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Sample records for achieving optimal outcomes

  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. 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

  3. 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

  4. Identification and Treatment of Pathophysiological Comorbidities of Autism Spectrum Disorder to Achieve Optimal Outcomes.

    PubMed

    Frye, Richard E; Rossignol, Daniel A

    2016-01-01

    the optimal treatments for these abnormalities. PMID:27330338

  5. Identification and Treatment of Pathophysiological Comorbidities of Autism Spectrum Disorder to Achieve Optimal Outcomes

    PubMed Central

    Frye, Richard E.; Rossignol, Daniel A.

    2016-01-01

    the optimal treatments for these abnormalities. PMID:27330338

  6. Academic Abilities in Children and Adolescents with a History of Autism Spectrum Disorders Who Have Achieved Optimal Outcomes

    ERIC Educational Resources Information Center

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

    2014-01-01

    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…

  7. Optimism versus Pessimism and Academic Achievement Evaluation

    ERIC Educational Resources Information Center

    Harpaz-Itay, Yifat; Kaniel, Shlomo

    2012-01-01

    This article integrates three central theories of optimism-pessimism (OP). The combination of the shared components of these theories--outcome expectancies, emotions, and behavioral intention--may produce an integrative academic achievement evaluation. Little has been written regarding the differentiation between general and domain-specific OP, a…

  8. 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

  9. 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…

  10. Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

    PubMed

    Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

    2016-07-01

    The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. PMID:27089522

  11. 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

  12. 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…

  13. Using Attitudinal Questionnaires to Achieve Benefits Optimization

    PubMed Central

    Lundsgaarde, Henry P.; Gardner, Reed M.; Menlove, Ron L.

    1989-01-01

    The evaluation of complex hospital medical and management information systems presents many complex methodological and logistical problems. Many studies, best characterized as outcome or summative evaluations, customarily document failures and successes associated with system implementation. We approach system implementation as an indeterminable process and evaluation as a management tool that can provide essential and timely feedback to both system developers and users. This paper discusses our ongoing and formative evaluation study of the transplacement of the HELP system from the LDS hospital in Salt Lake City to the McKay-Dee Hospital in Ogden, Utah. Surveys of future system users did not show any significant differences between three major groups of respondents (physicians, nurses, and staff) in terms of preferences for user education methods. The results of our work suggest that a formative evaluation study can facilitate system adoption and utilization without compromising concurrent needs of scientific objectivity.

  14. Optimal achieved blood pressure in acute intracerebral hemorrhage

    PubMed Central

    Arima, Hisatomi; Heeley, Emma; Delcourt, Candice; Hirakawa, Yoichiro; Wang, Xia; Woodward, Mark; Robinson, Thompson; Stapf, Christian; Parsons, Mark; Lavados, Pablo M.; Huang, Yining; Wang, Jiguang; Chalmers, John

    2015-01-01

    Objectives: To investigate the effects of intensive blood pressure (BP) lowering according to baseline BP levels and optimal achieved BP levels in patients with acute intracerebral hemorrhage (ICH). Methods: INTERACT2 was an open, blinded endpoint, randomized controlled trial in 2,839 patients with ICH within 6 hours of onset and elevated systolic BP (SBP) (150–220 mm Hg) who were allocated to receive intensive (target SBP <140 mm Hg within 1 hour, with lower limit of 130 mm Hg for treatment cessation) or guideline-recommended (target SBP <180 mm Hg) BP-lowering treatment. Outcome was physical function across all 7 levels of the modified Rankin Scale at 90 days. Results: Analysis of the randomized comparisons showed that intensive BP lowering produced comparable benefits on physical function at 90 days in 5 subgroups defined by baseline SBP of <160, 160–169, 170–179, 180–189, and ≥190 mm Hg (p homogeneity = 0.790). Analyses of achieved BP showed linear increases in the risk of physical dysfunction for achieved SBP above 130 mm Hg for both hyperacute (1–24 hours) and acute (2–7 days) phases while modest increases were also observed for achieved SBP below 130 mm Hg. Conclusions: Intensive BP lowering appears beneficial across a wide range of baseline SBP levels, and target SBP level of 130–139 mm Hg is likely to provide maximum benefit in acute ICH. Classification of evidence: This study provides Class I evidence that the effect of intensive BP lowering on physical function is not influenced by baseline BP. PMID:25552575

  15. WFH: closing the global gap--achieving optimal care.

    PubMed

    Skinner, Mark W

    2012-07-01

    For 50 years, the World Federation of Hemophilia (WFH) has been working globally to close the gap in care and to achieve Treatment for All patients, men and women, with haemophilia and other inherited bleeding disorders, regardless of where they might live. The WFH estimates that more than one in 1000 men and women has a bleeding disorder equating to 6,900,000 worldwide. To close the gap in care between developed and developing nations a continued focus on the successful strategies deployed heretofore will be required. However, in response to the rapid advances in treatment and emerging therapeutic advances on the horizon it will also require fresh approaches and renewed strategic thinking. It is difficult to predict what each therapeutic advance on the horizon will mean for the future, but there is no doubt that we are in a golden age of research and development, which has the prospect of revolutionizing treatment once again. An improved understanding of "optimal" treatment is fundamental to the continued evolution of global care. The challenges of answering government and payer demands for evidence-based medicine, and cost justification for the introduction and enhancement of treatment, are ever-present and growing. To sustain and improve care it is critical to build the body of outcome data for individual patients, within haemophilia treatment centers (HTCs), nationally, regionally and globally. Emerging therapeutic advances (longer half-life therapies and gene transfer) should not be justified or brought to market based only on the notion that they will be economically more affordable, although that may be the case, but rather more importantly that they will be therapeutically more advantageous. Improvements in treatment adherence, reductions in bleeding frequency (including microhemorrhages), better management of trough levels, and improved health outcomes (including quality of life) should be the foremost considerations. As part of a new WFH strategic plan

  16. 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

  17. The Effects of Academic Optimism on Elementary Reading Achievement

    ERIC Educational Resources Information Center

    Bevel, Raymona K.; Mitchell, Roxanne M.

    2012-01-01

    Purpose: The purpose of this paper is to explore the relationship between academic optimism (AO) and elementary reading achievement (RA). Design/methodology/approach: Using correlation and hierarchical linear regression, the authors examined school-level effects of AO on fifth grade reading achievement in 29 elementary schools in Alabama.…

  18. 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

  19. 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

  20. Paths to Success: Optimal and Equitable Health Outcomes for All

    PubMed Central

    Rust, George; Levine, Robert S.; Fry-Johnson, Yvonne; Baltrus, Peter; Ye, Jiali; Mack, Dominic

    2013-01-01

    U.S. health disparities are real, pervasive, and persistent, despite dramatic improvements in civil rights and economic opportunity for racial and ethnic minority and lower socioeconomic groups in the United States. Change is possible, however. Disparities vary widely from one community to another, suggesting that they are not inevitable. Some communities even show paradoxically good outcomes and relative health equity despite significant social inequities. A few communities have even improved from high disparities to more equitable and optimal health outcomes. These positive-deviance communities show that disparities can be overcome and that health equity is achievable. Research must shift from defining the problem (including causes and risk factors) to testing effective interventions, informed by the natural experiments of what has worked in communities that are already moving toward health equity. At the local level, we need multi-dimensional interventions designed in partnership with communities and continuously improved by rapid-cycle surveillance feedback loops of community-level disparities metrics. Similarly coordinated strategies are needed at state and national levels to take success to scale. We propose ten specific steps to follow on a health equity path toward optimal and equitable health outcomes for all Americans. PMID:22643550

  1. Comparative optimism for severity of negative health outcomes.

    PubMed

    Hevey, D; French, D P

    2012-01-01

    People tend to be comparatively optimistic (i.e., believe that negative outcomes are less likely for themselves than for typical others) regarding their susceptibility to negative health outcomes. The present study investigates the extent to which perceptions of the severity of these health outcomes show similar comparative optimism. A student sample (study 1; N = 200) and a healthy non-student adult sample (study 2; N = 257) completed self-report measures of susceptibility, severity, worry, control and experience in relation to negative health outcomes. Participants in both studies demonstrated significant levels of comparative optimism for both perceived likelihood and severity of health outcomes. Comparative optimism concerning severity was very strongly associated (r = 0.85 to 0.89) with comparative optimism concerning susceptibility. In addition to being comparatively optimistic over their chances of experiencing negative health outcomes, people are also comparatively optimistic regarding how severe the health outcomes will be. PMID:22111753

  2. Variation in Patient Profiles and Outcomes in US and Non-US Subgroups of the Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX Trial

    PubMed Central

    Vaduganathan, Muthiah; Harrington, Robert A.; Stone, Gregg W.; Steg, Ph. Gabriel; Gibson, C. Michael; Hamm, Christian W.; Price, Matthew J.; Prats, Jayne; Deliargyris, Efthymios N.; Mahaffey, Kenneth W.; White, Harvey D.

    2016-01-01

    Background— The Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION) PHOENIX trial demonstrated superiority of cangrelor in reducing ischemic events at 48 hours in patients undergoing percutaneous coronary intervention compared with clopidogrel. Methods and Results— We analyzed all patients included in the modified intention-to-treat analysis in US (n=4097; 37.4%) and non-US subgroups (n=6845; 62.6%). The US cohort was older, had a higher burden of cardiovascular risk factors, and had more frequently undergone prior cardiovascular procedures. US patients more frequently underwent percutaneous coronary intervention for stable angina (77.9% versus 46.2%). Almost all US patients (99.1%) received clopidogrel loading doses of 600 mg, whereas 40.5% of non-US patients received 300 mg. Bivalirudin was more frequently used in US patients (56.7% versus 2.9%). At 48 hours, rates of the primary composite end point were comparable in the US and non-US cohorts (5.5% versus 5.2%; P=0.53). Cangrelor reduced rates of the primary composite end point compared with clopidogrel in US (4.5% versus 6.4%; odds ratio 0.70 [95% confidence interval 0.53–0.92]) and in non-US patients (4.8% versus 5.6%; odds ratio 0.85 [95% confidence interval 0.69–1.05]; interaction P=0.26). Similarly, rates of the key secondary end point, stent thrombosis, were reduced by cangrelor in both regions. Rates of Global Use of Strategies to Open Occluded Arteries (GUSTO)–defined severe bleeding were low and not significantly increased by cangrelor in either region. Conclusions— Despite broad differences in clinical profiles and indications for percutaneous coronary intervention by region in a large global cardiovascular clinical trial, cangrelor consistently reduced rates of ischemic end points compared with clopidogrel without an excess in severe bleeding in both the US and non-US subgroups. Clinical Trial Registration— URL: http

  3. 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)

  4. Academic Optimism and Student Achievement in Urban Elementary Schools

    ERIC Educational Resources Information Center

    Smith, Page A.; Hoy, Wayne K.

    2007-01-01

    Purpose: The aim of this study was two-fold: to demonstrate a general construct of schools called academic optimism and to show it was related to student achievement in urban elementary schools, even controlling for socioeconomic factors, and school size. Design/methodology/approach: Data were collected from 99 urban elementary schools in Texas…

  5. The Influence of Outcome Desirability on Optimism

    ERIC Educational Resources Information Center

    Krizan, Zlatan; Windschitl, Paul D.

    2007-01-01

    People are often presumed to be vulnerable to a desirability bias, namely, a tendency to be overoptimistic about a future outcome as a result of their preferences or desires for that outcome. In this article, this form of wishful thinking is distinguished from the more general concepts of motivated reasoning and overoptimism, and the evidence for…

  6. 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

  7. 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…

  8. 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.…

  9. 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…

  10. 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…

  11. Translational geroscience: emphasizing function to achieve optimal longevity.

    PubMed

    Seals, Douglas R; Melov, Simon

    2014-09-01

    Among individuals, biological aging leads to cellular and organismal dysfunction and an increased risk of chronic degenerative diseases and disability. This sequence of events in combination with the projected increases in the number of older adults will result in a worldwide healthcare burden with dire consequences. Superimposed on this setting are the adults now reaching traditional retirement ages--the baby boomers--a group that wishes to remain active, productive and physically and cognitively fit as they grow older. Together, these conditions are producing an unprecedented demand for increased healthspan or what might be termed "optimal longevity"-to live long, but well. To meet this demand, investigators with interests in the biological aspects of aging from model organisms to human epidemiology (population aging) must work together within an interactive process that we describe astranslational geroscience. An essential goal of this new investigational platform should be the optimization and preservation of physiological function throughout the lifespan, including integrative physical and cognitive function, which would serve to increase healthspan, compress morbidity and disability into a shorter period of late-life, and help achieve optimal longevity. To most effectively utilize this new approach, we must rethink how investigators and administrators working at different levels of the translational research continuum communicate and collaborate with each other, how best to train the next generation of scientists in this new field, and how contemporary biological-biomedical aging research should be organized and funded. PMID:25324468

  12. Translational Geroscience: Emphasizing function to achieve optimal longevity

    PubMed Central

    Seals, Douglas R.; Melov, Simon

    2014-01-01

    Among individuals, biological aging leads to cellular and organismal dysfunction and an increased risk of chronic degenerative diseases and disability. This sequence of events in combination with the projected increases in the number of older adults will result in a worldwide healthcare burden with dire consequences. Superimposed on this setting are the adults now reaching traditional retirement ages--the baby boomers--a group that wishes to remain active, productive and physically and cognitively fit as they grow older. Together, these conditions are producing an unprecedented demand for increased healthspan or what might be termed “optimal longevity”—to live long, but well. To meet this demand, investigators with interests in the biological aspects of aging from model organisms to human epidemiology (population aging) must work together within an interactive process that we describe as translational geroscience. An essential goal of this new investigational platform should be the optimization and preservation of physiological function throughout the lifespan, including integrative physical and cognitive function, which would serve to increase healthspan, compress morbidity and disability into a shorter period of late-life, and help achieve optimal longevity. To most effectively utilize this new approach, we must rethink how investigators and administrators working at different levels of the translational research continuum communicate and collaborate with each other, how best to train the next generation of scientists in this new field, and how contemporary biological-biomedical aging research should be organized and funded. PMID:25324468

  13. 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…

  14. 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…

  15. 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…

  16. [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

  17. 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

  18. Toward Optimal Outcome Following Pivotal Response Treatment: A Case Series

    PubMed Central

    Ventola, Pamela E.; Oosting, Devon R.; Keifer, Cara M.; Friedman, Hannah E.

    2015-01-01

    There is a growing literature on children with autism spectrum disorder (ASD) who respond favorably to behavioral treatment, which is often termed “optimal outcome.” Rates and definitions of optimal outcome vary widely. The current case series describes an empirically validated behavioral treatment approach called Pivotal Response Treatment (PRT). We present two preschool-aged children who received an intensive course of PRT and seem to be on a trajectory toward potential optimal outcome. Understanding response to treatment and predictors of response is crucial, not necessarily to predict who may succeed, but to individualize medicine and match children with customized treatment programs that will be best tailored to their unique and varied needs. PMID:25745373

  19. Optimized Delivery System Achieves Enhanced Endomyocardial Stem Cell Retention

    PubMed Central

    Behfar, Atta; Latere, Jean-Pierre; Bartunek, Jozef; Homsy, Christian; Daro, Dorothee; Crespo-Diaz, Ruben J.; Stalboerger, Paul G.; Steenwinckel, Valerie; Seron, Aymeric; Redfield, Margaret M.; Terzic, Andre

    2014-01-01

    Background Regenerative cell-based therapies are associated with limited myocardial retention of delivered stem cells. The objective of this study is to develop an endocardial delivery system for enhanced cell retention. Methods and Results Stem cell retention was simulated in silico using one and three-dimensional models of tissue distortion and compliance associated with delivery. Needle designs, predicted to be optimal, were accordingly engineered using nitinol – a nickel and titanium alloy displaying shape memory and super-elasticity. Biocompatibility was tested with human mesenchymal stem cells. Experimental validation was performed with species-matched cells directly delivered into Langendorff-perfused porcine hearts or administered percutaneously into the endocardium of infarcted pigs. Cell retention was quantified by flow cytometry and real time quantitative polymerase chain reaction methodology. Models, computing optimal distribution of distortion calibrated to favor tissue compliance, predicted that a 75°-curved needle featuring small-to-large graded side holes would ensure the highest cell retention profile. In isolated hearts, the nitinol curved needle catheter (C-Cath) design ensured 3-fold superior stem cell retention compared to a standard needle. In the setting of chronic infarction, percutaneous delivery of stem cells with C-Cath yielded a 37.7±7.1% versus 10.0±2.8% retention achieved with a traditional needle, without impact on biocompatibility or safety. Conclusions Modeling guided development of a nitinol-based curved needle delivery system with incremental side holes achieved enhanced myocardial stem cell retention. PMID:24326777

  20. Toward achieving optimal response: understanding and managing antidepressant side effects

    PubMed Central

    Kelly, Karen; Posternak, Michael; Jonathan, E. Alpert

    2008-01-01

    The safety and tolerability of antidepressants have improved considerably over the past two decades, Nevertheless, antidepressant side effects are still common and problematic. The majority of patients treated with contemporary agents experience one or more bothersome side effects. These side effects often create barriers to achieving depressive remission, as well as to preventing relapse and recurrence. Clinicians tend to underestimate the prevalence of side effects, and as many as one quarter of patients discontinue their antidepressants because of difficult-to-tolerate side effects; others may continue on antidepressant therapy but experience diminished quality of life related to troublesome side effects. This article reviews the prevalence of side effects, the impact of side effects on treatment adherence, and methodological issues including the challenge of distinguishing side effects from residual depressive symptoms, discontinuation effects, and general medical problems. In addition, we address the most common side effects such as sexual dysfunction, gastrointestinal problems, sleep disturbance, apathy, and fatigue, and offer strategies for management that may help patients achieve optimal response to pharmacotherapy. PMID:19170398

  1. 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,…

  2. 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…

  3. 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…

  4. 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…

  5. 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.

  6. 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)…

  7. 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…

  8. 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…

  9. 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…

  10. The optimal polarizations for achieving maximum contrast in radar images

    NASA Technical Reports Server (NTRS)

    Swartz, A. A.; Yueh, H. A.; Kong, J. A.; Novak, L. M.; Shin, R. T.

    1988-01-01

    There is considerable interest in determining the optimal polarizations that maximize contrast between two scattering classes in polarimetric radar images. A systematic approach is presented for obtaining the optimal polarimetric matched filter, i.e., that filter which produces maximum contrast between two scattering classes. The maximization procedure involves solving an eigenvalue problem where the eigenvector corresponding to the maximum contrast ratio is an optimal polarimetric matched filter. To exhibit the physical significance of this filter, it is transformed into its associated transmitting and receiving polarization states, written in terms of horizontal and vertical vector components. For the special case where the transmitting polarization is fixed, the receiving polarization which maximizes the contrast ratio is also obtained. Polarimetric filtering is then applies to synthetic aperture radar images obtained from the Jet Propulsion Laboratory. It is shown, both numerically and through the use of radar imagery, that maximum image contrast can be realized when data is processed with the optimal polarimeter matched filter.

  11. Optimal Treatment Adherence Counseling Outcomes for People Living with HIV and Limited Health Literacy.

    PubMed

    Pellowski, Jennifer A; Kalichman, Seth C; Grebler, Tamar

    2016-01-01

    Limited health literacy has been shown to contribute to poor adherence to antiretroviral therapy (ART) in people living with HIV/AIDS. Given the mixed results of previous interventions for people with HIV and low health literacy, investigating possible targets for improved adherence is warranted. The present study aims to identify the correlates of optimal and suboptimal outcomes among participants of a recent skills-based medication adherence intervention. This secondary analysis included 188 men and women living with HIV who had low health literacy and who had complete viral load data. Adherence was assessed by unannounced pill count and follow-up viral loads were assessed by blood draw. Results showed that higher levels of health literacy and lower levels of alcohol use were the strongest predictors of achieving HIV viral load optimal outcomes. The interplay between lower health literacy and alcohol use on adherence should be the focus of future research. PMID:25211524

  12. 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

  13. 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…

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. Aircraft optimization by a system approach: Achievements and trends

    NASA Technical Reports Server (NTRS)

    Sobieszczanski-Sobieski, Jaroslaw

    1992-01-01

    Recently emerging methodology for optimal design of aircraft treated as a system of interacting physical phenomena and parts is examined. The methodology is found to coalesce into methods for hierarchic, non-hierarchic, and hybrid systems all dependent on sensitivity analysis. A separate category of methods has also evolved independent of sensitivity analysis, hence suitable for discrete problems. References and numerical applications are cited. Massively parallel computer processing is seen as enabling technology for practical implementation of the methodology.

  2. Multidisciplinary optimization for engineering systems: Achievements and potential

    NASA Technical Reports Server (NTRS)

    Sobieszczanski-Sobieski, Jaroslaw

    1989-01-01

    The currently common sequential design process for engineering systems is likely to lead to suboptimal designs. Recently developed decomposition methods offer an alternative for coming closer to optimum by breaking the large task of system optimization into smaller, concurrently executed and, yet, coupled tasks, identified with engineering disciplines or subsystems. The hierarchic and non-hierarchic decompositions are discussed and illustrated by examples. An organization of a design process centered on the non-hierarchic decomposition is proposed.

  3. Achieving Optimal Privacy in Trust-Aware Social Recommender Systems

    NASA Astrophysics Data System (ADS)

    Dokoohaki, Nima; Kaleli, Cihan; Polat, Huseyin; Matskin, Mihhail

    Collaborative filtering (CF) recommenders are subject to numerous shortcomings such as centralized processing, vulnerability to shilling attacks, and most important of all privacy. To overcome these obstacles, researchers proposed for utilization of interpersonal trust between users, to alleviate many of these crucial shortcomings. Till now, attention has been mainly paid to strong points about trust-aware recommenders such as alleviating profile sparsity or calculation cost efficiency, while least attention has been paid on investigating the notion of privacy surrounding the disclosure of individual ratings and most importantly protection of trust computation across social networks forming the backbone of these systems. To contribute to addressing problem of privacy in trust-aware recommenders, within this paper, first we introduce a framework for enabling privacy-preserving trust-aware recommendation generation. While trust mechanism aims at elevating recommender's accuracy, to preserve privacy, accuracy of the system needs to be decreased. Since within this context, privacy and accuracy are conflicting goals we show that a Pareto set can be found as an optimal setting for both privacy-preserving and trust-enabling mechanisms. We show that this Pareto set, when used as the configuration for measuring the accuracy of base collaborative filtering engine, yields an optimized tradeoff between conflicting goals of privacy and accuracy. We prove this concept along with applicability of our framework by experimenting with accuracy and privacy factors, and we show through experiment how such optimal set can be inferred.

  4. "Uh," "Um," and Autism: Filler Disfluencies as Pragmatic Markers in Adolescents with Optimal Outcomes from Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Irvine, Christina A.; Eigsti, Inge-Marie; Fein, Deborah A.

    2016-01-01

    Filler disfluencies--"uh" and "um"--are thought to serve distinct discourse functions. We examined fillers in spontaneous speech by youth with autism spectrum disorder (ASD), who struggle with pragmatic language, and by youth with ASD who have achieved an "optimal outcome" (OO), as well as in peers with typical…

  5. Gout: optimizing treatment to achieve a disease cure

    PubMed Central

    Bernal, José Antonio; Quilis, Neus; Andrés, Mariano; Sivera, Francisca; Pascual, Eliseo

    2016-01-01

    Gout is one of the most common inflammatory arthritides. The disease is due to the deposition of monosodium urate crystals. These deposits are reversible with proper treatment, suggesting that gout is a curable disease. The main aim in gout is to lower serum uric acid levels to a pre-established target; there are different urate-lowering drugs (xanthine oxidase inhibitors, uricosurics and uricases) through which this can be achieved. Proper treatment of gout also involves correct management of acute flares and their prevention. To ensure treatment adherence it is necessary to explain to the patient what the objectives are. PMID:26977282

  6. Optimal conservation outcomes require both restoration and protection.

    PubMed

    Possingham, Hugh P; Bode, Michael; Klein, Carissa J

    2015-01-01

    Conservation outcomes are principally achieved through the protection of intact habitat or the restoration of degraded habitat. Restoration is generally considered a lower priority action than protection because protection is thought to provide superior outcomes, at lower costs, without the time delay required for restoration. Yet while it is broadly accepted that protected intact habitat safeguards more biodiversity and generates greater ecosystem services per unit area than restored habitat, conservation lacks a theory that can coherently compare the relative outcomes of the two actions. We use a dynamic landscape model to integrate these two actions into a unified conservation theory of protection and restoration. Using nonlinear benefit functions, we show that both actions are crucial components of a conservation strategy that seeks to optimise either biodiversity conservation or ecosystem services provision. In contrast to conservation orthodoxy, in some circumstances, restoration should be strongly preferred to protection. The relative priority of protection and restoration depends on their costs and also on the different time lags that are inherent to both protection and restoration. We derive a simple and easy-to-interpret heuristic that integrates these factors into a single equation that applies equally to biodiversity conservation and ecosystem service objectives. We use two examples to illustrate the theory: bird conservation in tropical rainforests and coastal defence provided by mangrove forests. PMID:25625277

  7. Haemodialysate: long neglected, difficult to optimize, may modify hard outcomes.

    PubMed

    Perez-Gomez, Maria Vanessa; Gonzalez-Parra, Emilio; Ortiz, Alberto

    2015-10-01

    In two recent CKJ reviews, experts (Basile and Lomonte and Locatelli et al.) have reviewed haemodialysate composition. A long-neglected issue, observational studies have associated the composition of haemodialysate to adverse outcomes. However, the scarcity of clinical trial-derived information results in limited guideline recommendations on the issue. Indeed, guidelines have more frequently indicated what not to do rather than what to do. In this setting, expert opinion becomes invaluable. In designing haemodialysate composition, a balance should be struck between the need to correct within a time frame of around 4 hours the electrolyte and water imbalances that take 48 to 72 h to build, with the need for gradual correction of these imbalances. The issue is complicated further by the impact of individual variability in dietary habits, medications and comorbidities. In this regard, a personalized medicine approach to individualization of haemodialysate composition offers the best chance of improving patient outcomes. But how can haemodialysate individualization be achieved, and what clinical trial design will best test the impact of such approaches on patient outcomes? PMID:26413284

  8. Haemodialysate: long neglected, difficult to optimize, may modify hard outcomes

    PubMed Central

    Perez-Gomez, Maria Vanessa; Gonzalez-Parra, Emilio; Ortiz, Alberto

    2015-01-01

    In two recent CKJ reviews, experts (Basile and Lomonte and Locatelli et al.) have reviewed haemodialysate composition. A long-neglected issue, observational studies have associated the composition of haemodialysate to adverse outcomes. However, the scarcity of clinical trial-derived information results in limited guideline recommendations on the issue. Indeed, guidelines have more frequently indicated what not to do rather than what to do. In this setting, expert opinion becomes invaluable. In designing haemodialysate composition, a balance should be struck between the need to correct within a time frame of around 4 hours the electrolyte and water imbalances that take 48 to 72 h to build, with the need for gradual correction of these imbalances. The issue is complicated further by the impact of individual variability in dietary habits, medications and comorbidities. In this regard, a personalized medicine approach to individualization of haemodialysate composition offers the best chance of improving patient outcomes. But how can haemodialysate individualization be achieved, and what clinical trial design will best test the impact of such approaches on patient outcomes? PMID:26413284

  9. Optimal Conservation Outcomes Require Both Restoration and Protection

    PubMed Central

    Possingham, Hugh P.; Bode, Michael; Klein, Carissa J.

    2015-01-01

    Conservation outcomes are principally achieved through the protection of intact habitat or the restoration of degraded habitat. Restoration is generally considered a lower priority action than protection because protection is thought to provide superior outcomes, at lower costs, without the time delay required for restoration. Yet while it is broadly accepted that protected intact habitat safeguards more biodiversity and generates greater ecosystem services per unit area than restored habitat, conservation lacks a theory that can coherently compare the relative outcomes of the two actions. We use a dynamic landscape model to integrate these two actions into a unified conservation theory of protection and restoration. Using nonlinear benefit functions, we show that both actions are crucial components of a conservation strategy that seeks to optimise either biodiversity conservation or ecosystem services provision. In contrast to conservation orthodoxy, in some circumstances, restoration should be strongly preferred to protection. The relative priority of protection and restoration depends on their costs and also on the different time lags that are inherent to both protection and restoration. We derive a simple and easy-to-interpret heuristic that integrates these factors into a single equation that applies equally to biodiversity conservation and ecosystem service objectives. We use two examples to illustrate the theory: bird conservation in tropical rainforests and coastal defence provided by mangrove forests. PMID:25625277

  10. Concurrently adjusting interrelated control parameters to achieve optimal engine performance

    DOEpatents

    Jiang, Li; Lee, Donghoon; Yilmaz, Hakan; Stefanopoulou, Anna

    2015-12-01

    Methods and systems for real-time engine control optimization are provided. A value of an engine performance variable is determined, a value of a first operating condition and a value of a second operating condition of a vehicle engine are detected, and initial values for a first engine control parameter and a second engine control parameter are determined based on the detected first operating condition and the detected second operating condition. The initial values for the first engine control parameter and the second engine control parameter are adjusted based on the determined value of the engine performance variable to cause the engine performance variable to approach a target engine performance variable. In order to cause the engine performance variable to approach the target engine performance variable, adjusting the initial value for the first engine control parameter necessitates a corresponding adjustment of the initial value for the second engine control parameter.

  11. 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…

  12. Optimizing outcomes with azacitidine: recommendations from Canadian centres of excellence.

    PubMed

    Wells, R A; Leber, B; Zhu, N Y; Storring, J M

    2014-02-01

    Myelodysplastic syndromes (mdss) constitute a heterogeneous group of malignant hematologic disorders characterized by marrow dysplasia, ineffective hematopoiesis, peripheral blood cytopenias, and pronounced risk of progression to acute myeloid leukemia. Azacitidine has emerged as an important treatment option and is recommended by the Canadian Consortium on Evidence-Based Care in mds as a first-line therapy for intermediate-2 and high-risk patients not eligible for allogeneic stem cell transplant; however, practical guidance on how to manage patients through treatment is limited. This best practice guideline provides recommendations by a panel of experts from Canadian centres of excellence on the selection and clinical management of mds patients with azacitidine. Familiarity with the referral process, treatment protocols, dose scheduling, treatment expectations, response monitoring, management of treatment breaks and adverse events, and multidisciplinary strategies for patient support will improve the opportunity for optimizing treatment outcomes with azacitidine. PMID:24523604

  13. Optimizing outcomes with azacitidine: recommendations from Canadian centres of excellence

    PubMed Central

    Wells, R.A.; Leber, B.; Zhu, N.Y.; Storring, J.M.

    2014-01-01

    Myelodysplastic syndromes (mdss) constitute a heterogeneous group of malignant hematologic disorders characterized by marrow dysplasia, ineffective hematopoiesis, peripheral blood cytopenias, and pronounced risk of progression to acute myeloid leukemia. Azacitidine has emerged as an important treatment option and is recommended by the Canadian Consortium on Evidence-Based Care in mds as a first-line therapy for intermediate-2 and high-risk patients not eligible for allogeneic stem cell transplant; however, practical guidance on how to manage patients through treatment is limited. This best practice guideline provides recommendations by a panel of experts from Canadian centres of excellence on the selection and clinical management of mds patients with azacitidine. Familiarity with the referral process, treatment protocols, dose scheduling, treatment expectations, response monitoring, management of treatment breaks and adverse events, and multidisciplinary strategies for patient support will improve the opportunity for optimizing treatment outcomes with azacitidine. PMID:24523604

  14. Multiphase Nano-Composite Coatings for Achieving Energy Optimization

    SciTech Connect

    Nainaparampil, Jose

    2012-03-26

    UES Inc. and ANL teamed in this work to develop novel coating systems for the protection of surfaces from thermal degradation mainly in two applications; Machining and Die casting. These coatings were specifically designed for the purpose by incorporating required material phases and the overall architecture, which led to reduce the energy usage and increase efficiency of the operations. Following the UES/ANL's feasibility work, the coatings were developed utilizing High power impulse magnetron sputtering (HiPMS) and Large area filtered arc deposition (LAFAD) techniques. Toughness, hardness and oxidation resistance: contrasting qualities have been mixed in the right proportion to attain the suitable material characteristic for the cause. Hafnium diboride (HfB2) based materials provided such a system and its properties were tamed to attain the right combination of toughness and hardness by working on the microstructure and architecture of coatings. An effective interfacing material (graded concentrations of topcoat) was also achieved in this work to provide the required adhesion between the substrate and the coating. Combination of an appropriate bond coat and a functional top coat provided the present thermal degradation resistant coating for cutting tools and die-casting applications. Laboratory level performance tests and industrial level application tests by partner companies (Beta Site Testing) were used for the development of these coatings.

  15. Optimal designs for epidemiologic longitudinal studies with binary outcomes.

    PubMed

    Mehtälä, Juha; Auranen, Kari; Kulathinal, Sangita

    2015-12-01

    Alternating presence and absence of a medical condition in human subjects is often modelled as an outcome of underlying process dynamics. Longitudinal studies provide important insights into research questions involving such dynamics. This article concerns optimal designs for studies in which the dynamics are modelled as a binary continuous-time Markov process. Either one or both the transition rate parameters in the model are to be estimated with maximum precision from a sequence of observations made at discrete times on a number of subjects. The design questions concern the choice of time interval between observations, the initial state of each subject and the choice between number of subjects versus repeated observations per subject. Sequential designs are considered due to dependence of the designs on the model parameters. The optimal time spacing can be approximated by the reciprocal of the sum of the two rates. The initial distribution of the study subjects should be taken into account when relatively few repeated samples per subject are to be collected. A study with a reasonably large size should be designed in more than one phase because there are then enough observations to be spent in the first phase to revise the time spacing for the subsequent phases. PMID:22170892

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. Collective Responsibility, Academic Optimism, and Student Achievement in Taiwan Elementary Schools

    ERIC Educational Resources Information Center

    Wu, Hsin-Chieh

    2012-01-01

    Previous research indicates that collective efficacy, faculty trust in students and parents, and academic emphasis together formed a single latent school construct, called academic optimism. In the U.S., academic optimism has been proven to be a powerful construct that could effectively predict student achievement even after controlling for…

  2. 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.

  3. 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

  4. Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH

    PubMed Central

    2013-01-01

    Optimizing Population Health and Economic Outcomes: Innovative Treatment for Benign Prostatic Hyperplasia (BPH) Transcribed and adapted for publication by Janice L. Clarke, RN, BBA Editorial: David B. Nash, MD, MBA   S-2 Introduction   S-2 Benign Prostatic Hyperplasia (BPH)   S-3 • Overview   S-3• Current BPH Treatment Paradigm   S-4• BPH Continuum of Care: Bladder Health   S-5 New Treatment Option for BPH   S-5 • The UroLift® System   S-6• Positioning of UroLift® in BPH Treatment Paradigm   S-7 New Value Proposition   S-8 • Addressing Bladder Health: Breaking the Cycle   S-8• Cost Benefit Analysis: The Big Picture   S-8 Patient and Family Engagement   S-10 Summary   S-11 PMID:22823180

  5. Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes.

    PubMed

    Bischoff-Ferrari, Heike A

    2014-01-01

    Recent evidence suggests that vitamin D deficiency has harmful effects on health and that recent vitamin D intake recommendations may be associated with better health outcomes. In this chapter, evidence is summarized from different studies that evaluate threshold levels for serum 25(OH)D levels in relation to bone mineral density (BMD), lower extremity function, dental health, risk of falls, fractures, cancer prevention, incident hypertension and mortality. For all endpoints, levels in the deficient range (< 50 nmol/l; < 20 ng/ml) are associated with no benefit or adverse effects, while the most advantageous serum levels for 25(OH)D appeared to be close to 75 nmol/l (30 ng/ml). An intake of 800 IU (20 microg) of vitamin D3 (cholecalciferol) per day for all adults may bring 97% of the population to level of at least 50 nmol/l and about 50% up to 75 nmol/l. Thus, higher doses of vitamin D than currently recommended are needed to bring most individuals to75 nmol/l. While estimates suggest that 1600 to 2000 IU vitamin D3 per day may successfully and safely achieve this goal, the implications of higher doses for the total adult population need to be addressed in future studies. PMID:25207384

  6. 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

  7. 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

  8. 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

  9. Clinical Outcome Metrics for Optimization of Robust Training

    NASA Technical Reports Server (NTRS)

    Ebert, D.; Byrne, V. E.; McGuire, K. M.; Hurst, V. W., IV; Kerstman, E. L.; Cole, R. W.; Sargsyan, A. E.; Garcia, K. M,; Foy, M. H.; Dulchavsky, S. A.; Gibson, C. R.

    2015-01-01

    The emphasis of this research is on the Human Research Program (HRP) Exploration Medical Capabilities (ExMC) "Risk of Unacceptable Health and Mission Outcomes Due to Limitations of In-flight Medical Capabilities". Specifically, this project aims to contribute to the closure of gap ExMC 2.02: We do not know how the inclusion of a physician crew medical officer quantitatively impacts clinical outcomes during exploration missions. The experiments are specifically designed to address clinical outcome differences between physician and non-physician cohorts in both near-term and longer-term (mission impacting) outcomes.

  10. 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

  11. Current management of fecal incontinence: Choosing amongst treatment options to optimize outcomes

    PubMed Central

    Van Koughnett, Julie Ann M; Wexner, Steven D

    2013-01-01

    The severity of fecal incontinence widely varies and can have dramatic devastating impacts on a person’s life. Fecal incontinence is common, though it is often under-reported by patients. In addition to standard treatment options, new treatments have been developed during the past decade to attempt to effectively treat fecal incontinence with minimal morbidity. Non-operative treatments include dietary modifications, medications, and biofeedback therapy. Currently used surgical treatments include repair (sphincteroplasty), stimulation (sacral nerve stimulation or posterior tibial nerve stimulation), replacement (artificial bowel sphincter or muscle transposition) and diversion (stoma formation). Newer augmentation treatments such as radiofrequency energy delivery and injectable materials, are minimally invasive tools that may be good options before proceeding to surgery in some patients with mild fecal incontinence. In general, more invasive surgical treatments are now reserved for moderate to severe fecal incontinence. Functional and quality of life related outcomes, as well as potential complications of the treatment must be considered and the treatment of fecal incontinence must be individualized to the patient. General indications, techniques, and outcomes profiles for the various treatments of fecal incontinence are discussed in detail. Choosing the most effective treatment for the individual patient is essential to achieve optimal outcomes in the treatment of fecal incontinence. PMID:24409050

  12. 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…

  13. Optimizing outcomes in vasectomy: how to ensure sterility and prevent complications.

    PubMed

    Lowe, Gregory

    2016-04-01

    Vasectomy provides a long-term effective sterilization for men and is performed on nearly 500,000 men annually in the United States. Improvements in technique have led to a decreased failure rate and fewer complications, although significant variations in technique exist. Use of cautery occlusion with or without fascial interposition appears to have the least failures. A no-scalpel approach lowers risk of hematoma formation, infection and bleeding post-operatively. A patient can be considered sterile when azoospermia is achieved or the semen analysis shows less than 100,000 non-motile sperm per milliliter. Incorporating these principles may allow the physician to optimize outcomes in vasectomy. PMID:27141443

  14. Optimizing outcomes in vasectomy: how to ensure sterility and prevent complications

    PubMed Central

    2016-01-01

    Vasectomy provides a long-term effective sterilization for men and is performed on nearly 500,000 men annually in the United States. Improvements in technique have led to a decreased failure rate and fewer complications, although significant variations in technique exist. Use of cautery occlusion with or without fascial interposition appears to have the least failures. A no-scalpel approach lowers risk of hematoma formation, infection and bleeding post-operatively. A patient can be considered sterile when azoospermia is achieved or the semen analysis shows less than 100,000 non-motile sperm per milliliter. Incorporating these principles may allow the physician to optimize outcomes in vasectomy. PMID:27141443

  15. Clinical Outcome Metrics for Optimization of Robust Training

    NASA Technical Reports Server (NTRS)

    Ebert, Doug; Byrne, Vicky; Cole, Richard; Dulchavsky, Scott; Foy, Millennia; Garcia, Kathleen; Gibson, Robert; Ham, David; Hurst, Victor; Kerstman, Eric; McGuire, Kerry; Sargsyan, Ashot

    2015-01-01

    The objective of this research is to develop and use clinical outcome metrics and training tools to quantify the differences in performance of a physician vs non-physician crew medical officer (CMO) analogues during simulations.

