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Sample records for achieving optimal outcomes

  1. Using tailored methodical approaches to achieve optimal science outcomes

    NASA Astrophysics Data System (ADS)

    Wingate, Lory M.

    2016-08-01

    The science community is actively engaged in research, development, and construction of instrumentation projects that they anticipate will lead to new science discoveries. There appears to be very strong link between the quality of the activities used to complete these projects, and having a fully functioning science instrument that will facilitate these investigations.[2] The combination of using internationally recognized standards within the disciplines of project management (PM) and systems engineering (SE) has been demonstrated to lead to achievement of positive net effects and optimal project outcomes. Conversely, unstructured, poorly managed projects will lead to unpredictable, suboptimal project outcomes ultimately affecting the quality of the science that can be done with the new instruments. The proposed application of these two specific methodical approaches, implemented as a tailorable suite of processes, are presented in this paper. Project management (PM) is accepted worldwide as an effective methodology used to control project cost, schedule, and scope. Systems engineering (SE) is an accepted method that is used to ensure that the outcomes of a project match the intent of the stakeholders, or if they diverge, that the changes are understood, captured, and controlled. An appropriate application, or tailoring, of these disciplines can be the foundation upon which success in projects that support science can be optimized.

  2. Achieving optimal outcomes with all-zirconia crowns.

    PubMed

    Christensen, John Juel

    2014-01-01

    All-zirconia crowns are enjoying an unprecedented popularity. Dental laboratories are acquiring new equipment and adopting novel techniques, some of which require a learning curve. As a result, some crowns fabricated by computer-aided design/computer-aided manufacturing technology may come back to the dentist with unsatisfactory features. Dentists should carefully examine each crown under magnification prior to delivery to the patient. The dentist and dental laboratory should establish a close partnership with clear communication to yield the most favorable outcome for the patient.

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

    ERIC Educational Resources Information Center

    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…

  4. 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

  5. Language and Verbal Memory in Individuals with a History of Autism Spectrum Disorders Who Have Achieved Optimal Outcomes

    ERIC Educational Resources Information Center

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

    2014-01-01

    Some individuals who lose their autism spectrum disorder diagnosis may continue to display subtle weaknesses in language. We examined language and verbal memory in 44 individuals with high-functioning autism (HFA), 34 individuals with "optimal outcomes" (OO) and 34 individuals with typical development (TD). The OO group scored in the…

  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. Targeting treatment for optimal outcome.

    PubMed

    Husted, S E

    2000-01-01

    Rapid assessment of patients presenting with acute chest pain is essential, in order to distinguish between those who have a life-threatening condition, such as myocardial infarction or unstable angina, and the substantial proportion who do not have an acute coronary syndrome. It is thus of vital importance that reliable techniques are available to facilitate rapid risk stratification, as an aid to both clinical diagnosis and management strategy decisions. Assessments based on clinical findings, electrocardiographic monitoring, symptom-limited exercise testing, and biochemical marker measurements, used either singly or in various combinations, can fulfill this role. The present paper reviews some of the recent data that demonstrate the value of these techniques. Very few studies allow conclusions to be drawn about optimal treatment strategies in relation to groups stratified according to prognostic markers, and the question of whether intense medical treatment or early invasive intervention is most beneficial is one that clinical trials have yet to address adequately. In the recently completed Fragmin and Fast Revascularization during InStability in Coronary artery disease (FRISC II) study, comparisons were made of clinical outcomes achieved with early invasive versus noninvasive (i.e., medical) management strategies, and with short-term versus prolonged anticoagulation with dalteparin sodium (Fragmin), in patients with unstable coronary artery disease. All study participants underwent symptom-limited exercise testing and provided blood sample for measurements of biochemical markers; continuous electrocardiography monitoring and echocardiography were also performed in a high proportion of patients. Data from the FRISC II trial thus shed further light on the issue of risk stratification and its use to determine optimal treatment strategies.

  8. Low high-density lipoprotein cholesterol is a residual risk factor associated with long-term clinical outcomes in diabetic patients with stable coronary artery disease who achieve optimal control of low-density lipoprotein cholesterol.

    PubMed

    Ogita, Manabu; Miyauchi, Katsumi; Miyazaki, Tadashi; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Dohi, Tomotaka; Kasai, Takatoshi; Yokoyama, Takayuki; Okazaki, Shinya; Kurata, Takeshi; Daida, Hiroyuki

    2014-01-01

    Diabetes mellitus is recognized an independent risk factor for coronary artery disease (CAD) and mortality. Clinical trials have shown that statins significantly reduce cardiovascular events in diabetic patients. However, residual cardiovascular risk persists despite the achievement of target low-density lipoprotein cholesterol (LDL-C) levels with statin. High-density lipoprotein cholesterol (HDL-C) is an established coronary risk factor that is independent of LDL-C levels. We evaluated the impact of HDL-C on long-term mortality in diabetic patients with stable CAD who achieved optimal LDL-C. We enrolled 438 consecutive diabetic patients who were scheduled for percutaneous coronary intervention between 2004 and 2007 at our institution. We identified 165 patients who achieved target LDL-C <100 mg/dl. Patients were stratified into two groups according to HDL-C levels (low HDL-C group, baseline HDL-C <40 mg/dl; high HDL-C group, ≥40 mg/dl). Major adverse cardiac events (MACE) that included all-cause death, acute coronary syndrome, and target lesion revascularization were evaluated between the two groups. The median follow-up period was 946 days. The rate of MACE was significantly higher in diabetic patients with low-HDL-C who achieved optimal LDL-C (6.9 vs 17.9 %, log-rank P = 0.030). Multivariate Cox regression analysis showed that HDL-C is significantly associated with clinical outcomes (adjusted hazard ratio for MACE 1.33, 95 % confidence interval 1.01-1.75, P = 0.042). Low HDL-C is a residual risk factor that is significantly associated with long-term clinical outcomes among diabetic patients with stable CAD who achieve optimal LDL-C levels.

  9. Optimizing outcomes in bunion surgery.

    PubMed

    Haas, Zachary M

    2009-07-01

    The goal of fine-tuning bunion surgery is to optimize outcomes and prevent complications. This is accomplished through restoring anatomic alignment, imparting first ray stability, meticulous surgical technique, and accounting for other causes that may contribute to first ray instability. Despite various soft tissue and osseous surgical procedures along with anatomic variations of each patient, the principles of anatomic restoration and stability remain consistent. Maintenance of correction is predicated on the treatment of underlying pathology and the establishment of optimal stability and first ray alignment.

  10. Optimal nutrition for improved twin pregnancy outcome.

    PubMed

    Goodnight, William; Newman, Roger

    2009-11-01

    Twin pregnancies contribute a disproportionate degree to perinatal morbidity, partly because of increased risks of low birth weight and prematurity. Although the cause of the morbidity is multifactorial, attention to twin-specific maternal nutrition may be beneficial in achieving optimal fetal growth and birth weight. Achievement of body mass index (BMI)-specific weight gain goals, micronutrient and macronutrient supplementation specific to the physiology of twin gestations, and carbohydrate-controlled diets are recommended for optimal twin growth and pregnancy outcomes. The daily recommended caloric intake for normal-BMI women with twins is 40-45 kcal/kg each day, and iron, folate, calcium, magnesium, and zinc supplementation is recommended beyond a usual prenatal vitamin. Daily supplementation of docosahexaenoic acid and vitamin D should also be considered. Multiple gestation-specific prenatal care settings with a focus on nutritional interventions improve birth weight and length of gestation and should be considered for the care of women carrying multiples. Antepartum lactation consultation can also improve the rate of postpartum breastfeeding in twin pregnancies. Twin gestation-specific nutritional interventions seem effective in improving the outcome of these pregnancies and should be emphasized in the antepartum care of multiple gestations. This review examines the available evidence and offers recommendations for twin pregnancy-specific nutritional interventions.

  11. Living donor liver transplantation for hepatocellular carcinoma achieves better outcomes

    PubMed Central

    Lin, Chih-Che

    2016-01-01

    Liver transplantation (LT) for hepatocellular carcinoma (HCC) at Kaohsiung Chang Gung Memorial Hospital mainly relies on live donor LT (LDLT). Owing to taking the risk of LD, we are obligated to adopt strict selection criteria for HCC patients and optimize the pre-transplant conditions to ensure a high disease-free survival similar to those without HCC, even better than deceased donor LT (DDLT). Better outcomes are attributed to excellent surgical results and optimal patient selection. The hospital mortality of primary and salvage LDLT are lower than 2% in our center. Although Taiwan Health Insurance Policy extended the Milan to University of California, San Francisco (UCSF) criteria in 2006, selection criteria will not be consolidated to take into account only by the morphologic size/number of tumors but also by their biology. The criteria are divided into modifiable image morphology, alpha fetoprotein (AFP), and positron emission tomography (PET) scan with standard uptake value (SUV) and unmodifiable unfavorable pathology such as HCC combined with cholangiocarcinoma (CC), sarcomatoid type, and poor differentiation. Downstaging therapy is necessary for HCC patients beyond criteria to fit all modifiable standards. The upper limit of downstaging treatment seems to be extended by more effective drug eluting transarterial chemoembolization in cases without absolute contraindications. In contrast, the pitfall of unmodifiable tumor pathology should be excluded by the findings of pretransplant core biopsy/resection if possible. More recently, achieving complete tumor necrosis in explanted liver could almost predict no recurrence after transplant. Necrotizing therapy is advised if possible before transplant even the tumor status within criteria to minimize the possibility of tumor recurrence. LDLT with low surgical mortality in experienced centers provides the opportunities of optimizing the pre-transplant tumor conditions and timing of transplant to achieve better

  12. 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…

  13. An Examination of English Language Proficiency and Achievement Test Outcomes

    ERIC Educational Resources Information Center

    Mojica, Tammy C.

    2013-01-01

    The purpose of the study was to compare the relationship between grade eight English language proficiency as measured by the ACCESS for ELL's assessment (Assessing Comprehension and Communication in English State to State for English Language Learners) and achievement test outcomes on the Pennsylvania System of School Assessment, a state mandated…

  14. 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…

  15. Improving mental health outcomes: achieving equity through quality improvement

    PubMed Central

    Poots, Alan J.; Green, Stuart A.; Honeybourne, Emmi; Green, John; Woodcock, Thomas; Barnes, Ruth; Bell, Derek

    2014-01-01

    Objective To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting A psychological therapy service in Westminster, London, UK. Participants People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-referral) between February 2009 and May 2012. Intervention(s) Social marketing interventions were used to increase referrals, including the promotion of the service through local media and through existing social networks. Main Outcome Measure(s) (i) Severity of depression on entry using Patient Health Questionnaire-9 (PHQ9). (ii) Changes to severity of depression following treatment (ΔPHQ9). (iii) Changes in attainment of a meaningful improvement in condition assessed by a key performance indicator. Results Patients from areas of high deprivation entered the service with more severe depression (M = 15.47, SD = 6.75), compared with patients from areas of low (M = 13.20, SD = 6.75) and medium (M = 14.44, SD = 6.64) deprivation. Patients in low, medium and high deprivation areas attained similar changes in depression score (ΔPHQ9: M = −6.60, SD = 6.41). Similar proportions of patients achieved the key performance indicator across initiative phase and deprivation categories. Conclusions QI methods improved access to mental health services; this paper finds no evidence for differences in clinical outcomes in patients, regardless of level of deprivation, interpreted as no evidence of inequity in the service with respect to this outcome. PMID:24521701

  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.

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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…

  2. 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.…

  3. 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…

  4. Improving Student Achievement: A Study of High-Poverty Schools with Higher Student Achievement Outcomes

    ERIC Educational Resources Information Center

    Butz, Stephen D.

    2012-01-01

    This research examined the education system at high-poverty schools that had significantly higher student achievement levels as compared to similar schools with lower student achievement levels. A multischool qualitative case study was conducted of the educational systems where there was a significant difference in the scores achieved on the…

  5. When Children Move: Behavior and Achievement Outcomes during Elementary School

    ERIC Educational Resources Information Center

    Lleras, Christy; McKillip, Mary

    2017-01-01

    School moves are common during elementary school in the United States. The authors address whether changing schools and residences affects the academic and behavioral development of young students. Utilizing data from the Early Childhood Longitudinal Study, the regression analyses show that, after controlling for prior achievement and behavior,…

  6. 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

  7. The Role of Achievement Motivations and Achievement Goals in Taiwanese College Students' Cognitive and Psychological Outcomes

    ERIC Educational Resources Information Center

    Chen, Su-Yen; Lu, Luo

    2015-01-01

    This study explores how motivational factors are associated with Taiwanese college students' cognitive, personal, and social development by incorporating both relatively global, static self-attributes, such as social-oriented achievement motivation and individual-oriented achievement motivation, which are considered to be culturally balanced…

  8. Identifying Pedagogy and Teaching Strategies for Achieving Nationally Prescribed Learning Outcomes

    ERIC Educational Resources Information Center

    Delany, Clare; Kosta, Lauren; Ewen, Shaun; Nicholson, Patricia; Remedios, Louisa; Harms, Louise

    2016-01-01

    With the globalisation of university education, national frameworks are commonly used to prescribe standardised learning outcomes and achieve accountability. However, these frameworks are generally not accompanied by guiding pedagogy to support academics in adjusting their teaching practices to achieve the set outcomes. This paper reports the…

  9. 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…

  10. 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

  11. 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

  12. 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…

  13. 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,…

  14. Debiasing comparative optimism and increasing worry for health outcomes.

    PubMed

    Rose, Jason P

    2012-11-01

    Comparative optimism - feeling at less personal risk for negative outcomes than one's peers - has been linked to reduced prevention efforts. This study examined a novel debiasing technique aimed at simultaneously reducing both indirectly and directly measured comparative optimism. Before providing direct comparative estimates, participants provided absolute self and peer estimates in a joint format (same computer screen) or a separate format (different computer screens). Relative to the separate format condition, participants in the joint format condition showed (1) lower comparative optimism in absolute/indirect measures, (2) lower direct comparative optimism, and (3) heightened worry. Implications for risk perception screening are discussed.

  15. Optimizing cardiovascular outcomes in diabetes mellitus.

    PubMed

    Sobel, Burton E

    2007-09-01

    This article presents a series of take-home statements, compiled by a multidisciplinary steering committee, concerning significant aspects of macrovascular disease in patients with diabetes mellitus, including the extent of risk, pathogenetic mechanisms, and optimal management for risk reduction. The discussion focuses in particular on the impact of diabetes medications beyond blood glucose control. In summary, these statements are as follows: (1) Patients with diabetes have an increased risk for cardiovascular disease that contributes to decreased life expectancy; (2) prognosis after a cardiovascular event is poorer in patients with diabetes; (3) pathogenetic mechanisms include insulin resistance, endothelial dysfunction, dyslipidemia, chronic inflammation, procoagulability, and impaired fibrinolysis; (4) management of established cardiovascular risk factors, for example with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) and antihypertensive therapy, reduces cardiovascular event rates in diabetes; (5) correction of hyperglycemia can reduce macrovascular event rates, but the coupling to hyperglycemia is less tight for macrovascular events than it is for reduction of microvascular complications; (6) patients with diabetes should be screened for additional cardiovascular risk factors and appropriate interventions should be initiated; (7) results of observational and interventional studies have indicated that some insulin sensitizers appear to reduce the incidence of cardiovascular events and improve survival; (8) thiazolidinediones have beneficial effects on metabolism that may improve cardiovascular risk, and a randomized clinical trial in patients with advanced atherosclerosis indicates that addition of pioglitazone to therapy for hyperglycemia may reduce the incidence of cardiovascular events such as myocardial infarction and stroke.

  16. 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)…

  17. 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.

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

    PubMed

    Fitzsimons, James A; Carr, C Ben

    2014-09-01

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

  19. Impacts of comprehensive reading instruction on diverse outcomes of low- and high-achieving readers.

    PubMed

    Guthrie, John T; McRae, Angela; Coddington, Cassandra S; Lutz Klauda, Susan; 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 effects of Concept-Oriented Reading Instruction (CORI) with traditional instruction (TI) on several outcomes in a 12-week intervention for low achievers and high achievers. Low achievers in the CORI group were afforded explicit instruction, leveled texts, and motivation support. Compared with TI students, CORI students scored higher on posttest measures of word recognition speed, reading comprehension on the Gates-MacGinitie Reading Test, and ecological knowledge. CORI was equally effective for lower achievers and higher achievers. Explicitly supporting multiple aspects of reading simultaneously appeared to benefit diverse learners on a range of reading outcomes.

  20. 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.

  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. 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.

  3. Assuring Student Learning Outcomes Achievement through Faculty Development: An Online University Example

    ERIC Educational Resources Information Center

    Lewis, Shelia; Ewing, Christopher

    2016-01-01

    Asynchronous discussions in the online teaching and learning environment significantly contributes to the achievement of student learning outcomes, which is dependent upon qualified and engaged faculty members. The discourse within this article addresses how an online university conducted faculty development through its unique Robust Learning…

  4. 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…

  5. 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…

  6. 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…

  7. Social Capital, Value Consistency, and the Achievement Outcomes of Home Education.

    ERIC Educational Resources Information Center

    Ray, Brian D.

    Whether the constructs of value consistency and social capital can be used to explain the achievement outcomes of home education is explored. It is evident that children exposed to home schooling experience a high degree of value consistency. The values to which such children are exposed in education are those of their families. This would seem to…

  8. 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…

  9. Influence of Web Based Cooperative Learning Strategy and Achiever Motivation on Student Study Outcome

    ERIC Educational Resources Information Center

    Hariadi, Bambang; Wurijanto, Tutut

    2016-01-01

    The research aimed at examining the effect of instructional strategy (web-based STAD and text-based STAD) and achiever motivation toward student learning outcomes. The research implied quasi-experimental design with nonequivalent control group factorial version. The subjects were undergraduate students of Information Systems of academic year…

  10. 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…

  11. 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…

  12. Analysis of Year 2 (2003-2004) Student Achievement Outcomes for the Memphis KIPP DIAMOND Academy

    ERIC Educational Resources Information Center

    Gallagher, Brenda McSparrin; Ross, Steven M.

    2005-01-01

    The present study examined outcomes on the Tennessee Comprehensive Assessment Program/Achievement Test (TCAP/AT) for the KIPP:DIAMOND Academy (KIPP:DA), which is in its second year of operation. Importantly, as in Year 1, a rigorous quasi-experimental research design was employed, in which each KIPP:DA student was individually matched to a highly…

  13. Immigrant College Scholars in STEM: Generational Status, Family Achievement-Orientation, and Academic Outcomes

    NASA Astrophysics Data System (ADS)

    Beason, Tiffany S.

    Previous research has demonstrated that higher academic achievement among children of immigrants is related to higher academic expectations and aspirations among immigrant parents as compared to U.S.-born parents. The current study sought to further explore how family environment impacts the relation between immigrant generational status and academic outcomes. Specifically, it was hypothesized that family achievement-orientation, or family attitudes towards success at work or school, mediates the relation between immigrant generational status and academic outcomes (i.e. college GPA and career choice as indicated by graduate program entry). Results indicate that family achievement-orientation is higher among African American/Black children of immigrants than African Americans with US-born parents. Furthermore, African American/Black children of immigrants pursue the M.D. over the Ph.D. more often than their counterparts with US-born parents. The study concludes with a discussion of implications for future research.

  14. Gout: optimizing treatment to achieve a disease cure.

    PubMed

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

    2016-03-01

    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.

  15. 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

  16. 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.

  17. 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…

  18. 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…

  19. Standardization and optimization of CT protocols to achieve low dose.

    PubMed

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

    2014-03-01

    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, the authors summarize approaches to reduce dose, as discussed in lectures constituting the first session of the 2013 UCSF Virtual Symposium on Radiation Safety and 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.

  20. 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.

  1. An Analysis of Taiwanese Eighth Graders' Science Achievement, Scientific Epistemological Beliefs and Cognitive Structure Outcomes After Learning Basic Atomic Theory.

    ERIC Educational Resources Information Center

    Tsai, Chin-Chung

    1998-01-01

    Explores the interrelationships between students' general science achievement, scientific epistemological beliefs, and cognitive structure outcomes derived from instruction of basic atomic theory. Contains 19 references. (DDR)

  2. Outcomes of the Saturday School: a church-based approach to enhance achievement in reading & mathematics.

    PubMed

    Edwards, Karethy; Edwards, Boyze; Jones, Gail; Ham, Sharon

    2009-01-01

    Excellence in reading and math enable children entry to all of the professions. This is especially true for the nursing profession. Therefore, the purpose of this paper is to provide background information on the national crisis in reading and math achievement among school children, present the methodology of the Saturday School church-based approach to enhance reading and math skills, and the seven year outcomes.

  3. The clinical achievement portfolio: an outcomes-based assessment project in nursing education.

    PubMed

    Tracy, S M; Marino, G J; Richo, K M; Daly, E M

    2000-01-01

    Dynamic healthcare market forces impel educators to search for innovative methods of academic assessment to measure learning outcomes. The clinical achievement portfolio is a creative and systematic tool for documenting continuous improvement of student clinical learning. The authors describe the use of the portfolio as a pilot project aimed at introducing reflective thinking and measuring clinical learning in undergraduate nursing education. Potential benefits of the clinical portfolio and implications for future research are proposed.

  4. Interprofessional Curbside Consults to Develop Team Communication and Improve Student Achievement of Learning Outcomes.

    PubMed

    Kirwin, Jennifer; Greenwood, Kristin Curry; Rico, Janet; Nalliah, Romesh; DiVall, Margarita

    2017-02-25

    Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students' attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question. Students responded in verbal and written formats. Assessment. Student performance was assessed with a three-part rubric. The impact of the exercise was assessed by conducting pre- and post-intervention surveys and analyzing students' performance on relevant Center for the Advancement of Pharmacy Education (CAPE) outcomes. Survey results showed improvement in student attitudes related to team-delivered care. Students' performance on the problem solver and collaborator CAPE outcomes improved, while performance on the educator outcome worsened. Conclusions. The addition of an interprofessional communication activity with standardized health care professionals provided the opportunity for students to develop skills related to team communication. Students felt the activity was valuable and realistic; however, analysis of outcome achievement from the exercise revealed a need for more exposure to team communication skills.

  5. Interprofessional Curbside Consults to Develop Team Communication and Improve Student Achievement of Learning Outcomes

    PubMed Central

    Greenwood, Kristin Curry; Rico, Janet; Nalliah, Romesh; DiVall, Margarita

    2017-01-01

    Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students’ attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question. Students responded in verbal and written formats. Assessment. Student performance was assessed with a three-part rubric. The impact of the exercise was assessed by conducting pre- and post-intervention surveys and analyzing students’ performance on relevant Center for the Advancement of Pharmacy Education (CAPE) outcomes. Survey results showed improvement in student attitudes related to team-delivered care. Students’ performance on the problem solver and collaborator CAPE outcomes improved, while performance on the educator outcome worsened. Conclusions. The addition of an interprofessional communication activity with standardized health care professionals provided the opportunity for students to develop skills related to team communication. Students felt the activity was valuable and realistic; however, analysis of outcome achievement from the exercise revealed a need for more exposure to team communication skills. PMID:28289305

  6. "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…

  7. 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

  8. Does achieving the best practice tariff improve outcomes in hip fracture patients? An observational cohort study

    PubMed Central

    Oakley, B; Nightingale, J; Moran, CG; Moppett, IK

    2017-01-01

    Objectives To determine if the introduction of the best practice tariff (BPT) has improved survival of the elderly hip fracture population, or if achieving BPT results in improved survival for an individual. Setting A single university-affiliated teaching hospital. Participants 2541 patients aged over 60 admitted with a neck of femur fracture between 2008 and 2010 and from 2012 to 2014 were included, to create two cohorts of patients, before and after the introduction of BPT. The post-BPT cohort was divided into two groups, those who achieved the criteria and those who did not. Primary and secondary outcome measures Primary outcomes of interest were differences in mortality across cohorts. Secondary analysis was performed to identify associations between individual BPT criteria and mortality. Results The introduction of BPT did not significantly alter overall 30-mortality in the hip fracture population (8.3% pre-BPT vs 10.0% post-BPT; p=0.128). Neither was there a significant reduction in length of stay (15 days (IQR 9–21) pre-BPT vs 14 days (IQR 11–22); p=0.236). However, the introduction of BPT was associated with a reduction in the time from admission to theatre (median 44 hours pre-BPT (IQR 24–44) vs 23 hours post-BPT (IQR 17–30); p<0.005). 30-day mortality in those who achieved BPT was significantly lower (6.0% vs 21.0% in those who did not achieve-BPT; p<0.005). There was a survival benefit at 1 year for those who achieved BPT (28.6% vs 42.0% did not achieve-BPT; p<0.005). Multivariate logistic regression revealed that of the BPT criteria, AMT monitoring and expedited surgery were the only BPT criteria that significantly influenced survival. Conclusions The introduction of the BPT has not led to a demonstrable improvement in outcomes at organisational level, though other factors may have confounded any benefits. However, patients where BPT criteria are met appear to have improved outcomes. PMID:28167748

  9. 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.

  10. Knowledge Visualizations: A Tool to Achieve Optimized Operational Decision Making and Data Integration

    DTIC Science & Technology

    2015-06-01

    and pedigree possess additive implications toward the quality of the data utilized within the DSS. F. SUMMARY Decision - making theories such as...VISUALIZATIONS: A TOOL TO ACHIEVE OPTIMIZED OPERATIONAL DECISION MAKING AND DATA INTEGRATION by Paul C. Hudson Jeffrey A. Rzasa June 2015 Thesis...TOOL TO ACHIEVE OPTIMIZED OPERATIONAL DECISION MAKING AND DATA INTEGRATION 5. FUNDING NUMBERS 6. AUTHOR(S) Paul C. Hudson, and Jeffrey A. Rzasa

  11. Interrelationships Among Length of Stay in a Domestic Violence Shelter, Help Received, and Outcomes Achieved.

    PubMed

    Sullivan, Cris M; Virden, Tyler

    2017-04-10

    Survivors of intimate partner violence (IPV) have a variety of reasons for turning to domestic violence shelter programs. Some are seeking temporary respite and immediate safety while others are seeking longer term assistance to heal from their trauma and begin new lives. In line with these differing needs, some survivors only stay in shelter for a few days, while others may need to stay for months or even years. The current study involved secondary data analysis of an 8-state study that collected information from survivors shortly after they arrived in shelter and shortly before exit. The relationships between length of shelter stay and survivors' needs, help received, and outcomes achieved were examined. As hypothesized, length of stay was related to the number of needs reported by survivors at shelter entry, as well as the type of needs identified. Length of stay did not relate to outcomes achieved nor overall satisfaction with help received, supporting the argument that many shelter staff work from an empowering, survivor-driven philosophy to meet the myriad needs of shelter residents, and that the help they provide leads to positive outcomes. These findings substantiate the assertion that domestic violence shelters are critical resources that address far more than immediate safety needs of IPV survivors. (PsycINFO Database Record

  12. Student perceptions of their biology teacher's interpersonal teaching behaviors and student achievement and affective learning outcomes

    NASA Astrophysics Data System (ADS)

    Smith, Wade Clay, Jr.

    The primary goals of this dissertation were to determine the relationships between interpersonal teaching behaviors and student achievement and affective learning outcomes. The instrument used to collect student perceptions of teacher interpersonal teaching behaviors was the Questionnaire on Teacher Interactions (QTI). The instrument used to assess student affective learning outcomes was the Biology Student Affective Instrument (BSAI). The interpersonal teaching behavior data were collected using students as the observers. 111 students in an urban influenced, rural high school answered the QTI and BSAI in September 1997 and again in April 1998. At the same time students were pre and post tested using the Biology End of Course Examination (BECE). The QTI has been used primarily in European and Oceanic areas. The instrument was also primarily used in educational stratified environment. This was the first time the BSAI was used to assess student affective learning outcomes. The BECE is a Texas normed cognitive assessment test and it is used by Texas schools districts as the end of course examination in biology. The interpersonal teaching behaviors model was tested to ascertain if predictive power in the USA and in a non-stratified educational environment. Findings indicate that the QTI is an adequate predictor of student achievement in biology. The results were not congruent with the non-USA data and results, this indicates that the QTI is a society/culturally sensitive instrument and the instrument needs to be normed to a particular society/culture before it is used to affect teachers' and students' educational environments.

  13. Optimizing economic outcomes in the management of COPD

    PubMed Central

    Dal Negro, Roberto

    2008-01-01

    Attention to COPD is increasing worldwide because its high prevalence, morbidity, and mortality present a challenging problem for all healthcare systems. The burden of COPD, which is usually measured in terms of progressive lung function decline, impact on patients’ symptoms, patient’s disability, and quality of life, together with the corresponding use of health care resources, is still a major aspect of the disease. Recommendations to treat COPD according to the most accepted guidelines have expanded in recent years even though COPD still remains unacceptably under-diagnosed and under-treated worldwide. Obviously, more severe degrees of COPD receive major attention both in terms of monitoring of clinical outcomes and of assessing the economic value of therapeutic interventions. The role of different strategies against COPD should be valued on the basis of their effectiveness in outcome optimization, which primarily depends on the efficacy of prevention activities and of early diagnosis programs. It is generally agreed that the main proportion of COPD burden still depends on the clinically uncontrolled disease and on its high exacerbation rate, which frequently leads to the patient hospitalization. In COPD, the effects of guideline recommendations have been only sporadically investigated in pharmaoeconomic terms, even though symptoms and disability have declined substantially; the corresponding improvement in quality of life, and a significant decrease in both direct and indirect costs have been proved to depend on appropriate rehabilitative and pharmacological long-term treatment of the disease. At present, more precise indices and more fitting outcomes are continuously sought and found in order to assess more effective strategies for controlling COPD. PMID:18488425

  14. The Effects of Academic Optimism on Student Academic Achievement in Alabama

    ERIC Educational Resources Information Center

    Bevel, Raymona King

    2010-01-01

    The purpose of the research was to determine the effects of academic optimism on student academic achievement through measuring the individual and collective effects of academic emphasis, collective efficacy, and faculty trust in clients. Data for this study were obtained from the School Academic Optimism Scale and the reading section of the…

  15. 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…

  16. Blastocyst culture and cryopreservation to optimize clinical outcomes of warming cycles.

    PubMed

    Zhu, Lixia; Xi, Qingsong; Zhang, Hanwang; Li, Yufeng; Ai, Jihui; Jin, Lei

    2013-08-01

    Surplus embryos available for cryopreservation in fresh cycles are considered as having good potential for future use. However, the optimal stage of embryo cryopreservation remains unclear. In this study, 1190 patients with surplus embryos on day 3 were divided into two groups: cleavage-stage embryo cryopreservation (control group) and blastocyst cryopreservation (blastocyst group). The clinical outcomes of the subsequent warming cycles were evaluated. The proportion of cycles with blastocyst formation was 73.8% in the blastocyst group. Although in the blastocyst group, the cancellation rate of blastocyst transfer was increased due to lack of blastocysts available for cryopreservation, the blastocyst group achieved significantly higher rates of clinical pregnancy/cycle (43.2% versus 34.9%; P=0.003), pregnancy/transfer (59.5% versus 35.4%; P<0.001) and implantation (46.5% versus 22.2%; P<0.001) from the first warming cycle compared with the control group. In an embryo-number classified analysis, the clinical pregnancy rate was also higher in the blastocyst group. However, the cumulative pregnancy was similar between the two groups. Blastocyst culture as an embryo selection tool will not improve embryo viability but it will help patients to achieve pregnancy more quickly. Extended culture of surplus embryos to the blastocyst stage for cryopreservation optimizes the clinical outcomes.

