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Sample records for assess functional outcome

  1. Functional Outcome Measures for Knee Dysfunction Assessment

    PubMed Central

    Keskula, Douglas R.; Duncan, Jewell B.; Davis, Virginia L.; Finley, Paula W.

    1996-01-01

    Maximizing the functional abilities of the individual is the primary objective of any therapeutic intervention. Functional outcome data are valuable to those involved in the care of the athlete because such data provides information that helps facilitate the clinical decision-making process and, therefore, helps insure a safe and efficient return to athletics. Functional outcome measures also provide useful data for assessing therapeutic intervention efficacy. The clinician/researcher must consider various factors when selecting an appropriate outcome measure, such as: the patient population, pathology, specific test parameters, psychometric properties, and practicality of the measure. The primary purpose of this paper is to provide the reader with guidelines for either assessing existing measures or developing new measures of functional outcomes for use in clinical practice and research. PMID:16558382

  2. Functional outcomes assessment in shoulder surgery

    PubMed Central

    Wylie, James D; Beckmann, James T; Granger, Erin; Tashjian, Robert Z

    2014-01-01

    The effective evaluation and management of orthopaedic conditions including shoulder disorders relies upon understanding the level of disability created by the disease process. Validated outcome measures are critical to the evaluation process. Traditionally, outcome measures have been physician derived objective evaluations including range of motion and radiologic evaluations. However, these measures can marginalize a patient’s perception of their disability or outcome. As a result of these limitations, patient self-reported outcomes measures have become popular over the last quarter century and are currently primary tools to evaluate outcomes of treatment. Patient reported outcomes measures can be general health related quality of life measures, health utility measures, region specific health related quality of life measures or condition specific measures. Several patients self-reported outcomes measures have been developed and validated for evaluating patients with shoulder disorders. Computer adaptive testing will likely play an important role in the arsenal of measures used to evaluate shoulder patients in the future. The purpose of this article is to review the general health related quality-of-life measures as well as the joint-specific and condition specific measures utilized in evaluating patients with shoulder conditions. Advances in computer adaptive testing as it relates to assessing dysfunction in shoulder conditions will also be reviewed. PMID:25405091

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

    ERIC Educational Resources Information Center

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

    2000-01-01

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

  4. Longitudinal Outcomes of Functional Behavioral Assessment--Based Intervention

    ERIC Educational Resources Information Center

    Kern, Lee; Gallagher, Patricia; Starosta, Kristin; Hickman, Wesley; George, Michael

    2006-01-01

    A critical measure of intervention effectiveness is durability over time. Still, few studies have examined the long-term outcomes of support derived from a functional behavioral assessment as well as enablers and barriers that contribute to or impede successful outcomes. In the current study, a functional behavioral assessment was conducted with a…

  5. Assessing functional outcomes following intracerebral hemorrhage in rats.

    PubMed

    Hartman, Richard; Lekic, Tim; Rojas, Hugo; Tang, Jiping; Zhang, John H

    2009-07-14

    Translational neuroprotective and drug development studies need to be gauged against well-characterized functional outcomes, including motor, sensory and cognitive domains. Since intracerebral hemorrhage (ICH) causes dramatic neurological and cognitive deficits in humans, we hypothesized that ICH would result in prolonged motor-sensory and learning/memory deficits in rats. Neurological tests of sensorimotor functions were performed before ICH, 1-3 days and 10 weeks after ICH. Water maze, open field, and rotarod performance was tested 2 and 8 weeks after ICH. Early neurological evaluations revealed significant deficits, with almost full recovery by 10 weeks. The water maze revealed significant learning (but not motor) deficits at 2 weeks, but by 8 weeks, the learning deficits had diminished and significant motor deficits had emerged, coinciding with a drop in activity. The injured hemisphere showed significant atrophy at sacrifice. Therefore, ICH produced detectable cognitive and motor deficits in rats that evolved over a 10-week period, and thereby provides a suitable baseline for analysis of future therapeutic interventions following hemorrhagic stroke.

  6. Myocardial Infarction and Functional Outcome Assessment in Pigs

    PubMed Central

    Koudstaal, Stefan; Jansen of Lorkeers, Sanne J.; Gho, Johannes M.I.H.; van Hout, Gerardus P.J; Jansen, Marlijn S.; Gründeman, Paul F.; Pasterkamp, Gerard; Doevendans, Pieter A.

    2014-01-01

    Introduction of newly discovered cardiovascular therapeutics into first-in-man trials depends on a strictly regulated ethical and legal roadmap. One important prerequisite is a good understanding of all safety and efficacy aspects obtained in a large animal model that validly reflect the human scenario of myocardial infarction (MI). Pigs are widely used in this regard since their cardiac size, hemodynamics, and coronary anatomy are close to that of humans. Here, we present an effective protocol for using the porcine MI model using a closed-chest coronary balloon occlusion of the left anterior descending artery (LAD), followed by reperfusion. This approach is based on 90 min of myocardial ischemia, inducing large left ventricle infarction of the anterior, septal and inferoseptal walls. Furthermore, we present protocols for various measures of outcome that provide a wide range of information on the heart, such as cardiac systolic and diastolic function, hemodynamics, coronary flow velocity, microvascular resistance, and infarct size. This protocol can be easily tailored to meet study specific requirements for the validation of novel cardioregenerative biologics at different stages (i.e. directly after the acute ischemic insult, in the subacute setting or even in the chronic MI once scar formation has been completed). This model therefore provides a useful translational tool to study MI, subsequent adverse remodeling, and the potential of novel cardioregenerative agents. PMID:24796715

  7. The Lower Limb Functional Index - A reliable and valid functional outcome assessment in burns.

    PubMed

    Gittings, Paul M; Heberlien, Nicholas; Devenish, Neale; Parker, Matthew; Phillips, Michael; Wood, Fiona M; Edgar, Dale W

    2016-09-01

    Lower limb injuries account for up to 40% of all burns in Western Australia and affect physical function. Lower limb specific functional assessments are available to monitor recovery, yet no scale has been assessed for use in burns. The Lower Limb Functional Index (LLFI) which is validated in musculoskeletal patients was investigated for applicability in burn. Reliability was assessed using Cronbach's alpha, principal components analysis and Rasch analysis. Validity was assessed using Spearman's correlation coefficient with quality of life assessments (BSHS-B & SF-36) and physical assessments (TUG & ankle ROM). Regression analysis was performed with burn severity measures, time of recovery and location of the burn. The LLFI-10 was applied 1368 times on 739 patients at regular time points. It was internally consistent (α>0.8) and unidimensional. Associations were demonstrated with the BSHS-B and SF-36 (rho=-0.56 to -0.72, p<0.001), TUG (rho=0.41, p<0.001) and ankle ROM (rho=-0.31 to -0.35, p<0.001). The LLFI-10 also showed associations (p<0.001) with time since injury (rho=-0.29), age (rho=0.12) and TBSA (rho=0.12). The LLFI-10 is a reliable and valid tool to assess function in lower limb burns. This study supports the use of the LLFI-10 as part of a battery of assessment for lower limb burn recovery. PMID:27126812

  8. Tinnitus Outcomes Assessment

    PubMed Central

    Meikle, Mary B.; Stewart, Barbara J.; Griest, Susan E.; Henry, James A.

    2008-01-01

    Over the past two decades, recognition has grown that measures for evaluating treatment outcomes must be designed specifically to have high responsiveness. With that in mind, four major types of tinnitus measures are reviewed, including psychoacoustic measures, self-report questionnaires concerning functional effects of tinnitus, various rating scales, and global outcome measures. Nine commonly used tinnitus questionnaires, developed in the period 1980–1980, are reviewed. Because of many similarities between tinnitus and pain, comparisons between pain and tinnitus measures are discussed, and recommendations that have been made for developing a core set of measures to evaluate treatment-related changes in pain are presented as providing a fruitful path for developing a core set of measures for tinnitus. Finally, the importance of having both immediately obtainable outcome measures (psychoacoustic, rating scales, or single global measures) and longer term measures (questionnaires covering the negative effects of tinnitus) is emphasized for further work in tinnitus outcomes assessment. PMID:18599500

  9. Tinnitus outcomes assessment.

    PubMed

    Meikle, Mary B; Stewart, Barbara J; Griest, Susan E; Henry, James A

    2008-09-01

    Over the past two decades, recognition has grown that measures for evaluating treatment outcomes must be designed specifically to have high responsiveness. With that in mind, four major types of tinnitus measures are reviewed, including psychoacoustic measures, self-report questionnaires concerning functional effects of tinnitus, various rating scales, and global outcome measures. Nine commonly used tinnitus questionnaires, developed in the period 1980-2000, are reviewed. Because of many similarities between tinnitus and pain, comparisons between pain and tinnitus measures are discussed, and recommendations that have been made for developing a core set of measures to evaluate treatment-related changes in pain are presented as providing a fruitful path for developing a core set of measures for tinnitus. Finally, the importance of having both immediately obtainable outcome measures (psychoacoustic, rating scales, or single global measures) and longer term measures (questionnaires covering the negative effects of tinnitus) is emphasized for further work in tinnitus outcomes assessment. PMID:18599500

  10. BMIPP imaging to assess functional outcome in patients with acute and chronic left ventricular dysfunction.

    PubMed

    Franken, P R; Hambÿe, A S; De Geeter, F W

    1999-02-01

    Assessment of myocardial viability is an important clinical issue for patient management during the acute and chronic stages of myocardial infarction. BMIPP (15-(p-iodophenyl)-3-(R,S)-methyl pentadecanoic acid) is a free fatty acid analogue which is trapped in the myocardium, thus permitting for metabolic imaging with single photon emission computerized tomography (SPECT). Less BMIPP than flow tracers that may be observed in the areas of infarction, may reflect the metabolic shift from fatty acid to glucose utilization in ischaemic myocardium. In this sense, the combined imaging of BMIPP and a flow tracer with SPECT may provide similar and important information as fluoro-18 deoxyglucose (FDG) and positron emission tomography (PET) regarding the assessment of myocardial viability. The purpose of this article is to review the clinical impact of BMIPP in patients with acute and with chronic left ventricular dysfunction for the identification of jeopardized but viable myocardium and the prediction of the functional outcome.

  11. The Behavioural Assessment of the Dysexecutive Syndrome (BADS) in schizophrenia and its relation to functional outcomes.

    PubMed

    Katz, Noomi; Tadmor, Inbal; Felzen, Batya; Hartman-Maeir, Adina

    2007-04-01

    The purpose of this study was to establish further the validity of the Behavioural Assessment of the Dysexecutive Syndrome (BADS) in a population with schizophrenia. Specific objectives were: to examine the construct validity and sensitivity of the BADS in differentiating between adult inpatients during an acute episode of illness, adult outpatients in the chronic stages of illness, and healthy controls; and to examine the predictive validity of the BADS regarding functional outcomes within the chronic group. Participants were 30 inpatients during an acute episode of their illness; 31 outpatients in the chronic stage; and 93 healthy controls. Instruments included the BADS, the Neurobehavioral Cognitive Status Examination (Cognistat) and the Routine Task Inventory (RTI). Significant differences in BADS scores were found between participants with schizophrenia and healthy controls, and between both groups of patients, showing the chronic group to have more deficits in executive functions. In addition, within the chronic group the BADS was found to be a significant predictor of two of the RTI outcome areas, instrumental activities of daily living (IADL) and communication, beyond that accounted for by basic cognitive skills. These results support the validity of the BADS within the schizophrenic population, and highlight the importance of measuring executive functions for rehabilitation. PMID:17454693

  12. Parenteral nutrition in adult inpatients with functioning gastrointestinal tracts: assessment of outcomes.

    PubMed

    Zaloga, Gary P

    2006-04-01

    Malnutrition is a common comorbidity that places inpatients at risk of complications, infections, long length of stay, higher costs, and increased mortality. Thus, nutrition support has become an important therapeutic adjunctive to the care of these patients. For patients unable to feed themselves, nutrition can be delivered via the parenteral or enteral routes. The formulations used to deliver nutrients and the route of nutrient delivery, absorption, and processing differ substantially between parenteral and enteral nutrition. Over the past two decades, many randomised clinical trials have assessed the effects of parenteral versus enteral nutrition on outcomes (ie, complications, infections, length of stay, costs, mortality) in diverse inpatient populations. From a search of medical publications, studies were selected that assessed important clinical outcomes of parenteral versus enteral feeding or intravenous fluids in patients with trauma/burn injuries, surgery, cancer, pancreatic disease, inflammatory bowel disease, critical illness, liver failure, acute renal failure, and organ transplantation. Our goal was to determine the optimum route of feeding in these patient groups. The available evidence lends support to the use of enteral over parenteral feeding in inpatients with functioning gastrointestinal tracts. PMID:16581410

  13. Association between changes on the Negative Symptom Assessment scale (NSA-16) and measures of functional outcome in schizophrenia.

    PubMed

    Velligan, Dawn I; Alphs, Larry; Lancaster, Scott; Morlock, Robert; Mintz, Jim

    2009-09-30

    We examined whether changes in negative symptoms, as measured by scores on the 16-item Negative Symptom Assessment scale (NSA-16), were associated with changes in functional outcome. A group of 125 stable outpatients with schizophrenia were assessed at baseline and at 6 months using the NSA-16, the Brief Psychiatric Rating Scale, and multiple measures of functional outcome. Baseline adjusted regression coefficients indicated moderate correlations between negative symptoms and functional outcomes when baseline values of both variables were controlled. Results were nearly identical when we controlled for positive symptoms. Cross-lag panel correlations and Structural Equation Modeling were used to examine whether changes in negative symptoms drove changes in functional outcomes over time. Results indicated that negative symptoms drove the changes in the Social and Occupational Functioning Scale (SOFAS) rather than the reverse. Measures of Quality of Life and measures of negative symptoms may be assessing overlapping constructs or changes in both may be driven by a third variable. Negative symptoms were unrelated over time to scores on a performance-based measure of functional capacity. This study indicates that the relationship between negative symptom change and the change in functional outcomes is complex, and points to potential issues in selection of assessments.