  16. Clinical Outcome Metrics for Optimization of Robust Training

    NASA Technical Reports Server (NTRS)

    Ebert, D.; Byrne, V. E.; McGuire, K. M.; Hurst, V. W., IV; Kerstman, E. L.; Cole, R. W.; Sargsyan, A. E.; Garcia, K. M.; Reyes, D.; Young, M.

    2016-01-01

    Introduction: The emphasis of this research is on the Human Research Program (HRP) Exploration Medical Capability's (ExMC) "Risk of Unacceptable Health and Mission Outcomes Due to Limitations of In-Flight Medical Capabilities." Specifically, this project aims to contribute to the closure of gap ExMC 2.02: We do not know how the inclusion of a physician crew medical officer quantitatively impacts clinical outcomes during exploration missions. The experiments are specifically designed to address clinical outcome differences between physician and non-physician cohorts in both near-term and longer-term (mission impacting) outcomes. Methods: Medical simulations will systematically compare success of individual diagnostic and therapeutic procedure simulations performed by physician and non-physician crew medical officer (CMO) analogs using clearly defined short-term (individual procedure) outcome metrics. In the subsequent step of the project, the procedure simulation outcomes will be used as input to a modified version of the NASA Integrated Medical Model (IMM) to analyze the effect of the outcome (degree of success) of individual procedures (including successful, imperfectly performed, and failed procedures) on overall long-term clinical outcomes and the consequent mission impacts. The procedures to be simulated are endotracheal intubation, fundoscopic examination, kidney/urinary ultrasound, ultrasound-guided intravenous catheter insertion, and a differential diagnosis exercise. Multiple assessment techniques will be used, centered on medical procedure simulation studies occurring at 3, 6, and 12 months after initial training (as depicted in the following flow diagram of the experiment design). Discussion: Analysis of procedure outcomes in the physician and non-physician groups and their subsets (tested at different elapsed times post training) will allow the team to 1) define differences between physician and non-physician CMOs in terms of both procedure performance

  17. 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

  18. Epileptic encephalopathies: Optimizing seizure control and developmental outcome.

    PubMed

    Jehi, Lara; Wyllie, Elaine; Devinsky, Orrin

    2015-10-01

    Cognitive and developmental outcomes in patients with epileptic encephalopathy are hypothesized to result from an interplay between the underlying epileptic pathologic substrate and the acquired consequences of frequent and repetitive seizures and epileptiform discharges that often straddle the interictal and ictal boundaries. This article briefly reviews the evidence related to this assumption, presents critical questions that need to be answered to clarify this relationship, and advances a set of concrete steps that may help improve developmental patient outcomes. PMID:26293588

  19. Achieving optimal aesthetics for direct and indirect restorations with microhybrid composite resins.

    PubMed

    Okuda, Wynn H

    2005-04-01

    In aesthetic dentistry, material science has played a key role in the development of natural-appearing restorations. Despite the progress, there have been challenges in achieving a harmonious integration of direct and indirect posterior restorations. Although porcelain restorations provide natural aesthetics, ceramics cannot be applied via direct techniques. Consequently, composite resins are valuable alternatives for conservative posterior restorations. In addition, because of their differing physical and optical properties, optimal aesthetic blending with porcelain and resin cannot be routinely achieved. This article explores the potential of composite resins as a direct and indirect restorative option in achieving the most favorable natural blend in the posterior region. PMID:15974036

  20. Academic Optimism of High School Teachers: Its Relationship to Organizational Citizenship Behaviors and Student Achievement

    ERIC Educational Resources Information Center

    Wagner, Charles A.; DiPaola, Michael F.

    2011-01-01

    The purpose of this study is to build on an emergent research base for academic optimism by testing the construct and its relationship to student achievement and organizational citizenship behaviors in schools in a sample of public high schools. All participants in this study were full-time teachers, guidance counselors, and other full-time…

  1. 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…

  2. 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

  3. 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

  4. 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…

  5. 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;…

  6. Optimizing oncologic outcomes in upper tract urothelial carcinoma.

    PubMed

    Hutchinson, Ryan C; Margulis, Vitaly

    2016-08-01

    Upper tract urothelial carcinoma is a disease with rapidly changing management. Though rare, recent multi-institutional collaborations have allowed for study of its biology and treatment outcomes in greater detail than ever before. In coming years physicians treating ureteral cancers will have an expanded armamentarium of treatment options and better data on which to base treatment decisions. Currently there is exciting work underway both in terms of developmental therapies, including neoadjuvant chemotherapy, as well as improved prognostics allowing for better utilization of nephron-sparing approaches where applicable. We present a review of current management techniques and the data on which to base management choices for surgeons treating upper tract urothelial carcinoma. The ultimate goal is improving outcomes for patients; with recent developments and current work in the field, there is reason to be optimistic for the future in this rare, challenging disease. PMID:26756501

  7. 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…

  8. Current state of ST-segment myocardial infarction: evidence-based therapies and optimal patient outcomes in advanced systems of care.

    PubMed

    Thomas, Joseph L; French, William J

    2014-08-01

    Advances in reperfusion therapy for ST-segment elevation myocardial infarction (STEMI) provide optimal patient outcomes. Reperfusion therapies, including contemporary primary percutaneous coronary intervention, represent decades of clinical evidence development in large clinical trials and national databases. However, rapid identification of STEMI and guideline-directed management of patients across broad populations have been best achieved in advanced systems of care. Current outcomes in STEMI reflect the evolution of both clinical data and idealized health care delivery networks. PMID:25091964

  9. Robust, integrated computational control of NMR experiments to achieve optimal assignment by ADAPT-NMR.

    PubMed

    Bahrami, Arash; Tonelli, Marco; Sahu, Sarata C; Singarapu, Kiran K; Eghbalnia, Hamid R; Markley, John L

    2012-01-01

    ADAPT-NMR (Assignment-directed Data collection Algorithm utilizing a Probabilistic Toolkit in NMR) represents a groundbreaking prototype for automated protein structure determination by nuclear magnetic resonance (NMR) spectroscopy. With a [(13)C,(15)N]-labeled protein sample loaded into the NMR spectrometer, ADAPT-NMR delivers complete backbone resonance assignments and secondary structure in an optimal fashion without human intervention. ADAPT-NMR achieves this by implementing a strategy in which the goal of optimal assignment in each step determines the subsequent step by analyzing the current sum of available data. ADAPT-NMR is the first iterative and fully automated approach designed specifically for the optimal assignment of proteins with fast data collection as a byproduct of this goal. ADAPT-NMR evaluates the current spectral information, and uses a goal-directed objective function to select the optimal next data collection step(s) and then directs the NMR spectrometer to collect the selected data set. ADAPT-NMR extracts peak positions from the newly collected data and uses this information in updating the analysis resonance assignments and secondary structure. The goal-directed objective function then defines the next data collection step. The procedure continues until the collected data support comprehensive peak identification, resonance assignments at the desired level of completeness, and protein secondary structure. We present test cases in which ADAPT-NMR achieved results in two days or less that would have taken two months or more by manual approaches. PMID:22427982

  10. 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

  11. 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

  12. Patient-Centered Outcomes Research (PCOR): How Can We Optimize Outcomes in CNS Research?

    PubMed Central

    Sharma, Anil; Battaglia, Gina

    2015-01-01

    Background: Patient-centered outcomes research increases patient involvement in health-related decisions with better information of benefits, risks, and options as it pertains to patient health. Patient-centered outcomes research is valuable for improving patient options in general; however, the vulnerability of patients with certain central nervous system conditions and their variable capacity to consent may pose significant challenges. Methods/review: Authors acknowledge the historical issues and address needs regarding better dissemination of knowledge in central nervous system conditions like dementia, depression, and schizophrenia. Authors propose ethical safeguards necessary to carry out sound patient-centered outcomes research in this unique population. Discussion/recommendations: To facilitate ethical patient-centered outcomes research, researchers must 1) assess the individual’s mental capacity to provide consent, 2) determine vulnerability and risk of conducting research in specific subgroups, and 3) consider appointment of legally authorized representatives and/or consent monitors to ensure accurate understanding of research and ongoing direct communication with patients, especially when their future prognosis is unpredictable. PMID:26000203

  13. Optimizing the radiation treatment and outcome of prostate cancer

    SciTech Connect

    Hanks, G.E.

    1985-07-01

    The treatment of prostate cancer with external beam radiation therapy was initiated 28 years ago. The Stanford radiation results can be analyzed beyond 20 years and demonstrate equal effectiveness with radical surgery for early disease with fewer complications. Of greater importance, long term local tumor control and survival have been shown in patients with more advanced disease for whom there are no curative alternates to radiation therapy. This paper presents data from the Patterns of Care Studies (PCS) that allow us to further define and optimize radiation therapy of patients with cancer of the prostate. Major complications from treatment are discussed.

  14. Maximizing patient adherence for optimal outcomes in psoriasis.

    PubMed

    Bewley, A; Page, B

    2011-06-01

    Psoriasis is a chronic, disabling disease in which adherence to treatment is often poor. The aim of this article is to highlight the problem of adherence to long-term treatment in psoriasis and the factors that contribute to it, and to discuss how adherence, and thus outcomes, can be improved. This article is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. Adherence to topical medication is a major problem in psoriasis. Not only are prescriptions not being filled by patients (primary adherence) but topical medications are not being used as recommended (secondary adherence). The issue is complex due to the many factors which affect adherence, including efficacy, ease of use and convenience of application, and the healthcare professional-patient relationship. Due to the nature of the disease, patients suffer poor self-image and feel stigmatized, particularly when psoriasis is present on a visible part of the body. Consequently, the negative impact of psoriasis on patient quality of life underlies many adherence issues. It is therefore important for treatment to address the psychological aspects as well as the physical symptoms of psoriasis. Improvements in several areas of disease management may lead to benefits in medication adherence and hence clinical benefit. Prescribing therapy in line with patient preference for treatment vehicle and improving the healthcare professional-patient relationship may be key factors. Nurses have an important role in educating patients and delivering long-term care. This individualized, personal, approach may help improve treatment adherence, outcomes, and the quality of life for patients with psoriasis. PMID:21507078

  15. Preoperative treatment planning with intraoperative optimization can achieve consistent high-quality implants in prostate brachytherapy

    SciTech Connect

    Kudchadker, Rajat J.; Pugh, Thomas J.; Swanson, David A.; Bruno, Teresa L.; Bolukbasi, Yasemin; Frank, Steven J.

    2012-01-01

    Advances in brachytherapy treatment planning systems have allowed the opportunity for brachytherapy to be planned intraoperatively as well as preoperatively. The relative advantages and disadvantages of each approach have been the subject of extensive debate, and some contend that the intraoperative approach is vital to the delivery of optimal therapy. The purpose of this study was to determine whether high-quality permanent prostate implants can be achieved consistently using a preoperative planning approach that allows for, but does not necessitate, intraoperative optimization. To achieve this purpose, we reviewed the records of 100 men with intermediate-risk prostate cancer who had been prospectively treated with brachytherapy monotherapy between 2006 and 2009 at our institution. All patients were treated with iodine-125 stranded seeds; the planned target dose was 145 Gy. Only 8 patients required adjustments to the plan on the basis of intraoperative findings. Consistency and quality were assessed by calculating the correlation coefficient between the planned and implanted amounts of radioactivity and by examining the mean values of the dosimetric parameters obtained on preoperative and 30 days postoperative treatment planning. The amount of radioactivity implanted was essentially identical to that planned (mean planned radioactivity, 41.27 U vs. mean delivered radioactivity, 41.36 U; R{sup 2} = 0.99). The mean planned and day 30 prostate V100 values were 99.9% and 98.6%, respectively. The mean planned and day 30 prostate D90 values were 186.3 and 185.1 Gy, respectively. Consistent, high-quality prostate brachytherapy treatment plans can be achieved using a preoperative planning approach, mostly without the need for intraoperative optimization. Good quality assurance measures during simulation, treatment planning, implantation, and postimplant evaluation are paramount for achieving a high level of quality and consistency.

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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…

  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. 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

  8. Faculty Sense of Academic Optimism and Its Relationship to Students' Achievement in Well Performing High Schools

    ERIC Educational Resources Information Center

    Cromartie, Michael Tyrone

    2013-01-01

    The aim of this study was to determine the organizational characteristics and behaviors that contribute to sustaining a culture of academic optimism as a mechanism of student achievement. While there is a developing research base identifying both the individual elements of academic optimism as well as the academic optimism construct itself as…

  9. 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…

  10. 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…

  11. Developing demographic toxicity data: optimizing effort for predicting population outcomes

    PubMed Central

    Stark, John D.

    2016-01-01

    Mounting evidence suggests that population endpoints in risk assessment are far more accurate than static assessments. Complete demographic toxicity data based on full life tables are eminently useful in predicting population outcomes in many applications because they capture both lethal and sublethal effects; however, developing these life tables is extremely costly. In this study we investigated the efficiency of partial life cycle tests as a substitute for full life cycles in parameterizing population models. Life table data were developed for three species of Daphniids, Ceriodaphnia dubia, Daphnia magna, and D. pulex, weekly throughout the life span of these species. Population growth rates (λ) and a series of other demographic parameters generated from the complete life cycle were compared to those calculated from cumulative weeks of the life cycle in order to determine the minimum number of weeks needed to generate an accurate population projection. Results showed that for C. dubia and D. pulex, λ values developed at >4 weeks (44.4% of the life cycle) were not significantly different from λ developed for the full life cycle (9 weeks) of each species. For D. magna, λ values developed at >7 weeks (70% of the life cycle) were not significantly different from λ developed for the full life cycle (10 weeks). Furthermore, these cutoff points for λ were not the same for other demographic parameters, with no clear pattern emerging. Our results indicate that for C. dubia, D. magna, and D. pulex, partial life tables can be used to generate population growth rates in lieu of full life tables. However, the implications of differences in cutoff points for different demographic parameters need to be investigated further. PMID:27257546

  12. Developing demographic toxicity data: optimizing effort for predicting population outcomes.

    PubMed

    Stark, John D; Banks, John E

    2016-01-01

    Mounting evidence suggests that population endpoints in risk assessment are far more accurate than static assessments. Complete demographic toxicity data based on full life tables are eminently useful in predicting population outcomes in many applications because they capture both lethal and sublethal effects; however, developing these life tables is extremely costly. In this study we investigated the efficiency of partial life cycle tests as a substitute for full life cycles in parameterizing population models. Life table data were developed for three species of Daphniids, Ceriodaphnia dubia, Daphnia magna, and D. pulex, weekly throughout the life span of these species. Population growth rates (λ) and a series of other demographic parameters generated from the complete life cycle were compared to those calculated from cumulative weeks of the life cycle in order to determine the minimum number of weeks needed to generate an accurate population projection. Results showed that for C. dubia and D. pulex, λ values developed at >4 weeks (44.4% of the life cycle) were not significantly different from λ developed for the full life cycle (9 weeks) of each species. For D. magna, λ values developed at >7 weeks (70% of the life cycle) were not significantly different from λ developed for the full life cycle (10 weeks). Furthermore, these cutoff points for λ were not the same for other demographic parameters, with no clear pattern emerging. Our results indicate that for C. dubia, D. magna, and D. pulex, partial life tables can be used to generate population growth rates in lieu of full life tables. However, the implications of differences in cutoff points for different demographic parameters need to be investigated further. PMID:27257546

  13. 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

    patients achieves optimal outcomes. PMID:26056501

  14. On the Achievable Efficiency-Fairness Tradeoff in Utility-Optimal MAC Protocols

    NASA Astrophysics Data System (ADS)

    Lee, Jang-Won; Chiang, Mung; Calderbank, A. Robert

    We use the network utility maximization (NUM) framework to create an efficient and fair medium access control (MAC) protocol for wireless networks. By adjusting the parameters in the utility objective functions of NUM problems, we control the tradeoff between efficiency and fairness of radio resource allocation through a rigorous and systematic design. In this paper, we propose a scheduling-based MAC protocol. Since it provides an upper-bound on the achievable performance, it establishes the optimality benchmarks for comparison with other algorithms in related work.

  15. Achieving optimal gingival esthetics around restored natural teeth and implants. Rationale, concepts, and techniques.

    PubMed

    Bichacho, N

    1998-10-01

    The role of prosthetic restorations in the final appearance of the surrounding soft tissues has long been recognized. Innovative prosthodontic concepts as described should be used to enhance the biologic as well as the esthetic data of the supporting tissues, in natural teeth and implants alike. Combined dental treatment modalities of different kinds (i.e., orthodontics, periodontal treatment) are often required for optimal results. Meticulous care and attention to the delicate soft tissues should be given throughout all phases of the treatment, with a view to achieving a functional, healthy, and esthetic oral environment. PMID:9891656

  16. Optimized Prediction of Extreme Treatment Outcomes in Ovarian Cancer

    PubMed Central

    Misganaw, Burook; Ahsen, Eren; Singh, Nitin; Baggerly, Keith A.; Unruh, Anna; White, Michael A.; Vidyasagar, M.

    2015-01-01

    Ovarian cancer is the fifth leading cause of death among female cancers. Front-line therapy for ovarian cancer is platinum-based chemotherapy. However, the response of patients is highly nonuniform. The TCGA database of serous ovarian carcinomas shows that ~10% of patients respond poorly to platinum-based chemotherapy, with tumors relapsing in seven months or less. Another 10% or so enjoy disease-free survival of three years or more. The objective of the present research is to identify a small number of highly predictive biomarkers that can distinguish between the two extreme responders and then extrapolate to all patients. This is achieved using the lone star algorithm that is specifically developed for biological applications. Using this algorithm, we are able to identify biomarker panels of 25 genes (of 12,000 genes) that can be used to classify patients into one of the three groups: super responders, medium responders, and nonresponders. We are also able to determine a discriminant function that can divide the entire patient population into two classes, such that one group has a clear survival advantage over the other. These biomarkers are developed using the TCGA Agilent platform data and cross-validated on the TCGA Affymetrix platform data, as well as entirely independent data from Tothill et al. The P-values on the training data are extremely small, sometimes below machine zero, while the P-values on cross-validation are well below the widely accepted threshold of 0.05. PMID:27034613

  17. 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

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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

  4. 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…

  5. 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…

  6. Psychiatric Symptoms in Youth with a History of Autism and Optimal Outcome

    ERIC Educational Resources Information Center

    Orinstein, Alyssa; Tyson, Katherine E.; Suh, Joyce; Troyb, Eva; Helt, Molly; Rosenthal, Michael; Barton, Marianne L.; Eigsti, Inge-Marie; Kelley, Elizabeth; Naigles, Letitia; Schultz, Robert T.; Stevens, Michael C.; Fein, Deborah A.

    2015-01-01

    Since autism spectrum disorder (ASD) is often comorbid with psychiatric disorders, children who no longer meet criteria for ASD (optimal outcome; OO) may still be at risk for psychiatric disorders. A parent interview for DSM-IV psychiatric disorders (K-SADS-PL) for 33 OO, 42 high-functioning autism (HFA) and 34 typically developing (TD) youth,…

  7. Detail and Gestalt Focus in Individuals with Optimal Outcomes from Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Fitch, Allison; Fein, Deborah A.; Eigsti, Inge-Marie

    2015-01-01

    Individuals with high-functioning autism (HFA) have a cognitive style that privileges local over global or gestalt details. While not a core symptom of autism, individuals with HFA seem to reliably show this bias. Our lab has been studying a sample of children who have overcome their early ASD diagnoses, showing "optimal outcomes" (OO).…

  8. Residual Language Deficits in Optimal Outcome Children with a History of Autism

    ERIC Educational Resources Information Center

    Kelley, Elizabeth; Paul, Jennifer J.; Fein, Deborah; Naigles, Letitia R.

    2006-01-01

    This study examined whether language deficits persist even in children with optimal outcomes. We examined a group of children with prior diagnoses on the autism spectrum who had IQs in the normal range, were in age-appropriate mainstream classes, and had improved to such an extent that they were considered to be functioning at the level of their…

  9. 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

  10. 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

  11. Reversible Masking Using Low-Molecular-Weight Neutral Lipids to Achieve Optimal-Targeted Delivery

    PubMed Central

    Templeton, Nancy Smyth; Senzer, Neil

    2012-01-01

    Intravenous injection of therapeutics is required to effectively treat or cure metastatic cancer, certain cardiovascular diseases, and other acquired or inherited diseases. Using this route of delivery allows potential uptake in all disease targets that are accessed by the bloodstream. However, normal tissues and organs also have the potential for uptake of therapeutic agents. Therefore, investigators have used targeted delivery to attempt delivery solely to the target cells; however, use of ligands on the surface of delivery vehicles to target specific cell surface receptors is not sufficient to avoid nonspecific uptake. PEGylation has been used for decades to try to avoid nonspecific uptake but suffers from many problems known as “The PEGylation Dilemma.” We have solved this dilemma by replacing PEGylation with reversible masking using low-molecular-weight neutral lipids in order to achieve optimal-targeted delivery solely to target cells. Our paper will focus on this topic. PMID:22655199

  12. 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

  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

    This study provides an analytic description of quasi-experimental studies that may either support or deny the wisdom of educational reform through interdisciplinary mathematics and science. Interdisciplinarity is examined on two dimensions, the philosophic and the pedagogic, and by two methodologies, meta-analytic and qualitative, in a search for greater understanding of the definitions, forms, characteristics, and effects from studies of interdisciplinary mathematics and science. Thirty-four studies were collected from a search of the literature that spanned the century, the grade levels, and included many forms of interdisciplinarity. Several research questions were asked: (1) What forms of interdisciplinarity, philosophically and practically, are represented by the studies? (2) What are their qualitative effects in school settings? (3) What are the characteristics of interdisciplinary quasi-experimental research? (4) What achievement effects typify the interdisciplinary comparative studies? (5) What factors account for variation in these achievement effects? (6) What claims or criticisms regarding interdisciplinarity are supported or refuted by the qualitative analysis of forms and effects and the quantitative meta-analytic study? Results from this study support the concerns that terms of interdisciplinarity are used without regard for context and that there is a trend toward a great diversity of ideas regarding the nature of interdisciplinary education. Student achievement data were provided by the 34 studies for mathematics and/or science. The mean effect sizes for student achievement were computed as: mathematics achievement, .27 (SE = .09); science achievement, .37 (SE = .12). Curricular materials developed by teachers were significantly less related to student achievement than materials developed by researchers or commercially. The methods of integration employed by the 34 studies formed a continuum from sequenced instructional integration to total

  14. 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

  15. 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

  16. 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…

  17. 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…

  18. 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…

  19. 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 ...

  20. 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...

  1. 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…

  2. 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…

  3. 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

  4. Targeted Learning of the Mean Outcome under an Optimal Dynamic Treatment Rule

    PubMed Central

    van der Laan, Mark J.; Luedtke, Alexander R.

    2015-01-01

    We consider estimation of and inference for the mean outcome under the optimal dynamic two time-point treatment rule defined as the rule that maximizes the mean outcome under the dynamic treatment, where the candidate rules are restricted to depend only on a user-supplied subset of the baseline and intermediate covariates. This estimation problem is addressed in a statistical model for the data distribution that is nonparametric beyond possible knowledge about the treatment and censoring mechanism. This contrasts from the current literature that relies on parametric assumptions. We establish that the mean of the counterfactual outcome under the optimal dynamic treatment is a pathwise differentiable parameter under conditions, and develop a targeted minimum loss-based estimator (TMLE) of this target parameter. We establish asymptotic linearity and statistical inference for this estimator under specified conditions. In a sequentially randomized trial the statistical inference relies upon a second-order difference between the estimator of the optimal dynamic treatment and the optimal dynamic treatment to be asymptotically negligible, which may be a problematic condition when the rule is based on multivariate time-dependent covariates. To avoid this condition, we also develop TMLEs and statistical inference for data adaptive target parameters that are defined in terms of the mean outcome under the estimate of the optimal dynamic treatment. In particular, we develop a novel cross-validated TMLE approach that provides asymptotic inference under minimal conditions, avoiding the need for any empirical process conditions. We offer simulation results to support our theoretical findings. PMID:26236571

  5. Language comprehension and brain function in individuals with an optimal outcome from autism

    PubMed Central

    Eigsti, Inge-Marie; Stevens, Michael C.; Schultz, Robert T.; Barton, Marianne; Kelley, Elizabeth; Naigles, Letitia; Orinstein, Alyssa; Troyb, Eva; Fein, Deborah A.

    2015-01-01

    Although Autism Spectrum Disorder (ASD) is generally a lifelong disability, a minority of individuals with ASD overcome their symptoms to such a degree that they are generally indistinguishable from their typically-developing peers. That is, they have achieved an Optimal Outcome (OO). The question addressed by the current study is whether this normalized behavior reflects normalized brain functioning, or alternatively, the action of compensatory systems. Either possibility is plausible, as most participants with OO received years of intensive therapy that could alter brain networks to align with typical function or work around ASD-related neural dysfunction. Individuals ages 8 to 21 years with high-functioning ASD (n = 23), OO (n = 16), or typical development (TD; n = 20) completed a functional MRI scan while performing a sentence comprehension task. Results indicated similar activations in frontal and temporal regions (left middle frontal, left supramarginal, and right superior temporal gyri) and posterior cingulate in OO and ASD groups, where both differed from the TD group. Furthermore, the OO group showed heightened “compensatory” activation in numerous left- and right-lateralized regions (left precentral/postcentral gyri, right precentral gyrus, left inferior parietal lobule, right supramarginal gyrus, left superior temporal/parahippocampal gyrus, left middle occipital gyrus) and cerebellum, relative to both ASD and TD groups. Behaviorally normalized language abilities in OO individuals appear to utilize atypical brain networks, with increased recruitment of language-specific as well as right homologue and other systems. Early intensive learning and experience may normalize behavioral language performance in OO, but some brain regions involved in language processing may continue to display characteristics that are more similar to ASD than typical development, while others show characteristics not like ASD or typical development. PMID:26862477

  6. Predictors and Outcomes of Routine Versus Optimal Medical Therapy in Stable Coronary Heart Disease.

    PubMed

    Chun, Soohun; Qiu, Feng; Austin, Peter C; Ko, Dennis T; Mamdani, Muhammad; Wijeysundera, Duminda N; Czarnecki, Andrew; Bennell, Maria C; Wijeysundera, Harindra C

    2015-09-01

    Although randomized studies have shown optimal medical therapy (OMT) to be as efficacious as revascularization in stable coronary heart disease (CHD), the application of OMT in routine practice is suboptimal. We sought to understand the predictors of receiving OMT in stable CHD and its impact on clinical outcomes. All patients with stable CHD based on coronary angiography from October 2008 to September 2011 were identified in Ontario, Canada. OMT was defined as concurrent use of β blocker, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and statin. Aspirin use was not part of the OMT definition because of database limitations. Multivariable hierarchical logistic models identified predictors of OMT in the 12 months after angiography. Cox proportional hazard models with time-varying covariates for OMT and revascularization status examined differences in death and nonfatal myocardial infarction (MI). In these models, patients transitioned among 4 mutually exclusive treatment groups: no OMT and no revascularization, no OMT and revascularization, OMT and no revascularization, OMT and revascularization. Our cohort had 20,663 patients. Over a mean period of 2.5 years, 8.7% had died. Only 61% received OMT within 12 months. The strongest predictor of receiving OMT at 12 months was OMT before the angiogram (odds ratio 14.40, 95% confidence interval [CI] 13.17 to 15.75, p <0.001). Relative to no OMT and nonrevascularized patients, patients on OMT and revascularized had the greatest reduction in mortality (hazard ratio 0.52, 95% CI 0.45 to 0.60, p <0.001) and nonfatal MI (hazard ratio 0.74, 95% CI 0.64 to 0.84, p <0.001). In conclusion, our study highlights the low rate of OMT in stable CHD. Patients who received both OMT and revascularization achieved the greatest reduction in mortality and nonfatal MI. PMID:26119653

  7. 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

  8. 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

  9. Optimal Care Mother-Baby and Outcomes through Community-wide Data Sharing, Interoperability and Connectivity.

    PubMed

    Shaha, Steven H; Gilbert-Bradley, Diane

    2015-01-01

    The power of interoperable systems with data/information integration, central to achieving the goals of Telehealth, is illustrated through mutually beneficial sharing between Labor & Delivery (L&D) and Obstetrics (OBs) Clinics. Data shared between L&D and OB brought improved practice patterns and outcomes, and increased satisfaction at both. Staffing and skillsets were significantly improved by knowing complications arriving and anticipated volumes. OBs increased clinic efficiencies and improved patient-direct care time with improved clinical and cost outcomes. PMID:25980718

  10. 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

  11. Physiological geroscience: targeting function to increase healthspan and achieve optimal longevity.

    PubMed

    Seals, Douglas R; Justice, Jamie N; LaRocca, Thomas J

    2016-04-15

    Most nations of the world are undergoing rapid and dramatic population ageing, which presents great socio-economic challenges, as well as opportunities, for individuals, families, governments and societies. The prevailing biomedical strategy for reducing the healthcare impact of population ageing has been 'compression of morbidity' and, more recently, to increase healthspan, both of which seek to extend the healthy period of life and delay the development of chronic diseases and disability until a brief period at the end of life. Indeed, a recently established field within biological ageing research, 'geroscience', is focused on healthspan extension. Superimposed on this background are new attitudes and demand for 'optimal longevity' - living long, but with good health and quality of life. A key obstacle to achieving optimal longevity is the progressive decline in physiological function that occurs with ageing, which causes functional limitations (e.g. reduced mobility) and increases the risk of chronic diseases, disability and mortality. Current efforts to increase healthspan centre on slowing the fundamental biological processes of ageing such as inflammation/oxidative stress, increased senescence, mitochondrial dysfunction, impaired proteostasis and reduced stress resistance. We propose that optimization of physiological function throughout the lifespan should be a major emphasis of any contemporary biomedical policy addressing global ageing. Effective strategies should delay, reduce in magnitude or abolish reductions in function with ageing (primary prevention) and/or improve function or slow further declines in older adults with already impaired function (secondary prevention). Healthy lifestyle practices featuring regular physical activity and ideal energy intake/diet composition represent first-line function-preserving strategies, with pharmacological agents, including existing and new pharmaceuticals and novel 'nutraceutical' compounds, serving as potential

  12. Role of well-being therapy in achieving a balanced and individualized path to optimal functioning.

    PubMed

    Ruini, Chiara; Fava, Giovanni A

    2012-01-01

    A specific psychotherapeutic strategy for increasing psychological well-being and resilience, well-being therapy (WBT), based on Ryff's conceptual model, has been developed and tested in a number of randomized controlled trials. The findings indicate that flourishing and resilience can be promoted by specific interventions leading to a positive evaluation of one's self, a sense of continued growth and development, the belief that life is purposeful and meaningful, the possession of quality relations with others, the capacity to manage effectively one's life and a sense of self-determination. A decreased vulnerability to depression, mood swings and anxiety has been demonstrated after WBT in high-risk populations. School interventions based on the principles of WBT have been found to yield both promotion of well-being and decrease of distress compared with control groups. The differential technical characteristics and indications of WBT are described, with a special reference to the promotion of an individualized and balanced path to achieve optimal human functioning, avoiding the polarities in positive psychological dimensions. PMID:22570318

  13. 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

  14. Uh, Um, and Autism: Filler Disfluencies as Pragmatic Markers in Adolescents with Optimal Outcomes from Autism Spectrum Disorder.

    PubMed

    Irvine, Christina A; Eigsti, Inge-Marie; Fein, Deborah A

    2016-03-01

    Filler disfluencies--uh and um--are thought to serve distinct discourse functions. We examined fillers in spontaneous speech by youth with autism spectrum disorder (ASD), who struggle with pragmatic language, and by youth with ASD who have achieved an 'optimal outcome' (OO), as well as in peers with typical development (TD). While uh rates did not differ, participants with ASD produced um less frequently than OO or TD groups. Um rate was associated with autism symptom severity, but not executive function or language abilities, suggesting that um serves a pragmatic, listener-oriented function. Moreover, in contrast to minimal production in ASD, the typical OO um production substantiates the normalization of subtle social communication in this population. PMID:26586555

  15. Annual Research Review: Optimal outcomes of child and adolescent mental illness

    PubMed Central

    Costello, E. Jane; Maughan, Barbara

    2015-01-01

    Background ‘Optimal outcomes’ of child and adolescent psychiatric disorders may mean the best possible outcome, or the best considering a child’s history. Most research into the outcomes of child and adolescent psychiatric disorder concentrates on the likelihood of adult illness and disability given an earlier history of psychopathology. Methods In this article we review the research literature (based on a literature search using PubMed, RePORT and Google Advanced Scholar databases) on optimal outcomes for young people with a history of anxiety, depression, attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, or substance use disorders in childhood or adolescence. We consider three types of risks that these children may run later in development: future episodes of the same disorder, future episodes of a different disorder, and functional impairment. The impact of treatment or preventative interventions on early adult functioning is briefly reviewed. Results We found that very few studies enabled us to answer our questions with certainty, but that in general about half of adults with a psychiatric history were disorder-free and functioning quite well in their 20s or 30s. However, their chance of functioning well was less than that of adults without a psychiatric history, even in the absence of a current disorder. Conclusions Among adults who had a psychiatric disorder as a child or adolescent, about half can be expected to be disorder-free as young adults, and of these about half will be free of significant difficulties in the areas of work, health, relationships, and crime. Optimal outcomes are predicted by a mixture of personal characteristics and environmental supports. PMID:25496295

  16. Calibration of STUD+ parameters to achieve optimally efficient broadband adiabatic decoupling in a single transient

    PubMed

    Bendall; Skinner

    1998-10-01

    for a single sech/tanh pulse. Residual splitting of the centerband, normally associated with incomplete or inefficient decoupling, is not seen in sech/tanh decoupling and therefore cannot be used as a measure of adiabatic decoupling efficiency. The calibrated experimental performance levels achieved in this study are within 20% of theoretical performance levels derived previously for ideal sech/tanh decoupling at high power, indicating a small scope for further improvement at practical RF power levels. The optimization procedures employed here will be generally applicable to any good combination of adiabatic inversion pulse and phase cycle. Copyright 1998 Academic Press. PMID:9761708

  17. 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

    generated 3D ionosphere reconstructions as well as the final IRSs are validated with independent GNSS slant TEC (Total Electron Content) data, vertical sounding observations and JASON 1 and 2 derived vertical TEC. This presentation gives an overview about the DAIS project and the achieved results. We outline the assimilation approach, show the reconstruction and the validation results and finally address open questions.

  18. Challenges inherent in optimizing speech-language pathology outcomes: it's not just about counting the hours.

    PubMed

    Togher, Leanne

    2012-10-01

    Determining the optimal amount of intervention is possibly the biggest challenge facing speech-language pathologists (SLPs) today. Baker (2012) has provided an erudite and pithy summary of the relevant literature in the field of optimizing intervention outcomes, and proposed a conceptual framework to measure all the inputs and acts that may contribute to the algorithm of intervention intensity. In the following article, two issues are discussed: first, that the use of technological advances to increase intensity should focus on everyday communication outcomes and, secondly, that measuring the effects of treatments which aim to increase intensity should include the perceptions of the client. Describing the evidence-based kernels underlying treatment success is a complex endeavour, particularly when the target treatment outcome is improved conversation. A recent qualitative study is described where clients with brain injury and their families were asked about their perceptions of a communication partner training program, to help determine which part of the treatment worked and why. It is argued that such an approach may provide important information regarding the "active ingredients" of treatment success. PMID:22698154

  19. Optimal microelectromechanical systems (MEMS) device for achieving high pyroelectric response of AlN

    NASA Astrophysics Data System (ADS)

    Kebede, Bemnnet; Coutu, Ronald A.; Starman, LaVern

    2014-03-01

    This paper discusses research being conducted on aluminum nitride (AlN) as a pyroelectric material for use in detecting applications. AlN is being investigated because of its high pyroelectric coefficient, thermal stability, and high Curie temperature. In order to determine suitability of the pyroelectric properties of AlN for use as a detector, testing of several devices was conducted. These devices were fabricated using microelectromechanical systems (MEMS) fabrication processes; the devices were also designed to allow for voltage and current measurements. The deposited AlN films used were 150 nm - 300 nm in thickness. Thin-films were used to rapidly increase the temperature response after the thermal stimulus was applied to the pyroelectric material. This is important because the pyroelectric effect is directly proportional to the rate of temperature change. The design used was a face-electrode bridge that provides thermal isolation which minimizes heat loss to the substrate, thereby increasing operation frequency of the pyroelectric device. A thermal stimulus was applied to the pyroelectric material and the response was measured across the electrodes. A thermal imaging camera was used to monitor the changes in temperature. Throughout the testing process, the annealing temperatures, type of layers, and thicknesses were also varied. These changes resulted in improved MEMS designs, which were fabricated to obtain an optimal design configuration for achieving a high pyroelectric response. A pyroelectric voltage response of 38.9 mVp-p was measured without filtering, 12.45 mVp-p was measured in the infrared (IR) region using a Si filter, and 6.38 mVp-p was measured in the short wavelength IR region using a long pass filter. The results showed that AlN's pyroelectric properties can be used in detecting applications.

  20. 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

  1. Robust Airfoil Optimization to Achieve Consistent Drag Reduction Over a Mach Range

    NASA Technical Reports Server (NTRS)

    Li, Wu; Huyse, Luc; Padula, Sharon; Bushnell, Dennis M. (Technical Monitor)

    2001-01-01

    We prove mathematically that in order to avoid point-optimization at the sampled design points for multipoint airfoil optimization, the number of design points must be greater than the number of free-design variables. To overcome point-optimization at the sampled design points, a robust airfoil optimization method (called the profile optimization method) is developed and analyzed. This optimization method aims at a consistent drag reduction over a given Mach range and has three advantages: (a) it prevents severe degradation in the off-design performance by using a smart descent direction in each optimization iteration, (b) there is no random airfoil shape distortion for any iterate it generates, and (c) it allows a designer to make a trade-off between a truly optimized airfoil and the amount of computing time consumed. For illustration purposes, we use the profile optimization method to solve a lift-constrained drag minimization problem for 2-D airfoil in Euler flow with 20 free-design variables. A comparison with other airfoil optimization methods is also included.

  2. Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

    PubMed Central

    Semins, Michelle Jo; Matlaga, Brian R

    2015-01-01

    Shock wave lithotripsy (SWL) was introduced in 1980, modernizing the treatment of upper urinary tract stones, and quickly became the most commonly utilized technique to treat kidney stones. Over the past 5-10 years, however, use of SWL has been declining because it is not as reliably effective as more modern technology. SWL success rates vary considerably and there is abundant literature predicting outcome based on patient- and stone-specific parameters. Herein we discuss the ways to optimize SWL outcomes by reviewing proper patient selection utilizing stone characteristics and patient features. Stone size, number, location, density, composition, and patient body habitus and renal anatomy are all discussed. We also review the technical parameters during SWL that can be controlled to improve results further, including type of anesthesia, coupling, shock wave rate, focal zones, pressures, and active monitoring. Following these basic principles and selection criteria will help maximize success rate. PMID:25949936

  3. 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…

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. Development and optimization of SPECT gated blood pool cluster analysis for the prediction of CRT outcome

    SciTech Connect

    Lalonde, Michel Wassenaar, Richard; Wells, R. Glenn; Birnie, David; Ruddy, Terrence D.

