating and sustaining successful software process improvement efforts.

  16. Achieving process control through improved grinding techniques for ferrite materials

    SciTech Connect

    Bruce, J.

    1995-09-01

    In manufacturing soft ferrite materials the particle size of the raw material has a significant impact on the reactivity of calcination. The control of particle size distribution and final formulation at wet milling after calcining impacts the reactivity during sintering and the magnetic properties of the final product. This paper will deal with steps taken to improve process control during the grinding operations of raw material and calcine in soft ferrite production. Equipment modifications as well as changes to the grinding and material handling techniques will be included. All examples of process control and improvements will be supported by data.

  17. Achieving improved cycle efficiency via pressure gain combustors

    SciTech Connect

    Gemmen, R.S.; Janus, M.C.; Richards, G.A.; Norton, T.S.; Rogers, W.A.

    1995-04-01

    As part of the Department of Energy`s Advanced Gas Turbine Systems Program, an investigation is being performed to evaluate ``pressure gain`` combustion systems for gas turbine applications. This paper presents experimental pressure gain and pollutant emission data from such combustion systems. Numerical predictions for certain combustor geometries are also presented. It is reported that for suitable aerovalved pulse combustor geometries studied experimentally, an overall combustor pressure gain of nearly 1 percent can be achieved. It is also shown that for one combustion system operating under typical gas turbine conditions, NO{sub x} and CO emmissions, are about 30 ppmv and 8 ppmv, respectively.

  18. Quality improvement in pediatric inflammatory bowel disease: Moving forward to improve outcomes

    PubMed Central

    Quach, Pauline; Nguyen, Geoffrey C; Benchimol, Eric I

    2013-01-01

    In recent years, pediatric health care has embraced the concept of quality improvement to improve patient outcomes. As quality improvement efforts are implemented, network collaboration (where multiple centers and practices implement standardized programs) is a popular option. In a collaborative network, improvement in the conduct of structural, process and outcome quality measures can lead to improvements in overall health, and benchmarks can be used to assess and compare progress. In this review article, we provided an overview of the quality improvement movement and the role of quality indicators in this movement. We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD), as well as other pediatric chronic illnesses. We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care, and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance. We aimed to assess current quality improvement efforts in pediatric IBD and other diseases, such as childhood asthma, childhood arthritis, and neonatal health. By doing so, we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD. PMID:24151355

  19. Acute Type A Aortic Dissection: for Further Improvement of Outcomes

    PubMed Central

    2012-01-01

    Despite improved outcomes of acute type A aortic dissection (AAAD), many patients die at the moment of onset, and hospital mortality is still high. This article reviews the latest literature to seek the best possible way to optimize outcomes. Delayed diagnosis is caused by variation in or absence of typical symptoms, especially in patients with neurological symptoms. Misdiagnosis as acute myocardial infarction is another problem. Improved awareness by physicians is needed. On arrival, quick admission to the OR is desirable, followed by assessment with transesophageal echocardiography, and malperfusion already exists or newly develops in the OR; thus, timely diagnosis without delay with multimodality assessment is important. Although endovascular therapy is promising, careful introduction is mandatory so as not to cause complications. While various routes are used for the systemic perfusion, not a single route is perfect, and careful monitoring is essential. Surgical treatment on octogenarians is increasingly performed and produces better outcomes than conservative therapy. Complications are not rare, and consent from the family is essential. Prevention of AAAD is another important issue because more patients die at its onset than in the following treatment. In addition to hereditary diseases, including bicuspid aortic valve disease, the management of blood pressure is important. PMID:23555530

  20. Feedback to achieve improved sign-out technique.

    PubMed

    Doers, Matthew E; Beniwal-Patel, Poonam; Kuester, Jessica; Fletcher, Kathlyn E

    2015-01-01

    To maximize the quality of sign-out documents within the internal medicine residency, a quality improvement intervention was developed and implemented. Written sign-outs were collected from general medicine ward teams and graded using an 11-point checklist; in-person feedback was then given directly to the ward teams. Documentation of many of the 11 elements improved: mental status (22% to 66%, P < .0001), decisionality (40% to 66%, P < .0001), lab/test results (63% to 69%, P < .0001), level of acuity (34% to 50%, P < .0001), anticipatory guidance (69% to 82%, P < .0001), and future plans (35% to 38%, P < .0005). The use of vague language declined (41% to 26%, P < .0001). The mean total scores improved from 7.0 to 8.2 out of a possible 11 (P < .0001). As new house staff rotated onto the services, improvement over time was sustained with 1 feedback session per team, per month. Similar interventions could be made in other programs and other institutions. PMID:24878514

  1. ACHIEVING IRRIGATION RETURN FLOW QUALITY CONTROL THROUGH IMPROVED LEGAL SYSTEMS

    EPA Science Inventory

    The key to irrigated agricultural return flow quality control is proper utilization and management of the resource itself, and an accepted tool in out society is the law. This project is designed to develop legal alternatives that will facilitate the implementation of improved wa...

  2. Community Schools Seek to Improve High School Achievement, College Readiness

    ERIC Educational Resources Information Center

    Gilroy, Marilyn

    2011-01-01

    The Coalition for Community Schools, an alliance of more than 150 national, state, and local organizations, is bringing public schools in partnership with community resources to improve student success. While that might seem like an abstract idea, it has very concrete goals, such as boosting high school graduation rates and college readiness.…

  3. Achieving Continuous Improvement: Theories that Support a System Change.

    ERIC Educational Resources Information Center

    Armel, Donald

    Focusing on improvement is different than focusing on quality, quantity, customer satisfaction, and productivity. This paper discusses Open System Theory, and suggests ways to change large systems. Changing a system (meaning the way all the parts are connected) requires a considerable amount of data gathering and analysis. Choosing the proper…

  4. Using Curriculum-Based Measurement to Improve Achievement

    ERIC Educational Resources Information Center

    Clarke, Suzanne

    2009-01-01

    Response to intervention (RTI) is on the radar screen of most principals these days--finding out what it is, how it can improve teaching and learning, and what needs to be done to implement it effectively. One critical component of RTI that will require particular attention from principals is student progress monitoring, which is required in every…

  5. Improving Student Achievement in Solving Mathematical Word Problems.

    ERIC Educational Resources Information Center

    Roti, Joan; Trahey, Carol; Zerafa, Susan

    This report describes a program for improving students' comprehension of the language of mathematical problems. The targeted population consists of 5th and 6th grade multi-age students and multi-age learners with special needs at a middle school located outside a major city in a Midwestern community. Evidence for the existence of this problem…

  6. Improving International Research with Clinical Specimens: 5 Achievable Objectives

    PubMed Central

    LaBaer, Joshua

    2012-01-01

    Our increased interest in translational research has created a large demand for blood, tissue and other clinical samples, which find use in a broad variety of research including genomics, proteomics, and metabolomics. Hundreds of millions of dollars have been invested internationally on the collection, storage and distribution of samples. Nevertheless, many researchers complain in frustration about their inability to obtain relevant and/or useful samples for their research. Lack of access to samples, poor condition of samples, and unavailability of appropriate control samples have slowed our progress in the study of diseases and biomarkers. In this editorial, I focus on five major challenges that thwart clinical sample use for translational research and propose near term objectives to address them. They include: (1) defining our biobanking needs; (2) increasing the use of and access to standard operating procedures; (3) mapping inter-observer differences for use in normalizing diagnoses; (4) identifying natural internal protein controls; and (5) redefining the clinical sample paradigm by building partnerships with the public. In each case, I believe that we have the tools at hand required to achieve the objective within 5 years. Potential paths to achieve these objectives are explored. However we solve these problems, the future of proteomics depends on access to high quality clinical samples, collected under standardized conditions, accurately annotated and shared under conditions that promote the research we need to do. PMID:22998582

  7. Multidisciplinary in-hospital teams improve patient outcomes: A review

    PubMed Central

    Epstein, Nancy E.

    2014-01-01

    Background: The use of multidisciplinary in-hospital teams limits adverse events (AE), improves outcomes, and adds to patient and employee satisfaction. Methods: Acting like “well-oiled machines,” multidisciplinary in-hospital teams include “staff” from different levels of the treatment pyramid (e.g. staff including nurses’ aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others). Their enhanced teamwork counters the “silo effect” by enhancing communication between the different levels of healthcare workers and thus reduces AE (e.g. morbidity/mortality) while improving patient and healthcare worker satisfaction. Results: Multiple articles across diverse disciplines incorporate a variety of concepts of “teamwork” for staff covering emergency rooms (ERs), hospital wards, intensive care units (ICUs), and most critically, operating rooms (ORs). Cohesive teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay (LOS), and yielded greater patient “staff” satisfaction. Conclusion: Within hospitals, delivering the best medical/surgical care is a “team sport.” The goals include: Maximizing patient safety (e.g. limiting AE) and satisfaction, decreasing the LOS, and increasing the quality of outcomes. Added benefits include optimizing healthcare workers’ performance, reducing hospital costs/complications, and increasing job satisfaction. This review should remind hospital administrators of the critical need to keep multidisciplinary teams together, so that they can continue to operate their “well-oiled machines” enhancing the quality/safety of patient care, while enabling “staff” to optimize their performance and enhance their job satisfaction. PMID:25289149

  8. Systemic lupus erythematosus: strategies to improve pregnancy outcomes

    PubMed Central

    Yamamoto, Yuriko; Aoki, Shigeru

    2016-01-01

    Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with a high prevalence in females of childbearing age. Thus, reproduction in SLE patients is a major concern for clinicians. In the past, SLE patients were advised to defer pregnancy because of poor pregnancy outcomes and fear of SLE flares during pregnancy. Investigations to date show that maternal and fetal risks are higher in females with SLE than in the general population. However, with appropriate management of the disease, sufferers may have a relatively uncomplicated pregnancy course. Factors such as appropriate preconception counseling and medication adjustment, strict disease control prior to pregnancy, intensive surveillance during and after pregnancy by both the obstetrician and rheumatologist, and appropriate interventions when necessary play a key role. This review describes the strategies to improve pregnancy outcomes in SLE patients at different time points in the reproduction cycle (preconception, during pregnancy, and postpartum period) and also details the neonatal concerns. PMID:27468250

  9. Systemic lupus erythematosus: strategies to improve pregnancy outcomes.

    PubMed

    Yamamoto, Yuriko; Aoki, Shigeru

    2016-01-01

    Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with a high prevalence in females of childbearing age. Thus, reproduction in SLE patients is a major concern for clinicians. In the past, SLE patients were advised to defer pregnancy because of poor pregnancy outcomes and fear of SLE flares during pregnancy. Investigations to date show that maternal and fetal risks are higher in females with SLE than in the general population. However, with appropriate management of the disease, sufferers may have a relatively uncomplicated pregnancy course. Factors such as appropriate preconception counseling and medication adjustment, strict disease control prior to pregnancy, intensive surveillance during and after pregnancy by both the obstetrician and rheumatologist, and appropriate interventions when necessary play a key role. This review describes the strategies to improve pregnancy outcomes in SLE patients at different time points in the reproduction cycle (preconception, during pregnancy, and postpartum period) and also details the neonatal concerns. PMID:27468250

  10. Socially oriented achievement goals of Chinese university students in Singapore: structure and relationships with achievement motives, goals and affective outcomes.

    PubMed

    Chang, Weining C; Wong, Kaishi

    2008-10-01

    Contemporary literature on culture, self, and motivations (Markus & Kitayama, 1991) suggests that in collectivistic cultures, individual achievement is interdependent of one's social others. We proposed that this cultural characteristic could be exemplified in the achievement goal orientation and tested the notion with university students in a collectivistic community-Singapore. A socially oriented achievement goal construct was developed by taking into consideration the significant social others in the students' lives. A measuring instrument was established with a sample of Singaporean Chinese university students (N = 196; 144 females and 52 males); its relationships to achievement motives, goals, and consequences were examined. Although the socially oriented achievement goal items were originally constructed from four categories of social others, confirmatory factor analysis suggested a unifactor structure. Results showed that the socially oriented goal was related positively with students' performance goal, mastery goal, and competitive motive; it bore no relationship to mastery motive, work ethic, and interest in learning; and it predicted negatively future engagement. After the effects of mastery and performance goals were controlled for, the socially oriented goal did not predict test anxiety. PMID:22022792

  11. New approaches for improving outcomes in breast cancer in Europe.

    PubMed

    Di Leo, Angelo; Curigliano, Giuseppe; Diéras, Véronique; Malorni, Luca; Sotiriou, Christos; Swanton, Charles; Thompson, Alastair; Tutt, Andrew; Piccart, Martine

    2015-08-01

    Considerable progress has been made in breast cancer treatment in Europe over the past three decades, yet survival rates for metastatic disease remain poor, underlining the need for further advances. While the use of predictive biomarkers for response to systemic therapy could improve drug development efficiency, progress in identifying such markers has been slow. The currently inadequate classification of breast cancer subtypes is a further challenge. Improved understanding of the molecular pathology of the disease has led to the identification of new targets for drug treatment, and evolving classifications should reflect these developments. Further ongoing challenges include difficulties in finding optimal combinations and sequences of systemic therapies, circumventing multidrug resistance and intra-tumor heterogeneity, problems associated with fragmentation in clinical trials and translational research efforts. Adoption of some of the strategies identified in this article may lead to further improvements in outcomes for patients with the disease. PMID:25840656

  12. Juxtaposing Math Self-Efficacy and Self-Concept as Predictors of Long-Term Achievement Outcomes

    ERIC Educational Resources Information Center

    Parker, Philip David; Marsh, Herbert W.; Ciarrochi, Joseph; Marshall, Sarah; Abduljabbar, Adel Salah

    2014-01-01

    In this study, we tested the hypothesis that self-efficacy and self-concept reflect different underlying processes and both are critical to understanding long-term achievement outcomes. Although both types of self-belief are well established in educational psychology, research comparing and contrasting their relationship with achievement has been…

  13. Interdisciplinary mathematics and science: Characteristics, forms, and related effect sizes for student achievement and affective outcomes

    NASA Astrophysics Data System (ADS)

    Hurley, Marlene M.

    1999-12-01

    instructional integration and proved to also be significantly related to student achievement. Qualitative methodologies revealed student improvements in "thinking skills" and "dynamic factors" and the importance of teachers, administrators, and teacher education to the success of the interdisciplinary program. Claims and criticisms of interdisciplinary education in general, and integrated mathematics and science education specifically, were examined through both methodologies. Discussed are the pedagogical considerations necessary for a school district to institute a program of integrated mathematics and science.

  14. Improving stroke outcome: the benefits of increasing availability of technology.

    PubMed Central

    Heller, R. F.; Langhorne, P.; James, E.

    2000-01-01

    INTRODUCTION: A decision analysis was performed to explore the potential benefits of interventions to improve the outcome of patients admitted to hospital with a stroke, in the context of the technology available in different parts of the world. METHODS: The outcome of death or dependency was used with a six-month end-point. RESULTS: Four settings were identified that would depend on the resources available. The proportion of stroke patients who were dead or dependent at six months was 61.5% with no intervention at all. Setting 4, with the only intervention being the delayed introduction of aspirin, produced a 0.5% absolute improvement in outcome (death or dependency), and the addition of an organized stroke unit (Setting 3) produced the largest incremental improvement, of 2.7%. Extra interventions associated with non-urgent computed tomography and thus the ability to avoid anticoagulation or aspirin for those with a haemorrhagic stroke (Setting 2), and immediate computed tomography scanning to allow the use of thrombolytics in non-haemorrhagic stroke (Setting 1), produced only small incremental benefits of 0.4% in each case. DISCUSSION: To reduce the burden of illness due to stroke, efforts at primary prevention are essential and likely to have a greater impact than even the best interventions after the event. In the absence of good primary prevention, whatever is possible must be done to reduce the sequelae of stroke. This analysis provides a rational basis for beginning the development of clinical guidelines applicable to the economic setting of the patient. PMID:11143194

  15. Student Achievement Goal Setting: Using Data to Improve Teaching and Learning

    ERIC Educational Resources Information Center

    Stronge, James H.; Grant, Leslie W.

    2009-01-01

    The first book in the James H. Stronge Research-to-Practice series focuses on improving student achievement through academic goal setting. It offers the tools and plan of action to use performance data to improve instructional practice and increase student achievement. The book is divided into three parts: (1) How Student Achievement Data Can Be…

  16. Chemotherapy: Does Neoadjuvant or Adjuvant Therapy Improve Outcomes?

    PubMed

    Canter, Robert J

    2016-10-01

    Since preoperative chemotherapy has been clearly shown to improve outcomes for patients with Ewing sarcoma, rhabdomyosarcoma, and osteosarcoma, practitioners have attempted to extend the use of adjuvant/neoadjuvant chemotherapy to other types of adult soft tissue sarcoma. Given the high risk of distant recurrence and disease-specific death for patients with soft tissue sarcoma tumors larger than 10 cm, these patients should be considered candidates for neoadjuvant chemotherapy as well as investigational therapies. Yet, potential toxicity from cytotoxic chemotherapy is substantial, and there remains little consensus and wide variation regarding the indications for use of chemotherapy in the adjuvant/neoadjuvant setting. PMID:27591503

  17. Prenatal emotion management improves obstetric outcomes: a randomized control study

    PubMed Central

    Huang, Jian; Li, He-Jiang; Wang, Jue; Mao, Hong-Jing; Jiang, Wen-Ying; Zhou, Hong; Chen, Shu-Lin

    2015-01-01

    Introduction: Negative emotions can cause a number of prenatal problems and disturb obstetric outcomes. We determined the effectiveness of prenatal emotional management on obstetric outcomes in nulliparas. Methods: All participants completed the PHQ-9 at the baseline assessment. Then, the participants were randomly assigned to the emotional management (EM) and usual care (UC) groups. The baseline evaluation began at 31 weeks gestation and the participants were followed up to 42 days postpartum. Each subject in the EM group received an extra EM program while the participants in the UC groups received routine prenatal care and education only. The PHQ-9 and Edinburgh Postnatal Depression scale (EPDS) were used for assessment. Results: The EM group had a lower PHQ-9 score at 36 weeks gestation, and 7 and 42 days after delivery (P < 0.01), and a lower EPDS score 42 days postpartum (P < 0.05). The rate of cesarean section in the EM group was lower than the UC group (P < 0.01), and the cesarean section rate without a medical indication was lower (P < 0.01). The duration of the second stage of labor in the EM group was shorter than the UC group (P < 0.01). Conclusions: Prenatal EM intervention could control anxiety and depressive feelings in nulliparas, and improve obstetric outcomes. It may serve as an innovative approach to reduce the cesarean section rate in China. PMID:26309641

  18. Improving Outcomes in State AIDS Drug Assistance Programs

    PubMed Central

    Linas, Benjamin P.; Losina, Elena; Rockwell, Annette; Walensky, Rochelle P.; Cranston, Kevin; Freedberg, Kenneth A.

    2009-01-01

    Background State AIDS Drug Assistance Programs (ADAPs) provide antiretroviral medications to patients with no access to medications. Resource constraints limit many ADAPs' ability to meet demand for services. Objective To determine ADAP eligibility criteria that minimize morbidity and mortality and contain costs. Methods We used Discrete Event Simulation to model the progression of HIV-infected patients and track utilization of an ADAP. Outcomes included five-year mortality and incidence of first opportunistic infection or death, and time to starting ART. We compared expected outcomes for two policies: 1) first-come, first-served (FCFS) eligibility for all with CD4 count ≤350/μl (current standard), and 2) CD4 count prioritized eligibility for those with CD4 counts below a defined threshold. Results In the base case, prioritizing patients with CD4 counts ≤250/μl led to lower five-year mortality than FCFS eligibility [2.77 vs. 3.27 deaths/1,000 person months], and to a lower incidence of first opportunistic infection or death [5.55 vs. 6.98 events/1,000 person months]. CD4-based eligibility reduced the time to starting ART for patients with CD4 counts ≤200/μl. In sensitivity analyses, CD4-based eligibility consistently led to lower morbidity and mortality than FCFS eligibility. Conclusions When resources are limited, programs that provide ART can improve outcomes by prioritizing patients with low CD4 counts. PMID:19561518

  19. Exemplary Care and Learning Sites: A Model for Achieving Continual Improvement in Care and Learning in the Clinical Setting

    PubMed Central

    Ogrinc, Greg; Hoffman, Kimberly G.; Stevenson, Katherine M.; Shalaby, Marc; Beard, Albertine S.; Thörne, Karin E.; Coleman, Mary T.; Baum, Karyn D.

    2016-01-01

    Problem Current models of health care quality improvement do not explicitly describe the role of health professions education. The authors propose the Exemplary Care and Learning Site (ECLS) model as an approach to achieving continual improvement in care and learning in the clinical setting. Approach From 2008–2012, an iterative, interactive process was used to develop the ECLS model and its core elements—patients and families informing process changes; trainees engaging both in care and the improvement of care; leaders knowing, valuing, and practicing improvement; data transforming into useful information; and health professionals competently engaging both in care improvement and teaching about care improvement. In 2012–2013, a three-part feasibility test of the model, including a site self-assessment, an independent review of each site’s ratings, and implementation case stories, was conducted at six clinical teaching sites (in the United States and Sweden). Outcomes Site leaders reported the ECLS model provided a systematic approach toward improving patient (and population) outcomes, system performance, and professional development. Most sites found it challenging to incorporate the patients and families element. The trainee element was strong at four sites. The leadership and data elements were self-assessed as the most fully developed. The health professionals element exhibited the greatest variability across sites. Next Steps The next test of the model should be prospective, linked to clinical and educa tional outcomes, to evaluate whether it helps care delivery teams, educators, and patients and families take action to achieve better patient (and population) outcomes, system performance, and professional development. PMID:26760058

  20. Improving quality and reducing inequities: a challenge in achieving best care

    PubMed Central

    Nicewander, David A.; Qin, Huanying; Ballard, David J.

    2006-01-01

    The health care quality chasm is better described as a gulf for certain segments of the population, such as racial and ethnic minority groups, given the gap between actual care received and ideal or best care quality. The landmark Institute of Medicine report Crossing the Quality Chasm: A New Health System for the 21st Century challenges all health care organizations to pursue six major aims of health care improvement: safety, timeliness, effectiveness, efficiency, equity, and patient-centeredness. “Equity” aims to ensure that quality care is available to all and that the quality of care provided does not differ by race, ethnicity, or other personal characteristics unrelated to a patient's reason for seeking care. Baylor Health Care System is in the unique position of being able to examine the current state of equity in a typical health care delivery system and to lead the way in health equity research. Its organizational vision, “culture of quality,” and involved leadership bode well for achieving equitable best care. However, inequities in access, use, and outcomes of health care must be scrutinized; the moral, ethical, and economic issues they raise and the critical injustice they create must be remedied if this goal is to be achieved. Eliminating any observed inequities in health care must be synergistically integrated with quality improvement. Quality performance indicators currently collected and evaluated indicate that Baylor Health Care System often performs better than the national average. However, there are significant variations in care by age, gender, race/ethnicity, and socioeconomic status that indicate the many remaining challenges in achieving “best care” for all. PMID:16609733

  1. Academic abilities in children and adolescents with a history of autism spectrum disorders who have achieved optimal outcomes.

    PubMed

    Troyb, Eva; Orinstein, Alyssa; Tyson, Katherine; Helt, Molly; Eigsti, Inge-Marie; Stevens, Michael; Fein, Deborah

    2014-04-01

    This study examines the academic abilities of children and adolescents who were once diagnosed with an autism spectrum disorder, but who no longer meet diagnostic criteria for this disorder. These individuals have achieved social and language skills within the average range for their ages, receive little or no school support, and are referred to as having achieved "optimal outcomes." Performance of 32 individuals who achieved optimal outcomes, 41 high-functioning individuals with a current autism spectrum disorder diagnosis (high-functioning autism), and 34 typically developing peers was compared on measures of decoding, reading comprehension, mathematical problem solving, and written expression. Groups were matched on age, sex, and nonverbal IQ; however, the high-functioning autism group scored significantly lower than the optimal outcome and typically developing groups on verbal IQ. All three groups performed in the average range on all subtests measured, and no significant differences were found in performance of the optimal outcome and typically developing groups. The high-functioning autism group scored significantly lower on subtests of reading comprehension and mathematical problem solving than the optimal outcome group. These findings suggest that the academic abilities of individuals who achieved optimal outcomes are similar to those of their typically developing peers, even in areas where individuals who have retained their autism spectrum disorder diagnoses exhibit some ongoing difficulty. PMID:24096312

  2. Improving Outcome of Psychosocial Treatments by Enhancing Memory and Learning

    PubMed Central

    Harvey, Allison G.; Lee, Jason; Williams, Joseph; Hollon, Steven D.; Walker, Matthew P.; Thompson, Monique A.; Smith, Rita

    2014-01-01

    Mental disorders are prevalent and lead to significant impairment. Progress toward establishing treatments has been good. However, effect sizes are small to moderate, gains may not persist, and many patients derive no benefit. Our goal is to highlight the potential for empirically-supported psychosocial treatments to be improved by incorporating insights from cognitive psychology and research on education. Our central question is: If it were possible to improve memory for content of sessions of psychosocial treatments, would outcome substantially improve? This question arises from five lines of evidence: (a) mental illness is often characterized by memory impairment, (b) memory impairment is modifiable, (c) psychosocial treatments often involve the activation of emotion, (d) emotion can bias memory and (e) memory for psychosocial treatment sessions is poor. Insights from scientific knowledge on learning and memory are leveraged to derive strategies for a transdiagnostic and transtreatment cognitive support intervention. These strategies can be applied within and between sessions and to interventions delivered via computer, the internet and text message. Additional novel pathways to improving memory include improving sleep, engaging in exercise and imagery. Given that memory processes change across the lifespan, services to children and older adults may benefit from cognitive support. PMID:25544856

  3. Improving Outcome of Psychosocial Treatments by Enhancing Memory and Learning.

    PubMed

    Harvey, Allison G; Lee, Jason; Williams, Joseph; Hollon, Steven D; Walker, Matthew P; Thompson, Monique A; Smith, Rita

    2014-03-01

    Mental disorders are prevalent and can lead to significant impairment. Some progress has been made toward establishing treatments; however, effect sizes are small to moderate, gains may not persist, and many patients derive no benefit. Our goal is to highlight the potential for empirically supported psychosocial treatments to be improved by incorporating insights from cognitive psychology and research on education. Our central question is: If it were possible to improve memory for the content of sessions of psychosocial treatments, would outcome substantially improve? We leverage insights from scientific knowledge on learning and memory to derive strategies for transdiagnostic and transtreatment cognitive support interventions. These strategies can be applied within and between sessions and to interventions delivered via computer, the Internet, and text message. Additional novel pathways to improving memory include improving sleep, engaging in exercise, and using imagery. Given that memory processes change across the lifespan, services to children and older adults may benefit from different types and amounts of cognitive support. PMID:25544856

  4. Translating research into improved outcomes in comprehensive cancer control.

    PubMed

    Kerner, Jon F; Guirguis-Blake, Janelle; Hennessy, Kevin D; Brounstein, Paul J; Vinson, Cynthia; Schwartz, Randy H; Myers, Bradford A; Briss, Peter

    2005-10-01

    A key question in moving comprehensive cancer control (CCC) plans into action is, to what extent should the knowledge gained from investments in cancer prevention and control research influence the actions taken by states, tribes, and territories during implementation? Underlying this 'should' is the assumption that evidence-based approaches (i.e., a public health or clinical intervention or policy that has resulted in improved outcomes when scientifically tested), when implemented in a real-world setting, will increase the likelihood of improved outcomes. This article elucidates the barriers and opportunities for integrating science with practice across the cancer control continuum. However, given the scope of CCC and the substantial investment in generating new knowledge through science, it is difficult for any one agency, on its own, to make a sufficient investment to ensure new knowledge is translated and implemented at a national, state, or local level. Thus, if greater demand for evidence-based interventions and increased resources for adopting them are going to support the dissemination initiatives described herein, new interagency partnerships must be developed to ensure that sufficient means are dedicated to integrating science with service. Furthermore, for these collaborations to increase both in size and in frequency, agency leaders must clearly articulate their support for these collaborative initiatives and explicitly recognize those collaborative efforts that are successful. In this way, the whole (in this context, comprehensive cancer control) can become greater than the sum of its parts. PMID:16208572

  5. Executive functioning in individuals with a history of ASDs who have achieved optimal outcomes.

    PubMed

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

    2014-01-01

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

  6. Extreme masking: achieving predictable outcomes in challenging situations with lithium disilicate bonded restorations.

    PubMed

    Hatai, Yugo

    2014-01-01

    In contemporary dentistry, we have a vast range of materials to choose from, and metal free restorations have become the premier materials for achieving the ultimate in both esthetics and durability. Metal-free restorations are utilized with more conservative preparations to preserve the vital natural dentition, and have proven to be superior alternatives to traditional porcelain-fused-to-metal (PFM) restorations in many cases. There are always "pros and cons" when selecting materials, and to make the best choice it is essential for dental professionals to plan precisely and understand their options in any clinical situation. Selecting suitable materials and techniques involves consideration of the following factors: - Esthetic zone. - Required strength based on the patient's occlusion/dental habits. - Preparation reduction. - Position of the margin. - Type of restoration/preparation. - The treating clinician's philosophy. - Stump shade. Final shade. One of the most significant challenges in the metal-free dentistry is the reproduction of natural dentition without the influence of a "negative stump" - a very dark or metal core showing through the final restorations. There are many factors to be considered when working on such a case, and controlling the opacity of the coping and crown is the key to success. This article presents a unique "outside of the box" technique that provides consistent, predictable and durable restorations, which provide the best possible esthetic outcome. PMID:24765627

  7. Restricted and Repetitive Behaviors in Individuals with a History of ASDs Who Have Achieved Optimal Outcomes

    PubMed Central

    Troyb, Eva; Orinstein, Alyssa; Tyson, Katherine; Eigsti, Inge-Marie; Naigles, Letitia; Fein, Deborah

    2014-01-01

    Studies of Autism Spectrum Disorders (ASDs) suggest that Restricted and Repetitive Behaviors (RRBs) are particularly difficult to remediate. We examined present and past RRBs in 34 individuals who achieved optimal outcomes (OOs; lost their ASD diagnosis), 45 high-functioning individuals with ASD (HFA) and 34 typically developing (TD) peers. The OO group exhibited minimal residual RRBs at the time of the study. All OO participants were reported to have at least one RRB in early childhood and almost 90% met the RRB cutoff for ASD in early childhood, but RRBs were not more present in the OO than the TD group at the time of the study. History of RRBs in the HFA and OO groups differed only in oversensitivity to noise and insistence on sameness. Reports of current behavior indicated that RRB’s had almost totally disappeared in the OO group. Thus, although RRB’s were present in the OO group in childhood, they resolved along with social and communication deficits. PMID:25030967

  8. 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…

  9. A Student Outcomes Typology for Community Colleges: Identifying Achievers with Longitudinal Cohort Analysis.

    ERIC Educational Resources Information Center

    Boughan, Karl; Clagett, Craig A.

    A study was conducted by Prince George's Community College, in Maryland, to determine outcomes after 4 years for the 2,643 first-time students who entered the college in fall 1990. The analysis was based on an outcomes typology developed at the college which defines outcomes as award and transfer; transfer without an award; award without transfer;…

  10. The role of the hospital registry in achieving outcome benchmarks in cancer care.

    PubMed

    Greene, Frederick L; Gilkerson, Sharon; Tedder, Paige; Smith, Kathy

    2009-06-15

    The hospital registry is a valuable tool for evaluating quality benchmarks in cancer care. As payment for performance standards are adopted, the registry will assume a more dynamic and economically important role in the hospital setting. At Carolinas Medical Center, the registry has been a key instrument in the comparison of state and national benchmarks and for program improvement in meeting standards in the care of breast and colon cancer. One of the significant successes of the American College of Surgeons Commission on Cancer (CoC) Hospital Approvals Program is the support of hospital registries, especially in small and midsized community hospitals throughout the United States. To become a member of the Hospital Approvals Program, a registry must be staffed appropriately and include analytic data for patients who have their primary diagnosis or treatment at the facility 1. The current challenge for most hospitals is to prove that the registry has specific worth when many facets of care are not compensated. Unfortunately a small number of hospitals have disbanded their registries because of the short-sighted decision that the registry and its personnel are a drain on the hospital system and do not generate revenue. In the present era of meeting benchmarks for care as a prelude to being paid by third party and governmental agencies 2,3, a primary argument is that the registry can be revenue-enhancing by quantifying specific outcomes in cancer care. Without having appropriate registry and abstract capability, the hospital leadership cannot measure the specific outcome benchmarks required in the era of "pay for performance" or "pay for participation". PMID:19466739

  11. 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…

  12. Quality improvement initiatives in neonatal intensive care unit networks: achievements and challenges.

    PubMed

    Shah, Vibhuti; Warre, Ruth; Lee, Shoo K

    2013-01-01

    Neonatal intensive care unit networks that encompass regions, states, and even entire countries offer the perfect platform for implementing continuous quality improvement initiatives to advance the health care provided to vulnerable neonates. Through cycles of identification and implementation of best available evidence, benchmarking, and feedback of outcomes, combined with mutual collaborative learning through a network of providers, the performance of health care systems and neonatal outcomes can be improved. We use examples of successful neonatal networks from across North America to explore continuous quality improvement in the neonatal intensive care unit, including the rationale for the formation of neonatal networks, the role of networks in continuous quality improvement, quality improvement methods and outcomes, and barriers to and facilitators of quality improvement. PMID:24268090

  13. Assessment of Local HOx and ROx Measurement Techniques: Achievements, Challenges, and Future Directions - Outcomes from the International HOx Workshop 2015

    NASA Astrophysics Data System (ADS)

    Hofzumahaus, Andreas; Heard, Dwayne

    2016-04-01

    Measurements of HOx radicals are an important tool for the investigation of tropospheric chemistry in field campaigns and simulation chamber experiments. The measured data allow us to test chemical models simulating the atmospheric concentrations of OH, HO2 and RO2, and help to improve chemical mechanisms used in regional and global models for predictions of the atmospheric chemical composition. In Spring 2015, an international, IGAC-endorsed workshop took place at Forschungszentrum Jülich, Germany, to assess the performance and reliability of current HOx measurement techniques. Fifteen international groups from Germany, UK, Ireland, France, Finland, USA, China and Japan came together to discuss achievements, challenges and future directions of laser-based, mass-spectrometry based, and chemical techniques. Following the discussions, a working group was established to guide the community in the near future in making progress on continued improvement in HOx measurements. Three goals will be persued: the development of a common calibration unit, the development of procedures to investigate and, if necessary, eliminate possible measurement artefacts, and planning for future instrumental intercomparisons. This poster contribution will give an overview of the workshop, its outcome and planned activites.

  14. The Stories Clinicians Tell: Achieving High Reliability and Improving Patient Safety

    PubMed Central

    Cohen, Daniel L; Stewart, Kevin O

    2016-01-01

    The patient safety movement has been deeply affected by the stories patients have shared that have identified numerous opportunities for improvements in safety. These stories have identified system and/or human inefficiencies or dysfunctions, possibly even failures, often resulting in patient harm. Although patients’ stories tell us much, less commonly heard are the stories of clinicians and how their personal observations regarding the environments they work in and the circumstances and pressures under which they work may degrade patient safety and lead to harm. If the health care industry is to function like a high-reliability industry, to improve its processes and achieve the outcomes that patients rightly deserve, then leaders and managers must seek and value input from those on the front lines—both clinicians and patients. Stories from clinicians provided in this article address themes that include incident identification, disclosure and transparency, just culture, the impact of clinical workload pressures, human factors liabilities, clinicians as secondary victims, the impact of disruptive and punitive behaviors, factors affecting professional morale, and personal failings. PMID:26580146

  15. Improved facial outcome assessment using a 3D anthropometric mask.

    PubMed

    Claes, P; Walters, M; Clement, J

    2012-03-01

    The capacity to process three-dimensional facial surfaces to objectively assess outcomes of craniomaxillofacial care is urgently required. Available surface registration techniques depart from conventional facial anthropometrics by not including anatomical relationship in their analysis. Current registrations rely on the manual selection of areas or points that have not moved during surgery, introducing subjectivity. An improved technique is proposed based on the concept of an anthropometric mask (AM) combined with robust superimposition. The AM is the equivalent to landmark definitions, as used in traditional anthropometrics, but described in a spatially dense way using (∼10.000) quasi-landmarks. A robust superimposition is performed to align surface images facilitating accurate measurement of spatial differences between corresponding quasi-landmarks. The assessment describes magnitude and direction of change objectively and can be displayed graphically. The technique was applied to three patients, without any modification and prior knowledge: a 4-year-old boy with Treacher-Collins syndrome in a resting and smiling pose; surgical correction for hemimandibular hypoplasia; and mandibular hypoplasia with staged orthognathic procedures. Comparisons were made with a reported closest-point (CP) strategy. Contrasting outcomes were found where the CP strategy resulted in anatomical implausibility whilst the AM technique was parsimonious to expected differences. PMID:22103995

  16. Improved outcome of nasopharyngeal carcinoma treated with conventional radiotherapy

    SciTech Connect

    Palazzi, Mauro . E-mail: mauro.palazzi@istitutotumori.mi.it; Guzzo, Marco; Tomatis, Stefano Ph.D.; Cerrotta, Annamaria; Potepan, Paolo; Quattrone, Pasquale; Cantu, Giulio

    2004-12-01

    Purpose: To describe the outcome of patients with nonmetastatic nasopharyngeal carcinoma (NPC) treated with conventional radiotherapy at a single institution. Methods and materials: From 1990 to 1999, 171 consecutive patients with NPC were treated with conventional (two-dimensional) radiotherapy. Tumor histology was undifferentiated in 82% of cases. Tumor-node-metastasis Stage (American Joint Committee on Cancer/International Union Against Cancer 1997 system) was I in 6%, II in 36%, III in 22%, and IV in 36% of patients. Mean total radiation dose was 68.4 Gy. Chemotherapy was given to 62% of the patients. The median follow-up for surviving patients was 6.3 years (range, 3.1-13.1 years). Results: The 5-year overall survival, disease-specific survival, and disease-free survival rates were 72%, 74%, and 62%, respectively. The 5-year local, regional, and distant control rates were 84%, 80%, and 83% respectively. Late effects of radiotherapy were prospectively recorded in 100 patients surviving without relapse; 44% of these patients had Grade 3 xerostomia, 33% had Grade 3 dental damage, and 11% had Grade 3 hearing loss. Conclusions: This analysis shows an improved outcome for patients treated from 1990 to 1999 compared with earlier retrospective series, despite the use of two-dimensional radiotherapy. Late toxicity, however, was substantial with conventional radiotherapy.