  17. 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

  18. 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

  19. An In-Depth Examination of Optimal Outcome Children with a History of Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Kelley, Elizabeth; Naigles, Letitia; Fein, Deborah

    2010-01-01

    Previous research has suggested that some children with autism spectrum disorders (ASD) may improve to such an extent that they lose their diagnosis, yet little research has examined these "optimal outcome" children in depth. We examined multiple aspects of functioning in a group of 13 optimal outcome (OO) children, matched on age, gender, and…

  20. 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…

  1. The role of faith in adoption: achieving positive adoption outcomes for African American children.

    PubMed

    Belanger, Kathleen; Copeland, Sam; Cheung, Monit

    2008-01-01

    African American children are overrepresented in foster care by more than twice their proportion in the population (U.S. Government Accountability Office [USGAO], 2007). Building upon research relating faith (religiosity) to positive health and mental health, this study utilized cognitive and religious coping theories to examine the influence of faith on choosing to adopt, achieving positive adoption outcomes, and reducing disproportionality. From Louisiana and Texas, 113 families who adopted 226 children, 48% African American, participated in a survey measuring children's behavior and parent distress (PSI-SF Difficult Child and Parent Distress Subscales) and religiosity (Hoge Intrinsic Religiosity Index). Of the respondents, 93% of the respondents belonged to a religious congregation, 86% attended church weekly. Controlling for child's behavior, religiosity predicted lower stress in adoptive parenting; church attendance was related to improvement in parental health since adopting. Faith was rated most frequently as essential in parents' decisions to adopt. The study concludes that faith may be an asset in increasing adoptions and improving adoption outcomes resulting in increased numbers of African American children adopted.

  2. Nutrition prescription to achieve positive outcomes in chronic kidney disease: a systematic review.

    PubMed

    Ash, Susan; Campbell, Katrina L; Bogard, Jessica; Millichamp, Anna

    2014-01-22

    In Chronic Kidney Disease (CKD), management of diet is important in prevention of disease progression and symptom management, however evidence on nutrition prescription is limited. Recent international CKD guidelines and literature was reviewed to address the following question "What is the appropriate nutrition prescription to achieve positive outcomes in adult patients with chronic kidney disease?" Databases included in the search were Medline and CINAHL using EBSCOhost search engine, Embase and the Cochrane Database of Systematic Reviews published from 2000 to 2009. International guidelines pertaining to nutrition prescription in CKD were also reviewed from 2000 to 2013. Three hundred and eleven papers and eight guidelines were reviewed by three reviewers. Evidence was graded as per the National Health and Medical Research Council of Australia criteria. The evidence from thirty six papers was tabulated under the following headings: protein, weight loss, enteral support, vitamin D, sodium, fat, fibre, oral nutrition supplements, nutrition counselling, including protein and phosphate, nutrients in peritoneal dialysis solution and intradialytic parenteral nutrition, and was compared to international guidelines. While more evidence based studies are warranted, the customary nutrition prescription remains satisfactory with the exception of Vitamin D and phosphate. In these two areas, additional research is urgently needed given the potential of adverse outcomes for the CKD patient.

  3. Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review

    PubMed Central

    Ash, Susan; Campbell, Katrina L.; Bogard, Jessica; Millichamp, Anna

    2014-01-01

    In Chronic Kidney Disease (CKD), management of diet is important in prevention of disease progression and symptom management, however evidence on nutrition prescription is limited. Recent international CKD guidelines and literature was reviewed to address the following question “What is the appropriate nutrition prescription to achieve positive outcomes in adult patients with chronic kidney disease?” Databases included in the search were Medline and CINAHL using EBSCOhost search engine, Embase and the Cochrane Database of Systematic Reviews published from 2000 to 2009. International guidelines pertaining to nutrition prescription in CKD were also reviewed from 2000 to 2013. Three hundred and eleven papers and eight guidelines were reviewed by three reviewers. Evidence was graded as per the National Health and Medical Research Council of Australia criteria. The evidence from thirty six papers was tabulated under the following headings: protein, weight loss, enteral support, vitamin D, sodium, fat, fibre, oral nutrition supplements, nutrition counselling, including protein and phosphate, nutrients in peritoneal dialysis solution and intradialytic parenteral nutrition, and was compared to international guidelines. While more evidence based studies are warranted, the customary nutrition prescription remains satisfactory with the exception of Vitamin D and phosphate. In these two areas, additional research is urgently needed given the potential of adverse outcomes for the CKD patient. PMID:24451311

  4. When nursing takes ownership of financial outcomes: achieving exceptional financial performance through leadership, strategy, and execution.

    PubMed

    Goetz, Kristopher; Janney, Michelle; Ramsey, Kristin

    2011-01-01

    With nurses and unlicensed supportive personnel composing the greatest percentage of the workforce at any hospital, it is not surprising nursing leadership plays an increasing role in the attainment of financial goals. The nursing leadership team at one academic medical center reduced costs by more than $10 million over 4 years while outperforming national benchmarks on nurse-sensitive quality indicators. The most critical success factor in attaining exceptional financial performance is a personal and collective accountability to achieving outcomes. Whether it is financial improvement, advancing patient safety, or ensuring a highly engaged workforce, success will not be attained without thoughtful, focused leadership. The accountability model ensures there is a culture built around financial performance where nurses and leaders think and act, on a daily basis, in a manner necessary to understand opportunities, find answers, and overcome obstacles. While structures, processes, and tools may serve as the means to achieve a target, it is leadership's responsibility to set the right goal and motivate others.

  5. Preoperative optimization of cardiovascular hemodynamics improves outcome in peripheral vascular surgery. A prospective, randomized clinical trial.

    PubMed Central

    Berlauk, J F; Abrams, J H; Gilmour, I J; O'Connor, S R; Knighton, D R; Cerra, F B

    1991-01-01

    The hypothesis that optimizing hemodynamics using pulmonary artery (PA) catheter (preoperative 'tune-up') would improve outcome in patients undergoing limb-salvage arterial surgery was tested. Eighty-nine patients were randomized to preoperative tune-up either in the surgical intensive care unit (SICU) (group 1) or the preinduction room (group 2) or to control (group 3). The tune-up consisted of fluid loading, afterload reduction, and/or inotropic support to achieve predetermined endpoints. Patients with a PA catheter had significantly fewer adverse intraoperative events (p less than 0.05), less postoperative cardiac morbidity (p less than 0.05), and less early graft thrombosis (p less than 0.05) than the control group. The overall study mortality rate was 3.4%, with a mortality rate of 9.5% in the control group and 1.5% in the PA catheter groups. There were no differences in ICU length of stay (LOS), hospital LOS, or total hospital costs, although the percentage of cost from complications was higher in group 3 (p greater than 0.05). In this group of patients, preoperative cardiac assessment and optimization is associated with improved outcome. PMID:1929610

  6. Academic Optimism, Organizational Citizenship Behaviors, and Student Achievement at Charter Schools

    ERIC Educational Resources Information Center

    Guvercin, Mustafa

    2013-01-01

    The purpose of this study was to examine the relationship among academic optimism, Organizational Citizenship Behaviors (OCBs), and student achievement in college preparatory charter schools. A purposeful sample of elementary school teachers from college preparatory charter schools (N = 226) in southeast Texas was solicited to complete the…

  7. 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.

  8. 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

  9. National Institute of Nursing Research working group on "Optimizing pregnancy outcomes in minority populations".

    PubMed

    Grady, Patricia A

    2005-05-01

    The growing complexity of biomedical research requires new methods of discovery; scientists must use an interdisciplinary approach and explore new models of team science, as underscored in the Roadmap of the National Institutes of Health. In March 2003, the National Institute of Nursing Research convened a working group of scientists and clinicians with a wide range of backgrounds to address "Optimizing Pregnancy Outcomes in Minority Populations." The 2-day meeting included a variety of presentations on the current state of research on pregnancy in minority populations. Many participants provided specific insights regarding biobehavioral issues in human-environment interaction, stress and health status relationships to risk, maternal-fetal interactions, and the complications of pregnancy. This supplement presents articles from several participants at this interdisciplinary meeting. The National Institute of Nursing Research looks forward to further collaborations across the National Institutes of Health and other agencies to achieve the vital aims of this working group.

  10. 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

  11. Use of a Batch Reactive Distillation with Dynamic Optimization Strategy to Achieve Industrial Grade Ethyl Acetate

    NASA Astrophysics Data System (ADS)

    Konakom, Kwantip; Saengchan, Aritsara; Kittisupakorn, Paisan; Mujtaba, Iqbal M.

    2011-08-01

    Industrial grade ethyl acetate is available with minimum purity of 85.0%. It is mostly produced by an ethanol esterification in a distillation process on both batch and continuous modes. However, researches on high purity production with short operating time are rarely achieved. Therefore, the objective in this work is to study an approach to produce ethyl acetate of 90.0% by 8 hours using a batch reactive distillation column. Based on open-loop simulations, the distillation with constant reflux ratio cannot achieve the product specification. Thus, the dynamic optimization strategy is proposed to handle this problem. For the process safety—preventing the dried column and fractured, a minimum reflux ratio must be determined in advance and then an optimal reflux profile is calculated to achieve optimal product yield. Simulation results show that the industrial grade ethyl acetate can be produced by the dynamic optimization programming with two or more time intervals. Besides, the increasing of time intervals can produce more distillate product.

  12. Achieving graduate outcomes in undergraduate nursing education: following the Yellow Brick Road.

    PubMed

    Baldwin, Adele; Bentley, Karyn; Langtree, Tanya; Mills, Jane

    2014-01-01

    Nursing practice is a dynamic and constantly changing field within healthcare, with well-documented challenges to maintaining a suitably skilled workforce to meet the needs of the community it serves. Undergraduate nursing education provides the mandatory minimum requirements for professional registration. Each nursing program has clearly stated graduate attributes, qualities that their graduates will possess on graduation. The aim of this paper is to stimulate discussion about graduate attributes for nurses, a transferrable set of specific attributes that make nursing graduates work ready. This paper focuses on identifying specific attributes, the embedding of those attributes in nursing education, particularly through role modelling, with the aim of producing a future workforce that is knowledgeable, compassionate and confident. The graduate attributes are likened to the qualities sought by the characters in 'The Wizard of Oz'; brains, heart and courage and the learning process as the 'Yellow Brick Road'. There is a relative lack of discussion about role modelling by nurse educators for nursing students, a potentially undervalued learning experience that we believe must be brought to the forefront of discussions pertaining to undergraduate nursing education and achieving graduate outcomes.

  13. 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.

  14. Effects of Divalproex on Smoking Cue Reactivity and Cessation Outcomes Among Smokers Achieving Initial Abstinence

    PubMed Central

    Ditre, Joseph W.; Oliver, Jason A.; Myrick, Hugh; Henderson, Scott; Saladin, Michael E.; Drobes, David J.

    2015-01-01

    Divalproex, a GABA agonist, may be a useful agent in the treatment of tobacco dependence. Cue reactivity assessment paradigms are ideally suited to explore basic mechanisms underlying the pharmacological effects of medications that purport to have efficacy for smoking cessation. Our primary goal in the current study was to examine the effects of divalproex on in-treatment reactivity to smoking-relevant and affective cues, and to determine if these reactions were predictive of posttreatment smoking behavior. There were 120 nicotine dependent smokers enrolled in an 8-week double-blind clinical trial and randomly assigned to either divalproex or placebo conditions. Of these, 72 smokers (60% female) who achieved a minimal level of abstinence underwent an in-treatment cue reactivity assessment. Contrary to expectations, divalproex was associated with greater craving and arousal during smoking cue presentation. Divalproex also inhibited cardiovascular response to pleasant cues. Although no significant differences in cessation-related outcomes between divalproex- and placebo-treated participants were observed, cue-elicited craving to smoke predicted end-of-treatment and posttreatment smoking rates. These findings suggest that in-treatment cue reactivity assessment may proactively and dynamically inform ongoing treatment as well as provide a tool for screening potential medications for smoking cessation. PMID:22468897

  15. Effects of divalproex on smoking cue reactivity and cessation outcomes among smokers achieving initial abstinence.

    PubMed

    Ditre, Joseph W; Oliver, Jason A; Myrick, Hugh; Henderson, Scott; Saladin, Michael E; Drobes, David J

    2012-08-01

    Divalproex, a GABA agonist, may be a useful agent in the treatment of tobacco dependence. Cue reactivity assessment paradigms are ideally suited to explore basic mechanisms underlying the pharmacological effects of medications that purport to have efficacy for smoking cessation. Our primary goal in the current study was to examine the effects of divalproex on in-treatment reactivity to smoking-relevant and affective cues, and to determine if these reactions were predictive of posttreatment smoking behavior. There were 120 nicotine dependent smokers enrolled in an 8-week double-blind clinical trial and randomly assigned to either divalproex or placebo conditions. Of these, 72 smokers (60% female) who achieved a minimal level of abstinence underwent an in-treatment cue reactivity assessment. Contrary to expectations, divalproex was associated with greater craving and arousal during smoking cue presentation. Divalproex also inhibited cardiovascular response to pleasant cues. Although no significant differences in cessation-related outcomes between divalproex- and placebo-treated participants were observed, cue-elicited craving to smoke predicted end-of-treatment and posttreatment smoking rates. These findings suggest that in-treatment cue reactivity assessment may proactively and dynamically inform ongoing treatment as well as provide a tool for screening potential medications for smoking cessation.

  16. 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.

  17. 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

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

    ERIC Educational Resources Information Center

    Mushkin, Selma J.; Billings, Bradley B.

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

  19. 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.

  20. Need for optimizing catalyst loading for achieving affordable microbial fuel cells.

    PubMed

    Singh, Inderjeet; Chandra, Amreesh

    2013-08-01

    Microbial fuel cell (MFC) technology is a promising technology for electricity production together with simultaneous water treatment. Catalysts play an important role in deciding the MFC performance. In most reports, effect of catalyst - both type and quantity is not optimized. In this paper, synthesis of nanorods of MnO2-catalyst particles for application in Pt-free MFCs is reported. The effect of catalyst loading i.e., weight ratio, with respect to conducting element and binder has been optimized by employing large number of combinations. Using simple theoretical model, it is shown that too high (or low) concentration of catalysts result in loss of MFC performance. The operation of MFC has been investigated using domestic wastewater as source of bio-waste for obtaining real world situation. Maximum power density of ∼61 mW/m(2) was obtained when weight ratio of catalyst and conducting species was 1:1. Suitable reasons are given to explain the outcomes.

  1. 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

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. Academic Outcomes from Between-Class Achievement Grouping: The Australian Primary Context

    ERIC Educational Resources Information Center

    Macqueen, Suzanne

    2012-01-01

    Grouping students by academic achievement level has been practised in a wide variety of forms and contexts for over a century. Despite a general consensus in the research that between-class achievement grouping provides no overall benefit for students, the practice has persisted in various guises. Between-class achievement grouping is common in…

  11. 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…

  12. Optimizing Survival Outcomes For Adult Patients With Nontraumatic Cardiac Arrest.

    PubMed

    Jung, Julianna

    2016-10-01

    Patient survival after cardiac arrest can be improved significantly with prompt and effective resuscitative care. This systematic review analyzes the basic life support factors that improve survival outcome, including chest compression technique and rapid defibrillation of shockable rhythms. For patients who are successfully resuscitated, comprehensive postresuscitation care is essential. Targeted temperature management is recommended for all patients who remain comatose, in addition to careful monitoring of oxygenation, hemodynamics, and cardiac rhythm. Management of cardiac arrest in circumstances such as pregnancy, pulmonary embolism, opioid overdose and other toxicologic causes, hypothermia, and coronary ischemia are also reviewed.

  13. Discordance of Cognitive and Academic Achievement Outcomes in Youth with Perinatal HIV Exposure

    PubMed Central

    Garvie, Patricia A.; Zeldow, Bret; Malee, Kathleen; Nichols, Sharon L.; Smith, Renee A.; Wilkins, Megan L.; Williams, Paige L.

    2014-01-01

    Background To evaluate achievement in youth with perinatally acquired HIV (PHIV) compared to HIV-exposed uninfected peers (HEU), and to examine differential effects of HIV on cognition-achievement concordance. Methods Cognition and achievement were assessed using standardized measures. IQ-derived predicted achievement scores were subtracted from observed achievement scores to calculate discrepancy values. Linear regression models were used to compare achievement discrepancies between PHIV and HEU, adjusting for demographic covariates. Results Participants: 295 PHIV and 167 HEU youth; 71% black, 48% male, mean age 13.1 and 11.3 years, respectively. PHIV youth were relatively healthy (mean CD4%, 32%; viral load ≤400 copies/mL, 72%). PHIV and HEU youth had cognitive and achievement scores significantly below population norm means (p<0.001), but did not differ in cognition (mean FSIQ=86.7 vs. 89.4, respectively). In unadjusted models, HEU outperformed PHIV youth on Total Achievement (TA; mean=89.2 vs. 86.0, p=0.04) and Numerical Operations (NO; mean=88.8 vs. 82.9, p<0.001); no differences remained after adjustment. Mean observed-predicted achievement discrepancies reflected “underachievement”. History of encephalopathy predicted poorer achievement (p=0.039) and greater underachievement, even after adjustment. PHIV showed greater underachievement than HEU for NO (p<0.001) and TA (p=0.03), but these differences did not persist in adjusted models. Conclusions Both PHIV and HEU youth demonstrated lower achievement than normative samples, and underachieved relative to predicted achievement scores. Observed-predicted achievement discrepancies were associated with prior encephalopathy, older age and other non-HIV factors. PHIV youth with prior encephalopathy had significantly lower achievement and greater underachievement compared to PHIV without encephalopathy and HEU youth, even in adjusted models. PMID:25361033

  14. Achievements and challenges in automated parameter, shape and topology optimization for divertor design

    NASA Astrophysics Data System (ADS)

    Baelmans, M.; Blommaert, M.; Dekeyser, W.; Van Oevelen, T.

    2017-03-01

    Plasma edge transport codes play a key role in the design of future divertor concepts. Their long simulation times in combination with a large number of control parameters turn the design into a challenging task. In aerodynamics and structural mechanics, adjoint-based optimization techniques have proven successful to tackle similar design challenges. This paper provides an overview of achievements and remaining challenges with these techniques for complex divertor design. It is shown how these developments pave the way for fast sensitivity analysis and improved design from different perspectives.

  15. Optimal multistage designs for randomised clinical trials with continuous outcomes.

    PubMed

    Wason, James M S; Mander, Adrian P; Thompson, Simon G

    2012-02-20

    Multistage designs allow considerable reductions in the expected sample size of a trial. When stopping for futility or efficacy is allowed at each stage, the expected sample size under different possible true treatment effects (δ) is of interest. The δ-minimax design is the one for which the maximum expected sample size is minimised amongst all designs that meet the types I and II error constraints. Previous work has compared a two-stage δ-minimax design with other optimal two-stage designs. Applying the δ-minimax design to designs with more than two stages was not previously considered because of computational issues. In this paper, we identify the δ-minimax designs with more than two stages through use of a novel application of simulated annealing. We compare them with other optimal multistage designs and the triangular design. We show that, as for two-stage designs, the δ-minimax design has good expected sample size properties across a broad range of treatment effects but generally has a higher maximum sample size. To overcome this drawback, we use the concept of admissible designs to find trials which balance the maximum expected sample size and maximum sample size. We show that such designs have good expected sample size properties and a reasonable maximum sample size and, thus, are very appealing for use in clinical trials.

  16. Clinical Outcomes according to the Achievement of Target Low Density Lipoprotein-Cholesterol in Patients with Acute Myocardial Infarction

    PubMed Central

    Ahn, Taehoon; Lee, Kyounghoon; Kang, Woong Chol; Han, Seung Hwan; Ahn, Youngkeun; Jeong, Myung Ho

    2017-01-01

    Background and Objectives The clinical outcome of patient with an acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), with or without achievement of target low density lipoprotein-cholesterol (LDL-C), has little known information. This study investigated if target LDL-C level (below 70 mg/dL) achievements in patients with AMI showed better clinical outcomes or not. Subjects and Methods Between May 2008 and September 2012, this study enrolled 13473 AMI patients in a large-scale, prospective, multicenter Korean Myocardial Infarction (KorMI) registry. 12720 patients survived and 6746 patients completed a 1-year clinical follow up. Among them 3315 patients received serial lipid profile follow-ups. Propensity score matching was applied to adjust for differences in clinical baseline and angiographic characteristics, producing a total of 1292 patients (646 target LDL-C achievers vs. 646 non-achievers). The primary end point was the composite of a 1-year major adverse cardiac event (MACE) including cardiac death, recurrent myocardial infarction (MI), target lesion revascularization (TLR) and coronary artery bypass grafting. Results After propensity score matching, baseline clinical and angiographic characteristics were similar between the two groups. Clinical outcomes of the propensity score matched patients who showed no significant differences in cardiac death (0.5% vs. 0.5%, p=1.000), recurrent MI (1.1% vs. 0.8%, p=0.562), TLR (5.0% vs. 4.5%, p=0.649), MACEs (6.5% vs. 5.9%, p=0.644) and stent thrombosis (2.5% vs. 1.9%, p=0.560). Conclusion In this propensity-matched comparison, AMI patients undergoing PCI with a target LDL-C (below 70 mg/dL) achievement did not show better clinical outcomes. PMID:28154588

  17. 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…

  18. 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…

  19. 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…

  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. 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…

  2. What's Making the Difference in Achieving Outstanding Primary School Learning Outcomes in Numeracy?

    ERIC Educational Resources Information Center

    Busatto, Susan

    2004-01-01

    In this article, the author presents findings from a large NSW project designed to explore educational practices that "make a difference" in numeracy outcomes. The project was coordinated by the NSW Department of Education and Training, the Catholic Education Commission, the Association of Independent Schools, and research teams from the…

  3. 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

  4. 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

  5. Assessing the Claims of Participatory Measurement, Reporting and Verification (PMRV) in Achieving REDD+ Outcomes: A Systematic Review.

    PubMed

    Hawthorne, Sandra; Boissière, Manuel; Felker, Mary Elizabeth; Atmadja, Stibniati

    2016-01-01

    Participation of local communities in the Measurement, Reporting and Verification (MRV) of forest changes has been promoted as a strategy that lowers the cost of MRV and increases their engagement with REDD+. This systematic review of literature assessed the claims of participatory MRV (PMRV) in achieving REDD+ outcomes. We identified 29 PMRV publications that consisted of 20 peer-reviewed and 9 non peer-reviewed publications, with 14 publications being empirically based studies. The evidence supporting PMRV claims was categorized into empirical finding, citation or assumption. Our analysis of the empirical studies showed that PMRV projects were conducted in 17 countries in three tropical continents and across various forest and land tenure types. Most of these projects tested the feasibility of participatory measurement or monitoring, which limited the participation of local communities to data gathering. PMRV claims of providing accurate local biomass measurements and lowering MRV cost were well-supported with empirical evidence. Claims that PMRV supports REDD+ social outcomes that affect local communities directly, such as increased environmental awareness and equity in benefit sharing, were supported with less empirical evidence than REDD+ technical outcomes. This may be due to the difficulties in measuring social outcomes and the slow progress in the development and implementation of REDD+ components outside of experimental research contexts. Although lessons from other monitoring contexts have been used to support PMRV claims, they are only applicable when the enabling conditions can be replicated in REDD+ contexts. There is a need for more empirical evidence to support PMRV claims on achieving REDD+ social outcomes, which may be addressed with more opportunities and rigorous methods for assessing REDD+ social outcomes. Integrating future PMRV studies into local REDD+ implementations may help create those opportunities, while increasing the participation of

  6. 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

  7. Anchors weigh more than power: why absolute powerlessness liberates negotiators to achieve better outcomes.

    PubMed

    Schaerer, Michael; Swaab, Roderick I; Galinsky, Adam D

    2015-02-01

    The current research shows that having no power can be better than having a little power. Negotiators prefer having some power (weak negotiation alternatives) to having no power (no alternatives). We challenge this belief that having any alternative is beneficial by demonstrating that weak alternatives create low anchors that reduce the value of first offers. In contrast, having no alternatives is liberating because there is no anchor to weigh down first offers. In our experiments, negotiators with no alternatives felt less powerful but made higher first offers and secured superior outcomes compared with negotiators who had weak alternatives. We established the role of anchoring through mediation by first offers and through moderation by showing that weak alternatives no longer led to worse outcomes when negotiators focused on a countervailing anchor or when negotiators faced an opponent with a strong alternative. These results demonstrate that anchors can have larger effects than feelings of power. Absolute powerlessness can be psychologically liberating.

  8. Achieving quality and fiscal outcomes in patient care: the clinical mentor care delivery model.

    PubMed

    Burritt, Joan E; Wallace, Patricia; Steckel, Cynthia; Hunter, Anita

    2007-12-01

    Contemporary patient care requires sophisticated clinical judgment and reasoning in all nurses. However, the level of development regarding these abilities varies within a staff. Traditional care models lack the structure and process to close the expertise gap creating potential patient safety risks. In an innovative model, senior, experienced nurses were relieved of direct patient care assignments to oversee nursing care delivery. Evaluation of the model showed significant impact on quality and fiscal outcomes.

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

    PubMed

    van der Laan, Mark J; Luedtke, Alexander R

    2015-03-01

    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.

  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. 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

  12. How Do Life Goals and Motivations of International Students Studying in Australia Impact Their Achievement Outcomes?

    ERIC Educational Resources Information Center

    Guns, Ann; Richardson, Paul W.; Watt, Helen M. G.

    2012-01-01

    Many international students aim beyond their country boundaries by moving away from home and studying abroad. This longitudinal design addressed a gap in current research, by linking together antecedent life goals and motivations on entry to students' studies, to predict exit achievement scores, to provide information concerning optimising…

  13. 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…

  14. 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…

  15. Monitoring the Achievement of Deaf Pupils in Sweden and Scotland: Approaches and Outcomes

    ERIC Educational Resources Information Center

    Hendar, Ola; O'Neill, Rachel

    2016-01-01

    Over the past two decades there have been major developments in deaf education in many countries. Medical and technical advances have made it possible for more deaf children to hear and speak successfully. Most deaf pupils learn in ordinary classes in mainstream schools. In this article we explore patterns of achievements of deaf pupils to see if…

  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. 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

  18. 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.

  19. 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

  20. 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).…

  1. 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,…

  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. 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

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Can the EN keep the milestone and outcome... Payment Systems § 411.555 Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all outcome months? (a) Yes. The EN (or State VR agency acting as an EN) can keep...

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

    PubMed

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

    2015-10-01

    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.

  5. 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

  6. Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents.

    PubMed

    Jabbour, Elias; Strati, Paolo; Cabrero, Monica; O'Brien, Susan; Ravandi, Farhad; Bueso-Ramos, Carlos; Wei, Qiao; Hu, Jianhua; Abi Aad, Simon; Short, Nicholas J; Dinardo, Courtney; Daver, Naval; Kadia, Tapan; Wierda, William; Wei, Yue; Colla, Simona; Borthakur, Gautam; Cortes, Jorge; Estrov, Zeev; Kantarjian, Hagop; Garcia-Manero, Guillermo

    2017-04-01

    Two hundred and sixteen consecutive patients with MDS and abnormal karyotype treated with hypomethylating agents between 4/04 and 10/12 were reviewed. Median follow-up was 17 months. Using IWG criteria, best responses were complete response (CR) in 79 patients (37%), partial response (PR) in 4 (2%), and hematologic improvement (HI) in 10 (5%). Cytogenetic response (CyR) was achieved in 78 patients (36%): complete (CCyR) in 62 (29%) and partial in 16 (7%). CyR was achieved in 48 of 79 patients (61%) with CR, 1 of 14 (7%) with PR/HI, and in 29 of the 123 (24%) with no morphologic response. Median overall survival (OS) and leukemia-free survival (LFS) for patients with and without CCyR were 21 and 13 months (P = .007), and 16 and 9 months (P = .001), respectively. By multivariate analysis, the achievement of CCyR was predictive for better OS (HR = 2.1; P < .001). In conclusion, CyR occurs at a rate of 36% (complete in 29%) in patients with MDS treated with HMA and is not always associated with morphological response. The achievement of CCyR is associated with survival improvement and constitutes a major predictive factor for outcome particularly in patients without morphologic response. Therefore, the achievement of CCyR should be considered a milestone in the management of patients with MDS.

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

    PubMed

    Rose, Margaret

    2010-12-31

    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 animal welfare benchmarks cannot always be met. Based on the Australian experience, this paper will discuss the influences in and on-going challenges to the development and implementation of public policy when animals are used for these purposes.

  8. Promoting outcome achievement in child welfare: predictors of evidence-informed practice.

    PubMed

    Collins-Camargo, Crystal; Garstka, Teri A

    2014-01-01

    The use of data and evidence to inform practice in child welfare is the subject of increased discussion in the literature as well as in agencies striving to achieve child safety, permanency, and well-being. Survey data was collected from workers and supervisors in private agencies providing out-of-home care case management and residential treatment services to children and youth across three states. Hierarchical linear modeling tested the role of goal-oriented teamwork and supervisory practice involving the use of data to assess practice effectiveness in predicting evidence-informed practice. The partially mediated relationship showed that a more goal-oriented approach combined with supervisory practice led to increased use of evidence-informed practice. Implications for promoting evidence-informed practice in child welfare are discussed.

  9. Assessing the Claims of Participatory Measurement, Reporting and Verification (PMRV) in Achieving REDD+ Outcomes: A Systematic Review

    PubMed Central

    Hawthorne, Sandra; Boissière, Manuel; Felker, Mary Elizabeth; Atmadja, Stibniati

    2016-01-01

    Participation of local communities in the Measurement, Reporting and Verification (MRV) of forest changes has been promoted as a strategy that lowers the cost of MRV and increases their engagement with REDD+. This systematic review of literature assessed the claims of participatory MRV (PMRV) in achieving REDD+ outcomes. We identified 29 PMRV publications that consisted of 20 peer-reviewed and 9 non peer-reviewed publications, with 14 publications being empirically based studies. The evidence supporting PMRV claims was categorized into empirical finding, citation or assumption. Our analysis of the empirical studies showed that PMRV projects were conducted in 17 countries in three tropical continents and across various forest and land tenure types. Most of these projects tested the feasibility of participatory measurement or monitoring, which limited the participation of local communities to data gathering. PMRV claims of providing accurate local biomass measurements and lowering MRV cost were well-supported with empirical evidence. Claims that PMRV supports REDD+ social outcomes that affect local communities directly, such as increased environmental awareness and equity in benefit sharing, were supported with less empirical evidence than REDD+ technical outcomes. This may be due to the difficulties in measuring social outcomes and the slow progress in the development and implementation of REDD+ components outside of experimental research contexts. Although lessons from other monitoring contexts have been used to support PMRV claims, they are only applicable when the enabling conditions can be replicated in REDD+ contexts. There is a need for more empirical evidence to support PMRV claims on achieving REDD+ social outcomes, which may be addressed with more opportunities and rigorous methods for assessing REDD+ social outcomes. Integrating future PMRV studies into local REDD+ implementations may help create those opportunities, while increasing the participation of

  10. 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

  11. 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

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

    PubMed

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

    2016-01-01

    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.

  13. 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

  14. How to successfully achieve salt restriction in dialysis patients? What are the outcomes?

    PubMed

    Ok, Ercan

    2010-01-01

    Despite the fact that dietary salt restriction is the most logical measure to prevent accumulation of salt and water in patients without renal function, it is not applied in most dialysis centers. In this review, the reasons for this unlucky development are analyzed. First, it appears that many dialysis patients are slightly overhydrated, but this is often not noticed and, if so, the deleterious effects in the long run are not appreciated. These consist not only of 'drug-resistant' hypertension, but also dilatation of the cardiac compartments leading to preventable cardiovascular events. Second, there are practical reasons why salt restriction is neglected. It is very difficult to buy salt-poor food. Salt consumption is an addiction, which can be overcome, but time and efforts are needed to achieve that. Suggestions are made how to reach that goal. Finally, examples are given how cardiac damage (often considered irreversible) can be improved or even cured by a 'volume control' strategy, whose crucial part is serious salt restriction.

  15. 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.