    2014-07-15

    Purpose: Phase analysis of single photon emission computed tomography (SPECT) radionuclide angiography (RNA) has been investigated for its potential to predict the outcome of cardiac resynchronization therapy (CRT). However, phase analysis may be limited in its potential at predicting CRT outcome as valuable information may be lost by assuming that time-activity curves (TAC) follow a simple sinusoidal shape. A new method, cluster analysis, is proposed which directly evaluates the TACs and may lead to a better understanding of dyssynchrony patterns and CRT outcome. Cluster analysis algorithms were developed and optimized to maximize their ability to predict CRT response. Methods: About 49 patients (N = 27 ischemic etiology) received a SPECT RNA scan as well as positron emission tomography (PET) perfusion and viability scans prior to undergoing CRT. A semiautomated algorithm sampled the left ventricle wall to produce 568 TACs from SPECT RNA data. The TACs were then subjected to two different cluster analysis techniques, K-means, and normal average, where several input metrics were also varied to determine the optimal settings for the prediction of CRT outcome. Each TAC was assigned to a cluster group based on the comparison criteria and global and segmental cluster size and scores were used as measures of dyssynchrony and used to predict response to CRT. A repeated random twofold cross-validation technique was used to train and validate the cluster algorithm. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) and compare results to those obtained for SPECT RNA phase analysis and PET scar size analysis methods. Results: Using the normal average cluster analysis approach, the septal wall produced statistically significant results for predicting CRT results in the ischemic population (ROC AUC = 0.73;p < 0.05 vs. equal chance ROC AUC = 0.50) with an optimal operating point of 71% sensitivity and 60% specificity. Cluster

  10. Achieving Consistent Near-Optimal Pattern Recognition Accuracy Using Particle Swarm Optimization to Pre-Train Artificial Neural Networks

    ERIC Educational Resources Information Center

    Nikelshpur, Dmitry O.

    2014-01-01

    Similar to mammalian brains, Artificial Neural Networks (ANN) are universal approximators, capable of yielding near-optimal solutions to a wide assortment of problems. ANNs are used in many fields including medicine, internet security, engineering, retail, robotics, warfare, intelligence control, and finance. "ANNs have a tendency to get…

  11. A Study of the Relationships between Distributed Leadership, Teacher Academic Optimism and Student Achievement in Taiwanese Elementary Schools

    ERIC Educational Resources Information Center

    Chang, I-Hua

    2011-01-01

    The purpose of this study was to explore the relationships between distributed leadership, teachers' academic optimism and student achievement in learning. The study targeted public elementary schools in Taiwan and adopted stratified random sampling to investigate 1500 teachers. Teachers' perceptions were collected by a self-report scale. In…

  12. Should Schools Be Optimistic? An Investigation of the Association between Academic Optimism of Schools and Student Achievement in Primary Education

    ERIC Educational Resources Information Center

    Boonen, Tinneke; Pinxten, Maarten; Van Damme, Jan; Onghena, Patrick

    2014-01-01

    Academic emphasis, collective efficacy, and faculty trust in students and parents (3 school characteristics positively associated with student achievement) are assumed to form a higher order latent construct, "academic optimism" (Hoy, Tarter, & Woolfolk Hoy, 2006a, 2006b). The aim of the present study is to corroborate the latent…

  13. Vocational Rehabilitation Partnerships: Optimizing the Social Value Return on Investment of Employment Outcomes for People with Disabilities

    ERIC Educational Resources Information Center

    Ramos-Olszowy, Lorraine Florence

    2011-01-01

    This applied research project was developed to examine the social value return of investment (SV-ROI) of a community rehabilitation provider (CRP) in order to identify services that may optimize employment outcomes, better understand the associated factors affecting the employment outcomes and retention, and explore how vocational rehabilitation…

  14. Academic Optimism and Collective Responsibility: An Organizational Model of the Dynamics of Student Achievement

    ERIC Educational Resources Information Center

    Wu, Jason H.

    2013-01-01

    This study was designed to examine the construct of academic optimism and its relationship with collective responsibility in a sample of Taiwan elementary schools. The construct of academic optimism was tested using confirmatory factor analysis, and the whole structural model was tested with a structural equation modeling analysis. The data were…

  15. 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

  16. 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

  17. 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

  18. The Importance of Supportive Care in Optimizing Treatment Outcomes of Patients with Advanced Prostate Cancer

    PubMed Central

    2012-01-01

    Optimal oncologic care of older men with prostate cancer, including effective prevention and management of the disease and treatment side effects (so-called best supportive care measures) can prolong survival, improve quality of life, and reduce depressive symptoms. In addition, the proportion of treatment discontinuations can be reduced through early reporting and management of side effects. Pharmacologic care may be offered to manage the side effects of androgen-deprivation therapy and chemotherapy, which may include hot flashes, febrile neutropenia, fatigue, and diarrhea. Nonpharmacologic care (e.g., physical exercise, acupuncture, relaxation) has also been shown to benefit patients. At the Georges Pompidou European Hospital, the Program of Optimization of Chemotherapy Administration has demonstrated that improved outpatient follow-up by supportive care measures can reduce the occurrence of chemotherapy-related side effects, reduce cancellations and modifications of treatment, reduce chemotherapy wastage, and reduce the length of stay in the outpatient unit. The importance of supportive care measures to optimize management and outcomes of older men with advanced prostate cancer should not be overlooked. PMID:23015682

  19. Achieving Finite Element Mesh Quality via Optimization of the Jacobian Matrix Norm and Associated Quantities, Part 1 - A Framework for Surface Mesh Optimization

    SciTech Connect

    Knupp, P.M.

    1999-01-18

    Structured mesh quality optimization methods are extended to optimization of unstructured triangular, quadrilateral, and mixed finite element meshes. N"ew interpretations of well-known nodally-bssed objective functions are made possible using matrices and matrix norms. The matrix perspective also suggests several new objective functions. Particularly significant is the interpretation of the Oddy metric and the Smoothness objective functions in terms of the condition number of the metric tensor and Jacobian matrix, respectively. Objective functions are grouped according to dimensionality to form weighted combinations. A simple unconstrained local optimum is computed using a modiiied N-ewton iteration. The optimization approach was implemented in the CUBIT mesh generation code and tested on several problems. Results were compared against several standard element-based quaIity measures to demonstrate that good mesh quality can be achieved with nodally-based objective functions.

  20. Optimal Experience and Reading Achievement in Virtual Environments among College Level Developmental Readers

    ERIC Educational Resources Information Center

    Burgess, Melissa L.

    2010-01-01

    In this mixed methods study the potential for developmental readers to experience optimal experience (flow) within the multi-user virtual environment, "Second Life," was examined. In an educational context, "Second Life" provided a space for constructivist learning, socialization, exploration, discovery and creativity. The communicative, social…

  1. Achieving diverse and monoallelic olfactory receptor selection through dual-objective optimization design.

    PubMed

    Tian, Xiao-Jun; Zhang, Hang; Sannerud, Jens; Xing, Jianhua

    2016-05-24

    Multiple-objective optimization is common in biological systems. In the mammalian olfactory system, each sensory neuron stochastically expresses only one out of up to thousands of olfactory receptor (OR) gene alleles; at the organism level, the types of expressed ORs need to be maximized. Existing models focus only on monoallele activation, and cannot explain recent observations in mutants, especially the reduced global diversity of expressed ORs in G9a/GLP knockouts. In this work we integrated existing information on OR expression, and constructed a comprehensive model that has all its components based on physical interactions. Analyzing the model reveals an evolutionarily optimized three-layer regulation mechanism, which includes zonal segregation, epigenetic barrier crossing coupled to a negative feedback loop that mechanistically differs from previous theoretical proposals, and a previously unidentified enhancer competition step. This model not only recapitulates monoallelic OR expression, but also elucidates how the olfactory system maximizes and maintains the diversity of OR expression, and has multiple predictions validated by existing experimental results. Through making an analogy to a physical system with thermally activated barrier crossing and comparative reverse engineering analyses, the study reveals that the olfactory receptor selection system is optimally designed, and particularly underscores cooperativity and synergy as a general design principle for multiobjective optimization in biology. PMID:27162367

  2. Optimization of Composite Material System and Lay-up to Achieve Minimum Weight Pressure Vessel

    NASA Astrophysics Data System (ADS)

    Mian, Haris Hameed; Wang, Gang; Dar, Uzair Ahmed; Zhang, Weihong

    2013-10-01

    The use of composite pressure vessels particularly in the aerospace industry is escalating rapidly because of their superiority in directional strength and colossal weight advantage. The present work elucidates the procedure to optimize the lay-up for composite pressure vessel using finite element analysis and calculate the relative weight saving compared with the reference metallic pressure vessel. The determination of proper fiber orientation and laminate thickness is very important to decrease manufacturing difficulties and increase structural efficiency. In the present work different lay-up sequences for laminates including, cross-ply [ 0 m /90 n ] s , angle-ply [ ±θ] ns , [ 90/±θ] ns and [ 0/±θ] ns , are analyzed. The lay-up sequence, orientation and laminate thickness (number of layers) are optimized for three candidate composite materials S-glass/epoxy, Kevlar/epoxy and Carbon/epoxy. Finite element analysis of composite pressure vessel is performed by using commercial finite element code ANSYS and utilizing the capabilities of ANSYS Parametric Design Language and Design Optimization module to automate the process of optimization. For verification, a code is developed in MATLAB based on classical lamination theory; incorporating Tsai-Wu failure criterion for first-ply failure (FPF). The results of the MATLAB code shows its effectiveness in theoretical prediction of first-ply failure strengths of laminated composite pressure vessels and close agreement with the FEA results. The optimization results shows that for all the composite material systems considered, the angle-ply [ ±θ] ns is the optimum lay-up. For given fixed ply thickness the total thickness of laminate is obtained resulting in factor of safety slightly higher than two. Both Carbon/epoxy and Kevlar/Epoxy resulted in approximately same laminate thickness and considerable percentage of weight saving, but S-glass/epoxy resulted in weight increment.

  3. 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.

  4. Psychiatric Symptoms in Youth with a History of Autism and Optimal Outcome.

    PubMed

    Orinstein, Alyssa; Tyson, Katherine E; Suh, Joyce; Troyb, Eva; Helt, Molly; Rosenthal, Michael; Barton, Marianne L; Eigsti, Inge-Marie; Kelley, Elizabeth; Naigles, Letitia; Schultz, Robert T; Stevens, Michael C; Fein, Deborah A

    2015-11-01

    Since autism spectrum disorder (ASD) is often comorbid with psychiatric disorders, children who no longer meet criteria for ASD (optimal outcome; OO) may still be at risk for psychiatric disorders. A parent interview for DSM-IV psychiatric disorders (K-SADS-PL) for 33 OO, 42 high-functioning autism (HFA) and 34 typically developing (TD) youth, ages 8-21, showed that OO and HFA groups had elevated current ADHD and specific phobias, with tics in HFA. In the past, the HFA group also had elevated depression and ODD, and the OO group had tics. The HFA group also showed subthreshold symptoms of specific and social phobias, and generalized anxiety. Psychopathology in the OO group abated over time as did their autism, and decreased more than in HFA. PMID:26155764

  5. Residual language deficits in optimal outcome children with a history of autism.

    PubMed

    Kelley, Elizabeth; Paul, Jennifer J; Fein, Deborah; Naigles, Letitia R

    2006-08-01

    This study examined whether language deficits persist even in children with optimal outcomes. We examined a group of children with prior diagnoses on the autism spectrum who had IQs in the normal range, were in age-appropriate mainstream classes, and had improved to such an extent that they were considered to be functioning at the level of their typically developing peers. Fourteen such children between the ages of five and nine were matched on age and sex with typically developing children, and were given a battery of 10 language tests to investigate their language abilities. Results indicated that while these children's grammatical capabilities are mostly indistinguishable from their peers, they are still experiencing difficulties in pragmatic and semantic language. PMID:16897404

  6. Achieving Optimal Self-Adaptivity for Dynamic Tuning of Organic Semiconductors through Resonance Engineering.

    PubMed

    Tao, Ye; Xu, Lijia; Zhang, Zhen; Chen, Runfeng; Li, Huanhuan; Xu, Hui; Zheng, Chao; Huang, Wei

    2016-08-01

    Current static-state explorations of organic semiconductors for optimal material properties and device performance are hindered by limited insights into the dynamically changed molecular states and charge transport and energy transfer processes upon device operation. Here, we propose a simple yet successful strategy, resonance variation-based dynamic adaptation (RVDA), to realize optimized self-adaptive properties in donor-resonance-acceptor molecules by engineering the resonance variation for dynamic tuning of organic semiconductors. Organic light-emitting diodes hosted by these RVDA materials exhibit remarkably high performance, with external quantum efficiencies up to 21.7% and favorable device stability. Our approach, which supports simultaneous realization of dynamically adapted and selectively enhanced properties via resonance engineering, illustrates a feasible design map for the preparation of smart organic semiconductors capable of dynamic structure and property modulations, promoting the studies of organic electronics from static to dynamic. PMID:27403886

  7. The impact of an educational program on HCV patient outcomes using boceprevir in community practices (OPTIMAL trial)

    PubMed Central

    Rustgi, Vinod; Brown, Robert S.; Patel, Vishal; Kugelmas, Marcelo; Regenstein, Fredric; Balart, Luis; LaBrecque, Douglas; Brown, Kimberly; Avila, Mark; Biederman, Michael; Freed, Glenn; Smith, Richard; Bernstein, Marc; Arnold, Hays; Cahan, Joel; Fink, Scott; Katkov, William; Massoumi, Hatef; Harrison, Stephen

    2015-01-01

    Objectives: Although effective, direct acting antiviral (DAA) therapies for genotype 1 (GT 1) hepatitis C virus (HCV) have been associated with compliance challenges. Additionally, treatment at predominantly community-based centers has been associated with low retention of patients on treatment and higher dropout rates. The OPTIMAL Phase IV interventional trial (ClinicalTrials.gov Identifier: NCT01405027) was designed to evaluate the impact of an education program for community investigator (CI) sites participating in a Chronic Liver Disease Foundation study treating chronic GT 1 HCV patients. Methods: This physician educational program was administered by 22 Hepatology Centers of Educational Expertise (HCEE) academic sites to 33 CI sites asked to participate from December 2011 to July 2012. The HCEE mentors from DAA-experienced academic sites educated those at CI sites on therapeutic management, practice, and patient outcomes through a series of four standardized educational sequence visits regarding the use of first generation HCV protease inhibitors and the overall treatment of HCV. Results: Treatment duration compliance rates for patients treated at CI sites versus those treated at HCEE academic sites were evaluable in 77 of 84 HCEE academic site patients, 102 of 113 patients treated at CI sites, and 179 of 197 overall patients. The treatment duration compliance rates for patients treated at HCEE academic sites, CI sites and overall were 85.4 ± 25.39%, 83.8 ± 27.37%, and 84.5 ± 26.48%, respectively, and did not differ statistically between the groups (p = 0.49). Almost half (47%) of the patients in the study achieved a sustained virological response for 24 weeks (SVR24) regardless of the type of site (p = 0.64). Safety profiles were similar at both HCEE and CI sites. Conclusions: These results demonstrated that education of CI sites unfamiliar with DAAs resulted in patient outcomes consistent with those observed at DAA-experienced academic sites. PMID

  8. Optimal thickness of silicon membranes to achieve maximum thermoelectric efficiency: A first principles study

    NASA Astrophysics Data System (ADS)

    Mangold, Claudia; Neogi, Sanghamitra; Donadio, Davide

    2016-08-01

    Silicon nanostructures with reduced dimensionality, such as nanowires, membranes, and thin films, are promising thermoelectric materials, as they exhibit considerably reduced thermal conductivity. Here, we utilize density functional theory and Boltzmann transport equation to compute the electronic properties of ultra-thin crystalline silicon membranes with thickness between 1 and 12 nm. We predict that an optimal thickness of ˜7 nm maximizes the thermoelectric figure of merit of membranes with native oxide surface layers. Further thinning of the membranes, although attainable in experiments, reduces the electrical conductivity and worsens the thermoelectric efficiency.

  9. Optimizing outcomes in patients with cardiovascular disease and chronic kidney disease.

    PubMed

    Marrs, Joel C

    2011-12-01

    Chronic kidney disease (CKD) is an independent risk factor for the development of cardiovascular disease (CVD). Often, CKD and CVD coexist, and patients warrant optimal pharmacotherapy to reduce the risk of future cardiovascular (CV) events. Randomized trials have evaluated the role of antihypertensive therapy and lipid-lowering therapy as means to reduce CVD in patients with CKD. Many clinical trials support the role of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in the CKD population. In addition, many clinical trials have evaluated the role of statin therapy in reducing CV events in early- and late-stage CKD. The struggle with interpreting results from these trials is that there are a number of different CV composite end points and a lack of consistency in defining CKD, especially in some post hoc subanalyses. Overall, ACEI/ARB therapy is supported by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) and the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) hypertension guidelines and statin therapy is supported by the Adult Treatment Panel (ATP) III and NKF KDOQI dyslipidemia guidelines to optimally manage patients with CKD and CV risk factors. Questions remain as to the optimal role of statin therapy in patients with CKD receiving dialysis. JNC 8 and ATP IV guidelines will be available in the next year, and it is expected that there will be specific recommendations on both hypertension and dyslipidemia management in the CKD population. PMID:22214475

  10. Large, Sparse Optimal Matching with Refined Covariate Balance in an Observational Study of the Health Outcomes Produced by New Surgeons

    PubMed Central

    Pimentel, Samuel D.; Kelz, Rachel R.; Silber, Jeffrey H.; Rosenbaum, Paul R.

    2015-01-01

    Every newly trained surgeon performs her first unsupervised operation. How do the health outcomes of her patients compare with the patients of experienced surgeons? Using data from 498 hospitals, we compare 1252 pairs comprised of a new surgeon and an experienced surgeon working at the same hospital. We introduce a new form of matching that matches patients of each new surgeon to patients of an otherwise similar experienced surgeon at the same hospital, perfectly balancing 176 surgical procedures and closely balancing a total of 2.9 million categories of patients; additionally, the individual patient pairs are as close as possible. A new goal for matching is introduced, called “refined covariate balance,” in which a sequence of nested, ever more refined, nominal covariates is balanced as closely as possible, emphasizing the first or coarsest covariate in that sequence. A new algorithm for matching is proposed and the main new results prove that the algorithm finds the closest match in terms of the total within-pair covariate distances among all matches that achieve refined covariate balance. Unlike previous approaches to forcing balance on covariates, the new algorithm creates multiple paths to a match in a network, where paths that introduce imbalances are penalized and hence avoided to the extent possible. The algorithm exploits a sparse network to quickly optimize a match that is about two orders of magnitude larger than is typical in statistical matching problems, thereby permitting much more extensive use of fine and near-fine balance constraints. The match was constructed in a few minutes using a network optimization algorithm implemented in R. An R package called rcbalance implementing the method is available from CRAN. PMID:26273117

  11. Optimization of the cooling profile to achieve crack-free Yb:S-FAP crystals

    NASA Astrophysics Data System (ADS)

    Fang, H. S.; Qiu, S. R.; Zheng, L. L.; Schaffers, K. I.; Tassano, J. B.; Caird, J. A.; Zhang, H.

    2008-08-01

    Yb:S-FAP [Yb 3+:Sr 5(PO 4) 3F] crystals are an important gain medium for diode-pumped laser applications. Growth of 7.0 cm diameter Yb:S-FAP crystals utilizing the Czochralski (CZ) method from SrF 2-rich melts often encounters cracks during the post-growth cool-down stage. To suppress cracking during cool-down, a numerical simulation of the growth system was used to understand the correlation between the furnace power during cool-down and the radial temperature differences within the crystal. The critical radial temperature difference, above which the crystal cracks, has been determined by benchmarking the simulation results against experimental observations. Based on this comparison, an optimal three-stage ramp-down profile was implemented, which produced high-quality, crack-free Yb:S-FAP crystals.

  12. Optimization of the cooling profile to achieve crack-free Yb:S-FAP crystals

    SciTech Connect

    Fang, H; Qiu, S; Kheng, L; Schaffers, K; Tassano, J; Caird, J; Zhang, H

    2007-08-20

    Yb:S-FAP [Yb{sup 3+}:Sr{sub 5}(PO{sub 4}){sub 3}F] crystals are an important gain medium for diode-pumped laser applications. Growth of 7.0 cm diameter Yb:S-FAP crystals utilizing the Czochralski (CZ) method from SrF{sub 2}-rich melts often encounter cracks during the post growth cool down stage. To suppress cracking during cool down, a numerical simulation of the growth system was used to understand the correlation between the furnace power during cool down and the radial temperature differences within the crystal. The critical radial temperature difference, above which the crystal cracks, has been determined by benchmarking the simulation results against experimental observations. Based on this comparison, an optimal three-stage ramp-down profile was implemented and produced high quality, crack-free Yb:S-FAP crystals.

  13. High direct drive illumination uniformity achieved by multi-parameter optimization approach: a case study of Shenguang III laser facility.

    PubMed

    Tian, Chao; Chen, Jia; Zhang, Bo; Shan, Lianqiang; Zhou, Weimin; Liu, Dongxiao; Bi, Bi; Zhang, Feng; Wang, Weiwu; Zhang, Baohan; Gu, Yuqiu

    2015-05-01

    The uniformity of the compression driver is of fundamental importance for inertial confinement fusion (ICF). In this paper, the illumination uniformity on a spherical capsule during the initial imprinting phase directly driven by laser beams has been considered. We aim to explore methods to achieve high direct drive illumination uniformity on laser facilities designed for indirect drive ICF. There are many parameters that would affect the irradiation uniformity, such as Polar Direct Drive displacement quantity, capsule radius, laser spot size and intensity distribution within a laser beam. A novel approach to reduce the root mean square illumination non-uniformity based on multi-parameter optimizing approach (particle swarm optimization) is proposed, which enables us to obtain a set of optimal parameters over a large parameter space. Finally, this method is applied to improve the direct drive illumination uniformity provided by Shenguang III laser facility and the illumination non-uniformity is reduced from 5.62% to 0.23% for perfectly balanced beams. Moreover, beam errors (power imbalance and pointing error) are taken into account to provide a more practical solution and results show that this multi-parameter optimization approach is effective. PMID:25969321

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. "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…

  1. 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…

  2. 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…

  3. 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…

  4. Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications.

    PubMed

    Davis, Brenda C; Kris-Etherton, Penny M

    2003-09-01

    Although vegetarian diets are generally lower in total fat, saturated fat, and cholesterol than are nonvegetarian diets, they provide comparable levels of essential fatty acids. Vegetarian, especially vegan, diets are relatively low in alpha-linolenic acid (ALA) compared with linoleic acid (LA) and provide little, if any, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Clinical studies suggest that tissue levels of long-chain n-3 fatty acids are depressed in vegetarians, particularly in vegans. n-3 Fatty acids have numerous physiologic benefits, including potent cardioprotective effects. These effects have been demonstrated for ALA as well as EPA and DHA, although the response is generally less for ALA than for EPA and DHA. Conversion of ALA by the body to the more active longer-chain metabolites is inefficient: < 5-10% for EPA and 2-5% for DHA. Thus, total n-3 requirements may be higher for vegetarians than for nonvegetarians, as vegetarians must rely on conversion of ALA to EPA and DHA. Because of the beneficial effects of n-3 fatty acids, it is recommended that vegetarians make dietary changes to optimize n-3 fatty acid status. PMID:12936959

  5. Standardization and Optimization of Computed Tomography Protocols to Achieve Low-Dose

    PubMed Central

    Chin, Cynthia; Cody, Dianna D.; Gupta, Rajiv; Hess, Christopher P.; Kalra, Mannudeep K.; Kofler, James M.; Krishnam, Mayil S.; Einstein, Andrew J.

    2014-01-01

    The increase in radiation exposure due to CT scans has been of growing concern in recent years. CT scanners differ in their capabilities and various indications require unique protocols, but there remains room for standardization and optimization. In this paper we summarize approaches to reduce dose, as discussed in lectures comprising the first session of the 2013 UCSF Virtual Symposium on Radiation Safety in Computed Tomography. The experience of scanning at low dose in different body regions, for both diagnostic and interventional CT procedures, is addressed. An essential primary step is justifying the medical need for each scan. General guiding principles for reducing dose include tailoring a scan to a patient, minimizing scan length, use of tube current modulation and minimizing tube current, minimizing-tube potential, iterative reconstruction, and periodic review of CT studies. Organized efforts for standardization have been spearheaded by professional societies such as the American Association of Physicists in Medicine. Finally, all team members should demonstrate an awareness of the importance of minimizing dose. PMID:24589403

  6. Assessment of the Optimal Stimulus Pattern to Achieve Rapid Dorsal Hippocampal Kindling in Rats

    PubMed Central

    Etemadi, Fatemeh; Sayyah, Mohammad; Gholami Pourbadie, Hamid; Babapour, Vahab

    2015-01-01

    Introduction: Although hippocampus is the most famous brain area involved in temporal lobe epilepsy, hippocampal kindling (HK) develops very slowly. Hence, rapid kindling is usually preferred to the traditional kindling and it is widely used. In this article we aimed at finding the optimal stimulus pattern, which yields the fastest HK rate. Methods: Stimulus patterns with different duration (2, 3, 5 and 10 s) and inter-train interval (ITI) (5, 10 and 30 min) as well as number of trains in 24 h (8 and 12) were exerted to rats’ dorsal hippocampus. The stimuli were continued until appearance of 3 consecutive generalized seizures or maximum 7 days stimulations. Results: While the protocol with train duration of 10 s and ITI of 30 min caused the fastest kindling rate and the most growth of afterdischarges, the protocol with train duration of 5 s and ITI of 5 min was the most time-consuming protocol among protocols tested. Discussion: Rapid HK develops with a time course of days compared to weeks in traditional kindling. Train duration and inter-train interval are key factors for rapid HK. Among the patterns, 12 trains/24h of 50Hz monophasic square wave with 10 s duration and 30 min interval between trains, is the best stimulus pattern for eliciting rapid dorsal HK. PMID:27307955

  7. Narrative Performance of Optimal Outcome Children and Adolescents with a History of an Autism Spectrum Disorder (ASD)

    ERIC Educational Resources Information Center

    Suh, Joyce; Eigsti, Inge-Marie; Naigles, Letitia; Barton, Marianne; Kelley, Elizabeth; Fein, Deborah

    2014-01-01

    Autism Spectrum Disorders (ASDs) have traditionally been considered a lifelong condition; however, a subset of people makes such significant improvements that they no longer meet diagnostic criteria for an ASD. The current study examines whether these "optimal outcome" (OO) children and adolescents continue to have subtle pragmatic…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  9. Enhancing Self-Efficacy for Optimized Patient Outcomes through the Theory of Symptom Self-Management

    PubMed Central

    Hoffman, Amy J.

    2012-01-01

    Background In today’s world, greater patient empowerment is imperative since 90 million Americans live with one or more chronic conditions such as cancer. Evidence reveals that healthy behaviors such as effective symptom self-management can prevent or reduce much of the suffering from cancer. Oncology nurses play a pivotal role in developing a symptom self-management plan that is critical to optimizing a patient’s symptom self-management behaviors. Objective This article uses exemplars to describe how oncology nurses can apply a tested middle-range theory, the Theory of Symptom Self-Management, to clinical practice by incorporating interventions to increase a patient’s perceived self-efficacy to optimize patient outcomes. Methods The Theory of Symptom Self-Management provides a means to understand the dynamic aspects of symptom self-management and provides a tested framework for the development of efficacy enhancing interventions for use by oncology nurses in clinical practice. Results Exemplars based on the Theory of Symptom Self-Management that depict how oncology nursing can use perceived self-efficacy enhancing symptom self-management interventions to improve the functional status and quality of life of their patients. Conclusion Guided by a theoretical approach, oncology nurses can have a significant positive impact on the lives of their patients by reducing the symptom burden associated with cancer and its treatment. Implications for Practice Oncology nurses can partner with their patients to design tailored approaches to symptom self-management. These tailored approaches provide the ability to implement patient specific behaviors that recognize, prevent, relieve, or decrease the timing, intensity, distress, concurrence, and unpleasant quality of symptoms. PMID:22495550

  10. Isometric Scaling in Developing Long Bones Is Achieved by an Optimal Epiphyseal Growth Balance

    PubMed Central

    Stern, Tomer; Aviram, Rona; Rot, Chagai; Galili, Tal; Sharir, Amnon; Kalish Achrai, Noga; Keller, Yosi; Shahar, Ron; Zelzer, Elazar

    2015-01-01

    One of the major challenges that developing organs face is scaling, that is, the adjustment of physical proportions during the massive increase in size. Although organ scaling is fundamental for development and function, little is known about the mechanisms that regulate it. Bone superstructures are projections that typically serve for tendon and ligament insertion or articulation and, therefore, their position along the bone is crucial for musculoskeletal functionality. As bones are rigid structures that elongate only from their ends, it is unclear how superstructure positions are regulated during growth to end up in the right locations. Here, we document the process of longitudinal scaling in developing mouse long bones and uncover the mechanism that regulates it. To that end, we performed a computational analysis of hundreds of three-dimensional micro-CT images, using a newly developed method for recovering the morphogenetic sequence of developing bones. Strikingly, analysis revealed that the relative position of all superstructures along the bone is highly preserved during more than a 5-fold increase in length, indicating isometric scaling. It has been suggested that during development, bone superstructures are continuously reconstructed and relocated along the shaft, a process known as drift. Surprisingly, our results showed that most superstructures did not drift at all. Instead, we identified a novel mechanism for bone scaling, whereby each bone exhibits a specific and unique balance between proximal and distal growth rates, which accurately maintains the relative position of its superstructures. Moreover, we show mathematically that this mechanism minimizes the cumulative drift of all superstructures, thereby optimizing the scaling process. Our study reveals a general mechanism for the scaling of developing bones. More broadly, these findings suggest an evolutionary mechanism that facilitates variability in bone morphology by controlling the activity of

  11. Endonasal endoscopic dacryocystorhinostomy: how to achieve optimal results with simple punch technique.

    PubMed

    Naraghi, Mohsen; Tabatabaii Mohammadi, Sayed Ziaeddin; Sontou, Alain Fabrice; Farajzadeh Deroee, Armin; Boroojerdi, Masoud

    2012-05-01

    Endonasal endoscopic dacryocystorhinostomy (EEDCR) has been popularized as a minimally invasive technique. Although preliminary reports revealed less success in comparison with external approaches, recent endonasal endoscopic surgeries on various types of DCR have preserved advantages of this technique while diminishing the failures. We described our experience on EEDCR, including the main advantages and disadvantages of it. Hundred consecutive cases of lachrymal problems underwent EEDCR utilizing simple punch removal of bone, instead of powered instrumentation or lasers. The medial aspect of the sac was removed in all of patients, while preserving normal mucosa around the sac. Hundred cases of EEDCR were performed on 81 patients, with 19 bilateral procedures. Nine procedures were performed under local anesthesia. Based on a mean 14 months follow-up, 95 cases were free of symptoms, revealing 95% success rate. The punch technique diminishes the expenses of powered or laser instrumentation with comparable results. It seems that preserving normal tissues and creating a patent rhinostomy with least surgical trauma and less subsequent scar, plays the most important role in achieving desirable results. PMID:22065173

  12. Effectiveness of increasing the frequency of posaconazole syrup administration to achieve optimal plasma concentrations in patients with haematological malignancy.

    PubMed

    Park, Wan Beom; Cho, Joo-Youn; Park, Sang-In; Kim, Eun Jung; Yoon, Seonghae; Yoon, Seo Hyun; Lee, Jeong-Ok; Koh, Youngil; Song, Kyoung-Ho; Choe, Pyoeng Gyun; Yu, Kyung-Sang; Kim, Eu Suk; Bang, Su Mi; Kim, Nam Joong; Kim, Inho; Oh, Myoung-Don; Kim, Hong Bin; Song, Sang Hoon

    2016-07-01

    Few data are available on whether adjusting the dose of posaconazole syrup is effective in patients receiving anti-cancer chemotherapy. The aim of this prospective study was to analyse the impact of increasing the frequency of posaconazole administration on optimal plasma concentrations in adult patients with haematological malignancy. A total of 133 adult patients receiving chemotherapy for acute myeloid leukaemia or myelodysplastic syndrome who received posaconazole syrup 200 mg three times daily for fungal prophylaxis were enrolled in this study. Drug trough levels were measured by liquid chromatography-tandem mass spectrometry. In 20.2% of patients (23/114) the steady-state concentration of posaconazole was suboptimal (<500 ng/mL) on Day 8. In these patients, the frequency of posaconazole administration was increased to 200 mg four times daily. On Day 15, the median posaconazole concentration was significantly increased from 368 ng/mL [interquartile range (IQR), 247-403 ng/mL] to 548 ng/mL (IQR, 424-887 ng/mL) (P = 0.0003). The median increase in posaconazole concentration was 251 ng/mL (IQR, 93-517 ng/mL). Among the patients with initially suboptimal levels, 79% achieved the optimal level unless the steady-state level was <200 ng/mL. This study shows that increasing the administration frequency of posaconazole syrup is effective for achieving optimal levels in patients with haematological malignancy undergoing chemotherapy. PMID:27234674

  13. Optimizing outcome in SLE: treating-to-target and definition of treatment goals.

    PubMed

    Doria, Andrea; Gatto, Mariele; Zen, Margherita; Iaccarino, Luca; Punzi, Leonardo

    2014-07-01

    Patients affected with systemic lupus erythematosus (SLE) display poor-long term prognosis and increased mortality in respect of general population. This may be due to continuous organ damage accrual which is fostered both by persistent disease activity (mainly in the short term) and prolonged corticosteroid exposure (mainly in the long term). The effort of defining novel therapeutic goals to which patients should be treated in order to have their prognosis improved is named treat-to-target. Remission in SLE was shown to be associated with better outcome and prolonged survival; in clinical practice, patients may experience either complete or clinical remission, which are defined as complete clinical/serological healing or no clinical signs of lupus with active serology, respectively. The main treat-to-target in SLE is complete remission, however since longitudinal observations suggest that clinical remission or low disease activity even with minimal corticosteroid intake do improve patients prognosis and survival as well, they may be assumed as acceptable alternative targets. Suitable therapeutic strategies have to be defined in order for these goals to be achieved including early diagnosis, effective treatment and proper corticosteroid tapering which in turn require development of more reliable serum biomarkers for early disease detection and less toxic targeted therapies with a steroid-sparing potential. PMID:24480071

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. Reduction of exposure to acrylamide: achievements, potential of optimization, and problems encountered from the perspectives of a Swiss enforcement laboratory.

    PubMed

    Grob, Koni

    2005-01-01

    The most important initiatives taken in Switzerland to reduce exposure of consumers to acrylamide are the separate sale of potatoes low in reducing sugars for roasting and frying, the optimization of the raw material and preparation of french fries, and campaigns to implement suitable preparation methods in the gastronomy and homes. Industry works on improving a range of other products. Although these measures can reduce high exposures by some 80%, they have little effect on the background exposure resulting from coffee, bread, and numerous other products for which no substantial improvement is in sight. At this stage, improvements should be achieved by supporting voluntary activity rather than legal limits. Committed and consistent risk communication is key, and the support of improvements presupposes innovative approaches. PMID:15759749

  1. Optimization Correction Strength Using Contra Bending Technique without Anterior Release Procedure to Achieve Maximum Correction on Severe Adult Idiopathic Scoliosis

    PubMed Central

    Rahyussalim, Ahmad Jabir; Saleh, Ifran; Purnaning, Dyah; Kurniawati, Tri

    2016-01-01

    Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10 degrees in the coronal plain. Posterior-only approach with rod and screw corrective manipulation to add strength of contra bending manipulation has correction achievement similar to that obtained by conventional combined anterior release and posterior approach. It also avoids the complications related to the thoracic approach. We reported a case of 25-year-old male adult idiopathic scoliosis with double curve. It consists of main thoracic curve of 150 degrees and lumbar curve of 89 degrees. His curve underwent direct contra bending posterior approach using rod and screw corrective manipulation technique to achieve optimal correction. After surgery the main thoracic Cobb angle becomes 83 degrees and lumbar Cobb angle becomes 40 degrees, with 5 days length of stay and less than 800 mL blood loss during surgery. There is no complaint at two months after surgery; he has already come back to normal activity with good functional activity. PMID:27064801

  2. The validity and consistency of findings across international studies of mathematics and science achievement: A comparison of outcomes from IAEP2 and TIMSS

    NASA Astrophysics Data System (ADS)

    O'Leary, Michael

    The investigation reported in this dissertation was prompted by discrepancies between the performance of Irish students on two international tests of science achievement: the Second International Assessment of Educational Progress (IAEP2) administered in 1991 and the Third International Mathematics and Science Study (TIMSS) administered in 1995. While average science achievement for Irish 13-year-olds was reported to be at the low end of the distribution for the 20 participating countries in IAEP2, it was around the middle of the distribution for the 40 or so countries that participated in TIMSS in the early grades of secondary schooling. Initial comparisons suggested that there were also discrepancies in outcomes for some of the 11 other countries that participated in both surveys e.g. France, Portugal, and Switzerland. Such discrepancies were not as apparent in mathematics. The study set out to answer two interrelated questions: What accounts for the apparent inconsistency of Irish science performance in the two international assessments? And which of the reported findings provides the more accurate reflection of science achievement in Ireland? Following a review of design and implementation factors affecting the outcomes of international comparative studies, nine hypotheses were posited to account for differences in the relative performance of Ireland and other countries across IAEP2 and TIMSS. Analyses relevant to the hypotheses led to the conclusion that population definition, test-curriculum overlap, the use of aggregated scales, and the form in which items were presented all contributed to the differences between the outcomes of the two surveys. When these issues are taken into account, science achievement in Ireland does not turn out to be at the low level suggested by initial interpretations of the IAEP2 data. A number of implications of the study for future international comparative studies of student achievement are outlined.

  3. "I am a scientist": How setting conditions that enhance focused concentration positively relate to student motivation and achievement outcomes in inquiry-based science

    NASA Astrophysics Data System (ADS)

    Ellwood, Robin B.

    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 included eight eighth grade girls, aged thirteen to fourteen years old. Data sources included formal and informal participant interviews, participant journal reflections, curriculum artifacts including quizzes, worksheets, and student-generated research posters, digital video and audio recordings, photographs, and researcher field notes. Data were transcribed verbatim and coded, then collapsed into emergent themes using NVIVO 9. The results of this research illustrate how setting conditions that promote focused concentration and communicative interactions can be positively related to student motivation and achievement outcomes in inquiry-based science. Participants in the Off-Campus case experienced more frequent states of focused concentration and out performed their peers in the On-Campus case on forty-six percent of classroom assignments. Off-Campus participants also designed and implemented a more cognitively complex research project, provided more in-depth analyses of their research results, and expanded their perceptions of what it means to act like a scientist to a greater extent than participants in the On-Campus case. These results can be understood in relation to Flow Theory. Student interactions that promoted the criteria necessary for initiating flow, which included having clearly defined goals, receiving immediate feedback, and maintaining a balance between challenges and skills, fostered enhanced student motivation and achievement outcomes. This research also illustrates the positive gains in motivation and achievement outcomes that emerge from student experiences with extended time in isolated areas referred to

  4. Translating school health research to policy. School outcomes related to the health environment and changes in mathematics achievement.

    PubMed

    Snelling, Anastasia M; Belson, Sarah Irvine; Watts, Erin; George, Stephanie; Van Dyke, Hugo; Malloy, Elizabeth; Kalicki, Michelle

    2015-10-01

    This paper describes an exploration of the relationship between mathematic achievement and the school health environment relative to policy-driven changes in the school setting, specifically with regard to physical education/physical activity. Using school-level data, the authors seek to understand the relationship between mathematics achievement and the school health environment and physical education minutes. This work provides a description of the aspects of the school health environment, an exploration of the interrelationships between school health and student achievement, and an assessment of the effects of the school health policy and practice on student performance and health status. Based on these findings, we identify additional research necessary to describe the relationship between obesity and learning in children. PMID:26050913

  5. Intervention History of Children and Adolescents with High-Functioning Autism and Optimal Outcomes

    PubMed Central

    Orinstein, Alyssa J.; Helt, Molly; Troyb, Eva; Tyson, Katherine E.; Barton, Marianne L.; Eigsti, Inge-Marie; Naigles, Letitia; Fein, Deborah A.