  17. Postoperative management of hip fractures: interventions associated with improved outcomes.

    PubMed

    Colón-Emeric, Cathleen S

    2012-01-01

    The annual number of hip fractures worldwide is expected to exceed 6 million by 2050. Currently, nearly 50% of hip fracture patients will develop at least one short-term complication including infection, delirium, venous thromboembolism (VTE), pressure ulcers or cardiovascular events. More than half will experience an adverse long-term outcomes including worsened ambulation or functional status, additional fractures and excess mortality. This paper summarizes current evidence for postoperative interventions attempting to improve these outcomes, including pain management, anemia management, delirium prevention strategies, VTE prophylaxis, rehabilitation type, nutritional supplements, anabolic steroids and secondary fracture prevention. Models of care that have been tested in this population including interdisciplinary orthogeriatric services, clinical pathways and hospitalist care are summarized. In general, good quality evidence supports routine use of VTE prophylaxis, and moderate quality evidence supports multifactorial delirium prevention protocols, and a conservative transfusion strategy. Aggressive pain control with higher doses of opiates and/or regional blocks are associated with lower delirium rates. Low-moderate quality evidence supports the use of clinical pathways, and dedicated orthogeriatric consultative services or wards. After hospital discharge, good quality evidence supports the use of bisphosphonates for secondary fracture prevention and mortality reduction. Rehabilitation services are important, but evidence to guide quantity, type or venue is lacking. Additional research is needed to clarify the role of nutritional supplements, anabolic steroids, home care and psychosocial interventions. PMID:24340216

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

    NASA Astrophysics Data System (ADS)

    LondoñO Cadavid, Catalina; Ando, Amy W.

    2013-07-01

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

  19. Can restoring incomplete microcirculatory reperfusion improve stroke outcome after thrombolysis?

    PubMed Central

    Dalkara, Turgay; Arsava, Ethem Murat

    2012-01-01

    Substantial experimental data and recent clinical evidence suggesting that tissue reperfusion is a better predictor of outcome after thrombolysis than recanalization necessitate that patency of microcirculation after recanalization should be reevaluated. If indeed microcirculatory blood flow cannot be sufficiently reinstituted despite complete recanalization as commonly observed in coronary circulation, it may be one of the factors contributing to low efficacy of thrombolysis in stroke. Although microvascular no-reflow is considered an irreversible process that prevents tissue recovery from injury, emerging evidence suggests that it might be reversed with pharmacological agents administered early during recanalization. Therefore, therapeutic approaches aiming at reducing microvascular obstructions may improve success rate of recanalization therapies. Importantly, promoting oxygen delivery to the tissue, where entrapped erythrocytes cannot circulate in capillaries, with ongoing serum flow may improve survival of the underreperfused tissue. Altogether, these developments bring about the exciting possibility that benefit of reperfusion therapies can be further improved by restoring microcirculatory function because survival in the penumbra critically depends on adequate blood supply. Here, we review the available evidence suggesting presence of an ‘incomplete microcirculatory reperfusion' (IMR) after focal cerebral ischemia and discuss potential means that may help investigate IMR in stroke patients after recanalization therapies despite technical limitations. PMID:23047270

  20. Adaptive Programming Improves Outcomes in Drug Court: An Experimental Trial

    PubMed Central

    Marlowe, Douglas B.; Festinger, David S.; Dugosh, Karen L.; Benasutti, Kathleen M.; Fox, Gloria; Croft, Jason R.

    2011-01-01

    Prior studies in Drug Courts reported improved outcomes when participants were matched to schedules of judicial status hearings based on their criminological risk level. The current experiment determined whether incremental efficacy could be gained by periodically adjusting the schedule of status hearings and clinical case-management sessions in response to participants’ ensuing performance in the program. The adjustments were made pursuant to a priori criteria specified in an adaptive algorithm. Results confirmed that participants in the full adaptive condition (n = 62) were more than twice as likely as those assigned to baseline-matching only (n = 63) to be drug-abstinent during the first 18 weeks of the program; however, graduation rates and the average time to case resolution were not significantly different. The positive effects of the adaptive program appear to have stemmed from holding noncompliant participants more accountable for meeting their attendance obligations in the program. Directions for future research and practice implications are discussed. PMID:22923854

  1. Anti-lysophosphatidic acid antibodies improve traumatic brain injury outcomes

    PubMed Central

    2014-01-01

    Background Lysophosphatidic acid (LPA) is a bioactive phospholipid with a potentially causative role in neurotrauma. Blocking LPA signaling with the LPA-directed monoclonal antibody B3/Lpathomab is neuroprotective in the mouse spinal cord following injury. Findings Here we investigated the use of this agent in treatment of secondary brain damage consequent to traumatic brain injury (TBI). LPA was elevated in cerebrospinal fluid (CSF) of patients with TBI compared to controls. LPA levels were also elevated in a mouse controlled cortical impact (CCI) model of TBI and B3 significantly reduced lesion volume by both histological and MRI assessments. Diminished tissue damage coincided with lower brain IL-6 levels and improvement in functional outcomes. Conclusions This study presents a novel therapeutic approach for the treatment of TBI by blocking extracellular LPA signaling to minimize secondary brain damage and neurological dysfunction. PMID:24576351

  2. Improving MILSATCOM (Military Satellite Communication) acquisition outcomes: Lease versus buy

    NASA Astrophysics Data System (ADS)

    Dinneen, P. M.; Quinn, T. H.

    1985-01-01

    This study was requested by the Director of Space Systems and Command, Control, and Communications, Office of the Deputy Chief of Staff (Research, Development, and Acquisition), Headquarters United States Air Force, to assist in improving the outcomes of military satellite communication (MILSATCOM) programs. In view of rapidly rising costs of military space systems, leasing has been suggested as one way of controlling these costs. The purpose of this study, therefore, was to identify and analyze the central considerations relevant to determining whether to lease or by MILSATCOM services. The results of this report should be of interest to members of MILSATCOM acquisition community and others concerned with making lease versus buy decisions in the public sector. The work was conducted under the MILSATCOM Acquisition Policy project of the Project Air Force Resource Management Program.

  3. Defining lactation acuity to improve patient safety and outcomes.

    PubMed

    Mannel, Rebecca

    2011-05-01

    While substantial evidence exists identifying risks factors associated with premature weaning from breastfeeding, there are no previously published definitions of patient acuity in the lactation field. This article defines evidence-based levels of lactation acuity based on maternal and infant characteristics. Patient acuity, matching severity of illness to intensity of care required, is an important determinant of patient safety and outcomes. It is often used as part of a patient classification system to determine staffing needs and acceptable workloads in health care settings. As acuity increases, more resources, including more skilled clinicians, are needed to provide optimal care. Developing an evidence-based definition of lactation acuity can help to standardize terminology, more effectively distribute health care staff resources, encourage research to verify the validity and reliability of lactation acuity, and potentially improve breastfeeding initiation and duration rates. PMID:21527797

  4. Improving pregnancy outcome during imprisonment: a model residential care program.

    PubMed

    Siefert, K; Pimlott, S

    2001-04-01

    The female prison population has increased dramatically in recent years. Most women prisoners are involved with drugs, and as many as 25 percent are pregnant or have delivered within the past year. Reproductive health and drug treatment services for women in prison are inadequate, if they are available at all, and although illicit drugs are readily available in prison, drug-involved pregnant women often are incarcerated to protect fetal health. Studies of pregnancy outcome among women prisoners have demonstrated high rates of perinatal mortality and morbidity. This article examines issues related to pregnancy among women prisoners and describes an innovative residential program designed for pregnant, drug-dependent women in a state adult corrections system. Social workers can play an important role in promoting policy reform and improved services for this underserved population. PMID:11329642

  5. Improvement of debate competence: an outcome of an introductory course for medical humanities

    PubMed Central

    Chun, Kyung Hee; Lee, Young Hwan

    2016-01-01

    Purpose: Academic debate is an effective method to enhance the competences of critical thinking, problem solving, communication skills and cooperation skills. The present study examined the improvement of debate competence which is an outcome of debate-based flipped learning. Methods: A questionnaire was administrated to second-year premedical school students at Yeungnam University. In total 45 students participated in the survey. The survey questionnaire was composed of 60 items of eight subfactors on debate competence. To investigate the homogeneous of low and high achievement groups, 18 items on empathy and 75 items on critical thinking scales were used. To compare the pretest with posttest scores, data was analyzed using paired sample t-test. Results: There were no significant differences between low and high achievement groups by average grade at the beginning of the semester. There was a significant improvement in high achievers on the logical argumentation (p<0.001), proficiency in inquiry (p<0.01), active participation (p<0.001), ability to investigate and analyze (p<0.001), observance of debate rules (p<0.05), and acceptability (p<0.05). Even in low achievers, active participation (p<0.05) and ability to investigate and analyze (p<0.01) were significantly improved. Conclusion: Results showed that students could improve their debate competence by the debate-based flipped learning. A prospective and comparative study on the communication and teamwork competences needs to be conducted in the future. It is suggested that in-depth discussion for the curriculum design and teaching will be needed in terms of the effectiveness and the outcomes of the medical humanities. PMID:26838572

  6. Comparing the performance of English mental health providers in achieving patient outcomes.

    PubMed

    Moran, Valerie; Jacobs, Rowena

    2015-09-01

    Evidence on provider payment systems that incorporate patient outcomes is limited for mental health care. In England, funding for mental health care services is changing to a prospective payment system with a future objective of linking some part of provider payment to outcomes. This research examines performance of mental health providers offering hospital and community services, in order to investigate if some are delivering better outcomes. Outcomes are measured using the Health of the Nation Outcome Scales (HoNOS) - a clinician-rated routine outcome measure (CROM) mandated for national use. We use data from the Mental Health Minimum Data Set (MHMDS) - a dataset on specialist mental health care with national coverage - for the years 2011/12 and 2012/13 with a final estimation sample of 305,960 observations with follow-up HoNOS scores. A hierarchical ordered probit model is used and outcomes are risk adjusted with independent variables reflecting demographic, need, severity and social indicators. A hierarchical linear model is also estimated with the follow-up total HoNOS score as the dependent variable and the baseline total HoNOS score included as a risk-adjuster. Provider performance is captured by a random effect that is quantified using Empirical Bayes methods. We find that worse outcomes are associated with severity and better outcomes with older age and social support. After adjusting outcomes for various risk factors, variations in performance are still evident across providers. This suggests that if the intention to link some element of provider payment to outcomes becomes a reality, some providers may gain financially whilst others may lose. The paper contributes to the limited literature on risk adjustment of outcomes and performance assessment of providers in mental health in the context of prospective activity-based payment systems. PMID:26218853

  7. Effects of Improvements in Interval Timing on the Mathematics Achievement of Elementary School Students

    ERIC Educational Resources Information Center

    Taub, Gordon E.; McGrew, Kevin S.; Keith, Timothy Z.

    2015-01-01

    This article examines the effect of improvements in timing/rhythmicity on mathematics achievement. A total of 86 participants attending 1st through 4th grades completed pre- and posttest measures of mathematics achievement from the Woodcock-Johnson III Tests of Achievement. Students in the experimental group participated in a 4-week intervention…

  8. Individual prediction of treatment outcome in patients with temporomandibular disorders. A quality improvement model.

    PubMed

    Sundqvist, Bertil

    2007-01-01

    The general aim of this thesis was to create and evaluate a quality improvement model for prediction of treatment outcome in patients diagnosed with Temporomandibular Disorders (TMD) of either Muscle or Mainly TMJ (Temporomandibular Joint) origin, treated with interocclusal appliances and/or occlusal adjustment. The model was assumed to generate negative predictors of treatment outcome through evaluating all patients predicted Good reaching an objective treatment goal but not having an improvement of 50% or more. The model was created and evaluated by one TMD specialist. The questions were: (I) Was it possible for the TMD specialist to predict treatment outcome individually in patients diagnosed with TMD and, from the results, create a quality improvement model? (II) Was it possible for eight TMD-trained general dental practitioners, under the supervision of the TMD specialist, to treat TMD patients with similar results to the TMD specialist if the TMD specialist had examined, treatment planned, and individually predicted the treatment outcome? (III) Was it possible for the TMD specialist to improve the possibility to predict individual treatment outcome overtime? (IV) Was it possible for one TMD-trained general dental practitioner to copy the clinical part of the model and achieve the same results as the TMD specialist, in patients selected by the TMD specialist? Out of 5165 patients subjected to a functional examination of the masticatory system, 3602 were diagnosed with TMD and subgrouped as either Muscle or Mainly TMJ symptoms. The patients were predicted to have a Good, Dubious, or Poor possibility to have an improvement of 50% or more after treatment. Patients predicted Poor were not offered any treatment. A correct prediction of actual treatment outcome Good was defined as an improvement of 50% or more for muscle and/or TMJ symptoms. A total of 2625 patients began treatment at the specialist clinic for TMD and 2128 completed the full course of treatment. The

  9. Maternal obesity and metabolic risk to the offspring: why lifestyle interventions may have not achieved the desired outcomes

    PubMed Central

    Catalano, P; deMouzon, SH

    2015-01-01

    Obesity during pregnancy is associated with an increased risk of short- and long-term metabolic dysfunction in the mother and her offspring. Both higher maternal pregravid body mass index (kg m−2) and excessive gestational weight gain (GWG) have been associated with adverse pregnancy outcomes such as gestational diabetes, preeclampsia and fetal adiposity. Multiple lifestyle intervention trials consisting of weight management using various diets, increased physical activity and behavioral modification techniques have been employed to avoid excessive GWG and improve perinatal outcomes. These randomized controlled trials (RCTs) have achieved modest success in decreasing excessive GWG, although the decrease in GWG was often not within the current Institute of Medicine guidelines. RCTs have generally not had any success with decreasing the risk of maternal gestational diabetes (GDM), preeclampsia or excessive fetal growth often referred to as macrosomia. Although the lack of success for these trials has been attributed to lack of statistical power and poor compliance with study protocols, our own research suggests that maternal pregravid and early pregnancy metabolic condition programs early placenta function and gene expression. These alterations in maternal/placental function occur in the first trimester of pregnancy prior to when most intervention trials are initiated. For example, maternal accrural of adipose tissue relies on prior activation of genes controlling lipogenesis and low-grade inflammation in early pregnancy. These metabolic alterations occur prior to any changes in maternal phenotype. Therefore, trials of lifestyle interventions before pregnancy are needed to demonstrate the safety and efficacy for both the mother and her offspring. PMID:25777180

  10. Can States Simultaneously Improve Health Outcomes and Reduce Health Outcome Disparities?

    PubMed Central

    Lardinois, Nicholas; Chatterjee, Debanjana

    2016-01-01

    Introduction Reducing racial health disparities is often stated as a population health goal, but specific targets for such improvement are seldom set. It is often assumed that improving overall health outcomes will be linked to disparity reduction, but this is not necessarily the case. Methods We compared the annual change from 1999 through 2013 in combined-race (black and white) mortality with the annual change in absolute and relative racial mortality disparities for US states. Results Median annual improvement in combined-race mortality was 1.08% per year. Annual overall mortality rate reductions ranged from 0.24% per year in Oklahoma to 1.83% per year in Maryland. For disparities, the median for the black–white absolute gap was 3.60% per year, and the median for the relative black-to-white ratio was 1.19% per year. There was no significant correlation between the combined-race measure and either the absolute (0.03) or relative disparity measure reductions (−0.17). Conclusion For mortality in US states over a recent period, improvement in the population mean and disparity reduction do not usually occur together. The disparity reduction rates observed may provide realistic guidance for public and private policy makers in setting goals for reducing population health disparity and creating investment priorities. As a starting point for discussion, the observed national median annual percentage improvement of 1.1 per year combined, 3.6% per year absolute gap reduction, and 1.2% per year relative gap reduction would be modest and reasonable goals. PMID:27560720

  11. The Secondary Head of Department and the Achievement of Exceptional Student Outcomes

    ERIC Educational Resources Information Center

    Dinham, Stephen

    2007-01-01

    Purpose: The purpose of this paper is to explore the role of the secondary Head of Department (HoD) in leading teams producing exceptional education outcomes in Years 7-10 in New South Wales (NSW, Australia) government schools. Design/methodology/approach: Sites where exceptional educational outcomes were believed to be occurring were selected…

  12. Can Cooperative Learning Achieve the Four Learning Outcomes of Physical Education? A Review of Literature

    ERIC Educational Resources Information Center

    Casey, Ashley; Goodyear, Victoria A.

    2015-01-01

    Physical learning, cognitive learning, social learning, and affective learning are positioned as the legitimate learning outcomes of physical education. It has been argued that these four learning outcomes go toward facilitating students' engagement with the physically active life (Bailey et al., 2009; Kirk, 2013). With Cooperative Learning…

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

    ERIC Educational Resources Information Center

    Sujitparapitaya, Sutee

    2014-01-01

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

  14. The Effects of Physical Activity and Physical Fitness on Children's Achievement and Cognitive Outcomes: A Meta-Analysis

    ERIC Educational Resources Information Center

    Fedewa, Alicia L.; Ahn, Soyeon

    2011-01-01

    It is common knowledge that physical activity leads to numerous health and psychological benefits. However, the relationship between children's physical activity and academic achievement has been debated in the literature. Some studies have found strong, positive relationships between physical activity and cognitive outcomes, while other studies…

  15. It's Not Just "What" You Say: Verbal and Nonverbal Skills Help Leaders Address Challenges and Achieve Outcomes

    ERIC Educational Resources Information Center

    Zoller, Kendall; Lahera, Antonia Issa; Normore, Anthony H.

    2015-01-01

    This article presents a story about two school leaders in a large Southern California urban district who used skills developed in a university school leadership program to create rapport, empathy, and trust while leading through challenging situations and achieving actionable outcomes. In addition to developing relationships in support of…

  16. 20 CFR 411.575 - How does the EN request payment for milestones or outcome payment months achieved by a...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... outcome payment months achieved by a beneficiary who assigned a ticket to the EN? The EN (or State VR... provided as described in the IWP/IPE. (a) Milestone payments. (1) We will pay the EN (or State VR agency... VR agency's) elected payment system in effect at the time the beneficiary assigned a ticket to the...

  17. 20 CFR 411.575 - How does the EN request payment for milestones or outcome payment months achieved by a...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... outcome payment months achieved by a beneficiary who assigned a ticket to the EN? The EN (or State VR... provided as described in the IWP/IPE. (a) Milestone payments. (1) We will pay the EN (or State VR agency... VR agency's) elected payment system in effect at the time the beneficiary assigned a ticket to the...

  18. 20 CFR 411.575 - How does the EN request payment for milestones or outcome payment months achieved by a...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... outcome payment months achieved by a beneficiary who assigned a ticket to the EN? The EN (or State VR... provided as described in the IWP/IPE. (a) Milestone payments. (1) We will pay the EN (or State VR agency... VR agency's) elected payment system in effect at the time the beneficiary assigned a ticket to the...

  19. 20 CFR 411.575 - How does the EN request payment for milestones or outcome payment months achieved by a...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... outcome payment months achieved by a beneficiary who assigned a ticket to the EN? The EN (or State VR... provided as described in the IWP/IPE. (a) Milestone payments. (1) We will pay the EN (or State VR agency... VR agency's) elected payment system in effect at the time the beneficiary assigned a ticket to the...

  20. DoMINO: Donor milk for improved neurodevelopmental outcomes

    PubMed Central

    2014-01-01

    Background Provision of mother’s own milk is the optimal way to feed infants, including very low birth weight infants (VLBW, <1500 g). Importantly for VLBW infants, who are at elevated risk of neurologic sequelae, mother’s own milk has been shown to enhance neurocognitive development. Unfortunately, the majority of mothers of VLBW infants are unable to provide an adequate supply of milk and thus supplementation with formula or donor milk is necessary. Given the association between mother’s own milk and neurodevelopment, it is important to ascertain whether provision of human donor milk as a supplement may yield superior neurodevelopmental outcomes compared to formula. Our primary hypothesis is that VLBW infants fed pasteurized donor milk compared to preterm formula as a supplement to mother’s own milk for 90 days or until hospital discharge, whichever comes first, will have an improved cognitive outcome as measured at 18 months corrected age on the Bayley Scales of Infant Development, 3rd ed. Secondary hypotheses are that the use of pasteurized donor milk will: (1) reduce a composite of death and serious morbidity; (2) support growth; and (3) improve language and motor development. Exploratory research questions include: Will use of pasteurized donor milk: (1) influence feeding tolerance and nutrient intake (2) have an acceptable cost effectiveness from a comprehensive societal perspective? Methods/Design DoMINO is a multi-centre, intent-to-treat, double blinded, randomized control trial. VLBW infants (n = 363) were randomized within four days of birth to either (1) pasteurized donor milk or (2) preterm formula whenever mother’s own milk was unavailable. Study recruitment began in October 2010 and was completed in December 2012. The 90 day feeding intervention is complete and long-term follow-up is underway. Discussion Preterm birth and its complications are a leading cause long-term morbidity among Canadian children. Strategies to mitigate this

  1. Improved outcome of referrals for intestinal transplantation in the UK

    PubMed Central

    Gupte, Girish L; Beath, Susan V; Protheroe, Sue; Murphy, M Stephen; Davies, Paul; Sharif, Khalid; McKiernan, Patrick J; de Ville de Goyet, Jean; Booth, Ian W; Kelly, Deirdre A

    2007-01-01

    Aim To describe the outcome of children with intestinal failure referred to Birmingham Children's Hospital (BCH) for consideration of intestinal transplantation (ITx), to determine factors for an adverse outcome and to analyse the impact of post‐1998 strategies on survival. Subjects and methods A retrospective analysis was performed of children referred for ITx assessment from January 1989 to December 2003. Children were assessed by a multidisciplinary team and categorised into: (a) stable on parenteral nutrition; (b) unsuitable for transplantation (Tx); and (c) recommended for Tx. To analyse the impact of the post‐1998 strategies on survival, a comparison was made between the two eras (pre‐1998 and post‐1998). Results 152 children with chronic intestinal failure were identified (63M:89F, median age 10 months (range 1–170)). After assessment, 69 children were considered stable on parenteral nutrition (5‐year survival 95%); 28 children were unsuitable for Tx (5‐year survival 4%); and 55 children were recommended for Tx (5‐year survival 35%, which includes 14 children who died waiting for size‐matched organs). Twenty three ITx and nine isolated liver transplants (iLTx) were performed. In a multivariate analysis, the following factors in combination had an adverse effect on survival: the presence of a primary mucosal disorder (p = 0.007, OR ratio 3.16, 95% CI 1.37 to 7.31); absence of involvement of a nutritional care team at the referring hospital (p = 0.001, OR ratio 2.55, 95% CI 1.44 to 4.52); and a serum bilirubin>100 µmol/l (p = 0.001, OR ratio 3.70, 95% CI 1.84 to 7.47). Earlier referral (median serum bilirubin 78 µmol/l in the post‐1998 era compared with 237 µmol/l in the pre‐1998 era, p = 0.001) may be a contributory factor to improved survival. The strategies of combined en bloc reduced liver/small bowel transplantation and iLTx resulted in fewer deaths on the waiting list in the post‐1998 era (2 deaths in

  2. Out-of-School-Time Academic Programs to Improve School Achievement: A Community Guide Health Equity Systematic Review

    PubMed Central

    Knopf, John A.; Hahn, Robert A.; Proia, Krista K.; Truman, Benedict I.; Johnson, Robert L.; Muntaner, Carles; Fielding, Jonathan E.; Jones, Camara Phyllis; Fullilove, Mindy T.; Hunt, Pete C.; Qu, Shuli; Chattopadhyay, Sajal K.; Milstein, Bobby

    2015-01-01

    Context Low-income and minority status in the United States are associated with poor educational outcomes, which, in turn, reduce the long-term health benefits of education. Objective This systematic review assessed the extent to which out-of-school-time academic (OSTA) programs for at-risk students, most of whom are from low-income and racial/ethnic minority families, can improve academic achievement. Because most OSTA programs serve low-income and ethnic/racial minority students, programs may improve health equity. Design Methods of the Guide to Community Preventive Services were used. An existing systematic review assessing the effects of OSTA programs on academic outcomes (Lauer et al 2006; search period 1985–2003) was supplemented with a Community Guide update (search period 2003–2011). Main Outcome Measure Standardized mean difference. Results Thirty-two studies from the existing review and 25 studies from the update were combined and stratified by program focus (ie, reading-focused, math-focused, general academic programs, and programs with minimal academic focus). Focused programs were more effective than general or minimal academic programs. Reading-focused programs were effective only for students in grades K-3. There was insufficient evidence to determine effectiveness on behavioral outcomes and longer-term academic outcomes. Conclusions OSTA programs, particularly focused programs, are effective in increasing academic achievement for at-risk students. Ongoing school and social environments that support learning and development may be essential to ensure the longer-term benefits of OSTA programs. PMID:26062096

  3. [Improvement of outcomes by primary treatment for temporomandibular disorders].

    PubMed

    Aoyama, Shigeru; Kino, Koji; Iwaki, Hiroshi; Amagasa, Teruo

    2008-10-01

    The aim of this study was to survey the current state of the temporomandibular joint disorder treatment in our clinic and to confirm the therapeutic outcomes. The subjects in this study were recruited from among the patients with temporomandibular disorders who attended the Temporomandibular Disorder Special Clinic, Department of Oral Surgery, Hitachi Yokohama Hospital during one year period from February 2007 to January 2008. A total of 100 consecutive outpatients diagnosed with temporomandibular disorders were selected for the study. Pain intensity and the degree to which daily function was limited before and after treatment were evaluated using the Visual Analogue Scale (VAS). The Beck Depression Inventory-II (BDI-II) score was evaluated simultaneously, and the correlation with changes in symptom was evaluated. The median (25th, 75th percentiles) of pain intensity (VAS value) before treated was 45 (25.0, 65.0) and the degree of limitation of daily function (VAS value) was 15 (0.0, 50.0). The median (25th, 75th percentiles) of pain intensity at 4 weeks after was 10 (0.0, 30.0), and significantly lower than that before treatment (p = 0.000). The degree of limitation of daily function was 0 (0.0, 10.0), also significantly lower than that before treatment (p = 0.000). The BDI-II score decreased from 8 (2.0, 11.8) before treatment to 5 (2.0, 11.0, p = 0.024) and showed no significant correlation with the improvement in outcomes by primary treatment for temporomandibular disorders. PMID:19044015

  4. Can prebiotics and probiotics improve therapeutic outcomes for undernourished individuals?

    PubMed Central

    Sheridan, Paul O; Bindels, Laure B; Saulnier, Delphine M; Reid, Gregor; Nova, Esther; Holmgren, Kerstin; O'Toole, Paul W; Bunn, James; Delzenne, Nathalie; Scott, Karen P

    2014-01-01

    It has become clear in recent years that the human intestinal microbiota plays an important role in maintaining health and thus is an attractive target for clinical interventions. Scientists and clinicians have become increasingly interested in assessing the ability of probiotics and prebiotics to enhance the nutritional status of malnourished children, pregnant women, the elderly, and individuals with non-communicable disease-associated malnutrition. A workshop was held by the International Scientific Association for Probiotics and Prebiotics (ISAPP), drawing on the knowledge of experts from industry, medicine, and academia, with the objective to assess the status of our understanding of the link between the microbiome and under-nutrition, specifically in relation to probiotic and prebiotic treatments for under-nourished individuals. These discussions led to four recommendations:   (1) The categories of malnourished individuals need to be differentiated To improve treatment outcomes, subjects should first be categorized based on the cause of malnutrition, additional health-concerns, differences in the gut microbiota, and sociological considerations. (2) Define a baseline “healthy” gut microbiota for each category Altered nutrient requirement (for example, in pregnancy and old age) and individual variation may change what constitutes a healthy gut microbiota for the individual. (3) Perform studies using model systems to test the effectiveness of potential probiotics and prebiotics against these specific categories These should illustrate how certain microbiota profiles can be altered, as members of different categories may respond differently to the same treatment. (4) Perform robust well-designed human studies with probiotics and/or prebiotics, with appropriate, defined primary outcomes and sample size These are critical to show efficacy and understand responder and non-responder outcomes. It is hoped that these recommendations will lead to new approaches

  5. Social protection: potential for improving HIV outcomes among adolescents

    PubMed Central

    Cluver, Lucie D; Hodes, Rebecca J; Sherr, Lorraine; Mark Orkin, F; Meinck, Franziska; Lim Ah Ken, Patricia; Winder-Rossi, Natalia E; Wolfe, Jason; Vicari, Marissa

    2015-01-01

    Introduction Advances in biomedical technologies provide potential for adolescent HIV prevention and HIV-positive survival. The UNAIDS 90–90–90 treatment targets provide a new roadmap for ending the HIV epidemic, principally through antiretroviral treatment, HIV testing and viral suppression among people with HIV. However, while imperative, HIV treatment and testing will not be sufficient to address the epidemic among adolescents in Southern and Eastern Africa. In particular, use of condoms and adherence to antiretroviral therapy (ART) remain haphazard, with evidence that social and structural deprivation is negatively impacting adolescents’ capacity to protect themselves and others. This paper examines the evidence for and potential of interventions addressing these structural deprivations. Discussion New evidence is emerging around social protection interventions, including cash transfers, parenting support and educational support (“cash, care and classroom”). These interventions have the potential to reduce the social and economic drivers of HIV risk, improve utilization of prevention technologies and improve adherence to ART for adolescent populations in the hyper-endemic settings of Southern and Eastern Africa. Studies show that the integration of social and economic interventions has high acceptability and reach and that it holds powerful potential for improved HIV, health and development outcomes. Conclusions Social protection is a largely untapped means of reducing HIV-risk behaviours and increasing uptake of and adherence to biomedical prevention and treatment technologies. There is now sufficient evidence to include social protection programming as a key strategy not only to mitigate the negative impacts of the HIV epidemic among families, but also to contribute to HIV prevention among adolescents and potentially to remove social and economic barriers to accessing treatment. We urge a further research and programming agenda: to actively combine

  6. Does Aggregate School-Wide Achievement Mediate Fifth Grade Outcomes for Former Early Childhood Education Participants?

    ERIC Educational Resources Information Center

    Curenton, Stephanie M.; Dong, Nianbo; Shen, Xiangjin

    2015-01-01

    This study used a multilevel mediation model to test the theory that former early childhood education (ECE) attendees' 5th grade achievement is mediated by the aggregate school-wide achievement of their elementary school. Aggregate school-wide achievement was defined as the percentage of 5th graders in a school who were at/above academic…

  7. Dominant Achievement Goals of Older Workers and Their Relationship with Motivation-Related Outcomes

    ERIC Educational Resources Information Center

    de Lange, Annet H.; Van Yperen, Nico W.; Van der Heijden, Beatrice I. J. M.; Bal, P. Matthijs

    2010-01-01

    The aim of this study was to increase our insight into older employees' achievement motivation by examining the prevalence of dominant achievement goals among a "unique" group of 172 Dutch workers who remained active after their post-statutory retirement age. Moreover, we investigated how their dominant achievement goals were linked to…

  8. Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease?