  16. Development of the Optimality Index as a new approach to evaluating outcomes of maternity care.

    PubMed

    Murphy, Patricia Aikins; Fullerton, Judith T

    2006-01-01

    Evaluating perinatal outcomes within a framework of normalcy is a new focus of measurement. As maternal and child health clinicians and researchers look to evaluate care practices that are both of high quality and cost-effective, it is important to have measurement tools that assess differences among all women giving birth. The Optimality Index-US shifts the focus from rare adverse events to evidence-based optimal events. This article describes the continuing development of the index and discusses clinical implications for obstetric nurse clinicians.

  17. 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.

  18. Story Goodness in Adolescents With Autism Spectrum Disorder (ASD) and in Optimal Outcomes From ASD

    PubMed Central

    Canfield, Allison R.; de Marchena, Ashley; Fein, Deborah

    2016-01-01

    Purpose This study examined narrative quality of adolescents with autism spectrum disorder (ASD) using a well-studied “story goodness” coding system. Method Narrative samples were analyzed for distinct aspects of story goodness and rated by naïve readers on dimensions of story goodness, accuracy, cohesiveness, and oddness. Adolescents with high-functioning ASD were compared with adolescents with typical development (TD; n = 15 per group). A second study compared narratives from adolescents across three groups: ASD, TD, and youths with “optimal outcomes,” who were diagnosed with ASD early in development but no longer meet criteria for ASD and have typical behavioral functioning. Results In both studies, the ASD group's narratives had lower composite quality scores compared with peers with typical development. In Study 2, narratives from the optimal outcomes group were intermediate in scores and did not differ significantly from those of either other group. However, naïve raters were able to detect qualitative narrative differences across groups. Conclusions Findings indicate that pragmatic deficits in ASD are salient and could have clinical relevance. Furthermore, results indicate subtle differences in pragmatic language skills for individuals with optimal outcomes despite otherwise typical language skills in other domains. These results highlight the need for clinical interventions tailored to the specific deficits of these populations. PMID:27280731

  19. 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.

  20. 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.

  1. 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…

  2. 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…

  3. The Relationship of Mental Pressure with Optimism and Academic Achievement Motivation among Second Grade Male High School Students

    ERIC Educational Resources Information Center

    Sarouni, Ali Sedigh; Jenaabadi, Hossein; Pourghaz, Abdulwahab

    2016-01-01

    The present study aimed to examine the relationship of mental pressure with optimism and academic achievement motivation among second grade second period male high school students. This study followed a descriptive-correlational method. The sample included 200 second grade second period male high school students in Sooran. Data collection tools in…

  4. Navy Strategy for Achieving Information Dominance, 2013-2017. Optimizing Navy’s Primacy in the Maritime and Information Domains

    DTIC Science & Technology

    2013-01-01

    and resources to optimize decision making and maximize warfighting effects, Navy Information Dominance has become a leading Service priority. In 2009...This Strategy for Achieving Information Dominance provides the framework through which the Navy s information capabilities will be mainstreamed into...the Navy s culture as a distinct warfighting discipline. The strategy focuses on the three fundamental Information Dominance capabilities of Assured

  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, 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...

  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

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 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...

  7. Long-term management strategies to achieve optimal function in patients with bipolar disorder.

    PubMed

    Keck, Paul E

    2006-12-01

    Predictors of poor functional outcome in patients with bipolar disorder include psychiatric and medical comorbidity, interepisode subsyndromal symptoms, psychosis during manic or mixed episode, and low premorbid functioning. Cognitive dysfunction may also contribute to functional impairment. Psychosocial intervention has shown success in improving syndromal outcomes for people with bipolar disorder. Lithium, lamotrigine, olanzapine, and aripiprazole have all shown substantial improvements in relapse rates compared with placebo. Combination therapy with antipsychotics and antidepressants has also been shown to produce improvement in symptoms in people with bipolar disorder. However, limited evidence is available for the effects of these treatments on cognitive outcomes. This review discusses treatment strategies for the long-term management of bipolar disorder and functional outcome measures associated with these treatments.

  8. 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…

  9. 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

  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. On Sparse representation for Optimal Individualized Treatment Selection with Penalized Outcome Weighted Learning

    PubMed Central

    Song, Rui; Kosorok, Michael; Zeng, Donglin; Zhao, Yingqi; Laber, Eric; Yuan, Ming

    2015-01-01

    As a new strategy for treatment which takes individual heterogeneity into consideration, personalized medicine is of growing interest. Discovering individualized treatment rules (ITRs) for patients who have heterogeneous responses to treatment is one of the important areas in developing personalized medicine. As more and more information per individual is being collected in clinical studies and not all of the information is relevant for treatment discovery, variable selection becomes increasingly important in discovering individualized treatment rules. In this article, we develop a variable selection method based on penalized outcome weighted learning through which an optimal treatment rule is considered as a classification problem where each subject is weighted proportional to his or her clinical outcome. We show that the resulting estimator of the treatment rule is consistent and establish variable selection consistency and the asymptotic distribution of the estimators. The performance of the proposed approach is demonstrated via simulation studies and an analysis of chronic depression data. PMID:25883393

  12. Long-term management strategies to achieve optimal function in patients with bipolar disorder.

    PubMed

    Keck, Paul E

    2006-01-01

    Functional impairment is a problem for people with bipolar disorder. Predictors of poor functional outcome are psychiatric and medical comorbidity, interepisode subsyndromal symptoms, psychosis during a manic or mixed episode, and low premorbid functioning. Cognitive dysfunction may also be a contributory factor in functional impairment. Several psychosocial interventions designed for people with bipolar disorder have demonstrated success in improving syndromal outcomes, but the effects of psychosocial interventions on functioning and cognition have not been examined. Among pharmacologic interventions available for long-term treatment of bipolar disorder, there is a strong clinical trend away from monotherapy and toward combination therapy. Lithium, lamotrigine, olanzapine, and aripiprazole have all shown substantial improvements in relapse rates compared with placebo. Although some of these medications show superior results compared with the others in preventing the recurrence of either depressive or manic episodes, only anecdotal evidence exists regarding their effect on cognition. Combination therapy with antipsychotics or antidepressants has also been shown to produce better syndromal outcomes in people with bipolar disorder, but inadequate evidence is available on cognitive outcomes. Substantial information is needed regarding the prevalence and causes of cognitive dysfunction in bipolar disorder, the effects of existing treatments on cognition, and long-term treatments to improve cognition and functioning.

  13. 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

  14. 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…

  15. Fatalism, optimism, spirituality, depressive symptoms and stroke outcome: A population-based analysis

    PubMed Central

    Morgenstern, Lewis B.; Sánchez, Brisa N.; Skolarus, Lesli E.; Garcia, Nelda; Risser, Jan M.H.; Wing, Jeffrey J.; Smith, Melinda A.; Zahuranec, Darin B.; Lisabeth, Lynda D.

    2011-01-01

    Background and Purpose We sought to describe the association of spirituality, optimism, fatalism and depressive symptoms with initial stroke severity, stroke recurrence and post-stroke mortality. Methods Stroke cases June 2004–December 2008 were ascertained in Nueces County, Texas. Patients without aphasia were queried on their recall of depressive symptoms, fatalism, optimism, and non-organizational spirituality before stroke using validated scales. The association between scales and stroke outcomes was studied using multiple linear regression with log-transformed NIHSS and Cox proportional hazards regression for recurrence and mortality. Results 669 patients participated, 48.7% were women. In fully adjusted models, an increase in fatalism from the first to third quartile was associated with all-cause mortality (HR=1.41, 95%CI: 1.06, 1.88), marginally associated with risk of recurrence (HR=1.35, 95%CI: 0.97, 1.88), but not stroke severity. Similarly, an increase in depressive symptoms was associated with increased mortality (HR=1.32, 95%CI: 1.02, 1.72), marginally associated with stroke recurrence (HR=1.22, CI: 0.93, 1.62), and with a 9.0% increase in stroke severity (95%CI: 0.01, 18.0). Depressive symptoms altered the fatalism-mortality association such that the association of fatalism and mortality was more pronounced for patients reporting no depressive symptoms. Neither spirituality nor optimism conferred a significant effect on stroke severity, recurrence or mortality. Conclusions Among patients who have already had a stroke, self-described pre-stroke depressive symptoms and fatalism, but not optimism or spirituality, are associated with increased risk of stroke recurrence and mortality. Unconventional risk factors may explain some of the variability in stroke outcomes observed in populations, and may be novel targets for intervention. PMID:21940963

  16. 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…

  17. Study of optimal extraction conditions for achieving high yield and antioxidant activity of tomato seed oil

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Tomato seeds resulting from tomato processing by-product have not been effectively utilized as value-added products. This study investigated the kinetics of oil extraction from tomato seeds and sought to optimize the oil extraction conditions. The oil was extracted by using hexane as solvent for 0 t...

  18. 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.

  19. 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.

  20. Assessment of Local HOx and ROx Measurement Techniques: Achievements, Challenges, and Future Directions - Outcome From the International HOx Workshop 2015

    NASA Astrophysics Data System (ADS)

    Hofzumahaus, A.; Heard, D. E.

    2015-12-01

    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 contribution will give an overview of the workshop, its outcome and planned activites.

  1. Optimizing perioperative outcomes for older patients with rheumatoid arthritis undergoing arthroplasty: emphasis on medication management.

    PubMed

    Goodman, Susan M

    2015-05-01

    Patients with rheumatoid arthritis continue to undergo arthroplasty despite widespread use of potent disease-modifying drugs (DMARDs), including the biologic tumor necrosis-α inhibitors. In fact, over 80 % of RA patients are taking DMARDs or biologics at the time of arthroplasty. While many RA-specific factors including disease activity and disability may contribute to the increase in infection in RA patients undergoing arthroplasty, immunosuppressant medications may also play a role. As the age of patients with RA undergoing arthroplasty is rising, and the incidence of arthroplasty among the older population is increasing, optimal perioperative management of DMARDs and biologics in older patients with RA is an increasing challenge. Although evidence is sparse, most evidence supports withholding tumor necrosis-α inhibitors and other biologics prior to surgery based on the dosing interval, and continuing methotrexate and hydroxychloroquine through the perioperative period. There is no consensus regarding leflunomide, and rituximab risk does not appear related to the interval between infusion and surgery. This paper reviews arthroplasty outcomes including complications in patients with RA, and discusses the rationale for strategies for the optimal medication management of DMARDs and biologics in the perioperative period to minimize complications and improve outcomes.

  2. 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

  3. Optimal diabetes care outcomes following face-to-face medication therapy management services.

    PubMed

    Brummel, Amanda R; Soliman, Ahmed M; Carlson, Angeline M; de Oliveira, Djenane Ramalho

    2013-02-01

    Pharmacists play an integral role in influencing resolution of drug-related problems. This study examines the relationship between a pharmacist-led and delivered medication therapy management (MTM) program and achievement of Optimal Diabetes Care benchmarks. Data within Fairview Pharmacy Services were used to identify a group of patients with diabetes who received MTM services during a 2007 demonstration project (n=121) and a control group who were invited to receive MTM services but opted out (n=103). Rates of achieving optimal diabetes clinical management for both groups were compared using the D5 diabetes measure for years 2006, 2007, and 2008. The D5 components are: glycosolated hemoglobin (HbA1c<7%); low-density lipoprotein (<100 mg/dl); blood pressure (<130/80 mmHg); tobacco free; and daily aspirin use. Multivariate difference-in-differences (DID) estimation was used to determine the impact of 1 year of MTM services on each care component. Patients who opted in for MTM had higher Charlson scores, more complex medication regimens, and a higher percentage of diabetes with complications (P<0.05). In 2007, the percentage of diabetes patients optimally managed was significantly higher for MTM patients compared to 2006 values (21.49% vs. 45.45%, P<0.01). Nonlinear DID models showed that MTM patients were more likely to meet the HbA1c criterion in 2007 (odds ratio: 2.48, 95% confidence interval [CI]: 1.04-5.85, P=0.038). Linear DID models for HbA1c showed a mean reduction of 0.54% (95% CI: 0.091%-0.98%, P=0.018) for MTM patients. An MTM program contributed to improved optimal diabetes management in a population of patients with complex diabetes clinical profiles.

  4. Optimized atomistic force fields for aqueous solutions of Magnesium and Calcium Chloride: Analysis, achievements and limitations

    NASA Astrophysics Data System (ADS)

    Elfgen, Roman; Hülsmann, Marco; Krämer, Andreas; Köddermann, Thorsten; Kirschner, Karl N.; Reith, Dirk

    2016-10-01

    Molecular simulations are an important tool in the study of aqueous salt solutions. To predict the physical properties accurately and reliably, the molecular models must be tailored to reproduce experimental data. In this work, a combination of recent global and local optimization tools is used to derive force fields for MgCl2 (aq) and CaCl2 (aq). The molecular models for the ions are based on a Lennard-Jones (LJ) potential with a superimposed point charge. The LJ parameters are adjusted to reproduce the bulk density and shear viscosity of the different solutions at 1 bar and temperatures of 293.15, 303.15, and 318.15 K. It is shown that the σ-value of chloride consistently has the strongest influence on the system properties. The optimized force field for MgCl2 (aq) provides both properties in good agreement with the experimental data over a wide range of salt concentrations. For CaCl2 (aq), a compromise was made between the bulk density and shear viscosity, since reproducing the two properties requires two different choices of the LJ parameters. This is demonstrated by studying metamodels of the simulated data, which are generated to visualize the correlation between the parameters and observables by using projection plots. Consequently, in order to derive a transferable force field, an error of ˜3% on the bulk density has to be tolerated to yield the shear viscosity in satisfactory agreement with experimental data.

  5. Metal-binding sites are designed to achieve optimal mechanical and signaling properties

    PubMed Central

    Dutta, Anindita; Bahar, Ivet

    2010-01-01

    Many proteins require bound metals to achieve their function. We take advantage of increasing structural data on metal-binding proteins to elucidate three properties: the involvement of metal-binding sites in the global dynamics of the protein, predicted by elastic network models, their exposure/burial to solvent, and their signal-processing properties indicated by Markovian stochastics analysis. Systematic analysis of a dataset of 145 structures reveals that the residues that coordinate metal ions enjoy remarkably efficient and precise signal transduction properties. These properties are rationalized in terms of their physical properties: participation in hinge sites that control the softest modes collectively accessible to the protein and occupancy of central positions minimally exposed to solvent. Our observations suggest that metal-binding sites may have been evolutionary selected to achieve optimum allosteric communication. They also provide insights into basic principles for designing metal-binding sites, which are verified to be met by recently designed de novo metal-binding proteins. PMID:20826340

  6. Barriers to achieving optimal glycemic control in a multi-ethnic society: a US focus.

    PubMed

    Dagogo-Jack, Samuel; Funnell, Martha M; Davidson, Jaime

    2006-08-01

    The increasing prevalence of diabetes is particularly apparent in certain ethnic groups, such as African and Hispanic Americans. These groups generally also have poorer glycemic control and outcomes. To better understand the issues surrounding these problems and possible methods to overcome them we performed a literature review from the past 15 years on barriers to glycemic control with a focus on US data. The literature reveals that barriers may be inherent (eg, genetic, cultural, and language/communication) or acquired (eg, those associated with changes in lifestyle and socioeconomic factors). Healthcare interventions that take into consideration cultural and population-specific characteristics can reduce the prevalence and severity of diabetes and its resulting complications. Implementing such strategies will require suitable education for patients and providers, the availability of culturally-sensitive, patient-centered healthcare teams, the creation of collaborative relationships between providers and patients, better use of community resources, and assistance for patients to make informed decisions about available treatment options. There is also evidence suggesting that at the same level of glucose control Hispanics and African Americans have the same degree of complications as whites; therefore, good control is essential for the future well-being of all patients. Addressing these issues may help to decrease the ethnic disparities that currently exist in diabetes care.

  7. Detail and gestalt focus in individuals with optimal outcomes from autism spectrum disorders.

    PubMed

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

    2015-06-01

    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.

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

    PubMed Central

    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 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

  9. Achieving high lipid productivity of a thermotolerant microalga Desmodesmus sp. F2 by optimizing environmental factors and nutrient conditions.

    PubMed

    Ho, Shih-Hsin; Chang, Jo-Shu; Lai, Yen-Ying; Chen, Ching-Nen Nathan

    2014-03-01

    The optimal conditions for cultivating the thermotolerant lipid-rich microalga Desmodesmus sp. F2 to achieve maximal lipid productivity were determined in this study. The conditions were light intensity, 700μmol/m(2)s; temperature, 35°C; cultivation nitrogen source, nitrate; initial nitrogen level, 6.6mM nitrogen. Carbon dioxide (2.5%, 0.2 vvm) was pumped into the cultures continuously. In the pre-optimized conditions, the maximal lipid productivity of this microalga was 113mg/L/d, which was raised to 263mg/L/d in the optimized conditions. This level of lipid productivity of microalgae is the highest ever reported in the literature. Fatty acid composition of the lipid produced by Desmodesmus sp. F2 in the optimal conditions was determined, in which C16 and C18 species accounted for 95% of the fatty acids. Saturated, monounsaturated and polyunsaturated fatty acids accounted for 38.9%, 33.1% and 22.6%, respectively. Based on the analysis, this lipid quality makes it a good feedstock for biodiesel production.

  10. 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

    2015-05-04

    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.

  11. Optimization of Oxidation Temperature for Commercially Pure Titanium to Achieve Improved Corrosion Resistance

    NASA Astrophysics Data System (ADS)

    Bansal, Rajesh; Singh, J. K.; Singh, Vakil; Singh, D. D. N.; Das, Parimal

    2017-03-01

    Thermal oxidation of commercially pure titanium (cp-Ti) was carried out at different temperatures, ranging from 200 to 900 °C to achieve optimum corrosion resistance of the thermally treated surface in simulated body fluid. Scanning electron microscopy, x-ray diffraction, Raman spectroscopy and electrochemical impedance spectroscopy techniques were used to characterize the oxides and assess their protective properties exposed in the test electrolyte. Maximum resistance toward corrosion was observed for samples oxidized at 500 °C. This was attributed to the formation of a composite layer of oxides at this temperature comprising Ti2O3 (titanium sesquioxide), anatase and rutile phases of TiO2 on the surface of cp-Ti. Formation of an intact and pore-free oxide-substrate interface also improved its corrosion resistance.

  12. Optimization of Oxidation Temperature for Commercially Pure Titanium to Achieve Improved Corrosion Resistance

    NASA Astrophysics Data System (ADS)

    Bansal, Rajesh; Singh, J. K.; Singh, Vakil; Singh, D. D. N.; Das, Parimal

    2017-02-01

    Thermal oxidation of commercially pure titanium (cp-Ti) was carried out at different temperatures, ranging from 200 to 900 °C to achieve optimum corrosion resistance of the thermally treated surface in simulated body fluid. Scanning electron microscopy, x-ray diffraction, Raman spectroscopy and electrochemical impedance spectroscopy techniques were used to characterize the oxides and assess their protective properties exposed in the test electrolyte. Maximum resistance toward corrosion was observed for samples oxidized at 500 °C. This was attributed to the formation of a composite layer of oxides at this temperature comprising Ti2O3 (titanium sesquioxide), anatase and rutile phases of TiO2 on the surface of cp-Ti. Formation of an intact and pore-free oxide-substrate interface also improved its corrosion resistance.

  13. 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…

  14. 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.

  15. 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…

  16. 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…

  17. The Impact of an Advisor-Advisee Mentoring Program on the Achievement, School Engagement, and Behavior Outcomes of Rural Eighth Grade Students

    ERIC Educational Resources Information Center

    Herrick, Christopher J.

    2010-01-01

    The purpose of this exploratory two-group pretest-posttest comparative survey study was to determine the effect of a team adviser-advisee academic, behavior, and character mentoring program on the achievement, school engagement, and behavior outcomes of eighth grade students determined to be above (n = 21) and below (n = 15) eligibility guidelines…

  18. Feelings and Performance in the First Year at University: Learning-Related Emotions as Predictors of Achievement Outcomes in Mathematics and Statistics

    ERIC Educational Resources Information Center

    Niculescu, Alexandra C.; Templelaar, Dirk; Leppink, Jimmie; Dailey-Hebert, Amber; Segers, Mien; Gijselaers, Wim

    2015-01-01

    Introduction: This study examined the predictive value of four learning-related emotions--Enjoyment, Anxiety, Boredom and Hopelessness for achievement outcomes in the first year of study at university. Method: We used a large sample (N = 2337) of first year university students enrolled over three consecutive academic years in a mathematics and…

  19. "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…

  20. The Impact of Achieve3000 on Elementary Literacy Outcomes: Evidence from a Two-Year Randomized Control Trial

    ERIC Educational Resources Information Center

    Hill, Darryl V.; Lenard, Matthew A.; Page, Lindsay Coleman

    2016-01-01

    School districts are increasingly adopting technology-based resources in an attempt to improve student achievement. This paper reports the two-year results from randomized control trial of Achieve3000 in the Wake County Public School System (WCPSS) in Raleigh, North Carolina. Achieve3000 is an early literacy program that differentiates non-fiction…

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

    PubMed

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

    2015-08-01

    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

  2. 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

  3. Evidence-Based Interventions Are Necessary but Not Sufficient for Achieving Outcomes in Each Setting in a Complex World: Empowerment Evaluation, Getting to Outcomes, and Demonstrating Accountability

    ERIC Educational Resources Information Center

    Wandersman, Abraham; Alia, Kassandra; Cook, Brittany S.; Hsu, Lewis L.; Ramaswamy, Rohit

    2016-01-01

    Many evaluations of programs tend to show few outcomes. One solution to this has been an increasing prominence of the movement that requires programs to implement evidence-based interventions (EBIs). But in a complex world with complex organizations and complex interventions, many challenges have arisen to the implementation of EBIs with fidelity…

  4. Concurrently examining unrealistic absolute and comparative optimism: Temporal shifts, individual-difference and event-specific correlates, and behavioural outcomes.

    PubMed

    Ruthig, Joelle C; Gamblin, Bradlee W; Jones, Kelly; Vanderzanden, Karen; Kehn, Andre

    2017-02-01

    Researchers have spent considerable effort examining unrealistic absolute optimism and unrealistic comparative optimism, yet there is a lack of research exploring them concurrently. This longitudinal study repeatedly assessed unrealistic absolute and comparative optimism within a performance context over several months to identify the degree to which they shift as a function of proximity to performance and performance feedback, their associations with global individual difference and event-specific factors, and their link to subsequent behavioural outcomes. Results showed similar shifts in unrealistic absolute and comparative optimism based on proximity to performance and performance feedback. Moreover, increases in both types of unrealistic optimism were associated with better subsequent performance beyond the effect of prior performance. However, several differences were found between the two forms of unrealistic optimism in their associations with global individual difference factors and event-specific factors, highlighting the distinctiveness of the two constructs.

  5. 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.

  6. 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…

  7. 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…

  8. A Qualitative Study of Self-Esteem, Peer Affiliation, and Academic Outcome among Low Achieving Students in Hong Kong

    ERIC Educational Resources Information Center

    Leung, Chi-hung; Choi, Eudora

    2010-01-01

    Background: A limited amount of research has been conducted on children and adolescents who are low achievers. In Hong Kong, educators describe low achieving students in terms of academic performance, they seldom focus on socio-emotional aspects, such as self-esteem, peer affiliation, and inter-personal relationships. However, low achieving…

  9. The Impact of Motivation on Student's Academic Achievement and Learning Outcomes in Mathematics among Secondary School Students in Nigeria

    ERIC Educational Resources Information Center

    Tella, Adedeji

    2007-01-01

    In our match towards scientific and technological advancement, we need nothing short of good performance in mathematics at all levels of schooling. In an effort to achieve this, this study investigated the impact of motivation on students' school academic achievement in mathematics in secondary schools using motivation for academic preference…

  10. 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

  11. 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…

  12. 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,…

  13. 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…

  14. 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…

  15. 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…

  16. 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…

  17. Strategies for Achieving the New SHAPE America Standards and Grade-Level Outcomes: Bringing Obstacle Course Training into Physical Education

    ERIC Educational Resources Information Center

    Kulik, Keri S.; Brewer, Hannah; Windish, Lance; Carlson, Hollie

    2017-01-01

    The new SHAPE America standards and grade level outcomes for high-school physical education focus exclusively on physical activities that are suitable for lifelong participation. Some of the fastest-growing physical activities for adults in the United States are non-traditional multi-sport events and obstacle course races. As "Healthy People…

  18. Do Typical RCTS of Education Interventions Have Sufficient Statistical Power for Linking Impacts on Teacher Practice and Student Achievement Outcomes?

    ERIC Educational Resources Information Center

    Schochet, Peter Z.

    2011-01-01

    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 article develops statistical…

  19. 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.

  20. 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.

  1. "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

  2. 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…

  3. 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.…

  4. 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…

  5. Achievement Outcomes of Two Reading Programs: An Instance of Aptitude-Treatment Interaction. Technical Report No. 174.

    ERIC Educational Resources Information Center

    Tirre, William C.; And Others

    The reading achievement test performance of 180 sixth grade students in contrasting reading programs was examined. One program (Matteson) was an explicitly sequenced, behaviorally oriented skills program; the other (Scott Foresman) placed more emphasis on rich language experience and less emphasis on specific skill development. An…

  6. 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.

  7. Lipid Encapsulation Provides Insufficient Total-Tract Digestibility to Achieve an Optimal Transfer Efficiency of Fatty Acids to Milk Fat

    PubMed Central

    Bainbridge, Melissa; Kraft, Jana

    2016-01-01

    Transfer efficiencies of rumen-protected n-3 fatty acids (FA) to milk are low, thus we hypothesized that rumen-protection technologies allow for biohydrogenation and excretion of n-3 FA. The objectives of this study were to i) investigate the ruminal protection and post-ruminal release of the FA derived from the lipid-encapsulated echium oil (EEO), and ii) assess the bioavailability and metabolism of the EEO-derived FA through measuring the FA content in plasma lipid fractions, feces, and milk. The EEO was tested for rumen stability using the in situ nylon bag technique, then the apparent total-tract digestibility was assessed in vivo using six Holstein dairy cattle. Diets consisted of a control (no EEO); 1.5% of dry matter (DM) as EEO and 1.5% DM as encapsulation matrix; and 3% DM as EEO. The EEO was rumen-stable and had no effect on animal production. EEO-derived FA were incorporated into all plasma lipid fractions, with the highest proportion of n-3 FA observed in cholesterol esters. Fecal excretion of EEO-derived FA ranged from 7–14%. Biohydrogenation products increased in milk, plasma, and feces with EEO supplementation. In conclusion, lipid-encapsulation provides inadequate digestibility to achieve an optimal transfer efficiency of n-3 FA to milk. PMID:27741299

  8. Optimal functional outcome measures for assessing treatment for Dupuytren’s disease: a systematic review and recommendations for future practice

    PubMed Central

    2013-01-01

    Background Dupuytren's disease of the hand is a common condition affecting the palmar fascia, resulting in progressive flexion deformities of the digits and hence limitation of hand function. The optimal treatment remains unclear as outcomes studies have used a variety of measures for assessment. Methods A literature search was performed for all publications describing surgical treatment, percutaneous needle aponeurotomy or collagenase injection for primary or recurrent Dupuytren’s disease where outcomes had been monitored using functional measures. Results Ninety-one studies met the inclusion criteria. Twenty-two studies reported outcomes using patient reported outcome measures (PROMs) ranging from validated questionnaires to self-reported measures for return to work and self-rated disability. The Disability of Arm, Shoulder and Hand (DASH) score was the most utilised patient-reported function measure (n=11). Patient satisfaction was reported by eighteen studies but no single method was used consistently. Range of movement was the most frequent physical measure and was reported in all 91 studies. However, the methods of measurement and reporting varied, with seventeen different techniques being used. Other physical measures included grip and pinch strength and sensibility, again with variations in measurement protocols. The mean follow-up time ranged from 2 weeks to 17 years. Conclusions There is little consistency in the reporting of outcomes for interventions in patients with Dupuytren’s disease, making it impossible to compare the efficacy of different treatment modalities. Although there are limitations to the existing generic patient reported outcomes measures, a combination of these together with a disease-specific questionnaire, and physical measures of active and passive individual joint Range of movement (ROM), grip and sensibility using standardised protocols should be used for future outcomes studies. As Dupuytren’s disease tends to recur

  9. 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

  10. Decreased Sperm Motility Retarded ICSI Fertilization Rate in Severe Oligozoospermia but Good-Quality Embryo Transfer Had Achieved the Prospective Clinical Outcomes

    PubMed Central

    Zheng, Jufeng; Lu, Yongning; Qu, Xianqin; Wang, Peng; Zhao, Luiwen; Gao, Minzhi; Shi, Huijuan; Jin, Xingliang

    2016-01-01

    . Overall rates in all groups were 41.26% clinical pregnancy, 25.74% implantation and 36.32% live birth, which gave live birth to 252 girls and 252 boys. Conclusions The reduction of motile spermatozoa in severe oligozoospermia decreased the rates of fertilization and good-quality embryo. Obtaining and transfer of good-quality embryos was the good prognostic to achieve prospective clinical outcomes regardless of the severity of oligozoospermia. PMID:27661081

  11. Outcomes achieved by and police and clinician perspectives on a joint police officer and mental health clinician mobile response unit.

    PubMed

    Lee, Stuart J; Thomas, Phillipa; Doulis, Chantelle; Bowles, Doug; Henderson, Kathryn; Keppich-Arnold, Sandra; Perez, Eva; Stafrace, Simon

    2015-12-01

    Despite their limited mental health expertise, police are often first to respond to people experiencing a mental health crisis. Often the person in crisis is then transported to hospital for care, instead of receiving more immediate assessment and treatment in the community. The current study conducted an evaluation of an Australian joint police-mental health mobile response unit that aimed to improve the delivery of a community-based crisis response. Activity data were audited to demonstrate utilization and outcomes for referred people. Police officers and mental health clinicians in the catchment area were also surveyed to measure the unit's perceived impact. During the 6-month pilot, 296 contacts involving the unit occurred. Threatened suicide (33%), welfare concerns (22%) and psychotic episodes (18%) were the most common reasons for referral. The responses comprised direct admission to a psychiatric unit for 11% of contacts, transportation to a hospital emergency department for 32% of contacts, and community management for the remainder (57%). Police officers were highly supportive of the model and reported having observed benefits of the unit for consumers and police and improved collaboration between services. The joint police-mental health clinician unit enabled rapid delivery of a multi-skilled crisis response in the community.

  12. 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

  13. Prediction of the optimum surface orientation angles to achieve maximum solar radiation using Particle Swarm Optimization in Sabha City Libya

    NASA Astrophysics Data System (ADS)

    Mansour, F. A.; Nizam, M.; Anwar, M.

    2017-02-01

    This research aims to predict the optimum surface orientation angles in solar panel installation to achieve maximum solar radiation. Incident solar radiation is calculated using koronakis mathematical model. Particle Swarm Optimization (PSO) is used as computational method to find optimum angle orientation for solar panel installation in order to get maximum solar radiation. A series of simulation has been carried out to calculate solar radiation based on monthly, seasonally, semi-yearly and yearly period. South-facing was calculated also as comparison of proposed method. South-facing considers azimuth of 0°. Proposed method attains higher incident predictions than South-facing that recorded 2511.03 kWh/m2for monthly. It were about 2486.49 kWh/m2, 2482.13 kWh/m2and 2367.68 kWh/m2 for seasonally, semi-yearly and yearly. South-facing predicted approximately 2496.89 kWh/m2, 2472.40 kWh/m2, 2468.96 kWh/m2, 2356.09 kWh/m2for monthly, seasonally, semi-yearly and yearly periods respectively. Semi-yearly is the best choice because it needs twice adjustments of solar panel in a year. Yet it considers inefficient to adjust solar panel position in every season or monthly with no significant solar radiation increase than semi-yearly and solar tracking device still considers costly in solar energy system. PSO was able to predict accurately with simple concept, easy and computationally efficient. It has been proven by finding the best fitness faster.