  14. Physical functional outcome assessment of patients with major burns admitted to a UK Burn Intensive Care Unit.

    PubMed

    Smailes, Sarah T; Engelsman, Kayleen; Dziewulski, Peter

    2013-02-01

    Determining the discharge outcome of burn patients can be challenging and therefore a validated objective measure of functional independence would assist with this process. We developed the Functional Assessment for Burns (FAB) score to measure burn patients' functional independence. FAB scores were taken on discharge from ICU (FAB 1) and on discharge from inpatient burn care (FAB 2) in 56 patients meeting the American Burn Association criteria for major burn. We retrospectively analysed prospectively collected data to measure the progress of patients' physical functional outcomes and to evaluate the predictive validity of the FAB score for discharge outcome. Mean age was 38.6 years and median burn size 35%. Significant improvements were made in the physical functional outcomes between FAB 1 and FAB 2 scores (p<0.0001). 48 patients were discharged home, 8 of these with social care. 8 patients were transferred to another hospital for further inpatient rehabilitation. FAB 1 score (≤ 9) is strongly associated with discharge outcome (p<0.006) and as such can be used to facilitate early discharge planning. FAB 2 score (≤ 26) independently predicts discharge outcome (p<0.0001) and therefore is a valid outcome measure to determine discharge outcome of burn patients.

  15. Functional Assessment of Genetic Variants with Outcomes Adapted to Clinical Decision-Making

    PubMed Central

    Thouvenot, Pierre; Ben Yamin, Barbara; Fourrière, Lou; Lescure, Aurianne; Boudier, Thomas; Del Nery, Elaine; Chauchereau, Anne; Goldgar, David E.; Stoppa-Lyonnet, Dominique; Nicolas, Alain; Millot, Gaël A.

    2016-01-01

    Understanding the medical effect of an ever-growing number of human variants detected is a long term challenge in genetic counseling. Functional assays, based on in vitro or in vivo evaluations of the variant effects, provide essential information, but they require robust statistical validation, as well as adapted outputs, to be implemented in the clinical decision-making process. Here, we assessed 25 pathogenic and 15 neutral missense variants of the BRCA1 breast/ovarian cancer susceptibility gene in four BRCA1 functional assays. Next, we developed a novel approach that refines the variant ranking in these functional assays. Lastly, we developed a computational system that provides a probabilistic classification of variants, adapted to clinical interpretation. Using this system, the best functional assay exhibits a variant classification accuracy estimated at 93%. Additional theoretical simulations highlight the benefit of this ready-to-use system in the classification of variants after functional assessment, which should facilitate the consideration of functional evidences in the decision-making process after genetic testing. Finally, we demonstrate the versatility of the system with the classification of siRNAs tested for human cell growth inhibition in high throughput screening. PMID:27272900

  16. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 2: assessment of functional outcome following lumbar fusion.

    PubMed

    Ghogawala, Zoher; Resnick, Daniel K; Watters, William C; Mummaneni, Praveen V; Dailey, Andrew T; Choudhri, Tanvir F; Eck, Jason C; Sharan, Alok; Groff, Michael W; Wang, Jeffrey C; Dhall, Sanjay S; Kaiser, Michael G

    2014-07-01

    Assessment of functional patient-reported outcome following lumbar spinal fusion continues to be essential for comparing the effectiveness of different treatments for patients presenting with degenerative disease of the lumbar spine. When assessing functional outcome in patients being treated with lumbar spinal fusion, a reliable, valid, and responsive outcomes instrument such as the Oswestry Disability Index should be used. The SF-36 and the SF-12 have emerged as dominant measures of general health-related quality of life. Research has established the minimum clinically important difference for major functional outcomes measures, and this should be considered when assessing clinical outcome. The results of recent studies suggest that a patient's pretreatment psychological state is a major independent variable that affects the ability to detect change in functional outcome.

  17. Development of quantitative and sensitive assessments of physiological and functional outcome during recovery from spinal cord injury: a clinical initiative.

    PubMed

    Ellaway, P H; Kuppuswamy, A; Balasubramaniam, A V; Maksimovic, R; Gall, A; Craggs, M D; Mathias, C J; Bacon, M; Prochazka, A; Kowalczewski, J; Conway, B A; Galen, S; Catton, C J; Allan, D B; Curt, A; Wirth, B; van Hedel, H J A

    2011-03-10

    The ability to detect physiological changes associated with treatments to effect axonal regeneration, or novel rehabilitation strategies, for spinal cord injury will be challenging using the widely employed American Spinal Injuries Association (ASIA) impairment scales (AIS) for sensory and motor function. Despite many revisions to the AIS standard neurological assessment, there remains a perceived need for more sensitive, quantitative and objective outcome measures. The purpose of Stage 1 of the Clinical Initiative was to develop these tools and then, in Stage 2 to test them for reliability against natural recovery and treatments expected to produce functional improvements in those with complete or incomplete spinal cord injury (SCI). Here we review aspects of the progress made by four teams involved in Stage 2. The strategies employed by the individual teams were (1) application of repetitive transcranial magnetic stimulation (rTMS) to the motor cortex in stable (chronic) SCI with intent to induce functional improvement of upper limb function, (2) a tele-rehabilitation approach using functional electrical stimulation to provide hand opening and grip allowing incomplete SCI subjects to deploy an instrumented manipulandum for hand and arm exercises and to play computer games, (3) weight-assisted treadmill walking therapy (WAT) comparing outcomes in acute and chronic groups of incomplete SCI patients receiving robotic assisted treadmill therapy, and (4) longitudinal monitoring of the natural progress of recovery in incomplete SCI subjects using motor tests for the lower extremity to investigate strength and coordination.

  18. Surgical management of acromegaly: Long term functional outcome analysis and assessment of recurrent/residual disease

    PubMed Central

    Banerji, Deepu; Das, Nitu K.; Sharma, Siddhiraj; Jindal, Yogesh; Jain, Vijendra K.; Behari, Sanjay

    2016-01-01

    Context: Functional growth hormone producing adenomas have long-term deleterious effects on the visual apparatus, the cardiovascular and musculoskeletal systems, and often predispose to malignancies. Since persistence of acromegaly affects outcome and quality of life, therapeutic interventions become mandatory. Aim: This study represents an analysis of long-term clinical and endocrinal outcome of 115 patients of acromegaly after surgical management. Setting and Design: Tertiary care retrospective study. Materials and Methods: One hundred and fifteen patients (male:female ratio: 1:1.09) with acromegalic features were studied. Apart from acromegalic features, their main clinical presentation also included headache, diminution of vision, field defects, ptosis, irregular menstruation, diabetes insipidus, diabetes mellitus and hypertension. Six of them presented with apoplexy. Their preoperative endocrinal evaluation included basal and suppressed growth hormone (GH), prolactin and thyroid levels. On the basis of axial and coronal CT scan or multiplanar MR imaging or both, the tumors were classified according to their suprasellar and parasellar extension (Hardy's grade). Transnasal trans-sphenoidal surgery (TSS) (n = 37) and sublabial, rhinoseptal TSS (n = 72) were the preferred approaches. Six patients with significant parasellar extensions underwent trans-cranial explorations. The patients were followed up at 6 and 12 weeks and then at 6 monthly intervals. Hormonal and CT/MR evaluation were also done. Attainment of random GH value less than 2.5 µg/L, and the nadir GH value after oral glucose tolerance test (OGTT) less than 1 µg/L were used as the criteria of cure. Findings: The patients were preoperatively in Hardy's tumor grade 0 (29), A (21), A+E (3), B (21), B+E (5), C (9), C+E (10), D (1) D+E (11), E (5), respectively. One hundred and one patients were available for follow-up (FU; median FU duration: 84 months; range: 6 to 132 months). Surgical cure was achieved

  19. The assessment of auditory function in CSWS: lessons from long-term outcome.

    PubMed

    Metz-Lutz, Marie-Noëlle

    2009-08-01

    In Landau-Kleffner syndrome (LKS), the prominent and often first symptom is auditory verbal agnosia, which may affect nonverbal sounds. It was early suggested that the subsequent decline of speech expression might result from defective auditory analysis of the patient's own speech. Indeed, despite normal hearing levels, the children behave as if they were deaf, and very rapidly speech expression deteriorates and leads to the receptive aphasia typical of LKS. The association of auditory agnosia more or less restricted to speech with severe language decay prompted numerous studies aimed at specifying the defect in auditory processing and its pathophysiology. Long-term follow-up studies have addressed the issue of the outcome of verbal auditory processing and the development of verbal working memory capacities following the deprivation of phonologic input during the critical period of language development. Based on a review of neurophysiologic and neuropsychological studies of auditory and phonologic disorders published these last 20 years, we discuss the association of verbal agnosia and speech production decay, and try to explain the phonologic working memory deficit in the late outcome of LKS within the Hickok and Poeppel dual-stream model of speech processing.

  20. Measuring Treatment Outcome for Children with Serious Emotional Disturbances: Discriminant Validity and Clinical Significance of the Child and Adolescent Functioning Assessment Scale

    ERIC Educational Resources Information Center

    Roy, Kimberlee M.; Roberts, Michael C.; Vernberg, Eric M.; Randall, Camille J.

    2008-01-01

    We investigated the use of a popular measure, the Children and Adolescent Functional Assessment Scale (CAFAS), in treatment outcome research. The sample included 70 children who had been discharged from an elementary therapeutic classroom (Intensive Mental Health Program). Significant relationships were found between decreases in CAFAS scores and…

  1. Outcomes assessment in the NCCN.

    PubMed

    Weeks, J C

    1997-11-01

    Outcomes assessment has two primary goals: the evaluation of treatments and the evaluation of quality of care. Data on the outcomes associated with specific interventions may provide an empiric basis for guidelines in areas for which no randomized trial data are available. Also, monitoring of patterns of care and outcomes is an essential component of institutional efforts to implement guidelines and to benchmark themselves against regional and national norms. The National Comprehensive Cancer Network (NCCN) has adopted a three-phase approach to its outcomes assessment program. Phase 1, already completed, involved taking a systematic inventory of members' existing institutional data sources. Phase 2, which is currently in progress, entails pooling data from existing outcomes data bases. In particular, tumor registry data from the National Cancer Data Base are being used to examine patterns of care and outcomes in NCCN institutions and to benchmark them against national norms. Phase 3, begun within the past year, involves the creation of a uniform outcomes assessment system for the NCCN. PMID:9430183

  2. Techniques for objective outcome assessment.

    PubMed

    Hesbach, Amie Lamoreaux

    2007-11-01

    Companion animal rehabilitation, a collaborative practice of physical therapy and veterinary medicine, can only demonstrate the effectiveness of its theories, techniques, interventions, and modalities through evidence-based practice, utilizing standardized, reliable, and valid outcome measures, correlated with objective diagnostic data. This essay examines existing and potential objective outcome measures utilized in companion animal rehabilitation and physical therapy regarding pain, vital signs, body condition and composition, range of motion, muscle strength, inflammation, functional mobility, and gait. Discussion is included of the traditional disablement model and the evolution of the physical therapy diagnosis, prognosis, and plan of care. PMID:18198782

  3. Assessing outcomes in Alzheimer disease.

    PubMed

    Schneider, L S

    2001-08-01

    To gain a better overview of the effectiveness of treatment of patients with Alzheimer disease (AD), areas such as cognition, activities of daily living (ADL), behavior, caregiver burden, quality of life and economics need to be assessed. A number of instruments are available for assessing these domains, many of which are reviewed in this article. These include the cognitive subscale of the Alzheimer's Disease Assessment Scale (the standard instrument for the measurement of efficacy in dementia trials), scales that assess AD patients' abilities to perform ADL (including the Disability Assessment for Dementia scale and the Alzheimer's Disease Cooperative Study-Activities of Daily Living), scales to assess behavioral symptoms in dementia (including the Neuropsychiatric Inventory and the Behavioral Pathology in Alzheimer's Disease Rating Scale), scales for assessing global clinical change, and methods for assessing caregiver time, quality of life and health economics. Each instrument has its own advantages and disadvantages. However, the instruments used need to be selected carefully to provide credible and informative outcome data. PMID:11669509

  4. Functional outcomes of face transplantation.

    PubMed

    Fischer, S; Kueckelhaus, M; Pauzenberger, R; Bueno, E M; Pomahac, B

    2015-01-01

    In this study we provide a compilation of functional impairments before and improvements after face transplantation (FT) of five FT recipients of our institution and all FTs reported in current literature. Functional outcome included the ability to smell, breath, eat, speak, grimace and facial sensation. Before FT, all our patients revealed compromised ability to breath, eat, speak, grimace and experience facial sensation. The ability to smell was compromised in two of our five patients. Two patients were dependent on tracheostomy and one on gastrostomy tubes. After FT, all abilities were significantly improved and all patients were independent from artificial air airways and feeding tubes. Including data given in current literature about the other 24 FT recipients in the world, the abilities to smell, eat and feel were enhanced in 100% of cases, while the abilities of breathing, speaking and facial expressions were ameliorated in 93%, 71% and 76% of cases, respectively. All patients that required gastrostomy and 91% of patients depending on tracheostomy were decannulated after FT. Unfortunately, outcomes remain unreported in all other cases and therefore we are unable to comment on improvements.

  5. Surgical Outcomes and Correlation of the Copenhagen Neck Functional Disability Scale and Modified Japanese Orthopedic Association Assessment Scales in Patients with Cervical Spondylotic Myelopathy

    PubMed Central

    Azhari, Shirzad; Shazadi, Sohrab; Khayat Kashany, Hamid; Nayeb Aghaei, Hossein; Mohammadi, Hassan Reza

    2016-01-01

    Study Design Cross-sectional. Purpose Clinical outcome study comparing the Copenhagen Neck Functional Disability Scale (CNFDS) and modified Japanese orthopedic association (mJOA) assessment scales in patients with cervical spondylotic myelopathy (CSM). Overview of Literature Comparison of instruments that measure patient-reported outcomes is needed. Methods A cross-sectional analysis was conducted. Ninety five patients with CSM were entered into the study and completed the CNFDS and the mJOA preoperatively and postoperatively. Correlation between the CNFDS and the mJOA was evaluated preoperatively and at the end of follow-up. Responsiveness to change of CNFDS and mJOA was also assessed. Clinical outcomes were also measured with the recovery rate of mJOA score at end of follow-up. Results The mean age of patients was 58.2 (standard deviation, SD=8.7) years. Mean follow-up was 2.1 years (range, 1 to 4 years). The mJOA correlated strongly with the CNFDS score preoperatively and postoperatively (r=–0.81 and –0.82, respectively; p<0.001). The CNFDS and the mJOA were able to detect changes after the surgery (p<0.001). The mean mJOA recovery rate was 51.8% (SD=13.1%). Conclusions Surgery for the treatment of patients with CSM is an efficacious procedure. CNFDS and mJOA scores have a strong correlation in measuring disability among CSM patients. PMID:27340528

  6. Assessment of outcome in hypospadias surgery - a review.

    PubMed

    Springer, Alexander

    2014-01-01

    Hypospadias is a challenging field of urogenital reconstructive surgery with different techniques being currently used. Modern surgery claims that it is possible to create a functionally and cosmetically normal penis. Continuous re-evaluation and assessment of outcome may have a major impact on future clinical practice. Assessment of outcome includes: complication rate, cosmetic appearance of the penis, functional outcome (micturition, sexuality), and psychological factors such as quality of life and psychosexual life. This article briefly reviews current strategies of outcome assessment. Somehow in the future, we will be able to give an accurate estimation of the long-term consequences of being born with hypospadias.