    PubMed

    Aworanti, Olugbenga Michael; McDowell, Dermot Thomas; Martin, Ian Michael; Quinn, Feargal

    2016-04-01

    Purpose Constipation and incontinence are significant problems following pull-through surgery for Hirschsprung disease (HD). There is evidence that these problems improve with time. However, there is also evidence showing no improvements and furthermore, significant long-term data are lacking for the newer endorectal pull-through. We aim to determine if there is clinical evidence that show improvements in functional outcomes with time after an endorectal pull-through surgery for HD. Methods We utilized the validated pediatric incontinence and constipation scoring system (PICSS) to score 51 consecutive children 3 months to 15 years posttransabdominal or transanal endorectal pull-through for HD. Cases of total colonic aganglionosis and Down syndrome were excluded. PICSS scores below the age-specific lower limit 95% confidence interval scores represent incomplete continence or constipation, respectively. We performed linear regression to analyze the relationship between PICSS scores and the follow-up duration and then compared the demographics of children with and without incomplete continence and constipation, respectively. Significance was set at p < 0.05. Results The median age at PICSS interview was 71 months (range, 6-191 months). Incontinence scores obtained from 42 children older than 35 months showed a positive relationship with the follow-up duration (p = 0.03). Constipation scores obtained from 51 children were unrelated to follow-up duration (p = 0.486). When demographics were compared, the continent children had longer follow-up than those with incomplete continence (mean, 111.64 vs. 69.19 months; p = 0.051), however follow-up duration did not differ in the group of constipated children compared with the nonconstipated group (mean, 61.88 vs. 71.80 months; p = 0.321). Conclusion These findings suggest that after an endorectal pull-through, improved continence should be expected with time but constipation often continues to be an

  9. Certified kitchen managers: do they improve restaurant inspection outcomes?

    PubMed

    Cates, Sheryl C; Muth, Mary K; Karns, Shawn A; Penne, Michael A; Stone, Carmily N; Harrison, Judy E; Radke, Vincent J

    2009-02-01

    Restaurants are associated with a significant number of foodborne illness outbreaks in the United States. Certification of kitchen managers through an accredited training and testing program may help improve food safety practices and thus prevent foodborne illness. In this study, relationships between the results of routine restaurant inspections and the presence of a certified kitchen manager (CKM) were examined. We analyzed data for 4461 restaurants in Iowa that were inspected during 2005 and 2006 (8338 total inspections). Using logistic regression analysis, we modeled the outcome variable (0 = no critical violations [CVs]; 1 = one or more CVs) as a function of presence or absence of a CKM and other explanatory variables. We estimated separate models for seven inspection categories. Restaurants with a CKM present during inspection were less likely to have a CV for personnel (P < 0.01), food source or handling (P < 0.01), facility or equipment requirements (P < 0.05), ware-washing (P < 0.10), and other operations (P < 0.10). However, restaurants with a CKM present during inspection were equally likely to have a CV for temperature or time control and plumbing, water, or sewage as were restaurants without a CKM present. Analyses by type of violation within the temperature and time control category revealed that restaurants with a CKM present during inspection were less likely to have a CV for hot holding (P < 0.05), but the presence of a CKM did not affect other types of temperature and time control violations. Our analyses suggest that the presence of a CKM is protective for most types of CVs, and we identify areas for improving training of CKMs. PMID:19350984

  10. Fertility Treatments in the United States: Improving Access and Outcomes.

    PubMed

    Kissin, Dmitry M; Boulet, Sheree L; Jamieson, Denise J

    2016-08-01

    The recently released National Public Health Action Plan for the Detection, Prevention, and Management of Infertility calls for better access to high-quality infertility services and improved safety of fertility treatments. Both assisted reproductive technology (ART) and non-ART fertility treatments have allowed millions of patients worldwide to overcome infertility-a disease of the reproductive system and important public health issue. However, there are substantial disparities in access to effective treatments in the United States, largely attributable to high out-of-pocket costs, especially for ART. Moreover, the outcomes of fertility treatments are often complicated by the large proportion of multiple births with substantial health risks for both neonates and mothers. Prevention of multiple births is difficult during non-ART fertility treatments but can be effective with single-embryo transfer during ART. Several U.S. states have enacted legislative mandates that require private insurers to cover some portion of the costs associated with fertility treatments and thus reduce the financial pressure to transfer multiple embryos during ART. Although studies have shown that insurance coverage reduces per-cycle multiple births to a certain degree, states with insurance mandates have more ART-related multiple births attributable to substantially larger number of ART-conceived neonates. Experience from other countries shows that access to ART can be improved without concomitant increases in multiple births by providing reimbursement for ART in combination with restrictions on the number of embryos transferred per cycle. Such approaches may or may not be successful in the United States with its unique and complex health care system. PMID:27399992

  11. Improving health outcomes with better patient understanding and education.

    PubMed

    Adams, Robert John

    2010-01-01

    A central plank of health care reform is an expanded role for educated consumers interacting with responsive health care teams. However, for individuals to realize the benefits of health education also requires a high level of engagement. Population studies have documented a gap between expectations and the actual performance of behaviours related to participation in health care and prevention. Interventions to improve self-care have shown improvements in self-efficacy, patient satisfaction, coping skills, and perceptions of social support. Significant clinical benefits have been seen from trials of self-management or lifestyle interventions across conditions such as diabetes, coronary heart disease, heart failure and rheumatoid arthritis. However, the focus of many studies has been on short-term outcomes rather that long term effects. There is also some evidence that participation in patient education programs is not spread evenly across socio economic groups. This review considers three other issues that may be important in increasing the public health impact of patient education. The first is health literacy, which is the capacity to seek, understand and act on health information. Although health literacy involves an individual's competencies, the health system has a primary responsibility in setting the parameters of the health interaction and the style, content and mode of information. Secondly, much patient education work has focused on factors such as attitudes and beliefs. That small changes in physical environments can have large effects on behavior and can be utilized in self-management and chronic disease research. Choice architecture involves reconfiguring the context or physical environment in a way that makes it more likely that people will choose certain behaviours. Thirdly, better means of evaluating the impact of programs on public health is needed. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework has been

  12. Improving conservation outcomes with insights from local experts and bureaucracies.

    PubMed

    Haenn, Nora; Schmook, Birgit; Reyes, Yol; Calmé, Sophie

    2014-08-01

    We describe conservation built on local expertise such that it constitutes a hybrid form of traditional and bureaucratic knowledge. Researchers regularly ask how local knowledge might be applied to programs linked to protected areas. By examining the production of conservation knowledge in southern Mexico, we assert local expertise is already central to conservation. However, bureaucratic norms and social identity differences between lay experts and conservation practitioners prevent the public valuing of traditional knowledge. We make this point by contrasting 2 examples. The first is a master's thesis survey of local experts regarding the biology of the King Vulture (Sarcoramphus papa) in which data collection took place in communities adjacent to the Calakmul Biosphere Reserve. The second is a workshop sponsored by the same reserve that instructed farmers on how to monitor endangered species, including the King Vulture. In both examples, conservation knowledge would not have existed without traditional knowledge. In both examples, this traditional knowledge is absent from scientific reporting. On the basis of these findings, we suggest conservation outcomes may be improved by recognizing the knowledge contributions local experts already make to conservation programming. PMID:24628468

  13. Improving outcome of sensorimotor functions after traumatic spinal cord injury

    PubMed Central

    Dietz, Volker

    2016-01-01

    In the rehabilitation of a patient suffering a spinal cord injury (SCI), the exploitation of neuroplasticity is well established. It can be facilitated through the training of functional movements with technical assistance as needed and can improve outcome after an SCI. The success of such training in individuals with incomplete SCI critically depends on the presence of physiological proprioceptive input to the spinal cord leading to meaningful muscle activations during movement performances. Some actual preclinical approaches to restore function by compensating for the loss of descending input to spinal networks following complete/incomplete SCI are critically discussed in this report. Electrical and pharmacological stimulation of spinal neural networks is still in the experimental stage, and despite promising repair studies in animal models, translations to humans up to now have not been convincing. It is possible that a combination of techniques targeting the promotion of axonal regeneration is necessary to advance the restoration of function. In the future, refinement of animal models according to clinical conditions and requirements may contribute to greater translational success. PMID:27303641

  14. Improving outcomes in pancreatic cancer: key points in perioperative management.

    PubMed

    Alamo, José M; Marín, Luis M; Suarez, Gonzalo; Bernal, Carmen; Serrano, Juan; Barrera, Lydia; Gómez, Miguel A; Muntané, Jordi; Padillo, Francisco J

    2014-10-21

    This review focused in the perioperative management of patients with pancreatic cancer in order to improve the outcome of the disease. We consider that the most controversial points in pancreatic cancer management are jaundice management, vascular resection and neo-adjuvant therapy. Preoperative biliary drainage is recommended only in patients with severe jaundice, as it can lead to infectious cholangitis, pancreatitis and delay in resection, which can lead to tumor progression. The development of a phase III clinical trial is mandatory to clarify the role of neo-adjuvant radiochemotherapy in pancreatic adenocarcinoma. Venous resection does not adversely affect postoperative mortality and morbidity, therefore, the need for venous resection should not be a contraindication to surgical resection in selected patients. The data on arterial resection alone, or combined with vascular resection at the time of pancreatectomy are more heterogeneous, thus, patient age and comorbidity should be evaluated before a decision on operability is made. In patients undergoing R0 resection, arterial resection can also be performed. PMID:25339810

  15. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

    PubMed Central

    2012-01-01

    Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939

  16. Aortic Center: specialized care improves outcomes and decreases mortality

    PubMed Central

    Sales, Marcela da Cunha; Frota Filho, José Dario; Aguzzoli, Cristiane; Souza, Leonardo Dornelles; Rösler, Álvaro Machado; Lucio, Eraldo Azevedo; Leães, Paulo Ernesto; Pontes, Mauro Ricardo Nunes; Lucchese, Fernando Antônio

    2014-01-01

    Objective To compare in-hospital outcomes in aortic surgery in our cardiac surgery unit, before and after foundation of our Center for Aortic Surgery (CTA). Methods Prospective cohort with non-concurrent control. Foundation of CTA required specialized training of surgical, anesthetic and intensive care unit teams, routine neurological monitoring, endovascular and hybrid facilities, training of the support personnel, improvement of the registry and adoption of specific protocols. We included 332 patients operated on between: January/2003 to December/2007 (before-CTA, n=157, 47.3%); and January/2008 to December/2010 (CTA, n=175, 52.7%). Baseline clinical and demographic data, operative variables, complications and in-hospital mortality were compared between both groups. Results Mean age was 58±14 years, with 65% male. Group CTA was older, had higher rate of diabetes, lower rates of COPD and HF, more non-urgent surgeries, endovascular procedures, and aneurysms. In the univariate analysis, CTA had lower mortality (9.7 vs. 23.0%, P=0.008), which occurred consistently across different diseases and procedures. Other outcomes which were reduced in CTA included lower rates of reinterventions (5.7 vs 11%, P=0.046), major complications (20.6 vs. 33.1%, P=0.007), stroke (4.6 vs. 10.9%, P=0.045) and sepsis (1.7 vs. 9.6%, P=0.001), as compared to before-CTA. Multivariable analysis adjusted for potential counfounders revealed that CTA was independently associated with mortality reduction (OR=0.23, IC 95% 0.08 – 0.67, P=0.007). CTA independent mortality reduction was consistent in the multivariable analysis stratified by disease (aneurysm, OR=0.18, CI 95% 0.03 – 0.98, P=0.048; dissection, OR=0.31, CI 95% 0.09 – 0.99, P=0.049) and by procedure (hybrid, OR=0.07, CI 95% 0.007 – 0.72, P=0.026; Bentall, OR=0.18, CI 95% 0.038 – 0.904, P=0.037). Additional multivariable predictors of in-hospital mortality included creatinine (OR=1.7 [1.1-2.6], P=0.008), urgent surgery (OR=5

  17. Advanced Technology in Pediatric Intensive Care Units: Have They Improved Outcomes?

    PubMed

    Frederick, Sean A

    2016-04-01

    In medicine, providers strive to produce quality outcomes and work to continually improve those outcomes. Whether it is reducing cost, decreasing length of stay, mitigating nosocomial infections, or improving survival, there are a myriad of complex factors that contribute to each outcome. One of the greatest challenges to outcome improvement is in pediatric intensive care units, which tend to host the sickest, most complex, smallest, and frailest of pediatric patients. This article highlights some studies and advances in informatics that have influenced intensive care unit outcomes. PMID:27017036

  18. The Pediatrix BabySteps® Data Warehouse--a unique national resource for improving outcomes for neonates.

    PubMed

    Spitzer, Alan R; Ellsbury, Dan; Clark, Reese H

    2015-01-01

    The Pediatrix Medical Group Clinical Data Warehouse represents a unique electronic data capture system for the assessment of outcomes, the management of quality improvement (CQI) initiatives, and the resolution of important research questions in the neonatal intensive care unit (NICU). This system is described in detail and the manner in which the Data Warehouse has been used to measure and improve patient outcomes through CQI projects and research is outlined. The Pediatrix Data Warehouse now contains more than 1 million patients, serving as an exceptional tool for evaluating NICU care. Examples are provided of how significant outcome improvement has been achieved and several papers are cited that have used the "Big Data" contained in the Data Warehouse for novel observations that could not be made otherwise. PMID:25319813

  19. Assessment of Student Professional Outcomes for Continuous Improvement

    ERIC Educational Resources Information Center

    Keshavarz, Mohsen; Baghdarnia, Mostafa

    2013-01-01

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

  20. Improving Reliability and Validity of "Achievement via Conformance" Through Computer Applications.

    ERIC Educational Resources Information Center

    Riggs, Donald E.

    This paper describes an experiment conducted in order to improve the reliability and validity of the Achievement via Conformance (AC) scale of the California Psychological Inventory (CPI). The primary goal of AC is to identify those factors of interest and motivation which facilitate achievement in any setting where conformance is positive…

  1. Effective Strategies Urban Superintendents Utilize That Improve the Academic Achievement for African American Males

    ERIC Educational Resources Information Center

    Prioleau, Lushandra

    2013-01-01

    This study examined the effective strategies, resources, and programs urban superintendents utilize to improve the academic achievement for African-American males. This study employed a mixed-methods approach to answer the following research questions regarding urban superintendents and the academic achievement for African-American males: What…

  2. Improving Education Achievement and Attainment in Luxembourg. OECD Economics Department Working Papers, No. 508

    ERIC Educational Resources Information Center

    Carey, David; Ernst, Ekkehard

    2006-01-01

    Improving education achievement in Luxembourg is a priority for strengthening productivity growth and enhancing residents' employment prospects in the private sector, where employers mainly hire cross-border workers. Student achievement in Luxembourg is below the OECD average according to the 2003 OECD PISA study, with the performance gap between…

  3. Improving Student Motivation and Achievement in Mathematics through Teaching to the Multiple Intelligences.

    ERIC Educational Resources Information Center

    Bednar, Janet; Coughlin, Jane; Evans, Elizabeth; Sievers, Theresa

    This action research project described strategies for improving student motivation and achievement in mathematics through multiple intelligences. The targeted population consisted of kindergarten, third, fourth, and fifth grade students located in two major Midwestern cities. Documentation proving low student motivation and achievement in…

  4. Breaking through barriers: using technology to address executive function weaknesses and improve student achievement.

    PubMed

    Schwartz, David M

    2014-01-01

    Assistive technologies provide significant capabilities for improving student achievement. Improved accessibility, cost, and diversity of applications make integration of technology a powerful tool to compensate for executive function weaknesses and deficits and their impact on student performance, learning, and achievement. These tools can be used to compensate for decreased working memory, poor time management, poor planning and organization, poor initiation, and decreased memory. Assistive technology provides mechanisms to assist students with diverse strengths and weaknesses in mastering core curricular concepts. PMID:25010083

  5. Teachers' Perception of Their Principal's Leadership Style and the Effects on Student Achievement in Improving and Non-Improving Schools

    ERIC Educational Resources Information Center

    Hardman, Brenda Kay

    2011-01-01

    Teachers' perceptions of their school leaders influence student achievement in their schools. The extent of this influence is examined in this study. This quantitative study examined teachers' perceptions of the leadership style of their principals as transformational, transactional or passive-avoidant in improving and non-improving schools in…

  6. Collaborating to Create Change: How El Paso Community College Improved the Readiness of Its Incoming Students through Achieving the Dream. Culture of Evidence Series, Report No. 4

    ERIC Educational Resources Information Center

    Kerrigan, Monica Reid; Slater, Doug

    2010-01-01

    Launched in 2003, "Achieving the Dream: Community Colleges Count" is a multiyear national initiative designed to improve educational outcomes for community college students, particularly students of color and low-income students. Supported by Lumina Foundation for Education and other funders, the initiative has grown to include 98 community…

  7. Can targeting glutamate receptors with long-term heat acclimation improve outcomes following hypoxic injury?

    PubMed Central

    Ely, Brett R; Brunt, Vienna E; Minson, Christopher T

    2015-01-01

    Long-term heat acclimation appears to improve tolerance to hypoxic insults in various tissues, including brain, providing a promising avenue to improve functional outcomes following cerebrovascular events. Glutamate discharge is implicated in dysfunction following hypoxic stress and thus, targeting glutamate receptors with heat acclimation could improve cognitive outcomes following hypoxic injury. PMID:27227003

  8. Achieving Course Objectives and Student Learning Outcomes: Seeking Student Feedback on Their Progress

    ERIC Educational Resources Information Center

    Song, Danni; Loyle-Langholz, Anne; Higbee, Jeanne L.; Zhou, Zhou

    2013-01-01

    Most postsecondary faculty in the United States include course goals or objectives as key components of their syllabi. In addition to individual course objectives, many institutions have identified institution-wide student learning outcomes (SLOs). This paper describes one faculty member's attempts to elicit feedback from students regarding their…

  9. Narrowing the Field: Achieve Engagement Outcomes Faster by Targeting Potential Alumni Leaders

    ERIC Educational Resources Information Center

    Coolman, Jason

    2013-01-01

    Traditional alumni relations programs are about prompting graduates to do something--anything--for or with the institution. In this article, the author proposes something different: an outcome-oriented alumni relations programming model, which the author calls "strategic advancement," that focuses on smaller, targeted sets of graduates…

  10. Educational Attainment of Foster Youth: Achievement and Graduation Outcomes for Children in State Care.

    ERIC Educational Resources Information Center

    Burley, Mason; Halpern, Mina

    This report summarizes findings from a statewide analysis of the educational attainment of foster youth in Washington's public school system. It analyzes various factors related to educational success, comparing the outcomes of youth in long-term foster care with the state's school-age population. The report merges data from the child welfare…

  11. Differences in Teachers' Perceptions of the Causes of Positive Versus Negative Student Achievement Outcomes.

    ERIC Educational Resources Information Center

    Guskey, Thomas R.

    Past research on teachers' causal attributions has shown little relation between perceptions of responsibility for positive versus negative student learning outcomes. In this study, Weiner's model for causal attributions was employed to explore these perceived attributional differences. Data were gathered from 184 teachers from two metropolitan…

  12. Students' Motivational Profiles and Achievement Outcomes in Physical Education: A Self-Determination Perspective

    ERIC Educational Resources Information Center

    Boiche, Julie C. S.; Sarrazin, Philippe G.; Pelletier, Luc G.; Grouzet, Frederick M. E.; Chanal, Julien P.

    2008-01-01

    Previous studies in education have inspected the relations between students' autonomous versus controlled motivation and relevant outcomes. In most of those studies a global index of self-determined motivation was created. The purpose of this article was to examine (a) how the different types of motivation proposed by Self-Determination Theory…

  13. Guide to Success for Organisations in Achieving Employment Outcomes for Aboriginal and Torres Strait Islander People

    ERIC Educational Resources Information Center

    Giddy, Kristine; Lopez, Jessica; Redman, Anne

    2009-01-01

    Helping Aboriginal and Torres Strait Islander job-seekers find and keep a job has been the focus of recent reforms announced by the Australian Government. This guide describes seven essential characteristics of employment service organisations that lead to successful employment outcomes for their Indigenous clients. Based on a selection of…

  14. An Integrated Care Initiative to Improve Patient Outcome in Schizophrenia

    PubMed Central

    Mayer-Amberg, Norbert; Woltmann, Rainer; Walther, Stefanie

    2016-01-01

    The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various health-care service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The Integrated Care Initiative Schizophrenia has implemented a networked care concept in the German federal state of Lower Saxony that integrates various stakeholders of the health care system. In this initiative, office-based psychiatrists, specialized nursing staff, psychologists, social workers, hospitals, psychiatric institutional outpatient’s departments, and other community-based mental health services work together in an interdisciplinary approach. Much emphasis is placed on psychoeducation. Additional efforts cover socio-therapy, visiting care, and family support. During the period from October 2010 (start of the initiative) to December 2012, first experiences and results of quality indicators were collected of 713 registered patients and summarized in a quality monitoring report. In addition, standardized patient interviews were conducted, and duration of hospital days was recorded in 2013. By the end of 2012, patients had been enrolled for an average of 18.7 months. The overall patient satisfaction measured in a patient survey in June 2013 was high and the duration of hospital days measured in a pre–post analysis in July 2013 was reduced by 44%. Two years earlier than planned, the insurance fund will continue the successfully implemented Integrated Care Initiative and adopt it in the regular care setting. This initiative can serve as a learning case for how to set up and measure integrated care systems that may improve outcomes for patients suffering from schizophrenia. PMID:26779043

  15. Improving vascular access outcomes: attributes of arteriovenous fistula cannulation success

    PubMed Central

    Harwood, Lori E.; Wilson, Barbara M.; Oudshoorn, Abe

    2016-01-01

    Background Arteriovenous fistulas (AVFs) are the preferred access for hemodialysis (HD) yet they are underutilized. Cannulation of the fistula is a procedure requiring significant skill development and refinement and if not done well can have negative consequences for patients. The nurses' approach, attitude and skill with cannulation impacts greatly on the patient experience. Complications from miscannulation or an inability to needle fistulas can result in the increased use of central venous catheters. Some nurses remain in a state of a ‘perpetual novice’ resulting in a viscous cycle of negative patient consequences (bruising, pain), further influencing patients' decisions not to pursue a fistula or abandon cannulation. Method This qualitative study used organizational development theory (appreciative inquiry) and research method to determine what attributes/activities contribute to successful cannulation. This can be applied to interventions to promote change and skill development in staff members who have not advanced their proficiency. Eighteen HD nurses who self-identified with performing successful cannulation participated in audio-recorded interviews. The recordings were transcribed verbatim. The data were analyzed using content analysis. Results Four common themes, including patient-centered care, teamwork, opportunity and skill and nurse self-awareness, represented successful fistula cannulation. Successful cannulation is more than a learned technique to correctly insert a needle, but rather represents contextual influences and interplay between the practice environment and personal attributes. Conclusions Practice changes based on these results may improve cannulation, decrease complications and result in better outcomes for patients. Efforts to nurture positive patient experiences around cannulation may influence patient decision-making regarding fistula use. PMID:26985384

  16. Data Assimilation Techniques for Ionospheric Reference Scenarios - project overview and achieved outcomes

    NASA Astrophysics Data System (ADS)

    Gerzen, Tatjana; Wilken, Volker; Hoque, Mainul; Minkwitz, David; Schlueter, Stefan

    2016-04-01

    The ionosphere is the upper part of the Earth's atmosphere, where sufficient free electrons exist to affect the propagation of radio waves. Therefore, the treatment of the ionosphere is a critical issue for many applications dealing with trans-ionospheric signals such as GNSS positioning, GNSS related augmentation systems (e.g. EGNOS and WAAS) and remote sensing. The European Geostationary Navigation Overlay Service (EGNOS) is the European Satellite Based Augmentation Service (SBAS) that provides value added services, in particular to safety critical GNSS applications, e.g. aviation and maritime traffic. In the frame of the European GNSS Evolution Programme (EGEP), ESA has launched several activities, supporting the design, development and qualification of the operational EGNOS infrastructure and associated services. Ionospheric Reference Scenarios (IRSs) are used by ESA in order to conduct the EGNOS performance simulations and to assure the capability for maintaining accuracy, integrity and availability of the EGNOS system, especially during ionospheric storm conditions. The project Data Assimilation Techniques for Ionospheric Reference Scenarios (DAIS) - aims the provision of improved EGNOS IRSs. The main tasks are the calculation and validation of time series of IRSs by a 3D assimilation approach that combines space borne and ground based GNSS observations as well as ionosonde measurements with an ionospheric background model. The special focus thereby is to demonstrate that space-based measurements can significantly contribute to fill data gaps in GNSS ground networks (particularly in Africa and over the oceans) when generating the IRSs. In this project we selected test periods of perturbed and nominal ionospheric conditions and filtered the collected data for outliers. We defined and developed an applicable technique for the 3D assimilation and applied this technique for the generation of IRSs covering the EGNOS V3 extended service area. Afterwards the

  17. Resource Allocation Practices in Three Charter Middle Schools in Relation to Student Achievement Improvement Strategies

    ERIC Educational Resources Information Center

    Campo-Contreras, Susana

    2013-01-01

    The purpose of the study was to develop a better understanding of the allocation of resources used to improve student learning outcomes in three middle schools within a Charter Management Organization (CMO). The three middle schools that participated in the study have similar demographics and serve students in low socio-economic areas of Los…

  18. Thrombomodulin Improves Early Outcomes After Intraportal Islet Transplantation

    PubMed Central

    Cui, W.; Wilson, J. T.; Wen, J.; Angsana, J.; Qu, Z.; Haller, C. A.; Chaikof, E. L.

    2009-01-01

    Primary islet nonfunction due to an instant blood mediated inflammatory reaction (IBMIR) leads to an increase in donor islet mass required to achieve euglycemia. In the presence of thrombin, thrombomodulin generates activated protein C (APC), which limits procoagulant and proinflammatory responses. In this study, we postulated that liposomal formulations of thrombomodulin (lipo-TM), due to its propensity for preferential uptake in the liver, would enhance intraportal engraftment of allogeneic islets by inhibiting the IBMIR. Diabetic C57BL/6J mice underwent intraportal transplantation with B10.BR murine islets. In the absence of treatment, conversion to euglycemia was observed among 29% of mice receiving 250 allo-islets. In contrast, a single infusion of lipo-TM led to euglycemia in 83% of recipients (p = 0.0019). Fibrin deposition (p< 0.0001), neutrophil infiltration (p < 0.0001), as well as expression TNF-α and IL-β (p<0.03)were significantly reduced. Significantly, thrombotic responses mediated by human islets in contact with human blood were also reduced by this approach. Lipo-TM improves the engraftment of allogeneic islets through a reduction in local thrombotic and inflammatory processes. As an enzyme-based pharmacotherapeutic, this strategy offers the potential for local generation of APC at the site of islet infusion, during the initial period of elevated thrombin production. PMID:19459803

  19. Applying Quality Improvement into Systems-based Learning to Improve Diabetes Outcomes in Primary Care.

    PubMed

    Moreo, Kathleen; Sapir, Tamar; Greene, Laurence

    2015-01-01

    In the U.S., where the prevalence of type 2 diabetes has reached epidemic proportions, many patients with this disease are treated by primary care physicians in community-based systems, including accountable care organisations (ACOs). To address gaps in the quality of diabetes care, national quality measures have been established, including patient-centered measures adopted by the Centers for Medicare and Medicaid Services for its Shared Savings Program for ACOs. From a patient-centered perspective, high-quality diabetes care depends on effective communication between clinicians and patients, along with patient education and counseling about medications and lifestyle. We designed and implemented a quality improvement (QI) program for 30 primary care physicians treating patients with type 2 diabetes in three structurally similar but geographically diverse ACOs. Retrospective chart audits were conducted before (n = 300) and after (n = 300) each physician participated in accredited continuing medical education (CME) courses that focused on QI strategies. Randomly selected charts were audited to measurably assess essential interventions for improved outcomes in type 2 diabetes including the physicians' documentation of patient counseling and assessment of side effects, and patients' medication adherence status and changes in hemoglobin A1C (A1C) and body mass index (BMI). Paced educational interventions included a private performance improvement Internet live course conducted for each physician, small-group Internet live courses involving peer discussion, and a set of enduring materials, which were also multi-accredited for all clinicians in the physician's practice. Continual improvement cycles were guided by analysis of the baseline chart audits, quantitative survey data, and qualitative feedback offered by participants. To extend the benefit of the education, the enduring materials were offered to the interprofessional team of clinicians throughout the U.S. who did

  20. Applying Quality Improvement into Systems-based Learning to Improve Diabetes Outcomes in Primary Care

    PubMed Central

    Moreo, Kathleen; Sapir, Tamar; Greene, Laurence

    2015-01-01

    In the U.S., where the prevalence of type 2 diabetes has reached epidemic proportions, many patients with this disease are treated by primary care physicians in community-based systems, including accountable care organisations (ACOs). To address gaps in the quality of diabetes care, national quality measures have been established, including patient-centered measures adopted by the Centers for Medicare and Medicaid Services for its Shared Savings Program for ACOs. From a patient-centered perspective, high-quality diabetes care depends on effective communication between clinicians and patients, along with patient education and counseling about medications and lifestyle. We designed and implemented a quality improvement (QI) program for 30 primary care physicians treating patients with type 2 diabetes in three structurally similar but geographically diverse ACOs. Retrospective chart audits were conducted before (n = 300) and after (n = 300) each physician participated in accredited continuing medical education (CME) courses that focused on QI strategies. Randomly selected charts were audited to measurably assess essential interventions for improved outcomes in type 2 diabetes including the physicians’ documentation of patient counseling and assessment of side effects, and patients’ medication adherence status and changes in hemoglobin A1C (A1C) and body mass index (BMI). Paced educational interventions included a private performance improvement Internet live course conducted for each physician, small-group Internet live courses involving peer discussion, and a set of enduring materials, which were also multi-accredited for all clinicians in the physician's practice. Continual improvement cycles were guided by analysis of the baseline chart audits, quantitative survey data, and qualitative feedback offered by participants. To extend the benefit of the education, the enduring materials were offered to the interprofessional team of clinicians throughout the U.S. who

  1. 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…

  2. A Meta-Analysis of Educational Data Mining on Improvements in Learning Outcomes

    ERIC Educational Resources Information Center

    AlShammari, Iqbal A.; Aldhafiri, Mohammed D.; Al-Shammari, Zaid

    2013-01-01

    A meta-synthesis study was conducted of 60 research studies on educational data mining (EDM) and their impacts on and outcomes for improving learning outcomes. After an overview, an examination of these outcomes is provided (Romero, Ventura, Espejo, & Hervas, 2008; Romero, "et al.", 2011). Then, a review of other EDM-related research…

  3. School Improvement Plans and Student Achievement: Preliminary Evidence from the Quality and Merit Project in Italy

    ERIC Educational Resources Information Center

    Caputo, Andrea; Rastelli, Valentina

    2014-01-01

    This study provides preliminary evidence from an Italian in-service training program addressed to lower secondary school teachers which supports school improvement plans (SIPs). It aims at exploring the association between characteristics/contents of SIPs and student improvement in math achievement. Pre-post standardized tests and text analysis of…

  4. Training Theory of Mind and Executive Control: A Tool for Improving School Achievement?

    ERIC Educational Resources Information Center

    Kloo, Daniela; Perner, Josef

    2008-01-01

    In the preschool years, there are marked improvements in theory of mind (ToM) and executive functions. And, children's competence in these two core cognitive domains is associated with their academic achievement. Therefore, training ToM and executive control could be a valuable tool for improving children's success in school. This article reviews…

  5. A mnemonic for Parkinson disease patients considering DBS: a tool to improve perceived outcome of surgery.

    PubMed

    Okun, Michael S; Foote, Kelly D

    2004-09-01

    Patients considering deep brain stimulation (DBS) for Parkinson disease (PD) may be exposed to videotapes, media coverage, or literature which show dramatic improvements in PD symptoms after surgical intervention. Based on this information, patients may seek a medical center with expertise in DBS for an evaluation and assessment of their candidacy for surgery. If patients receive a device, they may be disappointed or despondent following surgery because of a failure to achieve a preconceived and unrealistic outcome. In order to address the important issue of patient misconception of potential outcome, we have introduced a simple mnemonic device. The device may be taught and then reviewed with patients and families both before and after surgery. Use of this mnemonic device may allow the patient and family the time necessary to alter the perception of perceived benefit. This education can help to ensure that outcome meets or exceeds expectation, and as a result they become a more satisfied and easy-to-manage DBS patient. PMID:15335446

  6. Exercise Improves Executive Function and Achievement and Alters Brain Activation in Overweight Children: A Randomized Controlled Trial

    PubMed Central

    Davis, Catherine L.; Tomporowski, Phillip D.; McDowell, Jennifer E.; Austin, Benjamin P.; Miller, Patricia H.; Yanasak, Nathan E.; Allison, Jerry D.; Naglieri, Jack A.

    2010-01-01

    Objective This experiment tested the hypothesis that exercise would improve executive function. Design Sedentary, overweight 7- to 11-year-old children (N = 171, 56% female, 61% Black, M ± SD age 9.3 ± 1.0 yrs, body mass index (BMI) 26 ± 4.6 kg/m2, BMI z-score 2.1 ± 0.4) were randomized to 13 ± 1.6 weeks of an exercise program (20 or 40 minutes/day), or a control condition. Main outcome measures Blinded, standardized psychological evaluations (Cognitive Assessment System and Woodcock-Johnson Tests of Achievement III) assessed cognition and academic achievement. Functional magnetic resonance imaging measured brain activity during executive function tasks. Results Intent to treat analysis revealed dose response benefits of exercise on executive function and mathematics achievement. Preliminary evidence of increased bilateral prefrontal cortex activity and reduced bilateral posterior parietal cortex activity due to exercise was also observed. Conclusion Consistent with results obtained in older adults, a specific improvement on executive function and brain activation changes due to exercise were observed. The cognitive and achievement results add evidence of dose response, and extend experimental evidence into childhood. This study provides information on an educational outcome. Besides its importance for maintaining weight and reducing health risks during a childhood obesity epidemic, physical activity may prove to be a simple, important method of enhancing aspects of children’s mental functioning that are central to cognitive development. This information may persuade educators to implement vigorous physical activity. PMID:21299297

  7. Achievable Convergence Angle and the Effect of Preparation Design on the Clinical Outcome of Full Veneer Crowns in Dogs

    PubMed Central

    Soukup, Jason W.; Snyder, Christopher J.; Karls, Tina L.; Riehl, Jessica

    2012-01-01

    Summary It is widely accepted that the convergence angle of a full veneer crown preparation should be as close to parallel as possible to attain adequate retention/resistance. The shape of the dog’s canine tooth limits the veterinary dentists’ ability to achieve the recommended convergence angle. However, the clinically achievable convergence angle of the canine tooth in dogs has not been evaluated. In addition, the convergence angle and other physical properties of a preparation, such as height and base diameter, have been shown to affect the retention/resistance of full veneer crowns, in vitro. This effect has not been evaluated clinically in the dog. Physical properties of 32 stone dies from full veneer crowns of canine teeth were studied to evaluate the clinically achievable convergence angle and the potential effect physical properties of the preparation had on the clinical outcome of the restoration. The clinically achievable convergence angle was much higher than the current recommendation. There was an association, albeit not statistically significant, between physical properties of a preparation (convergence angle, height, base diameter) and the clinical outcome of the restoration. PMID:21916370

  8. Including Emotional Intelligence in Pharmacy Curricula to Help Achieve CAPE Outcomes.

    PubMed

    Nelson, Michael H; Fierke, Kerry K; Sucher, Brandon J; Janke, Kristin K

    2015-05-25

    The importance of emotional intelligence (EI) for effective teamwork and leadership within the workplace is increasingly apparent. As suggested by the 2013 CAPE Outcomes, we recommend that colleges and schools of pharmacy consider EI-related competencies to build self-awareness and professionalism among students. In this Statement, we provide two examples of the introduction of EI into pharmacy curricula. In addition, we provide a 4-phase process based on recommendations developed by EI experts for structuring and planning EI development. Finally, we make 9 recommendations' to inform the process of including EI in pharmacy curricula. PMID:26089557

  9. Including Emotional Intelligence in Pharmacy Curricula to Help Achieve CAPE Outcomes

    PubMed Central

    Fierke, Kerry K.; Sucher, Brandon J.; Janke, Kristin K.

    2015-01-01

    The importance of emotional intelligence (EI) for effective teamwork and leadership within the workplace is increasingly apparent. As suggested by the 2013 CAPE Outcomes, we recommend that colleges and schools of pharmacy consider EI-related competencies to build self-awareness and professionalism among students. In this Statement, we provide two examples of the introduction of EI into pharmacy curricula. In addition, we provide a 4-phase process based on recommendations developed by EI experts for structuring and planning EI development. Finally, we make 9 recommendations’ to inform the process of including EI in pharmacy curricula. PMID:26089557

  10. SMS-Based Learning in Tertiary Education: Achievement and Attitudinal Outcomes

    ERIC Educational Resources Information Center

    Katz, Yaacov J.

    2013-01-01

    SMS delivery platforms are being increasingly used at the university level to enhance student achievement as well as traits and attitudes related to the learning process. SMS delivery provides access to learning materials without being limited by space or time and sophisticated technological advances in SMS delivery have led to enhanced learner…

  11. Impacts of Comprehensive Reading Instruction on Diverse Outcomes of Low- and High-Achieving Readers

    ERIC Educational Resources Information Center

    Guthrie, John T.; McRae, Angela; Coddington, Cassandra S.; Klauda, Susan Lutz; Wigfield, Allan; Barbosa, Pedro

    2009-01-01

    Low-achieving readers in Grade 5 often lack comprehension strategies, domain knowledge, word recognition skills, fluency, and motivation to read. Students with such multiple reading needs seem likely to benefit from instruction that supports each of these reading processes. The authors tested this expectation experimentally by comparing the…

  12. BOY SCOUT 5 A DAY ACHIEVEMENT BADGE: OUTCOME RESULTS OF A TROOP & INTERNET INTERVENTION

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective: A Boy Scout Five-A-Day Achievement Badge program (SAD), with both troop and Internet-based activities was developed and implemented, and its effect on fruit-juice (FJ) and low-fat vegetable (LV) consumption and psychosocial mediators evaluated. Methods: The nine-week program included 20 ...

  13. 5 A DAY ACHIEVEMENT BADGE FOR AFRICAN AMERICAN BOY SCOUTS: PILOT OUTCOME RESULTS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Boy Scouts are an important channel to complement school-based programs to enable boys to eat more fruit, 100% juice, and vegetables (FJV) for chronic disease prevention. The "5 a Day Achievement Badge" program was presented on a pilot study basis to African-American Boy Scout troops in Houston. Tro...

  14. Student-Level Analysis of Year 2 (2004-2005) Achievement Outcomes for Tennessee Charter Schools

    ERIC Educational Resources Information Center

    Ross, Steven M.; McDonald, Aaron J.; McSparrin-Gallagher, Brenda; Slawson, Deborah L.

    2006-01-01

    This report presents student-level achievement results for two groups of schools in Tennessee: (a) four charter schools that began operation in 2003-2004; and (b) three new charter schools that were established in 2004-2005. These two cohorts were therefore completing their second and first academic years, respectively, at the time the achievement…

  15. Improving energy audit process and report outcomes through planning initiatives

    NASA Astrophysics Data System (ADS)

    Sprau Coulter, Tabitha L.

    Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first

  16. Differences between African American and European American First-Year College Students in the Relationship between Self-Efficacy, Outcome Expectations, and Academic Achievement

    ERIC Educational Resources Information Center

    DeFreitas, Stacie Craft

    2012-01-01

    First-year African American and European American college students were surveyed to examine ethnic differences in how their social cognitive beliefs (self-efficacy and outcome expectations) influenced their academic achievement. It was hypothesized that outcome expectations may better explain academic achievement for African Americans due to the…

  17. Improving Student Performance Outcomes and Graduation Rates through Institutional Partnerships

    ERIC Educational Resources Information Center

    Roggow, Michael J.

    2014-01-01

    This chapter explores a grant-sponsored program and examines the role of departmental and institutional collaborations in advancing student performance outcomes. It provides a theoretical framework and a description of best practices for ensuring the success of first-generation urban community college students.

  18. Inside Quality Reform: Early Results on Using Outcomes for Improvement

    ERIC Educational Resources Information Center

    El-Khawas, Elaine

    2014-01-01

    This article offers evidence on ways in which assessment of student learning outcomes made a difference for some academic institutions in the United States. It offers perspectives on the internal changes that took place, especially within academic programmes. Even after the capacity for assessment was developed, challenges remained in evaluating…

  19. Partnership for Improving Outcomes in Indigenous Education: Relationship or Business?

    ERIC Educational Resources Information Center

    Ma Rhea, Zane

    2012-01-01

    This paper examines the Australian government's Indigenous policy by interrogating the concept of partnership between governments and Indigenous communities through three examples. Increasingly, the Australian federal government is focusing attention on the poor literacy and numeracy outcomes for Indigenous children in remote and very remote…

  20. High-Leverage Leadership: Improving Outcomes in Educational Settings

    ERIC Educational Resources Information Center

    Mongon, Denis; Chapman, Christopher

    2011-01-01

    Globalisation of world trade, international media, technological innovation and social change are creating opportunities and challenges that today's pupils will inherit and build on. A pupil's academic, technical and social capacity will define their success or failure. Therefore, educational outcomes and well-being for young people across…

  1. The Relationship between School Leadership and School Improvement Outcomes.

    ERIC Educational Resources Information Center

    Silins, Halia C.