  14. SU-E-T-368: Evaluating Dosimetric Outcome of Modulated Photon Radiotherapy (XMRT) Optimization for Head and Neck Patients

    SciTech Connect

    McGeachy, P; Villarreal-Barajas, JE; Khan, R; Zinchenko, Y

    2015-06-15

    Purpose: The dosimetric outcome of optimized treatment plans obtained by modulating the photon beamlet energy and fluence on a small cohort of four Head and Neck (H and N) patients was investigated. This novel optimization technique is denoted XMRT for modulated photon radiotherapy. The dosimetric plans from XMRT for H and N treatment were compared to conventional, 6 MV intensity modulated radiotherapy (IMRT) optimization plans. Methods: An arrangement of two non-coplanar and five coplanar beams was used for all four H and N patients. Both XMRT and IMRT were subject to the same optimization algorithm, with XMRT optimization allowing both 6 and 18 MV beamlets while IMRT was restricted to 6 MV only. The optimization algorithm was based on a linear programming approach with partial-volume constraints implemented via the conditional value-at-risk method. H and N constraints were based off of those mentioned in the Radiation Therapy Oncology Group 1016 protocol. XMRT and IMRT solutions were assessed using metrics suggested by International Commission on Radiation Units and Measurements report 83. The Gurobi solver was used in conjunction with the CVX package to solve each optimization problem. Dose calculations and analysis were done in CERR using Monte Carlo dose calculation with VMC{sub ++}. Results: Both XMRT and IMRT solutions met all clinical criteria. Trade-offs were observed between improved dose uniformity to the primary target volume (PTV1) and increased dose to some of the surrounding healthy organs for XMRT compared to IMRT. On average, IMRT improved dose to the contralateral parotid gland and spinal cord while XMRT improved dose to the brainstem and mandible. Conclusion: Bi-energy XMRT optimization for H and N patients provides benefits in terms of improved dose uniformity to the primary target and reduced dose to some healthy structures, at the expense of increased dose to other healthy structures when compared with IMRT.

  15. 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

  16. Optimal Threshold and Time of Absolute Lymphocyte Count Assessment for Outcome Prediction after Bone Marrow Transplantation.

    PubMed

    Bayraktar, Ulas D; Milton, Denái R; Guindani, Michele; Rondon, Gabriela; Chen, Julianne; Al-Atrash, Gheath; Rezvani, Katayoun; Champlin, Richard; Ciurea, Stefan O

    2016-03-01

    The recovery pace of absolute lymphocyte count (ALC) is prognostic after hematopoietic stem cell transplantation. Previous studies have evaluated a wide range of ALC cutoffs and time points for predicting outcomes. We aimed to determine the optimal ALC value for outcome prediction after bone marrow transplantation (BMT). A total of 518 patients who underwent BMT for acute leukemia or myelodysplastic syndrome between 1999 and 2010 were divided into a training set and a test set to assess the prognostic value of ALC on days 30, 60, 90, 120, 180, as well as the first post-transplantation day of an ALC of 100, 200, 300, 400, 500, and 1000/μL. In the training set, the best predictor of overall survival (OS), relapse-free survival (RFS), and nonrelapse mortality (NRM) was ALC on day 60. In the entire patient cohort, multivariable analyses demonstrated significantly better OS, RFS, and NRM and lower incidence of graft-versus-host disease (GVHD) in patients with an ALC >300/μL on day 60 post-BMT, both including and excluding patients who developed GVHD before day 60. Among the patient-, disease-, and transplant-related factors assessed, only busulfan-based conditioning was significantly associated with higher ALC values on day 60 in both cohorts. The optimal ALC cutoff for predicting outcomes after BMT is 300/μL on day 60 post-transplantation.

  17. Use of allopurinol with low-dose 6-mercaptopurine in inflammatory bowel disease to achieve optimal active metabolite levels: A review of four cases and the literature

    PubMed Central

    Witte, Todd N; Ginsberg, Allen L

    2008-01-01

    BACKGROUND: At least one-third of patients with inflammatory bowel disease do not respond or are intolerant to therapy with 6-mercaptopurine (6-MP). A subgroup fails to attain optimal levels of 6-thioguanine nucleotide (6-TGN) and instead shunts to 6-methylmercaptopurine nucleotide (6-MMPN). PATIENTS AND METHODS: A retrospective chart review was conducted, and four patients are described who had been previously unable to achieve optimal 6-TGN metabolite levels until allopurinol was added to their treatment. RESULTS: All four patients achieved optimal 6-TGN levels and undetectable 6-MMPN with a mean 6-MP dose of 0.49 mg/kg. Three achieved steroid-free clinical remission. Two of those three patients had normalization of liver enzymes; one patient had baseline normal liver enzymes despite an initial 6-MMPN level of 27,369 pmol/8×108 red blood cells. Two patients experienced reversible leukopenia. CONCLUSIONS: Combination allopurinol and low-dose 6-MP is an effective means to achieve optimal metabolite levels and steroid-free clinical remission in previously refractory patients. Caution is advised. PMID:18299738

  18. A quality improvement project to optimize patient outcomes following the maze procedure.

    PubMed

    Henry, Linda L; Ad, Niv; Martin, Lisa; Hunt, Sharon; Crippen, Pamela

    2009-01-01

    Atrial fibrillation (AF) is the most common of all clinically sustained heart arrhythmias with associated morbidities (shortness of breath, fatigue, and stroke). The maze cardiac surgical procedure is a new treatment option available for patients who have medical refractory AF. The purpose of this study was to determine whether a written postdischarge protocol was necessary to improve outcomes following the maze procedure. Only 3 (27%) patients with AF were actively treated by an arrhythmia protocol for restoration of sinus rhythm. Unnecessary pharmacologic management for AF was found in 44 patients with normal sinus rhythm. A postdischarge protocol was developed that improved outcomes.

  19. 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

  20. 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…

  1. Achieving breakthrough outcomes: measurable ROI.

    PubMed

    Orkin, Fredric I; Aruffo, Sylvia

    2006-01-01

    You're a case manager. Your boss is talking return on investment (ROI). Your patients don't want to be numbers on a spreadsheet. What does it take to be a hero to both the boss and the patient? Case managers frequently try to argue that great gains in quality of life for the patient are so valuable that management ought to ease up on case managers when talking about budget and returns. An experienced quality professional might respond, "Good luck."

  2. 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.

  3. Optimal screening for increased risk for adverse outcomes in hospitalised older adults

    PubMed Central

    Heim, Noor; van Fenema, Ester M.; Weverling-Rijnsburger, Annelies W. E.; Tuijl, Jolien P.; Jue, Peter; Oleksik, Anna M.; Verschuur, Margot J.; Haverkamp, Jasper S.; Blauw, Gerard Jan; van der Mast, Roos C.; Westendorp, Rudi G. J.

    2015-01-01

    Background: screening for frailty might help to prevent adverse outcomes in hospitalised older adults. Objective: to identify the most predictive and efficient screening tool for frailty. Design and setting: two consecutive observational prospective cohorts in four hospitals in the Netherlands. Subjects: patients aged ≥70 years, electively or acutely hospitalised for ≥2 days. Methods: screening instruments included in the Dutch Safety Management Programme [VeiligheidsManagementSysteem (VMS)] on four geriatric domains (ADL, falls, undernutrition and delirium) were used and the Identification of Seniors At Risk, the 6-item Cognitive Impairment Test and the Mini-Mental State Examination were assessed. Three months later, adverse outcomes including functional decline, high-healthcare demand or death were determined. Correlation and regression tree analyses were performed and predictive capacities were assessed. Results: follow-up data were available of 883 patients. All screening instruments were similarly predictive for adverse outcome (predictive power 0.58–0.66), but the percentage of positively screened patients (13–72%), sensitivity (24–89%) and specificity (35–91%) highly differed. The strongest predictive model for frailty was scoring positive on ≥3 VMS domains if aged 70–80 years; or being aged ≥80 years and scoring positive on ≥1 VMS domains. This tool classified 34% of the patients as frail with a sensitivity of 68% and a specificity of 74%. Comparable results were found in the validation cohort. Conclusions: the VMS-tool plus age (VMS+) offers an efficient instrument to identify frail hospitalised older adults at risk for adverse outcome. In clinical practice, it is important to weigh costs and benefits of screening given the rather low-predictive power of screening instruments. PMID:25432981

  4. The need for stent-lesion matching to optimize outcomes of intracoronary stent implantation.

    PubMed

    Lanzer, Peter; Strupp, Gerhard; Schmidt, Wolfram; Topoleski, L D Timmie

    2013-11-01

    Intracoronary stents have markedly improved the outcomes of catheter-based coronary interventions. Intracoronary stent implantation rates of over 90% during coronary angioplasty are common. Stent implantations are associated with a small but statistically significant number of adverse outcomes including restenosis, thrombosis, strut malapposition, incomplete strut endothelialization, and various types of stenting failure. Better matching of biomechanical properties of stents and lesions could further improve the clinical outcome of intracoronary stenting. Thus, in this article, we assess the need for advanced intracoronary stent-lesion matching. We reviewed the data on biomechanics of coronary stents and lesions to develop knowledge-based rationale for optimum intracoronary stent selection. The available technical information on marketed intracoronary stents and the current understanding of the biomechanical properties of coronary lesions at rest and under stress are limited, preventing the development of knowledge-based rationale for optimum intracoronary stent selection at present. Development of knowledge-based selection of intracoronary stents requires standardization of mechanical stent testing, communication of the nonproprietary technical data on stents by the industry and dedicated research into procedural stent-lesion interactions.

  5. 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

  6. 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

  7. Counselee participation in follow-up breast cancer genetic counselling visits and associations with achievement of the preferred role, cognitive outcomes, risk perception alignment and perceived personal control.

    PubMed

    Albada, Akke; Ausems, Margreet G E M; van Dulmen, Sandra

    2014-09-01

    The purpose of the study was to assess the counselee participation in the follow-up visits, compared to the first visits, for breast cancer genetic counselling and to explore associations with counselees' achievement of their preferred role in decision making, information recall, knowledge, risk perception alignment and perceived personal control. First and follow-up visits for breast cancer genetic counselling of 96 counselees of a Dutch genetics center were videotaped (2008-2010). Counselees completed questionnaires before counselling (T1), after the follow-up visit (T2) and one year after the follow-up visit (T3). Consultations were rated with the Roter Interaction Analysis System (RIAS). Counselee participation was measured as the percentage of counselee utterances, the percentage of counselee questions and the interactivity (number of turns per minute). Follow-up visits had higher levels of counselee participation than first visits as assessed by the percentage of counselee talk, the interactivity and counselee questions. More counselee talk in the follow-up visit was related to higher achievement of the preferred role (T2) and higher perceived personal control (T3). Higher interactivity in the follow-up visit was related to lower achievement of the preferred role in decision making and lower information recall (T2). There were no significant associations with the percentage of questions asked and none of the participation measures was related to knowledge, risk perception alignment and perceived personal control (T2). In line with the interviewing admonishment 'talk less and listen more', the only assessment of counselee participation associated to better outcomes is the percentage of counselee talk. High interactivity might be associated with lower recall in breast cancer genetic counselees who are generally highly educated. However, this study was limited by a small sample size and a heterogeneous group of counselees. Research is needed on the interactions

  8. Optimizing Outcomes following Total and Subtotal Tongue Reconstruction: A Systematic Review of the Contemporary Literature.

    PubMed

    Manrique, Oscar J; Leland, Hyuma A; Langevin, Claude-Jean; Wong, Alex; Carey, Joseph N; Ciudad, Pedro; Chen, Hung-Chi; Patel, Ketan M

    2017-02-01

    Background More than 45,000 Americans are diagnosed with oropharyngeal cancer annually and multimodal treatment often requires wide excision, lymphadenectomy, chemotherapy, and radiation. Total and subtotal lingual resection severely impairs speech, swallow, and quality of life (QoL). This study investigates functional outcomes and QoL following subtotal and total tongue resection with free tissue transfer reconstruction. Materials and Methods A systematic review of the English language literature was performed using PubMed, Ovid, Embase, and Cochrane databases based on predetermined inclusion/exclusion criteria. Included studies were reviewed for surgical technique, adjuvant treatment, surgical and functional outcomes, and QoL. Results From an initial search yield of 1,467 articles, 22 studies were included for final analysis. Speech intelligibility was correlated with the volume and degree of protuberance of the neotongue. Adjuvant therapy (radiation) and large tumor size were associated with worse speech and swallow recovery. At 1 year follow-up, despite 14 to 20% rates of silent aspiration, 82 to 97% of patients resumed oral feeding. Neurotized flaps have been demonstrated to improve flap sensation but have not yet demonstrated any significant impact on speech or swallow recovery. Finally, many patients continue to experience pain after surgery, but patient motivation, family support with physician, and speech therapist follow-up are associated with improved QoL scores. Conclusion Tongue reconstruction is dictated by the amount of soft tissue resection. Taking into consideration the most common factors involved after tongue resection and reconstruction, further studies should focus on more objective measurements to offer solutions and maximize final outcomes.

  9. A composite gene expression signature optimizes prediction of colorectal cancer metastasis and outcome

    PubMed Central

    Schell, Michael J.; Yang, Mingli; Missiaglia, Edoardo; Delorenzi, Mauro; Soneson, Charlotte; Yue, Binglin; Nebozhyn, Michael V.; Loboda, Andrey; Bloom, Gregory; Yeatman, Timothy J

    2015-01-01

    Purpose We previously found that an epithelial-to-mesenchymal transition (EMT)-based gene expression signature was highly correlated to the first principal component (PC1) of 326 colorectal cancer (CRC) tumors and was prognostic. This study was designed to improve these signatures for better prediction of metastasis and outcome. Experimental Design 468 CRC tumors including all stages (I–IV) and metastatic lesions were used to develop a new prognostic score (ΔPC1.EMT) by subtracting the EMT signature score from its correlated PC1 signature score. The score was validated on six other independent datasets with total 3697 tumors. Results ΔPC1.EMT was found to be far more predictive of metastasis and outcome than its parent scores. It performed well in Stages I–III, amongst MSI subtypes, and across multiple mutation-based subclasses, demonstrating a refined capacity to predict distant metastatic potential in tumors even with a “good” prognosis. For example, in the PETACC-3 clinical trial dataset it predicted worse overall survival in an adjusted multivariable model for Stage III patients (HR by IQR=1.50, 95%CI=1.25–1.81, P=0.000016, N=644). The improved performance of ΔPC1.EMT was related to its propensity of identifying epithelial-like subpopulations as well as mesenchymal-like subpopulations. Biologically, the signature was correlated positively with RAS signaling but negatively with mitochondrial metabolism. ΔPC1.EMT was a “best of assessed” prognostic score when compared to ten other known prognostic signatures. Conclusion The study developed a prognostic signature score with a propensity of detecting non-EMT features, including epithelial cancer stem cell-related properties, thereby improving its potential to predict metastasis and poorer outcome in Stages I-III patients. PMID:26446941

  10. 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

  11. Clinical Outcomes of an Optimized Prolate Ablation Procedure for Correcting Residual Refractive Errors Following Laser Surgery

    PubMed Central

    Chung, Byunghoon; Lee, Hun; Choi, Bong Joon; Seo, Kyung Ryul; Kim, Eung Kwon; Kim, Dae Yune

    2017-01-01

    Purpose The purpose of this study was to investigate the clinical efficacy of an optimized prolate ablation procedure for correcting residual refractive errors following laser surgery. Methods We analyzed 24 eyes of 15 patients who underwent an optimized prolate ablation procedure for the correction of residual refractive errors following laser in situ keratomileusis, laser-assisted subepithelial keratectomy, or photorefractive keratectomy surgeries. Preoperative ophthalmic examinations were performed, and uncorrected distance visual acuity, corrected distance visual acuity, manifest refraction values (sphere, cylinder, and spherical equivalent), point spread function, modulation transfer function, corneal asphericity (Q value), ocular aberrations, and corneal haze measurements were obtained postoperatively at 1, 3, and 6 months. Results Uncorrected distance visual acuity improved and refractive errors decreased significantly at 1, 3, and 6 months postoperatively. Total coma aberration increased at 3 and 6 months postoperatively, while changes in all other aberrations were not statistically significant. Similarly, no significant changes in point spread function were detected, but modulation transfer function increased significantly at the postoperative time points measured. Conclusions The optimized prolate ablation procedure was effective in terms of improving visual acuity and objective visual performance for the correction of persistent refractive errors following laser surgery. PMID:28243019

  12. The Effect of Physician Continuing Medical Education on Patient-Reported Outcomes for Identifying and Optimally Managing Obstructive Sleep Apnea

    PubMed Central

    Johnson, Sara S.; Castle, Patricia H.; Van Marter, Deborah; Roc, Anne; Neubauer, David; Auerbach, Sanford; DeAguiar, Emma

    2015-01-01

    Study Objective: To evaluate the effect of continuing medical education (CME) activities on patient reported outcomes with regard to (1) screening for excessive sleepiness (ES) and obstructive sleep apnea (OSA) and (2) appropriate referral and treatment. Methods: A total of 725 patients were recruited from 75 providers who either participated or did not participate in Transtheoretical Model (TTM)-based OSA CME activities. Patient reported outcomes from participating (n = 36) and non-participating providers (n = 39) were compared using generalized estimating equations examining random effects of provider as unit of assignment. Results: Patients' reports demonstrate that participating physicians were 1.7 times more likely to initiate discussion of sleep problems than non-participating physicians (t1,411 = 3.71, p = 0.05) and 2.25–2.86 times more likely to administer validated measures for OSA (Epworth Sleepiness Scale and STOP-BANG). Patient reports also indicated that participating clinicians (79.9%) were significantly more likely to recommend seeing a sleep specialist compared to non-participating clinicians (60.7%; t1,348 = 9.1, p < 0.01, OR = 2.6). Furthermore, while 89.4% of participating clinicians recommended a sleep study, only 73.2% of the non-participating physicians recommended one (t1,363 = 11.46, p < 0.001, OR = 3.1). Conclusions: Participation in TTM-based OSA CME activities was associated with improved patient reported outcomes compared to the non-participating clinicians. Citation: Johnson SS, Castle PH, Van Marter D, Roc A, Neubauer D, Auerbach S, DeAguiar E. The effect of physician continuing medical education on patient-reported outcomes for identifying and optimally managing obstructive sleep apnea. J Clin Sleep Med 2015;11(3):197–204. PMID:25845903

  13. Adult-to-adult living donor liver transplantation: Operative techniques to optimize the recipient's outcome

    PubMed Central

    Koh, Peng Soon; Chan, See Ching

    2017-01-01

    Adult-to-adult living donor liver transplantation (LDLT) is widely accepted today with good outcomes and safety reported worldwide for both donor and recipient. Nonetheless, it remained a highly demanding technical and complex surgery if undertaken. The last two decades have seen an increased in adult-to-adult LDLT following our first report of right lobe LDLT in overcoming graft size limitation in adults. In this article, we discussed the operative techniques and challenges of adult right lobe LDLT incorporating the middle hepatic vein, which is practiced in our center for the recipient operation. The various issues and challenges faced by the transplant surgeon in ensuring good recipient outcome are explored and discussed here as well. Hence, it is important to understand that a successful recipient operation is dependent of multifactorial events starting at the preoperative stage of planning, understanding the intraoperative technical challenges and the physiology of flow modulation that goes hand-in-hand with the operation. Therefore, one needs to arm oneself with all the possible knowledge in overcoming these technical challenges and the ability to be flexible and adaptable during LDLT by tailoring the needs of each patient individually. PMID:28250667

  14. Exquisite Moments: Achieving Optimal Flow in Three Activity-Based Groups Regardless of Early-Childhood Adversity

    ERIC Educational Resources Information Center

    Thomson, Paula; Jaque, S. Victoria

    2016-01-01

    Flow experiences (also known as optimal performance) occur when people engage in activities they enjoy. The authors discuss such events in their study that examined a number of healthy, active individuals (performing artists, athletes, and others engaged in a range of recreational activities) and divided these into three groups based on adverse…

  15. The Effect of Dispositional Optimism on Health Outcomes in Patient with Heart Failure

    DTIC Science & Technology

    2013-03-08

    0.57- 0.90) for non-fatal MI, 0.70 (95%CI: 0.55-0.90) for angina pectoris , and 0.75 (95%CI: 0.62-0.91) for total incident CHD after adjusting for age...Non-fatal MI, angina pectoris , incident CHD Non-fatal MI=0.72 (95%CI: 0.57-0.90), angina = 0.70 (95%CI: 0.55-0.90), incident CHD= 0.75 (95%CI: 0.62...into fatal CHD and nonfatal MI from verified angina showed a similar relationship direction, although high and moderate levels of optimism were only

  16. Optimizing the use of patient data to improve outcomes for patients: narcotics for chronic noncancer pain.

    PubMed

    Busse, Jason W; Guyatt, Gordon H

    2009-04-01

    Randomized trials can provide important direction to clinical decision-making; however, their strength of inferences may be weakened by methodological limitations, the extent that their reported outcomes fail to address patient-important end points and by failing to report results that provide interpretable estimates of magnitude of effect. Strategies that investigators can use to address interpretability include reporting mean differences between groups in relation to the minimal important difference and reporting the proportion of patients who benefit from treatment and the associated number needed to treat. These strategies also apply to reporting pooled estimates from meta-analyses, even when studies use different instruments to measure the same construct. We illustrate these techniques using, as an example, current evidence for the use of opioids in chronic noncancer pain.

  17. Combining radiofrequency ablation and ethanol injection may achieve comparable long-term outcomes in larger hepatocellular carcinoma (3.1-4 cm) and in high-risk locations.

    PubMed

    Lin, Ji-Wei; Lin, Chen-Chun; Chen, Wei-Ting; Lin, Shi-Ming

    2014-08-01

    Radiofrequency ablation (RFA) is more effective for hepatocellular carcinoma (HCC) < 3 cm. Combining percutaneous ethanol injection and RFA for HCC can increase ablation; however, the long-term outcome remains unknown. The aim of this study was to compare long-term outcomes between patients with HCC of 2-3 cm versus 3.1-4 cm and in high-risk versus non-high-risk locations after combination therapy. The primary endpoint was overall survival and the secondary endpoint was local tumor progression (LTP). Fifty-four consecutive patients with 72 tumors were enrolled. Twenty-two (30.6%) tumors and 60 (83.3%) tumors were of 3.1-4 cm and in high-risk locations, respectively. Primary technique effectiveness was comparable between HCC of 2-3 cm versus 3.1-4 cm (98% vs. 95.5%, p = 0.521), and HCC in non-high risk and high-risk locations (100% vs. 96.7%, p = 1.000). The cumulative survival rates at 1 year, 3 years, and 5 years were 90.3%, 78.9%, and 60.3%, respectively, in patients with HCC of 2-3 cm; 95.0%, 84.4%, and 69.3% in HCC of 3.1-4.0 cm (p = 0.397); 90.0%, 71.1%, and 71.1% in patients with HCC in non-high-risk locations; and 92.7%, 81.6%, and 65.4% in high-risk locations (p = 0.979). The cumulative LTP rates at 1 year, 3 years, and 5 years were 10.2%, 32.6%, and 32.6%, respectively, in all HCCs; 12.6%, 33.9%, and 33.9% in HCC of 2-3 cm; 4.8%, 29.5%, and 29.5% in HCC of 3.1-4 cm (p = 0.616); 16.7%, 50.0%, and 50.0% in patients with HCC in non-high-risk locations; and 8.8%, 29.9%, and 29.9% in patients with HCC in high-risk locations (p = 0.283). The cumulative survival and LTP rates were not significantly different among the various subgroups. Combining RFA and percutaneous ethanol injection achieved comparable long-term outcomes in HCCs of 2-3 cm versus 3.1-4.0 cm and in high-risk versus non-high-risk locations. A randomized controlled or cohort studies with larger sample size are warranted.

  18. 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.

  19. 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

  20. 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).

  1. 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.

  2. 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

  3. Treatment outcome of young children with acute lymphoblastic leukaemia: achievements and directions implied from Shanghai Children's Medical Centre based SCMC-ALL-2005 protocol.

    PubMed

    Liang, Yang; Yang, Lin-Hai; Jiang, Hui; Yuan, Xiao-Jun; Sun, Li-Rong; Wang, Ning-Ling; Tang, Jing-Yan

    2015-04-01

    This multicenter study used the Shanghai Children's Medical Center (SCMC)-ALL-2005 protocol for treatment of young patients (<2 years old) with acute lymphoblastic leukaemia (ALL), which was designed to improve treatment outcome in Chinese paediatric patients. These aims were pursued through risk-directed stratification based on presenting clinical and genetic features, minimal residual disease (MRD) levels and treatment response. All the patients achieved completed remission with 5-year event-free survivals of 82·6 ± 9·7% (low risk), 52·6 ± 8·4% (intermediate risk), 28·6 ± 17·1% (high risk). Disease recurrence was detected in bone marrow, bone marrow plus testis, testis alone and central nervous system in 16 (24·2%), 1 (1·5%), 1 (1·5%) and 1 (1·5%) patients respectively. No deaths were reported during induction. The SCMC-ALL-2005 trial for ALL patients <2 years old indicated high remission induction and low infection and treatment-related mortality rates.

  4. Adaptive interventions may optimize outcomes in drug courts: a pilot study.

    PubMed

    Marlowe, Douglas B; Festinger, David S; Arabia, Patricia L; Dugosh, Karen L; Benasutti, Kathleen M; Croft, Jason R

    2009-10-01

    Adaptive interventions apply a priori decision rules for adjusting treatment services in response to participants' clinical presentation or performance in treatment. This pilot study (n = 30) experimentally examined an adaptive intervention in a misdemeanor drug court. The participants were primarily charged with possession of marijuana (73%) or possession of drug paraphernalia (23%). Results revealed that participants in the adaptive condition had higher graduation rates and required significantly less time to graduate from the program and achieve a final resolution of the case. It took an average of nearly 4 fewer months for participants in the adaptive intervention to resolve their cases compared with those participating in drug court as usual. Participants in the adaptive condition also reported equivalent satisfaction with the program and therapeutic alliances with their counselors. These data suggest that adaptive interventions may enhance the efficiency and effectiveness of drug courts and justify examining adaptive interventions in large-scale drug court studies.

  5. Adaptive Interventions May Optimize Outcomes in Drug Courts: A Pilot Study

    PubMed Central

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

    2009-01-01

    Adaptive interventions apply a priori decision rules for adjusting treatment services in response to participants’ clinical presentation or performance in treatment. This pilot study (N = 30) experimentally examined an adaptive intervention in a misdemeanor drug court. The participants were primarily charged with possession of marijuana (73%) or possession of drug paraphernalia (23%). Results revealed that participants in the adaptive condition had relatively higher graduation rates and required significantly less time to graduate from the program and achieve a final resolution of the case. It took an average of nearly 4 fewer months for participants in the adaptive intervention to resolve their cases as compared to drug court as-usual. Participants in the adaptive condition also reported equivalent satisfaction with the program and therapeutic alliances with their counselors. These data suggest that adaptive interventions may enhance the efficiency and effectiveness of drug courts, and justify examining adaptive interventions in large-scale drug court studies. PMID:19785978

  6. 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.

  7. 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.

  8. Using ant colony optimization on the quadratic assignment problem to achieve low energy cost in geo-distributed data centers

    NASA Astrophysics Data System (ADS)

    Osei, Richard

    There are many problems associated with operating a data center. Some of these problems include data security, system performance, increasing infrastructure complexity, increasing storage utilization, keeping up with data growth, and increasing energy costs. Energy cost differs by location, and at most locations fluctuates over time. The rising cost of energy makes it harder for data centers to function properly and provide a good quality of service. With reduced energy cost, data centers will have longer lasting servers/equipment, higher availability of resources, better quality of service, a greener environment, and reduced service and software costs for consumers. Some of the ways that data centers have tried to using to reduce energy costs include dynamically switching on and off servers based on the number of users and some predefined conditions, the use of environmental monitoring sensors, and the use of dynamic voltage and frequency scaling (DVFS), which enables processors to run at different combinations of frequencies with voltages to reduce energy cost. This thesis presents another method by which energy cost at data centers could be reduced. This method involves the use of Ant Colony Optimization (ACO) on a Quadratic Assignment Problem (QAP) in assigning user request to servers in geo-distributed data centers. In this paper, an effort to reduce data center energy cost involves the use of front portals, which handle users' requests, were used as ants to find cost effective ways to assign users requests to a server in heterogeneous geo-distributed data centers. The simulation results indicate that the ACO for Optimal Server Activation and Task Placement algorithm reduces energy cost on a small and large number of users' requests in a geo-distributed data center and its performance increases as the input data grows. In a simulation with 3 geo-distributed data centers, and user's resource request ranging from 25,000 to 25,000,000, the ACO algorithm was able

  9. Considerations on Optimal Fluoride Intake using Dental Fluorosis and Dental Caries Outcomes – A Longitudinal Study

    PubMed Central

    Warren, John J.; Levy, Steven M.; Broffitt, Barbara; Cavanaugh, Joseph E.; Kanellis, Michael J.; Weber-Gasparoni, Karin

    2015-01-01

    Objectives The “optimal” intake of fluoride has been widely accepted for decades as between 0.05 and 0.07 mg fluoride per kilogram of body weight but is based on limited scientific evidence. The purpose of this paper is to present longitudinal fluoride intake data for children free of dental fluorosis in the early-erupting permanent dentition and free of dental caries in both the primary and early-erupting permanent teeth as an estimate of optimal fluoride intake. Methods Data on fluoride ingestion were obtained from parents of 602 Iowa Fluoride Study children through periodic questionnaires at the ages of 6 weeks, 3, 6, 9, 12, 16, 20, 24, 28, 32 and 36 months, and then at 6-month intervals thereafter. Estimates of total fluoride intake at each time point were made by summing amounts from water, dentifrice, and supplements as well as other foods and beverages made with or containing water. Caries data were obtained from examinations of children at ages 5 and 9 years, while fluorosis data were obtained from examinations only at age 9. Results The estimated mean daily fluoride intake for those children with no caries history and no fluorosis at age 9 was at or below 0.05 mgF/kg bw for nearly all time points through the first 48 months of life, and this level declined thereafter. Children with caries had generally slightly less intakes, while those with fluorosis generally had slightly higher intakes. Conclusions Given the overlap among caries/fluorosis groups in mean fluoride intake and extreme variability in individual fluoride intakes firmly recommending an “optimal” fluoride intake is problematic. PMID:19054310

  10. 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

    2003-07-01

    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 completion of Phase I and Phase II activities. 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. During this reporting period, optimization tests were performed to evaluate system performance and identify optimum operating conditions for the installed equipment. The overfire air system process design activities and preliminary engineering design were completed.

  11. Technology for monitoring shot-level light source performance data to achieve high-optimization of lithography processes

    NASA Astrophysics Data System (ADS)

    Moriya, Masato; Ochiai, Hideyuki; Watabe, Yoshinobu; Ishida, Keisuke; Masuda, Hiroyuki; Sasaki, Youichi; Kumazaki, Takahito; Kurosu, Akihiko; Ohta, Takeshi; Kakizaki, Kouji; Matsunaga, Takashi; Mizoguchi, Hakaru

    2014-03-01

    Gigaphoton has developed a new monitoring system that provides shot-level light source performance data to FDC systems during exposure time. The system provides basic monitoring data (e.g. Energy, Wavelength, Bandwidth, etc.) and beam performance data, such as Beam Profile, Pointing, Divergence, Polarization can also be monitored using a new metrology tool called the Beam Performance Monitor (BPM) module. During exposure time the system automatically identifies the start and end timing of the wafer and each shot based on the burst of firing signals from the scanner, and stores the measured data in sequence. The stored data is sorted by wafer or by shot, and sent to REDeeM Piece which in turn converts the data to the user's protocol and send it to the FDC system. The user also has the option to directly view or download the stored data using a GUI. Through this monitoring system, users can manage light sources data at the shot or reticle level to facilitate optimization of performance and running cost of the light source for each process. This monitoring system can be easily retrofitted to Gigaphoton's current ArF laser light sources. The beam splitter of the BPM was specially designed to bend only a small fraction of the source beam, so we are able to simply install the BPM without the need for special optical alignment.