  7. The Role of Diffusion-Weighted Imaging (DWI) in Locoregional Therapy Outcome Prediction and Response Assessment for Hepatocellular Carcinoma (HCC): The New Era of Functional Imaging Biomarkers

    PubMed Central

    Ludwig, Johannes M.; Camacho, Juan C.; Kokabi, Nima; Xing, Minzhi; Kim, Hyun S.

    2015-01-01

    Reliable response criteria are critical for the evaluation of therapeutic response in hepatocellular carcinoma (HCC). Current response assessment is mainly based on: (1) changes in size, which is at times unreliable and lag behind the result of therapy; and (2) contrast enhancement, which can be difficult to quantify in the presence of benign post-procedural changes and in tumors presenting with a heterogeneous pattern of enhancement. Given these challenges, functional magnetic resonance imaging (MRI) techniques, such as diffusion-weighted imaging (DWI) have been recently investigated, aiding specificity to locoregional therapy response assessment and outcome prediction. Briefly, DWI quantifies diffusion of water occurring naturally at a cellular level (Brownian movement), which is restricted in multiple neoplasms because of high cellularity. Disruption of cellular integrity secondary to therapy results in increased water diffusion across the injured membranes. This review will provide an overview of the current literature on DWI therapy response assessment and outcome prediction in HCC following treatment with locoregional therapies. PMID:26854170

  8. Assessment from Functional Perspectives: Using Sensorimotor Control in the Hand as an Outcome Indicator in the Surgical Treatment of Carpal Tunnel Syndrome

    PubMed Central

    Hsu, Hsiu-Yun; Su, Fong-Chin; Kuo, Yao-Lung; Jou, I-Ming; Chiu, Haw-Yen; Kuo, Li-Chieh

    2015-01-01

    To investigate whether sensorimotor control of the hand could be an outcome indicator after carpal tunnel release (CTR), this work examined changes in the results of patients’ manual tactile test (MTT), pinch-holding-up activity (PHUA), two-point discrimination (2PD) and Semmes-Weinstein monofilament (SWM) tests. Participants included 30 predominantly sensory neuropathy CTS patients, as confirmed by a nerve conduction study. The MTT, precision pinch performance in PHUA and traditional sensibility (2PD and SWM) tests were used to examine different aspects of sensory status at the time-points of two weeks before operation and one month post-operation, with a single-blind design. The results showed significant improvements in the sensory function as detected by the 2PD and SWM tests (p<0.001) and sensorimotor function as detected by the MTT (p<0.001) and PHUA test (p<0.05) for patients receiving CTR. The responsiveness of the SWM, MTT and PHUA tests (effect size>0.5, p<0.01) are better than that of two-point discrimination test (effect size<0.5, p<0.001). However, pinch strength saw a decline compared to baseline with a moderate effect sizes (effect size = 0.7, p<0.001). This cohort study found that the MTT and PHUA test can both meet all the statistical criteria with regard to assessing treatment outcomes for patients with CTS. In addition, the results of this work provide clinicians with the information that the sensorimotor functions of the hands, as assessed by MTT and PHUA, are responsive to clinical changes due to CTR. PMID:26053242

  9. Gesture Performance in Schizophrenia Predicts Functional Outcome After 6 Months

    PubMed Central

    Walther, Sebastian; Eisenhardt, Sarah; Bohlhalter, Stephan; Vanbellingen, Tim; Müri, René; Strik, Werner; Stegmayer, Katharina

    2016-01-01

    The functional outcome of schizophrenia is heterogeneous and markers of the course are missing. Functional outcome is associated with social cognition and negative symptoms. Gesture performance and nonverbal social perception are critically impaired in schizophrenia. Here, we tested whether gesture performance or nonverbal social perception could predict functional outcome and the ability to adequately perform relevant skills of everyday function (functional capacity) after 6 months. In a naturalistic longitudinal study, 28 patients with schizophrenia completed tests of nonverbal communication at baseline and follow-up. In addition, functional outcome, social and occupational functioning, as well as functional capacity at follow-up were assessed. Gesture performance and nonverbal social perception at baseline predicted negative symptoms, functional outcome, and functional capacity at 6-month follow-up. Gesture performance predicted functional outcome beyond the baseline measure of functioning. Patients with gesture deficits at baseline had stable negative symptoms and experienced a decline in social functioning. While in patients without gesture deficits, negative symptom severity decreased and social functioning remained stable. Thus, a simple test of hand gesture performance at baseline may indicate favorable outcomes in short-term follow-up. The results further support the importance of nonverbal communication skills in subjects with schizophrenia. PMID:27566843

  10. Neurocognition: clinical and functional outcomes in schizophrenia.

    PubMed

    Lepage, Martin; Bodnar, Michael; Bowie, Christopher R

    2014-01-01

    Schizophrenia is characterized by significant heterogeneity in outcome. The last decades have witnessed a significant interest in identifying factors that can moderate or influence clinical and functional outcomes in people with schizophrenia. One factor of particular interest is neurocognition, as performance on various measures of cognitive abilities, such as memory, attention, and executive functions, have been consistently related to functional outcome and, to a lesser extent, clinical outcome. This review aims to provide an up-to-date description of recent studies examining the association between neurocognition and clinical and (or) functional outcomes. In the first section, studies examining neurocognitive performance in relation to clinical outcome are examined. When clinical outcome is defined dichotomously (for example, comparing remitted and nonremitted), verbal memory performance consistently exhibits a strong association with clinical status, with the poor outcome group showing the largest deficits. In the second section, studies exploring the relation between neurocognition and various dimensions of functional outcome are reviewed. These dimensions include independent living, social functioning, and vocational functioning, among others. Again, a strong link between neurocognitive deficits and impairments in several aspects of functioning clearly emerges from this review. Finally, several measurement issues are discussed that pertain to the need to standardize definitions of clinical and (or) functional outcomes, the importance of defining cognitive domains consistently across studies, and distinguishing between one's competence to perform tasks and what one actually does in everyday life. Addressing these measurement issues will be key to studies examining the development of effective interventions targeting neurocognitive functions and their impact on clinical and functional outcomes.

  11. Assessment of functional outcomes by Sheehan Disability Scale in patients with major depressive disorder treated with duloxetine versus selective serotonin reuptake inhibitors

    PubMed Central

    Sheehan, David V.; Mancini, Michele; Wang, Jianing; Berggren, Lovisa; Cao, Haijun; Dueñas, Héctor José

    2016-01-01

    Objective We compared functional impairment outcomes assessed with Sheehan Disability Scale (SDS) after treatment with duloxetine versus selective serotonin reuptake inhibitors (SSRIs) in patients with major depressive disorder. Methods Data were pooled from four randomized studies comparing treatment with duloxetine and SSRIs (three double blind and one open label). Analysis of covariance, with last‐observation‐carried‐forward approach for missing data, explored treatment differences between duloxetine and SSRIs on SDS changes during 8 to 12 weeks of acute treatment for the intent‐to‐treat population. Logistic regression analysis examined the predictive capacity of baseline patient characteristics for remission in functional impairment (SDS total score ≤ 6 and SDS item scores ≤ 2) at endpoint. Results Included were 2193 patients (duloxetine n = 1029; SSRIs n = 835; placebo n = 329). Treatment with duloxetine and SSRIs resulted in significantly (p < 0.01) greater improvements in the SDS total score versus treatment with placebo. Higher SDS (p < 0.0001) or 17‐item Hamilton Depression Rating Scale baseline scores (p < 0.01) predicted lower probability of functional improvement after treatment with duloxetine or SSRIs. Female gender (p ≤ 0.05) predicted higher probability of functional improvement after treatment with duloxetine or SSRIs. Conclusions Treatment with SSRIs and duloxetine improved functional impairment in patients with major depressive disorder. Higher SDS or 17‐item Hamilton Depression Rating Scale baseline scores predicted less probability of SDS improvement; female gender predicted better improvement in functional impairment at endpoint. © 2015 The Authors. Human Psychopharmacology: Clinical and Experimental published by John Wiley & Sons, Ltd. PMID:26331440

  12. Interviews to Assess Learners' Outcomes.

    ERIC Educational Resources Information Center

    Seda, Ileana; Pearson, P. David

    1991-01-01

    Presents open-ended and semistructured interviews to assess reading comprehension. Highlights the potential value of interviews in aligning assessment practices with instruction and learning theory. (MG)

  13. Best evidence in multimodal pain management in spine surgery and means of assessing postoperative pain and functional outcomes.

    PubMed

    Devin, Clinton J; McGirt, Matthew J

    2015-06-01

    Multimodal approaches to pain management have arisen with the goal of improving postoperative pain and reducing opioid analgesic use. We performed a comprehensive literature review to determine grades of recommendation for commonly used agents in multimodal pain management and provide a best practice guideline. To evaluate common drugs used in multimodal treatment of pain, a search was performed on English language publications on Medline (PubMed; National Library of Medicine, Bethesda, MD, USA). Manuscripts were rated as Level I-V according to the North American Spine Society's (NASS) standardized levels of evidence tables. Grades of recommendation were assigned for each drug based on the NASS Clinical Guidelines for Multidisciplinary Spine Care. There is good (Grade A) evidence gabapentinoids, acetaminophen, neuraxial blockade and extended-release local anesthetics reduce postoperative pain and narcotic requirements. There is fair (Grade B) evidence that preemptive analgesia and nonsteroidal anti-inflammatory drugs (NSAID) result in reduced postoperative pain. There is insufficient and/or conflicting (Grade I) evidence that muscle relaxants and ketamine provide a significant reduction in postoperative pain or narcotic usage. There is fair (Grade B) evidence that short-term use of NSAID result in no long-term reduction in bone healing or fusion rates. Comprehensive assessment of the effectiveness of perioperative pain control can be accomplished through the use of validated measures. Multimodal pain management protocols have consistently been demonstrated to allow for improved pain control with less reliance on opioids. There is good quality evidence that supports many of the common agents utilized in multimodal therapy, however, there is a lack of evidence regarding optimal postoperative protocols or pathways. PMID:25766366

  14. The role of diffusion tensor imaging in establishing the proximity of tumor borders to functional brain systems: implications for preoperative risk assessments and postoperative outcomes.

    PubMed

    Ulmer, John L; Salvan, Carmen V; Mueller, Wade M; Krouwer, Hendrikus G; Stroe, Georgetta O; Aralasmak, Ayse; Prost, Robert W

    2004-12-01

    Diffusion Tensor Imaging (DTI) is a new MRI imaging technique sensitive to directional movements of water molecules, induced by tissue barriers. This provides a new form of contrast that allows the identification of functional white matter tracts within the brain, and has been proposed as a technique suitable for presurgical planning in brain tumor patients. Resection of primary brain tumors improves survival, functional performance, and the effectiveness of adjuvant therapies, provided that surgically-induced neurological deficits can be avoided. Diffusion Tensor Imaging (DTI) has the potential to establish spatial relationships between eloquent white matter and tumor borders, provide information essential to preoperative planning, and improve the accuracy of surgical risk assessments preoperatively. We present our experience in a series of 28 brain tumor patients where the integration of functional magnetic resonance imaging (fMRI) and DTI data was used to determine key anatomic spatial relationships preoperatively. Twice as many functional systems were localized to within 5 mm of tumor borders when DTI and fMRI were utilized for preoperative planning, compared to that afforded by fMRI alone. Our results show that the combined use of fMRI and DTI can provide a better estimation of the proximity of tumor borders to eloquent brain systems sub-serving language, speech, vision, motor and premotor functions. Additionally, a low regional complication rate (4%) observed in our series suggests that preoperative planning with these combined techniques may improve surgical outcomes compared to that previously reported in the literature. Larger studies specifically designed to establish the accuracy and predictive value of DTI in brain tumor patients are warranted to substantiate our preliminary observations.

  15. Outcome-based Carbon Sequestration Resource Assessment

    NASA Astrophysics Data System (ADS)

    Sundquist, E. T.; Jain, A. K.

    2015-12-01

    Opportunities for carbon sequestration are an important consideration in developing policies to manage the mass balance of atmospheric carbon dioxide (CO2). Assessments of potential carbon sequestration, like other resource assessments, should be widely accepted within the scientific community and broadly applicable to public needs over a range of spatial and temporal scales. The essential public concern regarding all forms of carbon sequestration is their effectiveness in offsetting CO2 emissions. But the diverse forms and mechanisms of potential sequestration are reflected in diverse assessment methodologies that are very difficult for decision-makers to compare and apply to comprehensive carbon management. For example, assessments of potential geologic sequestration are focused on total capacities derived from probabilistic analyses of rock strata, while assessments of potential biologic sequestration are focused on annual rates calculated using biogeochemical models. Non-specialists cannot readily compare and apply such dissimilar estimates of carbon storage. To address these problems, assessment methodologies should not only tabulate rates and capacities of carbon storage, but also enable comparison of the time-dependent effects of various sequestration activities on the mitigation of increasing atmospheric CO2. This outcome-based approach requires consideration of the sustainability of the assessed carbon storage, as well as the response of carbon-cycle feedbacks. Global models can be used to compare atmospheric CO2 trajectories implied by alternative global sequestration strategies, but such simulations may not be accessible or useful in many decision settings. Simplified assessment metrics, such as ratios using impulse response functions, show some promise in providing comparisons of CO2 mitigation that are broadly useful while minimizing sensitivity to differences in global models and emissions scenarios. Continued improvements will require close

  16. Assessing outcomes in body contouring.

    PubMed

    Klassen, Anne F; Cano, Stefan J; Scott, Amie; Tsangaris, Elena; Pusic, Andrea L

    2014-10-01

    Patient-reported outcome (PRO) instruments are questionnaires designed to measure outcomes of importance to patients from their perspective. This article describes the methods used to develop a new PRO instrument for obese patients and patients having bariatric and cosmetic body contouring surgery. The BODY-Q is composed of 19 newly designed scales that measure: (1) appearance; (2) health-related quality of life; and (3) process of care. Recommended guidelines for PRO instrument development were followed to ensure that the BODY-Q meets requirements of regulatory bodies. The BODY-Q is currently being field-tested in an international study.