    This paper tests the degree of overlap between operational definitions of transformational and transactional leadership, the nature of the relationships between the constructs of transformational and transactional leadership, and specified outcomes in an empirically derived data set by the application of two forms of analysis. Based on Bass's…

  2. Effects of simulated interventions to improve school entry academic skills on socioeconomic inequalities in educational achievement.

    PubMed

    Chittleborough, Catherine R; Mittinty, Murthy N; Lawlor, Debbie A; Lynch, John W

    2014-01-01

    Randomized controlled trial evidence shows that interventions before age 5 can improve skills necessary for educational success; the effect of these interventions on socioeconomic inequalities is unknown. Using trial effect estimates, and marginal structural models with data from the Avon Longitudinal Study of Parents and Children (n = 11,764, imputed), simulated effects of plausible interventions to improve school entry academic skills on socioeconomic inequality in educational achievement at age 16 were examined. Progressive universal interventions (i.e., more intense intervention for those with greater need) to improve school entry academic skills could raise population levels of educational achievement by 5% and reduce absolute socioeconomic inequality in poor educational achievement by 15%. PMID:25327718

  3. Effects of Simulated Interventions to Improve School Entry Academic Skills on Socioeconomic Inequalities in Educational Achievement

    PubMed Central

    Chittleborough, Catherine R; Mittinty, Murthy N; Lawlor, Debbie A; Lynch, John W

    2014-01-01

    Randomized controlled trial evidence shows that interventions before age 5 can improve skills necessary for educational success; the effect of these interventions on socioeconomic inequalities is unknown. Using trial effect estimates, and marginal structural models with data from the Avon Longitudinal Study of Parents and Children (n = 11,764, imputed), simulated effects of plausible interventions to improve school entry academic skills on socioeconomic inequality in educational achievement at age 16 were examined. Progressive universal interventions (i.e., more intense intervention for those with greater need) to improve school entry academic skills could raise population levels of educational achievement by 5% and reduce absolute socioeconomic inequality in poor educational achievement by 15%. PMID:25327718

  4. [Schematherapy in Eating Disorders - An Integrative Approach to Improve the Outcome].

    PubMed

    Archonti, Christina; de Zwaan, Martina

    2016-07-01

    Despite evidence-based psychotherapeutic treatment approaches such as cognitive behavioral therapy and psychodynamic therapy eating disorders still pose a challenge to therapists and patients alike. Eating disorders are associated with a high comorbid prevalence of personality disorders and other psychological axis-I-disorders, show highdrop-out rates and relapse rates and anorexia nervosa has the highest mortality rate compared to all psychiatric disorders. Even self-motivated patients frequently fail to achieve the treatment goals like developing a normal eating behavior, gaining weight, and changing the underlying dysfunctional behavioral patterns and cognitions. We will present a schematherapeutic approach with experiential methods, integrated in evidence-based CBT, with the intention to improve motivation and therapeutic outcome. PMID:27388869

  5. The Consequences of "School Improvement": Examining the Association between Two Standardized Assessments Measuring School Improvement and Student Science Achievement

    ERIC Educational Resources Information Center

    Maltese, Adam V.; Hochbein, Craig D.

    2012-01-01

    For more than half a century concerns about the ability of American students to compete in a global workplace focused policymakers' attention on improving school performance generally, and student achievement in science, technology, engineering, and mathematics (STEM) specifically. In its most recent form--No Child Left Behind--there is evidence…

  6. Raising African American Student Achievement: California Goals, Local Outcomes. Executive Summary

    ERIC Educational Resources Information Center

    EdSource, 2008

    2008-01-01

    Although academic performance is a concern, African American students represent less than 8 percent of California's K-12 students, and at times get lost in California policy debates about improving student performance. Findings of this study indicate that: (1) California's African American students are concentrated in relatively few counties and…

  7. KIPP Middle Schools: Impacts on Achievement and Other Outcomes. Final Report

    ERIC Educational Resources Information Center

    Tuttle, Christina Clark; Gill, Brian; Gleason, Philip; Knechtel, Virginia; Nichols-Barrer, Ira; Resch, Alexandra

    2013-01-01

    The Knowledge Is Power Program (KIPP) is a rapidly expanding network of public charter schools whose mission is to improve the education of low-income children. As of the 2012-2013 school year, 125 KIPP schools are in operation in 20 different states and the District of Columbia (DC). Ultimately, KIPP's goal is to prepare students to enroll and…

  8. Teacher- versus peer-mediated instruction: an ecobehavioral analysis of achievement outcomes.

    PubMed Central

    Greenwood, C R; Dinwiddie, G; Terry, B; Wade, L; Stanley, S O; Thibadeau, S; Delquadri, J C

    1984-01-01

    In three experiments, we compared the effects of instructional arrangements that varied in: teacher versus peer mediators, methods used, levels of student academic responding generated, and content taught and tested. Instructional arrangements (i.e., tasks, structure, teacher position, teacher behavior) and students' levels of academic responding were measured by an observation system which served as an index of the independent variables. Students' accuracy on weekly spelling, arithmetic, and vocabulary tests and pre- and post-standardized achievement tests (Experiments 2 and 3 only) were the dependent variables. Results indicated that the classwide peer tutoring, compared to the teacher's procedure, produced more student academic responding and higher weekly test scores, regardless of treatment order or subject matter content (Experiment 1). The four lowest performing students in each class, in particular, benefited from peer tutoring, often performing as well as the other students. These findings were replicated in Experiments 2 and 3 wherein content taught/tested was also manipulated. Standardized test score gains were higher in those areas in which peer tutoring was used longest. Issues related to the functional analysis of instruction and achievement gain are discussed. Images Figure 2 Figure 4 PMID:6526770

  9. Iliac Arteries: How Registries Can Help Improve Outcomes

    PubMed Central

    Tapping, Charles Ross; Uberoi, Raman

    2014-01-01

    There are many publications reporting excellent short and long-term results with endovascular techniques. Patients included in trials are often highly selected and may not represent real world practice. Registries are important to interventional radiologists for several reasons; they reflect prevailing practice and can be used to establish real world standards of care and safety profiles. This information allows individuals and centers to evaluate their outcomes compared with national norms. The British Iliac Angioplasty and Stenting (BIAS) registry is an example of a mature registry that has been collecting data since 2000 and has been reporting outcomes since 2001. This article discusses the evidence to support both endovascular and surgical intervention for aortoiliac occlusive disease, the role of registries, and optimal techniques for aortoiliac intervention. PMID:25435659

  10. Audit-based education: a potentially effective program for improving guideline achievement in CKD patients.

    PubMed

    de Goeij, Moniek C M; Rotmans, Joris I

    2013-09-01

    The achievement of treatment guidelines in patients with chronic kidney disease is poor, and more efforts are needed to improve this. Audit-based education is a program that may contribute to this improvement. de Lusignana et al. investigated whether audit-based education is effective in lowering systolic blood pressure in a primary-care setting. Although the program is inventive and promising, several adjustments are needed before it can be applied as an effective strategy. PMID:23989357

  11. Improving Mathematics Achievement for All California Students: The Report of the California Mathematics Task Force.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    This document is the result of the California Mathematics Task Force assigned to address the need to improve the mathematics achievement of California's students. Five recommendations are made and discussed: (1) The State Superintendent of Public Instruction (SSPI) must establish clear and specific content and performance standards for mathematics…

  12. Supporting Instructional Improvement in Low-Performing Schools to Increase Students' Academic Achievement

    ERIC Educational Resources Information Center

    Bellei, Cristian

    2013-01-01

    This is an impact evaluation of the Technical Support to Failing Schools Program, a Chilean compensatory program that provided 4-year in-school technical assistance to low-performing schools to improve students' academic achievement. The author implemented a quasi-experimental design by using difference-in-differences estimation combined with…

  13. Dynamic Geometry Software Improves Mathematical Achievement: Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Chan, Kan Kan; Leung, Siu Wai

    2014-01-01

    Dynamic geometry software (DGS) aims to enhance mathematics education. This systematic review and meta-analysis evaluated the quasi-experimental studies on the effectiveness of DGS-based instruction in improving students' mathematical achievement. Research articles published between 1990 and 2013 were identified from major databases according to a…

  14. What Matters for Elementary Literacy Coaching? Guiding Principles for Instructional Improvement and Student Achievement

    ERIC Educational Resources Information Center

    L'Allier, Susan; Elish-Piper, Laurie; Bean, Rita M.

    2010-01-01

    Literacy coaches provide job-embedded professional development for teachers, and the number of literacy coaches in elementary schools is increasing. Although literacy coaching offers promise in terms of improving teacher practice and student achievement, guidance is needed regarding the qualifications, activities, and roles of literacy coaches.…

  15. Instructional Leadership Influence on Collective Teacher Efficacy to Improve School Achievement

    ERIC Educational Resources Information Center

    Fancera, Samuel F.; Bliss, James R.

    2011-01-01

    The purpose of this study was to examine whether instructional leadership functions, as defined in Hallinger's Principal Instructional Management Rating Scale, positively influence collective teacher efficacy to improve school achievement. Teachers from sample schools provided data for measures of collective teacher efficacy and instructional…

  16. Investing in Educator Data Literacy Improves Student Achievement. Evidence of Impact: The Oregon Data Project

    ERIC Educational Resources Information Center

    Data Quality Campaign, 2012

    2012-01-01

    Since 2007 the Oregon DATA Project has been investing resources to provide educators on-the-job training around effective data use to improve student achievement. New evidence shows that their efforts are paying off. A 2011 Oregon DATA Project report detailed the impact of their investment in the state's educators, finding the following: (1)…

  17. Improving Student Interest and Achievement in Social Studies Using a Multiple Intelligence Approach.

    ERIC Educational Resources Information Center

    Hanley, Chris; Hermiz, Carmen; Lagioia-Peddy, Jennifer; Levine-Albuck, Valerie

    This action research paper describes a program initiated by teacher researchers to improve academic achievement and interest in social studies. The targeted group consisted of fifth graders in a lower middle class community in the Midwest. Analysis of the problem-causes data show three main factors: curriculum, attitude, and effect. In regard to…

  18. Staff Development Designed To Improve the Achievement of Students with Disabilities.

    ERIC Educational Resources Information Center

    Byrnes, MaryAnn; Majors, Martha

    This paper describes how the University of Massachusetts (Boston) developed partnership programs to improve achievement of students with significant disabilities just beginning to participate in a standards-based general curriculum. Fundamental to the effort was development of a 12-credit graduate certificate program focused on adapting the…

  19. Improving Teaching Capacity to Increase Student Achievement: The Key Role of Data Interpretation by School Leaders

    ERIC Educational Resources Information Center

    Lynch, David; Smith, Richard; Provost, Steven; Madden, Jake

    2016-01-01

    Purpose: This paper argues that in a well-organised school with strong leadership and vision coupled with a concerted effort to improve the teaching performance of each teacher, student achievement can be enhanced. The purpose of this paper is to demonstrate that while macro-effect sizes such as "whole of school" metrics are useful for…

  20. Improving High School Students' Mathematics Achievement through the Use of Motivational Strategies.

    ERIC Educational Resources Information Center

    Portal, Jamie; Sampson, Lisa

    This report describes a program for motivating students in mathematics in order to improve achievement at the high school level. The targeted population consisted of high school students in a middle class community located in a suburb of a large metropolitan area. The problems of underachievement were documented through data collected from surveys…

  1. Improving Achievement in Low-Performing Schools: Key Results for School Leaders

    ERIC Educational Resources Information Center

    Ward, Randolph E.; Burke, Mary Ann

    2004-01-01

    As accountability in schools becomes more crucial, educators are looking for comprehensive and innovative management practices that respond to challenges and realities of student academic achievement. In order to improve academic performance and the quality of instruction, the entire school community needs to be involved. This book provides six…

  2. Analyzing Academic Achievement of Junior High School Students by an Improved Rough Set Model

    ERIC Educational Resources Information Center

    Pai, Ping-Feng; Lyu, Yi-Jia; Wang, Yu-Min

    2010-01-01

    Rough set theory (RST) is an emerging technique used to deal with problems in data mining and knowledge acquisition. However, the RST approach has not been widely explored in the field of academic achievement. This investigation developed an improved RST (IMRST) model, which employs linear discriminant analysis to determine a reduct of RST, and…

  3. The effect of workshop groups on achievement goals and performance in biology: An outcome evaluation

    NASA Astrophysics Data System (ADS)

    Born, Wendi Kay

    This two-year quasi-experiment evaluated the effect of peer-led workshop groups on performance of minority and majority undergraduate biology students in a three-course series and investigated motivational explanations for performance differences. The workshop intervention used was modeled after a program pioneered by Treisman (1992) at the University of California. Majority volunteers randomly assigned to workshops (n = 61) performed between 1/2 and 1 standard deviation better than those assigned to the control group (n = 60; p < .05) in each quarter without spending more time studying. During Quarter 1, workshop minority students (n = 25) showed a pattern of increasing exam performance in comparison to historic control minority students (n = 21), who showed a decreasing pattern (p < .05). Although sex differences in biology performance were a focus of investigation, none were detected. Motivational predictions derived from the hierarchical model of approach and avoidance achievement motivation (Elliot & Church, 1997) were partially supported. Self-report survey measures of achievement goals, modeled after those used by Elliot and colleagues, were requested from all enrolled students. Volunteers (n = 121) reported higher average levels of approach and avoidance goals than nonvolunteers (n = 439; p < .05) and the relationship of goals to performance was moderated by volunteer status. Performance of volunteers was negatively related to avoidance of failure goals (r = .41, p < .01) and unrelated to performance approach goals. Performance of nonvolunteers was unrelated to avoidance of failure goals and positively related to performance approach goals (r = .28, p < .01). Mastery goals were unrelated to performance for all students. Results were inconsistent with Dweck and Leggett's (1988) theory of mastery vs. performance orientation, but were similar to results found by Elliot and colleagues. Contrary to hypotheses, motivational goals did not mediate performance for

  4. Outcome measures in MMN revisited: further improvement needed.

    PubMed

    Pruppers, Mariëlle H J; Draak, Thomas H P; Vanhoutte, Els K; Van der Pol, W-Ludo; Gorson, Kenneth C; Léger, Jean-Marc; Nobile-Orazio, Eduardo; Lewis, Richard A; van den Berg, Leonard H; Faber, Catharina G; Merkies, Ingemar S J

    2015-09-01

    The objectives of this study were to provide an overview of the outcome measures (OMs) applied in clinical trials in multifocal motor neuropathy (MMN) and to determine the responsiveness of a core set of selected OMs as part of the peripheral neuropathy outcome measures standardization (PeriNomS) study. The following OMs were serially applied in 26 patients with newly diagnosed or relapsing MMN, receiving intravenous immunoglobulin (assessments: T0/T3/T12 months): 14 muscle pairs MRC (Medical Research Council) scale, the Neuropathy Impairment Scale motor-subset, a self-evaluation scale, grip strength, and MMN-RODS© (Rasch-built overall disability scale). All data, except the grip strength, were subjected to Rasch analyses before determining responsiveness. For grip strength, responsiveness was examined using a combined anchor- (SF-36 question-2) and distribution-based (½ × SD) minimum clinically important difference (MCID) techniques, determining the proportion of patients exceeding both the identified cut-offs. For the remaining scales, the magnitude of change for each patient on each scale was determined using the MCID related to the individual SE (responder definition: MCID-SE ≥ 1.96). Overall, a great assortment of measures has been used in MMN trials with different responsiveness definitions. For the selected OMs, responsiveness was poor and only seen in one fourth to one third of the patients, the grip strength being more responsive. Despite the efforts taken to standardize outcome assessment, further clinimetric responsiveness studies are needed in MMN. PMID:26115442

  5. Building Mathematics Learning Communities: Improving Outcomes in Urban High Schools

    ERIC Educational Resources Information Center

    Walker, Erica N.

    2012-01-01

    Drawing on perceptions, behaviors, and experiences of students at an urban high school--both high and low achievers--this timely book demonstrates how urban youth can be meaningfully engaged in learning mathematics. The author presents a "potential" model rather than a "deficit" model, complete with teaching strategies and best practices for…

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

    ERIC Educational Resources Information Center

    Hannah, John; James, Alex; Williams, Phillipa

    2014-01-01

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

  7. Improving Educational Outcomes for Minority Males in Our Schools

    ERIC Educational Resources Information Center

    Gardner, Ralph, III; Rizzi, Gleides Lopes; Council, Morris, III

    2014-01-01

    This article examines the academic underachievement and disproportionate special education placement of minority males. Causes and consequences for poor academic performance by minority males are reviewed. The Individuals with Disabilities Education Act and No Child Left Behind Act are discussed in relation to minority male academic achievement.…

  8. Enhancing Lay Counselor Capacity to Improve Patient Outcomes with Multimedia Technology

    PubMed Central

    Robbins, Reuben N.; Mellins, Claude A.; Leu, Cheng-Shiun; Rowe, Jessica; Warne, Patricia; Abrams, Elaine J.; Witte, Susan; Stein, Dan J.; Remien, Robert H.

    2015-01-01

    Multimedia technologies offer powerful tools to increase capacity of health workers to deliver standardized, effective, and engaging antiretroviral medication adherence counseling. Masivukeni is an innovative multimedia-based, computer-driven, lay counselor-delivered intervention designed to help people living with HIV in resource-limited settings achieve optimal adherence. This pilot study examined medication adherence and key psychosocial outcomes among 55 non-adherent South African HIV+ patients, on ART for at least 6 months, who were randomized to receive either Masivukeni or standard of care (SOC) counseling for ART non-adherence. At baseline, there were no significant differences between the SOC and Masivukeni groups on any outcome variables. At post-intervention (approximately 5–6 weeks after baseline), clinic-based pill count adherence data available for 20 participants (10 per intervention arm) showed a 10% improvement for Masivukeni participants and a decrease of 8% for SOC participants. Masivukeni participants reported significantly more positive attitudes towards disclosure and medication social support, less social rejection, and better clinic-patient relationships than did SOC participants. Masivukeni shows promise to promote optimal adherence and provides preliminary evidence that multimedia, computer-based technology can help lay counselors offer better adherence counseling than standard approaches. PMID:25566763

  9. Team-Based Learning to Improve Learning Outcomes in a Therapeutics Course Sequence

    PubMed Central

    Remington, Tami L.; Wells, Trisha D.; Dorsch, Michael P.; Guthrie, Sally K.; Stumpf, Janice L.; Alaniz, Marissa C.; Ellingrod, Vicki L.; Tingen, Jeffrey M.

    2014-01-01

    Objective. To compare the effectiveness of team-based learning (TBL) to that of traditional lectures on learning outcomes in a therapeutics course sequence. Design. A revised TBL curriculum was implemented in a therapeutic course sequence. Multiple choice and essay questions identical to those used to test third-year students (P3) taught using a traditional lecture format were administered to the second-year pharmacy students (P2) taught using the new TBL format. Assessment. One hundred thirty-one multiple-choice questions were evaluated; 79 tested recall of knowledge and 52 tested higher level, application of knowledge. For the recall questions, students taught through traditional lectures scored significantly higher compared to the TBL students (88%±12% vs 82%±16%, p=0.01). For the questions assessing application of knowledge, no differences were seen between teaching pedagogies (81%±16% vs 77%±20%, p=0.24). Scores on essay questions and the number of students who achieved 100% were also similar between groups. Conclusion. Transition to a TBL format from a traditional lecture-based pedagogy allowed P2 students to perform at a similar level as students with an additional year of pharmacy education on application of knowledge type questions. However, P3 students outperformed P2 students regarding recall type questions and overall. Further assessment of long-term learning outcomes is needed to determine if TBL produces more persistent learning and improved application in clinical settings. PMID:24558281

  10. Vitamin D improves inflammatory bowel disease outcomes: Basic science and clinical review

    PubMed Central

    Reich, Krista M; Fedorak, Richard N; Madsen, Karen; Kroeker, Karen I

    2014-01-01

    Vitamin D deficiency is commonly diagnosed among patients with inflammatory bowel disease (IBD). Patients with IBD are at risk of low bone density and increased fractures due to low vitamin D levels, long standing disease, and frequent steroid exposures; as a result, it is well established that vitamin D supplementation in this population is important. There is increasing support for the role of vitamin D in strengthening the innate immune system by acting as an immunomodulator and reducing inflammation in experimental and human IBD. The active form of vitamin D, 1,25(OH)D3, acts on T cells to promote T helper (Th)2/regulatory T responses over Th1/Th17 responses; suppresses dendritic cell inflammatory activity; induces antibacterial activity; and regulates cytokine production in favor of an anti-inflammatory response. Murine and human IBD studies support a therapeutic role of vitamin D in IBD. Risk factors for vitamin D deficiency in this population include decreased sunlight exposure, disease duration, smoking, and genetics. Vitamin D normalization is associated with reduced risk of relapse, reduced risk of IBD-related surgeries, and improvement in quality of life. Vitamin D is an inexpensive supplement which has been shown to improve IBD outcomes. However, further research is required to determine optimal serum vitamin D levels which will achieve beneficial immune effects, and stronger evidence is needed to support the role of vitamin D in inducing disease response and remission, as well as maintaining this improvement in patients’ disease states. PMID:24803805

  11. Successful debriefing - best methods to achieve positive learning outcomes: a literature review.

    PubMed

    Dufrene, Claudine; Young, Anne

    2014-03-01

    The past several years have seen a dramatic increase in the use of simulation in nursing education. The process of debriefing, or guided reflection, follows these simulation activities. Although facilitated debriefing is recommended in the simulation literature, very few research articles reported results of the effectiveness of debriefing. A literature search was conducted using PubMed, Academic Search Complete, CINAHL, ERIC, and PsychInfo to identify articles and studies examining simulation and debriefing methods. A limited number of studies were found, that examined traditional faculty facilitated debriefing versus alternate forms of debriefing, debriefing versus no debriefing, and perceptions of debriefing. In most cases, improvement was noted in learners regardless of the debriefing process used. This review is grouped in two sections: (a) studies comparing debriefing strategies and (b) studies examining perceptions of the usefulness of debriefing. PMID:23890542

  12. Combining Chemotherapy with Bevacizumab Improves Outcomes for Ovarian Cancer Patients

    Cancer.gov

    Results from two phase III randomized clinical trials suggest that, at least for some patients with ovarian cancer, adding the antiangiogenesis agent bevacizumab to chemotherapy increases the time to disease progression and may improve survival.

  13. Cognitive behavioral therapy for suicidal behaviors: improving patient outcomes

    PubMed Central

    Mewton, Louise; Andrews, Gavin

    2016-01-01

    This systematic review provides an overview of the effectiveness of cognitive behavioral therapy (CBT) in reducing suicidal cognitions and behavior in the adult population. We identified 15 randomized controlled trials of CBT for adults (aged 18 years and older) that included suicide-related cognitions or behaviors as an outcome measure. The studies were identified from PsycINFO searches, reference lists, and a publicly available database of psychosocial interventions for suicidal behaviors. This review identified some evidence of the use of CBT in the reduction of both suicidal cognitions and behaviors. There was not enough evidence from clinical trials to suggest that CBT focusing on mental illness reduces suicidal cognitions and behaviors. On the other hand, CBT focusing on suicidal cognitions and behaviors was found to be effective. Given the current evidence, clinicians should be trained in CBT techniques focusing on suicidal cognitions and behaviors that are independent of the treatment of mental illness. PMID:27042148

  14. Toward Improved Public Health Outcomes From Urban Nature

    PubMed Central

    Bush, Robert; Gaston, Kevin J.; Dean, Julie H.; Barber, Elizabeth; Fuller, Richard A.

    2015-01-01

    There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities. PMID:25602866

  15. Diabetic microvascular complications: possible targets for improved macrovascular outcomes

    PubMed Central

    D’Elia, John A; Bayliss, George; Roshan, Bijan; Maski, Manish; Gleason, Ray E; Weinrauch, Larry A

    2011-01-01

    The results of recent outcome trials challenge hypotheses that tight control of both glycohemoglobin and blood pressure diminishes macrovascular events and survival among type 2 diabetic patients. Relevant questions exist regarding the adequacy of glycohemoglobin alone as a measure of diabetes control. Are we ignoring mechanisms of vasculotoxicity (profibrosis, altered angiogenesis, hypertrophy, hyperplasia, and endothelial injury) inherent in current antihyperglycemic medications? Is the polypharmacy for lowering cholesterol, triglyceride, glucose, and systolic blood pressure producing drug interactions that are too complex to be clinically identified? We review angiotensin–aldosterone mechanisms of tissue injury that magnify microvascular damage caused by hyperglycemia and hypertension. Many studies describe interruption of these mechanisms, without hemodynamic consequence, in the preservation of function in type 1 diabetes. Possible interactions between the renin–angiotensin–aldosterone system and physiologic glycemic control (through pulsatile insulin release) suggest opportunities for further clinical investigation. PMID:21694944

  16. Toward improved public health outcomes from urban nature.

    PubMed

    Shanahan, Danielle F; Lin, Brenda B; Bush, Robert; Gaston, Kevin J; Dean, Julie H; Barber, Elizabeth; Fuller, Richard A

    2015-03-01

    There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities. PMID:25602866

  17. Improving Health Outcomes for Low Health Literacy Heart Failure Patients.

    PubMed

    Friel, Catherine J

    2016-09-01

    According to the National Assessment of Adult Literacy (2003), only 12% of U.S. adults have a proficient level of health literacy, with adults 65 years and older more likely to have a below basic or a basic health literacy level. An estimated 5.8 million individuals in the United States have heart failure (HF) and it is one of the most common reasons for those aged 65 and over to be hospitalized. Many patients with HF are at risk for poor health outcomes due to low health literacy. This article reviews the literature with regard to the effectiveness of methods used to address low health literacy among HF patients and describes a pilot study implemented by a home care agency in the northeast to address high HF readmission rates. PMID:27580282

  18. Does Cryotherapy Improve Outcomes With Soft Tissue Injury?

    PubMed

    Hubbard, Tricia J; Denegar, Craig R

    2004-09-01

    REFERENCE: Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sport Med. 2004; 32:251-261. CLINICAL QUESTION: What is the clinical evidence base for cryotherapy use? DATA SOURCES: Studies were identified by using a computer-based literature search on a total of 8 databases: MEDLINE, Proquest, ISI Web of Science, Cumulative Index to Nursing and Allied Health (CINAHL) on Ovid, Allied and Complementary Medicine Database (AMED) on Ovid, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effectiveness, and Cochrane Controlled Trials Register (Central). This was supplemented with citation tracking of relevant primary and review articles. Search terms included surgery,orthopaedics,sports injury,soft tissue injury,sprains and strains,contusions,athletic injury,acute,compression, cryotherapy,ice,RICE, andcold. STUDY SELECTION: To be included in the review, each study had to fulfill the following conditions: be a randomized, controlled trial of human subjects; be published in English as a full paper; include patients recovering from acute soft tissue or orthopaedic surgical interventions who received cryotherapy in inpatient, outpatient, or home-based treatment, in isolation or in combination with placebo or other therapies; provide comparisons with no treatment, placebo, a different mode or protocol of cryotherapy, or other physiotherapeutic interventions; and have outcome measures that included function (subjective or objective), pain, swelling, or range of motion. DATA EXTRACTION: The study population, interventions, outcomes, follow-up, and reported results of the assessed trials were extracted and tabulated. The primary outcome measures were pain, swelling, and range of motion. Only 2 groups reported adequate data for return to normal function. All eligible articles were rated for methodologic quality using the PEDro scale. The

  19. Does Cryotherapy Improve Outcomes With Soft Tissue Injury?

    PubMed Central

    Denegar, Craig R.

    2004-01-01

    Reference: Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Am J Sport Med. 2004; 32:251–261. Clinical Question: What is the clinical evidence base for cryotherapy use? Data Sources: Studies were identified by using a computer-based literature search on a total of 8 databases: MEDLINE, Proquest, ISI Web of Science, Cumulative Index to Nursing and Allied Health (CINAHL) on Ovid, Allied and Complementary Medicine Database (AMED) on Ovid, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effectiveness, and Cochrane Controlled Trials Register (Central). This was supplemented with citation tracking of relevant primary and review articles. Search terms included surgery,orthopaedics,sports injury,soft tissue injury,sprains and strains,contusions,athletic injury,acute,compression, cryotherapy,ice,RICE, andcold. Study Selection: To be included in the review, each study had to fulfill the following conditions: be a randomized, controlled trial of human subjects; be published in English as a full paper; include patients recovering from acute soft tissue or orthopaedic surgical interventions who received cryotherapy in inpatient, outpatient, or home-based treatment, in isolation or in combination with placebo or other therapies; provide comparisons with no treatment, placebo, a different mode or protocol of cryotherapy, or other physiotherapeutic interventions; and have outcome measures that included function (subjective or objective), pain, swelling, or range of motion. Data Extraction: The study population, interventions, outcomes, follow-up, and reported results of the assessed trials were extracted and tabulated. The primary outcome measures were pain, swelling, and range of motion. Only 2 groups reported adequate data for return to normal function. All eligible articles were rated for methodologic quality using the PEDro scale. The

  20. Providing Outcomes Information to Nursing Homes: Can It Improve Quality of Care?

    ERIC Educational Resources Information Center

    Castle, Nicholas G.

    2003-01-01

    Purpose: This study examined whether providing outcomes information to 120 nursing homes facilitated improvements in quality over a 12-month period, as compared with 1,171 facilities not receiving this information. The outcomes information provided consisted of a report mailed to administrators that examined six measures of care quality. These…

  1. The Effectiveness Of The Manchester Even Start Program In Improving Literacy Outcomes for Preschool Latino Students

    ERIC Educational Resources Information Center

    Ryan, Andrew M.

    2005-01-01

    Although widely implemented, the effectiveness of the Even Start program and other programs involving home-visiting and bilingual education in improving preschool literacy outcomes, particularly among Latino students, is uncertain. This study used a non-equivalent groups design to compare preschool literacy outcomes (measured by the PALS-PreK…

  2. Live births achieved via IVF are increased by improvements in air quality and laboratory environment

    PubMed Central

    Heitmann, Ryan J; Hill, Micah J; James, Aidita N; Schimmel, Tim; Segars, James H; Csokmay, John M; Cohen, Jacques; Payson, Mark D

    2016-01-01

    Infertility is a common disease, which causes many couples to seek treatment with assisted reproduction techniques. Many factors contribute to successful assisted reproduction technique outcomes. One important factor is laboratory environment and air quality. Our facility had the unique opportunity to compare consecutively used, but separate assisted reproduction technique laboratories, as a result of a required move. Environmental conditions were improved by strategic engineering designs. All other aspects of the IVF laboratory, including equipment, physicians, embryologists, nursing staff and protocols, were kept constant between facilities. Air quality testing showed improved air quality at the new IVF site. Embryo implantation (32.4% versus 24.3%; P < 0.01) and live birth (39.3% versus 31.8%, P < 0.05) were significantly increased in the new facility compared with the old facility. More patients met clinical criteria and underwent mandatory single embryo transfer on day 5 leading to both a reduction in multiple gestation pregnancies and increased numbers of vitrified embryos per patient with supernumerary embryos available. Improvements in IVF laboratory conditions and air quality had profound positive effects on laboratory measures and patient outcomes. This study further strengthens the importance of the laboratory environment and air quality in the success of an IVF programme. PMID:26194882

  3. Improving patient and project outcomes using interorganisational innovation, collaboration and co-design.

    PubMed

    Evans, Liz; Green, Stuart; Howe, Cathy; Sharma, Kiran; Marinho, Fatima; Bell, Derek; Thomas, Paul

    2014-01-01

    Background Common mental disorders (CMDs) are a leading cause of disability. The Department of Health has launched a large-scale initiative to improve access to evidence-based psychological treatments, such as cognitive behavioural therapy (CBT), through the Improving Access to Psychological Therapy (IAPT) programme. Access to IAPT services by black and minority ethnic (BME) communities is lower than for other groups. Setting The London Borough of Ealing in west London; a diverse borough with areas of high BME population and relatively high deprivation. Aim To compare the outcomes of two linked quality improvement (QI) projects undertaken by Ealing Mental Health and Wellbeing Service (MHWBS), both with the same aim of increasing access to talking therapies for BME communities. Methods Application of QI methodologies supported by the NIHR CLAHRC for northwest London in two different settings in Ealing. One, the 'Southall project', was set within a wider initiative for collaborative improvements and shared learning (the Southall Initiative for Integrated Care) in an ethnically diverse area of Ealing; it was undertaken between April 2010 and September 2011. The second, 'the Ealing project', operated in the two other Ealing localities that did not have the advantage of a broader initiative for collaborative improvements; it was undertaken between April 2011 and September 2012. Results Comparison of the monthly referral rates of BME patients (standardised per 10 000 general practitioner (GP)-registered patients) show that the Southall project was more effective in increasing referrals from BME communities than the Ealing project. Conclusion Broad local participation and ownership in the project design of the Southall project may explain why it was more effective in achieving its aims than the Ealing project which lacked these ownership-creating mechanisms. PMID:25949710

  4. An Association of Cancer Physicians' strategy for improving services and outcomes for cancer patients.

    PubMed

    Baird, Richard; Banks, Ian; Cameron, David; Chester, John; Earl, Helena; Flannagan, Mark; Januszewski, Adam; Kennedy, Richard; Payne, Sarah; Samuel, Emlyn; Taylor, Hannah; Agarwal, Roshan; Ahmed, Samreen; Archer, Caroline; Board, Ruth; Carser, Judith; Copson, Ellen; Cunningham, David; Coleman, Rob; Dangoor, Adam; Dark, Graham; Eccles, Diana; Gallagher, Chris; Glaser, Adam; Griffiths, Richard; Hall, Geoff; Hall, Marcia; Harari, Danielle; Hawkins, Michael; Hill, Mark; Johnson, Peter; Jones, Alison; Kalsi, Tania; Karapanagiotou, Eleni; Kemp, Zoe; Mansi, Janine; Marshall, Ernie; Mitchell, Alex; Moe, Maung; Michie, Caroline; Neal, Richard; Newsom-Davis, Tom; Norton, Alison; Osborne, Richard; Patel, Gargi; Radford, John; Ring, Alistair; Shaw, Emily; Skinner, Rod; Stark, Dan; Turnbull, Sam; Velikova, Galina; White, Jeff; Young, Alison; Joffe, Johnathan; Selby, Peter

    2016-01-01

    The Association of Cancer Physicians in the United Kingdom has developed a strategy to improve outcomes for cancer patients and identified the goals and commitments of the Association and its members. PMID:26913066

  5. An Association of Cancer Physicians’ strategy for improving services and outcomes for cancer patients

    PubMed Central

    Baird, Richard; Banks, Ian; Cameron, David; Chester, John; Earl, Helena; Flannagan, Mark; Januszewski, Adam; Kennedy, Richard; Payne, Sarah; Samuel, Emlyn; Taylor, Hannah; Agarwal, Roshan; Ahmed, Samreen; Archer, Caroline; Board, Ruth; Carser, Judith; Copson, Ellen; Cunningham, David; Coleman, Rob; Dangoor, Adam; Dark, Graham; Eccles, Diana; Gallagher, Chris; Glaser, Adam; Griffiths, Richard; Hall, Geoff; Hall, Marcia; Harari, Danielle; Hawkins, Michael; Hill, Mark; Johnson, Peter; Jones, Alison; Kalsi, Tania; Karapanagiotou, Eleni; Kemp, Zoe; Mansi, Janine; Marshall, Ernie; Mitchell, Alex; Moe, Maung; Michie, Caroline; Neal, Richard; Newsom-Davis, Tom; Norton, Alison; Osborne, Richard; Patel, Gargi; Radford, John; Ring, Alistair; Shaw, Emily; Skinner, Rod; Stark, Dan; Turnbull, Sam; Velikova, Galina; White, Jeff; Young, Alison; Joffe, Johnathan; Selby, Peter

    2016-01-01

    The Association of Cancer Physicians in the United Kingdom has developed a strategy to improve outcomes for cancer patients and identified the goals and commitments of the Association and its members. PMID:26913066

  6. Improving Outcomes for Learners through Self-Evaluation

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2008

    2008-01-01

    This document supplements the advice given in "How good is our school?" (HGIOS)--third edition and "The Child at the Centre"--second edition which set out comprehensive quality frameworks and provide helpful advice on the process of improvement through self-evaluation. In particular, this document provides advice on the application of the three…

  7. A Measurement Model of Microgenetic Transfer for Improving Instructional Outcomes

    ERIC Educational Resources Information Center

    Pavlik, Philip I., Jr.; Yudelson, Michael; Koedinger, Kenneth R.