  12. Imaging Live Cells at the Nanometer-Scale with Single-Molecule Microscopy: Obstacles and Achievements in Experiment Optimization for Microbiology

    PubMed Central

    Haas, Beth L.; Matson, Jyl S.; DiRita, Victor J.; Biteen, Julie S.

    2015-01-01

    Single-molecule fluorescence microscopy enables biological investigations inside living cells to achieve millisecond- and nanometer-scale resolution. Although single-molecule-based methods are becoming increasingly accessible to non-experts, optimizing new single-molecule experiments can be challenging, in particular when super-resolution imaging and tracking are applied to live cells. In this review, we summarize common obstacles to live-cell single-molecule microscopy and describe the methods we have developed and applied to overcome these challenges in live bacteria. We examine the choice of fluorophore and labeling scheme, approaches to achieving single-molecule levels of fluorescence, considerations for maintaining cell viability, and strategies for detecting single-molecule signals in the presence of noise and sample drift. We also discuss methods for analyzing single-molecule trajectories and the challenges presented by the finite size of a bacterial cell and the curvature of the bacterial membrane. PMID:25123183

  13. 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…

  14. "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…

  15. 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…

  16. The relation of illness representations to the 'end-stage' appraisal of outcomes through health status, and the moderating role of optimism.

    PubMed

    Karademas, Evangelos C; Kynigopoulou, Eleftheria; Aghathangelou, Eleni; Anestis, Dimitrios

    2011-05-01

    The aim of this study was to examine an important pathway suggested by the common sense model (CSM): the relation of illness representations to the 'end-stage' appraisal of outcomes through health status. A further aim was to examine the moderating role of optimism in this relationship. One hundred and six chronic cardiac patients completed questionnaires about illness representations and dispositional optimism at baseline, and health status and illness-related helplessness (as an indicator of the 'end-stage' appraisal of outcomes) at a follow-up interview, 6 months later. Indirect (mediation) as well as conditional indirect (moderated mediation) effects were examined using bootstrapped models. According to the results, the effect of illness representations on helplessness was mediated by at least one of the health measures used. Also, most of these indirect relations were conditional on the values of optimism. That is, optimism moderated the 'illness representations-health status-"end-stage" appraisal of outcomes' relationship, as the mediating effects were absent at higher levels of optimism. These findings can provide us with a more comprehensive picture of adaptation to illness, as well as of the ways the illness-related information is being processed by patients. Thus, they have significant implications for theory, research and practice.

  17. Personalized integrative oncology: targeted approaches for optimal outcomes: the 11th International Conference of the Society for Integrative Oncology.

    PubMed

    Lee, Richard T; Yang, Peiying; Greenlee, Heather; Bauer-Wu, Susan; Balneaves, Lynda G; Zick, Suzanna

    2015-01-01

    The 11th International Conference of the Society for Integrative Oncology (SIO) brought together more than 300 clinicians, researchers, patients, and advocates to hear and interact with world-leading experts about the latest research in the areas of nutrition, exercise, acupuncture, health services research, meditation, and other integrative disciplines. The conference theme, "Personalized Integrative Oncology: Targeted Approaches for Optimal Outcomes," highlighted innovations in personalized medicine and ways this growing field will advance the evolution of individualized integrative cancer care to the next level. This year's conference also featured a clinical track focusing on clinical information for the practicing health care professional. The conference's rigorous schedule included 3 keynotes, 4 plenary sessions, 2 interdisciplinary tumor boards, 5 workshops, 45 concurrent oral sessions, and 106 posters. In addition to the conference theme, keynote and plenary sessions presented topics on stress and cancer, the importance of sleep for cancer patients, epigenetic mechanisms of lifestyle and natural products, recently published Journal of the National Cancer Institute monograph on integrative oncology, SIO's clinical practice guidelines for breast cancer survivors, and a joint session of the American Academy of Hospice and Palliative Medicine and SIO about supportive care and symptom management. This highly successful conference helped further the mission of the SIO to advance evidence-based, comprehensive, integrative health care to improve the lives of people affected by cancer.

  18. 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.

  19. Leader as achiever.

    PubMed

    Dienemann, Jacqueline

    2002-01-01

    This article examines one outcome of leadership: productive achievement. Without achievement one is judged to not truly be a leader. Thus, the ideal leader must be a visionary, a critical thinker, an expert, a communicator, a mentor, and an achiever of organizational goals. This article explores the organizational context that supports achievement, measures of quality nursing care, fiscal accountability, leadership development, rewards and punishments, and the educational content and teaching strategies to prepare graduates to be achievers.

  20. 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

  1. Optimism

    PubMed Central

    Carver, Charles S.; Scheier, Michael F.; Segerstrom, Suzanne C.

    2010-01-01

    Optimism is an individual difference variable that reflects the extent to which people hold generalized favorable expectancies for their future. Higher levels of optimism have been related prospectively to better subjective well-being in times of adversity or difficulty (i.e., controlling for previous well-being). Consistent with such findings, optimism has been linked to higher levels of engagement coping and lower levels of avoidance, or disengagement, coping. There is evidence that optimism is associated with taking proactive steps to protect one's health, whereas pessimism is associated with health-damaging behaviors. Consistent with such findings, optimism is also related to indicators of better physical health. The energetic, task-focused approach that optimists take to goals also relates to benefits in the socioeconomic world. Some evidence suggests that optimism relates to more persistence in educational efforts and to higher later income. Optimists also appear to fare better than pessimists in relationships. Although there are instances in which optimism fails to convey an advantage, and instances in which it may convey a disadvantage, those instances are relatively rare. In sum, the behavioral patterns of optimists appear to provide models of living for others to learn from. PMID:20170998

  2. The Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium: Reaching in Partnership for Optimal Orthopaedic Rehabilitation Outcomes.

    PubMed

    Stanhope, Steven J; Wilken, Jason M; Pruziner, Alison L; Dearth, Christopher L; Wyatt, Marilynn; Ziemke, Gregg W; Strickland, Rachel; Milbourne, Suzanne A; Kaufman, Kenton R

    2016-11-01

    The Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium began in September 2011 as a cooperative agreement with the Department of Defense (DoD) Congressionally Directed Medical Research Programs Peer Reviewed Orthopaedic Research Program. A partnership was formed with DoD Military Treatment Facilities (MTFs), U.S. Department of Veterans Affairs (VA) Centers, the National Institutes of Health (NIH), academia, and industry to rapidly conduct innovative, high-impact, and sustainable clinically relevant research. The BADER Consortium has a unique research capacity-building focus that creates infrastructures and strategically connects and supports research teams to conduct multiteam research initiatives primarily led by MTF and VA investigators.BADER relies on strong partnerships with these agencies to strengthen and support orthopaedic rehabilitation research. Its focus is on the rapid forming and execution of projects focused on obtaining optimal functional outcomes for patients with limb loss and limb injuries. The Consortium is based on an NIH research capacity-building model that comprises essential research support components that are anchored by a set of BADER-funded and initiative-launching studies. Through a partnership with the DoD/VA Extremity Trauma and Amputation Center of Excellence, the BADER Consortium's research initiative-launching program has directly supported the identification and establishment of eight BADER-funded clinical studies. BADER's Clinical Research Core (CRC) staff, who are embedded within each of the MTFs, have supported an additional 37 non-BADER Consortium-funded projects. Additional key research support infrastructures that expedite the process for conducting multisite clinical trials include an omnibus Cooperative Research and Development Agreement and the NIH Clinical Trials Database. A 2015 Defense Health Board report highlighted the Consortium's vital role, stating the research capabilities of the Do

  3. 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…

  4. 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…

  5. Strategy to Achieve Highly Porous/Biocompatible Macroscale Cell Blocks, Using a Collagen/Genipin-bioink and an Optimal 3D Printing Process.

    PubMed

    Kim, Yong Bok; Lee, Hyeongjin; Kim, Geun Hyung

    2016-11-30

    Recently, a three-dimensional (3D) bioprinting process for obtaining a cell-laden structure has been widely applied because of its ability to fabricate biomimetic complex structures embedded with and without cells. To successfully obtain a cell-laden porous block, the cell-delivering vehicle, bioink, is one of the significant factors. Until now, various biocompatible hydrogels (synthetic and natural biopolymers) have been utilized in the cell-printing process, but a bioink satisfying both biocompatibility and print-ability requirements to achieve a porous structure with reasonable mechanical strength has not been issued. Here, we propose a printing strategy with optimal conditions including a safe cross-linking procedure for obtaining a 3D porous cell block composed of a biocompatible collagen-bioink and genipin, a cross-linking agent. To obtain the optimal processing conditions, we modified the 3D printing machine and selected an optimal cross-linking condition (∼1 mM and 1 h) of genipin solution. To show the feasibility of the process, 3D pore-interconnected cell-laden constructs were manufactured using osteoblast-like cells (MG63) and human adipose stem cells (hASCs). Under these processing conditions, a macroscale 3D collagen-based cell block of 21 × 21 × 12 mm(3) and over 95% cell viability was obtained. In vitro biological testing of the cell-laden 3D porous structure showed that the embedded cells were sufficiently viable, and their proliferation was significantly higher; the cells also exhibited increased osteogenic activities compared to the conventional alginate-based bioink (control). The results indicated the fabrication process using the collagen-bioink would be an innovative platform to design highly biocompatible and mechanically stable cell blocks.

  6. 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.

  7. Optimal and safe standard doses of midazolam and propofol to achieve patient and doctor satisfaction with dental treatment: A prospective cohort study

    PubMed Central

    Nonaka, Mutsumi; Nishimura, Akiko; Gotoh, Kinuko; Oka, Shuichirou; Iijima, Takehiko

    2017-01-01

    Background The incidences of morbidity and mortality caused by pharmacosedation for dental treatment have not yet reached zero. Adverse events are related to inappropriate respiratory management, mostly originating from an overdose of sedatives. Since sedation is utilized for the satisfaction of both the dentist and the patient, the optimal dose should be minimized to prevent adverse events. We attempted to define the optimal doses of midazolam and propofol required to achieve high levels of patient and dentist satisfaction. Methods One thousand dental patients, including those undergoing third molar extractions, were enrolled in this study. A dose of 1 mg of midazolam was administered at 1-minute intervals until adequate sedation was achieved. Propofol was then infused continuously to maintain the sedation level. Both the patients and the dentists were subsequently interviewed and asked to complete a questionnaire. A multivariate logistic regression analysis was used to examine the factors that contributed to patient and dentist satisfaction. Results The peak midazolam dose resulting in the highest percentage of patient satisfaction was 3 mg. Both a lower dose and a higher dose reduced patient satisfaction. Patient satisfaction increased with an increasing dosage of propofol up until 4 mg/kg/hr, reaching a peak of 78.6%. The peak midazolam dose resulting in the highest percentage of dentist satisfaction (78.8%) was 2 mg. Incremental propofol doses reduced dentist satisfaction, in contrast to their effect on patient satisfaction. The strongest independent predictors of patient satisfaction and dentist satisfaction were no intraoperative memory (OR, 5.073; 95% CI, 3.532–7.287; P<0.001) and unintentional movements by the patient (OR, 0.035; 95% CI, 0.012–0.104; P<0.001), respectively. No serious adverse events were reported. Conclusion We found that 3 mg of midazolam and 3 mg/kg/hr of propofol may be the optimal doses for maximizing both patient and dentist

  8. 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.

  9. 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. The…

  10. Pharmacodynamic effects of cangrelor and clopidogrel: the platelet function substudy from the cangrelor versus standard therapy to achieve optimal management of platelet inhibition (CHAMPION) trials.

    PubMed

    Angiolillo, Dominick J; Schneider, David J; Bhatt, Deepak L; French, William J; Price, Matthew J; Saucedo, Jorge F; Shaburishvili, Tamaz; Huber, Kurt; Prats, Jayne; Liu, Tiepu; Harrington, Robert A; Becker, Richard C

    2012-07-01

    Cangrelor is an intravenous antagonist of the P2Y(12) receptor characterized by rapid, potent, predictable, and reversible platelet inhibition. However, cangrelor was not superior to clopidogrel in reducing the incidence of ischemic events in the cangrelor versus standard therapy to achieve optimal management of platelet inhibition (CHAMPION) trials. A prospectively designed platelet function substudy was performed in a selected cohort of patients to provide insight into the pharmacodynamic effects of cangrelor, particularly in regard to whether cangrelor therapy may interfere with the inhibitory effects of clopidogrel. This pre-defined substudy was conducted in a subset of patients from the CHAMPION-PCI trial (n = 230) comparing cangrelor with 600 mg of clopidogrel administered before percutaneous coronary intervention (PCI) and from the CHAMPION-PLATFORM trial (n = 4) comparing cangrelor at the time of PCI and 600 mg clopidogrel given after the PCI. Pharmacodynamic measures included P2Y12 reaction units (PRU) assessed by VerifyNow P2Y12 testing (primary endpoint marker), platelet aggregation by light transmittance aggregometry following 5 and 20 μmol/L adenosine diphosphate stimuli, and markers of platelet activation determined by flow cytometry. The primary endpoint was the percentage of patients who achieved <20 % change in PRU between baseline and >10 h after PCI. The main trial was stopped early limiting enrollment in the platelet substudy. A total of 167 patients had valid pharmacodynamic assessments for the primary endpoint. The percent of individuals achieving <20 % change in PRU between baseline and >10 h after PCI was higher with cangrelor + clopidogrel (32/84, 38.1 %) compared with placebo + clopidogrel (21/83, 25.3 %), but this was not statistically significant (difference:12.79 %, 95 % CI: -1.18 %, 26.77 %;p = 0.076). All pharmacodynamic markers as well as the prevalence of patients with high on-treatment platelet reactivity were significantly lower

  11. Association between the Achievement of Target Range CKD-MBD Markers and Mortality in Prevalent Hemodialysis Patients in Taiwan by Using the Kidney Disease: Improving Global Outcomes Clinical Guidelines

    PubMed Central

    Cheng, Ben-Chung; Lee, Chih-Hsiung; Chang, Wen-Xiu

    2016-01-01

    Background. This study evaluated the association between achieving target chronic kidney disease-mineral and bone disorder (CKD-MBD) marker levels and mortality in Taiwanese hemodialysis (HD) patients. Target levels were based on the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Methods. We performed a retrospective medical record review of 1126 HD patients between 2009 and 2013. A logistic regression model was used to evaluate the relationship between achieving target marker levels and the risk for all-cause and cardiovascular (CV) mortality. Reference target ranges were 7.9 ≤ calcium (Ca) ≤ 9.9 mg/dL, 2.4 ≤ phosphate (P) ≤ 4.7 mg/dL, and 144 ≤ intact parathyroid hormone (iPTH) ≤ 648 pg/mL. Results. Achievement of target P levels was associated with a lower risk for all-cause mortality compared to achievement of either target Ca or iPTH levels. Achieving target P + iPTH levels (OR 1.32) was associated with a lower odds ratio for all-cause mortality compared to achieving target Ca + P (OR 1.66) and Ca + iPTH (OR 1.43) levels. Similar trends were observed for CV mortality risk. Conclusions. The present study demonstrated that achieving serum P levels within the KDIGO target range is the most important factor for lowering mortality in HD patients. PMID:28003998

  12. Optimizing influenza vaccine distribution.

    PubMed

    Medlock, Jan; Galvani, Alison P

    2009-09-25

    The criteria to assess public health policies are fundamental to policy optimization. Using a model parametrized with survey-based contact data and mortality data from influenza pandemics, we determined optimal vaccine allocation for five outcome measures: deaths, infections, years of life lost, contingent valuation, and economic costs. We find that optimal vaccination is achieved by prioritization of schoolchildren and adults aged 30 to 39 years. Schoolchildren are most responsible for transmission, and their parents serve as bridges to the rest of the population. Our results indicate that consideration of age-specific transmission dynamics is paramount to the optimal allocation of influenza vaccines. We also found that previous and new recommendations from the U.S. Centers for Disease Control and Prevention both for the novel swine-origin influenza and, particularly, for seasonal influenza, are suboptimal for all outcome measures.

  13. 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…

  14. 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…

  15. 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…

  16. 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…

  17. A concept analysis of optimality in perinatal health.

    PubMed

    Kennedy, Holly Powell

    2006-01-01

    This analysis was conducted to describe the concept of optimality and its appropriateness for perinatal health care. The concept was identified in 24 scientific disciplines. Across all disciplines, the universal definition of optimality is the robust, efficient, and cost-effective achievement of best possible outcomes within a rule-governed framework. Optimality, specifically defined for perinatal health care, is the maximal perinatal outcome with minimal intervention placed against the context of the woman's social, medical, and obstetric history.

  18. Primary treatment of mandibular ameloblastoma with segmental resection and free fibula reconstruction: achieving satisfactory outcomes with low implant-prosthetic rehabilitation uptake.

    PubMed

    Ooi, Adrian; Feng, Jiajun; Tan, Hiang Khoon; Ong, Yee Siang

    2014-04-01

    Ameloblastoma is a locally aggressive and disfiguring oral cavity tumour and surgical management is the mainstay of treatment. The ideal management of ameloblastoma should minimise recurrence, restore function and appearance and present minimal donor site morbidity. Conservative management is associated with minimal downtime but high recurrence rates. By contrast, segmental mandibulectomy with appropriate margins have much lower recurrence rates but presents the challenge of reconstruction. Osseointegrated (OI) implants and permanent dental prosthesis, while ideal, are not always available. We conducted a retrospective review on 30 consecutive patients at our centre with unicystic and multicystic ameloblastoma who were treated with segmental mandibular resection and free fibula flap reconstruction. Only three patients underwent OI implant insertion, with 40% of the patients not receiving any form of dental rehabilitation. We performed a functional and aesthetic outcome survey to determine patient satisfaction with this form of treatment. At an average follow-up of 5 years, there were no recurrences of tumour in our population. Of the 26 patients who responded to the survey, 96% of the patients reported that they were satisfied with their appearance, 88% reported an absolutely normal diet and 93% of the patients reported no problems with donor site function. Overall, we found that low uptake of dental rehabilitation did not adversely affect patient satisfaction and outcomes.

  19. 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.

    PubMed

    Snyder, Frank; Flay, Brian; 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 (2(nd) 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.

  20. Ketones and lactate increase cancer cell "stemness," driving recurrence, metastasis and poor clinical outcome in breast cancer: achieving personalized medicine via Metabolo-Genomics.

    PubMed

    Martinez-Outschoorn, Ubaldo E; Prisco, Marco; Ertel, Adam; Tsirigos, Aristotelis; Lin, Zhao; Pavlides, Stephanos; Wang, Chengwang; Flomenberg, Neal; Knudsen, Erik S; Howell, Anthony; Pestell, Richard G; Sotgia, Federica; Lisanti, Michael P

    2011-04-15

    Previously, we showed that high-energy metabolites (lactate and ketones) "fuel" tumor growth and experimental metastasis in an in vivo xenograft model, most likely by driving oxidative mitochondrial metabolism in breast cancer cells. To mechanistically understand how these metabolites affect tumor cell behavior, here we used genome-wide transcriptional profiling. Briefly, human breast cancer cells (MCF7) were cultured with lactate or ketones, and then subjected to transcriptional analysis (exon-array). Interestingly, our results show that treatment with these high-energy metabolites increases the transcriptional expression of gene profiles normally associated with "stemness," including genes upregulated in embryonic stem (ES) cells. Similarly, we observe that lactate and ketones promote the growth of bonafide ES cells, providing functional validation. The lactate- and ketone-induced "gene signatures" were able to predict poor clinical outcome (including recurrence and metastasis) in a cohort of human breast cancer patients. Taken together, our results are consistent with the idea that lactate and ketone utilization in cancer cells promotes the "cancer stem cell" phenotype, resulting in significant decreases in patient survival. One possible mechanism by which these high-energy metabolites might induce stemness is by increasing the pool of Acetyl-CoA, leading to increased histone acetylation, and elevated gene expression. Thus, our results mechanistically imply that clinical outcome in breast cancer could simply be determined by epigenetics and energy metabolism, rather than by the accumulation of specific "classical" gene mutations. We also suggest that high-risk cancer patients (identified by the lactate/ketone gene signatures) could be treated with new therapeutics that target oxidative mitochondrial metabolism, such as the anti-oxidant and "mitochondrial poison" metformin. Finally, we propose that this new approach to personalized cancer medicine be termed

  1. Relationships among achieved heart rate, β-blocker dose and long-term outcomes in patients with heart failure with atrial fibrillation

    PubMed Central

    Howlett, Jonathan G; Chiu, Michael H; Southern, Danielle A; Knudtson, Merril; Wilton, Stephen B

    2016-01-01

    Objective Higher β-blocker dose and lower heart rate are associated with decreased mortality in patients with systolic heart failure (HF) and sinus rhythm. However, in the 30% of patients with HF with atrial fibrillation (AF), whether β-blocker dose or heart rate predict mortality is less clear. We assessed the association between β-blocker dose, heart rate and all-cause mortality in patients with HF and AF. Methods We performed a retrospective cohort study in 935 patients (60% men, mean age 74, 44.7% with reduced left ventricular ejection fraction (LVEF)) discharged with concurrent diagnoses of HF and AF. We used Cox models to test independent associations between higher versus lower predischarge heart rate (dichotomised at 70/min) and higher versus lower β-blocker dose (dichotomised at 50% of the evidence-based target), with the primary composite end point of mortality or cardiovascular rehospitalisation over a median of 2.9 years. All analyses were stratified by the presence of left ventricular systolic dysfunction (LVEF≤40%). Results After adjustment for covariates, neither β-blocker dose nor predischarge heart rate was associated with the primary composite end point. However, tachycardia at admission (heart rate >120/min) was associated with a reduced risk of the composite outcome in patients with both reduced LVEF (adjusted HR 0.67, 95% CI 0.52 to 0.88, p<0.01) and preserved LVEF (adjusted HR 0.79, 95% CI 0.64 to 0.98, p=0.04). Conclusions We found no associations between predischarge heart rate or β-blocker dosage and clinical outcomes in patients with recent hospitalisations for HF and AF. PMID:28123760

  2. 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

  3. Pups of dams fed low-fat diet during pregnancy and lactation showed strong preference for high-fat diet to achieve optimal growth.

    PubMed

    Nakashima, Yoko; Sato, Akie

    2011-01-01

    To investigate the causes why pups of dams fed a low-fat high-carbohydrate diet (LFD) showed a strong preference for fat, three groups of dams were fed one of three diets during pregnancy and lactation: the LFD, a control diet (CTD) or a high-fat low-carbohydrate diet (HFD). After weaning, pups of each of the three groups were divided into two equal subgroups (Pair 1 and Pair 2), for a total of six pup subgroups. Each subgroup was placed on a two-choice diet program of the LFD and the HFD (Pair 1), or the LFD and a HFDLE (with cellulose added to maintain the same energy concentration as the LFD) (Pair 2), for 3 wk. Although the energy intake of dams fed the LFD during the nursing period was lower than that of the HFD group, no significant difference in body weight was observed among the three groups. At weaning, the body weight of pups nursed by dams fed the LFD was lower than that of the other groups. In Pair 1, the HFD intake ratio of the LFD and the HFD groups during the self-selection period was higher than that of the CTD group. In Pair 2, the HFDLE intake ratio of the LFD and the CTD groups was lower than that of the HFD group. At the end of the self-selection period, no significant difference in body weight was observed among the three groups of Pair 1. However, in Pair 2, the body weight of the LFD group was lower than that of the other groups. Therefore, it was supposed that pups of dams fed the LFD showed strong preference for the HFD containing high energy in order to achieve optimal growth.

  4. 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…

  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. Codon and mRNA sequence optimization of microdystrophin transgenes improves expression and physiological outcome in dystrophic mdx mice following AAV2/8 gene transfer.

    PubMed

    Foster, Helen; Sharp, Paul S; Athanasopoulos, Takis; Trollet, Capucine; Graham, Ian R; Foster, Keith; Wells, Dominic J; Dickson, George

    2008-11-01

    Duchenne muscular dystrophy is a fatal muscle-wasting disorder. Lack of dystrophin compromises the integrity of the sarcolemma and results in myofibers that are highly prone to contraction-induced injury. Recombinant adeno-associated virus (rAAV)-mediated dystrophin gene transfer strategies to muscle for the treatment of Duchenne muscular dystrophy (DMD) have been limited by the small cloning capacity of rAAV vectors and high titers necessary to achieve efficient systemic gene transfer. In this study, we assess the impact of codon optimization on microdystrophin (DeltaAB/R3-R18/DeltaCT) expression and function in the mdx mouse and compare the function of two different configurations of codon-optimized microdystrophin genes (DeltaAB/R3-R18/DeltaCT and DeltaR4-R23/DeltaCT) under the control of a muscle-restrictive promoter (Spc5-12). Codon optimization of microdystrophin significantly increases levels of microdystrophin mRNA and protein after intramuscular and systemic administration of plasmid DNA or rAAV2/8. Physiological assessment demonstrates that codon optimization of DeltaAB/R3-R18/DeltaCT results in significant improvement in specific force, but does not improve resistance to eccentric contractions compared with noncodon-optimized DeltaAB/R3-R18/DeltaCT. However, codon-optimized microdystrophin DeltaR4-R23/DeltaCT completely restored specific force generation and provided substantial protection from contraction-induced injury. These results demonstrate that codon optimization of microdystrophin under the control of a muscle-specific promoter can significantly improve expression levels such that reduced titers of rAAV vectors will be required for efficient systemic administration.

  7. Optimal medical outcomes with limited liability: risk management principles for medical practices at the intersection of medicine, law, and business.

    PubMed

    Paterick, Timothy J; Paterick, Timothy E; Waterhouse, Blake E

    2007-01-01

    Physicians practice at the intersection of medicine, law, and business. Each discipline creates its own challenges for the practicing physician: to practice efficient, effective medicine; to limit potential liability; and to create a positive financial outcome. Those challenges increase with escalating costs and reduced reimbursements. In this paper, the common clinical presentation of chest pain has been used to create a paradigm to educate physicians to understand efficient and effective approaches to diagnosis and treatment, and how effective communication with patients and meticulous documentation of all medical encounters can limit the potential for liability. Ultimately, given today's reimbursement formulas, physicians must also understand the cost of testing, in relation to its benefits, in an attempt to yield a positive financial outcome.

  8. 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…

  9. Rationale, design, and methodology for the optimizing outcomes in women with gestational diabetes mellitus and their infants study

    PubMed Central

    2013-01-01

    Background Women who are diagnosed with gestational diabetes mellitus (GDM) are at increased risk for developing prediabetes and type 2 diabetes mellitus (T2DM). To date, there have been few interdisciplinary interventions that target predominantly ethnic minority low-income women diagnosed with GDM. This paper describes the rationale, design and methodology of a 2-year, randomized, controlled study being conducted in North Carolina. Methods/Design Using a two-group, repeated measures, experimental design, we will test a 14- week intensive intervention on the benefits of breastfeeding, understanding gestational diabetes and risk of progression to prediabetes and T2DM, nutrition and exercise education, coping skills training, physical activity (Phase I), educational and motivational text messaging and 3 months of continued monthly contact (Phase II). A total of 100 African American, non-Hispanic white, and bilingual Hispanic women between 22–36 weeks of pregnancy who are diagnosed with GDM and their infants will be randomized to either the experimental group or the wait-listed control group. The first aim of the study is to determine the feasibility of the intervention. The second aim of study is to test the effects of the intervention on maternal outcomes from baseline (22–36 weeks pregnant) to 10 months postpartum. Primary maternal outcomes will include fasting blood glucose and weight (BMI) from baseline to 10 months postpartum. Secondary maternal outcomes will include clinical, adiposity, health behaviors and self-efficacy outcomes from baseline to 10 months postpartum. The third aim of the study is to quantify the effects of the intervention on infant feeding and growth. Infant outcomes will include weight status and breastfeeding from birth through 10 months of age. Data analysis will include general linear mixed-effects models. Safety endpoints include adverse event reporting. Discussion Findings from this trial may lead to an effective

  10. Further Improvement in Outcomes of Nasopharyngeal Carcinoma With Optimized Radiotherapy and Induction Plus Concomitant Chemotherapy: An Update of the Milan Experience

    SciTech Connect

    Palazzi, Mauro Orlandi, Ester; Bossi, Paolo; Pignoli, Emanuele; Potepan, Paolo; Guzzo, Marco; Franceschini, Marzia; Scaramellini, Gabriele; Cantu, Giulio; Licitra, Lisa; Olmi, Patrizia; Tomatis, Stefano

    2009-07-01

    Purpose: To report the outcome of a consecutive series of patients with nonmetastatic nasopharyngeal carcinoma (NPC), focusing on the impact of treatment-related factors. Methods and Materials: Between 2000 and 2006, 87 patients with NPC were treated with either conventional (two- or three-dimensional) radiotherapy (RT) or with intensity-modulated RT (IMRT). Of these patients, 81 (93%) received either concomitant CHT (24%) or both induction and concomitant chemotherapy (CHT) (69%). Stage was III in 36% and IV in 39% of patients. Outcomes in this study population were compared with those in the previous series of 171 patients treated during 1990 to 1999. Results: With a median follow-up of 46 months, actuarial rates at 3 years were the following: local control, 96%; local-regional control, 93%; distant control (DC), 90%; disease-free survival (DFS), 82%; overall survival, 90%. In Stage III to IV patients, distant control at 3 years was 56% in patients treated with concomitant CHT only and 92% in patients treated with both induction and concomitant CHT (p = 0.014). At multivariate analysis, histology, N-stage, RT technique, and total RT dose had the strongest independent impact on DFS (p < 0.05). Induction CHT had a borderline effect on DC (p = 0.07). Most dosimetric statistics were improved in the group of patients treated with IMRT compared with conventional 3D technique. All outcome endpoints were substantially better in the study population compared with those in the previous series. Conclusions: Outcome of NPC has further improved in the study period compared with the previous decade, with a significant effect of RT technique optimization. The impact of induction CHT remains to be demonstrated in controlled trials.

  11. 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…

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

    PubMed Central

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

    2016-01-01

    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. 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

  14. Importance of adjunctive heart failure optimization immediately after implantation to improve long-term outcomes with cardiac resynchronization therapy.

    PubMed

    Mullens, Wilfried; Kepa, Jacek; De Vusser, Philippe; Vercammen, Jan; Rivero-Ayerza, Maximo; Wagner, Patrick; Dens, Joseph; Vrolix, Mathias; Vandervoort, Pieter; Tang, W H Wilson

    2011-08-01

    Despite improvement in morbidity and mortality with cardiac resynchronization therapy (CRT), disease progression continues to affect a subset of patients and there is limited effort to identify contributing factors. Our objective was to investigate if a protocol-driven approach incorporated in a management strategy of heart failure immediately after implantation would provide incremental benefits beyond usual care after implantation. We reviewed 114 consecutive patients with CRT implanted from 2005 through 2009 who received usual care after implantation or underwent protocol-driven CRT care after implantation. Preimplantation characteristics in patients receiving usual versus protocol-driven care were similar in left ventricular (LV) dimension (LV internal diastolic diameter 6.2 ± 0.8 vs 6.4 ± 1.0 cm), LV ejection fraction (26 ± 8% vs 25% ± 8%), QRS width, and medication usage. Major adjustments during the protocol-driven approach were uptitration of neurohormonal blockers (64%), echocardiographically guided atrioventricular optimization (50%), heart failure education (42%), arrhythmia management (19%), and LV lead repositioning (7%). Although positive LV remodeling was noted in the 2 groups at 6 months, extent was significantly greater in the protocol-driven approach compared to usual care (change in LV internal diastolic diameter 0.7 ± 0.6 cm vs 0.2 ± 1.2 cm, p = 0.01; change in LV ejection fraction 11 ± 7% vs 7 ± 9%, p = 0.01), which was associated with fewer major adverse events (14% vs 53%, p <0.001). In conclusion, a protocol-driven approach for patients with CRT started immediately after implantation is associated with incremental favorable effects on reverse remodeling and fewer adverse events compared to usual care after implantation. These effects appeared to be driven not only by changes in device settings and arrhythmia management but also by concomitant medication optimization and heart failure education.