  17. Predictors of Functional Outcome Following Stroke.

    PubMed

    Harvey, Richard L

    2015-11-01

    Predicting functional outcome in stroke is challenging to most clinicians, partly because of the complexity of the condition and also because of the lack of validated prognostic models. The strongest predictors of functional outcome are age and motor function at stroke onset. There is a growing literature on predicting recovery of upper limb after stroke; however, literature on prediction of language recovery remains sparse. This review covers the current status of predicting functional outcome after stroke focusing on recovery of activities of daily living, ambulation, upper limb use, and aphasia. Use of clinical factors, imaging, and neurophysiological measures are discussed.

  18. Outcomes Assessment in Dental Hygiene Programs.

    ERIC Educational Resources Information Center

    Grimes, Ellen B.

    1999-01-01

    A survey of 22 dental-hygiene-program directors found that programs routinely and effectively assess student outcomes and use the information for program improvements and to demonstrate accountability. Both policy and faculty/administrative support were deemed important to implementation. Time constraints were a major barrier. Outcomes-assessment…

  19. Authentic Assessment for Restorative Outcomes

    ERIC Educational Resources Information Center

    Doerr, Allison

    2008-01-01

    The Developmental Audit[R] is a comprehensive means of assessment and treatment planning that identifies the coping strategies underlying a youth's maladaptive and self-defeating behavior. This is a strength-based assessment that engages youth in conflict in the process of generating solutions rather than focusing on deficits. This process…

  20. Co-Curricular Outcomes Assessment and Accreditation

    ERIC Educational Resources Information Center

    Busby, Katie

    2015-01-01

    This chapter describes how assessment of co-curricular student learning outcomes can be used as part of the institutional accreditation process and the opportunities institutional researchers and student affairs educators have to collaborate in those efforts.

  1. Functional dysphonia: strategies to improve patient outcomes

    PubMed Central

    Behlau, Mara; Madazio, Glaucya; Oliveira, Gisele

    2015-01-01

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

  2. Assessment Faculty Guide: The Rationale and Process for Outcomes Assessment.

    ERIC Educational Resources Information Center

    Baker, Richard

    The Assessment Faculty Guide from St. Louis Community College provides guidance for faculty members about how to implement outcomes assessment. The handbook is divided into five areas: (1) assessment rationale, including history, definition, principles, and questions and answers; (2) the structure of assessment, providing a description,…

  3. Assessing Higher Education Learning Outcomes in Brazil

    ERIC Educational Resources Information Center

    Pedrosa, Renato H. L.; Amaral, Eliana; Knobel, Marcelo

    2013-01-01

    Brazil has developed an encompassing system for quality assessment of higher education, the National System of Higher Education Evaluation (SINAES), which includes a test for assessing learning outcomes at the undergraduate level, the National Exam of Student Performance (ENADE). The present system has been running since 2004, and also serves as…

  4. Assessing Outcomes in Optometric Education: A Commentary by the Council on Optometric Education.

    ERIC Educational Resources Information Center

    Optometric Education, 1998

    1998-01-01

    A statement of the Council for Optometric Education (COE) defines and characterizes educational outcomes, outcomes assessment, and outcomes data, and explains the reasons for outcomes assessment, its relationship to curricular design, and its function in accreditation of optometry programs. Stated COE standards and expectations of optometry…

  5. Assessing clinical ethics consultation: processes and outcomes.

    PubMed

    Batten, Jason

    2013-06-01

    The vast majority of hospitals use clinical ethics consultation (CEC) as a service to address ethical issues in patient care. Both proponents and critics alike recognize a need to evaluate CEC. I review three outcomes of CEC that have been formally evaluated: healthcare cost, clinical indicators in the intensive care unit, and user satisfaction. These outcome indicators cannot be used to evaluate the worth of CEC because they are contingent and outside of the consultant's control. However, the failure of outcomes-based assessment poses no threat to CEC since the service is continually justified by the fundamental necessity of resolving ethical problems in patient care. While outcome indicators can be used as heuristics to investigate quality issues in CEC, process indicators can capture the quality of CEC more directly. Therefore, further research should be directed toward developing process-based conceptual models for CEC and various methods for assessing these processes. PMID:23967789

  6. Functional Health Literacy and Smoking Cessation Outcomes

    ERIC Educational Resources Information Center

    Varekojis, Sarah M.; Miller, Larry; Schiller, M. Rosita; Stein, David

    2011-01-01

    Purpose: This paper aims to describe the relationship between functional health literacy level and smoking cessation outcomes. Design/methodology/approach: Participants in an inpatient smoking cessation program in a mid-western city in the USA were enrolled and the Short Test of Functional Health Literacy in Adults was administered while the…

  7. Effects of Language of Implementation on Functional Analysis Outcomes

    ERIC Educational Resources Information Center

    Rispoli, Mandy; O'Reilly, Mark; Lang, Russell; Sigafoos, Jeff; Mulloy, Austin; Aguilar, Jeannie; Singer, George

    2011-01-01

    This study evaluated the influence of language of implementation on functional analysis outcomes for a child with a severe intellectual disability from a Spanish-speaking home. Challenging behavior was assessed during 5-min sessions under 4 conditions; attention, play-verbal, play-nonverbal, and demand and across 2 phases; implementation in…

  8. Assessment of Outcomes of Free Expression Courses.

    ERIC Educational Resources Information Center

    Andsager, Julie; Ross, Susan Dente

    1999-01-01

    Assesses outcomes of instruction in three college-senior-level courses on freedom of expression. Suggests that increased attention to freedom-of-expression issues may have resulted in broader understanding of First Amendment issues, and individual and media rights. Notes that students seem to develop an appreciation of the reflexive nature of…

  9. Student Learning Outcomes Assessment Reports, 2004

    ERIC Educational Resources Information Center

    Filipp, Laura

    2004-01-01

    This report includes a Maryland statewide analysis, by competency, of student learning outcomes, assessment activities at community colleges, as well as public four-year colleges and universities. The workgroup decide that these reports would focus on each of the five competencies related to general education and essential skills that are…

  10. Outcomes Assessment in Veterinary Medical Education.

    ERIC Educational Resources Information Center

    Black, Leslie S.; Turnwald, Grant H.; Meldrum, James B.

    2002-01-01

    Describes the Virginia-Maryland Regional College of Veterinary Medicine's use of outcomes assessment (OA) as part of the accreditation review process for the American Veterinary Medical Association. Discusses its nine OA survey instruments and use of resulting data during accreditation. (EV)

  11. Prior Learning Assessment: Outcomes and Characteristics.

    ERIC Educational Resources Information Center

    White, Barbara

    1995-01-01

    Describes the Ontario college system's Prior Learning Assessment program for adult learners, focusing on outcomes and characteristics of students completing the process at Seneca College from April 1994 to February 1995. Indicates that of 77 participants, 46 were female, the mean age was 31, and 81% passed the process successfully. (BCY)

  12. Assessing Early Intervention Outcomes: Beyond Program Variables.

    ERIC Educational Resources Information Center

    Marfo, Kofi; Dinero, Thomas E.

    1991-01-01

    This paper argues that efficacy of early intervention must be assessed in relation to both program and extra-program variables. A framework outlining five classes of independent variables and two classes of outcomes to be considered in efficacy research is presented, and regression and path analytic techniques are suggested as tools for addressing…

  13. Using Outcomes Assessment to Change Classroom Instruction

    ERIC Educational Resources Information Center

    Cook, Michelle D.; Wiedenhoeft, Mary H.; Polito, Thomas A.; Gibson, Lance R.; Pogranichniy, Sherry; Mullen, Russ E.

    2006-01-01

    How can student outcomes assessment (SOA) be incorporated into ones courses and teaching? The purposes of this article are to explore a process enacted in the Department of Agronomy at Iowa State University using SOA to: (i) develop a clearer understanding of what students should learn in a course, (ii) determine how a course or courses fit within…

  14. Outcome Assessments in Children with Cerebral Palsy, Part II: Discriminatory Ability of Outcome Tools

    ERIC Educational Resources Information Center

    Bagley, Anita M; Gorton, George; Oeffinger, Donna; Barnes, Douglas; Calmes, Janine; Nicholson, Diane; Damiano, Diane; Abel, Mark; Kryscio, Richard; Rogers, Sarah; Tylkowski, Chester

    2007-01-01

    Discriminatory ability of several pediatric outcome tools was assessed relative to Gross Motor Function Classification System (GMFCS) level in patients with cerebral palsy. Five hundred and sixty-two patients (400 with diplegia, 162 with hemiplegia; 339 males, 223 females; age range 4-18y, mean 11y 1mo [SD 3y 7mo]), classified as GMFCS Levels I to…

  15. Early Decompression (< 8 h) after Traumatic Cervical Spinal Cord Injury Improves Functional Outcome as Assessed by Spinal Cord Independence Measure after One Year.

    PubMed

    Grassner, Lukas; Wutte, Christof; Klein, Barbara; Mach, Orpheus; Riesner, Silvie; Panzer, Stephanie; Vogel, Matthias; Bühren, Volker; Strowitzki, Martin; Vastmans, Jan; Maier, Doris

    2016-09-15

    There is an ongoing controversy about the optimal timing for surgical decompression after acute traumatic cervical spinal cord injury (SCI). For this reason, we performed a retrospective study of patients who were operated on after traumatic cervical SCI at the Trauma Center Murnau, Germany, and who met inclusion as well as exclusion criteria (n = 70 patients). Follow-up data were collected prospectively according to the European Multicenter Study about Spinal Cord Injury (EMSCI) protocol over a period of 1 year. Early decompression was defined as within the first 8 h after the insult (n = 35 patients). Primary outcome was the difference in the SCIM (Spinal Cord Independence Measure) 1 year after the trauma. After the follow-up period, patients who were decompressed earlier had a significantly higher SCIM difference (45.8 vs. 27.1, p < 0.005). A regression analysis showed that timing of decompression, age, as well as basal AIS (American Spinal Injury Association Impairment Scale) and basal SCIM scores were independent predictors for a better functional outcome (SCIM). Further, patients from the early decompression group had better AIS grades (p < 0.006) and a higher AIS conversion rate (p < 0.029). Additionally, this cohort also had a better total motor performance as well as upper extremity motor function after 1 year (p < 0.025 and p < 0.002). The motor and neurological levels of patients who were operated on within 8 h were significantly more caudal (p < 0.003 and p < 0.014) after 1 year. The present study suggests that early decompression after traumatic cervical SCI might have a positive impact on the functional and neurological outcome of affected individuals.

  16. Ideal functional outcomes for amputation levels.

    PubMed

    Meier, Robert H; Melton, Danielle

    2014-02-01

    This article provides a generalized overview of amputation classifications and the idealized outcomes for upper and lower amputations at their respective levels. The following levels are discussed: above knee/transfemoral, below knee/transtibial, above elbow/transhumeral, below elbow/transradial, and bilateral for upper and lower extremities. This classification defines a framework for clinicians to share with patients so that they understand the potential for their expected functional outcomes regarding mobility and activities of daily living, both with and without a prosthesis. Moreover, it addresses some of the vocational and avocational needs of the individual regarding amputation.

  17. Patellar resurfacing in total knee arthroplasty: functional outcome differs with different outcome scores

    PubMed Central

    Aunan, Eirik; Næss, Grethe; Clarke-Jenssen, John; Sandvik, Leiv; Kibsgård, Thomas Johan

    2016-01-01

    Background and purpose — Recent research on outcomes after total knee arthroplasty (TKA) has raised the question of the ability of traditional outcome measures to distinguish between treatments. We compared functional outcomes in patients undergoing TKA with and without patellar resurfacing, using the knee injury and osteoarthritis outcome score (KOOS) as the primary outcome and 3 traditional outcome measures as secondary outcomes. Patients and methods — 129 knees in 115 patients (mean age 70 (42–82) years; 67 female) were evaluated in this single-center, randomized, double-blind study. Data were recorded preoperatively, at 1 year, and at 3 years, and were assessed using repeated-measures mixed models. Results — The mean subscores for the KOOS after surgery were statistically significantly in favor of patellar resurfacing: sport/recreation, knee-related quality of life, pain, and symptoms. No statistically significant differences between the groups were observed with the Knee Society clinical rating system, with the Oxford knee score, and with visual analog scale (VAS) for patient satisfaction. Interpretation — In the present study, the KOOS—but no other outcome measure used—indicated that patellar resurfacing may be beneficial in TKA. PMID:26540368

  18. Science Outcomes Assessment Plan (SOAP): Design phase

    NASA Astrophysics Data System (ADS)

    Webster, Zodiac T.; Gurkas, P.; Shaw, K.

    2009-01-01

    Columbus State University is under pressure to reduce the number of "unproductive grades” in its introductory science classes, to increase the number of STEM majors, and to assess the level of attainment of science outcomes in its general education courses for accreditation documentation. The authors designed a study to examine affective, cognitive, social, and classroom factors as predictors of success in science while also attempting to document the link between introductory "gateway to science major” course outcomes and the general education program. One of the factors probed is the match between students’ understanding of important learning outcomes of the course and the instructor's stated priorities. A very real risk in content focused courses (e.g., astronomy) is the mismatch between the university's stated outcomes for a general education science course (e.g., critical thinking) and the instructor's content related outcomes. This mismatch may become a barrier for students taking `required’ courses as they may not comprehend the rationale for the requirement, fail to engage in the course, and consequently receive a failing grade. Another possible factor affecting student success in science is the student reasoning level. Students who are concrete thinkers may not be as successful in introductory science classes that require advanced logical thinking about unfamiliar concepts. The authors hope to use the results of this study to help inform university practices such as placement into introductory science courses and for future faculty development.