    2015-01-01

    Efforts to improve instructional task design often make reference to the mental structures, such as "schemas" (e.g., Gick & Holyoak, 1983) or "identical elements" (Thorndike & Woodworth, 1901), that are common to both the instructional and target tasks. This component based (e.g., Singley & Anderson, 1989) approach…

  8. Does residential mobility improve educational outcomes? Evidence from the Netherlands.

    PubMed

    Haelermans, Carla; De Witte, Kristof

    2015-07-01

    This paper explores the impact of residential mobility on educational outcomes. By considering a large Dutch city with substantial internal residential mobility, we examine how residential mobility influences the decision of students to drop out of school. The paper exploits a rich administrative dataset with extensive information on educational, individual, family, housing and moving characteristics of students. It combines a matching design with a multivariate regression analysis, such that the evaluation draws on a well-comparable control group for the treated students. Accounting for individual, family, educational, neighborhood and housing characteristics, as well as for school and year fixed effects, we observe that residential mobility increases the probability of school dropout in the first few years after moving. The estimated effect changes, however, to a lower risk of early school leaving after an initial period, and then changes again to a higher risk after 6years. This effect remains, regardless the level of education the students attended, or whether the student moves to a better or a worse neighborhood. PMID:26004467

  9. Vocational Rehabilitation Experiences among Individuals Who Achieved a Supported Employment Outcome: A Longitudinal Study of the Vocational Rehabilitation Service Program. Final Report.

    ERIC Educational Resources Information Center

    Tashjian, Michael D.; Schmidt-Davis, Holly

    This report contains findings from a descriptive study of the characteristics, services, and outcomes of consumers who achieved a supported employment (SE) outcome after exiting Vocational Rehabilitation (VR) services. Data were obtained through case file abstraction, consumer interviews, and an extended service provider interview of 259 SE…

  10. 20 CFR 411.555 - Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all outcome months? 411.555 Section 411.555 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment...

  11. 20 CFR 411.555 - Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... not achieve all outcome months? (a) Yes. The EN (or State VR agency acting as an EN) can keep each milestone and outcome payment for which the EN (or State VR agency acting as an EN) is eligible, even though... make or deny to an EN (or a State VR agency acting as an EN) may be subject to adjustment...

  12. 20 CFR 411.555 - Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... not achieve all outcome months? (a) Yes. The EN (or State VR agency acting as an EN) can keep each milestone and outcome payment for which the EN (or State VR agency acting as an EN) is eligible, even though... make or deny to an EN (or a State VR agency acting as an EN) may be subject to adjustment...

  13. 20 CFR 411.555 - Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... not achieve all outcome months? (a) Yes. The EN (or State VR agency acting as an EN) can keep each milestone and outcome payment for which the EN (or State VR agency acting as an EN) is eligible, even though... make or deny to an EN (or a State VR agency acting as an EN) may be subject to adjustment...

  14. 20 CFR 411.555 - Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... not achieve all outcome months? (a) Yes. The EN (or State VR agency acting as an EN) can keep each milestone and outcome payment for which the EN (or State VR agency acting as an EN) is eligible, even though... make or deny to an EN (or a State VR agency acting as an EN) may be subject to adjustment...

  15. Recipe for Success: An Updated Parents' Guide to Improving Colorado Schools and Student Achievement. Second Edition.

    ERIC Educational Resources Information Center

    Taher, Bonnie; Durr, Pamela

    This guide describes ways that parents can help improve student achievement and school quality. It answers such questions as how to choose the right early-education opportunity for a preschooler, how to make sure a 5-year-old is ready for school, how to help a daughter do well in school, how to work with a daughter's or son's teachers, how to help…

  16. Pediatric kidney disease: tracking onset and improving clinical outcomes.

    PubMed

    Bates, Carlton M; Charlton, Jennifer R; Ferris, Maria E; Hildebrandt, Friedhelm; Hoshizaki, Deborah K; Warady, Bradley A; Moxey-Mims, Marva M

    2014-06-01

    Recent studies confirm that much of adult kidney disease may have its origins in childhood, often as a result of abnormal or suboptimal fetal kidney development. Understanding of the etiology and pathogenesis of CKD in children is rapidly evolving because of robust longitudinal clinical data, identification of monogenic mutations related to common causes of CKD, and improved knowledge of factors that influence the onset and progression of CKD. The Kidney Research National Dialogue, supported by the National Institute of Diabetes and Digestive and Kidney Diseases, asked the research and clinical communities to formulate and prioritize research objectives that would improve understanding of kidney function and diseases. This commentary outlines high-priority research objectives to assess factors associated with the predisposition to develop renal disease in children, and address the unique challenges in treating this population. PMID:24651076

  17. Improving Patient Outcomes With Oral Heart Failure Medications.

    PubMed

    Sherrod, Melissa M; Cheek, Dennis J; Seale, Ashlie

    2016-05-01

    Hospitals are under immense pressure to reduce heart failure readmissions that occur within 30 days of discharge, and to improve the quality of care for these patients. Penalties mandated by the Affordable Care Act decrease hospital reimbursement and ultimately the overall cost of caring for these patients increases if they are not well managed. Approximately 25% of patients hospitalized for heart failure are at high risk for readmission and these rates have not changed over the past decade. As a result of an aging population, the incidence of heart failure is expected to increase to one in five Americans over the age of 65. Pharmacologic management can reduce the risk of death and help prevent unnecessary hospitalizations. Healthcare providers who have knowledge of heart failure medications and drug interactions and share this information with their patients contribute to improved long-term survival and physical functioning as well as fewer hospitalizations and a delay of progressive worsening of heart failure. PMID:27145405

  18. Improving Outcomes for Esophageal Cancer using Proton Beam Therapy.

    PubMed

    Chuong, Michael D; Hallemeier, Christopher L; Jabbour, Salma K; Yu, Jen; Badiyan, Shahed; Merrell, Kenneth W; Mishra, Mark V; Li, Heng; Verma, Vivek; Lin, Steven H

    2016-05-01

    Radiation therapy (RT) plays an essential role in the management of esophageal cancer. Because the esophagus is a centrally located thoracic structure there is a need to balance the delivery of appropriately high dose to the target while minimizing dose to nearby critical structures. Radiation dose received by these critical structures, especially the heart and lungs, may lead to clinically significant toxicities, including pneumonitis, pericarditis, and myocardial infarction. Although technological advancements in photon RT delivery like intensity modulated RT have decreased the risk of such toxicities, a growing body of evidence indicates that further risk reductions are achieved with proton beam therapy (PBT). Herein we review the published dosimetric and clinical PBT literature for esophageal cancer, including motion management considerations, the potential for reirradiation, radiation dose escalation, and ongoing esophageal PBT clinical trials. We also consider the potential cost-effectiveness of PBT relative to photon RT. PMID:27084662

  19. Febuxostat improves outcome in a rat model of cancer cachexia

    PubMed Central

    Konishi, Masaaki; Pelgrim, Loes; Tschirner, Anika; Baumgarten, Anna; von Haehling, Stephan; Palus, Sandra; Doehner, Wolfram; Anker, Stefan D; Springer, Jochen

    2015-01-01

    Background Activity of xanthine oxidase is induced in cancer cachexia, and its inhibition by allopurinol or oxypurinol improves survival and reduces wasting in the Yoshida hepatoma cancer cachexia model. Here, we tested the effects of the second-generation xanthine oxidase inhibitor febuxostat compared with placebo in the same model as used previously by our group. Methods Wistar rats (∽200 g) were treated daily with febuxostat at 5 mg/kg/day or placebo via gavage for a maximum of 17 days. Weight change, quality of life, and body composition were analysed. After sacrifice, proteasome activity in the gastrocnemius muscle was measured. Muscle-specific proteins involved in metabolism were analysed by western blotting. Results Treatment of the tumour-bearing rats with febuxostat led to a significantly improved survival compared with placebo (hazard ratio: 0.45, 95% confidence interval: 0.22–0.93, P = 0.03). Loss of body weight was reduced (−26.3 ± 12.4 g) compared with placebo (−50.2 ± 2.1 g, P < 0.01). Wasting of lean mass was attenuated (−12.7 ± 10.8 g) vs. placebo (−31.9 ± 2.1 g, P < 0.05). While we did not see an effect of febuxostat on proteasome activity at the end of the study, the pAkt/Akt ratio was improved by febuxostat (0.94 ± 0.09) vs. placebo (0.41 ± 0.05, P < 0.01), suggesting an increase in protein synthesis. Conclusions Febuxostat attenuated cachexia progression and improved survival of tumour-bearing rats. PMID:26136193

  20. OPTIMIZED FLUID MANAGEMENT IMPROVES OUTCOMES OF PEDIATRIC BURN PATIENTS

    PubMed Central

    Kraft, Robert; Herndon, David N; Branski, Ludwik K; Finnerty, Celeste C; Leonard, Katrina R; Jeschke, Marc G

    2012-01-01

    Background One of the major determinants for survival of severely burned patients is appropriate fluid resuscitation. At present, fluid resuscitation is calculated based on bodyweight or body surface area, burn size, and urinary output. However, recent evidence suggests that fluid calculation is inadequate and that over- and under-resuscitation is associated with increased morbidity and mortality. We hypothesize that optimizing fluid administration during the critical initial phase using a transcardiopulmonary thermo-dilution monitoring device (PiCCO) would have beneficial effects on the outcome of burned patients. Methods A cohort of seventy-six severely burned pediatric patients with burns over 30% total body surface area (TBSA) who received adjusted fluid resuscitation using the PiCCO (P) system were compared to 76 conventionally monitored patients (C). Clinical hemodynamic measurements, organ function (DENVER2 score), and biomarkers were recorded prospectively for the first 20 days after burn injury. Results Both cohorts were similar in demographic and injury characteristics. Patients in the PiCCO group received significantly less fluids (p<0.05) with similar urinary output, resulting in a significantly lower positive fluid balance (p<0.05). The central venous pressure (CVP) in the P group was maintained in a more controlled range (p<0.05), associated with a significantly lower heart rate and significantly lower incidence of cardiac and renal failure, p<0.05. Conclusions Fluid resuscitation guided by transcardiopulmonary thermo-dilution during hospitalization represents an effective adjunct and is associated with beneficial effects on post-burn morbidity. PMID:22703982

  1. Value Driven Outcomes (VDO): a pragmatic, modular, and extensible software framework for understanding and improving health care costs and outcomes

    PubMed Central

    Kawamoto, Kensaku; Martin, Cary J; Williams, Kip; Tu, Ming-Chieh; Park, Charlton G; Hunter, Cheri; Staes, Catherine J; Bray, Bruce E; Deshmukh, Vikrant G; Holbrook, Reid A; Morris, Scott J; Fedderson, Matthew B; Sletta, Amy; Turnbull, James; Mulvihill, Sean J; Crabtree, Gordon L; Entwistle, David E; McKenna, Quinn L; Strong, Michael B; Pendleton, Robert C; Lee, Vivian S

    2015-01-01

    Objective To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes). Materials and methods In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement. Results A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they spent in the unit; actual medication acquisition costs are allocated to patients based on utilization; and radiology costs are allocated based on the minutes required for study performance. Relevant process and outcome measures are also available. A visualization layer facilitates the identification of value improvement opportunities, such as high-volume, high-cost case types with high variability in costs across providers. Initial implementation was completed within 6 months, and all project objectives were fulfilled. The framework has been improved iteratively and is now a foundational tool for delivering high-value care. Conclusions The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value. PMID:25324556

  2. Bariatric surgery is associated with improvement in kidney outcomes.

    PubMed

    Chang, Alex R; Chen, Yuan; Still, Christopher; Wood, G Craig; Kirchner, H Lester; Lewis, Meredith; Kramer, Holly; Hartle, James E; Carey, David; Appel, Lawrence J; Grams, Morgan E

    2016-07-01

    Severe obesity is associated with increased risk of kidney disease. Whether bariatric surgery reduces the risk of adverse kidney outcomes is uncertain. To resolve this we compared the risk of estimated glomerular filtration rate (eGFR) decline of ≥30% and doubling of serum creatinine or end-stage renal disease (ESRD) in 985 patients who underwent bariatric surgery with 985 patients who did not undergo such surgery. Patients were matched on demographics, baseline body mass index, eGFR, comorbidities, and previous nutrition clinic use. Mean age was 45 years, 97% were white, 80% were female, and 33% had baseline eGFR <90 ml/min per 1.73 m(2). Mean 1-year weight loss was 40.4 kg in the surgery group compared with 1.4 kg in the matched cohort. Over a median follow-up of 4.4 years, 85 surgery patients had an eGFR decline of ≥30% (22 had doubling of serum creatinine/ESRD). Over a median follow-up of 3.8 years, 177 patients in the matched cohort had an eGFR decline of ≥30% (50 had doubling of serum creatinine/ESRD). In adjusted analysis, bariatric surgery patients had a significant 58% lower risk for an eGFR decline of ≥30% (hazard ratio 0.42, 95% confidence interval 0.32-0.55) and 57% lower risk of doubling of serum creatinine or ESRD (hazard ratio 0.43, 95% confidence interval: 0.26-0.71) compared with the matched cohort. Results were generally consistent among subgroups of patients with and without eGFR <90 ml/min per 1.73 m(2), hypertension, and diabetes. Thus, bariatric surgery may be an option to prevent kidney function decline in severely obese individuals. PMID:27181999

  3. Effective colonoscopy training techniques: strategies to improve patient outcomes

    PubMed Central

    Papanikolaou, Ioannis S; Karatzas, Pantelis S; Varytimiadis, Lazaros T; Tsigaridas, Athanasios; Galanopoulos, Michail; Viazis, Nikos; Karamanolis, Dimitrios G

    2016-01-01

    Colonoscopy has substantially evolved during the last 20 years and many different training techniques have been developed in order to improve the performance of endoscopists. The most known are mechanical simulators, virtual reality simulators, computer-simulating endoscopy, magnetic endoscopic imaging, and composite and explanted animal organ simulators. Current literature generally indicates that the use of simulators improves performance of endoscopists and enhances safety of patients, especially during the initial phase of training. Moreover, newer endoscopes and imaging techniques such as high-definition colonoscopes, chromocolonoscopy with dyes spraying, and third-eye retroscope have been incorporated in everyday practice, offering better visualization of the colon and detection of polyps. Despite the abundance of these different technological features, training devices are not widely used and no official guideline or specified training algorithm or technique for lower gastrointestinal endoscopy has been evolved. In this review, we present the most important training methods currently available and evaluate these using existing literature. We also try to propose a training algorithm for novice endoscopists. PMID:27099542

  4. Improved renal ischemia tolerance in females influences kidney transplantation outcomes

    PubMed Central

    Aufhauser, David D.; Wang, Zhonglin; Murken, Douglas R.; Bhatti, Tricia R.; Wang, Yanfeng; Ge, Guanghui; Redfield, Robert R.; Abt, Peter L.; Wang, Liqing; Reese, Peter P.; Hancock, Wayne W.; Levine, Matthew H.

    2016-01-01

    Experimentally, females show an improved ability to recover from ischemia-reperfusion injury (IRI) compared with males; however, this sex-dependent response is less established in humans. Here, we developed a series of murine renal ischemia and transplant models to investigate sex-specific effects on recovery after IRI. We found that IRI tolerance is profoundly increased in female mice compared with that observed in male mice and discovered an intermediate phenotype after neutering of either sex. Transplantation of adult kidneys from either sex into a recipient of the opposite sex followed by ischemia at a remote time resulted in ischemia recovery that reflected the sex of the recipient, not the donor, revealing that the host sex determines recovery. Likewise, renal IRI was exacerbated in female estrogen receptor α–KO mice, while female mice receiving supplemental estrogen before ischemia were protected. We examined data from the United Network for Organ Sharing (UNOS) to determine whether there is an association between sex and delayed graft function (DGF) in patients who received deceased donor renal transplants. A multivariable logistic regression analysis determined that there was a greater association with DGF in male recipients than in female recipients. Together, our results demonstrate that sex affects renal IRI tolerance in mice and humans and indicate that estrogen administration has potential as a therapeutic intervention to clinically improve ischemia tolerance. PMID:27088798

  5. Can adventurous training have a role in improving clinical outcomes?

    PubMed

    Mellor, A; Jackson, S; Hardern, R

    2012-06-01

    The aim of military adventurous training (AT) is "to develop, through authorised challenging pursuits and within an outdoor environment, leadership and the qualities necessary to enhance the performance of military personnel during peace and war". An increasing amount of effort is being applied by all three services to increase participation in AT to achieve these, largely immeasurable, aims. Existing guidance to Commanding Officers dictates that, where possible, 20% of a unit strength should undertake some form of AT annually with 5% taking part in an overseas expedition. In a speech in 2008 Alan Johnson, the then Secretary of State for Health, acknowledged that for Armed Forces medical personnel 'just as important as clinical skills are issues such as leadership, communication, adaptability and teamwork." Controlled exposure to risk, discomfort and personal hardship is a common theme for both AT activities and military deployments. Both General Medical Council competencies for all doctors and the Royal College of Anaesthetists military module include elements which can effectively be taught and developed through training in an outdoors environment. These skills include communication skills, leadership, risk assessment and interdisciplinary working. In this review the value of AT in training doctors to develop those attributes is examined. PMID:22860500

  6. Routine outcomes monitoring to support improving care for schizophrenia: report from the VA Mental Health QUERI.

    PubMed

    Young, Alexander S; Niv, Noosha; Chinman, Matthew; Dixon, Lisa; Eisen, Susan V; Fischer, Ellen P; Smith, Jeffrey; Valenstein, Marcia; Marder, Stephen R; Owen, Richard R

    2011-04-01

    In schizophrenia, treatments that improve outcomes have not been reliably disseminated. A major barrier to improving care has been a lack of routinely collected outcomes data that identify patients who are failing to improve or not receiving effective treatments. To support high quality care, the VA Mental Health QUERI used literature review, expert interviews, and a national panel process to increase consensus regarding outcomes monitoring instruments and strategies that support quality improvement. There was very good consensus in the domains of psychotic symptoms, side-effects, drugs and alcohol, depression, caregivers, vocational functioning, and community tenure. There are validated instruments and assessment strategies that are feasible for quality improvement in routine practice. PMID:20658320

  7. Engaging with blended learning to improve students' learning outcomes

    NASA Astrophysics Data System (ADS)

    Francis, Rebecca; Shannon, Susan J.

    2013-08-01

    When blended learning is embraced to enhance learning in engineering (architectural), design and architecture, we argue it is a best-practice instructional mode. Blended learning is the seamless amalgamation of carefully selected online modules with face-to-face instruction. This paper evaluates case studies of the introduction of blended learning in these disciplines. It demonstrates that students who do not engage with blended learning are academically disadvantaged. Alignment of the blended mode of delivery and the mode of assessment is next considered. Two case studies of the introduction of blended modes of assessment, for improved student satisfaction with feedback, are evaluated. Finally, the reliance upon non-faculty to provide both blended learning and assessment is evaluated using qualitative research methods to establish the barriers to adoption of what is now considered best educational practice.

  8. Intellectual, neuropsychological, and achievement outcomes in children six to eight years after recovery from Haemophilus influenzae meningitis.

    PubMed

    Taylor, H G; Michaels, R H; Mazur, P M; Bauer, R E; Liden, C B

    1984-08-01

    Twenty-four grade school children who had sustained an earlier episode of Haemophilus influenzae type b meningitis were tested, along with a group of 24 school-aged siblings. Evaluations consisted of tests of IQ, academic achievement, and neuropsychological skills. Parents completed forms rating each child's behavioral adjustment and temperament. Available school-administered standardized achievement tests were also obtained. Information relating to the episode of meningitis was extracted from the medical charts of each child who had had meningitis in order to investigate the relationship of these parameters to developmental outcome. Results showed that, compared with nearest-age siblings, children who had had meningitis scored lower on performance IQ and full-scale IQ. The group that had had meningitis also performed more poorly on several neuropsychological tasks. However, the groups did not differ in verbal IQ, and they performed comparably on all academic measures. Significant behavioral adjustment problems were absent from both groups, and there were no notable differences in temperament. Although findings support the existence of postmeningitis sequelae, the selective nature of the deficiencies observed indicate that prognosis for children in the age range examined may be better than that suggested by earlier studies. PMID:6611537

  9. The Impact of School Improvement Grants on Achievement: Plans for a National Evaluation Using a Regression Discontinuity Design

    ERIC Educational Resources Information Center

    Deke, John; Dragoset, Lisa

    2015-01-01

    Does receipt of School Improvement Grants (SIG) funding to implement a school intervention model have an impact on outcomes for low-performing schools? This study answers this question using a regression discontinuity design (RDD) that exploits cutoff values on the continuous variables used to define SIG eligibility tiers, comparing outcomes in…

  10. Hypothesis: selective phosphodiesterase-5 inhibition improves outcome in preeclampsia.

    PubMed

    Downing, J W; Ramasubramanian, R; Johnson, R F; Minzter, B H; Paschall, R L; Sundell, H W; Engelhardt, B; Lewis, R

    2004-01-01

    The pathogenesis of preeclampsia stems from aberrant changes at the placental interface. The trophoblastic endovascular invasion of tonic spiral arteries that converts them to passive conduits falters. Uteroplacental insufficiency and fetoplacental hypoxemia result. Secondary maternal oxidative stress and an excessive inflammatory response to pregnancy generate the clinical syndrome of preeclampsia. Current treatment focuses on preventing seizures, controlling hypertension, preserving renal function and delivering the baby. We propose that the pathophysiological changes induced by preeclampsia in the placenta parallel those caused by persistent hypoxemia in the lungs at high altitude or with chronic obstructive pulmonary disease. Unrelenting pulmonary hypoxic vasoconstriction induces pulmonary hypertension and cor pulmonale. Inhalation of nitric oxide and phosphodiesterase-5 inhibitors opposes pulmonary hypoxic vasoconstriction, alleviates pulmonary hypertension and improves systemic oxygenation. Notably nitric oxide donor therapy also counters hypoxemic fetoplacental vasoconstriction, a biological response analogous to pulmonary hypoxic vasoconstriction. Fetal oxygenation and nutrition improve. Placental upstream resistance to umbilical arterial blood flow decreases. Fetal right ventricular impedance falls. Heart failure (cor placentale) is avoided. Emergency preterm delivery can be postponed. Other than low dose aspirin and antioxidants vitamins C and E no available therapy specifically targets the underlying disease profile. We hypothesize that, like nitric oxide donation, pharmacological inhibition of placental phosphodiesterase-5 will also protect the fetus but for a longer time. Biological availability of guanosine 3'5'-cyclic monophosphate is boosted due to slowed hydrolysis. Adenosine 3'5'-cyclic monphosphate levels increase in parallel. Cyclic nucleotide accumulation dilates intact tonic spiral arteries and counters hypoxemic fetoplacental vasoconstriction

  11. The challenges in improving outcome of cataract surgery in low and middle income countries.

    PubMed

    Lindfield, Robert; Vishwanath, Kalluru; Ngounou, Faustin; Khanna, Rohit C

    2012-01-01

    Cataract is the leading cause of blindness globally and surgery is the only known measure to deal with it effectively. Providing high quality cataract surgical services is critical if patients with cataract are to have their sight restored. A key focus of surgery is the outcome of the procedure. In cataract surgery this is measured predominantly, using visual acuity. Population- and hospital-based studies have revealed that the visual outcome of cataract surgery in many low and middle income settings is frequently sub-optimal, often failing to reach the recommended standards set by the World Health Organization (WHO). Another way of measuring outcome of cataract surgery is to ask patients for their views on whether surgery has changed the functioning of their eyes and their quality of life. There are different tools available to capture patient views and now, these patient-reported outcomes are becoming more widely used. This paper discusses the visual outcome of cataract surgery and frames the outcome of surgery within the context of the surgical service, suggesting that the process and outcome of care cannot be separated. It also discusses the components of patient-reported outcome tools and describes some available tools in more detail. Finally, it describes a hierarchy of challenges that need to be addressed before a high quality cataract surgical service can be achieved. PMID:22944761

  12. Smoking cessation strategies for patients with asthma: improving patient outcomes

    PubMed Central

    Perret, Jennifer L; Bonevski, Billie; McDonald, Christine F; Abramson, Michael J

    2016-01-01

    Smoking is common in adults with asthma, yet a paucity of literature exists on smoking cessation strategies specifically targeting this subgroup. Adverse respiratory effects from personal smoking include worse asthma control and a predisposition to lower lung function and chronic obstructive pulmonary disease. Some data suggest that individuals with asthma are more likely than their non-asthmatic peers to smoke regularly at an earlier age. While quit attempts can be more frequent in smokers with asthma, they are also of shorter duration than in non-asthmatics. Considering these asthma-specific characteristics is important in order to individualize smoking cessation strategies. In particular, asthma-specific information such as “lung age” should be provided and longer-term follow-up is advised. Promising emerging strategies include reminders by cellular phone and web-based interventions using consumer health informatics. For adolescents, training older peers to deliver asthma education is another promising strategy. For smokers who are hospitalized for asthma, inpatient nicotine replacement therapy and counseling are a priority. Overall, improving smoking cessation rates in smokers with asthma may rely on a more personalized approach, with the potential for substantial health benefits to individuals and the population at large. PMID:27445499

  13. Estimates of achievable potential for electricity efficiency improvements in U.S. residences

    SciTech Connect

    Brown, Richard

    1993-05-01

    This paper investigates the potential for public policies to achieve electricity efficiency improvements in US residences. This estimate of achievable potential builds upon a database of energy-efficient technologies developed for a previous study estimating the technical potential for electricity savings. The savings potential and cost for each efficiency measure in the database is modified to reflect the expected results of policies implemented between 1990 and 2010. Factors included in these modifications are: the market penetration of efficiency measures, the costs of administering policies, and adjustments to the technical potential measures to reflect the actual energy savings and cost experienced in the past. When all adjustment factors are considered, this study estimates that policies can achieve approximately 45% of the technical potential savings during the period from 1990 to 2010. Thus, policies can potentially avoid 18% of the annual frozen-efficiency baseline electricity consumption forecast for the year 2010. This study also investigates the uncertainty in best estimate of achievable potential by estimating two alternative scenarios -- a

  14. Optimal delivery of colorectal cancer follow-up care: improving patient outcomes

    PubMed Central

    Jorgensen, Mikaela L; Young, Jane M; Solomon, Michael J

    2015-01-01

    Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. With population aging and increases in survival, the number of CRC survivors is projected to rise dramatically. The time following initial treatment is often described as a period of transition from intensive hospital-based care back into “regular life.” This review provides an overview of recommended follow-up care for people with CRC who have been treated with curative intent, as well as exploring the current state of the research that underpins these guidelines. For patients, key concerns following treatment include the development of recurrent and new cancers, late and long-term effects of cancer and treatment, and the interplay of these factors with daily function and general health. For physicians, survivorship care plans can be a tool for coordinating the surveillance, intervention, and prevention of these key patient concerns. Though much of the research in cancer survivorship to date has focused on surveillance for recurrent disease, many national guidelines differ in their conclusions about the frequency and timing of follow-up tests. Most CRC guidelines refer only briefly to the management of side effects, despite reports that many patients have a range of ongoing physiological, psychosocial, and functional needs. Guidance for surveillance and intervention is often limited by a small number of heterogeneous trials conducted in this patient group. However, recently released survivorship guidelines emphasize the potential for the effectiveness of secondary prevention strategies, such as physical activity, to improve patient outcomes. There is also emerging evidence for the role of primary care providers and nurse coordinated care to support the transition and increase the cost-effectiveness of follow-up. The shift in focus from recurrence alone to the assessment and management of a range of survivorship issues will be important for ensuring that this growing group of

  15. Nursing home-acquired pneumonia: outcomes from a clinical process improvement program.

    PubMed

    Dempsey, C L

    1995-01-01

    At EHS Christ Hospital and Medical Center, an eight-step process improvement model was developed that incorporates continuous quality improvement concepts for monitoring, evaluating and improving patient care. Nursing home residents admitted with pneumonia were identified as the group having the most influence on mortality and costs associated with treatment of pneumonia at our hospital. A multidisciplinary team evaluated clinical resource use and patient care processes, and identified root causes of various influencing treatment. Clinical guidelines were created and outcomes were defined, resulting in significant improvement in the clinical management of these patients. Average length of stay decreased from 8.6 days in 1992 to 7.6 days in 1993, with a charge reduction of $1830 per patient. The methodologic framework of a process improvement program combines epidemiologic, clinical, and quality improvement sciences. This mix is essential in improving patient care and quantifying outcomes. PMID:7753691

  16. The rationale for patient-reported outcomes surveillance in cancer and a reproducible method for achieving it.

    PubMed

    Smith, Tenbroeck G; Castro, Kathleen M; Troeschel, Alyssa N; Arora, Neeraj K; Lipscomb, Joseph; Jones, Shelton M; Treiman, Katherine A; Hobbs, Connie; McCabe, Ryan M; Clauser, Steven B

    2016-02-01

    Patient-reported outcomes (PROs) measure quality of life, symptoms, patient functioning, and patient perceptions of care; they are essential for gaining a full understanding of cancer care and the impact of cancer on people's lives. Repeatedly captured facility-level and/or population-level PROs (PRO surveillance) could play an important role in quality monitoring and improvement, benchmarking, advocacy, policy making, and research. This article describes the rationale for PRO surveillance and the methods of the Patient Reported Outcomes Symptoms and Side Effects Study (PROSSES), which is the first PRO study to use the American College of Surgeons Commission on Cancer's Rapid Quality Reporting System to identify patients and manage study data flow. The American Cancer Society, the National Cancer Institute, the Commission on Cancer, and RTI International collaborated on PROSSES. PROSSES was conducted at 17 cancer programs that participated in the National Cancer Institute Community Cancer Centers Program among patients diagnosed with locoregional breast or colon cancer. The methods piloted in PROSSES were successful as demonstrated by high eligibility (93%) and response (61%) rates. Differences in clinical and demographic characteristics between respondents and nonrespondents were mostly negligible, with the exception that non-white individuals were somewhat less likely to respond. These methods were consistent across cancer centers and reproducible over time. If repeated and expanded, they could provide PRO surveillance data from patients with cancer on a national scale. PMID:26619031

  17. Using Outcome to Improve a Career Development Course: Closing the Scientist-Practitioner Gap

    ERIC Educational Resources Information Center

    Reese, Robert J.; Miller, Charles D.

    2010-01-01

    The use of outcome data can serve as an important catalyst for improving career interventions. A follow-up to the Reese and Miller study was conducted over a 2-year period to assess whether modifications made to the course using the Reese and Miller data as a baseline resulted in subsequent improvements. Using a prepost group design that compared…

  18. A Measurement Feedback System (MFS) Is Necessary to Improve Mental Health Outcomes

    ERIC Educational Resources Information Center

    Bickman, Leonard

    2008-01-01

    The importance of measurement feedback system (MFS) for the improvement of mental health services for youths is discussed. As feedback obtained from clients and families is subject to distortions, a standardized MFS including clinical processes, contexts, outcomes, and feedback to clinicians and supervisors is necessary for improvement in quality…

  19. Identifying patients at high risk of breast cancer recurrence: strategies to improve patient outcomes

    PubMed Central

    Martei, Yehoda M; Matro, Jennifer M

    2015-01-01

    Identifying patients at high risk of breast cancer recurrence has important implications not only for enabling the ability to provide accurate information to patients but also the potential to improve patient outcomes. Patients at high recurrence risk can be offered appropriate treatment to improve the overall survival. However, the major challenge is identifying patients with early-stage breast cancer at lower risk who may be spared potentially toxic therapy. The successful integration of molecular assays into clinical practice may address the problem of overtreatment and improve overall patient outcomes. PMID:26504408

  20. Platlet Rich Plasma (PRP) Improves Fat Grafting Outcomes.

    PubMed

    Modarressi, Ali

    2013-01-01

    Autologous fat transfer offers many qualities of a ideal soft tissue filler. Main advantages of fat grafting ensue from the fact that the lipoaspirate tissue is an abundant source of regenerative pluripotential cells. However, the reported rates of fat cell survival vary greatly in the medical literature (10-90%). Different techniques of harvesting, processing, and reinjecting the fat cells are so claimed to be responsible for these differences, without any agreement concerning the best way to process. To address this important disadvantage, we propose the addition of autologous platelet rich plasma (PRP) which is known as a natural reservoir of growth factors stimulating tissue repair and regeneration. This approach is completely autologous and immediately employed without any type of preconditioning. Platelets rich plasma (PRP) preparation included bleeding of 8 ml of blood from patient's peripheral vein in Regen Lab© tubes containing sodium citrate anticoagulant. The whole blood was centrifugated at 1500 g during 3 min. As Regen-tubes contained a special gel separator, 99 % of red blood cells were discarded from the plasma at the bottom of the gel, and >90% of platelets were harvested in 4 ml of plasma on the top of the gel, called the platelet-rich plasma (PRP). The purified fat prepared by Coleman technique was mixed with different amount of PRP for in vitro, in vivo (mice) and clinical experiments: >50% of PRP for skin rejuvenation, superficial scars correction, infraorbital region, ..., and for 20% of PRP with 80% of purified fat for deep filler indication (nasolabial folds, lips, or soft tissue defect). In vitro studies demonstrated that PRP increased fat cells survival rate and stem cells differentiation. Animal models showed that fat graft survival rate was significantly increased by addition of PRP. Several clinical cases confirmed the improvement of wound healing and fat grafting survival in facial reconstruction and aesthetic cases by association of

  1. Platlet Rich Plasma (PRP) Improves Fat Grafting Outcomes

    PubMed Central

    Modarressi, Ali

    2013-01-01

    Autologous fat transfer offers many qualities of a ideal soft tissue filler. Main advantages of fat grafting ensue from the fact that the lipoaspirate tissue is an abundant source of regenerative pluripotential cells. However, the reported rates of fat cell survival vary greatly in the medical literature (10-90%). Different techniques of harvesting, processing, and reinjecting the fat cells are so claimed to be responsible for these differences, without any agreement concerning the best way to process. To address this important disadvantage, we propose the addition of autologous platelet rich plasma (PRP) which is known as a natural reservoir of growth factors stimulating tissue repair and regeneration. This approach is completely autologous and immediately employed without any type of preconditioning. Platelets rich plasma (PRP) preparation included bleeding of 8 ml of blood from patient’s peripheral vein in Regen Lab© tubes containing sodium citrate anticoagulant. The whole blood was centrifugated at 1500 g during 3 min. As Regen-tubes contained a special gel separator, 99 % of red blood cells were discarded from the plasma at the bottom of the gel, and >90% of platelets were harvested in 4 ml of plasma on the top of the gel, called the platelet-rich plasma (PRP). The purified fat prepared by Coleman technique was mixed with different amount of PRP for in vitro, in vivo (mice) and clinical experiments: >50% of PRP for skin rejuvenation, superficial scars correction, infraorbital region, ..., and for 20% of PRP with 80% of purified fat for deep filler indication (nasolabial folds, lips, or soft tissue defect). In vitro studies demonstrated that PRP increased fat cells survival rate and stem cells differentiation. Animal models showed that fat graft survival rate was significantly increased by addition of PRP. Several clinical cases confirmed the improvement of wound healing and fat grafting survival in facial reconstruction and aesthetic cases by association of

  2. Enhanced Physical Activity Improves Selected Outcomes in Children With ADHD: Systematic Review.

    PubMed

    Song, MinKyoung; Lauseng, Deborah; Lee, Soohee; Nordstrom, Megan; Katch, Victor

    2016-09-01

    This review examines associations between physical activity (PA) and cognitive, behavioral, and physiological outcomes in children with attention-deficit/hyperactivity disorder (ADHD). We reviewed studies on participants ≤18 years old, published in English between January 1998 and December 2014, in PubMed, CINAHL, PsycINFO, and Cochrane Reviews. Twenty-six studies were grouped into two categories: those that did and did not account for effects of ADHD medications. The first category showed lower levels of PA and improved cognitive and behavioral outcomes in youth whose ADHD was treated with medications. The second category showed a positive association between PA levels and cognitive and behavioral outcomes in youth whose ADHD was not treated with medications. For both categories of studies, results were inconclusive regarding physiological outcomes. Randomized controlled trials are needed to better clarify the relationship between PA and outcomes in youth with ADHD, and particularly to understand the impact of ADHD medications on that relationship. PMID:27226208

  3. Visual working memory in deaf children with diverse communication modes: improvement by differential outcomes.

    PubMed

    López-Crespo, Ginesa; Daza, María Teresa; Méndez-López, Magdalena

    2012-01-01

    Although visual functions have been proposed to be enhanced in deaf individuals, empirical studies have not yet established clear evidence on this issue. The present study aimed to determine whether deaf children with diverse communication modes had superior visual memory and whether their performance was improved by the use of differential outcomes. Severely or profoundly deaf children who employed spoken Spanish, Spanish Sign Language (SSL), and both spoken Spanish and SSL modes of communication were tested in a delayed matching-to-sample task for visual working memory assessment. Hearing controls were used to compare performance. Participants were tested in two conditions, differential outcome and non-differential outcome conditions. Deaf groups with either oral or SSL modes of communication completed the task with less accuracy than bilingual and control hearing children. In addition, the performances of all groups improved through the use of differential outcomes. PMID:22119682

  4. Improving post-intensive care unit neuropsychiatric outcomes: understanding cognitive effects of physical activity.

    PubMed

    Hopkins, Ramona O; Suchyta, Mary R; Farrer, Thomas J; Needham, Dale

    2012-12-15

    Critical illness and its treatment often result in long-term neuropsychiatric morbidities. Consequently, there is a need to focus on means to prevent or ameliorate these morbidities. Animal models provide important data regarding the neurobiological effects of physical activity, including angiogenesis, neurogenesis, and release of neurotrophic factors that enhance plasticity. Studies in noncritically ill patients demonstrate that exercise is associated with increased cerebral blood flow, neurogenesis, and brain volume, which are associated with improved cognition. Clinically, research in both healthy and diseased human subjects suggests that exercise improves neuropsychiatric outcomes. In the critical care setting, early physical rehabilitation and mobilization are safe and feasible, with demonstrated improvements in physical functional outcomes. Such activity may also reduce the duration of delirium in the intensive care unit (ICU) and improve neuropsychiatric outcomes, although data are limited. Barriers exist regarding implementing ICU rehabilitation in routine care, including use of sedatives and lack of awareness of post-ICU cognitive impairments. Further research is necessary to determine whether prior animal and human research, in conjunction with preliminary results from existing ICU studies, can translate into improvements for neuropsychiatric outcomes in critically ill patients. Studies are needed to evaluate biological mechanisms, risk factors, the role of pre-ICU functional level, and the timing, duration, and type of physical activity for optimal patient outcomes. PMID:23065013

  5. Could training executive function improve treatment outcomes for eating disorders?☆

    PubMed Central

    Juarascio, Adrienne S.; Manasse, Stephanie M.; Espel, Hallie M.; Kerrigan, Stephanie G.; Forman, Evan M.