    2015-01-01

    Objective Autism spectrum disorders (ASDs) were once considered lifelong disorders, but recent findings indicate that some children with ASDs no longer meet diagnostic criteria for any ASD and reach normal cognitive function. These children are considered to have achievedoptimal outcomes’ (OO). The present study aimed to retrospectively examine group differences in the intervention history of children and adolescents with OO and those with high-functioning autism (HFA) Method The current study examined intervention histories in 34 individuals with OO and 44 individuals with HFA (currently ages 8-21), who did not differ on age, sex, nonverbal IQ or family income. Intervention history was collected through detailed parent questionnaires. Results Children in the OO group had earlier parent concern, received earlier referrals to specialists, and earlier and more intensive intervention than those in the HFA group. Substantially more OO children received Applied Behavior Analysis (ABA) therapy than HFA children, although the intensity of ABA did not vary between groups. Children in the HFA group were more likely to have received medication, especially anti-psychotics and anti-depressants. There were no group differences in the percent of children receiving special diets or supplements. Conclusion These data suggest that OO individuals generally receive earlier, more intense interventions and more ABA, while HFA individuals receive more pharmacologic treatments. While the use of retrospective data is a clear limitation to the current study, the substantial differences in reported provision of early intervention, and ABA in particular, are highly suggestive and should be replicated in prospective studies. PMID:24799263

  6. Achievement and Climate Outcomes for the Knowledge Is Power Program in an Inner-City Middle School

    ERIC Educational Resources Information Center

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

    2007-01-01

    This study was designed to examine the effects of a whole school reform, the Knowledge is Power Program (KIPP), specifically designed to raise academic achievement of at-risk urban middle school students by establishing an extended school day and year, a rigorous curriculum, after-school access to teachers, and increased family-school connections.…

  7. The Validity of Goal Achievement as an Outcome Measure in Physical Rehabilitation Day Hospitals for Older People

    ERIC Educational Resources Information Center

    Kneebone, Ian I.; Hurn, Jane S.; Raisbeck, Elizabeth; Cropley, Mark; Khoshnaw, Hiro; Milton, Jane E.

    2010-01-01

    Physical rehabilitation day hospitals are widely used community-based services designed to meet the medical and rehabilitation needs of older people. While there is evidence for the effectiveness of these services, concerns about the shortcomings of how this is measured have led to the recommendation that the achievement of individually tailored…

  8. Perceived Teacher Factors in Relation to Students' Achievement-Related Outcomes in Science Classrooms in Elementary School

    ERIC Educational Resources Information Center

    Sakiz, Gönül

    2015-01-01

    The purpose of the current study was to investigate the roles that perceived teacher affective support (PTAS), perceived teacher mastery goal orientation (PTMGO), academic emotions, self-efficacy and behavioural engagement play on students' science achievement in elementary school science classrooms. The potential relations of different levels of…

  9. Achieving Equitable Outcomes. A Supporting Paper to Australia's National Strategy for Vocational Education and Training, 1998-2003.

    ERIC Educational Resources Information Center

    Australian National Training Authority, Brisbane.

    This paper is one of five supporting papers to "A Bridge to the Future: Australia's National Strategy for VET 1998-2003" (ED 420 764). Although some equity client groups in Australia are now relatively well represented in vocational education and training (VET), patterns of enrollment and achievement are not uniform. To respond to this situation…

  10. Evaluation of Achieving Collegiate Excellence and Success Program: Student Outcomes Year One, Grades 11 and 12. Evaluation Brief

    ERIC Educational Resources Information Center

    Wolanin, Natalie; Modarresi, Shahpar

    2015-01-01

    The Office of Shared Accountability in Montgomery County (Maryland) Public Schools (MCPS) is conducting a multiyear evaluation of the "Achieving Collegiate Excellence and Success" (ACES) program. ACES is a collaboration between MCPS, Montgomery College (MC), and the Universities at Shady Grove (USG) to create a seamless pathway from high…

  11. Variability in ESL Outcomes: The Influence of Age on Arrival and Length of Residence on Achievement in High School

    ERIC Educational Resources Information Center

    Roessingh, Hetty

    2008-01-01

    This article integrates findings from earlier research (Roessingh & Kover, 2003; Roessingh, Kover, & Watt, 2005) linking distinct patterns of achievement for diverse age-on-arrival (AOA) cohorts of ESL learners on the grade 12 Alberta English language arts (ELA) examination to their vocabulary and reading comprehension scores on a standardized…

  12. Optimal unified combination rule in application of Dempster-Shafer theory to lung cancer radiotherapy dose response outcome analysis.

    PubMed

    He, Yanyan; Hussaini, M Yousuff; Gong, Yutao U T; Xiao, Ying

    2016-01-01

     Our previous study demonstrated the application of the Dempster-Shafer theory of evidence to dose/volume/outcome data analysis. Specifically, it provided Yager's rule to fuse data from different institutions pertaining to radiotherapy pneumonitis versus mean lung dose. The present work is a follow-on study that employs the optimal unified combination rule, which optimizes data similarity among inde-pendent sources. Specifically, we construct belief and plausibility functions on the lung cancer radiotherapy dose outcome datasets, and then apply the optimal uni-fied combination rule to obtain combined belief and plausibility, which bound the probabilities of pneumonitis incidence. To estimate the incidence of pneumonitis at any value of mean lung dose, we use the Lyman-Kutcher-Burman (LKB) model to fit the combined belief and plausibility curves. The results show that the optimal unified combination rule yields a narrower uncertainty range (as represented by the belief-plausibility range) than Yager's rule, which is also theoretically proven. PMID:26894343

  13. 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

  14. Impact of the Positive Action program on school-level indicators of academic achievement, absenteeism, and disciplinary outcomes: A matched-pair, cluster randomized, controlled trial

    PubMed Central

    Snyder, Frank; Vuchinich, Samuel; Acock, Alan; Washburn, Isaac; Beets, Michael; Li, Kin-Kit

    2010-01-01

    This paper reports the effects of a comprehensive elementary school-based social-emotional and character education program on school-level achievement, absenteeism, and disciplinary outcomes utilizing a matched-pair, cluster randomized, controlled design. The Positive Action Hawai‘i trial included 20 racially/ethnically diverse schools (mean enrollment = 544) and was conducted from the 2002-03 through the 2005-06 academic years. Using school-level archival data, analyses comparing change from baseline (2002) to one-year post trial (2007) revealed that intervention schools scored 9.8% better on the TerraNova (2nd ed.) test for reading and 8.8% on math; 20.7% better in Hawai‘i Content and Performance Standards scores for reading and 51.4% better in math; and that intervention schools reported 15.2% lower absenteeism and fewer suspensions (72.6%) and retentions (72.7%). Overall, effect sizes were moderate to large (range 0.5-1.1) for all of the examined outcomes. Sensitivity analyses using permutation models and random-intercept growth curve models substantiated results. The results provide evidence that a comprehensive school-based program, specifically developed to target student behavior and character, can positively influence school-level achievement, attendance, and disciplinary outcomes concurrently. PMID:20414477

  15. Optimism, Social Support, and Mental Health Outcomes in Patients with Advanced Cancer

    PubMed Central

    Applebaum, Allison J.; Stein, Emma M.; Lord-Bessen, Jennifer; Pessin, Hayley; Rosenfeld, Barry; Breitbart, William

    2014-01-01

    Objective Optimism and social support serve as protective factors against distress in medically ill patients. Very few studies have specifically explored the ways in which these variables interact to impact quality of life (QOL), particularly among patients with advanced cancer. The present study examined the role of optimism as a moderator of the relationship between social support and anxiety, depression, hopelessness, and QOL among patients with advanced cancer. Methods Participants (N = 168) completed self-report assessments of psychosocial, spiritual, and physical well-being, including social support, optimism, hopelessness, depressive and anxious symptoms, and QOL. Hierarchical multiple regression analyses were conducted to determine the extent to which social support and optimism were associated with depressive and anxious symptomatology, hopelessness and QOL, and the potential role of optimism as a moderator of the relationship between social support and these variables. Results Higher levels of optimism were significantly associated with fewer anxious and depressive symptoms, less hopelessness and better QOL. Higher levels of perceived social support were also significantly associated with better QOL. Additionally, optimism moderated the relationship between social support and anxiety, such that there was a strong negative association between social support and anxiety for participants with low optimism. Conclusions This study highlights the importance of optimism and social support in the QOL of patients with advanced cancer. As such, interventions that attend to patients’ expectations for positive experiences and the expansion of social support should be the focus of future clinical and research endeavors. PMID:24123339

  16. 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

  17. Technology Education Using a Novel Approach in e-Learning-Towards Optimizing the Quality of Learning Outcomes

    NASA Astrophysics Data System (ADS)

    Malkawi, M. I.; Hawarey, M. M.

    2012-04-01

    Ever since the advent of the new era in presenting taught material in Electronic Form, international bodies, academic institutions, public sectors, as well as specialized entities in the private sector, globally, have all persevered to exploit the power of Distance Learning and e-Learning to disseminate the knowledge in Science and Art using the ubiquitous World Wide Web and its supporting Internet and Internetworking. Many Science & Education-sponsoring bodies, like UNESCO, the European Community, and the World Bank have been keen at funding multinational Distance Learning projects, many of which were directed at an educated audience in certain technical areas. Many countries around the Middle East have found a number of interested European partners to launch funding requests, and were generally successful in their solicitation efforts for the needed funds from these funding bodies. Albeit their intricacies in generating a wealth of knowledge in electronic form, many of the e-Learning schemas developed thus far, have only pursued their goals in the most conventional of ways; In essence, there had been little innovation introduced to gain anything, if any, above traditional classroom lecturing, other than, of course, the gained advantage of the simultaneous online testing and evaluation of the learned material by the examinees. In a sincere effort to change the way in which people look at the merits of e-Learning, and seek the most out of it, we shall propose a novel approach aimed at optimizing the learning outcomes of presented materials. In this paper we propose what shall henceforth be called as Iterative e-Learning. In Iterative e-Learning, as the name implies, a student uses some form of electronic media to access course material in a specific subject. At the end of each phase (Section, Chapter, Session, etc.) on a specific topic, the student is assessed online of how much he/she would have achieved before he/she would move on. If the student fails, due to

  18. Direct Oral Anticoagulants for the Management of Thromboembolic Disorders: The Importance of Adherence and Persistence in Achieving Beneficial Outcomes.

    PubMed

    Amin, Alpesh; Marrs, Joel C

    2016-10-01

    Anticoagulation therapy is central to the management of thromboembolic disorders, and the use of direct oral anticoagulants offers several advantages over standard therapy with parenteral heparins and vitamin K antagonists. In phase III clinical trials, the direct oral anticoagulants (given once or twice daily) all demonstrated favorable benefit-risk profiles compared with conventional standard therapy for the treatment and secondary prevention of venous thromboembolism and for stroke prevention in patients with nonvalvular atrial fibrillation. In clinical practice, many factors may influence overall clinical outcomes in patients receiving anticoagulant therapy, including adherence and persistence to the prescribed therapy, which becomes particularly important during long-term therapy. When choosing an anticoagulant for an individual patient, the pharmacological and clinical profile of the anticoagulant, its dosing regimen, and the patient's clinical characteristics (eg, renal function and comorbidities) and preferences should be considered. This review examines the rationale for and clinical evidence of the selected dosing regimens of the direct oral anticoagulants for the treatment of venous thromboembolism and stroke prevention in nonvalvular atrial fibrillation. The potential influence of dosing strategies (eg, once- or twice-daily dosing) and other factors on patient adherence and therapy persistence are also discussed. PMID:26316518

  19. Critical thinking: optimal outcomes through end user involvement in the design of critical care areas.

    PubMed

    Braun, Debra; Barnhardt, Kim

    2014-01-01

    Including end users in evidence-based design is vital to outcomes. The physical environment impacts caregiver efficiencies, safety, satisfaction, and quality of patient outcomes. End users are more than members of the organization: patients should have representation as well. Patients bring value by offering insight from a different perspective. Timing is key; therefore, it is critical in obtaining desired outcomes, to include end users as early as possible, gaining the most insight into the design of the build. Consideration should also be given to best practice standards, regulatory compliance, progressive sciences, and technologies. Another vital factor is education of the end users on their role and expectations for participation in a design team. When end users are educated and understand the significance of input, the design team will be able to conceive a critical care unit that will meet needs for today and be able to adapt to needs for the future. PMID:24309458

  20. Optimal Developmental Outcomes for the Child Aged Six to Twelve: Social, Moral, Cognitive, and Emotional Dimensions.

    ERIC Educational Resources Information Center

    Baker, Kay

    2001-01-01

    Discusses Montessori theories for development of social, moral, cognitive, and emotional dimensions of the human personality during the second plane of development--age six to puberty--as these theories relate to the theory of optimal experience. (JPB)

  1. Predicting Optimal Outcomes in Cognitive Therapy or Interpersonal Psychotherapy for Depressed Individuals Using the Personalized Advantage Index Approach

    PubMed Central

    Huibers, Marcus J. H.; Cohen, Zachary D.; Lemmens, Lotte H. J. M.; Arntz, Arnoud; Peeters, Frenk P. M. L.; Cuijpers, Pim; DeRubeis, Robert J.

    2015-01-01

    Introduction Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works best for the depressed individual. In this paper, we aim to replicate a recently developed treatment selection method, using data from an RCT comparing the effects of cognitive therapy (CT) and interpersonal psychotherapy (IPT). Methods 134 depressed patients completed the pre- and post-treatment BDI-II assessment. First, we identified baseline predictors and moderators. Second, individual treatment recommendations were generated by combining the identified predictors and moderators in an algorithm that produces the Personalized Advantage Index (PAI), a measure of the predicted advantage in one therapy compared to the other, using standard regression analyses and the leave-one-out cross-validation approach. Results We found five predictors (gender, employment status, anxiety, personality disorder and quality of life) and six moderators (somatic complaints, cognitive problems, paranoid symptoms, interpersonal self-sacrificing, attributional style and number of life events) of treatment outcome. The mean average PAI value was 8.9 BDI points, and 63% of the sample was predicted to have a clinically meaningful advantage in one of the therapies. Those who were randomized to their predicted optimal treatment (either CT or IPT) had an observed mean end-BDI of 11.8, while those who received their predicted non-optimal treatment had an end-BDI of 17.8 (effect size for the difference = 0.51). Discussion Depressed patients who were randomized to their predicted optimal treatment fared much better than those randomized to their predicted non-optimal treatment. The PAI provides a great opportunity for formal decision-making to improve individual patient outcomes in depression. Although

  2. Understanding Optimal Outcomes: The Role of Strategy Sequences in Competitive Negotiations.

    ERIC Educational Resources Information Center

    Olekalns, Mara; Smith, Philip L.

    2000-01-01

    Examines the relationship between negotiation strategies and the quality of negotiated outcomes among undergraduate students. Finds that: impasse negotiations showed the frequent use of contention and sequences that paired similar (either cooperative or competitive) strategies; settlement was associated with decreased contention and sequences that…

  3. A SMART design to optimize treatment strategies for patient and family caregiver outcomes.

    PubMed

    Song, Mi-Kyung; DeVito Dabbs, Annette; Ward, Sandra E

    2016-01-01

    Sequential multiple randomization trial (SMART) designs are experimental designs used to identify treatment strategies that maximize targeted health outcomes. SMART designs are receiving greater attention in nursing and other health disciplines to develop multicomponent interventions that are tailored to the patient's (or family caregiver's) needs and preferences. A SMART design resembles a traditional randomized controlled trial (RCT) design in that it scientifically examines intervention effects with randomization. However, the two designs address very different research inquiries. In this article, we compare traditional RCT designs and SMART designs, describe the adaptive treatment framework that underlies SMART designs and key features of SMART designs, and illustrate the application of a SMART design to develop an adaptive palliative care treatment to improve patient and caregiver outcomes. PMID:27264454

  4. What New Knowledge Would Help Policymakers Better Balance Investments for Optimal Health Outcomes?

    PubMed Central

    Kindig, David; Day, Patricia; Fox, Daniel M; Gibson, Mark; Knickman, James; Lomas, Jonathan; Stoddart, Gregory

    2003-01-01

    Objective Review the limitations in cross-sectoral health outcomes research and suggest a future research agenda. Data Sources, Study Design, Data Collection Literature review and workshop discussion. Principal Findings The research evidence that would aid public and private policy makers in answering the question the title poses is quite limited. Conclusions Much more evidence from diverse disciplines is needed, and key areas are suggested. Criteria for progress by 2010 are proposed. PMID:14727804

  5. Optimal tumor shrinkage predicts long-term outcome in advanced nonsmall cell lung cancer (NSCLC) treated with target therapy

    PubMed Central

    He, Xiaobo; Zhang, Yang; Ma, Yuxiang; Zhou, Ting; Zhang, Jianwei; Hong, Shaodong; Sheng, Jin; Zhang, Zhonghan; Yang, Yunpeng; Huang, Yan; Zhang, Li; Zhao, Hongyun

    2016-01-01

    Abstract Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are used as standard therapies for advanced nonsmall cell lung cancer (NSCLC) patients with EGFR mutation positive. Because these targeted therapies could cause tumor necrosis and shrinkage, the purpose of the study is to search for a value of optimal tumor shrinkage as an appropriate indicator of outcome for advanced NSCLC. A total of 88 NSCLC enrollees of 3 clinical trials (IRESSA registration clinical trial, TRUST study and ZD6474 study), who received Gefitinib (250 mg, QD), Erlotinib (150 mg, QD), and ZD6474 (100 mg, QD), respectively, during December 2003 and October 2007, were retrospectively analyzed. The response evaluation criteria in solid tumors (RECIST) were used to identify responders, who had complete response (CR) or partial responses (PR) and nonresponders who had stable disease (SD) or progressive disease (PD). Receiver operating characteristics (ROC) analysis was used to find the optimal tumor shrinkage as an indicator for tumor therapeutic outcome. Univariate and multivariate Cox regression analyses were performed to compare the progression-free survival (PFS) and overall survival (OS) between responders and nonresponders stratified based on radiologic criteria. Among the 88 NSCLC patients, 26 were responders and 62 were nonresponders based on RECIST 1.0. ROC indicated that 8.32% tumor diameter shrinkage in the sum of the longest tumor diameter (SLD) was the cutoff point of tumor shrinkage outcomes, resulting in 46 responders (≤8.32%) and 42 nonresponders (≥8.32%). Univariate and multivariate Cox regression analyses indicated that (1) the responders (≤8.32%) and nonresponders (≥ −8.32%) were significantly different in median PFS (13.40 vs 1.17 months, P < 0.001) and OS (19.80 vs 7.90 months, P < 0.001) and (2) –8.32% in SLD could be used as the optimal threshold for PFS (hazard ratio [HR], 8.11, 95% CI, 3.75 to 17.51, P < 0.001) and OS

  6. Optimal pathological response indicated better long-term outcome among patients with stage IB2 to IIB cervical cancer submitted to neoadjuvant chemotherapy.

    PubMed

    Huang, Kecheng; Sun, Haiying; Chen, Zhilan; Li, Xiong; Wang, ShaoShuai; Zhao, Xiaolin; Tang, Fangxu; Jia, Yao; Hu, Ting; Du, Xiaofang; Wang, Haoran; Lu, Zhiyong; Huang, Jia; Gui, Juan; Wang, Xiaoli; Zhou, Shasha; Wang, Lin; Zhang, Jincheng; Guo, Lili; Yang, Ru; Shen, Jian; Zhang, Qinghua; Li, Shuang; Wang, Shixuan

    2016-01-01

    The role of pathological response in long-term outcome is still unclear in cervical cancer patients treated with neoadjuvant chemotherapy (NACT) in China. This study aimed to investigate the effect of optimal pathologic response (OPR) on survival in the patients treated with NACT and radical hysterectomy. First, 853 patients with stage IB2-IIB cervical cancer were included in a retrospective analysis; a Cox proportional hazards model was used to investigate the relationship between pathological response and disease-free survival (DFS). In the retrospective database, 64 (7.5%) patients were found to have achieved an OPR (residual disease <3 mm stromal invasion); in the multivariate Cox model, the risk of death was much greater in the non-OPR group than in the OPR group (HR, 2.61; 95%CI, 1.06 to 6.45; P = 0.037). Next, the role of OPR was also evaluated in a prospective cohort of 603 patients with cervical cancer. In the prospective cohort, 56 (9.3%) patients were found to have achieved an OPR; the log-rank tests showed that the risk of recurrence was higher in the non-OPR patients than in the OPR group (P = 0.05). After combined analysis, OPR in cervical cancer was found to be an independent prognostic factor for DFS. PMID:27325186

  7. Optimal pathological response indicated better long-term outcome among patients with stage IB2 to IIB cervical cancer submitted to neoadjuvant chemotherapy

    PubMed Central

    Huang, Kecheng; Sun, Haiying; Chen, Zhilan; Li, Xiong; Wang, ShaoShuai; Zhao, Xiaolin; Tang, Fangxu; Jia, Yao; Hu, Ting; Du, Xiaofang; Wang, Haoran; Lu, Zhiyong; Huang, Jia; Gui, Juan; Wang, Xiaoli; Zhou, Shasha; Wang, Lin; Zhang, Jincheng; Guo, Lili; Yang, Ru; Shen, Jian; Zhang, Qinghua; Li, Shuang; Wang, Shixuan

    2016-01-01

    The role of pathological response in long-term outcome is still unclear in cervical cancer patients treated with neoadjuvant chemotherapy (NACT) in China. This study aimed to investigate the effect of optimal pathologic response (OPR) on survival in the patients treated with NACT and radical hysterectomy. First, 853 patients with stage IB2-IIB cervical cancer were included in a retrospective analysis; a Cox proportional hazards model was used to investigate the relationship between pathological response and disease-free survival (DFS). In the retrospective database, 64 (7.5%) patients were found to have achieved an OPR (residual disease <3 mm stromal invasion); in the multivariate Cox model, the risk of death was much greater in the non-OPR group than in the OPR group (HR, 2.61; 95%CI, 1.06 to 6.45; P = 0.037). Next, the role of OPR was also evaluated in a prospective cohort of 603 patients with cervical cancer. In the prospective cohort, 56 (9.3%) patients were found to have achieved an OPR; the log-rank tests showed that the risk of recurrence was higher in the non-OPR patients than in the OPR group (P = 0.05). After combined analysis, OPR in cervical cancer was found to be an independent prognostic factor for DFS. PMID:27325186

  8. Defining Optimal Aerobic Exercise Parameters to Affect Complex Motor and Cognitive Outcomes after Stroke: A Systematic Review and Synthesis

    PubMed Central

    Hasan, S. M. Mahmudul; Rancourt, Samantha N.; Austin, Mark W.; Ploughman, Michelle

    2016-01-01

    Although poststroke aerobic exercise (AE) increases markers of neuroplasticity and protects perilesional tissue, the degree to which it enhances complex motor or cognitive outcomes is unknown. Previous research suggests that timing and dosage of exercise may be important. We synthesized data from clinical and animal studies in order to determine optimal AE training parameters and recovery outcomes for future research. Using predefined criteria, we included clinical trials of stroke of any type or duration and animal studies employing any established models of stroke. Of the 5,259 titles returned, 52 articles met our criteria, measuring the effects of AE on balance, lower extremity coordination, upper limb motor skills, learning, processing speed, memory, and executive function. We found that early-initiated low-to-moderate intensity AE improved locomotor coordination in rodents. In clinical trials, AE improved balance and lower limb coordination irrespective of intervention modality or parameter. In contrast, fine upper limb recovery was relatively resistant to AE. In terms of cognitive outcomes, poststroke AE in animals improved memory and learning, except when training was too intense. However, in clinical trials, combined training protocols more consistently improved cognition. We noted a paucity of studies examining the benefits of AE on recovery beyond cessation of the intervention. PMID:26881101

  9. Defining Optimal Aerobic Exercise Parameters to Affect Complex Motor and Cognitive Outcomes after Stroke: A Systematic Review and Synthesis.

    PubMed

    Hasan, S M Mahmudul; Rancourt, Samantha N; Austin, Mark W; Ploughman, Michelle

    2016-01-01

    Although poststroke aerobic exercise (AE) increases markers of neuroplasticity and protects perilesional tissue, the degree to which it enhances complex motor or cognitive outcomes is unknown. Previous research suggests that timing and dosage of exercise may be important. We synthesized data from clinical and animal studies in order to determine optimal AE training parameters and recovery outcomes for future research. Using predefined criteria, we included clinical trials of stroke of any type or duration and animal studies employing any established models of stroke. Of the 5,259 titles returned, 52 articles met our criteria, measuring the effects of AE on balance, lower extremity coordination, upper limb motor skills, learning, processing speed, memory, and executive function. We found that early-initiated low-to-moderate intensity AE improved locomotor coordination in rodents. In clinical trials, AE improved balance and lower limb coordination irrespective of intervention modality or parameter. In contrast, fine upper limb recovery was relatively resistant to AE. In terms of cognitive outcomes, poststroke AE in animals improved memory and learning, except when training was too intense. However, in clinical trials, combined training protocols more consistently improved cognition. We noted a paucity of studies examining the benefits of AE on recovery beyond cessation of the intervention. PMID:26881101

  10. Reducing the Academic Risks of Over-Optimism: The Longitudinal Effects of Attributional Retraining on Cognition and Achievement

    ERIC Educational Resources Information Center

    Haynes, Tara L.; Ruthig, Joelle C.; Perry, Raymond P.; Stupnisky, Robert H.; Hall, Nathan C.

    2006-01-01

    Although optimism is generally regarded as a positive dispositional characteristic, unmitigated optimism can be problematic. The adaptiveness of overly optimistic expectations in novel or unfamiliar settings is questionable because individuals have little relevant experience on which to base such expectations. In this four-phase longitudinal…

  11. Acidosis in the critically ill - balancing risks and benefits to optimize outcome

    PubMed Central

    2014-01-01

    Acidosis is associated with poor outcome in critical illness. However, acidosis - both hypercapnic and metabolic - has direct effects that can limit tissue injury induced by many causes. There is also a clear potential for off-target harm with acute exposure (for example, raised intracranial pressure, pulmonary hypertension), and with exposure for prolonged periods (for example, increased risk of infection) or at high doses. Ongoing comprehensive determination of molecular, cellular and physiologic impact across a range of representative pathologies will allow us to understand better the risks and benefits of hypercapnia and acidosis during critical illness. PMID:25029442

  12. Optimal Combination Treatment and Vascular Outcomes in Recent Ischemic Stroke Patients by Premorbid Risk Level

    PubMed Central

    Park, Jong-Ho; Ovbiagele, Bruce

    2015-01-01

    Background Optimal combination of secondary stroke prevention treatment including antihypertensives, antithrombotic agents, and lipid modifiers is associated with reduced recurrent vascular risk including stroke. It is unclear whether optimal combination treatment has a differential impact on stroke patients based on level of vascular risk. Methods We analyzed a clinical trial dataset comprising 3680 recent non-cardioembolic stroke patients aged ≥35 years and followed for 2 years. Patients were categorized by appropriateness level 0 to III depending on the number of the drugs prescribed divided by the number of drugs potentially indicated for each patient (0=none of the indicated medications prescribed and III=all indicated medications prescribed [optimal combination treatment]). High-risk was defined as having a history of stroke or coronary heart disease (CHD) prior to the index stroke event. Independent associations of medication appropriateness level with a major vascular event (stroke, CHD, or vascular death), ischemic stroke, and all-cause death were analyzed. Results Compared with level 0, for major vascular events, the HR of level III in the low-risk group was 0.51 (95% CI: 0.20–1.28) and 0.32 (0.14–0.70) in the high-risk group; for stroke, the HR of level III in the low-risk group was 0.54 (0.16–1.77) and 0.25 (0.08–0.85) in the high-risk group; and for all-cause death, the HR of level III in the low-risk group was 0.66 (0.09–5.00) and 0.22 (0.06–0.78) in the high-risk group. Conclusion Optimal combination treatment is related to a significantly lower risk of future vascular events and death among high-risk patients after a recent non-cardioembolic stroke. PMID:26044963

  13. Optimal delivery of male breast cancer follow-up care: improving outcomes

    PubMed Central

    Ferzoco, Raina M; Ruddy, Kathryn J

    2015-01-01

    Male breast cancer is a rare disease. There are limited data to inform optimal treatment and follow-up strategies in this population. Currently, most follow-up guidelines are drawn from the vast literature on female breast cancer, despite the fact that male breast cancer has unique biological characteristics. In this review, we discuss clinical characteristics of male breast cancer as well as current best practices for long-term care with a focus on surveillance, screening, and treatment-related symptom management in male breast cancer survivors. PMID:26648754

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

    PubMed

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

    2015-08-01

    Youth who lose their ASD diagnosis may have subtle social and communication difficulties. We examined social and communication functioning in 44 high-functioning autism (HFA), 34 optimal outcome (OO) and 34 typically developing (TD) youth. Results indicated that OO participants had no autism communication symptoms, no pragmatic language deficits, and were judged as likable as TD peers. Some group differences were found: OO youth had less insight into social relationships and poorer friendship descriptions than TD youth. OO participants had attention, self-control, and immaturity difficulties that may impact social abilities. However, OO participants were most engaged, friendliest, warmest, and most approachable. Overall, OO participants had no social and communicative impairments, although some exhibited mild social difficulties that often accompany attentional problems. PMID:25758821

  15. Narrative performance of optimal outcome children and adolescents with a history of an Autism Spectrum Disorder (ASD).

    PubMed

    Suh, Joyce; Eigsti, Inge-Marie; Naigles, Letitia; Barton, Marianne; Kelley, Elizabeth; Fein, Deborah

    2014-07-01

    Autism Spectrum Disorders (ASDs) have traditionally been considered a lifelong condition; however, a subset of people makes such significant improvements that they no longer meet diagnostic criteria for an ASD. The current study examines whether these "optimal outcome" (OO) children and adolescents continue to have subtle pragmatic language deficits. The narratives of 15 OO individuals, 15 high-functioning individuals with an ASD (HFA), and 15 typically developing (TD) peers were evaluated. Despite average cognitive functioning, the ASD group produced narratives with fewer central "gist" descriptions, more ambiguous pronominal referents, idiosyncratic language, speech dysfluency (more repetitions and self-corrections), and were less likely to name story characters. The OO participants displayed only very subtle pragmatic and higher-level language deficits (idiosyncratic language and self-correction dysfluency). PMID:24500659

  16. Outcome, Pressure Reactivity and Optimal Cerebral Perfusion Pressure Calculation in Traumatic Brain Injury: A Comparison of Two Variants.

    PubMed

    Lang, Erhard W; Kasprowicz, Magdalena; Smielewski, Peter; Santos, Edgar; Pickard, John; Czosnyka, Marek

    2016-01-01

    This study investigates the outcome prediction and calculation of optimal cerebral perfusion pressure (CPPopt) in 307 patients after severe traumatic brain injury (TBI) based on cerebrovascular reactivity calculation of a moving correlation correlation coefficient, named PRx, between mean arterial pressure (ABP) and intracranial pressure (ICP). The correlation coefficient was calculated from simultaneously recorded data using different frequencies. PRx was calculated from oscillations between 0.008 and 0.05Hz and the longPRx (L-PRx) was calculated from oscillations between 0.0008 and 0.016 Hz. PRx was a significant mortality predictor, whereas L-PRx was not. CPPopt for pooled data was higher for L-PRx than for PRx, with no statistical difference. Mortality was associated with mean CPP below CPPopt. Severe disability was associated with CPP above CPPopt (PRx). These relationships were not statistically significant for CPPopt (L-PRx). We conclude that PRx and L-PRx cannot be used interchangeably. PMID:27165910

  17. Social function and communication in optimal outcome children and adolescents with an autism history on structured test measures

    PubMed Central

    Orinstein, A.; Suh, J.; Porter, K.; de Yoe, K.A; Tyson, K.; Troyb, E.; Barton, M.; Eigsti, I.M.; Stevens, M.C.; Fein, D. A.

    2015-01-01

    Youth who lose their ASD diagnosis may have subtle social and communication difficulties. We examined social and communication functioning in 44 high-functioning autism (HFA), 34 optimal outcome (OO) and 34 typically developing (TD) youth. Results indicated that OO participants had no autism communication symptoms, no pragmatic language deficits, and were judged as likable as TD peers. Some group differences were found: OO youth had less insight into social relationships and poorer friendship descriptions than TD youth. OO participants had attention, self-control, and immaturity difficulties that may impact social abilities. However, OO participants were most engaged, friendliest, warmest, and most approachable. Overall, OO participants had no social and communicative impairments, although some exhibited mild social difficulties that often accompany attentional problems. PMID:25758821

  18. Optimizing Performance on Linux Clusters Using Advanced Communication Protocols: Achieving Over 10 Teraflops on a 8.6 Teraflops Linpack-Rated Linux Cluster

    SciTech Connect

    Krishnan, Manoj Kumar; Nieplocha, Jarek

    2005-04-26

    Advancements in high-performance networks (Quadrics, Infiniband or Myrinet) continue to improve the efficiency of modern clusters. However, the average application efficiency is as small fraction of the peak as the system’s efficiency. This paper describes techniques for optimizing application performance on Linux clusters using Remote Memory Access communication protocols. The effectiveness of these optimizations is presented in the context of an application kernel, dense matrix multiplication. The result was achieving over 10 teraflops on HP Linux cluster on which LINPACK performance is measured as 8.6 teraflops.

  19. Detail and gestalt focus in individuals with optimal outcomes from Autism Spectrum Disorders

    PubMed Central

    Fitch, Allison; Fein, Deborah A.; Eigsti, Inge-Marie

    2015-01-01

    Individuals with high-functioning autism (HFA) have a cognitive style that privileges local over global or gestalt details. While not a core symptom of autism, individuals with HFA seem to reliably show this bias. Our lab has been studying a sample of children who have overcome their early ASD diagnoses, showing “optimal outcomes” (OO). This study characterizes performance by OO, HFA, and typically developing (TD) adolescents as they describe paintings under cognitive load. Analyses of detail focus in painting descriptions indicated that the HFA group displayed significantly more local focus than both OO and TD groups, while the OO and TD groups did not differ. We discuss implications for the centrality of detail focus to the autism diagnosis. PMID:25563455

  20. Optimizing the outcome of pregnancy in obese women: from pregestational to long-term management.

    PubMed

    Galtier, F; Raingeard, I; Renard, E; Boulot, P; Bringer, J

    2008-02-01

    The obesity epidemic is of some concern in women of reproductive age. Maternal obesity is associated with many pregnancy complications, especially gestational diabetes and hypertensive disorders of pregnancy. Delivery in obese women is characterized by a high caesarean-section rate and an increased risk of anaesthetic and postoperative complications. Weight retention after birth may increase the risk of type 2 diabetes in the long term. Foetal risks include macrosomia, malformations and increased perinatal mortality, with the long-term infant health marked by a higher risk of obesity and metabolic disorders. Optimal management includes preconception counselling, pregravid weight-loss programmes, monitoring of gestational weight gain, repeated screening for pregnancy complications and long-term follow-up to minimize the social and economic consequences of pregnancy in overweight women. PMID:18242113

  1. Violence, misconduct and schizophrenia: Outcome after four years of optimal treatment

    PubMed Central

    2005-01-01

    Background Aggressive behaviour in patients with schizophrenic disorders is an ongoing source of concern to community-based services. It has been suggested that optimal treatment may reduce the risk of serious misconduct. Objective To assess prospectively aggressive and sexual misconduct in a cohort of patients receiving continued evidence-based community treatment. Method Fifty patients with a DSM-IV diagnosis of a schizophrenic disorder were treated for 4 years with integrated biomedical and psychosocial strategies. The frequency and context of all aggressive and sexually inappropriate behaviour were assessed throughout. Correlations between an index of misconduct and demographic and clinical variables were examined. Results Levels of serious misconduct were low at the start of the project and declined as treatment progressed. Close examination of predictors of misconduct supported larger epidemiological studies imputing persistent psychotic symptoms, personality disorders and substance use. Conclusion The study supports the hypothesis that effective treatment reduces aggressive and sexual misconduct in schizophrenic disorders. PMID:15967054

  2. Malignant hyperthermia crisis: optimizing patient outcomes through simulation and interdisciplinary collaboration.

    PubMed

    Cain, Cindy L; Riess, Matthias L; Gettrust, Lynn; Novalija, Jutta

    2014-02-01

    Malignant hyperthermia (MH) is a rare, life-threatening event. Many clinicians are unprepared to manage an MH crisis in the perioperative setting because it requires the use of low-frequency, high-risk skills and procedures. Simulation is a recognized educational method for cumulative and integrative learning in a safe environment that resembles real-life clinical scenarios. The aim of this quality improvement project was to provide simulation-based learning to perioperative personnel to educate them in the early recognition, treatment, and management of MH. An interdisciplinary team developed an MH education plan. Implementation of the plan involved a two-part training: an educational session, and a role-playing scenario using high-fidelity OR simulation. Simulation teaching provided OR personnel with an opportunity for skill development, teamwork, interdisciplinary communication, and problem solving. Personnel responded favorably and identified positive outcomes, such as role clarity, improved anticipatory response, and overall team cohesion. In addition, the project included updating the MH cart and writing the hospital's MH policy. PMID:24472592

  3. Weight gain in twin gestations: Are the Institute of Medicine guidelines optimal for neonatal outcomes?

    PubMed Central

    Lal, Ann K.; Kominiarek, Michelle A.

    2015-01-01

    Objective To assess neonatal outcomes according to gestational weight gain (GWG) in twins Study Design This was a retrospective cohort study of twins delivered at ≥ 24 weeks. GWG was defined using the IOM guidelines as the referent. Birthweight and NICU admissions were compared with Chi-square and ANOVA tests, stratified by BMI. Results In all three BMI groups, mean birthweight of the larger and smaller twin increased as GWG increased, p<0.01. For the underweight/normal weight group, both twins < 2500 g, <1500 g and small for gestational age decreased significantly as GWG increased. Birthweight < 2500 g increased in all groups with GWG below the IOM guidelines, p < 0.01. In the multivariate analysis, both twins < 2500 g was significantly decreased with GWG above IOM guidelines. There was no difference in NICU admissions with GWG above the IOM guidelines. Conclusion GWG above the IOM guidelines may improve twin birthweights, with the findings most significant in underweight/normal weight women. PMID:25634520

  4. The main factors influencing canine demodicosis treatment outcome and determination of optimal therapy.

    PubMed

    Arsenović, Milica; Pezo, Lato; Vasić, Nebojša; Ćirić, Rodoljub; Stefanović, Milan

    2015-07-01

    The main idea of this research was to evaluate the efficacy of canine demodicosis conventional treatments using mathematical analyses. All available papers published between 1980 and 2014 were used in this study. One hundred six clinical trials enrolling 3414 cases of generalized demodicosis in dogs are studied. Dogs entered in the analysis were only the ones in which the disease occurred naturally, excluding the studies in which transplantation of Demodex canis mites was done from other animals. In conventional acaricide treatments, sorted according to active substances (moxidectin, amitraz, doramectin, ivermectin, and milbemycin oxime), the way of application (spot-on, dips, orally, or subcutaneous), concentration, and interval of application were used as input parameters in mathematical modeling. Data of interest were the treatment outcome, the number of dogs that went into remission, the number of animals not responding to treatment microscopically, the average duration of therapy, the follow-up period, the number of patients with disease recurrence, the number of adverse effects, and the number of animals with side effects. Dogs lost to follow-up or when the treatment was discontinued, due to various reasons not in connection with the therapy protocol, were not considered. Statistical and mathematical analyses were applied for prediction of the drugs' effectiveness. Developed mathematical models showed satisfactorily r (2), higher than 0.87. Good evidence for recommending the use of milbemycin oxime PO (0.5 mg/kg, daily) and moxidectin spot-on (Advocate®, Bayer) weekly is found. A bit less effective therapies were based on ivermectin PO (0.5 mg/kg, daily), moxidectin PO (0.35 mg/kg, daily), and amitraz dips (0.05 % solution, weekly), respectively. It is important to keep in mind that Advocate® is recommended by the manufacturer for use in milder cases. PMID:26013574

  5. Outcome based state budget allocation for diabetes prevention programs using multi-criteria optimization with robust weights.