  19. Fiber-optic endoscopic evaluation of swallowing to assess swallowing outcomes as a function of head position in a normal population

    PubMed Central

    2014-01-01

    Background Head position practice has been shown to influence pill-swallowing ability, but the impact of head position on measures of swallowing outcomes has not yet been studied with fiber-optic endoscopic evaluation of swallowing (FEES). The primary purpose of this study was to determine whether head position impacts penetration-aspiration scale scores and/or post-swallow pharyngeal residue as assessed by FEES. Documenting the incidence of pharyngeal residue and laryngeal penetration and aspiration in a normal population was a secondary goal. Methods Adults without swallowing difficulties (N = 84) were taught a pill swallowing technique based on learning five head positions and were asked to practice with small, hard candies (e.g., TicTacs) for two weeks. Then they demonstrated swallowing in each of the head positions for two conditions, liquid and purée, while undergoing FEES. Results Out of 840 examined swallows, one event of aspiration and 5 events of penetration occurred. During practice >50% participants found positions they preferred over the center position for swallowing but head position was not associated with penetration-aspiration scores assessed by FEES. Significant associations and non-significant trends were found between pharyngeal residue and three variables: age, most preferred head position, and least preferred head position. Conclusion Head position during swallowing (head up) and age greater than 40 years may result in increased pharyngeal residue but not laryngeal penetration or aspiration. PMID:24755159

  20. MULTIPLE-RESPONDENT ANECDOTAL ASSESSMENTS: AN ANALYSIS OF INTERRATER AGREEMENT AND CORRESPONDENCE WITH ANALOGUE ASSESSMENT OUTCOMES

    PubMed Central

    Smith, Carla M.; Smith, Richard G.; Dracobly, Joseph D.; Pace, Amy Peterson

    2012-01-01

    We evaluated interrater agreement across multiple respondents on anecdotal assessments and compared cases in which agreement was obtained with outcomes of functional analyses. Experiment 1 evaluated agreement among multiple respondents on the function of problem behavior for 27 individuals across 42 target behaviors using the Motivation Assessment Scale (MAS) and the Questions about Behavioral Function (QABF). Results showed that at least 4 of 5 respondents agreed on the primary maintaining consequence for 52% (22 of 42) of target behaviors with the MAS and 57% (24 of 42) with the QABF. Experiment 2 examined correspondence between the anecdotal assessment results and functional analysis results for 7 individuals for whom at least 4 of 5 respondents showed agreement in Experiment 1. Correspondence with functional analysis results was observed in 6 of 7 cases with the QABF and in 4 of 7 cases with the MAS. Implications of these outcomes for the utility of anecdotal assessments are discussed. PMID:23322932

  1. Technology and Outcomes Assessment in Lung Transplantation

    PubMed Central

    Yusen, Roger D.

    2009-01-01

    Lung transplantation offers the hope of prolonged survival and significant improvement in quality of life to patients that have advanced lung diseases. However, the medical literature lacks strong positive evidence and shows conflicting information regarding survival and quality of life outcomes related to lung transplantation. Decisions about the use of lung transplantation require an assessment of trade-offs: do the potential health and quality of life benefits outweigh the potential risks and harms? No amount of theoretical reasoning can resolve this question; empiric data are needed. Rational analyses of these trade-offs require valid measurements of the benefits and harms to the patients in all relevant domains that affect survival and quality of life. Lung transplant systems and registries mainly focus outcomes assessment on patient survival on the waiting list and after transplantation. Improved analytic approaches allow comparisons of the survival effects of lung transplantation versus continued waiting. Lung transplant entities do not routinely collect quality of life data. However, the medical community and the public want to know how lung transplantation affects quality of life. Given the huge stakes for the patients, the providers, and the healthcare systems, key stakeholders need to further support quality of life assessment in patients with advanced lung disease that enter into the lung transplant systems. Studies of lung transplantation and its related technologies should assess patients with tools that integrate both survival and quality of life information. Higher quality information obtained will lead to improved knowledge and more informed decision making. PMID:19131538

  2. Outcomes Assessment Handbook: How To Develop a Practical Outcomes Assessment Program for a Home Study School.

    ERIC Educational Resources Information Center

    Godfrey, Robert J.

    This handbook is designed to provide school decision makers with a global view of how assessment programs for home study schools are developed. Outcomes assessment (OA) is a required element for recognition by the National Home Study Council Accrediting Committee and hence for member schools. This handbook is designed to enable program developers…

  3. Carpal arthrodesis in cats. Long-term functional outcome.

    PubMed

    Calvo, I; Farrell, M; Chase, D; Aisa, J; Rayward, R; Carmichael, S

    2009-01-01

    Pancarpal and partial carpal arthrodesis were performed in 22 carpi (20 cats) using various surgical methods. Short and long-term outcomes were assessed using a retrospective review of the case notes and via owner questionnaires. Carpal arthrodesis was associated with complications that did not affect the functional outcome, and in most cases, did not necessitate major revision surgery. Following arthrodesis, the cats did not jump as high, and showed a reduction in their willingness to jump and climb. Based on our results, carpal arthrodesis is a suitable salvage surgery to treat severe carpal injuries in the cat. PMID:19876518

  4. Multiple-Respondent Anecdotal Assessments: An Analysis of Interrater Agreement and Correspondence with Analogue Assessment Outcomes

    ERIC Educational Resources Information Center

    Smith, Carla M.; Smith, Richard G.; Dracobly, Joseph D.; Pace, Amy Peterson

    2012-01-01

    We evaluated interrater agreement across multiple respondents on anecdotal assessments and compared cases in which agreement was obtained with outcomes of functional analyses. Experiment 1 evaluated agreement among multiple respondents on the function of problem behavior for 27 individuals across 42 target behaviors using the Motivation Assessment…

  5. Assessment Program Results 1996-1997. Focus on Assessing Outcomes.

    ERIC Educational Resources Information Center

    Deeter, Thomas; Prine, Don

    The Des Moines (Iowa) Public Schools continually evaluate the process of teaching for learning in order to provide quality programming for its diverse student body. Different methods of student outcome assessment are used to identify areas for study and analysis. This report provides information about the achievement of district students on: (1)…

  6. Clinical Outcome Assessments: Conceptual Foundation-Report of the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force.

    PubMed

    Walton, Marc K; Powers, John H; Hobart, Jeremy; Patrick, Donald; Marquis, Patrick; Vamvakas, Spiros; Isaac, Maria; Molsen, Elizabeth; Cano, Stefan; Burke, Laurie B

    2015-09-01

    An outcome assessment, the patient assessment used in an endpoint, is the measuring instrument that provides a rating or score (categorical or continuous) that is intended to represent some aspect of the patient's health status. Outcome assessments are used to define efficacy endpoints when developing a therapy for a disease or condition. Most efficacy endpoints are based on specified clinical assessments of patients. When clinical assessments are used as clinical trial outcomes, they are called clinical outcome assessments (COAs). COAs include any assessment that may be influenced by human choices, judgment, or motivation. COAs must be well-defined and possess adequate measurement properties to demonstrate (directly or indirectly) the benefits of a treatment. In contrast, a biomarker assessment is one that is subject to little, if any, patient motivational or rater judgmental influence. This is the first of two reports by the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force. This report provides foundational definitions important for an understanding of COA measurement principles. The foundation provided in this report includes what it means to demonstrate a beneficial effect, how assessments of patients relate to the objective of showing a treatment's benefit, and how these assessments are used in clinical trial endpoints. In addition, this report describes intrinsic attributes of patient assessments and clinical trial factors that can affect the properties of the measurements. These factors should be considered when developing or refining assessments. These considerations will aid investigators designing trials in their choice of using an existing assessment or developing a new outcome assessment. Although the focus of this report is on the development of a new COA to define endpoints in a clinical trial, these principles may be applied more generally. A critical element in appraising or developing a COA is to

  7. Clinical Outcome Assessments: Conceptual Foundation-Report of the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force.

    PubMed

    Walton, Marc K; Powers, John H; Hobart, Jeremy; Patrick, Donald; Marquis, Patrick; Vamvakas, Spiros; Isaac, Maria; Molsen, Elizabeth; Cano, Stefan; Burke, Laurie B

    2015-09-01

    An outcome assessment, the patient assessment used in an endpoint, is the measuring instrument that provides a rating or score (categorical or continuous) that is intended to represent some aspect of the patient's health status. Outcome assessments are used to define efficacy endpoints when developing a therapy for a disease or condition. Most efficacy endpoints are based on specified clinical assessments of patients. When clinical assessments are used as clinical trial outcomes, they are called clinical outcome assessments (COAs). COAs include any assessment that may be influenced by human choices, judgment, or motivation. COAs must be well-defined and possess adequate measurement properties to demonstrate (directly or indirectly) the benefits of a treatment. In contrast, a biomarker assessment is one that is subject to little, if any, patient motivational or rater judgmental influence. This is the first of two reports by the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force. This report provides foundational definitions important for an understanding of COA measurement principles. The foundation provided in this report includes what it means to demonstrate a beneficial effect, how assessments of patients relate to the objective of showing a treatment's benefit, and how these assessments are used in clinical trial endpoints. In addition, this report describes intrinsic attributes of patient assessments and clinical trial factors that can affect the properties of the measurements. These factors should be considered when developing or refining assessments. These considerations will aid investigators designing trials in their choice of using an existing assessment or developing a new outcome assessment. Although the focus of this report is on the development of a new COA to define endpoints in a clinical trial, these principles may be applied more generally. A critical element in appraising or developing a COA is to

  8. Meta-Assessment: Assessing the Learning Outcomes Assessment Program

    ERIC Educational Resources Information Center

    Schoepp, Kevin; Benson, Scott

    2016-01-01

    Assessing the effectiveness of an assessment program is essential and can be accomplished through analysing the quality of closing the loop actions and through gathering faculty feedback. In this article we present closing the loop data from over 3 years of learning assessment reporting and from findings garnered through a faculty survey. Results…

  9. [Functional Outcome after Chest Wall Stabilisation].

    PubMed

    Kyriss, T; Lenz, U; Friedel, G

    2016-09-01

    This overview reviews the current literature to compare the functional results after surgical and conservative treatment of patients with flail chest and multiple rib fractures. Regarding functional aspects, patients in the early phase after a thoracic trauma are those that benefit most from the stabilisation of the chest wall by internal fixation of the ribs. Patients recover faster from restrictive respiratory disorders, have less pain and return to the workplace earlier after an operation compared with those that receive conservative treatment. In the medium term, however, patients that are treated conservatively also achieve normal pulmonary function values and become free of pain. The period of convalescence after blunt thoracic trauma is generally underestimated. Future studies of the functional outcome after severe chest injuries should take this into account and the development of functional parameters should be monitored for at least 24 months. A prospective data collection of early and long-term surgical results in registries would be suitable to evaluate benefits and indications of chest wall stabilisation. PMID:27607891

  10. Discrepancies in how the impact of gout is assessed in outcomes research compared to how health professionals view the impact of gout, using the lens of the International Classification of Functioning, Health and Disability (ICF).

    PubMed

    Kool, Eveline M; Nijsten, Marieke J; van Ede, Annelies E; Jansen, Tim L; Taylor, William J

    2016-09-01

    The International Classification of Functioning, Disability and Health (ICF) provides a common language to understand what health means. An ICF core set, a list of ICF categories affected by a certain disease, is useful to objectify the content validity of a health status measurement. This study aims to identify the potential items of a gout specific 'ICF core set'. A three-round Delphi exercise was conducted, using web-based questionnaires. Health professionals, specialized in gout, nominated and subsequently rated the relevance of life areas divided into ICF categories. Agreement was determined by using the UCLA/RAND criteria. Simultaneously, a systematic review of gout measure outcomes was conducted. The results of these studies were compared using the second level of the ICF categories. In the Delphi study, consensus was found for 136 relevant ICF categories. The literature study extracted 134 different ICF categories in 149 articles. Three hundred and ten were non-defined outcomes. A large number of ICF categories were deemed to be relevant for people with gout. Only 29.7 % (19/64) of the level 2 categories, deemed to be relevant by health professionals, had been assessed as relevant in at least 5 % of gout outcome studies. Conversely, 70 % (19/27) of level 2 ICF categories assessed in at least 5 % of outcome studies were deemed relevant by health professionals. These ICF codes, which are found relevant in both studies, should be considered as mandatory in further research to a validated and practical core set of ICF categories. Published gout outcomes research fails to evaluate many life areas that are thought relevant by health professionals.

  11. Discrepancies in how the impact of gout is assessed in outcomes research compared to how health professionals view the impact of gout, using the lens of the International Classification of Functioning, Health and Disability (ICF).

    PubMed

    Kool, Eveline M; Nijsten, Marieke J; van Ede, Annelies E; Jansen, Tim L; Taylor, William J

    2016-09-01

    The International Classification of Functioning, Disability and Health (ICF) provides a common language to understand what health means. An ICF core set, a list of ICF categories affected by a certain disease, is useful to objectify the content validity of a health status measurement. This study aims to identify the potential items of a gout specific 'ICF core set'. A three-round Delphi exercise was conducted, using web-based questionnaires. Health professionals, specialized in gout, nominated and subsequently rated the relevance of life areas divided into ICF categories. Agreement was determined by using the UCLA/RAND criteria. Simultaneously, a systematic review of gout measure outcomes was conducted. The results of these studies were compared using the second level of the ICF categories. In the Delphi study, consensus was found for 136 relevant ICF categories. The literature study extracted 134 different ICF categories in 149 articles. Three hundred and ten were non-defined outcomes. A large number of ICF categories were deemed to be relevant for people with gout. Only 29.7 % (19/64) of the level 2 categories, deemed to be relevant by health professionals, had been assessed as relevant in at least 5 % of gout outcome studies. Conversely, 70 % (19/27) of level 2 ICF categories assessed in at least 5 % of outcome studies were deemed relevant by health professionals. These ICF codes, which are found relevant in both studies, should be considered as mandatory in further research to a validated and practical core set of ICF categories. Published gout outcomes research fails to evaluate many life areas that are thought relevant by health professionals. PMID:27300705

  12. Predictors of Functional Outcome Among Stroke Patients in Lima, Peru

    PubMed Central

    Abanto, Carlos; Ton, Thanh G.N.; Tirschwell, David L.; Montano, Silvia; Quispe, Yrma; Gonzales, Isidro; Valencia, Ana; Calle, Pilar; Garate, Arturo; Zunt, Joseph

    2013-01-01

    Background Due to the aging population in low- and middle-income countries, cerebrovascular disease is expected to remain a leading cause of death. Little has been published about stroke in Peru. Aims We conducted a retrospective cohort study of hospitalized stroke patients at a referral center hospital in Lima, Peru to explore factors associated with functional outcome among stroke patients. Methods We identified 579 patients hospitalized for ischemic stroke or intracerebral hemorrhage stroke at the National Institute of Neurologic Sciences in Lima, Peru in 2008 and 2009. A favorable outcome was defined as a modified Rankin score of ≤2 at discharge. Results The mean age was 63.3 years; 75.6% had ischemic stroke; the average length of stay was 17.3 days. At hospital discharge, 231 (39.9%) had a favorable outcome. The overall mortality rate was 5.2%. In multivariate models, the likelihood of having a favorable outcome decreased linearly with increasing age (p=0.02) and increasing NIHSS (p=0.02). Favorable outcome was also associated with male gender (relative risk [RR]=1.2; 95% confidence interval [CI]: 1.0, 1.5) and divorced status (RR=1.3, 95% CI: 1.1, 1.7). Patients on Salud Integral de Salud (public assistance-type insurance, SIS) (RR=0.7, 95% CI: 0.5,1.0) were also less likely to have a favorable outcome. Conclusions Favorable outcome after stroke was independently associated with younger age, lower NIHSS score, male gender, being divorced, and not being on SIS insurance. These findings suggest further study of worse functional outcomes in patients with SIS insurance and confirm the importance of risk adjustment for age, stroke severity (NIHSS) and other socioeconomic factors in outcomes studies. Future studies should preferentially assess outcome at 30-days and 6-months to provide more reliable comparisons and allow additional study of Peruvian end-of-life decision-making and care. PMID:23352681