    2016-01-01

    Current gold standard treatments for eating disorders (EDs) lack satisfactory efficacy, and traditional psychological treatments do not directly address executive functioning deficits underpinning ED pathology. The goal of this paper is to explore the potential for enhancing ED treatment outcomes by improving executive functioning deficits that have been demonstrated to underlie eating pathology. To achieve our objective, we (1) review existing evidence for executive functioning deficits that underpin EDs and consider the extent to which these deficits could be targeted in neurocognitive training programs, (2) present the evidence for the one ED neurocognitive training program well-studied to date (Cognitive Remediation Therapy), (3) discuss the utility of neurocognitive training programs that have been developed for other psychiatric disorders with similar deficits, and (4) provide suggestions for the future development and research of neurocognitive training programs for EDs. Despite the fact that the body of empirical work on neurocognitive training programs for eating disorders is very small, we conclude that their potential is high given the combined evidence for the role of deficits in executive functioning in EDs, the initial promise of Cognitive Remediation Training, and the success in treating related conditions with neurocognitive training. Based on the evidence to date, it appears that the development and empirical evaluation of neurocognitive training programs for EDs is warranted. PMID:25777264

  6. Modified surface loading process for achieving improved performance of the quantum dot-sensitized solar cells

    NASA Astrophysics Data System (ADS)

    Liu, Feng; Jin, Zhongxiu; Zhu, Jun; Xu, Yafeng; Zhou, Li; Dai, Songyuan

    2016-06-01

    Achieving high surface coverage of the colloidal quantum dots (QDs) on TiO2 films has been challenging for quantum dot-sensitized solar cells (QDSCs). Herein, a general surface engineering approach was proposed to increase the loading of these QDs. It was found that S2- treatment/QD re-uptake process can significantly improve the attachment of the QDs on TiO2 films. Surface concentration of the QDs was improved by ∼60%, which in turn greatly enhances light absorption and decreases carrier recombination in QDSCs. Ensuing QDSCs with optimized QD loading exhibit a power conversion efficiency of 3.66%, 83% higher than those fabricated with standard procedures.

  7. US objectives generally achieved at broadcasting satellite international conference. Improvements can help in future conferences

    NASA Astrophysics Data System (ADS)

    1984-08-01

    The implementation of broadcasting satellite service for the Western Hemisphere was planned. Broadcasting satellites transmit television programs and other information services from Earth orbit to home or office antennas. At the request of the Senate Appropriations Subcommittee on Commerce, Justice, State and the Judiciary, GAO reviewed conference results as compared to established conference objectives and examined the interagency coordination of U.S. participation in this international conference. The United States basically achieved its two most important conference objectives: adopting a technically and procedurally flexible plan for broadcasting satellite service and obtaining a sufficient allocation of satellite orbit slots and frequencies to meet domestic needs. The U.S. was unable, however, to obtain agreement on adopting a maximum signal power level for satellites. The Department of State could improve its preparation, internal coordination, and administrative support for future international conferences and recommends actions to the Secretary of State to improve its international telecommunications activities.

  8. Improving outcomes in lung cancer: the value of the multidisciplinary health care team

    PubMed Central

    Denton, Eve; Conron, Matthew

    2016-01-01

    Lung cancer is a major worldwide health burden, with high disease-related morbidity and mortality. Unlike other major cancers, there has been little improvement in lung cancer outcomes over the past few decades, and survival remains disturbingly low. Multidisciplinary care is the cornerstone of lung cancer treatment in the developed world, despite a relative lack of evidence that this model of care improves outcomes. In this article, the available literature concerning the impact of multidisciplinary care on key measures of lung cancer outcomes is reviewed. This includes the limited observational data supporting improved survival with multidisciplinary care. The impact of multidisciplinary care on other benchmark measures of quality lung cancer treatment is also examined, including staging accuracy, access to diagnostic investigations, improvements in clinical decision making, better utilization of radiotherapy and palliative care services, and improved quality of life for patients. Health service research suggests that multidisciplinary care improves care coordination, leading to a better patient experience, and reduces variation in care, a problem in lung cancer management that has been identified worldwide. Furthermore, evidence suggests that the multidisciplinary model of care overcomes barriers to treatment, promotes standardized treatment through adherence to guidelines, and allows audit of clinical services and for these reasons is more likely to provide quality care for lung cancer patients. While there is strengthening evidence suggesting that the multidisciplinary model of care contributes to improvements in lung cancer outcomes, more quality studies are needed. PMID:27099511

  9. Leveraging Improvements in Precipitation Measuring from GPM Mission to Achieve Prediction Improvements in Climate, Weather and Hydrometeorology

    NASA Technical Reports Server (NTRS)

    Smith, Eric A.

    2002-01-01

    The main scientific goal of the GPM mission, currently planned for start in the 2007 time frame, is to investigate important scientific problems arising within the context of global and regional water cycles. These problems cut across a hierarchy of scales and include climate-water cycle interactions, techniques for improving weather and climate predictions, and better methods for combining observed precipitation with hydrometeorological prediction models for applications to hazardous flood-producing storms, seasonal flood/draught conditions, and fresh water resource assessments. The GPM mission will expand the scope of precipitation measurement through the use of a constellation of some 9 satellites, one of which will be an advanced TRMM-like "core" satellite carrying a dual-frequency Ku-Ka band precipitation radar and an advanced, multifrequency passive microwave radiometer with vertical-horizontal polarization discrimination. The other constellation members will include new dedicated satellites and co-existing Operational/research satellites carrying similar (but not identical) passive microwave radiometers. The goal of the constellation is to achieve approximately 3-hour sampling at any spot on the globe. The constellation's orbit architecture will consist of a mix of sun-synchronous and non-sun-synchronous satellites with the core satellite providing measurements of cloud-precipitation microphysical processes plus calibration-quality rainrate retrievals to be used with the other retrieval information to ensure bias-free constellation coverage. GPM is organized internationally, currently involving a partnership between NASA in the US and the National Space Development Agency in Japan. Additionally, the program is actively pursuing agreements with other international partners and domestic scientific agencies and institutions, as well as participation by individual scientists from academia, government, and the private sector to fulfill mission goals and to pave

  10. Long-term outcomes of patients with advanced hepatocellular carcinoma who achieved complete remission after sorafenib therapy

    PubMed Central

    2015-01-01

    Background/Aims Sorafenib is currently the sole molecular targeted agent that improves overall survival in advanced hepatocellular carcinoma (HCC). Despite the efficacy of sorafenib, the response rate varies in patients with advanced HCC. We retrospectively analyzed a series of Korean patients with advanced HCC with complete remission (CR) after sorafenib therapy. Methods In total, 523 patients with advanced HCC were treated with sorafenib in 3 large tertiary referral hospitals in Korea. A survey was conducted to collect data on patients who experienced CR after sorafenib monotherapy, and their medical records and follow-up data were analyzed. The tumor response and recurrence rates were assessed by radiologic study, based on modified response evaluation criteria in solid tumors. Results Seven patients with advanced HCC experienced CR after sorafenib therapy. The median time to tumor disappearance and the median disease-free survival time were 3 months and 9 months, respectively. HCC recurrence was identified in three cases (42.9%). Of these, two patients discontinued sorafenib before or after achieving CR and the other patient continued sorafenib after achieving CR. HCC recurred at 3, 10, and 42 months after CR in these three patients. Three patients needed dose reduction for toxicity and adverse events. Conclusions Though CR was achieved after sorafenib therapy in patients with advanced HCC, the recurrence rate was relatively high. Subsequent strategies to reduce a chance of recurrence after sorafenib therapy are required to investigate. PMID:26527250

  11. Improved outcome of pediatric patients with acute megakaryoblastic leukemia in the AML-BFM 04 trial.

    PubMed

    Schweitzer, Jana; Zimmermann, Martin; Rasche, Mareike; von Neuhoff, Christine; Creutzig, Ursula; Dworzak, Michael; Reinhardt, Dirk; Klusmann, Jan-Henning

    2015-08-01

    Despite recent advances in the treatment of children with acute megakaryoblastic leukemia (AMKL) using intensified treatment protocols, clear prognostic indicators, and treatment recommendations for this acute myeloid leukemia (AML) subgroup are yet to be defined. Here, we report the outcome of 97 pediatric patients with de novo AMKL (excluding Down syndrome [DS]) enrolled in the prospective multicenter studies AML-BFM 98 and AML-BFM 04 (1998-2014). AMKL occurred in 7.4 % of pediatric AML cases, at younger age (median 1.44 years) and with lower white blood cell count (mean 16.5 × 10(9)/L) as compared to other AML subgroups. With 60 ± 5 %, children with AMKL had a lower 5-year overall survival (5-year OS; vs. 68 ± 1 %, P log rank = 0.038). Yet, we achieved an improved 5-year OS in AML-BFM 04 compared to AML-BFM 98 (70 ± 6 % vs. 45 ± 8 %, P log rank = 0.041). Allogeneic hematopoietic stem cell transplantation in first remission did not provide a significant survival benefit (5-year OS 70 ± 11 % vs. 63 ± 6 %; P Mantel-Byar = 0.85). Cytogenetic data were available for n = 78 patients. AMKL patients with gain of chromosome 21 had a superior 5-year OS (80 ± 9 %, P log rank = 0.034), whereas translocation t(1;22)(p13;q13) was associated with an inferior 5-year event-free survival (38 ± 17 %, P log rank = 0.04). However, multivariate analysis showed that treatment response (bone marrow morphology on day 15 and 28) was the only independent prognostic marker (RR = 4.39; 95 % CI, 1.97-9.78). Interestingly, GATA1-mutations were detected in six patients (11 %) without previously known trisomy 21. Thus, AMKL (excluding DS) remains an AML subgroup with inferior outcome. Nevertheless, with intensive therapy regimens, a steep increase in the survival rates was achieved. PMID:25913479

  12. The role of expectations in patients' reports of post-operative outcomes and improvement following therapy.

    PubMed

    Flood, A B; Lorence, D P; Ding, J; McPherson, K; Black, N A

    1993-11-01

    Outcomes research typically focuses on the technical capabilities associated with treatment that predicts patients' post-therapy outcomes adjusting for health-related factors. Research on the ability of placebo therapy to alter outcomes suggests that a patient's expectations about therapy can also influence outcomes. Few studies have examined the effects of expectations and their implications for assessing outcomes. This study followed 348 patients who had surgery for benign prostatic hyperplasia. Four hypotheses are tested: whether positive expectations about improvement influence: 1) patients' postoperative reports of symptoms; 2) their belief that they have improved; 3) their overall health after treatment; and 4) whether these effects persist during the year following treatment. Using step-wise regression to control for sociodemographic and clinical factors, we found positive expectations did not appear to strongly influence a patient's report of postoperative symptoms or their overall health. However, we found strong support for positive expectations increasing the likelihood of reporting they felt better after surgery, even after controlling for symptom changes. This effect persisted throughout the postoperative year. We conclude that positive expectations result in a more optimistic view of improvement after surgery rather than altering reports of outcomes or health. PMID:7694013

  13. A physical education trial improves adolescents' cognitive performance and academic achievement: the EDUFIT study.

    PubMed

    Ardoy, D N; Fernández-Rodríguez, J M; Jiménez-Pavón, D; Castillo, R; Ruiz, J R; Ortega, F B

    2014-02-01

    To analyze the effects of an intervention focused on increasing the time and intensity of Physical Education (PE), on adolescents' cognitive performance and academic achievement. A 4-month group-randomized controlled trial was conducted in 67 adolescents from South-East Spain, 2007. Three classes were randomly allocated into control group (CG), experimental group 1 (EG1) and experimental group 2 (EG2). CG received usual PE (two sessions/week), EG1 received four PE sessions/week and EG2 received four PE sessions/week of high intensity. Cognitive performance (non-verbal and verbal ability, abstract reasoning, spatial ability, verbal reasoning and numerical ability) was assessed by the Spanish Overall and Factorial Intelligence Test, and academic achievement by school grades. All the cognitive performance variables, except verbal reasoning, increased more in EG2 than in CG (all P < 0.05). Average school grades (e.g., mathematics) increased more in EG2 than in CG. Overall, EG2 improved more than EG1, without differences between EG1 and CG. Increased PE can benefit cognitive performance and academic achievement. This study contributes to the current knowledge by suggesting that the intensity of PE sessions might play a role in the positive effect of physical activity on cognition and academic success. Future studies involving larger sample sizes should confirm or contrast these preliminary findings. PMID:23826633

  14. Improving lung cancer outcomes by improving the quality of surgical care

    PubMed Central

    2015-01-01

    Surgical resection remains the most important curative treatment modality for non-small cell lung cancer, but variations in short- and long-term surgical outcomes jeopardize the benefit of surgery for certain patients, operated on by certain types of surgeons, at certain types of institutions. We discuss current understanding of surgical quality measures, and their role in promoting understanding of the causes of outcome disparities after lung cancer surgery. We also discuss the use of minimally invasive surgical resection approaches to expand the playing field for surgery in lung cancer care, and end with a discussion of the future role of surgery in a world of alternative treatment possibilities. PMID:26380183

  15. Employee Perceptions of Progress with Implementing a Student-Centered Model of Institutional Improvement: An Achieving the Dream Case Study

    ERIC Educational Resources Information Center

    Cheek, Annesa LeShawn

    2011-01-01

    Achieving the Dream is a national initiative focused on helping more community college students succeed, particularly students of color and low-income students. Achieving the Dream's student-centered model of institutional improvement focuses on eliminating gaps and raising student achievement by helping institutions build a culture of evidence…

  16. From Guide to Practice: Improving Your After School Science Program to Increase Student Academic Achievement

    NASA Astrophysics Data System (ADS)

    Taylor, J.

    2013-12-01

    Numerous science organizations, such as NASA, offer educational outreach activities geared towards after school. For some programs, the primary goal is to grow students' love of science. For others, the programs are also intended to increase academic achievement. For those programs looking to support student learning in out-of-school time environments, aligning the program with learning during the classroom day can be a challenge. The Institute for Education Sciences, What Works Clearinghouse, put together a 'Practice Guide' for maximizing learning time beyond the regular school day. These practice guides provide concrete recommendations for educators supported by research. While this guide is not specific to any content or subject-area, the recommendations provided align very well with science education. After school science is often viewed as a fun, dynamic environment for students. Indeed, one of the recommendations to ensure time is structured according to students' needs is to provide relevant and interesting experiences. Given that our after school programs provide such creative environments for students, what other components are needed to promote increased academic achievement? The recommendations provided to academic achievement, include: 1. Align Instruction, 2. Maximize Attendance and Participation, 3. Adapt Instruction, 4. Provide Engaging Experiences, and 5. Evaluate Program. In this session we will examine these five recommendations presented in the Practice Guide, discuss how these strategies align with science programs, and examine what questions each program should address in order to provide experiences that lend themselves to maximizing instruction. Roadblocks and solutions for overcoming challenges in each of the five areas will be presented. Jessica Taylor will present this research based on her role as an author on the Practice Guide, 'Improving Academic Achievement in Out-of-School Time' and her experience working in various informal science

  17. The improving outcomes in intermittent exotropia study: outcomes at 2 years after diagnosis in an observational cohort

    PubMed Central

    2012-01-01

    Background The purpose of this study was to investigate current patterns of management and outcomes of intermittent distance exotropia [X(T)] in the UK. Methods This was an observational cohort study which recruited 460 children aged < 12 years with previously untreated X(T). Eligible subjects were enrolled from 26 UK hospital ophthalmology clinics between May 2005 and December 2006. Over a 2-year period of follow-up, clinical data were prospectively recorded at standard intervals from enrolment. Data collected included angle, near stereoacuity, visual acuity, control of X(T) measured with the Newcastle Control Score (NCS), and treatment. The main outcome measures were change in clinical outcomes (angle, stereoacuity, visual acuity and NCS) in treated and untreated X(T), 2 years from enrolment (or, where applicable, 6 months after surgery). Change over time was tested using the chi-square test for categorical, Wilcoxon test for non-parametric and paired-samples t-test for parametric data. Results At follow-up, data were available for 371 children (81% of the original cohort). Of these: 53% (195) had no treatment; 17% (63) had treatment for reduced visual acuity only (pure refractive error and amblyopia); 13% (50) had non surgical treatment for control (spectacle lenses, occlusion, prisms, exercises) and 17% (63) had surgery. Only 0.5% (2/371) children developed constant exotropia. The surgically treated group was the only group with clinically significant improvements in angle or NCS. However, 8% (5) of those treated surgically required second procedures for overcorrection within 6 months of the initial procedure and at 6-month follow-up 21% (13) were overcorrected. Conclusions Many children in the UK with X(T) receive active monitoring only. Deterioration to constant exotropia, with or without treatment, is rare. Surgery appears effective in improving angle of X(T) and NCS, but rates of overcorrection are high. PMID:22257496

  18. Enduring improvement in Oswestry Disability Index outcomes following lumbar microscopic interlaminar decompression: An appraisal of prospectively collected patient outcomes

    PubMed Central

    Khan, Muhammad Babar; Bashir, Muhammad Umair; Kumar, Rajesh; Enam, Syed Ather

    2015-01-01

    Objectives: Our present study aims to assess the short and long-term postoperative outcome of microscopic interlaminar decompression from a neurosurgical center in a developing country and also aims to further determine any predictors of functional outcome. Materials and Methods: All patients with moderate to severe symptomatic stenosis undergoing elective posterior lumbar spinal decompression were prospectively enrolled in a database. Preoperative, 2 weeks and 2 years postoperative Oswestry Disability Index (ODI) scores were determined for all patients. These scores were retrospectively compared using repeated measures analysis of variance. Further, linear regression modelling was applied to determine the effect of preoperative ODI, body mass index, age, prior physiotherapy, duration of symptoms, and single or multiple level decompression on the change in ODI at 2 weeks and 2 years follow-up respectively. Results: A total of 60 consecutive patients (40 males, 20 females) were included for statistical analysis. The percentage of patients with a minimum clinically important difference (MCID), using an ODI threshold value of 10, was 86.7% (n = 52) at the 2 weeks postoperative follow-up. At the 2 years follow-up assessment, 3.3% (n = 2) patients who had earlier not achieved MCID did so, 78.3% (n = 47) of patients were found to have a change in ODI score of <10 or no change, while 18.3% (n = 11) reported a deterioration in their ODI scores. The preoperative ODI score was an independent predictor of change in ODI score at 2 weeks and 2 years respectively (P < 0.0005). The duration of symptoms prior to surgery was found to predict the change in ODI at 2 years follow-up (P = 0.04). Conclusion: The evidence regarding the long-term and short-term efficacy of microscopic interlaminar decompression in symptomatic lumbar stenosis is overwhelming. Preoperative ODI scores and duration of symptoms prior to surgery can predict postoperative outcomes. PMID:26692698

  19. Prospective monitoring improves outcomes of primary total hip replacement: a cohort study

    PubMed Central

    Streubel, Philipp N; Pachón, Marcela; Kerguelén, Carlos A; Navas, José; Portocarrero, Julio; Pesantez, Rodrigo F; Zayed, Gamal; Carrillo, Germán; Llinás, Adolfo M

    2009-01-01

    Background Over the past decade several studies have questioned current standards of patient safety in health care delivery. In response, our institution started a clinical pathway for total hip replacement in 1996. Prospective monitoring with regular feedback sessions to the individuals involved in patient care did however not start until 2003. The present study evaluates the effect of prospective monitoring on outcomes of total hip replacement. Methods Clinical records of patients undergoing primary elective total hip replacement between 1997 and 2004 were reviewed. Data on adverse events as well as adherence to protocols for venous thromboembolism prophylaxis were extracted retrospectively for the period 1997 to 2001 and prospectively from 2003 to 2004. Results were compared and analyzed in order to establish possible improvement in outcomes. Data was analyzed with Chi-square or Fisher's Exact test for categorical variables and Student's t-test for continuous variables. Alpha was set as less than 5% and analysis was performed with Stata 9.0 for Macintosh. Results Two-hundred and eighty-three patients were included from 1997 to 2001, and 62 from 2003 to 2004. Mean age, male to female ratio and initial diagnosis were similar in both groups. At least one adverse event occurred in 45% of patients in 1997–2001 and in 21% in 2003–2004 (p < 0.001). In-hospital hip dislocations occurred in 6% and 0% (p = 0.05), oliguria in 19% and 5% (p = 0.007), SSI and VTE in 3% and 0% (p = 0.37), adverse drug reactions in 11% and 13% (p = 0.66) and non-adherence to VTE prophylaxis protocols in 15% and 2% of cases respectively (p = 0.002). Conclusion Overall rate of adverse events as well as in-hospital hip dislocations, oliguria and non-adherence to VTE prophylaxis protocols were significantly reduced during the second period. We conclude that clinical pathways alone are insufficient to improve patient safety and require prospective monitoring and continuous feedback to health

  20. Improved outcomes for elderly patients who received care on a transitional care unit

    PubMed Central

    Manville, Margaret; Klein, Michael C.; Bainbridge, Lesley

    2014-01-01

    Abstract Objective To determine whether providing elderly alternate level of care (ALC) patients with interdisciplinary care on a transitional care unit (TCU) achieves better clinical outcomes and lowers costs compared with providing them with standard hospital care. Design Before-and-after structured retrospective chart audit. Setting St Joseph’s Hospital in Comox, BC. Participants One hundred thirty-five consecutively admitted patients aged 70 years and older with ALC designation during 5-month periods before (n = 49) and after (n = 86) the opening of an on-site TCU. Main outcome measures Length of stay, discharge disposition, complications of the acute and ALC portions of the patients’ hospital stays, activities of daily living (mobility, transfers, and urinary continence), psychotropic medications and vitamin D prescriptions, and ALC patient care costs, as well as annual hospital savings, were examined. Results Among the 86 ALC patients receiving care during the postintervention period, 57 (66%) were admitted to the TCU; 29 of the 86 (34%) patients in the postintervention group received standard care (SC). All 86 ALC patients in the postintervention group were compared with the 49 preintervention ALC patients who received SC. Length of stay reduction occurred among the postintervention group during the acute portion of the hospital stay (14.0 days postintervention group vs 22.5 days preintervention group; P < .01). Discharge home or to an assisted-living facility increased among the postintervention group (30% postintervention group vs 12% preintervention group; P < .01). Patients’ ability to transfer improved among the postintervention group (55% postintervention group vs 14% preintervention group; P < .01). At discharge, 48% of ALC patients in the postintervention group were able to transfer independently compared with 17% of ALC patients in the preintervention group. Hospital-acquired infections among the postintervention group decreased during the

  1. Breast Reconstruction Using Contour Fenestrated AlloDerm: Does Improvement in Design Translate to Improved Outcomes?

    PubMed Central

    Frey, Jordan D.; Alperovich, Michael; Weichman, Katie E.; Wilson, Stelios C.; Hazen, Alexes; Saadeh, Pierre B.; Levine, Jamie P.; Choi, Mihye

    2015-01-01

    Background: Acellular dermal matrices are used in implant-based breast reconstruction. The introduction of contour fenestrated AlloDerm (Life-Cell, Branchburg, N.J.) offers sterile processing, a crescent shape, and prefabricated fenestrations. However, any evidence comparing reconstructive outcomes between this newer generation acellular dermal matrices and earlier versions is lacking. Methods: Patients undergoing implant-based breast reconstruction from 2010 to 2014 were identified. Reconstructive outcomes were stratified by 4 types of implant coverage: aseptic AlloDerm, sterile “ready-to-use” AlloDerm, contour fenestrated AlloDerm, or total submuscular coverage. Outcomes were compared with significance set at P < 0.05. Results: A total of 620 patients (1019 reconstructions) underwent immediate, implant-based breast reconstruction; patients with contour fenestrated AlloDerm were more likely to have nipple-sparing mastectomy (P = 0.0001, 0.0004, and 0.0001) and immediate permanent implant reconstructions (P = 0.0001). Those with contour fenestrated AlloDerm coverage had lower infection rates requiring oral (P = 0.0016) and intravenous antibiotics (P = 0.0012) compared with aseptic AlloDerm coverage. Compared with sterile “ready-to-use” AlloDerm coverage, those with contour fenestrated AlloDerm had similar infection outcomes but significantly more minor mastectomy flap necrosis (P = 0.0023). Compared with total submuscular coverage, those with contour fenestrated AlloDerm coverage had similar infection outcomes but significantly more explantations (P = 0.0001), major (P = 0.0130) and minor mastectomy flap necrosis (P = 0.0001). Significant independent risk factors for increased infection were also identified. Conclusions: Contour fenestrated AlloDerm reduces infections compared with aseptic AlloDerm, but infection rates are similar to those of sterile, ready-to-use AlloDerm and total submuscular coverage. PMID:26495218

  2. The RAISE Connection Program for Early Psychosis: Secondary Outcomes and Mediators and Moderators of Improvement

    PubMed Central

    Marino, Leslie; Nossel, Ilana; Choi, Jean C.; Nuechterlein, Keith; Wang, Yuanjia; Essock, Susan; Bennett, Melanie; McNamara, Karen; Mendon, Sapna; Dixon, Lisa

    2015-01-01

    The aims of this study were to explore secondary outcomes of a coordinated specialty care program for persons with early psychosis, including quality of life and recovery, as well as to explore mediators and moderators of improvement in occupational and social functioning and symptoms. Sixty-five individuals across two sites were enrolled and received services for up to two years. Trajectories for individuals’ outcomes, over time were examined using linear and quadratic mixed-effects models with repeated measures. In addition, baseline prognostic factors of participant improvement in social and occupational functioning were explored based on previous literature and expert opinion of the analytic team. Results demonstrate that the program was effective in improving quality of life and recovery, over time. Furthermore, processing speed was identified as a significant moderator of improvement in occupational GAF, and treatment fidelity, engagement, and family involvement were identified as mediators of improvement in social and occupational functioning. PMID:25900546

  3. Improving educational achievement and anaemia of school children: design of a cluster randomised trial of school-based malaria prevention and enhanced literacy instruction in Kenya

    PubMed Central

    2010-01-01

    Background Improving the health of school-aged children can yield substantial benefits for cognitive development and educational achievement. However, there is limited experimental evidence on the benefits of school-based malaria prevention or how health interventions interact with other efforts to improve education quality. This study aims to evaluate the impact of school-based malaria prevention and enhanced literacy instruction on the health and educational achievement of school children in Kenya. Design A factorial, cluster randomised trial is being implemented in 101 government primary schools on the coast of Kenya. The interventions are (i) intermittent screening and treatment of malaria in schools by public health workers and (ii) training workshops and support for teachers to promote explicit and systematic literacy instruction. Schools are randomised to one of four groups: receiving either (i) the malaria intervention alone; (ii) the literacy intervention alone; (iii) both interventions combined; or (iv) control group where neither intervention is implemented. Children from classes 1 and 5 are randomly selected and followed up for 24 months. The primary outcomes are educational achievement and anaemia, the hypothesised mediating variables through which education is affected. Secondary outcomes include malaria parasitaemia, school attendance and school performance. A nested process evaluation, using semi-structured interviews, focus group discussion and a stakeholder analysis will investigate the community acceptability, feasibility and cost-effectiveness of the interventions. Discussion Across Africa, governments are committed to improve health and education of school-aged children, but seek clear policy and technical guidance as to the optimal approach to address malaria and improved literacy. This evaluation will be one of the first to simultaneously evaluate the impact of health and education interventions in the improvement of educational achievement

  4. Health Care Improvement and Continuing Interprofessional Education: Continuing Interprofessional Development to Improve Patient Outcomes

    ERIC Educational Resources Information Center

    Wilcock, Peter M.; Janes, Gillian; Chambers, Alison

    2009-01-01

    Health care improvement and continuing professional education must be better understood if we are to promote continuous service improvement through interprofessional learning in the workplace. We propose that situating interprofessional working, interprofessional learning, work-based learning, and service improvement within a framework of social…

  5. Differential outcomes training improves face recognition memory in children and in adults with Down syndrome.

    PubMed

    Esteban, Laura; Plaza, Victoria; López-Crespo, Ginesa; Vivas, Ana B; Estévez, Angeles F

    2014-06-01

    Previous studies have demonstrated that the differential outcomes procedure (DOP), which involves paring a unique reward with a specific stimulus, enhances discriminative learning and memory performance in several populations. The present study aimed to further investigate whether this procedure would improve face recognition memory in 5- and 7-year-old children (Experiment 1) and adults with Down syndrome (Experiment 2). In a delayed matching-to-sample task, participants had to select the previously shown face (sample stimulus) among six alternatives faces (comparison stimuli) in four different delays (1, 5, 10, or 15s). Participants were tested in two conditions: differential, where each sample stimulus was paired with a specific outcome; and non-differential outcomes, where reinforcers were administered randomly. The results showed a significantly better face recognition in the differential outcomes condition relative to the non-differential in both experiments. Implications for memory training programs and future research are discussed. PMID:24713518

  6. Parental Leave Policy as a Strategy to Improve Outcomes among Premature Infants.

    PubMed

    Greenfield, Jennifer C; Klawetter, Susanne

    2016-02-01

    Although gains have been made in premature birth rates among racial and ethnic minority and low socioeconomic status populations, tremendous disparities still exist in both prematurity rates and health outcomes for preterm infants. Parental involvement is known to improve health outcomes for preterm babies. However, a gap in evidence exists around whether parental involvement can help ameliorate the disparities in both short- and long-term out-comes for their preterm children. Families more likely to experience preterm birth are also less likely to have access to paid leave and thus experience significant systemic barriers to involvement, especially when their newborns are hospitalized. This article describes the research gap in this area and explores pathways by which social workers may ameliorate disparities in preterm birth outcomes through practice, policy, and research. PMID:26946882

  7. Do larger femoral heads improve the functional outcome in total hip arthroplasty?

    PubMed

    Allen, Charlotte L; Hooper, Gary J; Frampton, Christopher M A

    2014-02-01

    Use of larger diameter femoral heads has been popularised in total hip arthroplasty (THA). Recent studies have implicated larger femoral heads in early failure. We evaluated what effect the size of the femoral head had on the early functional outcome in order to determine the optimal head size for the maximal functional outcome. There were 726 patients who underwent elective THA and were divided into 3 groups according to head size then compared with respect to functional outcome scores and dislocation rates. This study failed to show that increasing the size of the femoral head significantly improved the functional outcome at 1 year after total hip arthroplasty but that the use of a 36 mm or greater femoral head did reduce the dislocation rate. PMID:23891058

  8. Effects of improved patient participation in primary care on health-related outcomes: a systematic review

    PubMed Central

    Sanders, Ariëtte R J; van Weeghel, Inge; Vogelaar, Maartje; Verheul, William; Pieters, Ron H M; de Wit, Niek J; Bensing, Jozien M

    2013-01-01

    Background. In primary care, many consultations address symptom-based complaints. Recovery from these complaints seldom exceeds placebo effects. Patient participation, because of its supposed effects on trust and patient expectancies, is assumed to benefit patients’ recovery. While the idea is theoretically promising, it is still unclear what the effects of increased patient participation are on patient outcomes. Aim. To review the effects of controlled intervention studies aiming to improve patient participation in face-to-face primary care consultations on patient-oriented and/or disease-oriented outcomes. Methods. This study is a systematic review. A systematic search was undertaken for randomized controlled trials designed to measure the effects of interventions that aimed to improve adult patients’ participation in primary care visits. The CINAHL, Cochrane, EMBASE, PsycINFO and PubMed databases were searched. Results. Seven different trials fulfilled the inclusion criteria. Three of the studies were related to symptom-based complaints. Five studies measured patient-oriented outcomes, the primary outcome of interest for this review. All studies suffered from substantial bias. Studies varied widely in their aims, types of complaints/diseases, strength of the interventions and their outcomes. The effects on patient-oriented outcomes and disease-oriented outcomes were ambiguous. Conclusion. Little research has been performed on health outcomes of interventions aiming to increase patient participation in general practice visits among patients suffering from symptom-based complaints. The results still are non-conclusive. The quality of the trials has been weak, possibly due to the complexity of the concept. This weak quality may explain the lack of conclusive results. Proposals for future research designs are offered. PMID:23629738

  9. Effect of Smoking on Joint Replacement Outcomes: Opportunities for Improvement Through Preoperative Smoking Cessation.

    PubMed

    Wright, Erik; Tzeng, Tony H; Ginnetti, Michael; El-Othmani, Mouhanad M; Saleh, Jamal K; Saleh, Jasmine; Lane, J M; Mihalko, William M; Saleh, Khaled J

    2016-01-01

    Because orthopaedic surgeons focus on identifying serious potential complications, such as heart attack, stroke, and deep vein thrombosis, during the preoperative assessment, correctable factors, such as smoking, may be overlooked. Chronic exposure to nicotine has been correlated with perioperative complications that lead to worse outcomes, including decreased patient satisfaction, longer hospitalization periods, and an increased rate of hospital readmission. It has been proven that smoking is a negative risk factor for decreased bone mineral density, which leads to increased fracture risk, heightened pain, postoperative wound and bone healing complications, decreased fusion rates, and postoperative tendon and ligament healing complications. Physician-led preoperative smoking cessation programs that include, but are not limited to, pharmacotherapy plans have been shown to improve primary surgical outcomes and smoking cessation rates. Smoking has detrimental effects on specialty-specific physiology; however, there are many effective options for intervention that can improve primary outcomes. PMID:27049216

  10. Integrating Hospital Administrative Data to Improve Health Care Efficiency and Outcomes: “The Socrates Story”

    PubMed Central

    Lawrence, Justin; Delaney, Conor P.

    2013-01-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes. PMID:24436649

  11. Cardiovascular disease in chronic kidney disease. A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO).

    PubMed

    Herzog, Charles A; Asinger, Richard W; Berger, Alan K; Charytan, David M; Díez, Javier; Hart, Robert G; Eckardt, Kai-Uwe; Kasiske, Bertram L; McCullough, Peter A; Passman, Rod S; DeLoach, Stephanie S; Pun, Patrick H; Ritz, Eberhard

    2011-09-01

    Cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) is high, and the presence of CKD worsens outcomes of cardiovascular disease (CVD). CKD is associated with specific risk factors. Emerging evidence indicates that the pathology and manifestation of CVD differ in the presence of CKD. During a clinical update conference convened by the Kidney Disease: Improving Global Outcomes (KDIGO), an international group of experts defined the current state of knowledge and the implications for patient care in important topic areas, including coronary artery disease and myocardial infarction, congestive heart failure, cerebrovascular disease, atrial fibrillation, peripheral arterial disease, and sudden cardiac death. Although optimal strategies for prevention, diagnosis, and management of these complications likely should be modified in the presence of CKD, the evidence base for decision making is limited. Trials targeting CVD in patients with CKD have a large potential to improve outcomes. PMID:21750584

  12. Integrating hospital administrative data to improve health care efficiency and outcomes: "the socrates story".

    PubMed

    Lawrence, Justin; Delaney, Conor P

    2013-03-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes. PMID:24436649

  13. How PEPFAR's public-private partnerships achieved ambitious goals, from improving labs to strengthening supply chains.