    PubMed

    Mehrotra, Sanjay; Kim, Kibaek

    2011-12-01

    We consider the problem of outcomes based budget allocations to chronic disease prevention programs across the United States (US) to achieve greater geographical healthcare equity. We use Diabetes Prevention and Control Programs (DPCP) by the Center for Disease Control and Prevention (CDC) as an example. We present a multi-criteria robust weighted sum model for such multi-criteria decision making in a group decision setting. The principal component analysis and an inverse linear programming techniques are presented and used to study the actual 2009 budget allocation by CDC. Our results show that the CDC budget allocation process for the DPCPs is not likely model based. In our empirical study, the relative weights for different prevalence and comorbidity factors and the corresponding budgets obtained under different weight regions are discussed. Parametric analysis suggests that money should be allocated to states to promote diabetes education and to increase patient-healthcare provider interactions to reduce disparity across the US. PMID:21674143

  6. Long term outcome of Ph+ CML patients achieving complete cytogenetic remission with interferon based therapy moving from interferon to imatinib era.

    PubMed

    Malagola, Michele; Breccia, Massimo; Skert, Cristina; Cancelli, Valeria; Soverini, Simona; Iacobucci, Ilaria; Cattina, Federica; Liberati, Anna Maria; Tiribelli, Mario; Annunziata, Mario; Trabacchi, Elena; De Vivo, Antonio; Castagnetti, Fausto; Martinelli, Giovanni; Fogli, Miriam; Stagno, Fabio; Pica, Gianmatteo; Iurlo, Alessandra; Pregno, Patrizia; Abruzzese, Elisabetta; Pardini, Simonetta; Bocchia, Monica; Russo, Sabina; Pierri, Ivana; Lunghi, Monia; Barulli, Sara; Merante, Serena; Mandelli, Franco; Alimena, Giuliana; Rosti, Gianatonio; Baccarani, Michele; Russo, Domenico

    2014-02-01

    Interferon α (IFNα) prolongs survival of CML patients achieving CCyR and potentially synergizes with TKIs. We report on the molecular status and long term outcome of 121 patients who were treated in Italy between 1986 and 2000 with IFNα based therapy and who obtained CCyR. After a median follow up of 16.5 years, 74 (61%) patients were switched to standard imatinib: 48 (65%) lost the CCyR on IFNα, and 36 (75%) are alive and in CCyR; 26 (35%) were switched to imatinib when they were still in CCyR on IFNα, and all 26 are alive and in CCyR. Forty-seven patients (39%) were never switched to imatinib: 24 (51%) continued and 23 (49%) discontinued IFNα, respectively, and 39/47 (83%) are alive and in CCyR. At last follow-up, the BCR-ABL transcripts level was available in 96/101 living patients (95%) The BCR-ABL:ABL ratio was between 0.1 and 0.01% (MR(3.0) ) in 17%, and less than 0.01% (MR(4.0) ) in 81% of patients. No patient was completely molecular negative (MR(4.5) or MR(5.0) ). The OS at 10 and 20 years is 92 and 84%, respectively. This study confirms that CCyR achieved with IFNα and maintained with or without imatinib or any other therapy significantly correlates with long term survival in CML patients who mostly have MR(4.0) . Complete molecular response (MR(4.5) or MR(5.0) ) seems to be unnecessary for such a long survival. This study further supports development of studies testing the clinical effect of the combinations of TKIs with IFNα. PMID:24122886

  7. SU-E-T-387: Achieving Optimal Patient Setup Imaging and Treatment Workflow Configurations in Multi-Room Proton Centers

    SciTech Connect

    Zhang, H; Prado, K; Langen, K; Yi, B; Mehta, M; Regine, W; D'Souza, W

    2014-06-01

    Purpose: To simulate patient flow in proton treatment center under uncertainty and to explore the feasibility of treatment preparation rooms to improve patient throughput and cyclotron utilization. Methods: Three center layout scenarios were modeled: (S1: In-Tx room imaging) patient setup and imaging (planar/volumetric) performed in treatment room, (S2: Patient setup in preparation room) each treatment room was assigned with preparation room(s) that was equipped with lasers only for patient setup and gross patient alignment, and (S3: Patient setup and imaging in preparation room) preparation room(s) was equipped with laser and volumetric imaging for patient setup, gross and fine patient alignment. A 'snap' imaging was performed in treatment room. For each scenario, the number of treatment rooms and the number of preparation rooms serving each treatment room were varied. We examined our results (average of 100 16-hour (two shifts) working days) by evaluating patient throughput and cyclotron utilization. Results: When the number of treatment rooms increased ([from, to]) [1, 5], daily patient throughput increased [32, 161], [29, 184] and [27, 184] and cyclotron utilization increased [13%, 85%], [12%, 98%], and [11%, 98%] for scenarios S1, S2 and S3 respectively. However, both measures plateaued after 4 rooms. With the preparation rooms, the throughput and the cyclotron utilization increased by 14% and 15%, respectively. Three preparation rooms were optimal to serve 1-3 treatment rooms and two preparation rooms were optimal to serve 4 or 5 treatment rooms. Conclusion: Patient preparation rooms for patient setup may increase throughput and decrease the need for additional treatment rooms (cost effective). Optimal number of preparation rooms serving each gantry room varies as a function of treatment rooms and patient setup scenarios. A 5th treatment room may not be justified by throughput or utilization.

  8. Response to Nadler's Commentary on Arch and Craske's (2011) "Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes"

    ERIC Educational Resources Information Center

    Arch, Joanna J.; Craske, Michelle G.

    2012-01-01

    Nadler (this issue), in his commentary of our article, "Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes" (Arch & Craske, 2011), argues that we misrepresent the role of panic attacks within learning theory and overlook cognitive treatment targets. He presents several case…

  9. Rod Visual Pigment Optimizes Active State to Achieve Efficient G Protein Activation as Compared with Cone Visual Pigments*

    PubMed Central

    Kojima, Keiichi; Imamoto, Yasushi; Maeda, Ryo; Yamashita, Takahiro; Shichida, Yoshinori

    2014-01-01

    Most vertebrate retinas contain two types of photoreceptor cells, rods and cones, which show different photoresponses to mediate scotopic and photopic vision, respectively. These cells contain different types of visual pigments, rhodopsin and cone visual pigments, respectively, but little is known about the molecular properties of cone visual pigments under physiological conditions, making it difficult to link the molecular properties of rhodopsin and cone visual pigments with the differences in photoresponse between rods and cones. Here we prepared bovine and mouse rhodopsin (bvRh and mRh) and chicken and mouse green-sensitive cone visual pigments (cG and mG) embedded in nanodiscs and applied time-resolved fluorescence spectroscopy to compare their Gt activation efficiencies. Rhodopsin exhibited greater Gt activation efficiencies than cone visual pigments. Especially, the Gt activation efficiency of mRh was about 2.5-fold greater than that of mG at 37 °C, which is consistent with our previous electrophysiological data of knock-in mice. Although the active state (Meta-II) was in equilibrium with inactive states (Meta-I and Meta-III), quantitative determination of Meta-II in the equilibrium showed that the Gt activation efficiency per Meta-II of bvRh was also greater than those of cG and mG. These results indicated that efficient Gt activation by rhodopsin, resulting from an optimized active state of rhodopsin, is one of the causes of the high amplification efficiency of rods. PMID:24375403

  10. Title III Accountability Policies and Outcomes for K-12: Annual Measurable Achievement Objectives for English Language Learner Students in Southeast Region States. Summary. 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…

  11. Impact of a Social-Emotional and Character Development Program on School-Level Indicators of Academic Achievement, Absenteeism, and Disciplinary Outcomes: A Matched-Pair, Cluster-Randomized, Controlled Trial

    ERIC Educational Resources Information Center

    Snyder, Frank; Flay, Brian; Vuchinich, Samuel; Acock, Alan; Washburn, Isaac; Beets, Michael; Li, Kin-Kit

    2010-01-01

    This article reports the effects of a comprehensive elementary school-based social-emotional and character education program on school-level achievement, absenteeism, and disciplinary outcomes utilizing a matched-pair, cluster-randomized, controlled design. The "Positive Action" Hawai'i trial included 20 racially/ethnically diverse schools (M…

  12. "Breakthrough" 1981 Eight Months Later. A Summary of the Presentations, Recommendations, and Outcomes of the 1981 Breakthrough Conference, to Assist Minority Women and Men and Nonminority Women Achieve Leadership Positions in Wisconsin's Vocational, Technical, and Adult Education System.

    ERIC Educational Resources Information Center

    Grengg, Dolores A., Ed.; Thompson, Mary B., Ed.

    These proceedings consist of a summary of the presentations, recommendations, and outcomes of a conference held to assist minority women and men and nonminority women achieve leadership positions in Wisconsin's vocational, technical, and adult education (VTAE) system. Following a brief introduction and copy of the conference agenda, summaries are…

  13. Strategies to optimize lithium-ion supercapacitors achieving high-performance: Cathode configurations, lithium loadings on anode, and types of separator

    NASA Astrophysics Data System (ADS)

    Cao, Wanjun; Li, Yangxing; Fitch, Brian; Shih, Jonathan; Doung, Tien; Zheng, Jim

    2014-12-01

    The Li-ion capacitor (LIC) is composed of a lithium-doped carbon anode and an activated carbon cathode, which is a half Li-ion battery (LIB) and a half electrochemical double-layer capacitor (EDLC). LICs can achieve much more energy density than EDLC without sacrificing the high power performance advantage of capacitors over batteries. LIC pouch cells were assembled using activated carbon (AC) cathode and hard carbon (HC) + stabilized lithium metal power (SLMP®) anode. Different cathode configurations, various SLMP loadings on HC anode, and two types of separators were investigated to achieve the optimal electrochemical performance of the LIC. Firstly, the cathode binders study suggests that the PTFE binder offers improved energy and power performances for LIC in comparison to PVDF. Secondly, the mass ratio of SLMP to HC is at 1:7 to obtain the optimized electrochemical performance for LIC among all the various studied mass ratios between lithium loading amounts and active anode material. Finally, compared to the separator Celgard PP 3501, cellulose based TF40-30 is proven to be a preferred separator for LIC.

  14. Clinical outcomes between optical path difference custom aspheric treatment and optimized prolate ablation photorefractive keratectomy in myopia exceeding 8 diopters

    PubMed Central

    Choi, B J; Park, Y M; Lee, J S

    2015-01-01

    Purpose Comparison of visual acuity, refractive, and wavefront outcomes associated with optimized prolate ablation (OPA) and optical path difference custom aspheric treatment (OPDCAT) algorithms for correction of myopia exceeding 8 diopters (D). Patients and Methods Patients were randomly assigned to have photorefractive keratectomy (PRK) with OPA (n=32) or OPDCAT (n=21) algorithms. Visual acuity, manifest refraction, ocular and corneal higher-order aberrations, corneal asphericity, modulated-transfer function, and point-spread function were compared 1, 3, and 6 months postoperatively. Results Mean manifest-refraction spherical equivalents at 6 months were −0.24 D in both groups. All patients in both groups had an uncorrected-distance visual acuity of 20/20 or better. Predictability (±1 D from intended refraction) at 6 months was 94% in the OPA group, and in the OPDCAT group it was 86%. The OPA group had less induced corneal and ocular spherical aberrations (SAs) than the OPDCAT group. Postoperative corneal asphericity change was lowest in the OPA group. Both the groups exhibited significantly-improved AreaRatio-Total value and insignificantly deteriorated AreaRatio-HO value throughout the postoperative period. The OPA group had significantly-higher AreaRatio-Total compared with OPDCAT group at both 1 and 6 months after the operation. Six months after surgery, the Strehl ratio had decreased in both groups, and there was no significant difference between the groups. Conclusion The OPA algorithms yielded higher-objective visual quality and predictability, induced less corneal and ocular SAs, and preserved more preoperative-corneal asphericity than the OPDCAT algorithms. PMID:25397788

  15. ACHIEVING NEW SOURCE PERFORMANCE STANDARDS (NSPS) EMISSION STANDARDS THROUGH INTEGRATION OF LOW-NOx BURNERS WITH AN OPTIMIZATION PLAN FOR BOILER COMBUSTION

    SciTech Connect

    Wayne Penrod; David Moyeda

    2003-04-01

    The objective of this project is to demonstrate the use of an Integrated Combustion Optimization System to achieve NO{sub x} emissions levels in the range of 0.15 to 0.22 lb/MMBtu while simultaneously enabling increased power output. The project consists of the integration of low-NO{sub x} burners and advanced overfire air technology with various process measurement and control devices on the Holcomb Station Unit 1 boiler. The project includes the use of sophisticated neural networks or other artificial intelligence technologies and complex software that can optimize several operating parameters, including NO{sub x} emissions, boiler efficiency, and CO emissions. The program is being performed in three phases. In Phase I, the boiler is being equipped with sensors that can be used to monitor furnace conditions and coal flow to permit improvements in boiler operation. In Phase II, the boiler will be equipped with burner modifications designed to reduce NO{sub x} emissions and automated coal flow dampers to permit on-line fuel balancing. In Phase III, the boiler will be equipped with an overfire air system to permit deep reductions in NO{sub x} emissions to be achieved. Integration of the overfire air system with the improvements made in Phases I and II will permit optimization of the boiler performance, output, and emissions. During this reporting period, efforts were focused on Phase I and Phase II activities. The furnace sensors were procured and installed in February 2003. Baseline testing was performed following the sensor installation. The low-NO{sub x} burner modifications, the coal flow dampers, and the coal flow monitoring system were procured and installed during a boiler outage in March 2003. Process design activities were performed to support design of the equipment installed and to develop specifications for the overfire air system. The overfire air system preliminary engineering design was initiated.

  16. Spatio-temporal optimization of agricultural practices to achieve a sustainable development at basin level; framework of a case study in Colombia

    NASA Astrophysics Data System (ADS)

    Uribe, Natalia; corzo, Gerald; Solomatine, Dimitri

    2016-04-01

    The flood events present during the last years in different basins of the Colombian territory have raised questions on the sensitivity of the regions and if this regions have common features. From previous studies it seems important features in the sensitivity of the flood process were: land cover change, precipitation anomalies and these related to impacts of agriculture management and water management deficiencies, among others. A significant government investment in the outreach activities for adopting and promoting the Colombia National Action Plan on Climate Change (NAPCC) is being carried out in different sectors and regions, having as a priority the agriculture sector. However, more information is still needed in the local environment in order to assess were the regions have this sensitivity. Also the continuous change in one region with seasonal agricultural practices have been pointed out as a critical information for optimal sustainable development. This combined spatio-temporal dynamics of crops cycle in relation to climate change (or variations) has an important impact on flooding events at basin areas. This research will develop on the assessment and optimization of the aggregated impact of flood events due to determinate the spatio-temporal dynamic of changes in agricultural management practices. A number of common best agricultural practices have been identified to explore their effect in a spatial hydrological model that will evaluate overall changes. The optimization process consists on the evaluation of best performance in the agricultural production, without having to change crops activities or move to other regions. To achieve this objectives a deep analysis of different models combined with current and future climate scenarios have been planned. An algorithm have been formulated to cover the parametric updates such that the optimal temporal identification will be evaluated in different region on the case study area. Different hydroinformatics

  17. Achieving New Source Performance Standards (NSPS) Emission Standards Through Integration of Low-NOx Burners with an Optimization Plan for Boiler Combustion

    SciTech Connect

    Wayne Penrod

    2006-12-31

    The objective of this project was to demonstrate the use of an Integrated Combustion Optimization System to achieve NO{sub X} emission levels in the range of 0.15 to 0.22 lb/MMBtu while simultaneously enabling increased power output. The project plan consisted of the integration of low-NO{sub X} burners and advanced overfire air technology with various process measurement and control devices on the Holcomb Station Unit 1 boiler. The plan included the use of sophisticated neural networks or other artificial intelligence technologies and complex software to optimize several operating parameters, including NO{sub X} emissions, boiler efficiency, and CO emissions. The program was set up in three phases. In Phase I, the boiler was equipped with sensors that can be used to monitor furnace conditions and coal flow to permit improvements in boiler operation. In Phase II, the boiler was equipped with burner modifications designed to reduce NO{sub X} emissions and automated coal flow dampers to permit on-line fuel balancing. In Phase III, the boiler was to be equipped with an overfire air system to permit deep reductions in NO{sub X} emissions. Integration of the overfire air system with the improvements made in Phases I and II would permit optimization of boiler performance, output, and emissions. This report summarizes the overall results from Phases I and II of the project. A significant amount of data was collected from the combustion sensors, coal flow monitoring equipment, and other existing boiler instrumentation to monitor performance of the burner modifications and the coal flow balancing equipment.

  18. Tracking Achievement Gaps and Assessing the Impact of NCLB on the Gaps: An In-Depth Look into National and State Reading and Math Outcome Trends

    ERIC Educational Resources Information Center

    Lee, Jaekyung

    2006-01-01

    This study offers systematic trend analyses of NAEP national and state-level public school fourth and eighth graders' reading and math achievement results during pre-NCLB (1990-2001) and post-NCLB (2002-2005) periods. It compares post-NCLB trends in reading and math achievement with pre-NCLB trends among different racial and socioeconomic groups…

  19. Does Entry Route Really Affect Academic Outcome? Academic Achievement of Traditional versus Non Traditional Entrants to BN(Hons) Pre-Registration Nursing Programmes

    ERIC Educational Resources Information Center

    Brimble, Mandy J.

    2015-01-01

    International trends for pre-registration nurse education at degree level alongside "widening access" initiatives mean that academic achievement of students entering via different educational routes is of interest to both higher and further education institutions. This article examines the academic achievement of students undertaking a…

  20. If I Read Better, Will I Score Higher ?: The Relationship between Oral Reading Fluency Instruction and Standardized Reading Achievement Test Outcomes

    ERIC Educational Resources Information Center

    Waldron, Chad H.

    2008-01-01

    The research study examined whether a difference existed between the reading achievement scores of an experimental group and a control group in standardized reading achievement. This difference measured the effect of systematic oral reading fluency instruction with repeated readings. Data from the 4Sight Pennsylvania Benchmark Reading Assessments…

  1. 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…

  2. Going-to-Scale with the Early Risers Conduct Problems Prevention Program: Use of a Comprehensive Implementation Support (CIS) System to Optimize Fidelity, Participation and Child Outcomes

    PubMed Central

    Bloomquist, Michael L.; August, Gerald J.; Lee, Susanne S.; Lee, Chih-Yuan S.; Realmuto, George M.; Klimes-Dougan, Bonnie

    2012-01-01

    The present study is a descriptive report of a comprehensive implementation support (CIS) service that was used to promote high levels of program fidelity in a going-to-scale intervention trial of the Early Risers conduct problems prevention program. The program was delivered across 27 geographically-dispersed, elementary school sites over a two-year period. In this study we examined the level of fidelity achieved by program implementers across intervention components, the rate of child and parent participation across intervention components, and proximal child outcomes targeted by the intervention across two years of programming. Results showed that over the two-year intervention period the program was implemented with high fidelity, participation rates were acceptable, and children made positive gains on target outcomes similar to those found in previous randomized controlled trials. The results suggest that implementation support services may be advantageous in the wide-scale implementation of prevention programs that aim to achieve high implementation fidelity. PMID:23266400

  3. Achievement of Optimal Medical Therapy Goals for US Adults with Coronary Artery Disease: Results from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

    PubMed Central

    Brown, Todd M.; Voeks, Jenifer H.; Bittner, Vera; Brenner, David A.; Cushman, Mary; Goff, David C.; Glasser, Stephen; Muntner, Paul; Tabereaux, Paul B.; Safford, Monika M.

    2014-01-01

    Objective In a non-clinical trial setting, to determine the proportion of individuals with coronary artery disease (CAD) with optimal risk factor levels based on the Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation (COURAGE) trial. Background In COURAGE, the addition of percutaneous coronary intervention (PCI) to optimal medical therapy did not reduce the risk of death or myocardial infarction in stable CAD patients but resulted in more revascularization procedures. Methods REGARDS is a national prospective cohort study of 30,239 African American and White community-dwelling individuals aged >45 years enrolled in 2003-7. We calculated the proportion of 3,167 participants with self-reported CAD meeting 7 risk factor goals based on COURAGE: 1) aspirin use, 2) systolic blood pressure <130 mmHg and diastolic blood pressure <85 mmHg (<80 mmHg if diabetic), 3) low density lipoprotein cholesterol <85 mg/dL, high density lipoprotein cholesterol >40 mg/dL, and triglycerides <150 mg/dL, 4) fasting glucose <126 mg/dL, 5) nonsmoking status, 6) body mass index <25 kg/m,2 and 7) exercise ≥4 days per week. Results The mean age of participants was 69±9 years, 33% were African American, and 35% were female. Overall, the median number of goals met was 4. Less than a quarter met ≥5 of the 7 goals, and 16% met all 3 goals for aspirin, blood pressure, and LDL-C. Older age, white race, higher income, more education, and higher physical functioning were independently associated with meeting more goals. Conclusions There is substantial room for improvement in risk factor reduction among US individuals with CAD. PMID:24534599

  4. Effects of Traditional and Nontraditional Forms of Parental Involvement on School-Level Achievement Outcome: An HLM Study Using SASS 2007-2008

    ERIC Educational Resources Information Center

    Shen, Jianping; Washington, Alandra L.; Bierlein Palmer, Louann; Xia, Jiangang

    2014-01-01

    The authors examined parental involvement's (PI) impact on school performance. The hierarchical linear modeling method was applied to national Schools and Staffing Survey 2007-2008 data. They found that PI variables explained significant variance for the outcomes of (a) meeting adequate yearly progress (AYP) and (b) being free from sanctions.…

  5. Long-Term (Six Years) Clinical Outcome Discrimination of Patients in the Vegetative State Could be Achieved Based on the Operational Architectonics EEG Analysis: A Pilot Feasibility Study

    PubMed Central

    Fingelkurts, Andrew A.; Fingelkurts, Alexander A.; Bagnato, Sergio; Boccagni, Cristina; Galardi, Giuseppe

    2016-01-01

    Electroencephalogram (EEG) recordings are increasingly used to evaluate patients with disorders of consciousness (DOC) or assess their prognosis outcome in the short-term perspective. However, there is a lack of information concerning the effectiveness of EEG in classifying long-term (many years) outcome in chronic DOC patients. Here we tested whether EEG operational architectonics parameters (geared towards consciousness phenomenon detection rather than neurophysiological processes) could be useful for distinguishing a very long-term (6 years) clinical outcome of DOC patients whose EEGs were registered within 3 months post-injury. The obtained results suggest that EEG recorded at third month after sustaining brain damage, may contain useful information on the long-term outcome of patients in vegetative state: it could discriminate patients who remain in a persistent vegetative state from patients who reach a minimally conscious state or even recover a full consciousness in a long-term perspective (6 years) post-injury. These findings, if confirmed in further studies, may be pivotal for long-term planning of clinical care, rehabilitative programs, medical-legal decisions concerning the patients, and policy makers. PMID:27347266

  6. Do Typical RCTs of Education Interventions Have Sufficient Statistical Power for Linking Impacts on Teacher Practice and Student Achievement Outcomes? NCEE 2009-4065

    ERIC Educational Resources Information Center

    Schochet, Peter Z.

    2009-01-01

    For RCTs of education interventions, it is often of interest to estimate associations between student and mediating teacher practice outcomes, to examine the extent to which the study's conceptual model is supported by the data, and to identify specific mediators that are most associated with student learning. This paper develops statistical power…

  7. Achieving the "triple aim" for inborn errors of metabolism: a review of challenges to outcomes research and presentation of a new practice-based evidence framework.

    PubMed

    Potter, Beth K; Chakraborty, Pranesh; Kronick, Jonathan B; Wilson, Kumanan; Coyle, Doug; Feigenbaum, Annette; Geraghty, Michael T; Karaceper, Maria D; Little, Julian; Mhanni, Aizeddin; Mitchell, John J; Siriwardena, Komudi; Wilson, Brenda J; Syrowatka, Ania

    2013-06-01

    Across all areas of health care, decision makers are in pursuit of what Berwick and colleagues have called the "triple aim": improving patient experiences with care, improving health outcomes, and managing health system impacts. This is challenging in a rare disease context, as exemplified by inborn errors of metabolism. There is a need for evaluative outcomes research to support effective and appropriate care for inborn errors of metabolism. We suggest that such research should consider interventions at both the level of the health system (e.g., early detection through newborn screening, programs to provide access to treatments) and the level of individual patient care (e.g., orphan drugs, medical foods). We have developed a practice-based evidence framework to guide outcomes research for inborn errors of metabolism. Focusing on outcomes across the triple aim, this framework integrates three priority themes: tailoring care in the context of clinical heterogeneity; a shift from "urgent care" to "opportunity for improvement"; and the need to evaluate the comparative effectiveness of emerging and established therapies. Guided by the framework, a new Canadian research network has been established to generate knowledge that will inform the design and delivery of health services for patients with inborn errors of metabolism and other rare diseases. PMID:23222662

  8. Achieving Successful Employment Outcomes with the Use of Assistive Technology. Report from the Study Group, Institute on Rehabilitation Issues (24th, Washington, DC, May 1998).

    ERIC Educational Resources Information Center

    Radtke, Jean, Ed.

    Developed as a result of an institute on rehabilitation issues, this document is a guide to assistive technology as it affects successful competitive employment outcomes for people with disabilities. Chapter 1 offers basic information on assistive technology including basic assumptions, service provider approaches, options for technology…

  9. Gestational age at delivery and neonatal outcome in uncomplicated twin pregnancies: what is the optimal gestational age for delivery according to chorionicity?

    PubMed Central

    Lee, Hye-Jung; Kim, Soo Hyun; Chang, Kylie Hae-Jin; Sung, Ji-Hee; Oh, Soo-young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2016-01-01

    Objective To investigate the neonatal outcome according to the gestational age at delivery and to determine the optimal timing for delivery in uncomplicated monochorionic and dichorionic twin pregnancies. Methods This is a retrospective cohort study of women with uncomplicated twin pregnancies delivered at or beyond 35 weeks of gestation from 1995 to 2013. The primary outcome was neonatal composite morbidity, which was defined as when either one or both twins have one or more of the followings: fetal death after 35 weeks gestation, admission to neonatal intensive care unit, mechanical ventilator requirement, respiratory distress syndrome and neonatal death. To determine the optimal gestational age for delivery according to chorionicity, we compared the neonatal composite morbidity rate between women who delivered and women who remained undelivered at each gestational week in both monochorionic and dichorionic twin pregnancies. Results A total of 697 twin pregnancies were included (171 monochorionic and 526 dichorionic twins). The neonatal composite morbidity rate significantly decreased with advancing gestational age at delivery and its nadir was observed at 38 and ≥39 weeks of gestation in monochorionic and dichorionic twins, respectively. However, the composite morbidity rate did not differ between women who delivered and women who remained undelivered ≥36 and ≥37 weeks in monochorionic and dichorionic twins, respectively. Conclusion Our data suggest that the optimal gestational age for delivery was at ≥36 and ≥37 weeks in uncomplicated monochorionic and dichorionic twin pregnancies, respectively. PMID:26866030

  10. Understanding the Effect of KIPP as It Scales: Volume I, Impacts on Achievement and Other Outcomes. Final Report of KIPP's "Investing in Innovation Grant Evaluation"

    ERIC Educational Resources Information Center

    Tuttle, Christina Clark; Gleason, Philip; Knechtel, Virginia; Nichols-Barrer, Ira; Booker, Kevin; Chojnacki, Gregory; Coen, Thomas; Goble, Lisbeth

    2015-01-01

    KIPP (Knowledge is Power Program) is a national network of public charter schools whose stated mission is to help underserved students enroll in and graduate from college. Prior studies (see Tuttle et al. 2013) have consistently found that attending a KIPP middle school positively affects student achievement, but few have addressed longer-term…

  11. Understanding the Effect of KIPP as It Scales: Volume I, Impacts on Achievement and Other Outcomes. Final Report of KIPP's Investing in Innovation Grant Evaluation. Executive Summary

    ERIC Educational Resources Information Center

    Tuttle, Christina Clark; Gleason, Philip; Knechtel, Virginia; Nichols-Barrer, Ira; Booker, Kevin; Chojnacki, Gregory; Coen, Thomas; Goble, Lisbeth

    2015-01-01

    KIPP (Knowledge is Power Program) is a national network of public charter schools whose stated mission is to help underserved students enroll in and graduate from college. Prior studies (see Tuttle et al. 2013) have consistently found that attending a KIPP middle school positively affects student achievement, but few have addressed longer-term…

  12. Do Goals Lead to Outcomes or Can It Be the Other Way Around?: Causal Ordering of Mastery Goals, Metacognitive Strategies, and Achievement

    ERIC Educational Resources Information Center

    King, Ronnel B.; McInerney, Dennis M.

    2016-01-01

    Background: Goal theory research has mostly focused on the unidirectional effects of goals on learning strategies and academic achievement. Reciprocal relationships have mostly been neglected. Aims: The primary aim of this study was to examine the reciprocal relations and causal ordering of mastery goals, metacognitive strategy use, and academic…

  13. Predicting Academic Outcomes for Third Grade Students: Examining the Reading Achievement of Diverse Students Using the Diagnostic Lens of the Dynamic Indicators of Basic Early Literacy Skills

    ERIC Educational Resources Information Center

    Adderley, Zhivago Trevino

    2013-01-01

    Despite the billions of dollars spent in the last forty years, America's efforts toward closing the achievement gaps among diverse learners and their receptive counterparts have not been realized. Limitations noted in previous research discussed the need to examine the unique contributions of diverse learner variables as a way of determining their…

  14. Achievement, Engagement, and Behavior Outcomes of At-Risk Youth Following Participation in a Required Ninth-Grade Academic Support Study Center Program

    ERIC Educational Resources Information Center

    Wagner, Jeffrey P.

    2012-01-01

    Overall, pretest-posttest results for achievement, behavior, and engagement for at-risk boys not eligible (n = 13) and eligible (n = 9) for participation in the free or reduced price lunch program who completed a school-year long academic support study center program were not statistically different over time and end of school year for cumulative…

  15. Examining the Relationship between Treatment Outcomes for Academic Achievement and Social Skills in School-Age Children with Attention-Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Rutherford, Laura E.; DuPaul, George J.; Jitendra, Asha K.

    2008-01-01

    The purpose of this study was to determine the relationship between treatment-induced changes in academic achievement and social skills in elementary school-age children with attention-deficit hyperactivity disorder. A sample of 123 children in grades 1 through 4 with symptoms of inattention, impulsivity and/or hyperactivity, and significant…

  16. Active Head Lifting from Supine in Early Infancy: An Indicator for Non-Optimal Cognitive Outcome in Late Infancy

    ERIC Educational Resources Information Center

    van Haastert, Ingrid C.; Groenendaal, Floris; van de Waarsenburg, Maria K.; Eijsermans, Maria J. C.; Koopman-Esseboom, Corine; Jongmans, Marian J.; Helders, Paul J. M.; de Vries, Linda S.

    2012-01-01

    Aim: To explore whether active head lifting from supine (AHLS) in early infancy is associated with cognitive outcome in the second year of life. Method: The presence of AHLS was always recorded in the notes of infants admitted to our tertiary neonatal intensive care unit. Random sampling was used to pair infants with AHLS with two comparison…

  17. Achieving an Undetectable PSA After Radiotherapy for Biochemical Progression After Radical Prostatectomy Is an Independent Predictor of Biochemical Outcome-Results of a Retrospective Study

    SciTech Connect

    Wiegel, Thomas Lohm, Gunnar; Bottke, Dirk; Hoecht, Stefan; Miller, Kurt; Siegmann, Alessandra; Schostak, Martin; Neumann, Konrad; Hinkelbein, Wolfgang

    2009-03-15

    Purpose: Salvage radiotherapy (SRT) is commonly used to treat patients with biochemical failure after radical prostatectomy (RP). Retrospective series have demonstrated biochemical response in approximately 60-75% of patients, but only a significantly lower rate of patients achieves a response with a decrease of the prostate-specific antigen (PSA) to a value below the limits of detectability. Therefore, long-term response at 10 years is only about 20-25% in all of these patients. The purpose of this study was to determine prognostic factors with impact on achieving the undetectable PSA range after SRT and to define the role of this end point. Methods and Materials: Between 1997 and 2004, 162 patients received SRT at the Charite Universitaetsmedizin, Berlin. No patient had hormonal treatment before SRT and 90% of the patients (143) had a SRT dose of 66 Gy. We analyzed the impact of nine potential risk factors on achieving an undetectable PSA after RT and on biochemical relapse-free survival (bNED) after SRT. Results: Median follow-up time was 41.5 months and median PSA pre-RT was 0.33 ng/mL. Calculated bNED for 3.5 years was 54%. A total of 60% of the patients achieved an undetectable PSA after SRT. Univariate analysis demonstrated statistically significant predictors of biochemical progression after SRT: Gleason score (p = 0.01), PSA pre-SRT (p = 0.031), tumor stage (p = 0.047), and persistent detectable PSA after RT (p < 0.00005). In multivariate analysis, margin status (p = 0.017) and PSA pre-SRT (p = 0.002) were significant predictors of an undetectable PSA after SRT. The most significant independent predictor of bNED was 'PSA undetectable after RT' (p < 0.0005) with a hazard ratio of 8.4, thus leading to a calculated bNED at 3.5 years of 75% compared with only 18% for those patients, who did not achieve an undetectable PSA after SRT. The rate of severe Grade 3-4 side effects was below 2.5%. Conclusions: The study represents one of the largest retrospective

  18. The international Study to Predict Optimized Treatment in Depression (iSPOT-D): outcomes from the acute phase of antidepressant treatment.

    PubMed

    Saveanu, Radu; Etkin, Amit; Duchemin, Anne-Marie; Goldstein-Piekarski, Andrea; Gyurak, Anett; Debattista, Charles; Schatzberg, Alan F; Sood, Satish; Day, Claire V A; Palmer, Donna M; Rekshan, William R; Gordon, Evian; Rush, A John; Williams, Leanne M

    2015-02-01

    We aimed to characterize a large international cohort of outpatients with MDD within a practical trial design, in order to identify clinically useful predictors of outcomes with three common antidepressant medications in acute-phase treatment of major depressive disorder (MDD). The international Study to Predict Optimized Treatment in Depression has presently enrolled 1008 treatment-seeking outpatients (18-65 years old) at 17 sites (five countries). At pre-treatment, we characterized participants by symptoms, clinical history, functional status and comorbidity. Participants were randomized to receive escitalopram, sertraline or venlafaxine-extended release and managed by their physician following usual treatment practices. Symptoms, function, quality of life, and side-effect outcomes were assessed 8 weeks later. The relationship of anxiety to response and remission was assessed by comorbid Axis I diagnosis, presence/absence of anxiety symptoms, and dimensionally by anxiety symptom severity. The sample had moderate-to-severe symptoms, but substantial comorbidity and functional impairment. Of completers at week 8, 62.2% responded and 45.4% reached remission on the 17-item Hamilton Rating Scale for Depression; 53.3% and 37.6%, respectively on the 16-item Quick Inventory of Depressive Symptoms. Functional improvements were seen across all domains. Most participants had side effects that occurred with a frequency of 25% or less and were reported as being in the "none" to minimal/mild range for intensity and burden. Outcomes did not differ across medication groups. More severe anxiety symptoms at pre-treatment were associated with lower remission rates across all medications, independent of depressive severity, diagnostic comorbidity or side effects. Across medications, we found consistent and similar improvements in symptoms and function, and a dimensional prognostic effect of comorbid anxiety symptoms. These equivalent outcomes across treatments lay the foundation for

  19. Similar Clinical and Surgical Outcomes Achieved with Early Compared to Late Anti-TNF Induction in Mild-to-Moderate Ulcerative Colitis: A Retrospective Cohort Study

    PubMed Central

    Fedorak, Darryl K.; Dieleman, Levinus A.; Halloran, Brendan P.

    2016-01-01

    Background. Biologic agents targeting tumor necrosis factor alpha are effective in the management of ulcerative colitis (UC), but their use is often postponed until after failure of other treatment modalities. Objectives. We aim to determine if earlier treatment with infliximab or adalimumab alters clinical and surgical outcomes in UC patients. Methods. A retrospective cohort study was conducted evaluating UC outpatients treated with infliximab or adalimumab from 2003 to 2014. Patients were stratified by time to first anti-TNF exposure; early initiation was defined as starting treatment within three years of diagnosis. Primary outcomes were colectomy, UC-related hospitalization, and clinical secondary loss of response. Kaplan-Meier analysis was used to assess time to the primary outcomes. Results. 115 patients were included (78 infliximab, 37 adalimumab). Median follow-up was 175.6 weeks (IQR 72.4–228.4 weeks). Fifty-seven (49.6%) patients received early anti-TNF therapy; median time to treatment in this group was 38.1 (23.3–91.0) weeks compared to 414.0 (254.0–561.3) weeks in the late initiator cohort (p < 0.0001). Patients treated with early anti-TNF therapy had more severe endoscopic disease at induction (mean Mayo endoscopy subscore 2.46 (SD ± 0.66) versus 1.86 (±0.67), p < 0.001) and trended towards increased risk of colectomy (17.5% versus 8.6%, p = 0.16) and UC-related hospitalization (43.9% versus 27.6%, p = 0.07). In multivariate regression analysis, early anti-TNF induction was not associated with colectomy (HR 2.02 [95% CI: 0.57–7.20]), hospitalization (HR 1.66 [0.84–3.30]), or secondary loss of response (HR 0.86 [0.52–1.42]). Conclusions. Anti-TNF therapy is initiated earlier in patients with severe UC but earlier treatment does not prevent hospitalization, colectomy, or secondary loss of response. PMID:27478817

  20. A Responsive Parenting Intervention: The Optimal Timing across Early Childhood for Impacting Maternal Behaviors and Child Outcomes

    ERIC Educational Resources Information Center

    Landry, Susan H.; Smith, Karen E.; Swank, Paul R.; Guttentag, Cathy

    2008-01-01

    This study examined the optimal timing (infancy, toddler-preschool, or both) for facilitating responsive parenting and the intervention effects on maternal behaviors and child social and communication skills for children who vary in biological risk. The intervention during infancy, Playing and Learning Strategies (PALS I), showed strong changes in…

  1. Predictors and outcomes of sustained, intermittent or never achieving remission in patients with recent onset inflammatory polyarthritis: results from the Norfolk Arthritis Register

    PubMed Central

    Cook, Michael J.; Diffin, Janet; Scirè, Carlo A.; Lunt, Mark; MacGregor, Alex J.; Symmons, Deborah P. M.

    2016-01-01

    Objectives. Early remission is the current treatment strategy for patients with inflammatory polyarthritis (IP) and RA. Our objective was to identify baseline factors associated with achieving remission: sustained (SR), intermittent (IR) or never (NR) over a 5-year period in patients with early IP. Methods. Clinical and demographic data of patients with IP recruited to the Norfolk Arthritis Register (NOAR) were obtained at baseline and years 1, 2, 3 and 5. Remission was defined as no tender or swollen joints (out of 51). Patients were classified as NR or PR, respectively, if they were in remission at: no assessment or ⩾3 consecutive assessments after baseline, and IR otherwise. Ordinal regression and a random effects model, respectively, were used to examine the association between baseline factors, remission group and HAQ scores over time. Results. A total of 868 patients (66% female) were included. Of these, 54%, 34% and 12% achieved NR, IR and SR, respectively. In multivariate analysis, female sex (odds ratio, OR 0.47, 95% CI: 0.35, 0.63), higher tender joint count (OR = 0.94, 95% CI: 0.93, 0.96), higher HAQ (OR = 0.59, 95% CI: 0.48, 0.74), being obese (OR = 0.70, 95% CI: 0.50, 0.99), hypertensive (OR = 0.67, 95% CI: 0.50, 0.90) or depressed (OR = 0.74, 95% CI: 0.55, 1.00) at baseline were independent predictors of being in a lower remission group. IR and SR were associated with lower HAQ scores over time and lower DAS28 at year 5. Conclusion. Women with higher tender joint count and disability at baseline, depression, obesity and hypertension were less likely to achieve remission. This information could help when stratifying patients for more aggressive therapy. PMID:27220594

  2. 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.