  13. Assessment of tinnitus: measurement of treatment outcomes.

    PubMed

    Meikle, M B; Stewart, B J; Griest, S E; Martin, W H; Henry, J A; Abrams, H B; McArdle, R; Newman, C W; Sandridge, S A

    2007-01-01

    There is a wide range of assessment techniques for tinnitus, but no consensus has developed concerning how best to measure either the presenting features of tinnitus or the effects of tinnitus treatments. Standardization of reliable and valid tinnitus measures would provide many advantages including improving the uniformity of diagnostic and screening criteria between clinics and facilitating comparison of treatment outcomes obtained at different sites. This chapter attempts to clarify issues involved in developing self-report questionnaires for the assessment of tinnitus. While the tinnitus questionnaires that are currently available provide valuable information on which to base diagnostic and screening decisions, they were not originally developed in such a way as to maximize their sensitivity to treatment-related changes in tinnitus. As a result, their construct validity for measuring treatment benefit has not received appropriate attention. In this paper, special emphasis is devoted to the use of effect sizes as an estimate of the ability of questionnaires (and their individual items) to measure changes associated with treatment. We discuss the criteria relevant to evaluating the effectiveness of a questionnaire for diagnostic purposes vs. for treatment-evaluation purposes, and we present a detailed illustration of how the various criteria have been applied in a recent questionnaire development effort. PMID:17956815

  14. Assessing and predicting successful tube placement outcomes in ALS patients.

    PubMed

    Beggs, Kathleen; Choi, Marcia; Travlos, Andrew

    2010-01-01

    This study reviews feeding tube placement outcomes in 69 ALS outpatients seen at an outpatient interdisciplinary ALS clinic in British Columbia, Canada. The objective was to determine at which point the risks outweigh the benefits of tube placement by reviewing outcomes against parameters of respiratory function, nutritional status and speech and swallowing deterioration. The study was a retrospective review of tube placements between January 2000 and 2005, analysing data on respiratory function (forced vital capacity and respiratory status), weight change from usual body weight (UBW) and speech/swallowing deterioration using ALS Severity Score ratings (Hillel et al., 1989) at time of tube placement. Results show a statistically significant association between nutritional status and successful tube placement outcomes (p=0.003), and none between respiratory status, speech/swallowing variables, or number of deteriorated variables in each patient. Study findings were impacted by lack of available respiratory data. The only study variable that predicted successful tube placement outcome was a body weight greater than or equal to 74% UBW at time of tube placement. In the absence of access to respiratory testing, the relatively simple assessment of weight may assist patients and caregivers in appropriate decisions around tube placement.

  15. A Perspective on Student Learning Outcome Assessment at Qatar University

    ERIC Educational Resources Information Center

    Al-Thani, Shaikha Jabor; Abdelmoneim, Ali; Daoud, Khaled; Cherif, Adel; Moukarzel, Dalal

    2014-01-01

    This paper provides a unique perspective on the student learning outcome assessment process as adopted and implemented at Qatar University from 2006 to 2012. The progress of the student learning outcome assessment and continuous improvement efforts at the university and the initiatives taken to establish a culture of assessment and evidence-based…

  16. Implementing Assessment in an Outcome-Based Marketing Curriculum

    ERIC Educational Resources Information Center

    Borin, Norm; Metcalf, Lynn E.; Tietje, Brian C.

    2008-01-01

    This article describes the development and implementation of assessment in a new outcome-based marketing curriculum that was developed using a zero-based approach. Outcomes for the marketing curriculum were specified at the program, department, course, and lesson levels. Direct embedded assessments as well as indirect assessment methods were used…

  17. Cognitive Mediators of Treatment Outcomes in Pediatric Functional Abdominal Pain

    PubMed Central

    Levy, Rona L.; Langer, Shelby L.; Romano, Joan M.; Labus, Jennifer; Walker, Lynn S.; Murphy, Tasha B.; Van Tilburg, Miranda; Feld, Lauren D.; Christie, Dennis L.; Whitehead, William E.

    2014-01-01

    Objectives Cognitive-behavioral interventions improve outcomes for many pediatric health conditions, but little is known about which mechanisms mediate these outcomes. The goal of this study was to identify whether changes in targeted process variables from baseline to one week post-treatment mediate improvement in outcomes in a randomized controlled trial of a brief cognitive-behavioral intervention for idiopathic childhood abdominal pain. Methods Two-hundred children with persistent functional abdominal pain and their parents were randomly assigned to one of two conditions: a 3-session social learning and cognitive-behavioral treatment (SLCBT) (N=100), or a 3-session educational intervention controlling for time and attention (N=100). Outcomes were assessed at 3, 6 and 12 month follow-ups. The intervention focused on altering parental responses to pain and on increasing adaptive cognitions and coping strategies related to pain in both parents and children. Results Multiple mediation analyses were applied to examine the extent to which the effects of the SLCBT condition on child GI symptom severity and pain as reported by children and their parents were mediated by changes in targeted cognitive process variables and parents’ solicitous responses to their child’s pain symptoms. Reductions in parents’ perceived threat regarding their child’s pain mediated reductions in both parent- and child-reported GI symptom severity and pain. Reductions in children’s catastrophic cognitions mediated reductions in child-reported GI symptom severity but no other outcomes. Reductions in parental solicitousness did not mediate outcomes. Discussion Results suggest that reductions in reports of children’s pain and GI symptoms following a social learning and cognitive-behavioral intervention were mediated at least in part by decreasing maladaptive parent and child cognitions. PMID:24469611

  18. Oncological and functional outcome of periosteal osteosarcoma

    PubMed Central

    Gulia, Ashish; Puri, Ajay; Pruthi, Manish; Desai, Saral

    2014-01-01

    Background: Periosteal osteosarcoma is an uncommon variant of osteosarcoma which constitutes less than 2% of all osteosarcomas. Whereas adequate surgical excision remains the cornerstone of treatment, the role of chemotherapy in this tumor is still unclear. Existing literature contains very few single center studies on the outcomes for periosteal osteosarcomas and any additional information will help in better understanding of these uncommon lesions. This study aims to evaluate the oncologic and functional outcomes of treatment of periosteal osteosarcoma treated at our institute. Materials and Methods: A retrospective analysis of 18 cases of periosteal osteosarcoma treated between January 2001 and December 2010 was carried out. There were 12 males and 6 females. The mean age at presentation was 16.3 years (range 5-26 years). Tibia and femur were the most common sites (n = 8). 16 of 18 patients received chemotherapy, 16 had limb sparing resection, one had an amputation and one had rotationplasty. Of the 16 patients with limb salvage, conventional wide excision was done in 11 cases. In 5 cases tumor was excised with hemicortical excision. Of the 11 cases treated with wide excisions, 4 patients underwent an osteoarticular resection and in 7 patients a joint preserving segmental intercalary resection was done. Results: All patients were available for followup. Surgical margins were free in all patients. A good response to chemotherapy was seen in 4/11 cases and poor in 6/11 cases. In one case the histological response was not discernible due to predominant chondromyxoid nature of the tumor. The median followup was 61 months (range: 18-130 months). There were two local recurrences (11%) at 9 and 18 months postsurgery. Pulmonary metastasis subsequently occurred in 4 cases (22%). Fourteen patients are currently alive and continuously disease free. Disease free survival at 5 years was 77.8% and overall survival (OVS) was 83.3%. Patients without marrow involvement had a

  19. Does obesity predict functional outcome in the dysvascular amputee?

    PubMed

    Kalbaugh, Corey A; Taylor, Spence M; Kalbaugh, Brooke A; Halliday, Matthew; Daniel, Grace; Cass, Anna L; Blackhurst, Dawn W; Cull, David L; Langan, Eugene M; Carsten, Christopher G; York, John W; Snyder, Bruce A; Youkey, Jerry R

    2006-08-01

    Limited information is available concerning the effects of obesity on the functional outcomes of patients requiring major lower limb amputation because of peripheral arterial disease (PAD). The purpose of this study was to examine the predictive ability of body mass index (BMI) to determine functional outcome in the dysvascular amputee. To do this, 434 consecutive patients (mean age, 65.8 +/- 13.3, 59% male, 71.4% diabetic) undergoing major limb amputation (225 below-knee amputation, 27 through-knee amputation, 132 above-knee amputation, and 50 bilateral) as a complication of PAD from January 1998 through May 2004 were analyzed according to preoperative BMI. BMI was classified according to the four-group Center for Disease Control system: underweight, 0 to 18.4 kg/m2; normal, 18.5 to 24.9 kg/m2; overweight, 25 to 29.9 kg/m2; and obese, > or = 30 kg/m2. Outcome parameters measured included prosthetic usage, maintenance of ambulation, survival, and maintenance of independent living status. The chi2 test for association was used to examine prosthesis wear. Kaplan-Meier curves were constructed to assess maintenance of ambulation, survival, and maintenance of independent living status. Multivariate analysis using the multiple logistic regression model and a Cox proportional hazards model were used to predict variables independently associated with prosthetic use and ambulation, survival, and independence, respectively. Overall prosthetic usage and 36-month ambulation, survival, and independent living status for the entire cohort was 48.6 per cent, 42.8 per cent, 48.1 per cent, 72.3 per cent, and for patients with normal BMI was 41.5 per cent, 37.4 per cent, 45.6 per cent, and 69.5 per cent, respectively. There was no statistically significant difference in outcomes for overweight patients (59.2%, 50.7%, 52.5%, and 75%) or obese patients (51.8%, 46.2%, 49.7%, and 75%) when compared with normal patients. Although there were significantly poorer outcomes for underweight

  20. Air ions and respiratory function outcomes: a comprehensive review

    PubMed Central

    2013-01-01

    Background From a mechanistic or physical perspective there is no basis to suspect that electric charges on clusters of air molecules (air ions) would have beneficial or deleterious effects on respiratory function. Yet, there is a large lay and scientific literature spanning 80 years that asserts exposure to air ions affects the respiratory system and has other biological effects. Aims This review evaluates the scientific evidence in published human experimental studies regarding the effects of exposure to air ions on respiratory performance and symptoms. Methods We identified 23 studies (published 1933–1993) that met our inclusion criteria. Relevant data pertaining to study population characteristics, study design, experimental methods, statistical techniques, and study results were assessed. Where relevant, random effects meta-analysis models were utilized to quantify similar exposure and outcome groupings. Results The included studies examined the therapeutic benefits of exposure to negative air ions on respiratory outcomes, such as ventilatory function and asthmatic symptoms. Study specific sample sizes ranged between 7 and 23, and studies varied considerably by subject characteristics (e.g., infants with asthma, adults with emphysema), experimental method, outcomes measured (e.g., subjective symptoms, sensitivity, clinical pulmonary function), analytical design, and statistical reporting. Conclusions Despite numerous experimental and analytical differences across studies, the literature does not clearly support a beneficial role in exposure to negative air ions and respiratory function or asthmatic symptom alleviation. Further, collectively, the human experimental studies do not indicate a significant detrimental effect of exposure to positive air ions on respiratory measures. Exposure to negative or positive air ions does not appear to play an appreciable role in respiratory function. PMID:24016271

  1. New trends in assessing the outcomes of mental health interventions

    PubMed Central

    Thornicroft, Graham; Slade, Mike

    2014-01-01

    Assessing the outcomes of interventions in mental health care is both important and challenging. The aim of this paper is to advance the field of outcomes research by proposing a taxonomy of the decisions that clinicians and researchers need to consider when evaluating outcomes. Our taxonomy has eight components, framed as decisions: Whose outcome will be considered? Which scientific stage is being investigated? What outcome domain(s) matter? What level of assessment will be used? Will clinical and/or recovery outcomes be assessed? Whose perspective will be considered? Will deficits and/or strengths be the focus? Will invariant or individualized measures be preferred? We propose a future focus on understanding what matters most to people using mental health services, and on the use of measures rated by service users as the primary approach to evaluating outcome. PMID:24890055

  2. Outcome Assessment in Aphasia: A Survey

    ERIC Educational Resources Information Center

    Simmons-Mackie, Nina; Threats, Travis T.; Kagan, Aura

    2005-01-01

    There has been a marked increase in attention to the measurement of ''outcomes'' after speech-language intervention for adult aphasia. Consumers, speech-language pathologists (SLPs), and funding sources desire evidence of therapy outcomes that improve communication and enhance the quality of life for people with aphasia. While many assessment…

  3. Outcomes of Math Faculty Engagement in Student Learning Outcomes Assessment in the Two-Year Colleges

    ERIC Educational Resources Information Center

    Bruley, Marie N.

    2013-01-01

    This study utilizes a mixed methods exploratory design to examine the nature of math faculty engagement in the student learning outcomes assessment cycle. The focus of the study is on the types of changes that math faculty are implementing as a result of assessment outcomes and the institutional environmental factors that impact faculty engagement…

  4. Functional assessment of nutrition status.

    PubMed

    Russell, Mary Krystofiak

    2015-04-01

    Functional status assessment has been recommended as a part of a complete nutrition assessment for decades, but the specific components of this assessment have eluded a consensus definition. The recent Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition consensus criteria for identification of malnutrition include functional assessment determined by handgrip dynamometry, with the understanding that this technique is not practical for use in some patient populations. Other techniques for functional assessment include physical performance measures such as timed gait and chair stands, as well as activities of daily living tools such as the Katz Index, Lawton Scale, and Karnofsky Scale Index. Manual muscle testing and computed tomography scan assessment of lean tissue are other tools that show promise in correlating functional and nutrition assessments. Functional assessment parameters may be least well correlated with nutrition status in older individuals. Despite a number of scientific studies of a variety of tools for functional assessment, there is to date no definitive tool for use in all individuals in all settings. Nutrition scientists and clinicians must continue to collaborate with colleagues in physical and occupational therapy, geriatrics, and nursing to refine current functional assessment tools to more effectively correlate with nutrition and malnutrition assessment parameters.

  5. Outcomes Assessment Planning: An Overview with Applications in Health Sciences.

    ERIC Educational Resources Information Center

    Trent, Ava M.