  15. 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…

  16. High-performance n-type organic semiconductors: incorporating specific electron-withdrawing motifs to achieve tight molecular stacking and optimized energy levels.

    PubMed

    Yun, Sun Woo; Kim, Jong H; Shin, Seunghoon; Yang, Hoichang; An, Byeong-Kwan; Yang, Lin; Park, Soo Young

    2012-02-14

    Novel π–conjugated cyanostilbene-based semiconductors (Hex-3,5-TFPTA and Hex-4-TFPTA) with tight molecular stacking and optimized energy levels are synthesized. Hex-4-TFPTA exhibits high-performance n-type organic field-effect transistor (OFET) properties with electron mobilities as high as 2.14 cm2 V−1s−1 and on-off current ratios

  17. 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,…

  18. 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…

  19. Ultralong, small-diameter TiOTiO₂ nanotubes achieved by an optimized two-step anodization for efficient dye-sensitized solar cells.

    PubMed

    Wang, Xiaoyan; Sun, Lidong; Zhang, Sam; Wang, Xiu

    2014-02-12

    An optimized two-step anodization is developed to fabricate ultralong, small-diameter TiO2 nanotubes, that is, with tube length of up to 31 μm and pore diameter of about 35 nm in this work. This overcomes the length limitation of small diameter tubes that usually presents in conventional one-step anodization. The small tubes with lengths of 23 μm yield a conversion efficiency of 5.02% in dye-sensitized solar cells under nonoptimized conditions.

  20. 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

  1. 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…

  2. Global Aesthetics Consensus: Hyaluronic Acid Fillers and Botulinum Toxin Type A—Recommendations for Combined Treatment and Optimizing Outcomes in Diverse Patient Populations

    PubMed Central

    Liew, Steven; Signorini, Massimo; Vieira Braz, André; Fagien, Steven; Swift, Arthur; De Boulle, Koenraad L.; Raspaldo, Hervé; Trindade de Almeida, Ada R.; Monheit, Gary

    2016-01-01

    Background: Combination of fillers and botulinum toxin for aesthetic applications is increasingly popular. Patient demographics continue to diversify, and include an expanding population receiving maintenance treatments over decades. Methods: A multinational panel of plastic surgeons and dermatologists convened the Global Aesthetics Consensus Group to develop updated guidelines with a worldwide perspective for hyaluronic acid fillers and botulinum toxin. This publication considers strategies for combined treatments, and how patient diversity influences treatment planning and outcomes. Results: Global Aesthetics Consensus Group recommendations reflect increased use of combined treatments in the lower and upper face, and some midface regions. A fully patient-tailored approach considers physiologic and chronologic age, ethnically associated facial morphotypes, and aesthetic ideals based on sex and culture. Lower toxin dosing, to modulate rather than paralyze muscles, is indicated where volume deficits influence muscular activity. Combination of toxin with fillers is appropriate for several indications addressed previously with toxin alone. New scientific data regarding hyaluronic acid fillers foster an evidence-based approach to selection of products and injection techniques. Focus on aesthetic units, rather than isolated rhytides, optimizes results from toxin and fillers. It also informs longitudinal treatment planning, and analysis of toxin nonresponders. Conclusions: The emerging objective of injectable treatment is facial harmonization rather than rejuvenation. Combined treatment is now a standard of care. Its use will increase further as we refine the concept that aspects of aging are intimately related, and that successful treatment entails identifying and addressing the primary causes of each. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V. PMID:27119917

  3. 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…

  4. 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.

  5. 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.

  6. 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…

  7. "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…

  8. 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

  9. 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

    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

  10. 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.

  11. Achievement Outcomes of Sixth-Grade Students with a Military Parent Deployed to a War Zone or a Military Parent Not Deployed Compared to Same School Students Whose Parents Have No Military Affiliation

    ERIC Educational Resources Information Center

    Ingram, Robert L., III

    2014-01-01

    The need for accurate information about the achievement of students whose military parents are deployed to a war zone or whose military parents are eligible although not currently deployed to a war zone is important in order to ensure that we are providing for the educational wellbeing of these children as their parents defend our nations…

  12. Achievement, Engagement, and Behavior Outcomes of Youth at Risk Following a Pre-Eighth-Grade Summer Academic Enrichment Program and Participation in a School-Wide, School Year Long, Ownership, Mastery, and Grading Initiative

    ERIC Educational Resources Information Center

    Alati, David K.

    2011-01-01

    No significant differences in beginning eighth-grade pretest compared to ending eighth-grade posttest California Achievement Test Normal Curve Equivalent Scores were found for youth at risk who completed a pre-eighth-grade summer academic enrichment program where comparisons for reading vocabulary t(19) = 0.46, p = 0.33 (one-tailed), d = 0.107,…

  13. 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…

  14. 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…

  15. Community-Based Interventions to Improve and Sustain Antiretroviral Therapy Adherence, Retention in HIV Care and Clinical Outcomes in Low- and Middle-Income Countries for Achieving the UNAIDS 90-90-90 Targets

    PubMed Central

    Adetokunboh, Olatunji; Uthman, Olalekan A.; Knowlton, Amy W.; Altice, Frederick L.; Schechter, Mauro; Galárraga, Omar; Geng, Elvin; Peltzer, Karl; Chang, Larry W.; Van Cutsem, Gilles; Jaffar, Shabbar S.; Ford, Nathan; Mellins, Claude A.; Remien, Robert H.; Mills, Edward J.

    2017-01-01

    Little is known about the effect of community versus health facility-based interventions to improve and sustain antiretroviral therapy (ART) adherence, virologic suppression, and retention in care among HIV-infected individuals in low-and middle-income countries (LMICs). We systematically searched four electronic databases for all available randomized controlled trials (RCTs) and comparative cohort studies in LMICs comparing community versus health facility-based interventions. Relative risks (RRs) for pre-defined adherence, treatment engagement (linkage and retention in care), and relevant clinical outcomes were pooled using random effect models. Eleven cohort studies and eleven RCTs (N = 97,657) were included. Meta-analysis of the included RCTs comparing community- versus health facility-based interventions found comparable outcomes in terms of ART adherence (RR = 1.02, 95 % CI 0.99 to 1.04), virologic suppression (RR = 1.00, 95 % CI 0.98 to 1.03), and all-cause mortality (RR = 0.93, 95 % CI 0.73 to 1.18). The result of pooled analysis from the RCTs (RR = 1.03, 95 % CI 1.01 to 1.06) and cohort studies (RR = 1.09, 95 % CI 1.03 to 1.15) found that participants assigned to community-based interventions had statistically significantly higher rates of treatment engagement. Two studies found community-based ART delivery model either cost-saving or cost-effective. Community- versus facility-based models of ART delivery resulted in at least comparable outcomes for clinically stable HIV-infected patients on treatment in LMICs and are likely to be cost-effective. PMID:27475643

  16. 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…

  17. 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…

  18. Evolution of ischemic damage and behavioural deficit over 6 months after MCAo in the rat: Selecting the optimal outcomes and statistical power for multi-centre preclinical trials.

    PubMed

    Rewell, Sarah S J; Churilov, Leonid; Sidon, T Kate; Aleksoska, Elena; Cox, Susan F; Macleod, Malcolm R; Howells, David W

    2017-01-01

    Key disparities between the timing and methods of assessment in animal stroke studies and clinical trial may be part of the reason for the failure to translate promising findings. This study investigates the development of ischemic damage after thread occlusion MCAo in the rat, using histological and behavioural outcomes. Using the adhesive removal test we investigate the longevity of behavioural deficit after ischemic stroke in rats, and examine the practicality of using such measures as the primary outcome for future studies. Ischemic stroke was induced in 132 Spontaneously Hypertensive Rats which were assessed for behavioural and histological deficits at 1, 3, 7, 14, 21, 28 days, 12 and 24 weeks (n>11 per timepoint). The basic behavioural score confirmed induction of stroke, with deficits specific to stroke animals. Within 7 days, these deficits resolved in 50% of animals. The adhesive removal test revealed contralateral neglect for up to 6 months following stroke. Sample size calculations to facilitate the use of this test as the primary experimental outcome resulted in cohort sizes much larger than are the norm for experimental studies. Histological damage progressed from a necrotic infarct to a hypercellular area that cleared to leave a fluid filled cavity. Whilst absolute volume of damage changed over time, when corrected for changes in hemispheric volume, an equivalent area of damage was lost at all timepoints. Using behavioural measures at chronic timepoints presents significant challenges to the basic science community in terms of the large number of animals required and the practicalities associated with this. Multicentre preclinical randomised controlled trials as advocated by the MultiPART consortium may be the only practical way to deal with this issue.

  19. Evolution of ischemic damage and behavioural deficit over 6 months after MCAo in the rat: Selecting the optimal outcomes and statistical power for multi-centre preclinical trials

    PubMed Central

    Churilov, Leonid; Sidon, T. Kate; Aleksoska, Elena; Cox, Susan F.; Macleod, Malcolm R.; Howells, David W.

    2017-01-01

    Key disparities between the timing and methods of assessment in animal stroke studies and clinical trial may be part of the reason for the failure to translate promising findings. This study investigates the development of ischemic damage after thread occlusion MCAo in the rat, using histological and behavioural outcomes. Using the adhesive removal test we investigate the longevity of behavioural deficit after ischemic stroke in rats, and examine the practicality of using such measures as the primary outcome for future studies. Ischemic stroke was induced in 132 Spontaneously Hypertensive Rats which were assessed for behavioural and histological deficits at 1, 3, 7, 14, 21, 28 days, 12 and 24 weeks (n>11 per timepoint). The basic behavioural score confirmed induction of stroke, with deficits specific to stroke animals. Within 7 days, these deficits resolved in 50% of animals. The adhesive removal test revealed contralateral neglect for up to 6 months following stroke. Sample size calculations to facilitate the use of this test as the primary experimental outcome resulted in cohort sizes much larger than are the norm for experimental studies. Histological damage progressed from a necrotic infarct to a hypercellular area that cleared to leave a fluid filled cavity. Whilst absolute volume of damage changed over time, when corrected for changes in hemispheric volume, an equivalent area of damage was lost at all timepoints. Using behavioural measures at chronic timepoints presents significant challenges to the basic science community in terms of the large number of animals required and the practicalities associated with this. Multicentre preclinical randomised controlled trials as advocated by the MultiPART consortium may be the only practical way to deal with this issue. PMID:28182727

  20. An evidence-based medicine strategy for achieving remission in bipolar disorder.

    PubMed

    Beyer, John L

    2008-01-01

    Controlled trials have demonstrated the efficacy of several classes of drugs for achieving acute response in bipolar mania and depression. For many years, clinical response has been the primary outcome in the majority of short-term efficacy studies. However, there is a growing consensus that the optimal goal in the long-term management of bipolar disorder is remission. The purpose of this article is to briefly summarize the clinical importance of remission in bipolar disorder and to review data on the effectiveness of available treatments for achieving and sustaining remission.

  1. 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.

  2. Early diagnosis and treatment referral of children born small for gestational age without catch-up growth are critical for optimal growth outcomes

    PubMed Central

    2012-01-01

    Approximately 10% of children born small for their gestational age (SGA) fail to show catch-up growth and may remain short-statured as adults. Despite treatment guidelines for children born SGA that recommend referral for growth hormone (GH) therapy evaluation and initiation by ages 2 to 4 years, the average age of GH treatment initiation is typically much later, at ages 7 to 9 years. Delayed referral for GH treatment is problematic as studies show younger age at GH treatment initiation in children born SGA is an independent predictor for responses such as optimal growth acceleration, normalization of prepubertal height, and most importantly, adult height (AH). This review discusses the importance and associated challenges of early diagnosis of children born SGA who fail to show catch-up growth, contrasts the recommended age of referral for these patients and the average age of GH treatment initiation, and discusses studies showing the significant positive effects of early referral and treatment with GH on AHs in short-statured children born SGA. To optimize the eventual height in short-statured SGA children who fail to manifest catch-up growth, a lowering of the average age of referral for GH therapy evaluation is needed to better align with consensus recommendations for SGA management. The importance of increasing parental and physician awareness that most children born SGA will do well developmentally and will optimally benefit from early initiation of GH treatment when short-statured is addressed, as is the need to shift the age of referral to better align with consensus recommendations. PMID:22559301

  3. 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.

  4. Introduction: Linkage, engagement, and retention in HIV care: essential for optimal individual- and community-level outcomes in the era of highly active antiretroviral therapy.

    PubMed

    Mayer, Kenneth Hugh

    2011-01-15

    Engagement in medical care after a diagnosis of human immunodeficiency virus (HIV) infection is essential to initiate lifesaving antiretroviral therapy and facilitate the delivery of important prevention messages for reducing HIV transmission. Failure to engage and be retained in HIV care can be associated with negative outcomes for both the individual and the community. However, many Americans living with HIV infection are, for a variety of reasons, undiagnosed, not in medical care, or not receiving HIV treatment. The articles in this supplement describe the barriers, challenges, and successes in linking HIV-infected patients to expert care in the United States, with a focus on the unique issues faced by specific populations of men who have sex with men, heterosexual men, and women, and the role of the health care system and other structural factors in facilitating or impeding engagement in care.

  5. 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

  6. Prosocial foundations of children's academic achievement.

    PubMed

    Caprara, G V; Barbaranelli, C; Pastorelli, C; Bandura, A; Zimbardo, P G

    2000-07-01

    The present longitudinal research demonstrates robust contributions of early prosocial behavior to children's developmental trajectories in academic and social domains. Both prosocial and aggressive behaviors in early childhood were tested as predictors of academic achievement and peer relations in adolescence 5 years later. Prosocialness included cooperating, helping, sharing, and consoling, and the measure of antisocial aspects included proneness to verbal and physical aggression. Prosocialness had a strong positive impact on later academic achievement and social preferences, but early aggression had no significant effect on either outcome. The conceptual model accounted for 35% of variance in later academic achievement, and 37% of variance in social preferences. Additional analysis revealed that early academic achievement did not contribute to later academic achievement after controlling for effects of early prosocialness. Possible mediating processes by which prosocialness may affect academic achievement and other socially desirable developmental outcomes are proposed.

  7. 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…

  8. 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…

  9. Optimizing antiretroviral product selection: a sample approach to improving patient outcomes, saving money, and scaling-up health services in developing countries.

    PubMed

    Amole, Carolyn D; Brisebois, Catherine; Essajee, Shaffiq; Koehler, Erin; Levin, Andrew D; Moore, Meredith C; Brown Ripin, David H; Sickler, Joanna J; Singh, Inder R

    2011-08-01

    Over the last decade, increased funding to support HIV treatment programs has enabled millions of new patients in developing countries to access the medications they need. Today, although demand for antiretrovirals continues to grow, the financial crisis has severely constrained funding leaving countries with difficult choices on program prioritization. Product optimization is one solution countries can pursue to continue to improve patient care while also uncovering savings that can be used for further scale up or other health system needs. Program managers can make procurement decisions that actually reduce program costs by considering additional factors beyond World Health Organization guidelines when making procurement decisions. These include in-country product availability, convenience, price, and logistics such as supply chain implications and laboratory testing requirements. Three immediate product selection opportunities in the HIV space include using boosted atazanavir in place of lopinovir for second-line therapy, lamivudine instead of emtricitabine in both first-line and second-line therapy, and tenofovir + lamivudine over abacavir + didanosine in second-line therapy. If these 3 opportunities were broadly implemented in sub-Saharan Africa and India today, approximately $300 million of savings would be realized over the next 5 years, enabling hundreds of thousands of additional patients to be treated. Although the discussion herein is specific to antriretrovirals, the principles of product selection are generalizable to diseases with multiple treatment options and fungible commodity procurement. Identifying and implementing approaches to overcome health system inefficiencies will help sustain and may expand quality care in resource-limited settings.

  10. What grades and achievement tests measure

    PubMed Central

    Borghans, Lex; Golsteyn, Bart H. H.; Heckman, James J.; Humphries, John Eric

    2016-01-01

    Intelligence quotient (IQ), grades, and scores on achievement tests are widely used as measures of cognition, but the correlations among them are far from perfect. This paper uses a variety of datasets to show that personality and IQ predict grades and scores on achievement tests. Personality is relatively more important in predicting grades than scores on achievement tests. IQ is relatively more important in predicting scores on achievement tests. Personality is generally more predictive than IQ on a variety of important life outcomes. Both grades and achievement tests are substantially better predictors of important life outcomes than IQ. The reason is that both capture personality traits that have independent predictive power beyond that of IQ. PMID:27830648

  11. 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

  12. 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…

  13. Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscle outcomes in older people

    PubMed Central

    Denison, Hayley J; Cooper, Cyrus; Sayer, Avan Aihie; Robinson, Sian M

    2015-01-01

    The growing recognition of sarcopenia, the age-related loss of skeletal muscle mass and function, has highlighted the need to understand more about its etiology. Declines in muscle mass and strength are expected aspects of aging, but there is significant variability between individuals in rates of loss. Although some of these differences can be explained by fixed factors, such as sex, much of the remaining variation is unexplained. This has led to increasing interest in the influence of adult lifestyle, particularly in the effects of modifiable factors such as physical activity and diet, and in identifying intervention opportunities both to prevent and manage sarcopenia. A number of trials have examined the separate effects of increased exercise or dietary supplementation on muscle mass and physical performance of older adults, but less is known about the extent to which benefits of exercise training could be enhanced when these interventions are combined. In a comprehensive review of the literature, we consider 17 studies of older adults (≥65 years) in which combined nutrition and exercise interventions were used to increase muscle strength and/or mass, and achieve improvements in physical performance. The studies were diverse in terms of the participants included (nutritional status, degree of physical frailty), supplementation strategies (differences in nutrients, doses), exercise training (type, frequency), as well as design (duration, setting). The main message is that enhanced benefits of exercise training, when combined with dietary supplementation, have been shown in some trials – indicating potential for future interventions, but that existing evidence is inconsistent. Further studies are needed, particularly of exercise training combined with dietary strategies that increase intakes of a range of nutrients, as well as bioactive non-nutrients, to provide the evidence on which public health and clinical recommendations can be based. PMID:25999704

  14. Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscle outcomes in older people.

    PubMed

    Denison, Hayley J; Cooper, Cyrus; Sayer, Avan Aihie; Robinson, Sian M

    2015-01-01

    The growing recognition of sarcopenia, the age-related loss of skeletal muscle mass and function, has highlighted the need to understand more about its etiology. Declines in muscle mass and strength are expected aspects of aging, but there is significant variability between individuals in rates of loss. Although some of these differences can be explained by fixed factors, such as sex, much of the remaining variation is unexplained. This has led to increasing interest in the influence of adult lifestyle, particularly in the effects of modifiable factors such as physical activity and diet, and in identifying intervention opportunities both to prevent and manage sarcopenia. A number of trials have examined the separate effects of increased exercise or dietary supplementation on muscle mass and physical performance of older adults, but less is known about the extent to which benefits of exercise training could be enhanced when these interventions are combined. In a comprehensive review of the literature, we consider 17 studies of older adults (≥65 years) in which combined nutrition and exercise interventions were used to increase muscle strength and/or mass, and achieve improvements in physical performance. The studies were diverse in terms of the participants included (nutritional status, degree of physical frailty), supplementation strategies (differences in nutrients, doses), exercise training (type, frequency), as well as design (duration, setting). The main message is that enhanced benefits of exercise training, when combined with dietary supplementation, have been shown in some trials - indicating potential for future interventions, but that existing evidence is inconsistent. Further studies are needed, particularly of exercise training combined with dietary strategies that increase intakes of a range of nutrients, as well as bioactive non-nutrients, to provide the evidence on which public health and clinical recommendations can be based.

  15. A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer: The International Consortium for Health Outcomes Measurement (ICHOM) Initiative.

    PubMed

    Ong, Wee Loon; Schouwenburg, Maartje G; van Bommel, Annelotte C M; Stowell, Caleb; Allison, Kim H; Benn, Karen E; Browne, John P; Cooter, Rodney D; Delaney, Geoff P; Duhoux, Francois P; Ganz, Patricia A; Hancock, Patricia; Jagsi, Reshma; Knaul, Felicia M; Knip, Anne M; Koppert, Linetta B; Kuerer, Henry M; McLaughin, Sarah; Mureau, Marc A M; Partridge, Ann H; Reid, Dereesa Purtell; Sheeran, Lisa; Smith, Thomas J; Stoutjesdijk, Mark J; Vrancken Peeters, Marie Jeanne T F D; Wengström, Yvonne; Yip, Cheng-Har; Saunders, Christobel

    2016-12-29

    A major challenge in value-based health care is the lack of standardized health outcomes measurements, hindering optimal monitoring and comparison of the quality of health care across different settings globally. The International Consortium for Health Outcomes Measurement (ICHOM) assembled a multidisciplinary international working group, comprised of 26 health care providers and patient advocates, to develop a standard set of value-based patient-centered outcomes for breast cancer (BC). The working group convened via 8 teleconferences and completed a follow-up survey after each meeting. A modified 2-round Delphi method was used to achieve consensus on the outcomes and case-mix variables to be included. Patient focus group meetings (8 early or metastatic BC patients) and online anonymized surveys of 1225 multinational BC patients and survivors were also conducted to obtain patients' input. The standard set encompasses survival and cancer control, and disutility of care (eg, acute treatment complications) outcomes, to be collected through administrative data and/or clinical records. A combination of multiple patient-reported outcomes measurement (PROM) tools is recommended to capture long-term degree of health outcomes. Selected case-mix factors were recommended to be collected at baseline. The ICHOM will endeavor to achieve wide buy-in of this set and facilitate its implementation in routine clinical practice in various settings and institutions worldwide.

  16. 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.…

  17. Which Achievement Gap?

    ERIC Educational Resources Information Center

    Anderson, Sharon; Medrich, Elliott; Fowler, Donna

    2007-01-01

    From the halls of Congress to the local elementary school, conversations on education reform have tossed around the term "achievement gap" as though people all know precisely what that means. As it's commonly used, "achievement gap" refers to the differences in scores on state or national achievement tests between various…

  18. Incidence, Predictors, and Mid-Term Outcomes of Percutaneous Closure Failure After Transfemoral Aortic Valve Implantation Using an Expandable Sheath (from the Optimized Transcatheter Valvular Intervention [OCEAN-TAVI] Registry).

    PubMed

    Nara, Yugo; Watanabe, Yusuke; Kozuma, Ken; Kataoka, Akihisa; Nakashima, Makoto; Hioki, Hirofumi; Kawashima, Hideyuki; Nagura, Fukuko; Shirai, Shinichi; Tada, Norio; Araki, Motoharu; Naganuma, Toru; Yamanaka, Futoshi; Yamamoto, Masanori; Hayashida, Kentaro

    2017-02-15

    The aim of this study was to evaluate the incidence, predictors, and outcomes of percutaneous closure device (PCD) failure during transfemoral transcatheter aortic valve implantation (TAVI) with an Edwards Sapien-XT prosthesis using an expandable sheath (eSheath). From October 2013 to April 2016, 1,215 patients who underwent TAVI were prospectively enrolled in the Optimized Transcatheter Valvular Intervention (OCEAN-TAVI) registry. Of these, 478 patients underwent transfemoral TAVI with Sapien-XT prosthesis using an eSheath and percutaneous closure with a Perclose ProGlide system. We evaluated the predictors of PCD failure and whether it affected the clinical outcomes. Patients were aged 85 years (interquartile range 82 to 88 years). PCD failure occurred in 36 patients (8%). Sheath-to-femoral artery ratio (SFAR) (per 1 increase) (odds ratio 5.40, 95% confidence interval 1.28 to 22.92, p = 0.022) predicted PCD failure in a multivariate model. The sensitivity-specificity curves identified an SFAR threshold of 1.03; the area under the curve for SFAR as a predictor of PCD failure was 0.629. The PCD failure group did not have a higher rate of 30-day mortality (0% vs 1%, p = 0.52) or mid-term (365-day) mortality (log-rank test p = 0.85) compared with the PCD success group in the Kaplan-Meier analysis. In conclusion, PCD failures occurred in 8% of the patients and were not associated with 30-day or mid-term mortality rates after percutaneous transfemoral TAVI. The SFAR threshold of 1.03 was useful for predicting PCD failures.

  19. Prospective Optimization.

    PubMed

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

    2014-05-01

    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.

  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. 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.

  2. 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…

  3. 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 ...

  4. 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

  5. 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…

  6. 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…

  7. 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…

  8. Matching achievement contexts with implicit theories to maximize motivation after failure: a congruence model.

    PubMed

    El-Alayli, Amani

    2006-12-01

    Previous research has shown that matching person variables with achievement contexts can produce the best motivational outcomes. The current study examines whether this is also true when matching entity and incremental beliefs with the appropriate motivational climate. Participants were led to believe that a personal attribute was fixed (entity belief) or malleable (incremental belief). After thinking that they failed a test that assessed the attribute, participants performed a second (related) task in a context that facilitated the pursuit of either performance or learning goals. Participants were expected to exhibit greater effort on the second task in the congruent conditions (entity belief plus performance goal climate and incremental belief plus learning goal climate) than in the incongruent conditions. These results were obtained, but only for participants who either valued competence on the attribute or had high achievement motivation. Results are discussed in terms of developing strategies for optimizing motivation in achievement settings.

  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. The Methodological Nettle: ICT and Student Achievement

    ERIC Educational Resources Information Center

    Chandra, Vinesh; Lloyd, Margaret

    2008-01-01

    A major challenge for researchers and educators has been to discern the effect of ICT use on student learning outcomes. This paper maps the achievements in Year 10 Science of two cohorts of students over two years where students in the first year studied in a traditional environment while students in the second took part in a blended or e-learning…

  11. 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…

  12. "Skin facts" to optimize aesthetic outcomes.

    PubMed

    Brennan, Connie

    2015-01-01

    Aesthetic providers need to be well versed in the anatomy and intricacies of the skin. This foundational skin knowledge is critical in assessing clients' aged skin during the aesthetic consultation. A sound understanding of the skin is also a prerequisite to any facial rejuvenation procedure. This article provides the aesthetic provider with the basics of skin anatomy and how the skin changes over time.

  13. Optimizing nutrition of the preterm infant.

    PubMed

    Hay, William W Jr

    2017-01-01

    The goal of nutrition of the preterm infant is to meet the growth rate of the healthy fetus of the same gestational age and to produce the same body composition of the healthy fetus in terms of organ growth, tissue components, and cell number and structure. Nutritional quantity and quality are fundamental for normal growth and development of preterm infants, including neurodevelopmental outcomes. Failure to provide the necessary amounts of all of the essential nutrients has produced not only growth failure, but also increased morbidity and less than optimal neurodevelopment. Growth velocities during the NICU hospitalization period for preterm infants exert a significant effect on neurodevelopmental and anthropometric outcomes. Despite the obvious need for optimal nutrition, growth failure is almost universal among preterm infants. There is every reason, therefore, to optimize nutrition of the preterm infant, in terms of total energy and protein, but also in terms of individual components such as amino acids, specific carbohydrates and lipids, and even oxygen. This review presents scientific rationale for nutrient requirements and practical guidelines and approaches to intravenous and enteral feeding for preterm infants. Intravenous feeding, including amino acids, should be started right after birth at rates that are appropriate for the gestational age of the infant. Enteral feeding should be started as soon as possible after birth, using mother's colostrum and milk as first choices. Enteral feeding should begin with trophic amounts and advanced as rapidly as tolerated, decreasing IV nutrition accordingly, while maintaining nutrient intakes at recommended rates. Feeding protocols are valuable for improving nutrition and related outcomes. Further research is needed to determine the optimal nutrition and rate of growth in preterm infants that will achieve optimal neurocognitive benefits while minimizing the longer-term risk of chronic diseases.

  14. A Primer on Unrealistic Optimism.

    PubMed

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

    2015-06-01

    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.

  15. Cognitive, Parent and Teacher Rating Measures of Executive Functioning: Shared and Unique Influences on School Achievement

    PubMed Central

    Dekker, Marielle C.; Ziermans, Tim B.; Spruijt, Andrea M.; Swaab, Hanna

    2017-01-01

    Very little is known about the relative influence of cognitive performance-based executive functioning (EF) measures and behavioral EF ratings in explaining differences in children's school achievement. This study examined the shared and unique influence of these different EF measures on math and spelling outcome for a sample of 84 first and second graders. Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF), and children were tested with computer-based performance tests from the Amsterdam Neuropsychological Tasks (ANT). Mixed-model hierarchical regression analyses, including intelligence level and age, showed that cognitive performance and teacher's ratings of working memory and shifting concurrently explained differences in spelling. However, teacher's behavioral EF ratings did not explain any additional variance in math outcome above cognitive EF performance. Parent's behavioral EF ratings did not add any unique information for either outcome measure. This study provides support for the ecological validity of performance- and teacher rating-based EF measures, and shows that both measures could have a complementary role in identifying EF processes underlying spelling achievement problems. The early identification of strengths and weaknesses of a child's working memory and shifting capabilities, might help teachers to broaden their range of remedial intervention options to optimize school achievement. PMID:28194121

  16. 'No delays achiever'.

    PubMed

    2007-05-01

    The latest version of the NHS Institute for Innovation and Improvement's 'no delays achiever', a web based tool created to help NHS organisations achieve the 18-week target for GP referrals to first treatment, is available at www.nodelaysachiever.nhs.uk.

  17. Vicarious Achievement Orientation.

    ERIC Educational Resources Information Center

    Leavitt, Harold J.; And Others

    This study tests hypotheses about achievement orientation, particularly vicarious achievement. Undergraduate students (N=437) completed multiple-choice questionnaires, indicating likely responses of one person to the success of another. The sex of succeeder and observer, closeness of relationship, and setting (medical school or graduate school of…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. Improving outcomes in peripartum cardiomyopathy.

    PubMed

    Dalzell, Jonathan R; Cannon, Jane A; Simpson, Joanne; Gardner, Roy S; Petrie, Mark C

    2015-06-01

    Peripartum cardiomyopathy (PPCM) is a rare condition with a diverse spectrum of potential outcomes, ranging from frequent complete recovery to fulminant heart failure and death. The pathogenesis of PPCM is not well understood, and relatively little is known about its incidence and prevalence. PPCM is often under-recognised in the clinical setting. Early investigation and diagnosis with subsequent expert management may improve outcomes. The development of registries will allow this condition to be better characterised and may help answer crucial questions regarding its optimal medical and surgical management. This paper reviews the potential approaches to improve outcomes in patients with PPCM.

  3. 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.

  4. Achievability for telerobotic systems

    NASA Astrophysics Data System (ADS)

    Kress, Reid L.; Draper, John V.; Hamel, William R.

    2001-02-01

    Methods are needed to improve the capabilities of autonomous robots to perform tasks that are difficult for contemporary robots, and to identify those tasks that robots cannot perform. Additionally, in the realm of remote handling, methods are needed to assess which tasks and/or subtasks are candidates for automation. We are developing a new approach to understanding the capability of autonomous robotic systems. This approach uses formalized methods for determining the achievability of tasks for robots, that is, the likelihood that an autonomous robot or telerobot can successfully complete a particular task. Any autonomous system may be represented in achievability space by the volume describing that system's capabilities within the 3-axis space delineated by perception, cognition, and action. This volume may be thought of as a probability density with achievability decreasing as the distance from the centroid of the volume increases. Similarly, any task may be represented within achievability space. However, as tasks have more finite requirements for perception, cognition, and action, each may be represented as a point (or, more accurately, as a small sphere) within achievability space. Analysis of achievability can serve to identify, a priori, the survivability of robotic systems and the likelihood of mission success; it can be used to plan a mission or portions of a mission; it can be used to modify a mission plan to accommodate unpredicted occurrences; it can also serve to identify needs for modifications to robotic systems or tasks to improve achievability. .