  3. Long-Term Treatment Outcomes of Patients Infected With Hepatitis C Virus: A Systematic Review and Meta-analysis of the Survival Benefit of Achieving a Sustained Virological Response

    PubMed Central

    Simmons, Bryony; Saleem, Jawaad; Heath, Katherine; Cooke, Graham S.; Hill, Andrew

    2015-01-01

    Background. Achievement of a sustained virologic response (SVR) after treatment for Hepatitis C infection is associated with improved outcomes. This meta-analysis aimed to determine the impact of SVR on long-term mortality risk compared with nonresponders in a range of populations. Methods. An electronic search identified all studies assessing all-cause mortality in SVR and non-SVR patients. Eligible articles were stratified into general, cirrhotic, and populations coinfected with human immunodeficiency virus. The adjusted hazard ratio (95% confidence interval [CI]) for mortality in patients achieving SVR vs non-SVR, and pooled estimates for the 5-year mortality in each group were calculated. Results. 31 studies (n = 33 360) were identified as suitable for inclusion. Median follow-up time was 5.4 years (interquartile range, 4.9–7.5) across all studies. The adjusted hazard ratio of mortality for patients achieving SVR vs non-SVR was 0.50 (95% CI, .37–.67) in the general population, 0.26 (95% CI, .18–.74) in the cirrhotic group, and 0.21 (.10–.45) in the coinfected group. The pooled 5-year mortality rates were significantly lower for patients achieving SVR compared with non-SVR in all 3 populations. Conclusions. The results suggest that there is a significant survival benefit of achieving an SVR compared with unsuccessful treatment in a range of populations infected with hepatitis C virus. PMID:25987643

  4. Transforming the Patient Role to Achieve Better Outcomes Through a Patient Empowerment Program: A Randomized Wait-List Control Trial Protocol

    PubMed Central

    Plaksin, Joseph; Zabar, Sondra; Wallach, Andrew; Sawicki, Chester; Kundrod, Sarita; Kalet, Adina

    2016-01-01

    Background In the patient-centered medical home model of health care, both health care providers (HCPs) and patients must understand their respective roles and responsibilities, view the other as a partner, and use communication skills that promote shared decision making. This is particularly necessary in chronic conditions where outcomes depend on behavior change and in underserved populations where the burden of chronic disease is high. Objective The objectives of this study are to determine if a Patient Empowerment Program (PEP) (1) is acceptable to patients and feasible across multiple clinical sites; (2) will increase patient preference for control in medical decision making, improve patient perceptions of patient-HCP communication, and increase patient activation; (3) is associated with an increase in diabetes self-management behaviors; and (4) has an effect on hemoglobin A 1c(HbA 1c) level. Methods This study recruited English-speaking adult patients with type 2 diabetes mellitus from three urban clinical sites in New York City and randomized them to an immediate intervention group that completed the PEP intervention or a deferred intervention group that served as a wait-list control and completed the PEP intervention after 3-4 months. The PEP intervention consists of two facilitated small group sessions. Session 1 focuses on defining HCP and patient roles in the medical encounter by introducing ideal communication behaviors in each role and by providing both positive and negative examples of patient-HCP encounters. Session 2 focuses on practicing communication skills by role-playing with actors who serve as standardized health care providers. After the role play, participants set goals for their own health care and for future interactions with their HCPs. Outcome measures include the Patient Activation Measure; Ask, Understand, Remember Assessment; Krantz Health Opinion Survey; SF-12v2 Health Survey; Diabetes Self-Management Questionnaire; and HbA 1c. These

  5. 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

    ERIC Educational Resources Information Center

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

    2016-01-01

    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…

  6. A responsive parenting intervention: the optimal timing across early childhood for impacting maternal behaviors and child outcomes.

    PubMed

    Landry, Susan H; Smith, Karen E; Swank, Paul R; Guttentag, Cathy

    2008-09-01

    This study examined the optimal timing (infancy, toddler-preschool, or both) for facilitating responsive parenting and the intervention effects on maternal behaviors and child social and communication skills for children who vary in biological risk. The intervention during infancy, Playing and Learning Strategies (PALS I), showed strong changes in maternal affective-emotional and cognitively responsive behaviors and infants' development. However, it was hypothesized that a 2nd intervention dose in the toddler-preschool period was needed for optimal results. Families from the PALS I phase were rerandomized into either the PALS II, the toddler-preschool phase, or a Developmental Assessment Sessions condition, resulting in 4 groups. Facilitation of maternal warmth occurred best with the PALS I intervention, while cognitive responsive behaviors were best supported with the PALS II intervention. Behaviors that required responsiveness to the child's changing signals (contingent responsiveness, redirecting) required the intervention across both the early and later periods. PMID:18793067

  7. The expanded invasive weed optimization metaheuristic for solving continuous and discrete optimization problems.

    PubMed

    Josiński, Henryk; Kostrzewa, Daniel; Michalczuk, Agnieszka; Switoński, Adam

    2014-01-01

    This paper introduces an expanded version of the Invasive Weed Optimization algorithm (exIWO) distinguished by the hybrid strategy of the search space exploration proposed by the authors. The algorithm is evaluated by solving three well-known optimization problems: minimization of numerical functions, feature selection, and the Mona Lisa TSP Challenge as one of the instances of the traveling salesman problem. The achieved results are compared with analogous outcomes produced by other optimization methods reported in the literature. PMID:24955420

  8. Incorporating measurable ('minimal') residual disease-directed treatment strategies to optimize outcomes in adults with acute myeloid leukemia.

    PubMed

    Pettit, Kristen; Stock, Wendy; Walter, Roland B

    2016-07-01

    Curative-intent therapy leads to complete remissions in many adults with acute myeloid leukemia (AML), but relapse remains common. Numerous studies have unequivocally demonstrated that the persistence of measurable ('minimal') residual disease (MRD) at the submicroscopic level during morphologic remission identifies patients at high risk of disease recurrence and short survival. This association has provided the impetus to customize anti-leukemia therapy based on MRD data, a strategy that is now routinely pursued in acute promyelocytic leukemia (APL). While it is currently uncertain whether this approach will improve outcomes in AML other than APL, randomized studies have validated MRD-based risk-stratified treatment algorithms in acute lymphoblastic leukemia. Here, we review the available studies examining MRD-directed therapy in AML, appraise their strengths and limitations, and discuss avenues for future investigation. PMID:27269126

  9. Optimizing facial rejuvenation outcomes by combining poly-L-lactic acid, hyaluronic acid, calcium hydroxylapatite, and neurotoxins: two case studies.

    PubMed

    Lorenc, Z Paul; Daro-Kaftan, Elizabeth

    2014-02-01

    Reversal of the visible signs of facial aging with the use of injectable products as an alternative to surgery has become more popular, with nearly 5 million procedures performed in the United States in 2012. Volume augmentation products, such as hyaluronic acid (HA), calcium hydroxylapatite (CaHA), and poly-L-lactic acid (PLLA), are often used in combination with one another and with neurotoxins for facial rejuvenation because of the complementary modes of action. This article presents 2 case reports involving patientspecific combinations of 2 different HA products, injectable PLLA, and CaHA with incobotulinumtoxinA or abobotulinumtoxinA. The combination of HA, CaHA, PLLA, and neurotoxins has resulted in outstanding outcomes for many patients, with no clinical evidence of increased adverse events secondary to combination therapy. PMID:24509971

  10. Optimization of dental status improves long-term outcome after alveolar bone grafting in unilateral cleft lip and palate.

    PubMed

    Jabbari, Fatima; Skoog, Valdemar; Reiser, Eicka; Hakelius, Malin; Nowinski, Daniel

    2015-03-01

    Objective : To evaluate the importance of dental status for long-term outcome after alveolar bone grafting in patients with unilateral cleft lip and palate. Design : Retrospective longitudinal study. Setting : Cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. Patients : A total of 67 consecutive patients with unilateral complete cleft lip and palate. Interventions : Secondary alveolar bone grafting, prior to the eruption of the permanent canine, was performed at the average age of 10.0 years (range, 8.5 to 12.0 years). Main Outcome Measures : Alveolar bone height was evaluated with the modified Bergland index at 1 and 10 years after surgery. Results : Of the patients, 97% had modified Bergland index grade I and the remaining 3% had modified Bergland index grade II at 1 year after surgery. At 10 years' follow-up, 43% showed modified Bergland index grade I; 55%, modified Bergland index grade II; and 2% (one patient), modified Bergland index grade III. The degree of dental anomalies in the cleft area, such as enamel hypoplasia, incisor rotation, incisor inclination, canine inclination, and oral hygiene registered preoperatively, all correlated negatively to the modified Bergland index at 10 years after surgery. Enamel hypoplasia (ρ = 0.70195, P < .0001), followed by canine inclination (ρ = 0.55429, P < .0001), showed the strongest correlation to reduced bone height in the cleft area. Conclusions : In patients with unilateral cleft lip and palate, excellent results from secondary alveolar bone grafting in terms of bone height in the alveolar cleft tend to decrease with time. This seems to be correlated with factors that might to some extent be treated preoperatively through adequate planning and execution of the orthodontic treatment. PMID:24568558

  11. Narrative Performance of Optimal Outcome Children and Adolescents with a History of an Autism Spectrum Disorder (ASD)

    PubMed Central

    Suh, Joyce; Eigsti, Inge-Marie; Naigles, Letitia; Barton, Marianne; Kelley, Elizabeth; Fein, Deborah

    2014-01-01

    Autism Spectrum Disorders (ASDs) have traditionally been considered a lifelong condition; however, a subset of people makes such significant improvements that they no longer meet diagnostic criteria for an ASD. The current study examines whether these “optimal outcome” (OO) children and adolescents continue to have subtle pragmatic language deficits. The narratives of 15 OO individuals, 15 high-functioning individuals with an ASD (HFA), and 15 typically developing peers (TD) were evaluated. Despite average cognitive functioning, the ASD group produced narratives with fewer central “gist” descriptions, more ambiguous pronominal referents, idiosyncratic language, speech dysfluency (more repetitions and self-corrections), and were less likely to name story characters. The OO participants displayed only very subtle pragmatic and higher-level language deficits (idiosyncratic language and self-correction dysfluency). PMID:24500659

  12. Role of Physical Therapists in Reducing Hospital Readmissions: Optimizing Outcomes for Older Adults During Care Transitions From Hospital to Community.

    PubMed

    Falvey, Jason R; Burke, Robert E; Malone, Daniel; Ridgeway, Kyle J; McManus, Beth M; Stevens-Lapsley, Jennifer E

    2016-08-01

    Hospital readmissions in older adult populations are an emerging quality indicator for acute care hospitals. Recent evidence has linked functional decline during and after hospitalization with an elevated risk of hospital readmission. However, models of care that have been developed to reduce hospital readmission rates do not adequately address functional deficits. Physical therapists, as experts in optimizing physical function, have a strong opportunity to contribute meaningfully to care transition models and demonstrate the value of physical therapy interventions in reducing readmissions. Thus, the purposes of this perspective article are: (1) to describe the need for physical therapist input during care transitions for older adults and (2) to outline strategies for expanding physical therapy participation in care transitions for older adults, with an overall goal of reducing avoidable 30-day hospital readmissions. PMID:26939601

  13. Daily Review of Antimicrobial Use Facilitates the Early Optimization of Antimicrobial Therapy and Improves Clinical Outcomes of Patients with Bloodstream Infections.

    PubMed

    Niwa, Takashi; Watanabe, Tamayo; Goto, Takayuki; Ohta, Hirotoshi; Nakayama, Asami; Suzuki, Keiko; Shinoda, Yasutaka; Tsuchiya, Mayumi; Yasuda, Koji; Murakami, Nobuo; Itoh, Yoshinori

    2016-05-01

    Insufficient information is available to confirm the beneficial effects of implementing an antimicrobial stewardship program in reducing mortality of patients with bloodstream infections. A single institutional cohort study was conducted to evaluate clinical outcomes after implementation of a daily review of antimicrobials used to treat patients with bloodstream infections. Subjects were allocated to groups receiving either intervention or nonintervention. After implementation of an antimicrobial stewardship program, the day from the onset of infection required to administer effective intravenous antimicrobial treatment was significantly shortened (p=0.022), and the rate of de-escalation was significantly elevated (p<0.001) compared with the nonintervention group. Further, the rate of 30-d death associated with bloodstream infection was siginificantly reduced from 11.4 to 5.4% (p=0.030) compared with the nonintervention group. The incidence of adverse events was significantly lower in the intervention group than in the nonintervention group (7.7 vs. 28.0%, p<0.001). Our present findings suggest that daily review of the use of antimicrobials was highly effective for optimizing early antimicrobial therapy and improved clinical outcomes of patients with bloodstream infections. PMID:26923491

  14. Sub-optimal adherence to doxycycline and treatment outcomes among men with non-gonococcal urethritis: a prospective cohort study

    PubMed Central

    Khosropour, Christine M.; Manhart, Lisa E.; Colombara, Danny V.; Gillespie, Catherine W.; Lowens, M. Sylvan; Totten, Patricia A.; Golden, Matthew R.; Simoni, Jane

    2014-01-01

    Objective Doxycycline, one of two recommended therapies for non-gonococcal urethritis (NGU), consists of a seven-day course of therapy (100mg BID). Since suboptimal adherence may contribute to poor treatment outcomes, we examined the association between self-reported imperfect adherence to doxycycline and clinical and microbiologic failure among men with NGU. Methods Men aged ≥16 years with NGU attending a Seattle, WA sexually transmitted diseases clinic were enrolled in a double-blind, parallel-group superiority trial from January 2007 to July 2011. Men were randomized to active doxycycline/placebo azithromycin or placebo doxycycline/active azithromycin. Imperfect adherence was defined as missing ≥1 dose in 7 days. Urine was tested for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), and Ureaplasma urealyticum-biovar2 (UU-2) using nucleic acid amplification tests. Clinical failure (symptoms and ≥5 PMNs/HPF or discharge) and microbiologic failure (positive tests for CT, MG, and/or UU-2) were determined after 3-weeks. Results 184 men with NGU were randomized to active doxycycline and provided data on adherence. Baseline prevalence of CT, MG, and UU-2 was 26%, 13%, and 27%, respectively. 28% of men reported imperfect adherence and this was associated with microbiologic failure among men with CT (aRR=9.33; 95% CI=1.00–89.2) and UU-2 (aRR=3.08; 95% CI=1.31–7.26) but not MG. Imperfect adherence was not significantly associated with clinical failure overall or for any specific pathogens, but it was more common among imperfectly adherent men with CT (aRR=2.63; 0.93–7.41, p=0.07). Conclusions Adherence may be important for microbiologic cure of select pathogens. Factors other than adherence should be considered for CT-negative men with persistent NGU. PMID:24106340

  15. Personalized therapy with TNF-inhibitors in Crohn's disease: optimizing treatment outcomes by monitoring drug levels and anti-drug antibodies.

    PubMed

    Steenholdt, Casper

    2016-08-01

    Therapeutic monoclonal antibodies (Abs) targeting the proinflammatory cytokine, TNF-α have revolutionized the treatment of inflammatory bowel disease (IBD), and raised treatment goals from symptom control to maintenance of clinical remission with mucosal healing. However, clinicians are challenged by a significant proportion of patients not responding to TNF-inhibitors or losing effect over time, and by the high costs of these drugs along with their potential side effects. The aim of this dissertation was therefore to examine if anti-TNF treatment outcomes can be improved by tailoring therapy on an individual patient basis by considering relevant prognostic variables. The main finding is that personalized treatment with TNF-inhibitors by use of an algorithm defined by measurements of anti-TNF drug and anti-drug Abs to guide interventions at therapeutic failure can be useful to secure optimal clinical, economic, and patient reported outcomes. Furthermore, the present studies have documented the key role of measurements of anti-TNF drug and anti-drug Abs to elucidate conditions related to pharmacokinetics and pharmacodynamics of these agents in individual patients, and to serve as prognostic markers of anti-TNF treatment outcomes. In addition, knowledge has been provided on how to interpret and integrate measurements of anti-TNF drug and anti-drug Abs in the clinical management of individual IBD patients taking into account potential pit-falls and biases. Hence, the studies forming the basis for this dissertation have yielded novel insights into the technical, temporal, and methodological complexities and challenges related to application of personalized anti-TNF treatment strategies based on measurements of anti-TNF drug and anti-drug Abs, and established measures to proactively address and accommodate these - both technically and clinically. Although not yet completely resolved, this dissertation has also laid a foundation for individually tailored anti

  16. Essays on Educational Achievement

    ERIC Educational Resources Information Center

    Ampaabeng, Samuel Kofi

    2013-01-01

    This dissertation examines the determinants of student outcomes--achievement, attainment, occupational choices and earnings--in three different contexts. The first two chapters focus on Ghana while the final chapter focuses on the US state of Massachusetts. In the first chapter, I exploit the incidence of famine and malnutrition that resulted to…

  17. Minority Achievement Report.

    ERIC Educational Resources Information Center

    Prince George's Community Coll., Largo, MD. Office of Institutional Research and Analysis.

    This report summarizes the achievements of Prince George's Community College (PGCC) with regard to minority outcomes. Table 1 summarizes the undergraduate enrollment trends for African Americans as well as total minorities from fall 1994 through fall 1998. Both the headcount number of African American students and the proportion of African…

  18. Dermal Fillers: Tips to Achieve Successful Outcomes

    PubMed Central

    Vedamurthy, Maya; Vedamurthy, Amar

    2008-01-01

    Fillers have become a common aesthetic treatment for several cosmetic problems. Several types of fillers are available from different sources and of different longevities. It is important that the treating physician be aware of the different techniques of administration and their possible side effects. This article reviews the available literature on the subject. PMID:20300346

  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. Matching Pupils and Teachers to Maximize Expected Outcomes.

    ERIC Educational Resources Information Center

    Ward, Joe H., Jr.; And Others

    To achieve a good teacher-pupil match, it is necessary (1) to predict the learning outcomes that will result when each student is instructed by each teacher, (2) to use the predicted performance to compute an Optimality Index for each teacher-pupil combination to indicate the quality of each combination toward maximizing learning for all students,…

  1. Regenerative Endodontic Treatment: Report of Two Cases with Different Clinical Management and Outcomes

    PubMed Central

    Khoshkhounejad, Mehrfam; Shokouhinejad, Noushin

    2015-01-01

    Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal disinfection protocol or the method to achieve predictable clinical outcome. This article presents two cases of regenerative treatment in necrotic immature teeth, using mineral trioxide aggregate (MTA) and BiodentineTM as coronal barriers and different irrigants, which led to different clinical outcomes. PMID:26884781

  2. Regenerative Endodontic Treatment: Report of Two Cases with Different Clinical Management and Outcomes.

    PubMed

    Khoshkhounejad, Mehrfam; Shokouhinejad, Noushin; Pirmoazen, Salma

    2015-06-01

    Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal disinfection protocol or the method to achieve predictable clinical outcome. This article presents two cases of regenerative treatment in necrotic immature teeth, using mineral trioxide aggregate (MTA) and Biodentine(TM) as coronal barriers and different irrigants, which led to different clinical outcomes. PMID:26884781

  3. Optimization of self-coherent reflective PON to achieve a new record 42 dB ODN power budget after 100 km at 1.25 Gbps.

    PubMed

    Straullu, S; Forghieri, F; Ferrero, V; Gaudino, R

    2012-12-31

    We demonstrate a greater than 42 dB optical distribution network power budget in the upstream of a 1.25 Gbps self-coherent reflective PON after 100 km of installed fibers, using off-the-shelf optoelectronic components, improving our previous result by 4 dB. We discuss all system optimizations introduced in the setup in order to reach such a result, including 8B/10B high-pass filtering and Faraday rotation at the ONU. PMID:23388785

  4. Sub-optimal achievement of guideline-derived lipid goals in management of diabetes patients with atherosclerotic cardiovascular disease, despite high use of evidence-based therapies.

    PubMed

    DeGuzman, Pamela B; Akosah, Kwame O; Simpson, Allan G; Barbieri, Kirk E; Megginson, Gregory C; Goldberg, Randal I; Beller, George A

    2012-04-01

    Guidelines recommend aggressive goals for lipid and blood pressure reduction for high risk patients with diabetes mellitus and atherosclerotic coronary disease. However, it remains unclear how many patients achieve treatment goals versus the number of people merely placed on treatment. We conducted an observational study in an academic cardiology clinic. A total of 926 patients with atherosclerotic cardiovascular disease and concomitant diabetes mellitus met criteria. Mean age was 68.4 ± 10.2, 65.6% were male, and 86.8% were Caucasian. By the last visit a high percentage of patients were receiving recommended medications. Mean LDL-cholesterol achieved was 80.4 mg/dl with 40.9% reaching ≤ 70 mg/dl, and 61.7% reaching SBP ≤ 130 mmHg. Many patients with diabetes mellitus and atherosclerotic cardiovascular disease are prescribed recommended medications; however, few achieve guidelines-specified therapeutic goals for LDL-cholesterol and blood pressure. Studies evaluating performance improvement should include percentage of patients reaching treatment goals. Mechanisms underlying the treatment gap need to be identified and addressed. PMID:22234950

  5. Effective Doctoral Education: Interpreting Factors and Outcomes of Success through a New Framework, Autoethnography, and Quantitative Study of Passion

    ERIC Educational Resources Information Center

    Anderson, Nathan Charles

    2013-01-01

    The purpose of this disquisition is to increase knowledge about the factors and outcomes of success in doctoral education. Enhanced understanding about the factors and outcomes of success could help optimize effectiveness of the complex systems that educate doctoral students. To achieve the purpose of this disquisition, three manuscripts were…

  6. Appraising Reading Achievement.

    ERIC Educational Resources Information Center

    Ediger, Marlow

    To determine quality sequence in pupil progress, evaluation approaches need to be used which guide the teacher to assist learners to attain optimally. Teachers must use a variety of procedures to appraise student achievement in reading, because no one approach is adequate. Appraisal approaches might include: (1) observation and subsequent…

  7. The content of African diets is adequate to achieve optimal efficacy with fixed-dose artemether-lumefantrine: a review of the evidence

    PubMed Central

    Premji, Zulfiqarali G; Abdulla, Salim; Ogutu, Bernhards; Ndong, Alice; Falade, Catherine O; Sagara, Issaka; Mulure, Nathan; Nwaiwu, Obiyo; Kokwaro, Gilbert

    2008-01-01

    A fixed-dose combination of artemether-lumefantrine (AL, Coartem®) has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat. As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat) results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat). African diets are typically based on a carbohydrate staple (starchy root vegetables, fruit [plantain] or cereals) supplemented by soups, relishes and sauces derived from vegetables, pulses, nuts or fish. The most important sources of dietary fat in African countries are oil crops (e.g. peanuts, soya beans) and cooking oils as red palm, peanut, coconut and sesame oils. Total fat intake in the majority of subSaharan countries is estimated to be in the range 30–60 g/person/day across the whole population (average 43 g/person/day). Breast-feeding of infants up to two years of age is standard, with one study estimating a fat intake of 15–30 g fat/day from breast milk up to the age of 18 months. Weaning foods typically contain low levels of fat, and the transition from breast milk to complete weaning is associated with a marked reduction in dietary fat. Nevertheless, fat intake >10 g/day has been reported in young children post-weaning. A randomized trial in Uganda reported no difference in the efficacy of AL between patients receiving supervised meals with a fixed fat content (~23 g fat) or taking AL unsupervised, suggesting that fat intake at home was sufficient for optimal efficacy. Moreover, randomized trials in African children aged 5–59 months have shown similar high cure rates to those observed

  8. The content of African diets is adequate to achieve optimal efficacy with fixed-dose artemether-lumefantrine: a review of the evidence.

    PubMed

    Premji, Zulfiqarali G; Abdulla, Salim; Ogutu, Bernhards; Ndong, Alice; Falade, Catherine O; Sagara, Issaka; Mulure, Nathan; Nwaiwu, Obiyo; Kokwaro, Gilbert

    2008-01-01

    A fixed-dose combination of artemether-lumefantrine (AL, Coartem(R)) has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat.As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat) results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat). African diets are typically based on a carbohydrate staple (starchy root vegetables, fruit [plantain] or cereals) supplemented by soups, relishes and sauces derived from vegetables, pulses, nuts or fish. The most important sources of dietary fat in African countries are oil crops (e.g. peanuts, soya beans) and cooking oils as red palm, peanut, coconut and sesame oils. Total fat intake in the majority of subSaharan countries is estimated to be in the range 30-60 g/person/day across the whole population (average 43 g/person/day). Breast-feeding of infants up to two years of age is standard, with one study estimating a fat intake of 15-30 g fat/day from breast milk up to the age of 18 months. Weaning foods typically contain low levels of fat, and the transition from breast milk to complete weaning is associated with a marked reduction in dietary fat. Nevertheless, fat intake >10 g/day has been reported in young children post-weaning. A randomized trial in Uganda reported no difference in the efficacy of AL between patients receiving supervised meals with a fixed fat content (~23 g fat) or taking AL unsupervised, suggesting that fat intake at home was sufficient for optimal efficacy. Moreover, randomized trials in African children aged 5-59 months have shown similar high cure rates to those observed in

  9. Superintendent Tenure and Student Achievement

    ERIC Educational Resources Information Center

    Simpson, Jennifer

    2013-01-01

    A correlational research design was used to examine the influence of superintendent tenure on student achievement in rural Appalachian Kentucky school districts. Superintendent tenure was compared to aggregated student achievement scores for 2011 and to changes in students' learning outcomes over the course of the superintendents' tenure. The…

  10. Achieving Finite Element Mesh Quality via Optimization of the Jacobian Matrix Norm and Associated Quantities, Part II - A Framework for Volume Mesh Optimization and the Condition Number of the Jacobian Matrix

    SciTech Connect

    Knupp, P.M.

    1999-03-26

    Three-dimensional unstructured tetrahedral and hexahedral finite element mesh optimization is studied from a theoretical perspective and by computer experiments to determine what objective functions are most effective in attaining valid, high quality meshes. The approach uses matrices and matrix norms to extend the work in Part I to build suitable 3D objective functions. Because certain matrix norm identities which hold for 2 x 2 matrices do not hold for 3 x 3 matrices. significant differences arise between surface and volume mesh optimization objective functions. It is shown, for example, that the equivalence in two-dimensions of the Smoothness and Condition Number of the Jacobian matrix objective functions does not extend to three dimensions and further. that the equivalence of the Oddy and Condition Number of the Metric Tensor objective functions in two-dimensions also fails to extend to three-dimensions. Matrix norm identities are used to systematically construct dimensionally homogeneous groups of objective functions. The concept of an ideal minimizing matrix is introduced for both hexahedral and tetrahedral elements. Non-dimensional objective functions having barriers are emphasized as the most logical choice for mesh optimization. The performance of a number of objective functions in improving mesh quality was assessed on a suite of realistic test problems, focusing particularly on all-hexahedral ''whisker-weaved'' meshes. Performance is investigated on both structured and unstructured meshes and on both hexahedral and tetrahedral meshes. Although several objective functions are competitive, the condition number objective function is particularly attractive. The objective functions are closely related to mesh quality measures. To illustrate, it is shown that the condition number metric can be viewed as a new tetrahedral element quality measure.

  11. Enriching the Hierarchical Model of Achievement Motivation: Autonomous and Controlling Reasons Underlying Achievement Goals

    ERIC Educational Resources Information Center

    Michou, Aikaterini; Vansteenkiste, Maarten; Mouratidis, Athanasios; Lens, Willy

    2014-01-01

    Background: The hierarchical model of achievement motivation presumes that achievement goals channel the achievement motives of need for achievement and fear of failure towards motivational outcomes. Yet, less is known whether autonomous and controlling reasons underlying the pursuit of achievement goals can serve as additional pathways between…

  12. Project ACHIEVE final report

    SciTech Connect

    1997-06-13

    Project ACHIEVE was a math/science academic enhancement program aimed at first year high school Hispanic American students. Four high schools -- two in El Paso, Texas and two in Bakersfield, California -- participated in this Department of Energy-funded program during the spring and summer of 1996. Over 50 students, many of whom felt they were facing a nightmare future, were given the opportunity to work closely with personal computers and software, sophisticated calculators, and computer-based laboratories -- an experience which their regular academic curriculum did not provide. Math and science projects, exercises, and experiments were completed that emphasized independent and creative applications of scientific and mathematical theories to real world problems. The most important outcome was the exposure Project ACHIEVE provided to students concerning the college and technical-field career possibilities available to them.

  13. Achieving optimal SERS through enhanced experimental design

    PubMed Central

    Fisk, Heidi; Westley, Chloe; Turner, Nicholas J.

    2016-01-01

    One of the current limitations surrounding surface‐enhanced Raman scattering (SERS) is the perceived lack of reproducibility. SERS is indeed challenging, and for analyte detection, it is vital that the analyte interacts with the metal surface. However, as this is analyte dependent, there is not a single set of SERS conditions that are universal. This means that experimental optimisation for optimum SERS response is vital. Most researchers optimise one factor at a time, where a single parameter is altered first before going onto optimise the next. This is a very inefficient way of searching the experimental landscape. In this review, we explore the use of more powerful multivariate approaches to SERS experimental optimisation based on design of experiments and evolutionary computational methods. We particularly focus on colloidal‐based SERS rather than thin film preparations as a result of their popularity. © 2015 The Authors. Journal of Raman Spectroscopy published by John Wiley & Sons, Ltd.

  14. Thin sheets achieve optimal wrapping of liquids

    NASA Astrophysics Data System (ADS)

    Paulsen, Joseph; Démery, Vincent; Davidovitch, Benny; Santangelo, Christian; Russell, Thomas; Menon, Narayanan

    2015-03-01

    A liquid drop can wrap itself in a sheet using capillary forces [Py et al., PRL 98, 2007]. However, the efficiency of ``capillary origami'' at covering the surface of a drop is hampered by the mechanical cost of bending the sheet. Thinner sheets deform more readily by forming small-scale wrinkles and stress-focussing patterns, but it is unclear how coverage efficiency competes with mechanical cost as thickness is decreased, and what wrapping shapes will emerge. We place a thin (~ 100 nm) polymer film on a drop whose volume is gradually decreased so that the sheet covers an increasing fraction of its surface. The sheet exhibits a complex sequence of axisymmetric and polygonal partially- and fully- wrapped shapes. Remarkably, the progression appears independent of mechanical properties. The gross shape, which neglects small-scale features, is correctly predicted by a simple geometric approach wherein the exposed area is minimized. Thus, simply using a thin enough sheet results in maximal coverage.

  15. Achieving Optimal Enrollments and Tuition Revenues.

    ERIC Educational Resources Information Center

    Ihlanfeldt, William

    A modern marketing approach to student recruitment is offered as a means of facilitating institutional planning, enhancing communication with prospective students, improving enrollment forecasting, and eliminating unexpected shortfalls in tuition income. Marketing is distinguished from mere salesmanship and discussed in a practical program of…

  16. Dispositional Optimism

    PubMed Central

    Carver, Charles S.; Scheier, Michael F.

    2014-01-01

    Optimism is a cognitive construct (expectancies regarding future outcomes) that also relates to motivation: optimistic people exert effort, whereas pessimistic people disengage from effort. Study of optimism began largely in health contexts, finding positive associations between optimism and markers of better psychological and physical health. Physical health effects likely occur through differences in both health-promoting behaviors and physiological concomitants of coping. Recently, the scientific study of optimism has extended to the realm of social relations: new evidence indicates that optimists have better social connections, partly because they work harder at them. In this review, we examine the myriad ways this trait can benefit an individual, and our current understanding of the biological basis of optimism. PMID:24630971

  17. Molecular sources of residual cardiovascular risk, clinical signals, and innovative solutions: relationship with subclinical disease, undertreatment, and poor adherence: implications of new evidence upon optimizing cardiovascular patient outcomes

    PubMed Central

    Kones, Richard

    2013-01-01

    Residual risk, the ongoing appreciable risk of major cardiovascular events (MCVE) in statin-treated patients who have achieved evidence-based lipid goals, remains a concern among cardiologists. Factors that contribute to this continuing risk are atherogenic non-low-density lipoprotein (LDL) particles and atherogenic processes unrelated to LDL cholesterol, including other risk factors, the inherent properties of statin drugs, and patient characteristics, ie, genetics and behaviors. In addition, providers, health care systems, the community, public policies, and the environment play a role. Major statin studies suggest an average 28% reduction in LDL cholesterol and a 31% reduction in relative risk, leaving a residual risk of about 69%. Incomplete reductions in risk, and failure to improve conditions that create risk, may result in ongoing progression of atherosclerosis, with new and recurring lesions in original and distant culprit sites, remodeling, arrhythmias, rehospitalizations, invasive procedures, and terminal disability. As a result, identification of additional agents to reduce residual risk, particularly administered together with statin drugs, has been an ongoing quest. The current model of atherosclerosis involves many steps during which disease may progress independently of guideline-defined elevations in LDL cholesterol. Differences in genetic responsiveness to statin therapy, differences in ability of the endothelium to regenerate and repair, and differences in susceptibility to nonlipid risk factors, such as tobacco smoking, hypertension, and molecular changes associated with obesity and diabetes, may all create residual risk. A large number of inflammatory and metabolic processes may also provide eventual therapeutic targets to lower residual risk. Classically, epidemiologic and other evidence suggested that raising high-density lipoprotein (HDL) cholesterol would be cardioprotective. When LDL cholesterol is aggressively lowered to targets, low HDL

  18. The electronic medical office: optimizing solutions.

    PubMed

    Kirschenbaum, Ira H; Mabrey, Jay D; Wood, George W; Alexander, A Herbert; Rhoades, Charles E; Alexander, Ian J; Golladay, Gregory J; Wheeless, Clifford

    2008-01-01

    Optimizing the care for patients in the orthopaedic clinical setting involves a wide range of issues. Surgical techniques, preoperative and postoperative care, long-term outcomes follow-up, continuing education, and patient communication are a few of the important areas that surgeons deal with on a regular basis. Successful management of this information has an impact on clinical outcomes, direct patient care, financial decisions, and management of the surgeon's time. The development of a comprehensive electronic medical office is a powerful and probably necessary tool to successfully manage such information and achieve the goals of an effective and safe orthopaedic practice. PMID:18399621

  19. 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

  20. WWC Review of the Report "Staying on Track: Testing Higher Achievement's Long-Term Impact on Academic Outcomes and High School Choice." What Works Clearinghouse Single Study Review

    ERIC Educational Resources Information Center

    What Works Clearinghouse, 2014

    2014-01-01

    This study of 952 fifth and sixth graders in Washington, DC, and Alexandria, Virginia, found that students who were offered the "Higher Achievement" program had higher test scores in mathematical problem solving and were more likely to be admitted to and attend private competitive high schools. "Higher Achievement" is a…

  1. "I Gained a Skill and a Change in Attitude": A Case Study Describing How an Online Continuing Professional Education Course for Pharmacists Supported Achievement of Its Transfer-to-Practice Outcomes

    ERIC Educational Resources Information Center

    Marks, Pia Zeni; Jennings, Brad; Farrell, Barbara; Kennie-Kaulbach, Natalie; Jorgenson, Derek; Sharpe, Jane Pearson; Waite, Nancy

    2014-01-01

    The convenience and flexibility of online learning clearly make it an attractive option for learners in professional development contexts. There is less clarity, however, about how it fares as a vehicle for enabling the applied, practice-oriented outcomes typically associated with professional development learning. This paper presents a case study…

  2. Achievement Goals and Discrete Achievement Emotions: A Theoretical Model and Prospective Test

    ERIC Educational Resources Information Center

    Pekrun, Reinhard; Elliot, Andrew J.; Maier, Markus A.

    2006-01-01

    A theoretical model linking achievement goals to discrete achievement emotions is proposed. The model posits relations between the goals of the trichotomous achievement goal framework and 8 commonly experienced achievement emotions organized in a 2 (activity/outcome focus) x 2 (positive/negative valence) taxonomy. Two prospective studies tested…

  3. Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-ST-segment elevation myocardial infarction: the British Heart Foundation FAMOUS–NSTEMI randomized trial

    PubMed Central

    Layland, Jamie; Oldroyd, Keith G.; Curzen, Nick; Sood, Arvind; Balachandran, Kanarath; Das, Raj; Junejo, Shahid; Ahmed, Nadeem; Lee, Matthew M.Y.; Shaukat, Aadil; O'Donnell, Anna; Nam, Julian; Briggs, Andrew; Henderson, Robert; McConnachie, Alex; Berry, Colin; Hannah, Andrew; Stewart, Andrew; Metcalfe, Malcolm; Norrie, John; Chowdhary, Saqib; Clark, Andrew; Henderson, Robert; Balachandran, Kanarath; Berry, Colin; Baird, Gordon; O'Donnell, Anna; Sood, Arvind; Curzen, Nick; Das, Raj; Ford, Ian; Layland, Jamie; Junejo, Shahid; Oldroyd, Keith

    2015-01-01

    Aim We assessed the management and outcomes of non-ST segment elevation myocardial infarction (NSTEMI) patients randomly assigned to fractional flow reserve (FFR)-guided management or angiography-guided standard care. Methods and results We conducted a prospective, multicentre, parallel group, 1 : 1 randomized, controlled trial in 350 NSTEMI patients with ≥1 coronary stenosis ≥30% of the lumen diameter assessed visually (threshold for FFR measurement) (NCT01764334). Enrolment took place in six UK hospitals from October 2011 to May 2013. Fractional flow reserve was disclosed to the operator in the FFR-guided group (n = 176). Fractional flow reserve was measured but not disclosed in the angiography-guided group (n = 174). Fractional flow reserve ≤0.80 was an indication for revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). The median (IQR) time from the index episode of myocardial ischaemia to angiography was 3 (2, 5) days. For the primary outcome, the proportion of patients treated initially by medical therapy was higher in the FFR-guided group than in the angiography-guided group [40 (22.7%) vs. 23 (13.2%), difference 95% (95% CI: 1.4%, 17.7%), P = 0.022]. Fractional flow reserve disclosure resulted in a change in treatment between medical therapy, PCI or CABG in 38 (21.6%) patients. At 12 months, revascularization remained lower in the FFR-guided group [79.0 vs. 86.8%, difference 7.8% (−0.2%, 15.8%), P = 0.054]. There were no statistically significant differences in health outcomes and quality of life between the groups. Conclusion In NSTEMI patients, angiography-guided management was associated with higher rates of coronary revascularization compared with FFR-guided management. A larger trial is necessary to assess health outcomes and cost-effectiveness. PMID:25179764

  4. Optimal tumor shrinkage predicts long-term outcome in advanced nonsmall cell lung cancer (NSCLC) treated with target therapy: Result from 3 clinical trials of advanced NSCLC by 1 institution.