    PubMed

    Sturchio, Jeffrey L; Cohen, Gary M

    2012-07-01

    The President's Emergency Plan for AIDS Relief (PEPFAR), established in 2003, is widely recognized as one of the most ambitious and successful bilateral programs ever implemented to address a single disease. Part of the program's success is attributable to the participation of the private sector, working in partnership with the US and local governments and implementing organizations to maximize the reach and effectiveness of every dollar spent. We examined key public-private partnerships that grew out of PEPFAR to identify features that have made them effective. For example, PEPFAR's Supply Chain Management System took advantage of private industry's best practices in logistics, and a partnership with the medical technology company BD (Becton, Dickinson and Company) improved laboratory systems throughout sub-Saharan Africa. We found that setting ambitious goals, enlisting both global and local partners, cultivating a culture of collaboration, careful planning, continuous monitoring and evaluation, and measuring outcomes systematically led to the most effective programs. The Office of the US Global AIDS Coordinator and PEPFAR should continue to strengthen their capacity for private-sector partnerships, learning from a decade of experience and identifying new ways to make smart investments that will make the most efficient use of taxpayer resources, expand proven interventions more rapidly, and help ensure the sustainability of key programs. PMID:22778334

  14. Improved Characters and Student Learning Outcomes through Development of Character Education Based General Physics Learning Model

    ERIC Educational Resources Information Center

    Derlina; Sabani; Mihardi, Satria

    2015-01-01

    Education Research in Indonesia has begun to lead to the development of character education and is no longer fixated on the outcomes of cognitive learning. This study purposed to produce character education based general physics learning model (CEBGP Learning Model) and with valid, effective and practical peripheral devices to improve character…

  15. Improving the Transition Outcomes of Low-Income Minority Youth with Disabilities

    ERIC Educational Resources Information Center

    Balcazar, Fabricio E.; Taylor-Ritzler, Tina; Dimpfl, Shawn; Portillo-Pena, Nelson; Guzman, Alberto; Schiff, Rachel; Murvay, Michele

    2012-01-01

    This study describes the results of a program developed to improve the transition outcomes of low-income minority youth with disabilities. The program relies on case management support to facilitate interagency collaboration. The participants included 164 graduates from special education and 26 youth from an equivalent comparison group. Two case…

  16. Increased Preclass Preparation Underlies Student Outcome Improvement in the Flipped Classroom

    ERIC Educational Resources Information Center

    Gross, David; Pietri, Evava S.; Anderson, Gordon; Moyano-Camihort, Karin; Graham, Mark J.

    2015-01-01

    Active-learning environments such as those found in a flipped classroom are known to increase student performance, although how these gains are realized over the course of a semester is less well understood. In an upper-level lecture course designed primarily for biochemistry majors, we examine how students attain improved learning outcomes, as…

  17. The LLEN: The Purpose of Local Partnerships in the Provision of Improved Outcomes for Young People.

    ERIC Educational Resources Information Center

    Fowler, Sue

    2002-01-01

    Local Learning and Employment Networks (LLENs) are incorporated organizations and groups whose mission is to facilitate local partnerships for the purpose of improving young people's education and training outcomes in Australia. LLENs are supported by grants from Australia's Department of Education and Training. Of the 31 LLENs currently existing…

  18. How Can Placement Policy Improve Math Remediation Outcomes? Evidence from Experimentation in Community Colleges

    ERIC Educational Resources Information Center

    Ngo, Federick; Melguizo, Tatiana

    2016-01-01

    Changing placement policy may help to improve developmental education student outcomes in community colleges, but there is little understanding of the impacts of these reforms. We take advantage of heterogeneous placement policy in a large urban community college district in California to compare the effects of math remediation under different…

  19. Pregnancy Medical Home Care Pathways Improve Quality of Perinatal Care and Birth Outcomes.

    PubMed

    Berrien, Kate; Ollendorff, Arthur; Menard, M Kathryn

    2015-01-01

    The clinical leadership of the Pregnancy Medical Home (PMH) program develops and disseminates clinical pathways to promote evidence-based practice and to improve quality of care and outcomes. PMH pathways represent the first standardized clinical guidance for obstetric providers statewide across all care settings. PMID:26509523

  20. How Learning and Cognitive Science Can Improve Student Outcomes. Middle School Matters Program No. 1

    ERIC Educational Resources Information Center

    Graesser, Art; Rodriguez, Gina; Brasiel, Sarah J.

    2013-01-01

    There are research-based principles and practices from the learning and cognitive sciences that can be applied to all content areas in middle grades education to improve student outcomes. Even teachers of courses like Physical Education can consider these strategies for assisting students in remembering rules of sports, different sports…

  1. Information Landscapes and Exploratory User Interfaces: Redesigning To Improve Learning Outcomes.

    ERIC Educational Resources Information Center

    Hedberg, John G.; And Others

    This paper examines improving learning outcomes through redesigning information landscapes. The concept of information landscapes has been a constant theme in the development of interactive multimedia packages. For the user interface to this information to be effective and efficient, consideration must be given to the cognitive load placed on the…

  2. Revised Models and Conceptualisation of Successful School Principalship for Improved Student Outcomes

    ERIC Educational Resources Information Center

    Mulford, Bill; Silins, Halia

    2011-01-01

    Purpose: This study aims to present revised models and a reconceptualisation of successful school principalship for improved student outcomes. Design/methodology/approach: The study's approach is qualitative and quantitative, culminating in model building and multi-level statistical analyses. Findings: Principals who promote both capacity building…

  3. Does Prison-Based Adult Basic Education Improve Postrelease Outcomes for Male Prisoners in Florida?

    ERIC Educational Resources Information Center

    Cho, Rosa Minhyo; Tyler, John H.

    2013-01-01

    The authors use administrative data from Florida to determine the extent to which prison-based adult basic education (ABE) improves inmate's postrelease labor market outcomes, such as earnings and employment. Using two nonexperimental comparison groups, the authors find evidence that ABE participation is associated with higher postrelease…

  4. Adaptive and innovative Radiation Treatment FOR improving Cancer treatment outcomE (ARTFORCE); a randomized controlled phase II trial for individualized treatment of head and neck cancer

    PubMed Central

    2013-01-01

    Background Failure of locoregional control is the main cause of recurrence in advanced head and neck cancer. This multi-center trial aims to improve outcome in two ways. Firstly, by redistribution of the radiation dose to the metabolically most FDG-PET avid part of the tumour. Hereby, a biologically more effective dose distribution might be achieved while simultaneously sparing normal tissues. Secondly, by improving patient selection. Both cisplatin and Epidermal Growth Factor Receptor (EGFR) antibodies like Cetuximab in combination with Radiotherapy (RT) are effective in enhancing tumour response. However, it is unknown which patients will benefit from either agent in combination with irradiation. We will analyze the predictive value of biological markers and 89Zr-Cetuximab uptake for treatment outcome of chemoradiation with Cetuximab or cisplatin to improve patient selection. Methods ARTFORCE is a randomized phase II trial for 268 patients with a factorial 2 by 2 design: cisplatin versus Cetuximab and standard RT versus redistributed RT. Cisplatin is dosed weekly 40 mg/m2 for 6 weeks. Cetuximab is dosed 250mg/m2 weekly (loading dose 400 mg/m2) for 6 weeks. The standard RT regimen consists of elective RT up to 54.25 Gy with a simultaneous integrated boost (SIB) to 70 Gy in 35 fractions in 6 weeks. Redistributed adaptive RT consists of elective RT up to 54.25 Gy with a SIB between 64-80 Gy in 35 fractions in 6 weeks with redistributed dose to the gross tumour volume (GTV) and clinical target volume (CTV), and adaptation of treatment for anatomical changes in the third week of treatment. Patients with locally advanced, biopsy confirmed squamous cell carcinoma of the oropharynx, oral cavity or hypopharynx are eligible. Primary endpoints are: locoregional recurrence free survival at 2 years, correlation of the median 89Zr-cetuximab uptake and biological markers with treatment specific outcome, and toxicity. Secondary endpoints are quality of life, swallowing function

  5. Normalization of coagulopathy is associated with improved outcome after isolated traumatic brain injury.

    PubMed

    Epstein, Daniel S; Mitra, Biswadev; Cameron, Peter A; Fitzgerald, Mark; Rosenfeld, Jeffrey V

    2016-07-01

    Acute traumatic coagulopathy (ATC) has been reported in the setting of isolated traumatic brain injury (iTBI) and is associated with poor outcomes. We aimed to evaluate the effectiveness of procoagulant agents administered to patients with ATC and iTBI during resuscitation, hypothesizing that timely normalization of coagulopathy may be associated with a decrease in mortality. A retrospective review of the Alfred Hospital trauma registry, Australia, was conducted and patients with iTBI (head Abbreviated Injury Score [AIS] ⩾3 and all other body AIS <3) and coagulopathy (international normalized ratio ⩾1.3) were selected for analysis. Data on procoagulant agents used (fresh frozen plasma, platelets, cryoprecipitate, prothrombin complex concentrates, tranexamic acid, vitamin K) were extracted. Among patients who had achieved normalization of INR or survived beyond 24hours and were not taking oral anticoagulants, the association of normalization of INR and death at hospital discharge was analyzed using multivariable logistic regression analysis. There were 157 patients with ATC of whom 68 (43.3%) received procoagulant products within 24hours of presentation. The median time to delivery of first products was 182.5 (interquartile range [IQR] 115-375) minutes, and following administration of coagulants, time to normalization of INR was 605 (IQR 274-1146) minutes. Normalization of INR was independently associated with significantly lower mortality (adjusted odds ratio 0.10; 95% confidence interval 0.03-0.38). Normalization of INR was associated with improved mortality in patients with ATC in the setting of iTBI. As there was a substantial time lag between delivery of products and eventual normalization of coagulation, specific management of coagulopathy should be implemented as early as possible. PMID:26947341

  6. Do high rates of OSCAR deficiencies prompt improved nursing facility processes and outcomes?

    PubMed

    Klopfenstein, Kristin; Lockhart, Charles; Giles-Sims, Jean

    2011-10-01

    Recently, some researchers have argued that high state rates of Centers for Medicare and Medicaid Services (CMS) Online Survey, Certification and Reporting (OSCAR) nursing facility deficiencies indicate stringent enforcement, leaving the impression of better-quality care soon to follow; others maintain that the rank ordering of states' quality of nursing facility care remains fairly constant, resting on deep-seated state characteristics that change slowly, so that short-term improvement in poor-quality care is unlikely. The authors examine change in the process and outcome quality of states' Medicare nursing facility long-term care programs across 1999 to 2005, using linear and two-stage least squares regression. They find that (1) nationally, process quality generally falls across this period while outcome quality generally increases; (2) neither a prominent enforcement stringency index nor state culture, a relatively stable state characteristic, exerts much influence on state process and outcome quality scores over time, but (3) the relative costs and benefits for CMS compliance appear to contribute to explaining change in states' quality of resident outcomes over time; and (4) states' process quality is much less stable than outcome quality, and outcome indices distinct from OSCAR deficiency data provide more reliable and possibly more valid measures of care quality. PMID:21985066

  7. Contingency management improves outcomes in cocaine-dependent outpatients with depressive symptoms.

    PubMed

    García-Fernández, Gloria; Secades-Villa, Roberto; García-Rodríguez, Olaya; Peña-Suárez, Elsa; Sánchez-Hervás, Emilio

    2013-12-01

    Despite depressive symptoms being very common among patients seeking treatment for cocaine dependence, few studies have examined the effects of depressive symptoms on cocaine outpatient treatment outcomes, and there is even less research in the context of Contingency Management (CM). The purpose of this study was to assess the main and interactive effects of co-occurring depressive symptoms on CM outcomes. Cocaine-dependent individuals (N = 108) were randomized to Community Reinforcement Approach (CRA) or CRA plus CM in two outpatient community clinical settings. Participants were categorized according to depression symptoms, self-reported by means of the BDI at treatment entry. Outcome measures included treatment retention and documented cocaine abstinence over a 6-month treatment period. Depressive symptoms were more commonly found in females and in unemployed participants, and were associated with more drug-related, social, and psychiatric problems at treatment entry. Individuals with baseline depressive symptoms had poorer treatment outcomes than patients without depressive symptoms. The addition of CM to CRA made the program more effective than with CRA alone, regardless of depressive symptoms. CM was associated with better abstinence treatment outcomes, while the interaction between unemployment and depressive symptoms was associated with negative retention treatment outcomes. This study supports the efficacy of CM for cocaine-dependent outpatients with and without depressive symptoms, and highlights its importance for improving treatment for unemployed and depressed cocaine-dependent individuals. PMID:24080020

  8. Patient or treatment centre? Where are efforts invested to improve cancer patients' psychosocial outcomes?

    PubMed Central

    Carey, ML; Clinton-McHarg, T; Sanson-Fisher, RW; Campbell, S; Douglas, HE

    2011-01-01

    The psychosocial outcomes of cancer patients may be influenced by individual-level, social and treatment centre predictors. This paper aimed to examine the extent to which individual, social and treatment centre variables have been examined as predictors or targets of intervention for psychosocial outcomes of cancer patients. Medline was searched to find studies in which the psychological outcomes of cancer patient were primary variables. Papers published in English between 1999 and 2009 that reported primary data relevant to psychosocial outcomes for cancer patients were included, with 20% randomly selected for further coding. Descriptive studies were coded for inclusion of individual, social or treatment centre variables. Intervention studies were coded to determine if the unit of intervention was the individual patient, social unit or treatment centre. After random sampling, 412 publications meeting the inclusion criteria were identified, 169 were descriptive and 243 interventions. Of the descriptive papers 95.0% included individual predictors, and 5.0% social predictors. None of the descriptive papers examined treatment centre variables as predictors of psychosocial outcomes. Similarly, none of the interventions evaluated the effectiveness of treatment centre interventions for improving psychosocial outcomes. Potential reasons for the overwhelming dominance of individual predictors and individual-focused interventions in psychosocial literature are discussed. PMID:20646035

  9. The Differentiated Outcome Hypothesis or, When Will We Stop Using Conventional Achievement as the Sole Criterion for Evaluating Unconventional Instruction.

    ERIC Educational Resources Information Center

    Tuckman, Bruce W.

    The differentiated outcome hypothesis posits that the maximum effects of an educational program are realized along those dimensions emphasized in the program or in those central to the persons involved. The idea that educational programs employing unconventional means should be examined on outcomes that are consistent with those means is derived…

  10. The Impact of a Proficiency-Based Assessment and Reassessment of Learning Outcomes System on Student Achievement and Attitudes

    ERIC Educational Resources Information Center

    Posner, Michael A.

    2011-01-01

    This research compares a student-centered, proficiency-based assessment and reassessment of learning outcomes (PARLO) system to traditional assessment in a college-level introductory statistics class. The PARLO class was assessed on learning outcomes using a three-tiered proficiency scale and given the opportunity to resubmit assignments to…

  11. Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series

    PubMed Central

    Arun, G R; Kumar, Pradeep; Patnaik, Sarthak; Selvaraj, Karthik; Rajan, David; Singh, Anant; Kumaraswamy, Vinay

    2016-01-01

    Background: Rotator cuff tears are a common cause of shoulder pain and dysfunction. More recently, there has been a renewed interest in understanding the subscapularis tears. There are multiple articles in the literature showing the short term results of isolated subscapularis tendon repair. However, the midterm and long term outcome studies for arthroscopic subscapularis repair are few. This study evaluates the functional outcome after arthroscopic subscapularis repair. Materials and Methods: The records of 35 patients who underwent an arthroscopic subscapularis repair between May 2008 and June 2012 were included in this retrospective study. The records of all patients were reviewed. There were 22 males and 13 female patients with mean age of 58.2 years (range 41-72 years). All patients had a complete history, physical examination, and radiographs of their shoulders. Visual analogue scale (VAS), range of movements, power of cuff muscles, and modified University of California at Los Angeles (UCLA) score were assessed. Results: The mean followup was 2.8 years (range 2-4 year). Functional outcome after arthroscopic subscapularis repair has an excellent outcome as analysed by clinical outcome, VAS score and UCLA score. Results were analyzed and had statistically significant values. The VAS for pain improved significantly (P < 0.001), and the mean modified UCLA score improved significantly (P < 0.001) from 14.24 ± 4.72 preoperatively to 33.15 ± 2.29 at 2 years postoperative. According to the UCLA system, there were 22 excellent, 11 good, and 2 fair results. Around 95% of patients returned to their usual work after surgery. Conclusion: At a median followup of 2 years, 95% of patients had a good to excellent result after an arthroscopic subscapularis tendon repair. We conclude that the midterm results show that arthroscopic subscapularis repair remains a good option for the treatment of patients with subscapularis tendon repair. PMID:27293291

  12. High-dose CD20-targeted radioimmunotherapy-based autologous transplantation improves outcomes for persistent mantle cell lymphoma.

    PubMed

    Cassaday, Ryan D; Stevenson, Philip A; Gooley, Theodore A; Chauncey, Thomas R; Pagel, John M; Rajendran, Joseph; Till, Brian G; Philip, Mary; Orozco, Johnnie J; Bensinger, William I; Holmberg, Leona A; Shustov, Andrei R; Green, Damian J; Smith, Stephen D; Libby, Edward N; Maloney, David G; Press, Oliver W; Gopal, Ajay K

    2015-12-01

    Autologous stem cell transplant (ASCT) can improve outcomes for mantle cell lymphoma (MCL) patients, yet relapses are frequent. We hypothesized that high-dose anti-CD20 radioimmunotherapy (RIT)-based conditioning could improve results in this setting. We thus assessed 162 consecutive patients with MCL at our centre undergoing ASCT following high-dose RIT-based (n = 61) or standard (n = 101) conditioning. RIT patients were less likely to be in first remission (48% vs. 72%; P = 0·002), be in complete remission (CR) (26% vs. 61%; P < 0·001) and have chemosensitive disease (84% vs. 96%; P = 0·006). RIT-based conditioning was associated with a reduced risk of treatment failure [hazard ratio (HR) 0·40; P = 0·001] and mortality (HR 0·49; P = 0·01) after adjusting for these imbalances. This difference increased as disease status worsened (from CR to partial remission to stable/progressive disease), with respective HRs of 1·14, 0·53 and 0·04 for mortality, and 0·66, 0·36 and 0·14 for treatment failure. RIT-based conditioning appears to improve outcome following ASCT for MCL patients unable to achieve CR after controlling for imbalances in important risk factors. These data support the further study of RIT and radiation-based strategies in a risk-adapted approach to ASCT for persistent MCL. PMID:26455717

  13. Title III Accountability Policies and Outcomes for K-12: Annual Measurable Achievement Objectives for English Language Learner Students in Southeast Region States. Issues & Answers. REL 2011-No. 105

    ERIC Educational Resources Information Center

    Anderson, Kimberly S.; Dufford-Melendez, Kathleen

    2011-01-01

    This report details Title III accountability policies and outcomes for K-12 English language learner (ELL) students for school year 2007/08 in the six Southeast Region states (Alabama, Florida, Georgia, Mississippi, North Carolina, and South Carolina) under the Title III annual measurable achievement objectives (AMAO) provision of the No Child…

  14. Graduate Management Admission Test Outcomes and the Academic Achievement: A Study on Masters of Business Administration Students at Makerere University, Uganda

    ERIC Educational Resources Information Center

    Wamala, Robert; Kizito, Saint Omala; Kakumba, Umar

    2012-01-01

    This study investigates whether the outcomes of the Graduate Management Admission Test (GMAT) can predict the academic achievement of enrollees in masters programs. The study is based on administrative data of 516 Masters of Business Administration (MBA) enrollees at the College of Business and Management Science, Makerere University in the 2011…

  15. Benefits of Career and Technical Student Organizations' on Female and Racial Minority Students' Psychosocial and Achievement Outcomes

    ERIC Educational Resources Information Center

    Aragon, Steven R.; Alfeld, Corinne; Hansen, David M.

    2013-01-01

    The purpose of this study was to determine to what extent do CTSOs affect student psychosocial and achievement outcomes (above and beyond stand-alone CTE programs) when controlling for gender and race. Using a cross-sectional descriptive research design, a total of 5,677 students from 10 states were surveyed regarding their high school…

  16. A Comparison of the Influences of Different Training Approaches on Trainees' Perceptions of Self-Efficacy to Achieve Training Outcomes among Bankers in Taiwan

    ERIC Educational Resources Information Center

    Huang, WenRou

    2010-01-01

    The purpose of this study was to compare the influences of the classroom training and the structured on-the-job training (S-OJT) approaches on trainees' self-efficacy to achieve the training outcomes among bankers in Taiwan. Based on the conditions for training effectiveness identified in the literature, the study examined whether trainees with…

  17. "I Am a Scientist": How Setting Conditions That Enhance Focused Concentration Positively Relate to Student Motivation and Achievement Outcomes in Inquiry-Based Science

    ERIC Educational Resources Information Center

    Ellwood, Robin B.

    2013-01-01

    This research investigated how student social interactions within two approaches to an inquiry-based science curriculum could be related to student motivation and achievement outcomes. This qualitative case study consisted of two cases, Off-Campus and On-Campus, and used ethnographic techniques of participant observation. Research participants…

  18. Feelings and Performance in the First Year at University: Learning-Related Emotions as Predictors of Achievement Outcomes in Mathematics and Statistics

    ERIC Educational Resources Information Center

    Niculescu, Alexandra C.; Templelaar, Dirk; Leppink, Jimmie; Dailey-Hebert, Amber; Segers, Mien; Gijselaers, Wim

    2015-01-01

    Introduction: This study examined the predictive value of four learning-related emotions--Enjoyment, Anxiety, Boredom and Hopelessness for achievement outcomes in the first year of study at university. Method: We used a large sample (N = 2337) of first year university students enrolled over three consecutive academic years in a mathematics and…

  19. Trans-sodium crocetinate improves outcomes in rodent models of occlusive and hemorrhagic stroke.

    PubMed

    Wang, Yi; Yoshimura, Ryo; Manabe, Hiroaki; Schretter, Catherine; Clarke, Ryon; Cai, Yu; Fitzgerald, Mark; Lee, Kevin S

    2014-10-01

    Trans-sodium crocetinate (TSC) is a novel carotenoid compound capable of enhancing the diffusion of small molecules in aqueous solutions. TSC improves the diffusion of oxygen and glucose, and increases oxygenation in ischemic brain tissue. TSC also dampens the intensity of an ischemic challenge during an ongoing ischemic event. The current study examined the impact of TSC in rat models of ischemic and hemorrhagic stroke. Rat three vessel occlusion (3VO), and combined 3VO and one vessel occlusion (3VO/1VO) models of ischemic stroke were evaluated for structural and behavioral outcomes. The effects of TSC were also tested in a rat model of intracerebral hemorrhage (ICH). Delayed treatment with TSC reduced infarct volume in a rodent model of transient focal ischemia involving either 2 or 6h of ischemia. Neurological outcomes, based on a multi-scale assessment and automated gait analysis, also were improved by TSC treatment. Additionally, TSC reduced edema and hemorrhagic volume in a rat model of ICH. An optimal therapeutic candidate for early intervention in ischemic stroke should be effective when administered on a delayed basis and should not aggravate outcomes associated with hemorrhagic stroke. The current findings demonstrate that delayed TSC treatment improves outcomes in experimental models of both ischemic and hemorrhagic stroke. Together, these findings suggest that TSC may be a safe and beneficial therapeutic modality for early stroke intervention, irrespective of the type of stroke involved. PMID:25128603

  20. Presurgical navigated TMS motor cortex mapping improves outcome in glioblastoma surgery: a controlled observational study.

    PubMed

    Picht, Thomas; Frey, Dietmar; Thieme, Stefan; Kliesch, Stefan; Vajkoczy, Peter

    2016-02-01

    The authors report on an observational study designed to isolate the impact of navigated transcranial magnetic stimulation (nTMS) on surgical outcome in glioblastoma treatment. We undertook a controlled observational study to identify the additive impact of presurgical nTMS in patients scheduled for surgical treatment of glioblastoma in or near motor eloquent locations. The trial data is derived from a large university hospital with a differential availability of its nTMS mapping service at its two campuses, both equally served by a single neurosurgical department. When available, the nTMS cortical mapping data and nTMS-based fiber tractography are used for surgical planning and patient counseling as well as intraoperative identification of the primary motor cortex and guidance in subcortical motor mapping. The addition of preoperative nTMS mapping data to a clinical routine already incorporating preoperative fiber tractography and intraoperative neuronavigation and electrophysiology was shown to improve surgical outcomes by increasing the extent of resection, without compromising patient safety or long-term functional outcomes in comparison to the concurrent non-TMS control group. This study is the first to prove that the improved surgical outcomes observed in previous studies after the implementation of nTMS to presurgical work-up are not caused by any overall improvement in patient care or a paradigm shift toward more aggressive resection but by the additional functional data provided by nTMS. PMID:26566653

  1. Improving the estimation of flavonoid intake for study of health outcomes

    PubMed Central

    Dwyer, Johanna T.; Jacques, Paul F.; McCullough, Marjorie L.

    2015-01-01

    Imprecision in estimating intakes of non-nutrient bioactive compounds such as flavonoids is a challenge in epidemiologic studies of health outcomes. The sources of this imprecision, using flavonoids as an example, include the variability of bioactive compounds in foods due to differences in growing conditions and processing, the challenges in laboratory quantification of flavonoids in foods, the incompleteness of flavonoid food composition tables, and the lack of adequate dietary assessment instruments. Steps to improve databases of bioactive compounds and to increase the accuracy and precision of the estimation of bioactive compound intakes in studies of health benefits and outcomes are suggested. PMID:26084477

  2. Major liver resection for hepatocellular carcinoma in the morbidly obese: A proposed strategy to improve outcome

    PubMed Central

    Barakat, Omar; Skolkin, Mark D; Toombs, Barry D; Fischer, John H; Ozaki, Claire F; Wood, R Patrick

    2008-01-01

    Background Morbid obesity strongly predicts morbidity and mortality in surgical patients. However, obesity's impact on outcome after major liver resection is unknown. Case presentation We describe the management of a large hepatocellular carcinoma in a morbidly obese patient (body mass index >50 kg/m2). Additionally, we propose a strategy for reducing postoperative complications and improving outcome after major liver resection. Conclusion To our knowledge, this is the first report of major liver resection in a morbidly obese patient with hepatocellular carcinoma. The approach we used could make this operation nearly as safe in obese patients as it is in their normal-weight counterparts. PMID:18783621

  3. An evidence-based program to improve analgesic practice and pain outcomes in residential aged care facilities.

    PubMed

    Savvas, Steven M; Toye, Chris M; Beattie, Elizabeth R A; Gibson, Stephen J

    2014-08-01

    Pain is common in individuals living in residential aged care facilities (RACFs), and a number of obstacles have been identified as recurring barriers to adequate pain management. To address this, the Australian Pain Society developed 27 recommendations for comprehensive good practice in the identification, assessment, and management of pain. This study reviewed preexisting pain management practice at five Australian RACFs and identified changes needed to implement the recommendations and then implemented an evidence-based program that aimed to facilitate better pain management. The program involved staff training and education and revised in-house pain-management procedures. Reviews occurred before and after the program and included the assessment of 282 residents for analgesic use and pain status. Analgesic use improved after the program (P<.001), with a decrease in residents receiving no analgesics (from 15% to 6%) and an increase in residents receiving around-the-clock plus as-needed analgesics (from 24% to 43%). There were improvements in pain relief for residents with scores indicative of pain, with Abbey pain scale (P=.005), Pain Assessment in Advanced Dementia Scale (P=.001), and Non-communicative Patient's Pain Assessment Instrument scale (P<.001) scores all improving. Although physical function declined as expected, Medical Outcomes Study 36-item Short-Form Survey bodily pain scores also showed improvement (P=.001). Better evidence-based practice and outcomes in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce using this program improved analgesic practice and pain relief in participating sites. Further attention to the continued targeted pain management training of aged care staff is likely to improve pain-focused care for residents. PMID:25040607

  4. The use of individually tailored environmental supports to improve medication adherence and outcomes in schizophrenia.

    PubMed

    Velligan, Dawn I; Diamond, Pamela M; Mintz, Jim; Maples, Natalie; Li, Xueying; Zeber, John; Ereshefsky, Larry; Lam, Yui-Wing F; Castillo, Desiree; Miller, Alexander L

    2008-05-01

    Cognitive adaptation training (CAT) is a psychosocial treatment that uses environmental supports such as signs, checklists, alarms, and the organization of belongings to cue and sequence adaptive behaviors in the home. Ninety-five outpatients with schizophrenia (structured clinical interview for diagnosis, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) were randomly assigned to (1) Full-CAT (CAT focused on many aspects of community adaptation including grooming, care of living quarters, leisure skills, social and role performance, and medication adherence), (2) Pharm-CAT (CAT focused only on medication and appointment adherence), or (3) treatment as usual (TAU). Treatment lasted for 9 months, and patients were followed for 6 months after the withdrawal of home visits. Medication adherence (assessed during unannounced, in-home pill counts) and functional outcomes were assessed at 3-month intervals. Results of mixed-effects regression models indicated that both CAT and Pharm-CAT treatments were superior to TAU for improving adherence to prescribed medication (P < .0001). Effects on medication adherence remained significant when home visits were withdrawn. Full-CAT treatment improved functional outcome relative to Pharm-CAT and TAU (P < .0001). However, differences for functional outcome across groups decreased following the withdrawal of home visits and were no longer statistically significant at the 6-month follow-up. Survival time to relapse or significant exacerbation was significantly longer in both CAT and Pharm-CAT in comparison to TAU (.004). Findings indicate that supports targeting medication adherence can improve and maintain this behavior. Comprehensive supports targeting multiple domains of functioning are necessary to improve functional outcomes. Maintenance of gains in functional outcome may require some form of continued intervention. PMID:17932089

  5. The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment

    PubMed Central

    Hong, Mihee; Kook, Yoon-Ah; Kim, Myeng-Ki; Lee, Jae-Il; Kim, Hong-Gee

    2016-01-01

    Objective Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system―the Improvement and Completion of Outcome (ICO) index―to evaluate the outcome of orthodontic treatment. Methods Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or −1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process. PMID:27478797

  6. Elbow ulnar collateral ligament injuries in athletes: Can we improve our outcomes?

    PubMed Central

    Redler, Lauren H; Degen, Ryan M; McDonald, Lucas S; Altchek, David W; Dines, Joshua S

    2016-01-01

    Injury to the ulnar collateral ligament (UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strategies and rehabilitation programs. Conservative treatment strategies for partial injuries, improved operative techniques for reconstruction in complete tears, adjunctive treatments, as well as structured sport specific rehabilitation programs including resistive exercises for the entire upper extremity kinetic chain are all important factors in allowing for a return to throwing in competitive environments. In this review, we explore each of these factors and provide recommendations based on the available literature to improve outcomes in UCL injuries in athletes. PMID:27114930

  7. Elbow ulnar collateral ligament injuries in athletes: Can we improve our outcomes?

    PubMed

    Redler, Lauren H; Degen, Ryan M; McDonald, Lucas S; Altchek, David W; Dines, Joshua S

    2016-04-18

    Injury to the ulnar collateral ligament (UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strategies and rehabilitation programs. Conservative treatment strategies for partial injuries, improved operative techniques for reconstruction in complete tears, adjunctive treatments, as well as structured sport specific rehabilitation programs including resistive exercises for the entire upper extremity kinetic chain are all important factors in allowing for a return to throwing in competitive environments. In this review, we explore each of these factors and provide recommendations based on the available literature to improve outcomes in UCL injuries in athletes. PMID:27114930

  8. Structuring Out-of-School Time to Improve Academic Achievement. IES Practice Guide. NCEE 2009-012

    ERIC Educational Resources Information Center

    Beckett, Megan; Borman, Geoffrey; Capizzano, Jeffrey; Parsley, Danette; Ross, Steven; Schirm, Allen; Taylor, Jessica

    2009-01-01

    Out-of-school time programs can enhance academic achievement by helping students learn outside the classroom. The purpose of this practice guide is to provide recommendations for organizing and delivering school-based out-of-school time (OST) programs to improve the academic achievement of student participants. The five recommendations in this…

  9. Improving Science Achievement and Attitudes of Students With and Without Learning Disabilities

    NASA Astrophysics Data System (ADS)

    Sanders-White, Pamela

    The primary purpose of this study was to investigate the effect of structured note-taking compared to traditional note-taking on the acquisition of scientific knowledge for students with and without learning disabilities (LD) and students with reading difficulties (RD). An additional purpose was to examine whether the two note-taking methods affected students' attitudes toward science. The sample population consisted of 203 fifth grade students across four public schools in the southern area of the United States. A standardized instrument aligned to Florida's science standards was used to measure the acquisition of scientific knowledge and the Test of Science-Related Attitudes (TOSRA) was used to measure seven distinct science-related attitudes. For meaningful analyses, students with LD and students with RD were collapsed to form a single group due to the small numbers of participants in each of the subgroups; the collapsed group was referred to as "low achievers." A three-way repeated measures ANOVA was conducted to determine the effects of the pretest-posttest Science Interim assessment by group, type of student, and gender. The pretest-posttest Science Interim assessment scores were the within-group factor, while group, type of student, and gender were the between-groups factors. Results revealed that there was a significant interaction between the pretest-posttest Science Interim assessment and group, F(1, 191) = 9.320, p = .003, indicating that scientific knowledge scores increased for the experimental group, but decreased for the control group. Results also indicated that there was a significant three-way interaction between the pretest-posttest Science Interim assessment, group, and gender, F(1, 191) = 5.197, p = .024, showing that all participants in the experimental group improved their scores; while in the control group, female scores decreased and male scores increased. Participants in the experimental and control groups did not show improved attitudes

  10. Provider and patient directed financial incentives to improve care and outcomes for patients with diabetes.

    PubMed

    Lorincz, Ilona S; Lawson, Brittany C T; Long, Judith A

    2013-04-01

    Incentive programs directed at both providers and patients have become increasingly widespread. Pay-for-performance (P4P) where providers receive financial incentives to carry out specific care or improve clinical outcomes has been widely implemented. The existing literature indicates they probably spur initial gains which then level off or partially revert if incentives are withdrawn. The literature also indicates that process measures are easier to influence through P4P programs but that intermediate outcomes such as glucose, blood pressure, and cholesterol control are harder to influence, and the long-term impact of P4P programs on health is largely unknown. Programs directed at patients show greater promise as a means to influence patient behavior and intermediate outcomes such as weight loss; however, the evidence for long-term effects are lacking. In combination, both patient and provider incentives are potentially powerful tools but whether they are cost-effective has yet to be determined. PMID:23225214

  11. Improved single-cell culture achieved using micromolding in capillaries technology coupled with poly (HEMA)

    PubMed Central

    Ye, Fang; Jiang, Jin; Chang, Honglong; Xie, Li; Deng, Jinjun; Ma, Zhibo; Yuan, Weizheng

    2015-01-01

    Cell studies at the single-cell level are becoming more and more critical for understanding the complex biological processes. Here, we present an optimization study investigating the positioning of single cells using micromolding in capillaries technology coupled with the cytophobic biomaterial poly (2-hydroxyethyl methacrylate) (poly (HEMA)). As a cytophobic biomaterial, poly (HEMA) was used to inhibit cells, whereas the glass was used as the substrate to provide a cell adhesive background. The poly (HEMA) chemical barrier was obtained using micromolding in capillaries, and the microchannel networks used for capillarity were easily achieved by reversibly bonding the polydimethylsiloxane mold and the glass. Finally, discrete cell adhesion regions were presented on the glass surface. This method is facile and low cost, and the reagents are commercially available. We validated the cytophobic abilities of the poly (HEMA), optimized the channel parameters for higher quality and more stable poly (HEMA) patterns by investigating the effects of changing the aspect ratio and the width of the microchannel on the poly (HEMA) grid pattern, and improved the single-cell occupancy by optimizing the dimensions of the cell adhesion regions. PMID:26339307

  12. Traditional birth attendant training for improving health behaviours and pregnancy outcomes

    PubMed Central

    Sibley, Lynn M; Sipe, Theresa Ann; Barry, Danika

    2014-01-01

    rate was lower but not significant (adjusted OR 0.74, 95% CI 0.45 to 1.22). Additionally trained TBAs versus trained TBAs: three large cluster-randomised trials compared TBAs who received additional training in initial steps of resuscitation, including bag-valve-mask ventilation, with TBAs who had received basic training in safe, clean delivery and immediate newborn care. Basic training included mouth-to-mouth resuscitation (two studies) or bag-valve-mask resuscitation (one study). There was no significant difference in the perinatal death rate between the intervention and control clusters (one study, adjusted OR 0.79, 95% CI 0.61 to 1.02) and no significant difference in late neonatal death rate between intervention and control clusters (one study, adjusted risk ratio (RR) 0.47, 95% CI 0.20 to 1.11). The neonatal death rate, however, was 45% lower in intervention compared with the control clusters (one study, 22.8% versus 40.2%, adjusted RR 0.54, 95% CI 0.32 to 0.92). We conducted a meta-analysis on two outcomes: stillbirths and early neonatal death. There was no significant difference between the additionally trained TBAs versus trained TBAs for stillbirths (two studies, mean weighted adjusted RR 0.99, 95% CI 0.76 to 1.28) or early neonatal death rate (three studies, mean weighted adjusted RR 0.83, 95% CI 0.68 to 1.01). Authors’ conclusions The results are promising for some outcomes (perinatal death, stillbirth and neonatal death). However, most outcomes are reported in only one study. A lack of contrast in training in the intervention and control clusters may have contributed to the null result for stillbirths and an insufficient number of studies may have contributed to the failure to achieve significance for early neonatal deaths. Despite the additional studies included in this updated systematic review, there remains insufficient evidence to establish the potential of TBA training to improve peri-neonatal mortality. PMID:22895949

  13. Wilms’ tumour in African children: Can an institutional approach improve outcome?

    PubMed Central

    Anyanwu, Lofty-John Chukwuemeka; Atanda, Akinfenwa Taoheed; Atanda, Jareenat Oladoyin

    2015-01-01

    Background: The poor outcome for patients with Wilms’ tumour (WT) in developing countries has been predicated on late presentation, poverty and low rate of chemotherapeutic access. This study aims to evaluate the effects of an institutionalised approach to improving outcome for patients managed in a tertiary hospital in Nigeria. Materials and Methods: Oncology records of children diagnosed with WT between 2009 and 2013 were analysed for therapy completion and other prognostic parameters. Ensuing data were then compared with those from other centres in Africa. Results: Compared with results from some local and African studies, the therapy completion rate was higher (60%) with a survival rate among this group being between 1 and 4 years. No patient was lost to follow-up because of unavailability or unaffordability of cytotoxic agents. Conclusion: This study shows that an institutionalised approach can help to improve access to anti-cancer drugs, reduce the rate of loss to follow-up and thus improve outcome. There is however need to improve on patient-doctor communication, form support groups and establish a WT registry. PMID:25659542

  14. Using public policy to improve outcomes for asthmatic children in schools.

    PubMed

    Lynn, Jewlya; Oppenheimer, Sophie; Zimmer, Lorena

    2014-12-01

    School-based services to improve asthma management need to be accompanied by public policies that can help sustain services, scale effective interventions, create greater equity across schools, and improve outcomes for children. Several national organizations, including the Centers for Disease Control and Prevention, have recommended specific public policies the adoption of which in school settings can improve asthma outcomes for children. Although many states and school districts have adopted some of these policies, adoption is not universal, and implementation is not always successful, leaving inequities in children's access to asthma services and supports. These issues can be addressed by changing public policy. Policy change is a complex process, but it is one that will benefit from greater involvement by asthma experts, including the researchers who generate the knowledge base on what services, supports, and policies have the best outcomes for children. Asthma experts can participate in the policy process by helping to build awareness of the need for school-based asthma policy, estimating the costs associated with policy options and with inaction, advocating for the selection of specific policies, assisting in implementation (including providing feedback), conducting the research that can evaluate the effectiveness of implementation, and ultimately providing information back into the policy process to allow for improvements to the policies. PMID:25482868

  15. Direct investment by stepfathers can mitigate effects on educational outcomes but does not improve behavioural difficulties

    PubMed Central

    Emmott, Emily H.; Mace, Ruth

    2014-01-01

    In contemporary developed populations, stepfather presence has been associated with detrimental effects on child development. However, the proximate mechanisms behind such effects are yet to be fully explored. From a behavioural ecological perspective, the negative effects associated with stepfathers may be due to the reduced quantity and quality of investments children receive within stepfather households. Here, we build on previous studies by investigating whether the effects of stepfather presence on child outcomes are driven by differences in maternal and partner (i.e., father or stepfather) direct investments. We use data from the Avon Longitudinal Study of Parents and Children to explore stepfather effects on children’s educational achievement and behavioural difficulties at age 7. Our results indicate that, for educational achievement, stepfather effects are due to the lower levels of direct investments children receive. For behavioural difficulty, stepfather effects are due to multiple factors whereby stepfather presence is associated with greater difficulties independent of investment levels, and direct investments from stepfathers are ineffective. Our results suggest that the negative effects of stepfathers on child outcomes can be explained, in part, by the reduced quantity and the ineffectiveness of direct investments children receive from stepfathers. Furthermore, the effects of stepfather direct investments seem to vary between child outcomes. PMID:25214758

  16. Manual Therapy and Exercise to Improve Outcomes in Patients With Muscle Tension Dysphonia: A Case Series

    PubMed Central

    Archer, Kristin R.