    2002-01-01

    Provides a brief overview of the process of outcomes assessment and examples of its application in professional health science education. Provides a background for other articles in this issue describing ongoing activities in outcomes assessment in veterinary education and for programs considering developing a plan. Focuses on health professions…

  6. Outcomes Assessment in Accredited Health Information Management Programs

    ERIC Educational Resources Information Center

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  7. An Application of Outcomes Assessment in Dental Education.

    ERIC Educational Resources Information Center

    Feldman, Cecile A.; Desjardins, Paul J.

    1995-01-01

    The outcomes assessment process developed by the New Jersey Dental School is described and discussed, including required resources, selected outcome measures, strengths and weaknesses, and the evolution of ongoing assessment activities. Documentation produced as part of the process is also described so that other health professions schools may…

  8. General Business Competencies of Students as Outcomes Assessment

    ERIC Educational Resources Information Center

    Ready, Kathryn J.; Novicevic, Milorad M.; Elfessi, Abdulaziz; Kuffel, Thomas

    2007-01-01

    The purpose of this paper is to develop an analytical framework to assess students' general business competencies, acquired in core and capstone courses, as learning outcomes. First, the rationale for the use of students' general business competencies as outcomes assessment is provided. Second, the methodology for measuring these competencies is…

  9. Faculty Governance and Outcomes Assessment: Compatible or Combustible?

    ERIC Educational Resources Information Center

    DeBoy, James L.; Monsilovich, Sally B.; DeBoy, Joanne R.

    2013-01-01

    This paper identifies the various factors driving the outcomes assessment movement, contrasts the old paradigm with the model now espoused by regional accreditors, discusses the six-step process of student outcomes assessment, emphasizes faculty ownership of the process to prevent administrative usurpation, and proposes specific strategies to…

  10. Functional Impairment and Occupational Outcome in Adults with ADHD

    ERIC Educational Resources Information Center

    Gjervan, Bjorn; Torgersen, Terje; Nordahl, Hans M.; Rasmussen, Kirsten

    2012-01-01

    Objective: ADHD is associated with poor functional outcomes. The objectives were to investigate the prevalence of functional impairment and occupational status in a clinically referred sample of adults with ADHD and explore factors predicting occupational outcome. Method: A sample of 149 adults with a confirmed diagnosis of ADHD participated in…

  11. Physical Education Performance Outcomes and Cognitive Function

    ERIC Educational Resources Information Center

    Castelli, Darla M.; Hillman, Charles H.

    2007-01-01

    This article intends to inform physical education teachers about the current research describing the relationship between physical education performance outcomes as identified by the national physical education standards (i.e., regular participation in physical activity, physical fitness, motor competence; National Association of Physical…

  12. Fundamentals of Clinical Outcomes Assessment for Spinal Disorders: Clinical Outcome Instruments and Applications

    PubMed Central

    Vavken, Patrick; Ganal-Antonio, Anne Kathleen B.; Quidde, Julia; Shen, Francis H.; Chapman, Jens R.; Samartzis, Dino

    2015-01-01

    Study Design A broad narrative review. Objectives Outcome assessment in spinal disorders is imperative to help monitor the safety and efficacy of the treatment in an effort to change the clinical practice and improve patient outcomes. The following article, part two of a two-part series, discusses the various outcome tools and instruments utilized to address spinal disorders and their management. Methods A thorough review of the peer-reviewed literature was performed, irrespective of language, addressing outcome research, instruments and tools, and applications. Results Numerous articles addressing the development and implementation of health-related quality-of-life, neck and low back pain, overall pain, spinal deformity, and other condition-specific outcome instruments have been reported. Their applications in the context of the clinical trial studies, the economic analyses, and overall evidence-based orthopedics have been noted. Additional issues regarding the problems and potential sources of bias utilizing outcomes scales and the concept of minimally clinically important difference were discussed. Conclusion Continuing research needs to assess the outcome instruments and tools used in the clinical outcome assessment for spinal disorders. Understanding the fundamental principles in spinal outcome assessment may also advance the field of “personalized spine care.” PMID:26225283

  13. Designing measurements to assess case management outcomes.

    PubMed

    Mateo, M A; Matzke, K; Newton, C

    1998-01-01

    Evaluating outcomes begins with determining the goals of case management. As the emphasis on the delivery of cost-effective patient care increases, comparing outcomes across settings is desirable and essential. A key component to comparing how an organization rates with similar institutions is to identify commonly used measures. Conducting a literature search, benchmarking, participating in initiatives of accrediting bodies, and establishing ways to collect and manage reliable and valid data are vital in laying the groundwork for an organization's ability to join evaluation projects across settings. PMID:9526390

  14. Designing measurements to assess case management outcomes.

    PubMed

    Mateo, Magdalena A; Matzke, Karen; Newton, Cheryl

    2002-01-01

    Evaluating outcomes begins with determining the goals of case management. As the emphasis on the delivery of cost-effective patient care increases, comparing outcomes across settings is desirable and essential. A key component to comparing how an organization rates with similar institutions is to identify commonly used measures. Conducting a literature search, benchmarking, participating in initiatives of accrediting bodies, and establishing ways to collect and manage reliable and valid data are vital in laying the groundwork for an organization's ability to join evaluation projects across settings. PMID:12478228

  15. Assessing health status and outcomes in a geriatric day hospital.

    PubMed

    Fowler, R W; Congdon, P; Hamilton, S

    2000-11-01

    The study objective was to assess the feasibility and usefulness of recommended outcome measures in older people attending a geriatric day hospital for multidisciplinary assessment and rehabilitation. We used the 'Short Form 36' (SF36) questionnaire which had been proposed as a suitable outcome tool for the elderly, as well as standard assessment scales (eg Barthel index). These were administered by interviewers at the start of day hospital attendance and repeated by postal survey three and six months later. Change in overall health status was rated by the clinical team. The study took place in a geriatric day unit based in a support hospital, specialising in assessment and rehabilitation of older people. Participants were older people referred directly from the community, or following an inpatient day, whose assessment indicated a need for multidisciplinary rehabilitation. Stroke and musculo-skeletal disorders were the commonest underlying conditions. There was a high incidence of non-completion on SF36 questions relating to physical and mental function. Subsequent interviews showed that patients found some questions irrelevant. Floor effects were common. In contrast, the standard scales were invariably fully completed. Compared with local population survey data, respondents had low baseline scores on all SF36 dimensions. Differences over time were probably explained by varying methods of administration. In spite of a clinical perception of improved health status during day hospital attendance, both standard and SF36 scores showed overall deterioration. Two conclusions could be drawn from this study. 1. Measures of physical and mental disability and quality of life gave lower results than expected and continued declining over a six month period, even when the clinical team felt that the patient had improved. 2. Administration of SF36 by an interviewer is essential to obtain meaningful results in older people with poor physical health, which should be interpreted

  16. Is Outcomes Assessment Hurting Higher Education?

    ERIC Educational Resources Information Center

    Pontuso, James F.; Thornton, Saranna R.

    2008-01-01

    This article addresses the issue of assessment and how it is becoming such a critical problem for higher education, especially for teachers of the liberal arts. While the common-sense goals of assessment are laudable, the actual consequences of the process are far from beneficial. It is suggested that ongoing assessment diverts teachers from…

  17. Postsurgical examination of functional outcome of patients having undergone surgical treatment of intracranial aneurysm.

    PubMed

    Slusarz, Robert; Beuth, Wojciech; Ksiazkiewicz, Barbara

    2009-03-01

    Research into outcomes from surgical intervention for intracranial aneurysms have focused on the clinical picture of the disease entity and death rate, comparison of different surgical methods, as well as the most common postoperative and postbleeding complications. From the nursing standpoint, the crucial element in assessing postoperative patients is the broadly understood functional outcome defining patients' ability to function in life, while at the same time recognising the impairments, in which patients will be dependent on the nursing staff. The aim of the study was to assess the functional outcomes of patients in the days following the surgical treatment. The research was carried out in Neurosurgical Department and Clinic, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland. A longitudinal study was carried out with 128 patients having undergone removal of an intracranial aneurysm. In the research both the observation and measuring scores were used. Also Hunt and Hess Grades, the Glasgow Coma Score and the Glasgow Outcome Score were used. To assess functional outcomes of patients, the Functional Capacity Scale was used. The research shows that the functional outcome improves with time, see Statistical analysis (p < 0.001). In the majority of patients some functional outcome deficit was observed mainly in the areas such as relieving oneself and maintaining personal hygiene. The conclusions from the research are as follows: (1) following the surgical treatment of the intracranial aneurysm (day 1, 3, 6 and 9) the majority of patients displayed considerable lack of functional outcome, and were therefore dependent on the nursing staff and relatives (family and friends); (2) on discharge (final measurement) patients were largely self-dependent and displayed negligible impairments of functional outcome.

  18. Symmetry of cardiac function assessment.

    PubMed

    Bai, Xu-Fang; Ma, Amy X

    2016-09-01

    Both right and left ventricles are developed from two adjacent segments of the primary heart tube. Though they are different with regard to shape and power, they mirror each other in terms of behavior. This is the first level of symmetry in cardiac function assessment. Both cardiac muscle contraction and relaxation are active. This constructs the second level of symmetry in cardiac function assessment. Combination of the two levels will help to find some hidden indexes or approaches to evaluate cardiac function. In this article, four major indexes from echocardiography were analyzed under this principal, another seventeen indexes or measurement approaches came out of the shadow, which is very helpful in the assessment of cardiac function, especially for the right cardiac function and diastolic cardiac function.

  19. Symmetry of cardiac function assessment.

    PubMed

    Bai, Xu-Fang; Ma, Amy X

    2016-09-01

    Both right and left ventricles are developed from two adjacent segments of the primary heart tube. Though they are different with regard to shape and power, they mirror each other in terms of behavior. This is the first level of symmetry in cardiac function assessment. Both cardiac muscle contraction and relaxation are active. This constructs the second level of symmetry in cardiac function assessment. Combination of the two levels will help to find some hidden indexes or approaches to evaluate cardiac function. In this article, four major indexes from echocardiography were analyzed under this principal, another seventeen indexes or measurement approaches came out of the shadow, which is very helpful in the assessment of cardiac function, especially for the right cardiac function and diastolic cardiac function. PMID:27582768

  20. Symmetry of cardiac function assessment

    PubMed Central

    Bai, Xu-Fang; Ma, Amy X

    2016-01-01

    Both right and left ventricles are developed from two adjacent segments of the primary heart tube. Though they are different with regard to shape and power, they mirror each other in terms of behavior. This is the first level of symmetry in cardiac function assessment. Both cardiac muscle contraction and relaxation are active. This constructs the second level of symmetry in cardiac function assessment. Combination of the two levels will help to find some hidden indexes or approaches to evaluate cardiac function. In this article, four major indexes from echocardiography were analyzed under this principal, another seventeen indexes or measurement approaches came out of the shadow, which is very helpful in the assessment of cardiac function, especially for the right cardiac function and diastolic cardiac function. PMID:27582768

  1. Regional Accreditation and Learning Outcomes Assessment: Mapping the Territory

    ERIC Educational Resources Information Center

    Provezis, Staci J.

    2010-01-01

    This case study examined the intersection of collegiate-level student learning outcomes assessment with regional accreditation to understand how regional accreditation policies and practices leverage student learning outcomes efforts on US college campuses. To that end, the standards of each of the regional accreditation agencies were carefully…

  2. Assessment of Student Learning Outcomes: Workplace, Family, and Community Roles

    ERIC Educational Resources Information Center

    Johnson, Cheryl A.; Heath, Claudia J.

    2011-01-01

    A project was conducted to assess Family Studies bachelor's degree graduates' use of learning outcomes from course competencies in personal finance, family lifespan development, intervention, and advocacy and policy, and to determine how they apply these learning outcomes to their workplace, family, and community roles. Alumni surveys completed by…

  3. Assessment of Student Professional Outcomes for Continuous Improvement

    ERIC Educational Resources Information Center

    Keshavarz, Mohsen; Baghdarnia, Mostafa

    2013-01-01

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

  4. Student Learning Outcomes Assessment Materials Guidebook

    ERIC Educational Resources Information Center

    ACPA College Student Educators International, 2011

    2011-01-01

    The American College Personnel Association's (ACPA's) Sustainability Task Force partnered with the Commission on Assessment and Evaluation with the goal of creating assessment tools to help ACPA members effectively measure student learning around sustainability. Towards these ends, Kimberly Yousey-Elsener (StudentVoice), Diana Richter Keith…

  5. Using Art to Assess Environmental Education Outcomes

    ERIC Educational Resources Information Center

    Flowers, Ami A.; Carroll, John P.; Green, Gary T.; Larson, Lincoln R.

    2015-01-01

    Construction of developmentally appropriate tools for assessing the environmental attitudes and awareness of young learners has proven to be challenging. Art-based assessments that encourage creativity and accommodate different modes of expression may be a particularly useful complement to conventional tools (e.g. surveys), but their efficacy and…

  6. Outcomes Assessment: The Tip of the Iceberg.

    ERIC Educational Resources Information Center

    Cole, Susan S.

    1990-01-01

    Describes the multifaceted process for assessing students over the course of their undergraduate degree work in the Department of Theater and Dance at Appalachian State University in North Carolina. (SR)

  7. Assessing Outcomes: Practical Methods and Evidence

    ERIC Educational Resources Information Center

    Moore, Jon; Owen, Jesse

    2014-01-01

    University counseling center clients' (N = 52) perceptions of precounseling functioning were highly correlated with their actual well-being scores at intake. The magnitude of change based on perceptions of precounseling functioning to current well-being was approximately double of what is found from the difference of actual precounseling…

  8. Structural equation modeling of motor impairment, gross motor function, and the functional outcome in children with cerebral palsy.

    PubMed

    Park, Eun-Young; Kim, Won-Ho

    2013-05-01

    Physical therapy intervention for children with cerebral palsy (CP) is focused on reducing neurological impairments, improving strength, and preventing the development of secondary impairments in order to improve functional outcomes. However, relationship between motor impairments and functional outcome has not been proved definitely. This study confirmed the construct of motor impairment and performed structural equation modeling (SEM) between motor impairment, gross motor function, and functional outcomes of regarding activities of daily living in children with CP. 98 children (59 boys, 39 girls) with CP participated in this cross-sectional study. Mean age was 11 y 5 mo (SD 1 y 9 mo). The Manual Muscle Test (MMT), the Modified Ashworth Scale (MAS), range of motion (ROM) measurement, and the selective motor control (SMC) scale were used to assess motor impairments. Gross motor function and functional outcomes were measured using the Gross Motor Function Measure (GMFM) and the Functional Skills domain of the Pediatric Evaluation of Disability Inventory (PEDI) respectively. Measurement of motor impairment was consisted of strength, spasticity, ROM, and SMC. The construct of motor impairment was confirmed though an examination of a measurement model. The proposed SEM model showed good fit indices. Motor impairment effected gross motor function (β=-.0869). Gross motor function and motor impairment affected functional outcomes directly (β=0.890) and indirectly (β=-0.773) respectively. We confirmed that the construct of motor impairment consist of strength, spasticity, ROM, and SMC and it was identified through measurement model analysis. Functional outcomes are best predicted by gross motor function and motor impairments have indirect effects on functional outcomes. PMID:23500167

  9. Functional Outcomes after Chemoradiotherapy of Laryngeal and Pharyngeal Cancers

    PubMed Central

    Hutcheson, Katherine A.; Lewin, Jan S.