    PubMed

    He, Xiaobo; Zhang, Yang; Ma, Yuxiang; Zhou, Ting; Zhang, Jianwei; Hong, Shaodong; Sheng, Jin; Zhang, Zhonghan; Yang, Yunpeng; Huang, Yan; Zhang, Li; Zhao, Hongyun

    2016-08-01

    Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are used as standard therapies for advanced nonsmall cell lung cancer (NSCLC) patients with EGFR mutation positive. Because these targeted therapies could cause tumor necrosis and shrinkage, the purpose of the study is to search for a value of optimal tumor shrinkage as an appropriate indicator of outcome for advanced NSCLC.A total of 88 NSCLC enrollees of 3 clinical trials (IRESSA registration clinical trial, TRUST study and ZD6474 study), who received Gefitinib (250 mg, QD), Erlotinib (150 mg, QD), and ZD6474 (100 mg, QD), respectively, during December 2003 and October 2007, were retrospectively analyzed. The response evaluation criteria in solid tumors (RECIST) were used to identify responders, who had complete response (CR) or partial responses (PR) and nonresponders who had stable disease (SD) or progressive disease (PD). Receiver operating characteristics (ROC) analysis was used to find the optimal tumor shrinkage as an indicator for tumor therapeutic outcome. Univariate and multivariate Cox regression analyses were performed to compare the progression-free survival (PFS) and overall survival (OS) between responders and nonresponders stratified based on radiologic criteria.Among the 88 NSCLC patients, 26 were responders and 62 were nonresponders based on RECIST 1.0. ROC indicated that 8.32% tumor diameter shrinkage in the sum of the longest tumor diameter (SLD) was the cutoff point of tumor shrinkage outcomes, resulting in 46 responders (≤8.32%) and 42 nonresponders (≥8.32%). Univariate and multivariate Cox regression analyses indicated that (1) the responders (≤8.32%) and nonresponders (≥ -8.32%) were significantly different in median PFS (13.40 vs 1.17 months, P < 0.001) and OS (19.80 vs 7.90 months, P < 0.001) and (2) -8.32% in SLD could be used as the optimal threshold for PFS (hazard ratio [HR], 8.11, 95% CI, 3.75 to 17.51, P < 0.001) and OS (HR, 2.36, 95

  5. Pre-transplant achievement of negativity in minimal residual disease and French-American-British L1 morphology predict superior outcome after allogeneic transplant for Philadelphia chromosome positive acute lymphoblastic leukemia: an analysis of Southeast Asian patients.

    PubMed

    Ma, Liyuan; Hao, Siguo; Diong, Colin; Goh, Yeow-Tee; Gopalakrishnan, Sathish; Ho, Aloysius; Hwang, William; Koh, Liang-Piu; Koh, Mickey; Lim, Zi-Yi; Loh, Yvonne; Poon, Michelle; Tan, Lip-Kun; Tan, Patrick; Linn, Yeh-Ching

    2015-05-01

    To better understand predictive factors and improve the clinical outcome of allogeneic transplant for patients with Philadelphia positive acute lymphoblastic leukemia, we analyzed 67 Southeast Asian patients transplanted in our institutions. Multivariate analysis showed that disease status before transplant, year of transplant and, interestingly, French-American-British (FAB) subtype had a significant impact on overall survival (OS) and non-relapse mortality. Patients who were minimal residual disease (MRD) negative at transplant had a 3-year OS of 73% compared to those who were MRD positive (45%) and refractory (0%). The 3-year cumulative incidence of relapse was 18% and 36% for the MRD negative and positive groups, respectively. FAB L1 subtype had a significantly superior 3-year OS of 63% vs. 29% for L2 subtype. Pre-transplant use of a tyrosine kinase inhibitor significantly improved outcomes in univariate but not multivariate analysis, as it served to induce more patients into MRD negativity, which was the factor that directly improved transplant outcome. PMID:25139689

  6. Optimizing Stability in Femoral Neck Fracture Fixation.

    PubMed

    Ye, Ye; Hao, Jiandong; Mauffrey, Cyril; Hammerberg, E Mark; Stahel, Philip F; Hak, David J

    2015-10-01

    Optimizing stability of femoral neck fracture fixation is important in obtaining a successful outcome. The mechanical problems and strategies for achieving optimal stability differ depending on patients' age and degree of osteoporosis. Femoral neck fractures in younger adults usually result from high-energy trauma and have a vertical fracture pattern. Strategies for optimizing fixation stability in this group include placing additional screws at right angles to the fracture plane and medial buttress plate augmentation. In elderly patients, screw position relative to the intact cortical femoral neck bone is of critical importance. Additional strategies for optimizing fixation stability in this group include the concept of length stable fixation, use of adjunctive calcium phosphate cement, and use of novel fixed angle fixation implants. PMID:26488776

  7. Long-Term Outcome in Patients With Ductal Carcinoma In Situ Treated With Breast-Conserving Therapy: Implications for Optimal Follow-up Strategies

    SciTech Connect

    Shaitelman, Simona F.; Wilkinson, J. Ben; Kestin, Larry L.; Ye Hong; Goldstein, Neal S.; Martinez, Alvaro A.; Vicini, Frank A.

    2012-07-01

    Purpose: To determine 20-year rates of local control and outcome-associated factors for ductal carcinoma in situ (DCIS) after breast-conserving therapy (BCT). Methods and Materials: All DCIS cases receiving BCT between 1980 and 1993 were reviewed. Patient demographics and pathologic factors were analyzed for effect on outcomes, including ipsilateral breast tumor recurrence (IBTR) and survival. Results: One hundred forty-five cases were evaluated; the median follow-up time was 19.3 years. IBTR developed in 25 patients, for 5-, 10-, 15-, and 20-year actuarial rates of 9.9%, 12.2%, 13.7%, and 17.5%, respectively. One third of IBTRs were elsewhere failures, and 68% of IBTRs occurred <10 years after diagnosis. Young age and cancerization of lobules predicted for IBTR at <10 years, and increased slide involvement and atypical ductal hyperplasia were associated with IBTR at later time points. Conclusions: Patients with DCIS treated with BCT have excellent long-term rates of local control. Predictors of IBTR vary over time, and the risk of recurrence seems highest within 10 to 12 years after diagnosis.

  8. Non-Verbal Reasoning Ability and Academic Achievement as Moderators of the Relation between Adverse Life Events and Emotional and Behavioural Problems in Early Adolescence: The Importance of Moderator and Outcome Specificity

    ERIC Educational Resources Information Center

    Flouri, Eirini; Tzavidis, Nikos

    2011-01-01

    This study was carried out to model the functional form of the effect of contextual risk (number of adverse life events) on emotional and behavioural problems in early adolescence, and to test how intelligence and academic achievement compare as moderators of this effect. The effect of number of adverse life events on emotional and behavioural…

  9. Can Social Support Protect Bullied Adolescents from Adverse Outcomes? A Prospective Study on the Effects of Bullying on the Educational Achievement and Mental Health of Adolescents at Secondary Schools in East London

    ERIC Educational Resources Information Center

    Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen

    2011-01-01

    This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to…

  10. 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…

  11. Optimal Skin-to-Stone Distance Is a Positive Predictor for Successful Outcomes in Upper Ureter Calculi following Extracorporeal Shock Wave Lithotripsy: A Bayesian Model Averaging Approach

    PubMed Central

    Cho, Kang Su; Jung, Hae Do; Ham, Won Sik; Chung, Doo Yong; Kang, Yong Jin; Jang, Won Sik; Kwon, Jong Kyou; Choi, Young Deuk; Lee, Joo Yong

    2015-01-01

    Objectives To investigate whether skin-to-stone distance (SSD), which remains controversial in patients with ureter stones, can be a predicting factor for one session success following extracorporeal shock wave lithotripsy (ESWL) in patients with upper ureter stones. Patients and Methods We retrospectively reviewed the medical records of 1,519 patients who underwent their first ESWL between January 2005 and December 2013. Among these patients, 492 had upper ureter stones that measured 4–20 mm and were eligible for our analyses. Maximal stone length, mean stone density (HU), and SSD were determined on pretreatment non-contrast computed tomography (NCCT). For subgroup analyses, patients were divided into four groups. Group 1 consisted of patients with SSD<25th percentile, group 2 consisted of patients with SSD in the 25th to 50th percentile, group 3 patients had SSD in the 50th to 75th percentile, and group 4 patients had SSD≥75th percentile. Results In analyses of group 2 patients versus others, there were no statistical differences in mean age, stone length and density. However, the one session success rate in group 2 was higher than other groups (77.9% vs. 67.0%; P = 0.032). The multivariate logistic regression model revealed that shorter stone length, lower stone density, and the group 2 SSD were positive predictors for successful outcomes in ESWL. Using the Bayesian model-averaging approach, longer stone length, lower stone density, and group 2 SSD can be also positive predictors for successful outcomes following ESWL. Conclusions Our data indicate that a group 2 SSD of approximately 10 cm is a positive predictor for success following ESWL. PMID:26659086

  12. 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…

  13. Self-Beliefs and Student Goal Achievement

    ERIC Educational Resources Information Center

    Wesson, Caroline J.; Derrer-Rendall, Nicola M.

    2011-01-01

    Two preliminary studies are presented investigating the self-beliefs that may affect goal achievement in a student population. In Study 1, goal achievement on an abstract task, where goals are externally set by others, is considered in relation to students' levels of optimism. In Study 2, goal achievement on academic performance, where goals are…

  14. Student Outcomes Report.

    ERIC Educational Resources Information Center

    Clagett, Craig A.

    Prince George's Community College (PGCC) created a Student Outcomes Report in December 1996 that measures course completion, retention, student achievement, program completion, transfer, and certification. Findings indicated that though the course pass rate was 75%, individual course completion ranged from 44% to 100%. Divisional pass rates ranged…

  15. Graded Achievement, Tested Achievement, and Validity

    ERIC Educational Resources Information Center

    Brookhart, Susan M.

    2015-01-01

    Twenty-eight studies of grades, over a century, were reviewed using the argument-based approach to validity suggested by Kane as a theoretical framework. The review draws conclusions about the meaning of graded achievement, its relation to tested achievement, and changes in the construct of graded achievement over time. "Graded…

  16. Optimizing Care and Outcomes for People with Type 2 Diabetes – Lessons from a Translational Research Program on Insulin Initiation in General Practice

    PubMed Central

    Furler, John; Blackberry, Irene; Manski-Nankervis, Jo-Anne; O’Neal, David; Best, James; Young, Doris

    2015-01-01

    Background: Clinical inertia, failure to intensify treatment according to evidence-based guidelines, leads to prolonged, avoidable hyperglycemia in people with type 2 diabetes (T2D). This is a challenge for General Practice and Primary Care, where most people with T2D receive most of their care. Sustained, integrated translational research programs are needed to embed effective treatments in routine practice, yet many challenges exist for developing such programs. Objectives: To explore challenges and facilitators to implementing a translational research program focused on insulin initiation and titration among people with T2D in general practice and to identify key factors important to support and sustain such translation research in primary care. Operationalizing a program of translational work in primary care: We describe a series of studies on insulin initiation and titration in general practice including theory and qualitative work (Phase 1), a small feasibility and acceptability pilot (Phase 2), a large scale pilot (Phase 3), and a pragmatic cluster randomized trial currently under way (Phase 4). We used mixed methods to explore practice level implementation issues, and reflective investigator discussions to explore broader research program sustainability. Challenges for translational research in primary care: Key facilitators and barriers at practice and research program levels, include: Appropriate funding structures to secure long-term capacity building and people support; Building and maintaining linkages between communities of practice, primary and secondary/tertiary care researchers, institutions, and industry partners; Strategies for engagement and support for practitioners and participants. Conclusion: Building effective and sustainable translational research programs are critical for developing evidence-based policy that drives improved outcomes at a population level. Diverse sources of funding that support extensive and sustained trans

  17. Chronic stroke survivors achieve comparable outcomes following virtual task specific repetitive training guided by a wearable robotic orthosis (UL-EXO7) and actual task specific repetitive training guided by a physical therapist.

    PubMed

    Byl, Nancy N; Abrams, Gary M; Pitsch, Erica; Fedulow, Irina; Kim, Hyunchul; Simkins, Matt; Nagarajan, Srikantan; Rosen, Jacob

    2013-01-01

    Survivors post stroke commonly have upper limb impairments. Patients can drive neural reorganization, brain recovery and return of function with task specific repetitive training (TSRT). Fifteen community independent stroke survivors (25-75 years, >6 months post stroke, Upper Limb Fugl Meyer [ULFM] scores 16-39) participated in this randomized feasibility study to compare outcomes of upper limb TSRT guided by a robotic orthosis (bilateral or unilateral) or a physical therapist. After 6 weeks of training (18 h), across all subjects, there were significant improvements in depression, flexibility, strength, tone, pain and voluntary movement (ULFM) (p < 0.05; effect sizes 0.49-3.53). Each training group significantly improved ULFM scores and range of motion without significant group differences. Virtual or actual TSRT performed with a robotic orthosis or a physical therapist significantly reduced arm impairments around the shoulder and elbow without significant gains in fine motor hand control, activities of daily living or independence. PMID:23911077

  18. Developmental Outcome of Childhood Leukemia.

    ERIC Educational Resources Information Center

    Coniglio, Susan J.; Blackman, James A.

    1995-01-01

    Literature on developmental and psychosocial outcomes of childhood leukemia is reviewed, focusing on preschool-age children. Studies are categorized in terms of outcome measures: intelligence/achievement, neuropsychological, memory/attention, and psychosocial tests. Evidence suggests that preschool children with leukemia are at high risk for…

  19. Development of a Yellow Flag Assessment Tool for Orthopaedic Physical Therapists: Results From the Optimal Screening for Prediction of Referral and Outcome (OSPRO) Cohort.

    PubMed

    Lentz, Trevor A; Beneciuk, Jason M; Bialosky, Joel E; Zeppieri, Giorgio; Dai, Yunfeng; Wu, Samuel S; George, Steven Z

    2016-05-01

    Study Design Clinical measurement, cross-sectional. Background Pain-associated psychological distress adversely influences outcomes for patients with musculoskeletal pain. However, assessment of pain-associated psychological distress (ie, yellow flags) is not routinely performed in orthopaedic physical therapy practice. A standardized yellow flag assessment tool will better inform treatment decision making related to psychologically informed practice. Objectives To describe the development of a concise, multidimensional yellow flag assessment tool for application in orthopaedic physical therapy clinical practice. Methods A 136-item yellow flag item bank was developed from validated psychological questionnaires across domains related to pain vulnerability (negative mood, fear avoidance) and resilience (positive affect/coping). Patients seeking physical therapy with neck, back, knee, or shoulder pain completed the item bank. Iterative statistical analyses determined minimal item sets meeting thresholds for identifying elevated vulnerability or low resilience (ie, upper or lower quartile, as indicated). Further item reduction yielded a concise yellow flag assessment tool to assess 11 psychological constructs measuring pain-associated psychological distress. Correlations between the assessment tool and individual psychological questionnaires were measured and compared between anatomical regions. Concurrent validity was assessed by determining variance explained in pain and disability scores by the assessment tool. Results Subjects with elevated vulnerability and decreased resilience were identified with a high degree of accuracy (minimum of 85%) using a 17-item tool. Correlations were moderate to high between the 17-item tool and individual psychological questionnaires, with no significant differences in correlations between different anatomical regions. Shorter 10- and 7-item versions of the assessment tool allow clinicians the flexibility to assess for yellow flags

  20. Prospective Optimization

    PubMed Central

    Sejnowski, Terrence J.; Poizner, Howard; Lynch, Gary; Gepshtein, Sergei; Greenspan, Ralph J.

    2014-01-01

    Human performance approaches that of an ideal observer and optimal actor in some perceptual and motor tasks. These optimal abilities depend on the capacity of the cerebral cortex to store an immense amount of information and to flexibly make rapid decisions. However, behavior only approaches these limits after a long period of learning while the cerebral cortex interacts with the basal ganglia, an ancient part of the vertebrate brain that is responsible for learning sequences of actions directed toward achieving goals. Progress has been made in understanding the algorithms used by the brain during reinforcement learning, which is an online approximation of dynamic programming. Humans also make plans that depend on past experience by simulating different scenarios, which is called prospective optimization. The same brain structures in the cortex and basal ganglia that are active online during optimal behavior are also active offline during prospective optimization. The emergence of general principles and algorithms for goal-directed behavior has consequences for the development of autonomous devices in engineering applications. PMID:25328167

  1. Reciprocal Effects between Adolescent Externalizing Problems and Measures of Achievement

    ERIC Educational Resources Information Center

    Zimmermann, Friederike; Schütte, Kerstin; Taskinen, Päivi; Köller, Olaf

    2013-01-01

    Student misbehavior is a pervasive problem and may seriously affect academic achievement. Previous research hints at different effects depending on whether achievement tests or achievement judgments are used as academic outcomes. Previous research also indicates that low achievement can conversely contribute to problem behavior and that low…

  2. Defining, constructing and assessing learning outcomes.

    PubMed

    Taylor, R M

    2009-08-01

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

  3. Driving external chemistry optimization via operations management principles.

    PubMed

    Bi, F Christopher; Frost, Heather N; Ling, Xiaolan; Perry, David A; Sakata, Sylvie K; Bailey, Simon; Fobian, Yvette M; Sloan, Leslie; Wood, Anthony

    2014-03-01

    Confronted with the need to significantly raise the productivity of remotely located chemistry CROs Pfizer embraced a commitment to continuous improvement which leveraged the tools from both Lean Six Sigma and queue management theory to deliver positive measurable outcomes. During 2012 cycle times were reduced by 48% by optimization of the work in progress and conducting a detailed workflow analysis to identify and address pinch points. Compound flow was increased by 29% by optimizing the request process and de-risking the chemistry. Underpinning both achievements was the development of close working relationships and productive communications between Pfizer and CRO chemists. PMID:23973340

  4. Educational Achievement and Black-White Inequality. Statistical Analysis Report.

    ERIC Educational Resources Information Center

    Jacobson, Jonathan; Olsen, Cara; Rice, Jennifer King; Sweetland, Stephen

    This study explored relationships between black-white differences in educational achievement and black-white differences in various educational and economic outcomes. Three data sets examined the extent to which black-white differences in labor market outcomes, in educational attainment, and in mathematics and reading achievement were present for…

  5. A Primer on Unrealistic Optimism

    PubMed Central

    Shepperd, James A.; Waters, Erika; Weinstein, Neil D.; Klein, William M. P.

    2014-01-01

    People display unrealistic optimism in their predictions for countless events, believing that their personal future outcomes will be more desirable than can possibly be true. We summarize the vast literature on unrealistic optimism by focusing on four broad questions: What is unrealistic optimism; when does it occur; why does it occur; and what are its consequences. PMID:26089606

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

    PubMed Central

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

    2015-01-01

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

  7. Using the 2 x 2 Framework of Achievement Goals to Predict Achievement Emotions and Academic Performance

    ERIC Educational Resources Information Center

    Putwain, David W.; Sander, Paul; Larkin, Derek

    2013-01-01

    Previous work has established how achievement emotions are related to the trichotomous model of achievement goals, and how they predict academic performance. In our study we examine relations using an additional, mastery-avoidance goal, and whether outcome-focused emotions are predicted by mastery as well as performance goals. Results showed that…

  8. Operative Outcomes for Cervical Myelopathy and Radiculopathy

    PubMed Central

    Galbraith, J. G.; Butler, J. S.; Dolan, A. M.; O'Byrne, J. M.

    2012-01-01

    Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications. PMID:22046575

  9. A nursing focus on EMR usability enhancing documentation of patient outcomes.

    PubMed

    Page, Cecilia Anne Kennedy; Schadler, Aric

    2014-03-01

    Achieving the healthcare reform goals of broad electronic medical record (EMR) adoption and meaningful use will require that usability of EMR's be addressed. A usability checklist was implemented in a process improvement redesign of nursing documentation in an academic medical center to ensure optimal design of the user interface in the EMR. The outcomes of this framework were based on metrics of usability: efficiency, effectiveness and satisfaction. Implementation of a usability checklist as standard work ensures a focus on the user interface design to enhance use of the EMR by nursing in clinical care and improve patient outcomes. PMID:24485189

  10. National Medical School Matching Program: optimizing outcomes

    PubMed Central

    Eltorai, Adam EM; Daniels, Alan H

    2016-01-01

    The medical school admissions process is inefficient and costly to both applicants and medical schools. For the many rejected applicants, this process represents a costly, unproductive use of time. For medical schools, numerous applications are reviewed that ultimately do not yield matriculants, representing a substantial inefficiency. In order to streamline the process and reduce costs, we propose the development of a national medical school matching program.

  11. Gear optimization

    NASA Technical Reports Server (NTRS)

    Vanderplaats, G. N.; Chen, Xiang; Zhang, Ning-Tian

    1988-01-01

    The use of formal numerical optimization methods for the design of gears is investigated. To achieve this, computer codes were developed for the analysis of spur gears and spiral bevel gears. These codes calculate the life, dynamic load, bending strength, surface durability, gear weight and size, and various geometric parameters. It is necessary to calculate all such important responses because they all represent competing requirements in the design process. The codes developed here were written in subroutine form and coupled to the COPES/ADS general purpose optimization program. This code allows the user to define the optimization problem at the time of program execution. Typical design variables include face width, number of teeth and diametral pitch. The user is free to choose any calculated response as the design objective to minimize or maximize and may impose lower and upper bounds on any calculated responses. Typical examples include life maximization with limits on dynamic load, stress, weight, etc. or minimization of weight subject to limits on life, dynamic load, etc. The research codes were written in modular form for easy expansion and so that they could be combined to create a multiple reduction optimization capability in future.

  12. Optimizing Medical Kits for Spaceflight

    NASA Technical Reports Server (NTRS)

    Keenan, A. B,; Foy, Millennia; Myers, G.

    2014-01-01

    The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulation outcomes describing the impact of medical events on the mission may be used to optimize the allocation of resources in medical kits. Efficient allocation of medical resources, subject to certain mass and volume constraints, is crucial to ensuring the best outcomes of in-flight medical events. We implement a new approach to this medical kit optimization problem. METHODS We frame medical kit optimization as a modified knapsack problem and implement an algorithm utilizing a dynamic programming technique. Using this algorithm, optimized medical kits were generated for 3 different mission scenarios with the goal of minimizing the probability of evacuation and maximizing the Crew Health Index (CHI) for each mission subject to mass and volume constraints. Simulation outcomes using these kits were also compared to outcomes using kits optimized..RESULTS The optimized medical kits generated by the algorithm described here resulted in predicted mission outcomes more closely approached the unlimited-resource scenario for Crew Health Index (CHI) than the implementation in under all optimization priorities. Furthermore, the approach described here improves upon in reducing evacuation when the optimization priority is minimizing the probability of evacuation. CONCLUSIONS This algorithm provides an efficient, effective means to objectively allocate medical resources for spaceflight missions using the Integrated Medical Model.

  13. 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

  14. Helping Students Pay for College--and Achieve Better Outcomes

    ERIC Educational Resources Information Center

    MDRC, 2013

    2013-01-01

    America faces a two-pronged problem in higher education: increasing costs and low completion rates. Despite the recent expansion of federal Pell Grants, many students still are left with unmet financial needs and may drop out of college because of financial concerns, pressing work responsibilities, and fears of taking on too much debt. One idea…

  15. Motivational Profiles and Their Associations with Achievement Outcomes

    ERIC Educational Resources Information Center

    Shen, Bo; McCaughtry, Nate; Martin, Jeffrey J.; Fahlman, Mariane M.

    2009-01-01

    With the belief that theoretical integration in motivation may help us better understand motivational behavior, we designed this study to explore adolescents' motivational profiles and their associations with knowledge acquisition, leisure-time exercise behaviors, and cardiorespiratory fitness. Middle school students from a large urban inner-city…

  16. USING SUBSURFACE TRANSPORT RESEARCH TO ACHIEVE AGENCY OUTCOMES

    EPA Science Inventory

    Gasoline leaks from underground storage tanks can cause ground water contamination because there are a number of organic chemicals in gasoline. These chemicals have varying properties that influence how far contamination extends from the release. Research on transport of these ...

  17. 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…

  18. Using Toolkits to Achieve STEM Enterprise Learning Outcomes

    ERIC Educational Resources Information Center

    Watts, Carys A.; Wray, Katie

    2012-01-01

    Purpose: The purpose of this paper is to evaluate the effectiveness of using several commercial tools in science, technology, engineering and maths (STEM) subjects for enterprise education at Newcastle University, UK. Design/methodology/approach: The paper provides an overview of existing toolkit use in higher education, before reviewing where and…

  19. Comparing Science Achievement Constructs: Targeted and Achieved

    ERIC Educational Resources Information Center

    Ferrara, Steve; Duncan, Teresa

    2011-01-01

    This article illustrates how test specifications based solely on academic content standards, without attention to other cognitive skills and item response demands, can fall short of their targeted constructs. First, the authors inductively describe the science achievement construct represented by a statewide sixth-grade science proficiency test.…

  20. Optimization in development of acetaminophen syrup formulation.

    PubMed

    Worakul, Nimit; Wongpoowarak, Wibul; Boonme, Prapaporn

    2002-03-01

    Formulation of acetaminophen syrup could be developed by an optimization technique to reduce the time and cost of study. Cosolvents were used in the formulation because of the low solubility of acetaminophen in water. They were composed of polyethylene glycol 4000, propylene glycol, sorbitol solution, and glycerin. Their effects on the solubility of acetaminophen and the pH of formulations were investigated. Effects on taste and price were calculated based on their properties. Simulation study of the effect of cosolvents upon the formulation scores was performed, using an algorithm based upon a simulated annealing concept to achieve the global optima and heuristic optimization concept to accelerate convergence. The program written as a Visual Basic module within Microsoft Access 97 was used to simulate and assess the optimal cosolvent amounts to achieve the most desirable formulations automatically according to the specified criteria. Formulators could customize the optimal formulation according to their needs and cost constraints by redefining the desirable outcomes in the source code of the program. PMID:12026227

  1. Varieties of Achievement Motivation.

    ERIC Educational Resources Information Center

    Kukla, Andre; Scher, Hal

    1986-01-01

    A recent article by Nicholls on achievement motivation is criticized on three points: (1) definitions of achievement motives are ambiguous; (2) behavioral consequences predicted do not follow from explicit theoretical assumptions; and (3) Nicholls's account of the relation between his theory and other achievement theories is factually incorrect.…

  2. Motivation and School Achievement.

    ERIC Educational Resources Information Center

    Maehr, Martin L.; Archer, Jennifer

    Addressing the question, "What can be done to promote school achievement?", this paper summarizes the literature on motivation relating to classroom achievement and school effectiveness. Particular attention is given to how values, ideology, and various cultural patterns impinge on classroom performance and serve to enhance motivation to achieve.…

  3. Mobility and Reading Achievement.

    ERIC Educational Resources Information Center

    Waters, Theresa Z.

    A study examined the effect of geographic mobility on elementary school students' achievement. Although such mobility, which requires students to make multiple moves among schools, can have a negative impact on academic achievement, the hypothesis for the study was that it was not a determining factor in reading achievement test scores. Subjects…

  4. PASS and Reading Achievement.

    ERIC Educational Resources Information Center

    Kirby, John R.

    Two studies examined the effectiveness of the PASS (Planning, Attention, Simultaneous, and Successive cognitive processes) theory of intelligence in predicting reading achievement scores of normally achieving children and distinguishing children with reading disabilities from normally achieving children. The first study dealt with predicting…

  5. 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

  6. Regenerative treatments to enhance orthopedic surgical outcome.

    PubMed

    Murrell, William D; Anz, Adam W; Badsha, Humeira; Bennett, William F; Boykin, Robert E; Caplan, Arnold I

    2015-04-01

    In orthopedic surgery there has been a never-ending quest to improve surgical outcome and the patient's experience. Progression has been marked by the refinement of surgical techniques and instruments and later by enhanced diagnostic imaging capability, specifically magnetic resonance. Over time implant optimization was achieved, along with the development of innovative minimally invasive arthroscopic technical skills to leverage new versions of classic procedures and implants to improve short-term patient morbidity and initial, mid-term, and long-term patient outcomes. The use of regenerative and/or biological adjuncts to aid the healing process has followed in the drive for continual improvement, and major breakthroughs in basic science have significantly unraveled the mechanisms of key healing and regenerative pathways. A wide spectrum of primary and complementary regenerative treatments is becoming increasingly available, including blood-derived preparations, growth factors, bone marrow preparations, and stem cells. This is a new era in the application of biologically active material, and it is transforming clinical practice by providing effective supportive treatments either at the time of the index procedure or during the postoperative period. Regenerative treatments are currently in active use to enhance many areas of orthopedic surgery in an attempt to improve success and outcome. In this review we provide a comprehensive overview of the peer-reviewed evidence-based literature, highlighting the clinical outcomes in humans both with preclinical data and human clinical trials involving regenerative preparations within the areas of rotator cuff, meniscus, ligament, and articular cartilage surgical repair. PMID:25864660

  7. Consumer-driven health care: a path to achieving shared goals.

    PubMed

    Levine, S R

    2000-01-01

    Consumers are the driving force for a transition to a best outcomes-driven health care system that values and rewards outreach, innovation, and the rapid translation of scientific advances into everyday practice. They are the engine for change that can drive outcomes improvement, encourage broader and more timely use of new knowledge, and demand mechanisms to evaluate and report the effects. Consumers alone are fueled by the passion and urgency that results from living with the effects of illness, or seeing those they care about suffer. This best outcomes-driven system will need to be defined by consumers, professionals, and scientific evidence. But to participate as effective change agents, consumers will need good information, decision-support tools, access to resources, and ongoing support from entities they trust. By putting the consumer in the center of a best outcomes-driven system, we can begin to achieve our shared goals: universal access to high-quality, affordable health care and the opportunity for everyone to achieve optimal health-related quality of life and function. PMID:11187400

  8. Pediatric hydrocephalus outcomes: a review

    PubMed Central

    2012-01-01

    The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. In this paper, we review the different facets of outcome, including surgical outcome (shunt failure, infection and independence, and complications of endoscopy), clinical outcome (neurological, sensory, cognitive sequels, epilepsy), schooling and social integration. We then provide a brief review of the English-language literature and highlighting selected studies that provide information on the outcome and sequelae of pediatric hydrocephalus, and the impact of predictive variables on outcome. Mortality caused by hydrocephalus and its treatments is between 0 and 3%, depending on the duration of follow-up. Shunt event-free survival (EFS) is about 70% at one year and 40% at ten years. The EFS after endoscopic third ventriculostomy (ETV) appears better but likely benefits from selection bias and long-term figures are not available. Shunt infection affects between 5 and 8% of surgeries, and 15 to 30% of patients according to the duration of follow-up. Shunt independence can be achieved in 3 to 9% of patients, but the definition of this varies. Broad variations in the prevalence of cognitive sequelae, affecting 12 to 50% of children, and difficulties at school, affecting between 20 and 60%, attest of disparities among studies in their clinical evaluation. Epilepsy, affecting 6 to 30% of patients, has a serious impact on outcome. In adulthood, social integration is poor in a substantial number of patients but data are sparse. Few controlled prospective studies exist regarding hydrocephalus outcomes; in their absence, largely retrospective studies must be used to evaluate the long-term consequences of hydrocephalus and its treatments. This review aims to help to establish

  9. Developing a Motivational Model of College Achievement.

    ERIC Educational Resources Information Center

    Tuckman, Bruce W.; Abry, Dennis

    This study involves developing a motivational model of college achievement. The predictor variables, which were procrastination tendency, self-efficacy, self-regulation, intrinsic value, outcome value, cognitive strategy, test anxiety, students grade goals, parent grade goals, and grade point average, as well as the criterion variable exam…

  10. Achieving Excellence in Preschool Literacy Instruction

    ERIC Educational Resources Information Center

    Justice, Laura M., Ed.; Vukelich, Carol, Ed.

    2007-01-01

    High-quality preschool programs are essential to improving children's outcomes in reading achievement and leveling language and literacy disparities among students from diverse backgrounds. Grounded in state-of-the-art research evidence, this practice-oriented book demonstrates how preschool professionals can create, evaluate, and sustain…

  11. The optimal coyness game.

    PubMed

    McNamara, John M; Fromhage, Lutz; Barta, Zoltan; Houston, Alasdair I

    2009-03-01

    In many animal species, females will benefit if they can secure their mate's help in raising their young. It has been suggested that they can achieve this by being coy (i.e. reluctant to mate) when courted, because this gives them time to assess a prospective mate's helpfulness and hence allows them to reject non-helpful males. According to this view, coyness should (i) reflect a trade-off between information gain and time lost on the part of the female, and (ii) be subject to an evolutionary feedback between optimal female coyness and male helping behaviour. Previous theory has considered each of these aspects in isolation. By contrast, here we present a comprehensive game theory model of this situation, leading to qualitatively new insights. We predict that a high degree of coyness should be associated with a high encounter rate during mate search, with an intermediate rate of information gain during mate inspection and with an intermediate dependence of reproduction on male help. Strongly biased sex ratios, however, preclude coyness. Due to the mutual feedback between coyness and helpfulness in our model, alternatively stable evolutionary outcomes (with or without coyness) are possible under broad conditions. We also discuss alternative interpretations of coyness. PMID:19129134

  12. Optimizing management of glycaemia.

    PubMed

    Chatterjee, Sudesna; Khunti, Kamlesh; Davies, Melanie J

    2016-06-01

    The global epidemic of type 2 diabetes (T2DM) continues largely unabated due to an increasingly sedentary lifestyle and obesogenic environment. A cost-effective patient-centred approach, incorporating glucose-lowering therapy and modification of cardiovascular risk factors, could help prevent the inevitable development and progression of macrovascular and microvascular complications. Glycaemic optimization requires patient structured education, self-management and empowerment, and psychological support along with early and proactive use of glucose lowering therapies, which should be delivered in a system of care as shown by the Chronic Care Model. From diagnosis, intensive glycaemic control and individualised care is aimed at reducing complications. In older people, the goal is maintaining quality of life and minimizing morbidity, especially as overtreatment increases hypoglycaemia risk. Maintaining durable glycaemic control is challenging and complex to achieve without hypoglycaemia, weight gain and other significant adverse effects. Overcoming patient and physician barriers can help ensure adequate treatment initiation and intensification. Cardiovascular safety studies with newer glucose-lowering agents are now mandatory, with a sodium glucose co-transporter-2 inhibitor (empagliflozin), and two glucagon like peptide-1 receptor agonists (liraglutide and semaglutide) being the first to demonstrate superior CV outcomes compared with placebo. PMID:27432074

  13. Nursing Practice Environment and Outcomes for Oncology Nursing

    PubMed Central

    Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

    2012-01-01

    Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

  14. Regulating Debilitating Emotions in the Context of Performance: Achievement Goal Orientations, Achievement-Elicited Emotions, and Socialization Contexts

    ERIC Educational Resources Information Center

    Tyson, Diana F.; Linnenbrink-Garcia, Lisa; Hill, Nancy E.

    2009-01-01

    A theoretical framework that incorporates emotional responses and emotion regulation into achievement goal theory is proposed as an alternative view to understanding the inconsistent pattern of findings linking achievement goal orientations to academic outcomes. In this critical review and synthesis, the relation of achievement goal orientations…

  15. Achieving Developmental Synchrony in Young Children With Hearing Loss

    PubMed Central

    Mellon, Nancy K.; Ouellette, Meredith; Greer, Tracy; Gates-Ulanet, Patricia

    2009-01-01

    Children with hearing loss, with early and appropriate amplification and intervention, demonstrate gains in speech, language, and literacy skills. Despite these improvements many children continue to exhibit disturbances in cognitive, behavioral, and emotional control, self-regulation, and aspects of executive function. Given the complexity of developmental learning, educational settings should provide services that foster the growth of skills across multiple dimensions. Transdisciplinary intervention services that target the domains of language, communication, psychosocial functioning, motor, and cognitive development can promote academic and social success. Educational programs must provide children with access to the full range of basic skills necessary for academic and social achievement. In addition to an integrated curriculum that nurtures speech, language, and literacy development, innovations in the areas of auditory perception, social emotional learning, motor development, and vestibular function can enhance student outcomes. Through ongoing evaluation and modification, clearly articulated curricular approaches can serve as a model for early intervention and special education programs. The purpose of this article is to propose an intervention model that combines best practices from a variety of disciplines that affect developmental outcomes for young children with hearing loss, along with specific strategies and approaches that may help to promote optimal development across domains. Access to typically developing peers who model age-appropriate skills in language and behavior, small class sizes, a co-teaching model, and a social constructivist perspective of teaching and learning, are among the key elements of the model. PMID:20150187

  16. Heritability of Creative Achievement

    ERIC Educational Resources Information Center

    Piffer, Davide; Hur, Yoon-Mi

    2014-01-01

    Although creative achievement is a subject of much attention to lay people, the origin of individual differences in creative accomplishments remain poorly understood. This study examined genetic and environmental influences on creative achievement in an adult sample of 338 twins (mean age = 26.3 years; SD = 6.6 years). Twins completed the Creative…

  17. Confronting the Achievement Gap

    ERIC Educational Resources Information Center

    Gardner, David

    2007-01-01

    This article talks about the large achievement gap between children of color and their white peers. The reasons for the achievement gap are varied. First, many urban minorities come from a background of poverty. One of the detrimental effects of growing up in poverty is receiving inadequate nourishment at a time when bodies and brains are rapidly…

  18. States Address Achievement Gaps.

    ERIC Educational Resources Information Center

    Christie, Kathy

    2002-01-01

    Summarizes 2 state initiatives to address the achievement gap: North Carolina's report by the Advisory Commission on Raising Achievement and Closing Gaps, containing an 11-point strategy, and Kentucky's legislation putting in place 10 specific processes. The North Carolina report is available at www.dpi.state.nc.us.closingthegap; Kentucky's…

  19. Wechsler Individual Achievement Test.

    ERIC Educational Resources Information Center

    Taylor, Ronald L.

    1999-01-01

    This article describes the Wechsler Individual Achievement Test, a comprehensive measure of achievement for individuals in grades K-12. Eight subtests assess mathematics reasoning, spelling, reading comprehension, numerical operations, listening comprehension, oral expression, and written expression. Its administration, standardization,…

  20. Inverting the Achievement Pyramid

    ERIC Educational Resources Information Center

    White-Hood, Marian; Shindel, Melissa

    2006-01-01

    Attempting to invert the pyramid to improve student achievement and increase all students' chances for success is not a new endeavor. For decades, educators have strategized, formed think tanks, and developed school improvement teams to find better ways to improve the achievement of all students. Currently, the No Child Left Behind Act (NCLB) is…

  1. Achievement Test Program.

    ERIC Educational Resources Information Center

    Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

    The Ohio Trade and Industrial Education Achievement Test battery is comprised of seven basic achievement tests: Machine Trades, Automotive Mechanics, Basic Electricity, Basic Electronics, Mechanical Drafting, Printing, and Sheet Metal. The tests were developed by subject matter committees and specialists in testing and research. The Ohio Trade and…

  2. General Achievement Trends: Maryland

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  3. General Achievement Trends: Arkansas

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  4. General Achievement Trends: Idaho

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  5. General Achievement Trends: Nebraska

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  6. General Achievement Trends: Colorado

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  7. General Achievement Trends: Iowa

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  8. General Achievement Trends: Hawaii

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  9. General Achievement Trends: Kentucky

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  10. General Achievement Trends: Florida

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  11. General Achievement Trends: Texas

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  12. General Achievement Trends: Oregon

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  13. General Achievement Trends: Virginia

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  14. Honoring Student Achievement

    ERIC Educational Resources Information Center

    Education Digest: Essential Readings Condensed for Quick Review, 2004

    2004-01-01

    Is the concept of "honor roll" obsolete? The honor roll has always been a way for schools to recognize the academic achievement of their students. But does it motivate students? In this article, several elementary school principals share their views about honoring student achievement. Among others, Virginia principal Nancy Moga said that students…

  15. Aiming at Achievement.

    ERIC Educational Resources Information Center

    Martinez, Paul

    The Raising Quality and Achievement Program is a 3-year initiative to support further education (FE) colleges in the United Kingdom in their drive to improve students' achievement and the quality of provision. The program offers the following: (1) quality information and advice; (2) onsite support for individual colleges; (3) help with…

  16. Achieving Perspective Transformation.

    ERIC Educational Resources Information Center

    Nowak, Jens

    Perspective transformation is a consciously achieved state in which the individual's perspective on life is transformed. The new perspective serves as a vantage point for life's actions and interactions, affecting the way life is lived. Three conditions are basic to achieving perspective transformation: (1) "feeling" experience, i.e., getting in…

  17. Achieving Public Schools

    ERIC Educational Resources Information Center

    Abowitz, Kathleen Knight

    2011-01-01

    Public schools are functionally provided through structural arrangements such as government funding, but public schools are achieved in substance, in part, through local governance. In this essay, Kathleen Knight Abowitz explains the bifocal nature of achieving public schools; that is, that schools are both subject to the unitary Public compact of…

  18. General Achievement Trends: Tennessee

    ERIC Educational Resources Information Center

    Center on Education Policy, 2009

    2009-01-01

    This general achievement trends profile includes information that the Center on Education Policy (CEP) and the Human Resources Research Organization (HumRRO) obtained from states from fall 2008 through April 2009. Included herein are: (1) Bullet points summarizing key findings about achievement trends in that state at three performance…

  19. Achievement-Based Resourcing.

    ERIC Educational Resources Information Center

    Fletcher, Mike; And Others

    1992-01-01

    This collection of seven articles examines achievement-based resourcing (ABR), the concept that the funding of educational institutions should be linked to their success in promoting student achievement, with a focus on the application of ABR to postsecondary education in the United Kingdom. The articles include: (1) "Introduction" (Mick…

  20. Social outcomes in the Childhood Cancer Survivor Study cohort.

    PubMed

    Gurney, James G; Krull, Kevin R; Kadan-Lottick, Nina; Nicholson, H Stacy; Nathan, Paul C; Zebrack, Brad; Tersak, Jean M; Ness, Kirsten K

    2009-05-10

    Difficulties with negotiating and achieving desired social outcomes in life may be exacerbated by the experience of childhood cancer, including adverse effects from therapies used to achieve a cure. This review of previous publications from the Childhood Cancer Survivor Study (CCSS) and other relevant literature provides insight into the prevalence of, and risk factors for, poor educational attainment, less than optimal employment status, and interpersonal relationship issues among long-term survivors of childhood cancer. The impacts of emotional health and physical disability on social outcomes are also examined. Study results suggest that childhood cancer survivors generally have similar high school graduation rates, but are more likely to require special education services than sibling comparison groups. Survivors are slightly less likely than expected to attend college, and are more likely to be unemployed and not married as young adults. Cancers and treatments that result in impairment to the CNS, particularly brain tumors, or that impact sensory functioning, such as hearing loss, are associated with greater risk for undesirable social outcomes, as are emotional health problems and physical disability. This review of relevant data from CCSS and other studies provides information on risk factors for social problems into adulthood. A greater understanding of the long-term social impacts from the diagnosis and treatment of childhood cancer is critically important for developing targeted interventions to prevent or ameliorate adverse psychosocial effects. PMID:19224833

  1. Optimization in Bilingual Language Use

    ERIC Educational Resources Information Center

    Bhatt, Rakesh M.