  5. 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.

  6. Achieving real-time performance in FIESTA

    NASA Technical Reports Server (NTRS)

    Wilkinson, William; Happell, Nadine; Miksell, Steve; Quillin, Robert; Carlisle, Candace

    1988-01-01

    The Fault Isolation Expert System for TDRSS Applications (FIESTA) is targeted for operation in a real-time online environment. Initial stages of the prototype development concentrated on acquisition and representation of the knowledge necessary to isolate faults in the TDRSS Network. Recent efforts focused on achieving real-time performance including: a discussion of the meaning of FIESTA real-time requirements, determination of performance levels (benchmarking) and techniques for optimization. Optimization techniques presented include redesign of critical relations, filtering of redundant data and optimization of patterns used in rules. Results are summarized.

  7. Student Achievement Factors

    ERIC Educational Resources Information Center

    Bertolini, Katherine; Stremmel, Andrew; Thorngren, Jill

    2012-01-01

    Effective practices for education are essential to insure public investment in our schools provides the maximum yield for our students, communities, states, and nation. The challenge has been defining and measuring terms such as effective, proficient, and sufficient when we examine instructional practice, student outcomes and funding equity. This…

  8. 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

  9. Culture and Achievement Motivation

    ERIC Educational Resources Information Center

    Maehr, Martin L.

    1974-01-01

    A framework is suggested for the cross-cultural study of motivation that stresses the importance of contextual conditions in eliciting achievement motivation and emphasizes cultural relativity in the definition of the concept. (EH)

  10. Achieving Salary Equity

    ERIC Educational Resources Information Center

    Nevill, Dorothy D.

    1975-01-01

    Three techniques are outlined for use by higher education institutions to achieve salary equity: salary prediction (using various statistical procedures), counterparting (comparing salaries of persons of similar rank), and grievance procedures. (JT)

  11. Optimally Stopped Optimization

    NASA Astrophysics Data System (ADS)

    Vinci, Walter; Lidar, Daniel A.

    2016-11-01

    We combine the fields of heuristic optimization and optimal stopping. We propose a strategy for benchmarking randomized optimization algorithms that minimizes the expected total cost for obtaining a good solution with an optimal number of calls to the solver. To do so, rather than letting the objective function alone define a cost to be minimized, we introduce a further cost-per-call of the algorithm. We show that this problem can be formulated using optimal stopping theory. The expected cost is a flexible figure of merit for benchmarking probabilistic solvers that can be computed when the optimal solution is not known and that avoids the biases and arbitrariness that affect other measures. The optimal stopping formulation of benchmarking directly leads to a real-time optimal-utilization strategy for probabilistic optimizers with practical impact. We apply our formulation to benchmark simulated annealing on a class of maximum-2-satisfiability (MAX2SAT) problems. We also compare the performance of a D-Wave 2X quantum annealer to the Hamze-Freitas-Selby (HFS) solver, a specialized classical heuristic algorithm designed for low-tree-width graphs. On a set of frustrated-loop instances with planted solutions defined on up to N =1098 variables, the D-Wave device is 2 orders of magnitude faster than the HFS solver, and, modulo known caveats related to suboptimal annealing times, exhibits identical scaling with problem size.

  12. 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

  13. Polymeric mixed micelles as nanomedicines: Achievements and perspectives.

    PubMed

    Cagel, Maximiliano; Tesan, Fiorella C; Bernabeu, Ezequiel; Salgueiro, Maria J; Zubillaga, Marcela B; Moretton, Marcela A; Chiappetta, Diego A

    2017-04-01

    During the past few decades, polymeric micelles have raised special attention as novel nano-sized drug delivery systems for optimizing the treatment and diagnosis of numerous diseases. These nanocarriers exhibit several in vitro and in vivo advantages as well as increased stability and solubility to hydrophobic drugs. An interesting approach for optimizing these properties and overcoming some of their disadvantages is the combination of two or more polymers in order to assemble polymeric mixed micelles. This review article gives an overview on the current state of the art of several mixed micellar formulations as nanocarriers for drugs and imaging probes, evaluating their ongoing status (preclinical or clinical stage), with special emphasis on type of copolymers, physicochemical properties, in vivo progress achieved so far and toxicity profiles. Besides, the present article presents relevant research outcomes about polymeric mixed micelles as better drug delivery systems, when compared to polymeric pristine micelles. The reported data clearly illustrates the promise of these nanovehicles reaching clinical stages in the near future.

  14. 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.

  15. A global study of the unmet need for glycemic control and predictor factors among patients with type 2 diabetes mellitus who have achieved optimal fasting plasma glucose control on basal insulin

    PubMed Central

    Chou, Engels; Colagiuri, Stephen; Gaàl, Zsolt; Lavalle, Fernando; Mkrtumyan, Ashot; Nikonova, Elena; Tentolouris, Nikolaos; Vidal, Josep; Davies, Melanie

    2016-01-01

    Abstract Background This study used data from different sources to identify the extent of the unmet need for postprandial glycemic control in patients with type 2 diabetes mellitus (T2DM) after the initiation of basal insulin therapy in Europe, Asia Pacific, the United States, and Latin America. Methods Different levels of evidence were used as available for each country/region, with data extracted from seven randomized controlled trials (RCTs), three clinical trial registries (CTRs), and three electronic medical record (EMR) databases. Glycemic status was categorized as “well controlled” (glycated hemoglobin [HbA1c] at target [<7%]), “residual hyperglycemia” (fasting plasma glucose [FPG] but not HbA1c at target [FPG <7.2/7.8 mmol/L, <130/140 mg/dL, depending on country‐specific recommendations]), or “uncontrolled” (both FPG and HbA1c above target). Predictor factors were identified from the RCT data set using logistic regression analysis. Results RCT data showed that 16.9% to 28.0%, 42.7% to 54.4%, and 16.9% to 38.1% of patients with T2DM had well‐controlled glycemia, residual hyperglycemia, and uncontrolled hyperglycemia, respectively. In CTRs, respective ranges were 21.8% to 33.6%, 31.5% to 35.6%, and 30.7% to 46.8%, and in EMR databases were 4.4% to 21.0%, 23.9% to 31.8%, and 53.6% to 63.8%. Significant predictor factors of residual hyperglycemia identified from RCT data included high baseline HbA1c (all countries/regions except Brazil), high baseline FPG (United Kingdom/Japan), longer duration of diabetes (Brazil), and female sex (Europe/Latin America). Conclusions Irrespective of intrinsic differences between data sources, 24% to 54% of patients with T2DM globally had residual hyperglycemia with HbA1c not at target, despite achieving FPG control, indicating a significant unmet need for postprandial glycemic control. PMID:27606888

  16. 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…

  17. 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,…

  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. 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…

  20. 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.

  1. 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,…

  2. Cognitive Processes and Achievement.

    ERIC Educational Resources Information Center

    Hunt, Dennis; Randhawa, Bikkar S.

    For a group of 165 fourth- and fifth-grade students, four achievement test scores were correlated with success on nine tests designed to measure three cognitive functions: sustained attention, successive processing, and simultaneous processing. This experiment was designed in accordance with Luria's model of the three functional units of the…

  3. Graders' Mathematics Achievement

    ERIC Educational Resources Information Center

    Bond, John B.; Ellis, Arthur K.

    2013-01-01

    The purpose of this experimental study was to investigate the effects of metacognitive reflective assessment instruction on student achievement in mathematics. The study compared the performance of 141 students who practiced reflective assessment strategies with students who did not. A posttest-only control group design was employed, and results…

  4. 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…

  5. Improving Educational Achievement.

    ERIC Educational Resources Information Center

    New York University Education Quarterly, 1979

    1979-01-01

    This is a slightly abridged version of the report of the National Academy of Education panel, convened at the request of HEW Secretary Joseph Califano and Assistant Secretary for Education Mary F. Berry, to study recent declines in student achievement and methods of educational improvement. (SJL)

  6. The Achievement Club

    ERIC Educational Resources Information Center

    Rogers, Ibram

    2009-01-01

    When Gabrielle Carpenter became a guidance counselor in Northern Virginia nine years ago, she focused on the academic achievement gap and furiously tried to close it. At first, she was compelled by tremendous professional interest. However, after seeing her son lose his zeal for school, Carpenter joined forces with other parents to form an…

  7. Achievement in Problem Solving

    ERIC Educational Resources Information Center

    Friebele, David

    2010-01-01

    This Action Research Project is meant to investigate the effects of incorporating research-based instructional strategies into instruction and their subsequent effect on student achievement in the area of problem-solving. The two specific strategies utilized are the integration of manipulatives and increased social interaction on a regular basis.…

  8. 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…

  9. 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…

  10. 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…

  11. CEBAF Accelerator Achievements

    NASA Astrophysics Data System (ADS)

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

    2011-05-01

    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.

  12. 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…

  13. The "not so simple" ankle fracture: avoiding problems and pitfalls to improve patient outcomes.

    PubMed

    Hak, David J; Egol, Kenneth A; Gardner, Michael J; Haskell, Andrew

    2011-01-01

    Ankle fractures are among the most common injuries managed by orthopaedic surgeons. Many ankle fractures are simple, with straightforward management leading to successful outcomes. Some fractures, however, are challenging, and debate arises regarding the best treatment to achieve an optimal outcome. Some patients have medical comorbidities that increase the risk for complications or may require modifications to standard surgical techniques and fixation methods. Several recent investigations have highlighted the pitfalls in accurately reducing syndesmotic injuries. Controversy remains regarding the number and diameter of screws, the duration of weight-bearing limitations, and the need or timing of screw removal. Open reduction may allow more accurate reduction than standard closed methods. Direct fixation of associated posterior malleolus fractures may provide improved syndesmotic stability. Posterior malleolus fractures vary in size and can be classified based on the orientation of the fracture line. As the size of the posterior malleolus fracture fragment increases, the load pattern in the ankle is altered. Direct or indirect reduction and surgical fixation may be required to prevent posterior talar subluxation and restore articular congruency. The supination-adduction fracture pattern is also important to recognize. Articular depression of the medial tibial plafond may require reduction and bone grafting. Optimal fixation requires directing screws parallel to the ankle joint or using a buttress plate. Identifying ankle fractures that may present additional treatment challenges is essential to achieving a successful outcome. A careful review of radiographs and CT scans, a thorough patient assessment, and detailed preoperative planning are needed to improve patient outcomes.

  14. 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…

  15. Achievement Gap and Sustainability: A Case Study of an Elementary School Bridging the Achievement Gap

    ERIC Educational Resources Information Center

    Gray, Sandra Jean

    2010-01-01

    The achievement gap problem is a growing phenomenon in the United States of America. In many schools, minority student populations are failing at alarming rates and are looking at different outcomes than those of their White and Asian counterparts. However, a few schools are breaking through the barriers of poverty, poor school attendance, low…

  16. 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.

  17. 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.

  18. Faculty achievement tracking tool.

    PubMed

    Pettus, Sarah; Reifschneider, Ellen; Burruss, Nancy

    2009-03-01

    Faculty development and scholarship is an expectation of nurse educators. Accrediting institutions, such as the Commission on Collegiate Nursing Education, the National League for Nursing Accrediting Commission, and the Higher Learning Commission, all have criteria regarding faculty achievement. A faculty achievement tracking tool (FATT) was developed to facilitate documentation of accreditation criteria attainment. Based on criteria from accrediting organizations, the roles that are addressed include scholarship, service, and practice. Definitions and benchmarks for the faculty as an aggregate are included. Undergoing reviews from different accrediting organizations, the FATT has been used once for accreditation of the undergraduate program and once for accreditation of the graduate program. The FATT is easy to use and has become an excellent adjunct for the preparation for accreditation reports. In addition, the FATT may be used for yearly evaluations, advancement, and merit.

  19. Measuring Wheelchair Intervention Outcomes: Development of the Wheelchair Outcome Measure

    PubMed Central

    Mortenson, William B; Miller, William C; Miller-Pogar, Jan

    2013-01-01

    Purpose Provision of a wheelchair has immediate intuitive benefits; however, it can be difficult to evaluate which wheelchair and seating components best meet an individual’s needs. As well, funding agencies now prefer evidence of outcomes; and therefore measurement upon prescription of a wheelchair or its components is essential to demonstrate the efficacy of intervention. As no existing tool can provide individualized goal-oriented measure of outcome after wheelchair prescription, a research project was undertaken to create the Wheelchair Outcome Measure (WhOM). Method A mixed method research design was employed to develop the instrument, which used in-depth interviews of prescribers, individuals who use wheelchairs and their associates, supplemented by additional questions in which participant preferences in key areas of the measure were quantified. Results The WhOM is a client-specific wheelchair intervention measurement tool that is based on the World Health Organization’s International Classification of Function, Disability, and Health. It identifies desired outcomes at a participation level and also acknowledges concerns about body structure and function. Conclusion The new outcome instrument will allow clients to identify and evaluate the outcomes they wish to achieve with their wheelchairs and seating and provide clinicians a way to quantify outcomes of their interventions in a way that is meaningful to the client and potential funding sources. PMID:19263533

  20. 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…

  1. 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

  2. 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

  3. Achieving timely adoption.

    PubMed

    Carnochan, Sarah; Moore, Megan; Austin, Michael J

    2013-01-01

    While family reunification is the primary permanency objective for children who must be placed temporarily outside of their homes, reunification is not possible for all children. For those children who do not return to their parents and cannot find permanent homes with other family members, adoption is the favored outcome. This review examines the composite measure in the federal Child and Family Services Review that measures agency performance related to the timeliness of adoptions of foster children. It summarizes the multiple factors that research has found to be associated with increased risk for adoption delay and disruption. These include child characteristics, family of origin and adoptive family characteristics, and features of child welfare services and systems. Practices that have been broadly linked to adoption timeliness or address risk factors associated with delays in adoption are described, including social worker activities and agency or system-wide practice.

  4. Family, school, and community factors and relationships to racial-ethnic attitudes and academic achievement.

    PubMed

    Smith, Emilie Phillips; Atkins, Jacqueline; Connell, Christian M

    2003-09-01

    This study examined family, school, and community factors and the relationships to racial-ethnic attitudes and academic achievement among 98 African American fourth-grade children. It has been posited that young people who feel better about their racial-ethnic background have better behavioral and academic outcomes, yet there is a need for more empirical tests of this premise. Psychometric information is reported on measures of parent, teacher, and child racial-ethnic attitudes. Path analysis was used to investigate ecological variables potentially related to children's racial-ethnic attitudes and achievement. Parental education and level of racial-ethnic pride were correlated and both were related to children's achievement though in the final path model, only the path from parental education level was statistically significant. Children whose teachers exhibited higher levels of racial-ethnic trust and perceived fewer barriers due to race and ethnicity evidenced more trust and optimism as well. Children living in communities with higher proportions of college-educated residents also exhibited more positive racial-ethnic attitudes. For children, higher racial-ethnic pride was related to higher achievement measured by grades and standardized test scores, while racial distrust and perception of barriers due to race were related to reduced performance. This study suggests that family, school, and community are all important factors related to children's racial-ethnic attitudes and also to their academic achievement.

  5. 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.…

  6. 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…

  7. Academic Self-Handicapping and Achievement: A Meta-Analysis

    ERIC Educational Resources Information Center

    Schwinger, Malte; Wirthwein, Linda; Lemmer, Gunnar; Steinmayr, Ricarda

    2014-01-01

    Self-handicapping represents a frequently used strategy for regulating the threat to self-esteem elicited by the fear of failing in academic achievement settings. Several studies have documented negative associations between self-handicapping and different educational outcomes, inter alia academic achievement. However, studies on the relation…

  8. 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)

  9. Optimal Consensus Based Decentralized Cooperative Spectrum Sensing in Cognitive Radio Networks

    NASA Astrophysics Data System (ADS)

    Shen, Liang; Xu, Yuhua; Gao, Zhan; Wu, Qihui

    2013-03-01

    We study the problem of decentralized cooperative spectrum sensing in cognitive radio ad hoc networks without a fusion center, using a consensus based solution. First, the received logarithmic likelihood ratio (LLR) is employed as the local detection outcome; then, it is exchanged between neighboring CR users and is updated based on the LLR received from the neighbors. It is proved that with the proposed decentralized algorithm, the optimal sensing performance is achieved via just local information exchange between neighbors. In addition, it is shown that the proposed algorithm outperforms previous work in which the received energy was employed as the local detection outcome.

  10. Addressing barriers to achieving nursing certification: development of a certification achievement program on a medical-surgical unit.

    PubMed

    Perlstein, Lori; Hoffmann, Rosemary L; Lindberg, Judy; Petras, Denise

    2014-01-01

    Nursing certification is recognized as advanced competency and knowledge beyond basic preparation, thus empowering nurses to contribute to improved outcomes by demonstrating expertise in their specialties. It has been recognized that nurses do not seek certification because of identified barriers. Through a structured Certification Achievement Program that reduced barriers, a cohort of nurses was able to achieve certification in medical-surgical nursing.

  11. 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)

  12. Achieving closure at Fernald

    SciTech Connect

    Bradburne, John; Patton, Tisha C.

    2001-02-25

    When Fluor Fernald took over the management of the Fernald Environmental Management Project in 1992, the estimated closure date of the site was more than 25 years into the future. Fluor Fernald, in conjunction with DOE-Fernald, introduced the Accelerated Cleanup Plan, which was designed to substantially shorten that schedule and save taxpayers more than $3 billion. The management of Fluor Fernald believes there are three fundamental concerns that must be addressed by any contractor hoping to achieve closure of a site within the DOE complex. They are relationship management, resource management and contract management. Relationship management refers to the interaction between the site and local residents, regulators, union leadership, the workforce at large, the media, and any other interested stakeholder groups. Resource management is of course related to the effective administration of the site knowledge base and the skills of the workforce, the attraction and retention of qualified a nd competent technical personnel, and the best recognition and use of appropriate new technologies. Perhaps most importantly, resource management must also include a plan for survival in a flat-funding environment. Lastly, creative and disciplined contract management will be essential to effecting the closure of any DOE site. Fluor Fernald, together with DOE-Fernald, is breaking new ground in the closure arena, and ''business as usual'' has become a thing of the past. How Fluor Fernald has managed its work at the site over the last eight years, and how it will manage the new site closure contract in the future, will be an integral part of achieving successful closure at Fernald.

  13. Achievement Goals and Achievement Emotions: A Meta-Analysis

    ERIC Educational Resources Information Center

    Huang, Chiungjung

    2011-01-01

    This meta-analysis synthesized 93 independent samples (N = 30,003) in 77 studies that reported in 78 articles examining correlations between achievement goals and achievement emotions. Achievement goals were meaningfully associated with different achievement emotions. The correlations of mastery and mastery approach goals with positive achievement…

  14. Further Evidence Concerning the Effects of Perceptions of Effort and Ability on Achievement Evaluation

    ERIC Educational Resources Information Center

    Rest, Stanley; And Others

    1973-01-01

    Three experiments were reported based on the findings that perceived effort expenditure and level of ability, in addition to achievement outcome, are determinants of reward and punishment in achievement-related contexts. (Author/KM)

  15. Optimized solar module design

    NASA Technical Reports Server (NTRS)

    Santala, T.; Sabol, R.; Carbajal, B. G.

    1978-01-01

    The minimum cost per unit of power output from flat plate solar modules can most likely be achieved through efficient packaging of higher efficiency solar cells. This paper outlines a module optimization method which is broadly applicable, and illustrates the potential results achievable from a specific high efficiency tandem junction (TJ) cell. A mathematical model is used to assess the impact of various factors influencing the encapsulated cell and packing efficiency. The optimization of the packing efficiency is demonstrated. The effect of encapsulated cell and packing efficiency on the module add-on cost is shown in a nomograph form.

  16. Contemporary outcomes research: tools of the trade.

    PubMed

    Calkins, Casey M

    2008-05-01

    Outcomes are, simply put, why a surgeon comes to work each day. For decades, surgeons have insisted on a regular self-examination of outcomes to ensure the optimal treatment of our patients. Clinical research in pediatric surgery has largely subsisted on outcome analysis as it relates to the rudimentary end-result of an operation, utilizing variables such as mortality, operative time, specific complication rates, and hospital length of stay to name a few. Recently, outcomes research has become a more complex endeavor. This issue of Seminars in Pediatric Surgery addresses a wide array of these newfound complexities in contemporary outcomes research. The purpose of this review is to assist the pediatric surgeon in understanding the tools that are used in contemporary outcomes research and to be able to use this information to ask new questions of our patients and ourselves as we continue to strive for excellence in caring for sick infants and children.

  17. Leadership, self-efficacy, and student achievement

    NASA Astrophysics Data System (ADS)

    Grayson, Kristin

    This study examined the relationships between teacher leadership, science teacher self-efficacy, and fifth-grade science student achievement in diverse schools in a San Antonio, Texas, metropolitan school district. Teachers completed a modified version of the Leadership Behavior Description Question (LBDQ) Form XII by Stogdill (1969), the Science Efficacy and Belief Expectations for Science Teaching (SEBEST) by Ritter, Boone, and Rubba (2001, January). Students' scores on the Texas Assessment of Knowledge and Skills (TAKS) measured fifth-grade science achievement. At the teacher level of analysis multiple regressions showed the following relationships between teachers' science self-efficacy and teacher classroom leadership behaviors and the various teacher and school demographic variables. Predictors of teacher self efficacy beliefs included teacher's level of education, gender, and leadership initiating structure. The only significant predictor of teacher self-efficacy outcome expectancy was gender. Higher teacher self-efficacy beliefs predicted higher leadership initiating structure. At the school level of analysis, higher school levels of percentage of students from low socio-economic backgrounds and higher percentage of limited English proficient students predicted lower school student mean science achievement. These findings suggest a need for continued research to clarify relationships between teacher classroom leadership, science teacher self-efficacy, and student achievement especially at the teacher level of analysis. Findings also indicate the importance of developing instructional methods to address student demographics and their needs so that all students, despite their backgrounds, will achieve in science.

  18. 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.

  19. Students' Goal Achievement: Exploring Individual and Situational Factors

    ERIC Educational Resources Information Center

    Derrer-Rendall, Nicola; Wesson, Caroline; Anderson, Lindsey; Bould, Emma

    2009-01-01

    Introduction: This paper reports a preliminary investigation of the individual and situational factors affecting goal achievement in a psychology student population. The impact of normative information on goal achievement is considered in relation to goal commitment, optimism, gender and academic setting. Method: Psychology students (n=121) from…

  20. 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

  1. 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…

  2. 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…

  3. Predicting Dental Caries Outcomes in Children

    PubMed Central

    Divaris, K.

    2015-01-01

    In recent years, unprecedented gains in the understanding of the biology and mechanisms underlying human health and disease have been made. In the domain of oral health, although much remains to be learned, the complex interactions between different systems in play have begun to unravel: host genome, oral microbiome with its transcriptome, proteome and metabolome, and more distal influences, including relevant behaviors and environmental exposures. A reasonable expectation is that this emerging body of knowledge can help improve the oral health and optimize care for individuals and populations. These goals are articulated by the National Institutes of Health as “precision medicine” and the elimination of health disparities. Key processes in these efforts are the discovery of causal factors or mechanistic pathways and the identification of individuals or population segments that are most likely to develop (any or severe forms of) oral disease. This article critically reviews the fundamental concepts of risk assessment and outcome prediction, as they relate to early childhood caries (ECC)—a common complex disease with significant negative impacts on children, their families, and the health system. The article highlights recent work and advances in methods available to estimate caries risk and derive person-level caries propensities. It further discusses the reasons for their limited utility in predicting individual ECC outcomes and informing clinical decision making. Critical issues identified include the misconception of defining dental caries as a tooth or surface-level condition versus a person-level disease; the fallacy of applying population-level parameters to individuals, termed privatization of risk; and the inadequacy of using frequentist versus Bayesian modeling approaches to derive individual disease propensity estimates. The article concludes with the notion that accurate caries risk assessment at the population level and “precision dentistry

  4. Lifting Minority Achievement: Complex Answers. The Achievement Gap.

    ERIC Educational Resources Information Center

    Viadero, Debra; Johnston, Robert C.

    2000-01-01

    This fourth in a four-part series on why academic achievement gaps exist describes the Minority Achievement Committee scholars program at Shaker Heights High School in Cleveland, Ohio, a powerful antidote to the achievement gap between minority and white and Asian American students. It explains the need to break down stereotypes about academic…

  5. Achievement Motivation of Women: Effects of Achievement and Affiliation Arousal.

    ERIC Educational Resources Information Center

    Gama, Elizabeth Maria Pinheiro

    1985-01-01

    Assigned 139 Brazilian women to neutral, affiliation arousal, and achievement arousal conditions based on their levels of achievement (Ach) and affiliative (Aff) needs. Results of story analyses revealed that achievement arousal increased scores of high Ach subjects and that high Aff subjects obtained higher scores than low Aff subjects. (BL)

  6. Attitude Towards Physics and Additional Mathematics Achievement Towards Physics Achievement

    ERIC Educational Resources Information Center

    Veloo, Arsaythamby; Nor, Rahimah; Khalid, Rozalina

    2015-01-01

    The purpose of this research is to identify the difference in students' attitude towards Physics and Additional Mathematics achievement based on gender and relationship between attitudinal variables towards Physics and Additional Mathematics achievement with achievement in Physics. This research focused on six variables, which is attitude towards…

  7. The Impact of Reading Achievement on Overall Academic Achievement

    ERIC Educational Resources Information Center

    Churchwell, Dawn Earheart

    2009-01-01

    This study examined the relationship between reading achievement and achievement in other subject areas. The purpose of this study was to determine if there was a correlation between reading scores as measured by the Standardized Test for the Assessment of Reading (STAR) and academic achievement in language arts, math, science, and social studies…

  8. Assessing the suitability of medial sural artery perforator flaps in tongue reconstruction – An outcome study

    PubMed Central

    Kwon, Soo-Ha; Tsai, Chia-Hsuan; Chang, Kai-Ping; Kao, Huang-Kai

    2017-01-01

    Introduction Oncological resection of the tongue can be reconstructed using a multitude of free flaps. The medial sural artery perforator (MSAP) flap has been well described in the literature in terms of its anatomy and harvest. However, functional outcome studies of post-reconstruction tongue defects using the MSAP flap have not been reported. This study represents the largest outcome study of patients with tongue reconstructions using MSAP flaps and a comprehensive review of its use. Materials and methods From December of 2010 to October of 2015, 579 patients with subtotal glossectomy and free flap reconstructions in Chang Gung Memorial Hospital were retrospectively reviewed. 27 patients were reconstructed with MSAP flap. The pre- and intra-operative factors, as well as flap-related factors were analyzed. Post-operative complications and functional outcomes were evaluated. Donor site assessment were also conducted. Results A 96.3% flap survival rate was found with an average total operating time of 6 hours and 18 minutes. 84.6% of patients had primary closure of the donor site with and the remaining either had skin grafts or delayed closure. Donor site closure can be achieved primarily with no functional deficit. Speech intelligibility remained for most patients. 100% of patients resumed normal oral feeding. Conclusion The MSAP flap is a small to medium sized flap most suited for subtotal glossectomy defects where optimal outcomes can be achieved in terms of speech clarity and restoration of oral intake. PMID:28182639

  9. 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 .

  10. Sense of Coherence and Academic Achievement of Domestic and International Students: A Comparative Analysis

    ERIC Educational Resources Information Center

    Grayson, J. Paul

    2008-01-01

    Traditional models of educational outcomes relate academic achievement to university experiences controlling for background characteristics, like former levels of achievement. In these models, most of the variance in the outcome under consideration is explained not by experiences inside the university but by background characteristics, such as…

  11. The Benefits of Following Your Pride: Authentic Pride Promotes Achievement.

    PubMed

    Weidman, Aaron C; Tracy, Jessica L; Elliot, Andrew J

    2016-10-01

    Although the emotion authentic pride has been posited to promote achievement, it remains unclear precisely how this works. Here, we tested whether authentic pride promotes adaptive downstream achievement outcomes by motivating individuals to engage in appropriate behavioral responses to success and failure. In two longitudinal studies (N = 1,132), we measured pride emotional responses to a prior performance and subsequent changes in achievement-oriented behavior and performance outcomes among (a) adults training for long-distance running races and (b) undergraduates completing class exams. Authentic pride shifted in direct response to achievement outcomes, such that those who performed well felt greater pride. Furthermore, individuals who felt low authentic pride responded to these feelings by changing their achievement behavior in a functional manner. In Studies 2a, 2b, and 2c, we found that pride-driven behavioral changes led to improved future performance among low performers. In these studies we also demonstrated that the effect of authentic pride on achievement is independent of that of self-efficacy, which in fact works in an opposite manner. Taken together, these results suggest that authentic pride functions as a barometer of achievement, promoting behavioral responses that lead to improved performance.

  12. Achievements in Stratospheric Ozone Protection

    EPA Pesticide Factsheets

    This report describes achievements in protecting the ozone layer, the benefits of these achievements, and strategies involved (e.g., using alternatives to ozone-depleting substances, phasing out harmful substances, and creating partnerships).

  13. The Value of Full Correction: Achieving Excellent and Affordable Results.

    PubMed

    Kaplan, Julie Bass

    2016-01-01

    Patients often come to medical aesthetic offices with hopes to fully correct lost facial volume and achieve a natural appearance. Unfortunately, the cost per syringe of dermal filler can be a barrier to desired outcomes. Many aesthetic practitioners do the best they can with the amount of product the patient can afford, often falling short of the "wow" effect for the patient. This article describes what one office implemented to solve the conundrum of affordability while still allowing offices to cover its own financial realities. This tool can help patients achieve beautiful, natural, and affordable outcomes while helping offices advance in manufacturer's tiers, improve word-of-mouth advertising, and increase job satisfaction.

  14. Optimism and spontaneous self-affirmation are associated with lower likelihood of cognitive impairment and greater positive affect among cancer survivors

    PubMed Central

    Taber, Jennifer M.; Klein, William M. P.; Ferrer, Rebecca A.; Kent, Erin E.; Harris, Peter R.

    2016-01-01

    Background Optimism and self-affirmation promote adaptive coping, goal achievement, and better health. Purpose To examine the associations of optimism and spontaneous self-affirmation (SSA) with physical, mental, and cognitive health and information seeking among cancer survivors. Methods Cancer survivors (n=326) completed the Health Information National Trends Survey 2013, a national survey of U.S. adults. Participants reported optimism, SSA, cognitive and physical impairment, affect, health status, and information seeking. Results Participants higher in optimism reported better health on nearly all indices examined, even when controlling for SSA. Participants higher in SSA reported lower likelihood of cognitive impairment, greater happiness and hopefulness, and greater likelihood of cancer information seeking. SSA remained significantly associated with greater hopefulness and cancer information seeking when controlling for optimism. Conclusions Optimism and SSA may be associated with beneficial health-related outcomes among cancer survivors. Given the demonstrated malleability of self-affirmation, these findings represent important avenues for future research. PMID:26497697

  15. Achieving army nursing evidence-based practice competencies through a civilian-military nurse partnership.

    PubMed

    Siaki, Leilani A; Lentino, Cynthia V; Mark, Debra D; Hopkins-Chadwick, Denise L

    2014-01-01

    Despite the Institute of Medicine's goal of 90% of all practice being evidence-based by 2020, educational and practice institutions are not on target to achieve this goal. Evidence-based practice is one of 5 core elements of the Army Nurse Corps' patient care delivery system and a key focus of the Hawaii State Center for Nursing. In order to increase evidence-based practice (EBP), a civilian-military partnership was formed to include healthcare organizations in the state, optimize resources, and share strategies for successful practice changes statewide. The partnership has been successful in meeting each of these goals using national EBP competencies and Bloom's taxonomy as a guide. The article presents a discussion regarding the history, processes, and outcomes of this partnership.