    2015-01-01

    Background and Purpose Muscle tension dysphonia (MTD), a common voice disorder that is not commonly referred for physical therapy intervention, is characterized by excessive muscle recruitment, resulting in incorrect vibratory patterns of vocal folds and an alteration in voice production. This case series was conducted to determine whether physical therapy including manual therapy, exercise, and stress management education would be beneficial to this population by reducing excess muscle tension. Case Description Nine patients with MTD completed a minimum of 9 sessions of the intervention. Patient-reported outcomes of pain, function, and quality of life were assessed at baseline and the conclusion of treatment. The outcome measures were the numeric rating scale (NRS), Patient-Specific Functional Scale (PSFS), and Voice Handicap Index (VHI). Cervical and jaw range of motion also were assessed at baseline and postintervention using standard goniometric measurements. Outcomes Eight of the patients had no pain after treatment. All 9 of the patients demonstrated an improvement in PSFS score, with 7 patients exceeding a clinically meaningful improvement at the conclusion of the intervention. Three of the patients also had a clinically meaningful change in VHI scores. All 9 of the patients demonstrated improvement in cervical flexion and lateral flexion and jaw opening, whereas 8 patients improved in cervical extension and rotation postintervention. Discussion The findings suggest that physical therapists can feasibly implement an intervention to improve outcomes in patients with MTD. However, a randomized clinical trial is needed to confirm the results of this case series and the efficacy of the intervention. A clinical implication is the expansion of physical therapy to include referrals from voice centers for the treatment of MTD. PMID:25256740

  17. Optimizing healthcare at the population level: results of the improving cardiovascular outcomes in Nova Scotia partnership.

    PubMed

    Cox, Jafna; Johnstone, David; Nemis-White, Joanna; Montague, Terrence

    2008-01-01

    Disease management is increasingly considered a valid strategy in the chronic care of our aging patient populations with multiple diseases. The Improving Cardiovascular Outcomes in Nova Scotia (ICONS) project examined whether a community-oriented health management partnership would lead to enhanced care and improved outcomes across an entire healthcare system. ICONS was a prospective cohort study, with baseline and repeated measurements of care and outcomes fed back to all project partners, along with other interventions aimed at optimizing care; preceding interval cohorts served as controls to post-intervention cohorts. The setting was the province of Nova Scotia, whose population is approximately 950,000. All 34,060 consecutive adult patients hospitalized in Nova Scotia with acute myocardial infarction (AMI), unstable angina (UA) or congestive heart failure (CHF) October 1997-March 2002 were included. Interventions were a combination of serial audits and feedbacks of practices and outcomes, web-based publication of findings, newsletter-based education and reminders, physician small-group workshops, pharmacy monitoring and compliance programs, care maps, algorithms, discharge forms and patient information cards. Rates of use of evidence-based marker therapies were the primary outcome measure. Secondary measures included one-year, all-cause mortality and re-hospitalization. Evidence-based prescription practices, for all target diseases, continuously and markedly improved over time. At the population level, there were no changes in one-year mortality for any disease state, although use of proven therapies predicted survival at the individual level throughout the five-year period for all disease states. Rates of re-hospitalization decreased significantly for all disease states over the course of ICONS; but most traditional positive and negative predictors of this outcome, like advanced age and use of proven therapies, respectively, were not predictive. ICONS

  18. Deciding when to "cash in" when outcomes are continuously improving: an escalating interest task.

    PubMed

    Young, Michael E; Webb, Tara L; Jacobs, Eric A

    2011-10-01

    A first-person shooter video game was adapted for the study of choice between smaller sooner and larger later outcomes. Participants chose when to fire a weapon that increased in damage potential over a 10s interval, an escalating interest situation. Across two experiments, participants demonstrated sensitivity to the nature of the mathematical function that defined the relationship between waiting and damage potential. In Experiment 1, people tended to wait longer when doing so allowed them to eliminate targets more quickly. In Experiment 2, people tended to wait longer to increase the probability of a constant magnitude outcome than to increase the magnitude of a 100% certain outcome that was matched for the same expected value (i.e., probability times magnitude). The two experiments demonstrated sensitivity to the way in which an outcome improves when the outcome is continuously available. The results also demonstrate that this new video game task is useful for generating sensitivity to delay to reinforcement over time scales that are typically used in nonhuman animal studies. PMID:21871951

  19. Is it possible to predict improved diabetes outcomes following diabetes self-management education: a mixed-methods longitudinal design

    PubMed Central

    Huxley, Caroline; Sturt, Jackie; Dale, Jeremy; Walker, Rosie; Caramlau, Isabela; O'Hare, Joseph P; Griffiths, Frances

    2015-01-01

    to achieve improvement in outcomes from DSME. DSME should be promoted to all patients with diabetes according to guidelines. PMID:26525722

  20. Outcomes Improvement is Not Continuous Along the Learning Curve for Pancreaticoduodenectomy at the Hospital Level

    PubMed Central

    Coe, Taylor M.; Fong, Zhi Ven; Wilson, Samuel E.; Talamini, Mark A; Lillemoe, Keith D.; Chang, David C.

    2015-01-01

    Background Most studies on learning curves for pancreaticoduodenectomy have been based on single-surgeon series at tertiary academic centers or are inferred indirectly from volume-outcome relationships. Our aim is to describe mortality rates associated with cumulative surgical experience among non-teaching hospitals. Study Design Observational study of a statewide in-patient database. Analysis included hospitals that began performing pancreaticoduodenectomy between 1996–2010, as captured by the California Office of Statewide Health Planning and Development database. Cases were numbered sequentially within each hospital. The same sequential series (e.g. first 10 cases, 11th through 20th cases) were identified across hospitals. The outcome measure was in-hospital mortality. Results A total of 1,210 cases from 143 non-teaching hospitals were analyzed. The average age was 63 years and the majority of patients were non-Hispanic white. The median overall mortality rate was 9.75%. The mortality rate for the first ten aggregated cases was 11.3%. This improved for subsequent cases, reaching 7.1% for the 21st-30th cases. However, the mortality rate then increased, reaching 16.7% by the 41st-50th cases before falling to 0.0% by the 61st-70th cases. Conclusions Initial improvement in surgical outcomes relative to cumulative surgical experience is not sustained. It is likely that factors other than surgical experience affect outcomes, such as less rigorous assessment of comorbidities or changes in support services. Vigilance regarding outcomes should be maintained even after initial improvements. PMID:26438484

  1. Performance Incentives to Improve Community College Completion: Learning from Washington State's Student Achievement Initiative. A State Policy Brief

    ERIC Educational Resources Information Center

    Shulock, Nancy; Jenkins, Davis

    2011-01-01

    Amid growing signs of America's weakening position in the global economy, federal and state policymakers and major foundations have set ambitious goals for increasing postsecondary attainment in the United States. Given changing U.S. demographics, it has become clear that these national goals are attainable only with vastly improved outcomes among…

  2. Short Duration Combined Mild Hypothermia Improves Resuscitation Outcomes in a Porcine Model of Prolonged Cardiac Arrest

    PubMed Central

    Yu, Tao; Yang, Zhengfei; Li, Heng; Ding, Youde; Huang, Zitong; Li, Yongqin

    2015-01-01

    Objective. In this study, our aim was to investigate the effects of combined hypothermia with short duration maintenance on the resuscitation outcomes in a porcine model of ventricular fibrillation (VF). Methods. Fourteen porcine models were electrically induced with VF and untreated for 11 mins. All animals were successfully resuscitated manually and then randomized into two groups: combined mild hypothermia (CH group) and normothermia group (NT group). A combined hypothermia of ice cold saline infusion and surface cooling was implemented in the animals of the CH group and maintained for 4 hours. The survival outcomes and neurological function were evaluated every 24 hours until a maximum of 96 hours. Neuron apoptosis in hippocampus was analyzed. Results. There were no significant differences in baseline physiologies and primary resuscitation outcomes between both groups. Obvious improvements of cardiac output were observed in the CH group at 120, 180, and 240 mins following resuscitation. The animals demonstrated better survival at 96 hours in the CH group when compared to the NT group. In comparison with the NT group, favorable neurological functions were observed in the CH group. Conclusion. Short duration combined cooling initiated after resuscitation improves survival and neurological outcomes in a porcine model of prolonged VF. PMID:26558261

  3. Paying the price: the pressing need for quality, cost, and outcomes data to improve correctional health care for older prisoners.

    PubMed

    Ahalt, Cyrus; Trestman, Robert L; Rich, Josiah D; Greifinger, Robert B; Williams, Brie A

    2013-11-01

    Despite a recent decline in the U.S. prison population, the older prisoner population is growing rapidly. U.S. prisons are constitutionally required to provide health care to prisoners. As the population ages, healthcare costs rise, states are forced to cut spending, and many correctional agencies struggle to meet this legal standard of care. Failure to meet the healthcare needs of older prisoners, who now account for nearly 10% of the prison population, can cause avoidable suffering in a medically vulnerable population and violation of the constitutional mandate for timely access to an appropriate level of care while incarcerated. Older prisoners who cannot access adequate health care in prison also affect community healthcare systems because more than 95% of prisoners are eventually released, many to urban communities where healthcare disparities are common and acute healthcare resources are overused. A lack of uniform quality and cost data has significantly hampered innovations in policy and practice to improve value in correctional health care (achieving desired health outcomes at sustainable costs). With their unique knowledge of complex chronic disease management, experts in geriatrics are positioned to help address the aging crisis in correctional health care. This article delineates the basic health, cost, and outcomes data that geriatricians and gerontologists need to respond to this crisis, identifies gaps in the available data, and anticipates barriers to data collection that, if addressed, could enable clinicians and policy-makers to evaluate and improve the value of geriatric prison health care. PMID:24219203

  4. Improving maternal and infant health outcomes in Medicaid and the Children's Health Insurance Program.

    PubMed

    Applegate, Mary; Gee, Rebekah E; Martin, James N

    2014-07-01

    Maternal and infant health is critical to our nation's health. Disparities remain unacceptably high, particularly in the areas of prematurity and infant mortality. In 2012, traditionally distant partners such as federal and state governments, Medicaid and commercial payers, patients, public health and private clinicians, and multiple advocacy groups collaborated to focus on improving birth outcomes. To catalyze the alignment, the Centers for Medicare and Medicaid Services convened an Expert Panel on Improving Maternal and Infant Health Outcomes in Medicaid and the Children's Health Insurance Program. Over a year's time, the Expert Panel assimilated the best available evidence in clinical science and policy from content leaders and patients. These recommendations culminated in the present report, which challenges us as a nation to implement strategies to help all children have the best chance to survive and thrive comparable to that of other westernized nations. PMID:24901270

  5. Improvement in clinical outcomes after dry needling in a patient with occipital neuralgia.

    PubMed

    Bond, Bryan M; Kinslow, Christopher

    2015-06-01

    The primary purpose of this case report is to outline the diagnosis, intervention and clinical outcome of a patient presenting with occipital neuralgia. Upon initial presentation, the patient described a four-year history of stabbing neck pain and headaches. After providing informed consent, the patient underwent a total of four dry needling (DN) sessions over a two-week duration. During each of the treatment sessions, needles were inserted into the trapezii and suboccipital muscles. Post-intervention, the patient reported a 32-point change in her neck disability index score along with a 28-point change in her headache disability index score. Thus, it appears that subsequent four sessions of DN over two weeks, our patient experienced meaningful improvement in her neck pain and headaches. To the best of our knowledge, this is the first case report describing DN to successfully improve clinical outcomes in a patient diagnosed with occipital neuralgia. PMID:26136602

  6. Improvement in clinical outcomes after dry needling in a patient with occipital neuralgia

    PubMed Central

    Bond, Bryan M.; Kinslow, Christopher

    2015-01-01

    The primary purpose of this case report is to outline the diagnosis, intervention and clinical outcome of a patient presenting with occipital neuralgia. Upon initial presentation, the patient described a four-year history of stabbing neck pain and headaches. After providing informed consent, the patient underwent a total of four dry needling (DN) sessions over a two-week duration. During each of the treatment sessions, needles were inserted into the trapezii and suboccipital muscles. Post-intervention, the patient reported a 32-point change in her neck disability index score along with a 28-point change in her headache disability index score. Thus, it appears that subsequent four sessions of DN over two weeks, our patient experienced meaningful improvement in her neck pain and headaches. To the best of our knowledge, this is the first case report describing DN to successfully improve clinical outcomes in a patient diagnosed with occipital neuralgia. PMID:26136602

  7. Ultrasound combined with electrodiagnosis improves lesion localization and outcome in posterior interosseous neuropathy

    PubMed Central

    Wininger, Yevgeniya Dvorkin; Buckalew, Neilly A.; Kaufmann, Robert A.; Munin, Michael C.

    2016-01-01

    INTRODUCTION Posterior interosseous nerve (PIN) syndrome is a rare compression neuropathy. Electrodiagnostic studies (EDX) combined with neuromuscular ultrasound (US) enable precise lesion localization and may improve patient outcome. METHODS In 4 patients with finger extension weakness, US was used to accurately localize concentric EMG needle placement in PIN muscles and to visualize the lesion site. RESULTS EMG with US guidance showed decreased recruitment with abnormal configuration in PIN muscles. Active denervation was not always observed. US scanning demonstrated larger PIN diameter in the affected arm. All patients had surgical intervention to confirm EDX and US findings with improved outcome on follow-up. CONCLUSION These cases demonstrate the benefits of augmenting EDX with US by guiding accurate electrode localization and providing diagnostic information about lesion location. PMID:26206065

  8. Liver transplantation at the Ochsner Clinic: programmatic expansion and outcomes improvement.

    PubMed

    Carmody, Ian C; Reichman, Trevor W; Bohorquez, Humberto; Cohen, Ari J; Bruce, David S; Therapondos, George; Girgrah, Nigel; Joshi, Shobha; Loss, George E

    2012-01-01

    Liver transplantation has become the best and most durable treatment for both acute and chronic liver disease. Over 1400 liver transplants have been performed at the Ochsner Clinic since the first successful transplant in 1987. Since its inception, the program has gone through several changes and advancements and has become one of the largest liver transplant programs in the United States. We have helped evolve steroid sparing immunosuppression and the use of extended criteria, donor organs. Establishment of criteria for the selection of recipients for re-transplantation has resulted in better than expected short and long-term results. Our center has faced the challenge of Hurricane Katrina and overcome it. We have improved steadily in both outcomes and transplants performed. The Ochnser Clinic Liver Transplant program will continue to improve access and outcomes for all patients with liver disease. PMID:23721014

  9. Achieving a "Grand Convergence" in Global Health by 2035: Rwanda Shows the Way Comment on "Improving the World's Health Through the Post-2015 Development Agenda: Perspectives From Rwanda".

    PubMed

    Yamey, Gavin; Fewer, Sara; Beyeler, Naomi

    2015-01-01

    Global Health 2035, the report of The Lancet Commission on Investing in Health, laid out a bold, highly ambitious framework for making rapid progress in improving global public health outcomes. It showed that with the right health investments, the international community could achieve a "grand convergence" in global health-a reduction in avertable infectious, maternal, and child deaths down to universally low levels-within a generation. Rwanda's success in rapidly reducing such deaths over the last 20 years shows that convergence is feasible. Binagwaho and Scott have argued that 5 lessons from this success are the importance of equity, quality health services, evidence-informed policy, intersectoral collaboration, and effective collaboration between countries and multilateral agencies. This article re-examines these lessons through the lens of the Global Health 2035 report to analyze how the experience in Rwanda might be generalized for other countries to making progress towards achieving a grand convergence. PMID:26673345

  10. 41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-193.25 What type of records management business process improvements should my agency strive to... management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25... that needed records can be found rapidly to conduct agency business, to ensure that records...

  11. 41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...-193.25 What type of records management business process improvements should my agency strive to... of temporary records. Retention and disposal of records is governed by NARA regulations in 36...

  12. 41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...-193.25 What type of records management business process improvements should my agency strive to... of temporary records. Retention and disposal of records is governed by NARA regulations in 36...

  13. 41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...-193.25 What type of records management business process improvements should my agency strive to... of temporary records. Retention and disposal of records is governed by NARA regulations in 36...

  14. 41 CFR 102-193.25 - What type of records management business process improvements should my agency strive to achieve?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... management business process improvements should my agency strive to achieve? 102-193.25 Section 102-193.25...-193.25 What type of records management business process improvements should my agency strive to... of temporary records. Retention and disposal of records is governed by NARA regulations in 36...

  15. Using Technology To Improve Academic Achievement in Out-of-School-Time Programs in Washington, D.C.

    ERIC Educational Resources Information Center

    Liu, Meredith; Russell, Victoria; Chaplin, Duncan; Raphael, Jacqueline; Fu, Helen; Anthony, Emily

    This paper describes implementation of the federal government's DC 21st Century Community Learning Center (DC 21st CCLC) program during the summer of 2001, focusing on the use of computer technology to improve academic achievement. The DC 21st CCLC program provides funding to schools in the District of Columbia to improve their out-of-school-time…

  16. Does supplementation of in-vitro culture medium with melatonin improve IVF outcome in PCOS?

    PubMed

    Kim, Mi Kyoung; Park, Eun A; Kim, Hyung Joon; Choi, Won Yun; Cho, Jung Hyun; Lee, Woo Sik; Cha, Kwang Yul; Kim, You Shin; Lee, Dong Ryul; Yoon, Tae Ki

    2013-01-01

    Human pre-ovulatory follicular fluid (FF) contains a higher concentration of melatonin than serum. The aim of this study was to evaluate the effect of melatonin supplementation of culture medium on the clinical outcomes of an in-vitro maturation (IVM) IVF-embryo transfer programme for patients with polycystic ovarian syndrome (PCOS). Melatonin concentrations in the culture media of granulosa cells (GC) or cumulus-oocyte-complexes (COC) were measured and the clinical outcomes after using IVM media with or without melatonin were analysed. In the culture media of GC or COC, melatonin concentrations gradually increased. When human chorionic gonadotrophin priming protocols were used, implantation rates in the melatonin-supplemented group were higher than those of the non-supplemented control group (P<0.05). Pregnancy rates were also higher, although not significantly. The findings suggest that the addition of melatonin to IVM media may improve the cytoplasmic maturation of human immature oocytes and subsequent clinical outcomes. It is speculated that follicular melatonin may be released from luteinizing GC during late folliculogenesis and that melatonin supplementation may be used to improve the clinical outcomes of IVM IVF-embryo transfer. Melatonin is primarily produced by the pineal gland and regulates a variety of important central and peripheral actions related to circadian rhythms and reproduction. Interestingly, human pre-ovulatory follicular fluid contains a higher concentration of melatonin than serum. However, in contrast to animal studies, the direct role of melatonin on oocyte maturation in the human system has not yet been investigated. So, the aim of the study was to evaluate the effect of melatonin supplementation of culture medium on the clinical outcome of an in-vitro maturation (IVM) IVF-embryo transfer programme for PCOS patients. The melatonin concentrations in culture medium of granulosa cells (GC) or cumulus-oocyte-complexes (COC) were measured and

  17. Acid ceramidase improves the quality of oocytes and embryos and the outcome of in vitro fertilization.

    PubMed

    Eliyahu, Efrat; Shtraizent, Nataly; Martinuzzi, Kurt; Barritt, Jason; He, Xingxuan; Wei, Hong; Chaubal, Sanjeev; Copperman, Alan B; Schuchman, Edward H

    2010-04-01

    A major challenge of assisted reproduction technologies (ARTs) is to mimic the natural environment required to sustain oocyte and embryo survival. Herein, we show that the ceramide-metabolizing enzyme, acid ceramidase (AC), is expressed in human cumulus cells and follicular fluid, essential components of this environment, and that the levels of this enzyme are positively correlated with the quality of human embryos formed in vitro. These observations led us to develop a new approach for oocyte and embryo culture that markedly improved the outcome of in vitro fertilization (IVF). The addition of recombinant AC (rAC) to human and mouse oocyte culture medium maintained their healthy morphology in vitro. Following fertilization, the number of mouse embryos formed in the presence of rAC also was improved (from approximately 40 to 88%), leading to approximately 5-fold more healthy births. To confirm these observations, immature bovine oocytes were matured in vitro and subjected to IVF in the presence of rAC. Significantly more high-grade blastocysts were formed, and the number of morphologically intact, hatched embryos was increased from approximately 24 to 70%. Overall, these data identify AC as an important component of the in vivo oocyte and embryo environment, and provide a novel technology for enhancing the outcome of assisted fertilization. Eliyahu, E., Shtraizent, N., Martinuzzi, K., Barritt, J., He, X., Wei, H., Chaubal, S., Copperman, A. B., Schuchman, E. H. Acid ceramidase improves the quality of oocytes and embryos and the outcome of in vitro fertilization. PMID:20007509

  18. Comparing the Efficacy of Interventions that use environmental supports to Improve Outcomes in Patients with Schizophrenia

    PubMed Central

    Velligan, Dawn I.; Diamond, Pamela M.; Maples, Natalie J.; Mintz, James; Li, Xueying; Glahn, David C.; Miller, Alexander L.

    2008-01-01

    We examined the efficacy of 2 treatments using environmental supports (e.g. signs, alarms, pill containers, checklists) to improve functional outcomes in individuals with schizophrenia. 120 participants were randomized into one of 3 treatment groups 1) Cognitive Adaptation Training (CAT; supports customized to individual cognitive impairments and behaviors and maintained on weekly home visits 2) Generic Environmental Supports (GES; a generic set of supports given to patients at a routine clinic visit and replaced on a monthly basis) and 3) treatment as usual (TAU). Functional outcomes, positive symptoms and motivation were assessed at baseline, 3, 6, 9, 18 and 24 months. After 9 months of intensive treatment with CAT, visits were decreased from weekly to monthly to examine whether treatment gains could be maintained. Results of a mixed effects regression model with repeated measures indicated a significant main effect of group (CAT>GES>TAU) with non-significant time and group by time interactions. Post-hoc analyses indicated that while individuals in CAT remained significantly better than those in TAU when treatment frequency was reduced, gains in CAT decreased to the level of those seen in GES. While group differences for positive symptoms were not significant, motivation improved in CAT and GES relative to TAU. The highest intensity treatment produced the best outcomes with respect to functioning. However, some improvements were seen with a relatively inexpensive, clinic-based treatment using a package of generic environmental supports. PMID:18374542

  19. Increasing Patient Activation Could Improve Outcomes for Patients with Inflammatory Bowel Disease.

    PubMed

    Shah, Shawn L; Siegel, Corey A

    2015-12-01

    Inflammatory bowel disease (IBD) is a complex disease process that often requires the integration of skills from various health care providers to adequately meet the needs of patients with IBD. The medical and surgical treatment options for IBD have become more complicated and are frequently a source of angst for both the patient and provider. However, it has become more important than ever to engage patients in navigating the treatment algorithm. Although novel in the IBD world, the concept of patients' becoming more active and effective managers of their care has been well studied in other disease processes such as diabetes mellitus and mental illness. This idea of patient activation refers to a patient understanding his or her role in the care process and having the skill sets and self-reliance necessary to manage his or her own health care. Over the past decade, evidence supporting the role of patient activation in chronic illness has grown, revealing improved health outcomes, enhanced patient experiences, and lower overall costs. Patient activation can be measured, and interventions have been shown to improve levels of activation over time and influence outcomes. A focus on patient activation is very appropriate for patients with IBD because this may potentially serve as a tool for IBD providers to not only improve patient outcomes and experience but also reduce health care costs. PMID:26422517

  20. The Effects of Single-Gender Math Classroom Activities on the Achievement and Behavior Outcomes of Fifth-Grade Girls and Boys at a Public Elementary School

    ERIC Educational Resources Information Center

    Chaussee, Erik P.

    2012-01-01

    The purpose of this study was to examine single-gender schools and/or classes as a method of improving student achievement and gaining greater satisfaction in school. The paper will further examine the effects of single-gender classes on student achievement, the academic gender gap, and the attitudes of students and teachers. It will also look at…

  1. Comparing Dichotomous and Trichotomous Approaches to Achievement Goal Theory: An Example Using Motivational Regulations as Outcome Variables

    ERIC Educational Resources Information Center

    Barkoukis, Vassilis; Ntoumanis, Nikos; Nikitaras, Nikitas

    2007-01-01

    Background: It is commonly assumed that there is conceptual equivalence between the task and ego achievement goals proposed by Nicholl's (1989) dichotomous achievement goal theory (Nicholls, 1989), and the mastery and performance approach goals advanced by Elliot's (1997) trichotomous hierarchical model of approach and avoidance achievement…

  2. College Expectations for All? The Early Adult Outcomes of Low-Achieving Adolescents Who Expect to Earn a Bachelor's Degree

    ERIC Educational Resources Information Center

    Martin, Anne; Gardner, Margo

    2016-01-01

    Critics of the college-for-all ethos argue that it encourages low-achieving adolescents to develop unrealistically high expectations. This argument posits that low-achievers waste time and money, and risk disappointment and self-recrimination, pursuing college when they are unlikely to complete it. The present study uses two national data…

  3. What Effective Principals Do to Improve Instruction and Increase Student Achievement

    ERIC Educational Resources Information Center

    Turner, Elizabeth Anne

    2013-01-01

    The purposes of this mixed method study were to (a) Examine the relationships among principal effectiveness, principal instructional leadership, and student achievement; (b) examine the differences among principal effectiveness, principal instructional leadership and student achievement; and (c) investigate what effective principals do to improve…

  4. How Urban School Superintendents Effectively Use Data Driven Decision Making to Improve Student Achievement

    ERIC Educational Resources Information Center

    Root, Lonny Gene

    2010-01-01

    With the passage of the No Child Left Behind (NCLB) Act of 2002, schools, districts, and therefore, superintendents have been held increasingly accountable for the achievement of the students. The states and federal governments have used student achievement data to measure the progress and success of schools and districts and have held districts…

  5. Pieces of the Puzzle: Factors in Improving Achievement of Urban School Districts. Education Outlook. No. 4

    ERIC Educational Resources Information Center

    Casserly, Michael

    2012-01-01

    In one of the first large-scale analyses of urban trends on the National Assessment of Educational Progress (NAEP), the Council of the Great City Schools and the American Institutes for Research identified urban school systems that demonstrated high achievement or significant achievement gains on the NAEP, and examined possible factors behind…

  6. Improving Student Achievement: Can 9th Grade Academies Make a Difference?

    ERIC Educational Resources Information Center

    Styron, Ronald Anthony; Peasant, Eddie J.

    2010-01-01

    This study focused on student achievement in ninth grade schools or academies compared to ninth grade students enrolled in traditional high schools. Student achievement was measured by standardized test scores. Other variables tested were gender and ethnicity. All students used in this study were enrolled in the ninth grade during the 2005-2006…

  7. Developing and Improving Modified Achievement Level Descriptors: Rationale, Procedures, and Tools

    ERIC Educational Resources Information Center

    Quenemoen, Rachel; Albus, Debra; Rogers, Chris; Lazarus, Sheryl

    2010-01-01

    Some states are developing alternate assessments based on modified achievement standards (AA-MAS) to measure the academic achievement of some students with disabilities (Albus, Lazarus, Thurlow, & Cormier, 2009; Lazarus, Thurlow, Christensen, & Cormier, 2007). These assessments measure the same content as the general assessment for a given…

  8. Improving Upper Grade Math Achievement via the Integration of a Culturally Responsive Curriculum.

    ERIC Educational Resources Information Center

    Pajkos, Diane; Klein-Collins, John

    This report describes an intervention program for increasing mathematical achievement of African American students. Within the targeted population, it was evident that the disparity in math achievement between African American and White students was increasing each year. The targeted population consisted of sixth, seventh, and eighth grade…

  9. Foundations for Success: Case Studies of How Urban School Systems Improve Student Achievement [and] Abstract.

    ERIC Educational Resources Information Center

    Snipes, Jason; Doolittle, Fred; Herlihy, Corinne

    This report examines the experiences of three large urban school districts (and part of a fourth) that raised academic performance for their districts as a whole, while also reducing racial differences in achievement. Educational challenges included low achievement, political conflict, inexperienced teachers, low expectations, and lack of…

  10. Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

    PubMed Central

    McLees, Anita W.; Nawaz, Saira; Thomas, Craig; Young, Andrea

    2015-01-01

    We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

  11. The Enabling Role of Education in the Lives of Young People with Disabilities in India: Achieved and Desired Outcomes

    ERIC Educational Resources Information Center

    Singal, Nidhi; Jeffery, Roger; Jain, Aanchal; Sood, Neeru

    2011-01-01

    In India, the last few years have seen an increase in the school enrolment rates of children with disabilities; however, there are continuing concerns about the outcomes of these efforts, especially in terms of employment. This paper presents the findings of a qualitative enquiry into how young people (aged 15-30 years) with various impairments…

  12. Views from the Field: Conservation Educators' and Practitioners' Perceptions of Education as a Strategy for Achieving Conservation Outcomes

    ERIC Educational Resources Information Center

    Ardoin, Nicole M.; Heimlich, Joe E.

    2013-01-01

    This article presents data from a mixed-methods study that collected data through surveys (n = 656), interviews (n = 15), and discussion groups (n = 75) to explore the use of social strategies such as education and outreach by non-governmental organizations and government agencies to reach outcomes related to biodiversity conservation and resource…

  13. The Effect of an English Language Learner Program on Student Achievement Outcomes in Language, Reading, and Math

    ERIC Educational Resources Information Center

    Reid, Jennifer L.

    2011-01-01

    The purpose of the study was to determine the reading, math, and language proficiency outcomes of 4th-grade through 7th-grade students with limited English proficiency following nearly two years or more of instruction in the English Language Learner Program (ELL) and concurrent general education studies. The maximum accrual for this study was…

  14. Identification with Academics and Motivation to Achieve in School: How the Structure of the Self Influences Academic Outcomes

    ERIC Educational Resources Information Center

    Osborne, Jason W.; Jones, Brett D.

    2011-01-01

    Authors since William James ("1892/1968") have implied that the structure of the self-concept can influence motivation and outcomes in particular domains. The value or importance an individual places on a domain influences how motivated that individual is to expend effort in that domain, ultimately influencing the positivity or negativity of the…

  15. Decentralising Education and Improving Student Outcomes: Implications of the International Research for Developing Countries.

    ERIC Educational Resources Information Center

    Townsend, Tony

    In Australia as in many other countries, the idea of decentralization of education is an idea being widely adopted. However, it is not clear whether this has resulted in improved student achievement. A review of international research on decentralization provides clear indications that it cannot be asserted that a decentralized system, in itself,…

  16. "What Works": Recommendations on Improving Academic Experiences and Outcomes for Black Males

    ERIC Educational Resources Information Center

    Howard, Tyrone C.; Douglas, Ty-Ron, M. O.; Warren, Chezare A.

    2016-01-01

    This brief presents the most significant recommendations based on a review of key findings from research presented in this special issue. The authors offer what they believe to be the most important considerations of what works for improving Black male school achievement in the domains of research, practice, and policy.

  17. Focus First on Outcomes: When Planning Change, Improved Student Learning Is the Ultimate Goal

    ERIC Educational Resources Information Center

    Bradley, Janice; Munger, Linda; Hord, Shirley

    2015-01-01

    Educators working to achieve changes in classroom teaching practices that lead to improvement in student learning need to gain clarity in where they are going--what they want to accomplish. Teachers in a professional learning community need a road map as they begin learning and applying a new practice to ensure they reach their intended goal…

  18. The Flipped Classroom Improves Student Achievement and Course Satisfaction in a Statistics Course

    ERIC Educational Resources Information Center

    Peterson, Daniel J.

    2016-01-01

    There are but a handful of experimental or quasi-experimental studies comparing student outcomes from flipped or inverted classrooms to more traditional lecture formats. In the current study, I present cumulative exam performance and student evaluation data from two sections of a statistics course I recently taught: one a traditional lecture (N =…

  19. Continuous Assessment Improved Academic Achievement and Satisfaction of Psychology Students in Spain

    ERIC Educational Resources Information Center

    Carrillo-de-la-Pena, Maria T.; Perez, Jorge

    2012-01-01

    The authors present the experience of a continuous assessment procedure carried out in the second term of a physiological psychology course during 3 consecutive academic years at a Spanish university. Each year, the academic outcomes of students under continuous assessment (the experimental group) were compared with those of students under…

  20. Improving Heart Failure Outcomes: The Role of the Clinical Nurse Specialist.

    PubMed

    Coen, Jennifer; Curry, Kimberly

    2016-01-01

    This article identifies and explains barriers to optimal outcomes of heart failure and the role of the clinical nurse specialist in overcoming these obstacles, improving patient outcomes and quality of life. In recent years, advances in heart failure management have increased survival rates, and as a result, the number of patients requiring services to manage disease progression and the complex array of symptoms associated with end-stage heart disease. Management of the heart failure patient is dependent on the severity of the disease and wide range of available treatment regimens. Disease progression can be unpredictable and treatment regimens increasingly complex. The authors present a typical case of a patient with heart failure, identify the barriers to optimal outcomes in managing heart failure, as well as describe the roles of the clinical nurse specialist in overcoming these barriers within 3 spheres of clinical nurse specialist influence: patient, health care provider, and health care systems. The clinical nurse specialist role is ideally suited to positively affect heart failure outcomes. These positive effects are drawn from the dynamic and unique nature of the clinical nurse specialist role and are perpetrated through the 3 spheres of clinical nurse specialist practice: patient, health care provider, and heath care system. PMID:27575796