    2013-01-01

    Pieter Muysken's keynote paper, "Language contact outcomes as a result of bilingual optimization strategies", undertakes an ambitious project to theoretically unify different empirical outcomes of language contact, for instance, SLA, pidgins and Creoles, and code-switching. Muysken has dedicated a life-time to researching, rather…

  2. Using Quality of Life to Evaluate Outcomes and Measure Effectiveness

    ERIC Educational Resources Information Center

    Kober, Ralph; Eggleton, Ian R. C.

    2009-01-01

    Evaluating the outcomes achieved by service providers who assist people with intellectual disabilities is extremely important in terms of ascertaining whether service providers achieve their goals. Furthermore, knowledge of the outcomes achieved by service providers better equips those charged with managing them to make strategic decisions to…

  3. Student Outcomes: Annual Summary Report.

    ERIC Educational Resources Information Center

    Prince George's Community Coll., Largo, MD. Office of Institutional Research.

    Each year a study is conducted at Prince George's Community College (PGCC) to update student outcomes data using quantifiable measures of student achievement. Data for the 1989 study were obtained from the college's student information system, the University of Maryland (UM) system, and surveys of all 825 fiscal year 1988 graduates and 118 of…

  4. Prospects: Student Outcomes. Final Report.

    ERIC Educational Resources Information Center

    Puma, Michael J.; Karweit, Nancy; Price, Cristofer; Ricciuti, Anne; Thompson, William; Vaden-Kiernan, Michael

    This report is one of a series presenting findings from "Prospects: The Congressionally Mandated Study of Educational Growth and Opportunity." This study, conducted in response to the 1988 Hawkins-Stafford Amendments, was a major effort to examine the effects of Chapter 1 on student achievement and other school-related educational outcomes. Data…

  5. Issues impacting therapeutic outcomes in pediatric patients: an overview.

    PubMed

    Kalra, Atin; Goindi, Shishu

    2014-01-01

    The quest for achieving optimal therapeutic outcomes in pediatric patients has evaded the healthcare professionals for long and often lack of child specific dosage forms and the associated events that follow with it have been considered to be major contributor towards suboptimal outcomes. Consequently, there have been sustained efforts over the years to address this issue with the enactment of legislations like Best Pharmaceutical for Children Act (BPCA), Pediatric Research Equity Act (PREA) and Pediatric Regulation by European Union (EU) to incentivise the participation of pharmaceutical industry towards development of child friendly dosage forms. Initiatives taken in past by organisations like World Health Organisation (WHO) and Drugs for Neglected Diseases Initiative (DNDi) to spur the development of child friendly dosage forms has helped to address issues pertaining to management of Human Immunodeficiency Virus (HIV) and malaria in pediatric patients. Present efforts aimed at developing child friendly dosage forms include oro-dispersible platforms including thin films and mini-tablets. Despite these leaps and advancements in developing better dosage forms for children, lower therapeutic outcomes in pediatric patients continue to remain an unresolved issue because of detrimental effects of additional factors such as parents understanding of label instructions and complexities involved in executing pediatric clinical studies thus requiring a concerted effort from pharmaceutical companies, academic researchers, parents and healthcare providers to work for better treatment outcomes in children. PMID:25088338

  6. [Achievement of therapeutic objectives].

    PubMed

    Mantilla, Teresa

    2014-07-01

    Therapeutic objectives for patients with atherogenic dyslipidemia are achieved by improving patient compliance and adherence. Clinical practice guidelines address the importance of treatment compliance for achieving objectives. The combination of a fixed dose of pravastatin and fenofibrate increases the adherence by simplifying the drug regimen and reducing the number of daily doses. The good tolerance, the cost of the combination and the possibility of adjusting the administration to the patient's lifestyle helps achieve the objectives for these patients with high cardiovascular risk. PMID:25043543

  7. Burns: Treatment and Outcomes

    PubMed Central

    Burd, Andrew

    2010-01-01

    Burns can cause extensive and devastating injuries of the head and neck. Prevention of the initial injury must always be a priority, but once an injury has occurred, then prevention of progression of the damage together with survival of the patient must be the immediate goals. The acute care will have a major influence on the subsequent scarring, reconstructive need, and long-term outcome. In the majority of cases, the reconstruction will involve restoration of form and function to the soft tissues, and the methods used will depend very much on the extent of scarring locally and elsewhere in the body. In nearly all cases, a significant improvement in functional and aesthetic outcomes can be achieved, which, in conjunction with intensive psychosocial rehabilitation, can lead to high-quality patient outcomes. With the prospect of facial transplantation being a clinical reality, the reconstructive spectrum has opened up even further, and, with appropriate reconstruction and support, no patient should be left economically deprived or socially isolated after a burn injury. PMID:22550448

  8. Predicting Achievement and Motivation.

    ERIC Educational Resources Information Center

    Uguroglu, Margaret; Walberg, Herbert J.

    1986-01-01

    Motivation and nine other factors were measured for 970 students in grades five through eight in a study of factors predicting achievement and predicting motivation. Results are discussed. (Author/MT)

  9. Attractiveness and School Achievement

    ERIC Educational Resources Information Center

    Salvia, John; And Others

    1977-01-01

    The purpose of this study was to ascertain the relationship between rated attractiveness and two measures of school performance. Attractive children received significantly higher report cards and, to some degree, higher achievement test scores than their unattractive peers. (Author)

  10. Student Achievement and Motivation

    ERIC Educational Resources Information Center

    Flammer, Gordon H.; Mecham, Robert C.

    1974-01-01

    Compares the lecture and self-paced methods of instruction on the basis of student motivation and achieveme nt, comparing motivating and demotivating factors in each, and their potential for motivation and achievement. (Authors/JR)

  11. Childhood Maltreatment and Educational Outcomes.

    PubMed

    Romano, Elisa; Babchishin, Lyzon; Marquis, Robyn; Fréchette, Sabrina

    2015-10-01

    Children (0-18 years) with maltreatment histories are vulnerable to experiencing difficulties across multiple domains of functioning, including educational outcomes that encompass not only academic achievement but also mental well-being. The current literature review adopted Slade and Wissow's model to examine (1) the link between childhood maltreatment and academic achievement, (2) the link between childhood maltreatment and mental health outcomes (i.e., emotional and behavioral difficulties), and (3) the bidirectional relationship between childhood academic achievement and mental health. In addition, we reviewed variables that might influence or help explain the link between childhood maltreatment and educational outcomes, drawing on developmental perspectives and Bronfenbrenner's ecological model. Finally, whenever possible, we presented findings specific to maltreated children in out-of-home care to highlight the unique challenges experienced by this population. Results indicated that children with maltreatment histories often experience impairments in both their academic performance (e.g., special education, grade retention, lower grades) and mental well-being (e.g., anxiety, low mood, aggression, social skills deficits, poor interpersonal relationships). These impairments appeared to be particularly pronounced among maltreated children in out-of-home care. Findings, albeit sparse, also indicated that mental health difficulties are negatively associated with children's academic achievement and, similarly, that academic achievement deficits are linked with mental health problems. The link between childhood maltreatment and educational outcomes may be partly explained through the disruption of key developmental processes in children, such as attachment, emotion regulation, and sense of agency. As well, maltreatment characteristics and the functioning of various systems in which children are embedded (e.g., family, school, child welfare) can serve to positively

  12. Evaluating stakeholder participation in water management: intermediary outcomes as potential indicators for future resource management outcomes

    NASA Astrophysics Data System (ADS)

    Carr, Gemma; Bloeschl, Guenter; Loucks, Daniel Pete

    2013-04-01

    Evaluation of participation programmes, projects and activities is essential to identify whether stakeholder involvement has been successful in achieving its aims. Aims may include an improvement in water resource management such as enhanced ecological functioning, an improvement in human wellbeing and economic conditions, or overcoming a conflict between interest groups. Evaluating against "interest-based" resource management criteria requires that a desirable outcome can be identified, agreed upon and be measured at the time of evaluation. In many water management situations where collaborative approaches are applied, multiple interests and objectives are present, or stakeholders have not yet identified their own positions and priorities. Even if a resource management objective has been identified and strategy agreed upon, resource management changes tend to emerge over longer timescales and evaluation frequently takes place before they can be recognised. Evaluating against resource management criteria may lead evaluators to conclude that a programme has failed because it has not achieved a resource management objective at the time of evaluation. This presents a critical challenge to researchers assessing the effectiveness of stakeholder participation programmes. One strategy to overcome this is to conduct "goal-free" evaluation to identify what the programme is actually achieving. An evaluation framework that includes intermediary outcomes that are both tangible achievements such as innovation, creation of new organisations, and shared information and knowledge, as well as intangible achievements such as trust and network development can be applied to more broadly assess a programme's success. Analysis of case-studies in the published literature for which a resource management outcome has been achieved shows that intermediary outcomes frequently precede resource management outcomes. They seem to emerge over shorter timescales than resource management outcomes

  13. Cardiotocography in the Prognosis of Perinatal Outcome

    PubMed Central

    Bogdanovic, Gordana; Babovic, Adnan; Rizvanovic, Mirzeta; Ljuca, Dzenita; Grgic, Gordana; Djuranovic–Milicic, Jadranaka

    2014-01-01

    ABSTRACT Aim: The objective of the study was to examine whether cardiotocography can (CTG) predict asphyxia of the embryo, manifested as hypoxic-ischemic encephalopathy (HIE), and to what extent one can rely on CTG record. Material and methods: Retrospective research was carried out at the Clinic for Gynecology and Obstetrics UKC Tuzla and medical documentation from the history of mothers and newborns was used. The study group consisted of 68 pregnancies and newborns who developed HIE. The control group consisted of 40 pregnancies, which resulted in birth of healthy newborns – without signs of asphyxia. CTG records were analyzed, Apgar score, the ways of finishing delivery. Results: Pathological CTG records (bradycardia 100, tachycardia 180, silent type of curve, late decelerations) were found in 45 (66,17%) cases of the study group in comparison to 11 (27,5%) in the control group. In the study group Apgar score in 5th minute lower than 7 had 17,46% newborns and the highest incidence of the normally finished deliveries. We conclude that cardiotocography is one of the reliable methods of fetal monitoring in pregnancy and delivery, and that pathological CTG record very likely indicates the possible presence of perinatal asphyxia. Conclusion: Achieving a low degree of correlation between pathological intrapartum cardiotocography findings and long-term outcome of children can be achieved by rapid and adequate obstetric intervention and the relatively short duration of fetal acidosis, and optimal procedures during intensive care of newborns. PMID:24937932

  14. Imidazolopiperazines: Lead Optimization of the Second-Generation Antimalarial Agents

    PubMed Central

    2012-01-01

    On the basis of the initial success of optimization of a novel series of imidazolopiperazines, a second generation of compounds involving changes in the core piperazine ring was synthesized to improve antimalarial properties. These changes were carried out to further improve the potency and metabolic stability of the compounds by leveraging the outcome of a set of in vitro metabolic identification studies. The optimized 8,8-dimethyl imidazolopiperazine analogues exhibited improved potency, in vitro metabolic stability profile and, as a result, enhanced oral exposure in vivo in mice. The optimized compounds were found to be more efficacious than the current antimalarials in a malaria mouse model. They exhibit moderate oral exposure in rat pharmacokinetic studies to achieve sufficient multiples of the oral exposure at the efficacious dose in toxicology studies. PMID:22524250

  15. 34 CFR 361.56 - Requirements for closing the record of services of an individual who has achieved an employment...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... individual who has achieved an employment outcome. 361.56 Section 361.56 Education Regulations of the Offices... closing the record of services of an individual who has achieved an employment outcome. The record of services of an individual who has achieved an employment outcome may be closed only if all of the...

  16. Implications of Student Health Problems on Achievement and Engagement

    ERIC Educational Resources Information Center

    La Salle, Tamika P.; Hagermoser Sanetti, Lisa M.

    2016-01-01

    Healthy students are better learners. Establishing positive school climates where students are healthy, engaged, and prepared to learn is a critical component in increasing student engagement and closing the achievement gap. As such, educators need to be aware of the impact of education-related outcomes on student outcomes and schools' ability to…

  17. Competency Outcomes for Learning and Performance Assessment. Redesigning a BSN Curriculum.

    ERIC Educational Resources Information Center

    Luttrell, Marjorie F.; Lenburg, Carrie B.; Scherubel, Janet C.; Jacob, Susan R.; Koch, Robert W.

    1999-01-01

    A baccalaureate nursing curriculum was redesigned around eight core competencies with measurable indicators for each performance-based competency outcome. Effective learning strategies to achieve outcomes and methods to document achievement were also outlined. (SK)

  18. Associations of Future Expectations, Negative Friends, and Academic Achievement in High-Achieving African American Adolescents

    ERIC Educational Resources Information Center

    Cunningham, Michael; Corprew, Charles S., III; Becker, Jonathan E.

    2009-01-01

    The relations of future expectations (general and academic) to academic outcomes were examined in a sample of 129 African American high-achieving adolescents (majority female participants, n = 92). This study was interested in the multidimensional nature of future expectations. Results from the study confirm the hypothesis that academic future…

  19. Achieving yield gains in wheat.

    PubMed

    Reynolds, Matthew; Foulkes, John; Furbank, Robert; Griffiths, Simon; King, Julie; Murchie, Erik; Parry, Martin; Slafer, Gustavo

    2012-10-01

    Wheat provides 20% of calories and protein consumed by humans. Recent genetic gains are <1% per annum (p.a.), insufficient to meet future demand. The Wheat Yield Consortium brings expertise in photosynthesis, crop adaptation and genetics to a common breeding platform. Theory suggest radiation use efficiency (RUE) of wheat could be increased ~50%; strategies include modifying specificity, catalytic rate and regulation of Rubisco, up-regulating Calvin cycle enzymes, introducing chloroplast CO(2) concentrating mechanisms, optimizing light and N distribution of canopies while minimizing photoinhibition, and increasing spike photosynthesis. Maximum yield expression will also require dynamic optimization of source: sink so that dry matter partitioning to reproductive structures is not at the cost of the roots, stems and leaves needed to maintain physiological and structural integrity. Crop development should favour spike fertility to maximize harvest index so phenology must be tailored to different photoperiods, and sensitivity to unpredictable weather must be modulated to reduce conservative responses that reduce harvest index. Strategic crossing of complementary physiological traits will be augmented with wide crossing, while genome-wide selection and high throughput phenotyping and genotyping will increase efficiency of progeny screening. To ensure investment in breeding achieves agronomic impact, sustainable crop management must also be promoted through crop improvement networks. PMID:22860982

  20. Project Achieve, 1990-91. Part I.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Research, Evaluation, and Assessment.

    First-year outcomes of the 1990-91 Project Achieve in 32 New York City public high schools are presented in this paper. The program aimed to reduce the dropout rate and improve at-risk student performance by expanding proven initiatives and support services for school-based decision-making committees. This report, the first of a two-part study,…

  1. Heart to Heart: Using Heart Rate Telemetry to Meet Physical Education Outcomes.

    ERIC Educational Resources Information Center

    Deal, Tami Benham; Deal, Laurence O.

    1995-01-01

    Presents a foundation for establishing measurable physical education outcomes, demonstrating how heart rate telemetry can help measure and achieve such outcomes. After explaining heart rate telemetry function, the article examines student and teacher outcomes that could be included in school physical education outcomes and achieved using heart…

  2. Replantation: current concepts and outcomes.

    PubMed

    Bueno, Reuben A; Battiston, Bruno; Ciclamini, Davide; Titolo, Paolo; Panero, Bernardino; Tos, Pierluigi

    2014-07-01

    Techniques to improve the chance of successful replantation of digits are well established. Indications and contraindications for replantation are generally agreed on, but they continue to evolve as excellent outcomes are achieved at centers with experience and expertise. Form and function can be restored with avulsion injuries and distal amputations, with good results and high patient satisfaction. Increased financial pressure to control the costs of health care and increased accountability for evidence-based outcomes may lead to the regionalization of replantation care and shared decision making in recommending replantation or revision amputation. PMID:24996460

  3. CEBAF accelerator achievements

    SciTech Connect

    Y.C. Chao, M. Drury, C. Hovater, A. Hutton, G.A. Krafft, M. Poelker, C. Reece, M. Tiefenback

    2011-06-01

    In the past decade, nuclear physics users of Jefferson Lab's Continuous Electron Beam Accelerator Facility (CEBAF) have benefited from accelerator physics advances and machine improvements. As of early 2011, CEBAF operates routinely at 6 GeV, with a 12 GeV upgrade underway. This article reports highlights of CEBAF's scientific and technological evolution in the areas of cryomodule refurbishment, RF control, polarized source development, beam transport for parity experiments, magnets and hysteresis handling, beam breakup, and helium refrigerator operational optimization.

  4. 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.

  5. Explorations in achievement motivation

    NASA Technical Reports Server (NTRS)

    Helmreich, Robert L.

    1982-01-01

    Recent research on the nature of achievement motivation is reviewed. A three-factor model of intrinsic motives is presented and related to various criteria of performance, job satisfaction and leisure activities. The relationships between intrinsic and extrinsic motives are discussed. Needed areas for future research are described.

  6. Achieving health care affordability.

    PubMed

    Payson, Norman C

    2002-10-01

    Not all plans are jumping headlong into the consumer-centric arena. In this article, the CEO of Oxford Health Plans discusses how advanced managed care can achieve what other consumer-centric programs seek to do--provide affordable, quality health care. PMID:12391815

  7. Issues in Achievement Testing.

    ERIC Educational Resources Information Center

    Baker, Eva L.

    This booklet is intended to help school personnel, parents, students, and members of the community understand concepts and research relating to achievement testing in public schools. The paper's sections include: (1) test use with direct effects on students (test of certification, selection, and placement); (2) test use with indirect effects on…

  8. Achieving Peace through Education.

    ERIC Educational Resources Information Center

    Clarken, Rodney H.

    While it is generally agreed that peace is desirable, there are barriers to achieving a peaceful world. These barriers are classified into three major areas: (1) an erroneous view of human nature; (2) injustice; and (3) fear of world unity. In a discussion of these barriers, it is noted that although the consciousness and conscience of the world…

  9. Achieving All Our Ambitions

    ERIC Educational Resources Information Center

    Hartley, Tricia

    2009-01-01

    National learning and skills policy aims both to build economic prosperity and to achieve social justice. Participation in higher education (HE) has the potential to contribute substantially to both aims. That is why the Campaign for Learning has supported the ambition to increase the proportion of the working-age population with a Level 4…

  10. Intelligence and Educational Achievement

    ERIC Educational Resources Information Center

    Deary, Ian J.; Strand, Steve; Smith, Pauline; Fernandes, Cres

    2007-01-01

    This 5-year prospective longitudinal study of 70,000+ English children examined the association between psychometric intelligence at age 11 years and educational achievement in national examinations in 25 academic subjects at age 16. The correlation between a latent intelligence trait (Spearman's "g"from CAT2E) and a latent trait of educational…

  11. SALT and Spelling Achievement.

    ERIC Educational Resources Information Center

    Nelson, Joan

    A study investigated the effects of suggestopedic accelerative learning and teaching (SALT) on the spelling achievement, attitudes toward school, and memory skills of fourth-grade students. Subjects were 20 male and 28 female students from two self-contained classrooms at Kennedy Elementary School in Rexburg, Idaho. The control classroom and the…

  12. NCLB: Achievement Robin Hood?

    ERIC Educational Resources Information Center

    Bracey, Gerald W.

    2008-01-01

    In his "Wall Street Journal" op-ed on the 25th of anniversary of "A Nation At Risk", former assistant secretary of education Chester E. Finn Jr. applauded the report for turning U.S. education away from equality and toward achievement. It was not surprising, then, that in mid-2008, Finn arranged a conference to examine the potential "Robin Hood…

  13. INTELLIGENCE, PERSONALITY AND ACHIEVEMENT.

    ERIC Educational Resources Information Center

    MUIR, R.C.; AND OTHERS

    A LONGITUDINAL DEVELOPMENTAL STUDY OF A GROUP OF MIDDLE CLASS CHILDREN IS DESCRIBED, WITH EMPHASIS ON A SEGMENT OF THE RESEARCH INVESTIGATING THE RELATIONSHIP OF ACHIEVEMENT, INTELLIGENCE, AND EMOTIONAL DISTURBANCE. THE SUBJECTS WERE 105 CHILDREN AGED FIVE TO 6.3 ATTENDING TWO SCHOOLS IN MONTREAL. EACH CHILD WAS ASSESSED IN THE AREAS OF…

  14. School Students' Science Achievement

    ERIC Educational Resources Information Center

    Shymansky, James; Wang, Tzu-Ling; Annetta, Leonard; Everett, Susan; Yore, Larry D.

    2013-01-01

    This paper is a report of the impact of an externally funded, multiyear systemic reform project on students' science achievement on a modified version of the Third International Mathematics and Science Study (TIMSS) test in 33 small, rural school districts in two Midwest states. The systemic reform effort utilized a cascading leadership strategy…

  15. Advancing Student Achievement

    ERIC Educational Resources Information Center

    Walberg, Herbert J.

    2010-01-01

    For the last half century, higher spending and many modern reforms have failed to raise the achievement of students in the United States to the levels of other economically advanced countries. A possible explanation, says Herbert Walberg, is that much current education theory is ill informed about scientific psychology, often drawing on fads and…

  16. Increasing Male Academic Achievement

    ERIC Educational Resources Information Center

    Jackson, Barbara Talbert

    2008-01-01

    The No Child Left Behind legislation has brought greater attention to the academic performance of American youth. Its emphasis on student achievement requires a closer analysis of assessment data by school districts. To address the findings, educators must seek strategies to remedy failing results. In a mid-Atlantic district of the Unites States,…

  17. Setting and Achieving Objectives.

    ERIC Educational Resources Information Center

    Knoop, Robert

    1986-01-01

    Provides basic guidelines which school officials and school boards may find helpful in negotiating, establishing, and managing objectives. Discusses characteristics of good objectives, specific and directional objectives, multiple objectives, participation in setting objectives, feedback on goal process and achievement, and managing a school…

  18. Schools Achieving Gender Equity.

    ERIC Educational Resources Information Center

    Revis, Emma

    This guide is designed to assist teachers presenting the Schools Achieving Gender Equity (SAGE) curriculum for vocational education students, which was developed to align gender equity concepts with the Kentucky Education Reform Act (KERA). Included in the guide are lesson plans for classes on the following topics: legal issues of gender equity,…

  19. Iowa Women of Achievement.

    ERIC Educational Resources Information Center

    Ohrn, Deborah Gore, Ed.

    1993-01-01

    This issue of the Goldfinch highlights some of Iowa's 20th century women of achievement. These women have devoted their lives to working for human rights, education, equality, and individual rights. They come from the worlds of politics, art, music, education, sports, business, entertainment, and social work. They represent Native Americans,…

  20. Achievements or Disasters?

    ERIC Educational Resources Information Center

    Goodwin, MacArthur

    2000-01-01

    Focuses on policy issues that have affected arts education in the twentieth century, such as: interest in discipline-based arts education, influence of national arts associations, and national standards and coordinated assessment. States that whether the policy decisions are viewed as achievements or disasters are for future determination. (CMK)

  1. The "Strategies-for-Achievement" Approach for Teaching Study Skills.

    ERIC Educational Resources Information Center

    Tuckman, Bruce W.

    An educational psychology-based study skills program called Strategies for Achievement was developed to teach learning and motivation strategies to college students. It involved teaching student four major achievement strategies: take reasonable risk, take responsibility for outcomes, search the environment (for information), and use feedback.…

  2. Cultural Identification and Academic Achievement among African American Males

    ERIC Educational Resources Information Center

    Irving, Miles Anthony; Hudley, Cynthia

    2008-01-01

    This study investigated the relationship between intercultural perceptions, identity, and academic achievement among African American males. Specifically, this study investigated the relationship of academic achievement, cultural mistrust, oppositional cultural attitudes, ethnic identity development and educational outcome expectations and value,…

  3. Closing Achievement Gaps: Revisiting Benjamin S. Bloom's "Learning for Mastery"

    ERIC Educational Resources Information Center

    Guskey, Thomas R.

    2007-01-01

    The problem of achievement gaps among different subgroups of students has been evident in education for many years. This manuscript revisits the work of renowned educator Benjamin S. Bloom, who saw reducing gaps in the achievement of various groups of students as a simple problem of reducing variation in student learning outcomes. Bloom observed…

  4. The Hispanic-Asian Achievement Gap in Elementary School

    ERIC Educational Resources Information Center

    Martinez, Lina Maria

    2012-01-01

    There is little research of Hispanic and Asian children's educational outcomes; in particular, the achievement gap between these two racial/ethnic groups has not been fully explored. The objective of this investigation is to analyze the Hispanic-Asian achievement gap in elementary school using the ECLS-K, a longitudinal nationally…

  5. Narrowing the Achievement Gap: Perspectives and Strategies for Challenging Times

    ERIC Educational Resources Information Center

    Timar, Thomas B., Ed.; Maxwell-Jolly, Julie, Ed.

    2012-01-01

    This timely and thoughtful book provides multiple perspectives on closing achievement gaps. Closing persistent gaps in educational outcomes between different groups of students has been a central goal of educational policy for the past forty years. The commitment to close existing achievement gaps poses an unprecedented challenge to policy makers,…

  6. Achieving Goal Blood Pressure.

    PubMed

    Laurent, Stéphane

    2015-07-01

    Both monotherapy and combination therapy options are appropriate for antihypertensive therapy according to the 2013 European Society of Hypertension (ESH)/European Society of Cardiology (ESC) guidelines. Most patients require more than one agent to achieve blood pressure (BP) control, and adding a second agent is more effective than doubling the dose of existing therapy. The addition of a third agent may be required to achieve adequate BP reductions in some patients. Single-pill fixed-dose combinations (FDCs) allow multiple-drug regimens to be delivered without any negative impact on patient compliance or persistence with therapy. FDCs also have documented beneficial clinical effects and use of FDCs containing two or three agents is recommended by the 2013 ESH/ESC guidelines. PMID:26002423

  7. Optimization of evaporative cooling

    NASA Astrophysics Data System (ADS)

    Sackett, C. A.; Bradley, C. C.; Hulet, R. G.

    1997-05-01

    Recent experiments have used forced evaporative cooling to produce Bose-Einstein condensation in dilute gases. The evaporative cooling process can be optimized to provide the maximum phase-space density with a specified number of atoms remaining. We show that this global optimization is approximately achieved by locally optimizing the cooling efficiency at each instant. We discuss how this method can be implemented, and present the results for our 7Li trap. The predicted behavior of the gas is found to agree well with experiment.

  8. Integrated Arrival and Departure Schedule Optimization Under Uncertainty

    NASA Technical Reports Server (NTRS)

    Xue, Min; Zelinski, Shannon

    2014-01-01

    In terminal airspace, integrating arrivals and departures with shared waypoints provides the potential of improving operational efficiency by allowing direct routes when possible. Incorporating stochastic evaluation as a post-analysis process of deterministic optimization, and imposing a safety buffer in deterministic optimization, are two ways to learn and alleviate the impact of uncertainty and to avoid unexpected outcomes. This work presents a third and direct way to take uncertainty into consideration during the optimization. The impact of uncertainty was incorporated into cost evaluations when searching for the optimal solutions. The controller intervention count was computed using a heuristic model and served as another stochastic cost besides total delay. Costs under uncertainty were evaluated using Monte Carlo simulations. The Pareto fronts that contain a set of solutions were identified and the trade-off between delays and controller intervention count was shown. Solutions that shared similar delays but had different intervention counts were investigated. The results showed that optimization under uncertainty could identify compromise solutions on Pareto fonts, which is better than deterministic optimization with extra safety buffers. It helps decision-makers reduce controller intervention while achieving low delays.

  9. Denver airport pumping systems achieve optimal [Delta] T's

    SciTech Connect

    Mannion, G.F.; Krist, G.D. )

    1994-07-01

    This article describes how the pumping and generating systems at the new Denver Airport operate efficiently with the user loops in the buildings producing design temperature rise at all load levels. Fifteen miles east of Denver's Stapleton International Airport lies the newly completed Denver International Airport (DIA)--the world's largest and most high-tech airport. Besides being one of the largest construction projects in the works, it has many of the latest technical innovations available. Of particular interest to the HVAC industry is the design of the heating and cooling water systems. These systems provide environmental cooling and heating water to the three concourses, the airport office building, and the main terminal. The mechanical engineers for the project were all from the Denver area. The central plant design was the work of Behrent Engineering Co.; the three concourses were designed by Swanson-Rink Associates; and the main terminal and administrative office building were designed by Abeyta Engineering Consultants. The overall system concept was developed during the initial design phase by engineers from these firms, members of the DIA staff, and application engineers from several manufacturers.

  10. Earning the Stamp of Approval: How To Achieve Optimal Usability.

    ERIC Educational Resources Information Center

    Makar, Susan

    2003-01-01

    Describes the redesign of the Web site at the virtual library of the NIST (National Institute of Standards and Technology). Discusses usability problems with the original site, including navigation difficulties; focus groups to determine user needs; usability testing for the new Web site; and the importance of customer input. (LRW)

  11. Acute Outcomes after Introduction of a Standardized Clinical Assessment and Management Plan (SCAMP) for Balloon Aortic Valvuloplastyin Congenital Aortic Stenosis

    PubMed Central

    Porras, Diego; Brown, David W; Rathod, Rahul; Friedman, Kevin; Gauvreau, Kimberly; Lock, James E; Esch, Jesse J; Bergersen, Lisa; Marshall, Audrey C

    2014-01-01

    Introduction Standardization of care can reduce practice variation, optimize resource utilization and improve clinical outcomes. We have created a standardized clinical assessment and management plan (SCAMP) for patients having balloon aortic valvuloplasty (BAV) for congenital aortic stenosis (AS). This study compares acute outcomes of BAV at our institution before and after introduction of this SCAMP. Methods In this retrospective matched cohort study each SCAMP patient was matched to 4 historical controls. Outcomes were categorized based on the combination of residual AS and AR as: 1)Optimal: gradient ≤ 35 mmHg and trivial or no AR, 2)Adequate: gradient ≤ 35 mmHg and mild AR, 3)Inadequate: gradient > 35 mmHg and/or moderate or severe AR. Results All 23 SCAMP patients achieved a residual AS gradient ≤ 35 mmHg; the median residual AS gradient for the SCAMP group was lower (25 (10 – 35) mmHg) than in matched controls (30 (0 – 65) mmHg; p=0.005). The two groups did not differ with regard to degree of AR grade after BAV. Compared to controls, SCAMP patients were more likely to have an optimal result, and less likely to have an inadequate result (52% versus34% and 17% versus 45%, respectively; p=0.02) Conclusions A SCAMP for BAV resulted in optimal acute results in half of the initial 23 patients enrolled, and outcomes in this group were better than those of matched historical controls. Whether these improved acute outcomes translate into better long term outcomes for this patient population remains to be seen. PMID:24127834

  12. Partial compliance in schizophrenia and the impact on patient outcomes.

    PubMed

    Llorca, Pierre-Michel

    2008-11-30

    This review evaluates the impact of partial compliance on treatment outcomes in schizophrenia and discusses strategies that may be implemented to enhance compliance. As such, a search of English language articles evaluating compliance in schizophrenia was performed using Medline and EMBASE, with no time limits. Abstracts and posters presented at key psychiatry congresses were also reviewed. Results demonstrated that partial compliance with antipsychotic medication is a significant barrier to achieving optimal outcomes in schizophrenia. The problem increases with the duration of treatment, and is difficult to monitor. The impact of partial compliance is significant, leading to increases in psychotic symptoms, the risk of relapse and rehospitalization, and even suicide. Compliance is a complex phenomenon, influenced by aspects of the illness itself such as cognitive impairment and patients' health beliefs. The patient's environment and therapeutic alliance also influence medication compliance. Behavioural and pharmacological measures should be used together to improve compliance. While atypical antipsychotics have demonstrated improvements in psychotic symptoms, insight and cognition, these may not be enough to ensure compliance with oral daily medication. Long-acting risperidone may therefore bring together the benefits of the atypical antipsychotics with the long-acting injection delivery system required to build a platform for improved outcomes. PMID:18849080

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

    PubMed Central

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

    2014-01-01

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

  14. Achieving Magnet status.

    PubMed

    Ellis, Beckie; Gates, Judy

    2005-01-01

    Magnet has become the gold standard for nursing excellence. It is the symbol of effective and safe patient care. It evaluates components that inspire safe care, including employee satisfaction and retention, professional education, and effective interdisciplinary collaboration. In an organization whose mission focuses on excellent patient care, Banner Thunderbird Medical Center found that pursuing Magnet status was clearly the next step. In this article, we will discuss committee selection, education, team building, planning, and the discovery process that define the Magnet journey. The road to obtaining Magnet status has permitted many opportunities to celebrate our achievements. PMID:16056158

  15. Incorporating Learning Outcomes into an Introductory Geotechnical Engineering Course

    ERIC Educational Resources Information Center

    Fiegel, Gregg L.

    2013-01-01

    The article describes the process of incorporating a set of learning outcomes into a geotechnical engineering course. The outcomes were developed using Bloom's taxonomy and define the knowledge, skills, and abilities the students are expected to achieve upon completion of the course. Each outcome begins with an action-oriented verb corresponding…

  16. Making Sense of Bali: Unintended Outcomes of Study Abroad Programs

    ERIC Educational Resources Information Center

    Hill, Bob; Thomas, Noel

    2005-01-01

    Study abroad programmes for teacher education students are increasingly being evaluated to determine their effectiveness in achieving intended outcomes. There is a danger, however, that such evaluations will ignore valuable but unintended and serendipitous outcomes of such programmes. This paper investigates an example of such an outcome, the…

  17. Can Unpredicted Outcomes Be Intended? The Role of Outcome-Beliefs in Children's Judgments of Intention

    ERIC Educational Resources Information Center

    Liao, Yu; Li, Hong; Deak, Gedeon O.

    2011-01-01

    An adult-like concept of intention includes a deliberate action to achieve a goal and a belief that one's action (if successful) will cause the desired outcome. For example, good outcomes caused by accident or by chance are not believed to be caused intentionally. In two experiments, we asked whether children understand this connection between…

  18. Optimal refrigerator

    NASA Astrophysics Data System (ADS)

    Allahverdyan, Armen E.; Hovhannisyan, Karen; Mahler, Guenter

    2010-05-01

    We study a refrigerator model which consists of two n -level systems interacting via a pulsed external field. Each system couples to its own thermal bath at temperatures Th and Tc , respectively (θ≡Tc/Th<1) . The refrigerator functions in two steps: thermally isolated interaction between the systems driven by the external field and isothermal relaxation back to equilibrium. There is a complementarity between the power of heat transfer from the cold bath and the efficiency: the latter nullifies when the former is maximized and vice versa. A reasonable compromise is achieved by optimizing the product of the heat-power and efficiency over the Hamiltonian of the two systems. The efficiency is then found to be bounded from below by ζCA=(1)/(1-θ)-1 (an analog of the Curzon-Ahlborn efficiency), besides being bound from above by the Carnot efficiency ζC=(1)/(1-θ)-1 . The lower bound is reached in the equilibrium limit θ→1 . The Carnot bound is reached (for a finite power and a finite amount of heat transferred per cycle) for lnn≫1 . If the above maximization is constrained by assuming homogeneous energy spectra for both systems, the efficiency is bounded from above by ζCA and converges to it for n≫1 .

  19. Optimal refrigerator.

    PubMed

    Allahverdyan, Armen E; Hovhannisyan, Karen; Mahler, Guenter

    2010-05-01

    We study a refrigerator model which consists of two n -level systems interacting via a pulsed external field. Each system couples to its own thermal bath at temperatures T h and T c, respectively (θ ≡ T c/T h < 1). The refrigerator functions in two steps: thermally isolated interaction between the systems driven by the external field and isothermal relaxation back to equilibrium. There is a complementarity between the power of heat transfer from the cold bath and the efficiency: the latter nullifies when the former is maximized and vice versa. A reasonable compromise is achieved by optimizing the product of the heat-power and efficiency over the Hamiltonian of the two systems. The efficiency is then found to be bounded from below by [formula: see text] (an analog of the Curzon-Ahlborn efficiency), besides being bound from above by the Carnot efficiency [formula: see text]. The lower bound is reached in the equilibrium limit θ → 1. The Carnot bound is reached (for a finite power and a finite amount of heat transferred per cycle) for ln n > 1. If the above maximization is constrained by assuming homogeneous energy spectra for both systems, the efficiency is bounded from above by ζ CA and converges to it for n > 1. PMID:20866207

  20. SWITCHING NEURONAL STATE: OPTIMAL STIMULI REVEALED USING A STOCHASTICALLYSEEDED GRADIENT ALGORITHM

    PubMed Central

    Chang, Joshua; Paydarfar, David

    2014-01-01

    Inducing a switch in neuronal state using energy optimal stimuli is relevant to a variety of problems in neuroscience. Analytical techniques from optimal control theory can identify such stimuli; however, solutions to the optimization problem using indirect variational approaches can be elusive in models that describe neuronal behavior. Here we develop and apply a direct gradient-based optimization algorithm to find stimulus waveforms that elicit a change in neuronal state while minimizing energy usage. We analyze standard models of neuronal behavior, the Hodgkin-Huxley and FitzHugh-Nagumo models, to show that the gradient-based algorithm: 1) enables automated exploration of a wide solution space, using stochastically generated initial waveforms that converge to multiple locally optimal solutions; and 2) finds optimal stimulus waveforms that achieve a physiological outcome condition, without a priori knowledge of the optimal terminal condition of all state variables. Analysis of biological systems using stochastically-seeded gradient methods can reveal salient dynamical mechanisms underlying the optimal control of system behavior. The gradient algorithm may also have practical applications in future work, for example, finding energy optimal waveforms for therapeutic neural stimulation that minimizes power usage and diminishes off-target effects and damage to neighboring tissue. PMID:25145955