  16. Modular optimization code package: MOZAIK

    NASA Astrophysics Data System (ADS)

    Bekar, Kursat B.

    existing beam port configuration of the Penn State Breazeale Reactor (PSBR) was designed to test and validate the code package in its entirety, as well as its modules separately. The selected physics code, TORT, and the requisite data such as source distribution, cross-sections, and angular quadratures were comprehensively tested with these computational models. The modular feature and the parallel performance of the code package were also examined using these computational models. Another outcome of these computational models is to provide the necessary background information for determining the optimal shape of the D2O moderator tank for the new beam tube configurations for the PSBR's beam port facility. The first mission of the code package was completed successfully by determining the optimal tank shape which was sought for the current beam tube configuration and two new beam tube configurations for the PSBR's beam port facility. The performance of the new beam tube configurations and the current beam tube configuration were evaluated with the new optimal tank shapes determined by MOZAIK. Furthermore, the performance of the code package with the two different optimization strategies were analyzed showing that while GA is capable of achieving higher thermal beam intensity for a given beam tube setup, Min-max produces an optimal shape that is more amenable to machining and manufacturing. The optimal D2O moderator tank shape determined by MOZAIK with the current beam port configuration improves the thermal neutron beam intensity at the beam port exit end by 9.5%. Similarly, the new tangential beam port configuration (beam port near the core interface) with the optimal moderator tank shape determined by MOZAIK improves the thermal neutron beam intensity by a factor of 1.4 compared to the existing beam port configuration (with the existing D2O moderator tank). Another new beam port configuration, radial beam tube configuration, with the optimal moderator tank shape

  17. Social optimality in quantum Bayesian games

    NASA Astrophysics Data System (ADS)

    Iqbal, Azhar; Chappell, James M.; Abbott, Derek

    2015-10-01

    A significant aspect of the study of quantum strategies is the exploration of the game-theoretic solution concept of the Nash equilibrium in relation to the quantization of a game. Pareto optimality is a refinement on the set of Nash equilibria. A refinement on the set of Pareto optimal outcomes is known as social optimality in which the sum of players' payoffs is maximized. This paper analyzes social optimality in a Bayesian game that uses the setting of generalized Einstein-Podolsky-Rosen experiments for its physical implementation. We show that for the quantum Bayesian game a direct connection appears between the violation of Bell's inequality and the social optimal outcome of the game and that it attains a superior socially optimal outcome.

  18. Supply-Chain Optimization Template

    NASA Technical Reports Server (NTRS)

    Quiett, William F.; Sealing, Scott L.

    2009-01-01

    The Supply-Chain Optimization Template (SCOT) is an instructional guide for identifying, evaluating, and optimizing (including re-engineering) aerospace- oriented supply chains. The SCOT was derived from the Supply Chain Council s Supply-Chain Operations Reference (SCC SCOR) Model, which is more generic and more oriented toward achieving a competitive advantage in business.

  19. Students’ Achievement Goals, Learning-Related Emotions and Academic Achievement

    PubMed Central

    Lüftenegger, Marko; Klug, Julia; Harrer, Katharina; Langer, Marie; Spiel, Christiane; Schober, Barbara

    2016-01-01

    In the present research, the recently proposed 3 × 2 model of achievement goals is tested and associations with achievement emotions and their joint influence on academic achievement are investigated. The study was conducted with 388 students using the 3 × 2 Achievement Goal Questionnaire including the six proposed goal constructs (task-approach, task-avoidance, self-approach, self-avoidance, other-approach, other-avoidance) and the enjoyment and boredom scales from the Achievement Emotion Questionnaire. Exam grades were used as an indicator of academic achievement. Findings from CFAs provided strong support for the proposed structure of the 3 × 2 achievement goal model. Self-based goals, other-based goals and task-approach goals predicted enjoyment. Task-approach goals negatively predicted boredom. Task-approach and other-approach predicted achievement. The indirect effects of achievement goals through emotion variables on achievement were assessed using bias-corrected bootstrapping. No mediation effects were found. Implications for educational practice are discussed. PMID:27199836

  20. Long-Term Outcome After Radiotherapy in Patients With Atypical and Malignant Meningiomas-Clinical Results in 85 Patients Treated in a Single Institution Leading to Optimized Guidelines for Early Radiation Therapy

    SciTech Connect

    Adeberg, Sebastian; Hartmann, Christian; Welzel, Thomas; Rieken, Stefan; Habermehl, Daniel; Deimling, Andreas von; Debus, Juergen; Combs, Stephanie E.

    2012-07-01

    Purpose: Previously, we could show that the new World Health Organization (WHO) classification of meningiomas significantly correlated with outcome in patients with atypical and anaplastic histology. In the present work, we analyzed our long-term experience in radiotherapy for atypical and malignant meningioma diagnosed according to the most recent WHO categorization system. Patients and Methods: Sixty-two patients with atypical and 23 patients with malignant meningioma have been treated with radiotherapy. Sixty percent of all patients received radiotherapy (RT) after surgical resection, 19% at disease progression and 8.3% as a primary treatment. Radiation was applied using different techniques including fractionated stereotactic RT (FSRT), intensity-modulated RT, and combination treatment with carbon ions. The median PTV was 156.0 mL. An average dose of 57.6 Gy (range, 30-68.4 Gy) in 1.8-3 Gy fractions was applied. All patients were followed regularly including clinical-neurological follow-up as well as computed tomographies or magnetic resonance imaging. Results: Overall survival was impacted significantly by histological grade, with 81% and 53% at 5 years for atypical or anaplastic meningiomas, respectively. This difference was significant at p = 0.022. Eighteen patients died of tumor progression during follow-up. Progression-free survival was 95% and 50% for atypical, and 63% and 13% for anaplastic histology at 2 and 5 years. This difference was significant at p = 0.017. Despite histology, we could not observe any prognostic factors including age, resection status, or Karnofsky performance score. However, preexisting clinical symptoms observed in 63 patients improved in 29.3% of these patients. Conclusion: RT resulted in improvement of preexisting clinical symptoms; outcome is comparable to other series reported in the literature. RT should be offered after surgical resection after initial diagnosis to increase progression-free survival as well as overall

  1. Enteral nutrition for optimal growth in preterm infants

    PubMed Central

    2016-01-01

    Early, aggressive nutrition is an important contributing factor of long-term neurodevelopmental outcomes. To ensure optimal growth in premature infants, adequate protein intake and optimal protein/energy ratio should be emphasized rather than the overall energy intake. Minimal enteral nutrition should be initiated as soon as possible in the first days of life, and feeding advancement should be individualized according to the clinical course of the infant. During hospitalization, enteral nutrition with preterm formula and fortified human milk represent the best feeding practices for facilitating growth. After discharge, the enteral nutrition strategy should be individualized according to the infant's weight at discharge. Infants with suboptimal weight for their postconceptional age at discharge should receive supplementation with human milk fortifiers or nutrient-enriched feeding, and the enteral nutrition strategy should be reviewed and modified continuously to achieve the target growth parameters. PMID:28194211

  2. Optimizing antibiotic therapy in the intensive care unit setting

    PubMed Central

    Kollef, Marin H

    2001-01-01

    Antibiotics are one of the most common therapies administered in the intensive care unit setting. In addition to treating infections, antibiotic use contributes to the emergence of resistance among pathogenic microorganisms. Therefore, avoiding unnecessary antibiotic use and optimizing the administration of antimicrobial agents will help to improve patient outcomes while minimizing further pressures for resistance. This review will present several strategies aimed at achieving optimal use of antimicrobial agents. It is important to note that each intensive care unit should have a program in place which monitors antibiotic utilization and its effectiveness. Only in this way can the impact of interventions aimed at improving antibiotic use (e.g. antibiotic rotation, de-escalation therapy) be evaluated at the local level. PMID:11511331

  3. Optimal Control of Electrodynamic Tethers

    DTIC Science & Technology

    2008-06-01

    method.46 Even though the derivation that produced Eq. (11) required integration over a hypothetical integer number of revolutions, the optimizer ... approach to multi-revolution, long time scale optimal control of an electrodynamic tether is investigated for a tethered satellite system in Low Earth...time scale approach is used to capture the effects of the Earth’s rotating tilted magnetic field. Optimal control solutions are achieved using a

  4. Protein "requirements" beyond the RDA: implications for optimizing health.

    PubMed

    Phillips, Stuart M; Chevalier, Stéphanie; Leidy, Heather J

    2016-05-01

    Substantial evidence supports the increased consumption of high-quality protein to achieve optimal health outcomes. A growing body of research indicates that protein intakes well above the current Recommended Dietary Allowance help to promote healthy aging, appetite regulation, weight management, and goals aligned with athletic performance. Higher protein intakes may help prevent age-related sarcopenia, the loss of muscle mass, and strength that predisposes older adults to frailty, disability, and loss of autonomy. Higher protein diets also improve satiety and lead to greater reductions in body weight and fat mass compared with standard protein diets, and may therefore serve as a successful strategy to help prevent and/or treat obesity. Athletes can also benefit from higher protein intakes to maximize athletic performance given the critical role protein plays in stimulating muscle protein remodelling after exercise. Protein quality, per meal dose, and timing of ingestion are also important considerations. Despite persistent beliefs to the contrary, we can find no evidence-based link between higher protein diets and renal disease or adverse bone health. This brief synopsis highlights recent learnings based on presentations at the 2015 Canadian Nutrition Society conference, Advances in Protein Nutrition across the Lifespan. Current evidence indicates intakes in the range of at least 1.2 to 1.6 g/(kg·day) of high-quality protein is a more ideal target for achieving optimal health outcomes in adults.

  5. Exemplar pediatric collaborative improvement networks: achieving results.

    PubMed

    Billett, Amy L; Colletti, Richard B; Mandel, Keith E; Miller, Marlene; Muething, Stephen E; Sharek, Paul J; Lannon, Carole M

    2013-06-01

    A number of pediatric collaborative improvement networks have demonstrated improved care and outcomes for children. Regionally, Cincinnati Children's Hospital Medical Center Physician Hospital Organization has sustained key asthma processes, substantially increased the percentage of their asthma population receiving "perfect care," and implemented an innovative pay-for-performance program with a large commercial payor based on asthma performance measures. The California Perinatal Quality Care Collaborative uses its outcomes database to improve care for infants in California NICUs. It has achieved reductions in central line-associated blood stream infections (CLABSI), increased breast-milk feeding rates at hospital discharge, and is now working to improve delivery room management. Solutions for Patient Safety (SPS) has achieved significant improvements in adverse drug events and surgical site infections across all 8 Ohio children's hospitals, with 7700 fewer children harmed and >$11.8 million in avoided costs. SPS is now expanding nationally, aiming to eliminate all events of serious harm at children's hospitals. National collaborative networks include ImproveCareNow, which aims to improve care and outcomes for children with inflammatory bowel disease. Reliable adherence to Model Care Guidelines has produced improved remission rates without using new medications and a significant increase in the proportion of Crohn disease patients not taking prednisone. Data-driven collaboratives of the Children's Hospital Association Quality Transformation Network initially focused on CLABSI in PICUs. By September 2011, they had prevented an estimated 2964 CLABSI, saving 355 lives and $103,722,423. Subsequent improvement efforts include CLABSI reductions in additional settings and populations.

  6. Environmental contributors to the achievement gap.

    PubMed

    Miranda, Marie Lynn; Kim, Dohyeong; Reiter, Jerome; Overstreet Galeano, M Alicia; Maxson, Pamela

    2009-11-01

    Extensive research shows that blacks, those of low socioeconomic status, and other disadvantaged groups continue to exhibit poorer school performance compared with middle and upper-class whites in the United States' educational system. Environmental exposures may contribute to the observed achievement gap. In particular, childhood lead exposure has been linked to a number of adverse cognitive outcomes. In previous work, we demonstrated a relationship between early childhood lead exposure and end-of-grade (EOG) test scores on a limited dataset. In this analysis, data from the North Carolina Childhood Lead Poisoning Prevention Program surveillance registry were linked to educational outcomes available through the North Carolina Education Research Data Center for all 100 counties in NC. Our objectives were to confirm the earlier study results in a larger population-level database, determine whether there are differences in the impact of lead across the EOG distribution, and elucidate the impact of cumulative childhood social and environmental stress on educational outcomes. Multivariate and quantile regression techniques were employed. We find that early childhood lead exposure is associated with lower performance on reading EOG test scores in a clear dose-response pattern, with the effects increasingly more pronounced in moving from the high end to the low end of the test score distribution. Parental educational attainment and family poverty status also affect EOG test scores, in a similar dose-response fashion, with the effects again most pronounced at the low end of the EOG test score distribution. The effects of environmental and social stressors (especially as they stretch out the lower tail of the EOG distribution) demonstrate the particular vulnerabilities of socioeconomically and environmentally disadvantaged children. Given the higher average lead exposure experienced by African American children in the United States, lead does in fact explain part of the

  7. RF Gun Optimization Study

    SciTech Connect

    Alicia Hofler; Pavel Evtushenko

    2007-07-03

    Injector gun design is an iterative process where the designer optimizes a few nonlinearly interdependent beam parameters to achieve the required beam quality for a particle accelerator. Few tools exist to automate the optimization process and thoroughly explore the parameter space. The challenging beam requirements of new accelerator applications such as light sources and electron cooling devices drive the development of RF and SRF photo injectors. A genetic algorithm (GA) has been successfully used to optimize DC photo injector designs at Cornell University [1] and Jefferson Lab [2]. We propose to apply GA techniques to the design of RF and SRF gun injectors. In this paper, we report on the initial phase of the study where we model and optimize a system that has been benchmarked with beam measurements and simulation.

  8. Process validation: achieving the Operational Qualification phase.

    PubMed

    Buffaloe, Vera

    2004-01-01

    The OQ phase of process validation is very important and is where the complete understanding of the process is determined by experimentation. This understanding is useful to: * establish optimal process parameters * understand variation that affect the process * aid in investigating process deviations. OQ is an important part of the entire process validation activity and essential to understanding a manufacturing process. The benefits of completing the OQ and overall process validation are the reasons that it makes business sense and receive the long-term benefits of producing high quality product and achieving customer satisfaction.

  9. Critical Pedagogy for Transformative Optimism

    ERIC Educational Resources Information Center

    Mayo, Peter

    2006-01-01

    This essay critically highlights the main features of a study that attaches importance to the concepts of time and optimism and their effects on the achievement and goals of high and low achievers in a North American and a Brazilian context. The focus on the time factor that serves as a leitmotif throughout the study gives this work its…

  10. Optimizing Locomotion

    NASA Astrophysics Data System (ADS)

    Hosoi, Anette

    2006-11-01

    In this talk we will discuss two optimization topics related to low Reynolds number locomotion: optimal stroke patterns in linked swimmers and optimal fluid material properties in adhesive locomotion. In contrast to many optimization problems, we do not consider geometry, rather we optimize the swimming kinematics or fluid material properties for a given geometrical configuration. In the first case, we begin by optimizing stroke patterns for Purcell's 3-link swimmer. We model the swimmer as a jointed chain of three slender links moving in an inertialess flow. The swimmer is optimized for both efficiency and speed. In the second case, we analyze the adhesive locomotion used by common gastropods such as snails and slugs. Such organisms crawl on a solid substrate by propagating muscular waves of shear stress on a viscoelastic mucus. Using a simple mechanical model, we derive criteria for favorable fluid material properties to lower the energetic cost of locomotion.

  11. Outcome Expectations and Associated Treatment Outcomes in Motivational Enhancement Therapy Delivered in English and Spanish

    PubMed Central

    Serafini, Kelly; Decker, Suzanne; Kiluk, Brian D.; Añez, Luis; Paris, Manuel; Frankforter, Tami; Carroll, Kathleen M.

    2016-01-01

    Background and Objectives The relationship between patients’ baseline expectations regarding treatment outcome and actual outcomes has not been widely studied within the field of substance use disorders. We hypothesized that outcome expectations would be unrelated to outcomes in a study investigating Motivational Enhancement Therapy delivered in English (MET-E) consistent with our earlier work, and conducted exploratory analyses in a separate study that investigated the same treatment delivered in Spanish (MET-S). Methods These secondary analyses compared patient outcome expectations and substance use treatment outcomes in two large, multisite randomized controlled clinical trials that evaluated three sessions of MET-E or MET-S. The MET-E sample included 461 participants and the MET-S sample included 405 participants. Outcome expectations were measured by a single item regarding expectations about abstinence prior to initiating treatment. Results Outcome expectations were strongly associated with most substance use outcomes in the MET-S trial (but not in MET-E), even after controlling for severity of substance use at baseline. In MET-S, those who indicated that they were ‘unsure’ that they would achieve abstinence during treatment submitted a greater percentage of drug-positive urine toxicology screens during the treatment period than those who were ‘sure’ they would achieve abstinence (F = 18.83, p <.001). Discussion and Conclusions Patients’ outcome expectations regarding the likelihood of abstinence may be an important predictor of drug use treatment outcomes among Spanish-speakers, but not necessarily for English-speakers. Scientific Significance Individual differences and cultural factors may play a role in the association between outcome expectations and treatment outcomes. PMID:26541501

  12. The Mechanics of Human Achievement.

    PubMed

    Duckworth, Angela L; Eichstaedt, Johannes C; Ungar, Lyle H

    2015-07-01

    Countless studies have addressed why some individuals achieve more than others. Nevertheless, the psychology of achievement lacks a unifying conceptual framework for synthesizing these empirical insights. We propose organizing achievement-related traits by two possible mechanisms of action: Traits that determine the rate at which an individual learns a skill are talent variables and can be distinguished conceptually from traits that determine the effort an individual puts forth. This approach takes inspiration from Newtonian mechanics: achievement is akin to distance traveled, effort to time, skill to speed, and talent to acceleration. A novel prediction from this model is that individual differences in effort (but not talent) influence achievement (but not skill) more substantially over longer (rather than shorter) time intervals. Conceptualizing skill as the multiplicative product of talent and effort, and achievement as the multiplicative product of skill and effort, advances similar, but less formal, propositions by several important earlier thinkers.

  13. The Mechanics of Human Achievement

    PubMed Central

    Duckworth, Angela L.; Eichstaedt, Johannes C.; Ungar, Lyle H.

    2015-01-01

    Countless studies have addressed why some individuals achieve more than others. Nevertheless, the psychology of achievement lacks a unifying conceptual framework for synthesizing these empirical insights. We propose organizing achievement-related traits by two possible mechanisms of action: Traits that determine the rate at which an individual learns a skill are talent variables and can be distinguished conceptually from traits that determine the effort an individual puts forth. This approach takes inspiration from Newtonian mechanics: achievement is akin to distance traveled, effort to time, skill to speed, and talent to acceleration. A novel prediction from this model is that individual differences in effort (but not talent) influence achievement (but not skill) more substantially over longer (rather than shorter) time intervals. Conceptualizing skill as the multiplicative product of talent and effort, and achievement as the multiplicative product of skill and effort, advances similar, but less formal, propositions by several important earlier thinkers. PMID:26236393

  14. Optimism and Physical Health: A Meta-analytic Review

    PubMed Central

    Rasmussen, Heather N.; Greenhouse, Joel B.

    2010-01-01

    Background Prior research links optimism to physical health, but the strength of the association has not been systematically evaluated. Purpose The purpose of this study is to conduct a meta-analytic review to determine the strength of the association between optimism and physical health. Methods The findings from 83 studies, with 108 effect sizes (ESs), were included in the analyses, using random-effects models. Results Overall, the mean ES characterizing the relationship between optimism and physical health outcomes was 0.17, p<.001. ESs were larger for studies using subjective (versus objective) measures of physical health. Subsidiary analyses were also conducted grouping studies into those that focused solely on mortality, survival, cardiovascular outcomes, physiological markers (including immune function), immune function only, cancer outcomes, outcomes related to pregnancy, physical symptoms, or pain. In each case, optimism was a significant predictor of health outcomes or markers, all p<.001. Conclusions Optimism is a significant predictor of positive physical health outcomes. PMID:19711142

  15. Utility Theory for Evaluation of Optimal Process Condition of SAW: A Multi-Response Optimization Approach

    SciTech Connect

    Datta, Saurav; Biswas, Ajay; Bhaumik, Swapan; Majumdar, Gautam

    2011-01-17

    Multi-objective optimization problem has been solved in order to estimate an optimal process environment consisting of optimal parametric combination to achieve desired quality indicators (related to bead geometry) of submerged arc weld of mild steel. The quality indicators selected in the study were bead height, penetration depth, bead width and percentage dilution. Taguchi method followed by utility concept has been adopted to evaluate the optimal process condition achieving multiple objective requirements of the desired quality weld.

  16. The Role of Feedback on Studying, Achievement and Calibration.

    ERIC Educational Resources Information Center

    Chu, Stephanie T. L.; Jamieson-Noel, Dianne L.; Winne, Philip H.

    One set of hypotheses examined in this study was that various types of feedback (outcome, process, and corrective) supply different information about performance and have different effects on studying processes and on achievement. Another set of hypotheses concerned students' calibration, their accuracy in predicting and postdicting achievement…

  17. Grade Level of Achievement: 2007-08 Report on Programs

    ERIC Educational Resources Information Center

    Alberta Education, 2009

    2009-01-01

    This report presents the outcomes of the analysis of Grade Level of Achievement (GLA) data at the provincial level to inform the program planning and evaluation needs of Alberta Education as well as school and central office based administrators. GLA data reported to Alberta Education is a teacher's judgment of a student's academic progress. GLA…

  18. Measuring Achievement in Non-vocational Adult Education.

    ERIC Educational Resources Information Center

    Trodd, Geoff

    1996-01-01

    When records of achievement were introduced in Hillingdon (England) Adult and Continuing Education Service, 78% of adult students used them and some were motivated to persist because of them. Tutors found the increased emphasis on learning outcomes and assessment made their teaching more systematic, although their workload was increased. (SK)

  19. Assessing Student Achievement in Physical Education for Teacher Evaluation

    ERIC Educational Resources Information Center

    Mercier, Kevin; Doolittle, Sarah

    2013-01-01

    While many teachers continue to ignore the practice of assessing student achievement in physical education, recent federal pressures to include student assessment data in teacher evaluation systems has shown that assessment of student outcomes is here to stay. Though there is a strong tradition of assessing teacher practice in physical education,…

  20. Aligning Student Support with Achievement Goals. The Secondary Principals Guide

    ERIC Educational Resources Information Center

    Louis, Karen Seashore; Gordon, Molly F.

    2005-01-01

    Many principals feel they lack the personnel necessary to raise student achievement to mandated levels. Yet, as school leaders seek to improve educational outcomes, one of the most underutilized groups remains student support professionals-the counselors, social workers, and nurses already on site. The authors offer a practical approach to…

  1. Magnet Schools and Peers: Effects on Mathematics Achievement

    ERIC Educational Resources Information Center

    Ballou, Dale

    2007-01-01

    I estimate the impact of attending a magnet school on student achievement in mathematics in a moderately large Southern district. Admission to magnet schools is through lotteries. Actual attendance by lottery winners is of course voluntary. I use lottery outcomes as instruments to control for bias due to self-selection of enrollees. Because…

  2. Implicit Beliefs, Achievement Goals, and Procrastination: A Mediational Analysis

    ERIC Educational Resources Information Center

    Howell, Andrew J.; Buro, Karen

    2009-01-01

    As a maladaptive behavioural outcome, procrastination should correlate with beliefs about ability and achievement goals that are themselves relatively maladaptive. Accordingly, procrastination should be predicted by entity as opposed to incremental implicit theories (i.e., viewing attributes such as ability as relatively fixed vs. malleable,…

  3. Essays on Academic Achievement and Student Behavior in Public Schools

    ERIC Educational Resources Information Center

    Moussa, Wael Soheil

    2013-01-01

    This dissertation examines the student academic achievement through various mechanisms, put in place by the public school district, classroom student behavior, and negative external shocks to the students' living environment. I examine the impacts of various treatments on student short and long run academic outcomes such as math and English test…

  4. Reading First in Pennsylvania: Achievement Findings after Five Years

    ERIC Educational Resources Information Center

    Bean, Rita; Draper, Jason; Turner, Greg; Zigmond, Naomi

    2010-01-01

    This article reports on the student achievement outcomes for third graders in Reading First (RF) schools in Pennsylvania over the five years of implementation for the group as a whole, for disaggregated groups of third graders, and for third graders who received reading instruction in RF schools for one, two, and three years. We also present a…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  6. Organizational Health and Student Achievement in Tennessee Middle Level Schools

    ERIC Educational Resources Information Center

    Henderson, Christopher L.; Buehler, Alison E.; Stein, William L.; Dalton, John E.; Robinson, Teresa R.; Anfara, Vincent A., Jr.

    2005-01-01

    Although the successful middle level school was designed to address both the affective and cognitive development of young adolescents (NMSA 2003), academic achievement is the outcome of paramount importance in the current political context of accountability, high-stakes testing, and the No Child Left Behind Act of 2001. In their efforts to reform,…

  7. Black Males' Structural Conditions, Achievement Patterns, Normative Needs, and "Opportunities."

    ERIC Educational Resources Information Center

    Swanson, Dena Phillips; Cunningham, Michael; Spencer, Margaret Beale

    2003-01-01

    Examined the relations between normative developmental transitions, contextual influences, and life-stage outcomes, such as academic achievement, for African American males. Data from a longitudinal study in a large southeastern U.S. city indicated that negative stereotyping and tracking from early experience in educational settings affected black…

  8. Are Reductions in Population Sodium Intake Achievable?

    PubMed Central

    Levings, Jessica L.; Cogswell, Mary E.; Gunn, Janelle Peralez

    2014-01-01

    The vast majority of Americans consume too much sodium, primarily from packaged and restaurant foods. The evidence linking sodium intake with direct health outcomes indicates a positive relationship between higher levels of sodium intake and cardiovascular disease risk, consistent with the relationship between sodium intake and blood pressure. Despite communication and educational efforts focused on lowering sodium intake over the last three decades data suggest average US sodium intake has remained remarkably elevated, leading some to argue that current sodium guidelines are unattainable. The IOM in 2010 recommended gradual reductions in the sodium content of packaged and restaurant foods as a primary strategy to reduce US sodium intake, and research since that time suggests gradual, downward shifts in mean population sodium intake are achievable and can move the population toward current sodium intake guidelines. The current paper reviews recent evidence indicating: (1) significant reductions in mean population sodium intake can be achieved with gradual sodium reduction in the food supply, (2) gradual sodium reduction in certain cases can be achieved without a noticeable change in taste or consumption of specific products, and (3) lowering mean population sodium intake can move us toward meeting the current individual guidelines for sodium intake. PMID:25325254

  9. Disease management improves ESRD outcomes.

    PubMed

    Sands, J J

    2006-02-01

    Renal disease management organizations have reported achieving significant decreases in mortality and hospitalization in conjunction with cost savings, improved patient satisfaction and quality of life. Disease management organizations strive to fill existing gaps in care delivery through the standardized use of risk assessment, predictive modeling, evidence based guidelines and process and outcomes measurement. Patient self-management education and the provision of individual nurse care managers are also key program components. As we more fully measure clinical outcomes and total health-care costs including payments from all insurance and government entities, pharmacy costs and out-of-pocket expenditures, the full implications of disease management can be better defined. The results of this analysis will have a profound influence on United States healthcare policy. At present, current data suggests that the promise of disease management, improved care at reduced cost, can and is being realized in ESRD.

  10. Primer on outcomes research.

    PubMed

    In, Haejin; Rosen, Jennifer E

    2014-10-01

    Outcomes research uses diverse inputs to examine innovative end results aimed to deliver quality patient care. Yet defining "outcomes research" remains a challenge, and its interpretation is often nuanced. In this review, we discuss the definition of outcomes research in the context of its historical evolution along with the rise of other similar types of research. We then discuss key considerations in interpreting the results of outcomes analysis.

  11. EDUCATIONAL ACHIEVEMENT AND THE NAVAJO.

    ERIC Educational Resources Information Center

    HAAS, JOHN; MELVILLE, ROBERT

    A STUDY WAS DEVISED TO APPRAISE THE ACADEMIC ACHIEVEMENT OF NAVAJO STUDENTS LIVING IN DORMITORIES AWAY FROM THE INDIAN RESERVATION. THE FOLLOWING SEVEN FACTORS WERE CHOSEN TO BE INVESTIGATED AS BEING DIRECTLY RELATED TO ACHIEVEMENT--(1) INTELLIGENCE, (2) READING ABILITY, (3) ANXIETY, (4) SELF-CONCEPT, (5) MOTIVATION, (6) VERBAL DEVELOPMENT, (7)…

  12. Sociocultural Origins of Achievement Motivation

    ERIC Educational Resources Information Center

    Maehr, Martin L.

    1977-01-01

    Presents a theoretical review of work on sociocultural influences on achievement, focusing on a critical evaluation of the work of David McClellan. Offers an alternative conception of achievement motivation which stresses the role of contextual and situational factors in addition to personality factors. Available from: Transaction Periodicals…

  13. Raising Boys' Achievement in Schools.

    ERIC Educational Resources Information Center

    Bleach, Kevan, Ed.

    This book offers insights into the range of strategies and good practice being used to raise the achievement of boys. Case studies by school-based practitioners suggest ideas and measures to address the issue of achievement by boys. The contributions are: (1) "Why the Likely Lads Lag Behind" (Kevan Bleach); (2) "Helping Boys Do…

  14. Teaching the Low Level Achiever.

    ERIC Educational Resources Information Center

    Salomone, Ronald E., Ed.

    1986-01-01

    Intended for teachers of the English language arts, the articles in this issue offer suggestions and techniques for teaching the low level achiever. Titles and authors of the articles are as follows: (1) "A Point to Ponder" (Rachel Martin); (2) "Tracking: A Self-Fulfilling Prophecy of Failure for the Low Level Achiever" (James Christopher Davis);…

  15. Early Intervention and Student Achievement

    ERIC Educational Resources Information Center

    Hormes, Mridula T.

    2009-01-01

    The United States Department of Education has been rigorous in holding all states accountable with regard to student achievement. The No Child Left Behind Act of 2001 clearly laid out federal mandates for all schools to follow. K-12 leaders of public schools are very aware of the fact that results in terms of student achievement need to improve…

  16. Parental Involvement and Academic Achievement

    ERIC Educational Resources Information Center

    Goodwin, Sarah Christine

    2015-01-01

    This research study examined the correlation between student achievement and parent's perceptions of their involvement in their child's schooling. Parent participants completed the Parent Involvement Project Parent Questionnaire. Results slightly indicated parents of students with higher level of achievement perceived less demand or invitations…

  17. Asperger Syndrome and Academic Achievement.

    ERIC Educational Resources Information Center

    Griswold, Deborah E.; Barnhill, Gena P.; Myles, Brenda Smith; Hagiwara, Taku; Simpson, Richard L.

    2002-01-01

    A study focused on identifying the academic characteristics of 21 children and youth who have Asperger syndrome. Students had an extraordinary range of academic achievement scores, extending from significantly above average to far below grade level. Lowest achievement scores were shown for numerical operations, listening comprehension, and written…

  18. Perils of Standardized Achievement Testing

    ERIC Educational Resources Information Center

    Haladyna, Thomas M.

    2006-01-01

    This article argues that the validity of standardized achievement test-score interpretation and use is problematic; consequently, confidence and trust in such test scores may often be unwarranted. The problem is particularly severe in high-stakes situations. This essay provides a context for understanding standardized achievement testing, then…

  19. Stress Correlates and Academic Achievement.

    ERIC Educational Resources Information Center

    Bentley, Donna Anderson; And Others

    An ongoing concern for educators is the identification of factors that contribute to or are associated with academic achievement; one such group of variables that has received little attention are those involving stress. The relationship between perceived sources of stress and academic achievement was examined to determine if reactions to stress…

  20. School Size and Student Achievement

    ERIC Educational Resources Information Center

    Riggen, Vicki

    2013-01-01

    This study examined whether a relationship between high school size and student achievement exists in Illinois public high schools in reading and math, as measured by the Prairie State Achievement Exam (PSAE), which is administered to all Illinois 11th-grade students. This study also examined whether the factors of socioeconomic status, English…