    2014-01-01

    Organ preservation regimens that combine chemotherapy and radiotherapy (chemoradiotherapy) are increasingly used as the primary treatment of laryngeal and pharyngeal cancers. Meta-analytic data show a survival benefit with combined modality therapy, but the functional sequelae can be significant. Dysphagia is recognized as a common and often devastating late effect of chemoradiotherapy. This review examines functional outcomes after chemoradiotherapy for laryngeal and pharyngeal cancers, with a particular emphasis on dysphagia. Topics examined include the burden of dysphagia after chemoradiation, pathophysiology of dysphagia, baseline functioning, recommendations to improve long-term function, and voice outcomes. PMID:22249533

  10. Functional MRI and Outcome in Traumatic Coma

    PubMed Central

    Giacino, Joseph T.; Wu, Ona

    2013-01-01

    Advances in task-based functional MRI (fMRI), resting-state fMRI (rs-fMRI), and arterial-spin labeled (ASL) perfusion MRI have occurred at a rapid pace in recent years. These techniques for measuring brain function have great potential to improve the accuracy of prognostication for civilian and military patients with traumatic coma. In addition, fMRI, rs-fMRI, and ASL have provided novel insights into the pathophysiology of traumatic disorders of consciousness, as well as mechanisms of recovery from coma. However, functional neuroimaging techniques have yet to achieve widespread clinical use as prognostic tests for patients with traumatic coma. Rather, a broad spectrum of methodological hurdles currently limits the feasibility of clinical implementation. In this review, we discuss the basic principles of fMRI, rs-fMRI and ASL and their potential applications as prognostic tools for patients with traumatic coma. We also discuss future strategies for overcoming the current barriers to clinical implementation. PMID:23881623

  11. Assessing Outcomes through Congruence of Course Objectives and Reflective Work

    ERIC Educational Resources Information Center

    Lockyer, Jocelyn M.; Fidler, Herta; Hogan, David B.; Pereles, Laurie; Wright, Bruce; Lebeuf, Christine; Gerritsen, Cory

    2005-01-01

    Introduction: Course outcomes have been assessed by examining the congruence between statements of commitment to change (CTCs) and course objectives. Other forms of postcourse reflective exercises (for example, impact and unmet-needs statements) have not been examined for congruence with course objectives or their utility in assessing course…

  12. A Model for Effectively Assessing Student Learning Outcomes

    ERIC Educational Resources Information Center

    Ohia, Uche O.

    2011-01-01

    This paper describes a model proven to be effective for assessing and documenting evidence of student learning outcomes. Specifically, it will share a model, F.A.M.O.U.S. Copyright ©2008, which is an acronym exemplifying six effective steps for complying with institutional accountability and eternal assessment requirements proscribed by the…

  13. Investigating ESL Students' Performance on Outcomes Assessments in Higher Education

    ERIC Educational Resources Information Center

    Lakin, Joni M.; Elliott, Diane Cardenas; Liu, Ou Lydia

    2012-01-01

    Outcomes assessments are gaining great attention in higher education because of increased demand for accountability. These assessments are widely used by U.S. higher education institutions to measure students' college-level knowledge and skills, including students who speak English as a second language (ESL). For the past decade, the increasing…

  14. Assessing outcomes of industrial hygiene graduate education.

    PubMed

    Brosseau, Lisa; Fredrickson, Ann

    2009-05-01

    To ensure that industrial hygiene professionals continue to be prepared for current and future trends, it is important to regularly assess the value of their education. Described here are the results of discussions with employers and a mailed survey of graduates. Comparisons are made with past mailed surveys of both groups. Two sets of discussions were held in late 2005 with employers of industrial hygienists and other health and safety professionals. Twenty-eight participants were asked to discuss current and future needs for professionals in their organization and economic sector, their expectations for knowledge and skills when hiring professionals, methods for finding and hiring, and the importance of ABET accreditation. At the same time, a survey was mailed to 71 industrial hygiene students graduating in the last 15 years. Respondents were asked to rank the value of and their proficiency in 42 competencies. Questions also assessed employment experience, certification, the importance of ABET accreditation, and demographic characteristics. There was a lot of agreement between the two stakeholder groups (employers and graduates) about the most important skill and knowledge areas. Most employers identified communicating effectively and exposure assessment among the most important skills, with designing and initiating research as among the least. Hazard recognition, exposure measurement principles, and personal protective equipment were the most highly ranked knowledge areas. Employers discussed the need for good "business skills" such as teamwork, communication, and project management, and the importance of problem-solving skills. Graduates reported that skills in the areas of recognition, evaluation, and control were most valuable in their first jobs and generally reported high levels of proficiency in these skill areas. There was a similar dichotomy in opinions about accreditation within each stakeholder group. The reputation of the academic program was

  15. Assessing outcomes of industrial hygiene graduate education.

    PubMed

    Brosseau, Lisa; Fredrickson, Ann

    2009-05-01

    To ensure that industrial hygiene professionals continue to be prepared for current and future trends, it is important to regularly assess the value of their education. Described here are the results of discussions with employers and a mailed survey of graduates. Comparisons are made with past mailed surveys of both groups. Two sets of discussions were held in late 2005 with employers of industrial hygienists and other health and safety professionals. Twenty-eight participants were asked to discuss current and future needs for professionals in their organization and economic sector, their expectations for knowledge and skills when hiring professionals, methods for finding and hiring, and the importance of ABET accreditation. At the same time, a survey was mailed to 71 industrial hygiene students graduating in the last 15 years. Respondents were asked to rank the value of and their proficiency in 42 competencies. Questions also assessed employment experience, certification, the importance of ABET accreditation, and demographic characteristics. There was a lot of agreement between the two stakeholder groups (employers and graduates) about the most important skill and knowledge areas. Most employers identified communicating effectively and exposure assessment among the most important skills, with designing and initiating research as among the least. Hazard recognition, exposure measurement principles, and personal protective equipment were the most highly ranked knowledge areas. Employers discussed the need for good "business skills" such as teamwork, communication, and project management, and the importance of problem-solving skills. Graduates reported that skills in the areas of recognition, evaluation, and control were most valuable in their first jobs and generally reported high levels of proficiency in these skill areas. There was a similar dichotomy in opinions about accreditation within each stakeholder group. The reputation of the academic program was

  16. Functional Outcome Evaluation of Septorhinoplasty for Nasal Obstruction.

    PubMed

    Zahedi, Farah Dayana; Husain, Salina; Gendeh, Balwant Singh

    2016-06-01

    A prospective single blinded interventional study was held in Otorhinolaryngology Clinic, Universiti Kebangsaan Malaysia Medical Centre in August 2010 until November 2012 to evaluate the functional outcome of septorhinoplasty objectively and subjectively. Objective assessment was done using rhinomanometry and subjective assessment using Nasal Obstruction Symptoms Evaluation (NOSE) scale and Health-Related Quality of Life Questionnaires (HRQOL) in Rhino Surgery. All measurements were taken preoperatively and 3 months postoperatively. A total of 29 patients were enrolled and completed the study. Septorhinoplasty was commonly performed in Malays and Indians and rare amongst Chinese, with age ranged from 18 to 54 years. Majority had no history of trauma. Twisted nose was the most common external nose abnormality followed by crooked and saddle nose. All patients had internal valve insufficiency. There were significant improvement of the total and of all the parameters in the NOSE scale post septorhinoplasty (p < 0.05). Furthermore, there were significant improvement in total and in all parameters in HRQOL score post septorhinoplasty (p < 0.05). There were improvements in the rhinomanometry data bilaterally during inspiration and expiration, but were not statistically significant (p > 0.05). Significant correlations were noted in the improvement between the two subjective assessments (NOSE scale and HRQOL score). However, there was no significant correlation in the improvement between the subjective (NOSE scale and HRQOL score) with objective (rhinomanometry score) assessments. Septorhinoplasty improves the nasal airflow and quality of life of patients with nasal obstruction. PMID:27340641

  17. Vineland Adaptive Behavior Scales as a summary of functional outcome of extremely low-birthweight children.

    PubMed

    Rosenbaum, P; Saigal, S; Szatmari, P; Hoult, L

    1995-07-01

    This study reports moderate to high Pearson correlations between Vineland Adaptive Behavior Scale (VABS) subscale and total scores and a variety of cognitive, academic and motor performance tests on a population of extremely low-birthweight infants assessed at eight years of age. The subscales describe adaptive behaviour in daily living, communication, motor function and socialization, as well as an adaptive behaviour composite score. Because it can provide a norm-referenced description of functional outcomes and can be used to assess all children regardless of disability, the authors believe that the VABS should be applied uniformly by all groups reporting school-age outcome of neonatal intensive-care populations.

  18. Assessment of postural balance function.

    PubMed

    Kostiukow, Anna; Rostkowska, Elzbieta; Samborski, Włodzimierz

    2009-01-01

    Postural balance is defined as the ability to stand unassisted without falling. Examination of the patient's postural balance function is a difficult diagnostic task. Most of the balance tests used in medicine provide incomplete information on this coordination ability of the human body. The aim of this study was to review methods of assessment of the patient's postural balance function, including various tests used in medical diagnostics centers. PMID:20698188

  19. Assessment of postural balance function.

    PubMed

    Kostiukow, Anna; Rostkowska, Elzbieta; Samborski, Włodzimierz

    2009-01-01

    Postural balance is defined as the ability to stand unassisted without falling. Examination of the patient's postural balance function is a difficult diagnostic task. Most of the balance tests used in medicine provide incomplete information on this coordination ability of the human body. The aim of this study was to review methods of assessment of the patient's postural balance function, including various tests used in medical diagnostics centers.

  20. Functional Outcomes in the Treatment of Adults with ADHD

    ERIC Educational Resources Information Center

    Adler, Lenard A.; Spencer, Thomas J.; Levine, Louise R.; Ramsey, Janet L.; Tamura, Roy; Kelsey, Douglas; Ball, Susan G.; Allen, Albert J.; Biederman, Joseph

    2008-01-01

    Objective: ADHD is associated with significant functional impairment in adults. The present study examined functional outcomes following 6-month double-blind treatment with either atomoxetine or placebo. Method: Patients were 410 adults (58.5% male) with "DSM-IV"--defined ADHD. They were randomly assigned to receive either atomoxetine 40 mg/day to…

  1. Patient assessment: preparing for a predictable aesthetic outcome.

    PubMed

    Mehta, Shamir B; Banerji, Subir; Aulakh, Raman

    2015-01-01

    The flux of patients seeking to make changes to the appearance of their smile zone appears to be on a pathway of continual increase. This is possibly due to an increase in awareness towards oral health, and perhaps social, peer and media pressures, respectively. Cohorts of dental practitioners have thus responded to the latter demands by attending a plethora of educational courses, often focusing on either restorative techniques or other disciplines, notably orthodontics and clear aligners in particular. Consequently, treatment planning and thus treatment provision may carry the risk of being biased or indeed 'outcome driven' whereby the skills and knowledge of any clinician towards a particular faculty may significantly influence the ultimate treatment plan, with the unfortunate tendency sometimes to overlook the role of the interdisciplinary approach of concomitant restorative and contemporary techniques. The role of orthodontics to facilitate the provision of such treatment, along with predictable enamel bonding, has the distinct advantage of providing an acceptable aesthetic result with minimal biological intervention. However, to achieve an optimal result in such cases requires meticulous treatment planning and patient selection to avoid pitfalls with regards to long-term stability and function. This article suggests a standardized approach to patient assessment, with an interdisciplinary perspective in mind. Clinical Relevance: With the growth of patient demand for improving the appearance of the smile, a meticulous assessment protocol is required along with effective interdisciplinary communication. This enables a comprehensive treatment plan to be developed with the correct priorities.

  2. Nutrition assessment outcomes: a protocol for Native American hospitals.

    PubMed

    Bickford, G R; Brugler, L J; Gannon, C

    2000-12-01

    The incorporation of visceral protein testing into nutrition assessment protocols can help all hospitals rapidly and accurately identify patients in need of restorative nutrition therapy. Reilly showed that a 3- to 5-day delay in identifying malnutrition has a direct variable cost of $1,500 per case. Studies by Brugler, Mears, and Reilly have demonstrated longer lengths of stay and increased care costs because of nosocomial complications (i.e., infections, pressure ulcers, wound dehiscence, dyspnea, system failures) related to malnutrition. Brugler showed that functionality--a measure of a patient's independence and ability to perform daily activities--both at admission and discharge, the number of care interventions, the occurrence of complications, the level of nutrition treatment needed, and the patient's discharge disposition were strongly associated with their admission albumin value. Conversely, nutrition restoration leads to improved patient outcomes, reduced costs, maximization of care reimbursement, and fulfillment of regulatory requirements. Adoption of this protocol by other hospitals should allow them to demonstrate comparable results, thereby justifying the incorporation of visceral protein testing into their nutrition assessment methods.

  3. Social cognition and its relationship to functional outcomes in patients with sustained acquired brain injury

    PubMed Central

    Ubukata, Shiho; Tanemura, Rumi; Yoshizumi, Miho; Sugihara, Genichi; Murai, Toshiya; Ueda, Keita

    2014-01-01

    Deficits in social cognition are common after traumatic brain injury (TBI). However, little is known about how such deficits affect functional outcomes. The purpose of this study was to investigate the relationship between social cognition and functional outcomes in patients with TBI. We studied this relationship in 20 patients with TBI over the course of 1 year post-injury. Patients completed neurocognitive assessments and social cognition tasks. The social cognition tasks included an emotion-perception task and three theory of mind tasks: the Faux Pas test, Reading the Mind in the Eyes (Eyes) test, and the Moving-Shapes paradigm. The Craig Handicap Assessment and Reporting Technique was used to assess functional outcomes. Compared with our database of normal subjects, patients showed impairments in all social cognition tasks. Multiple regression analysis revealed that theory of mind ability as measured by the Eyes test was the best predictor of the cognitive aspects of functional outcomes. The findings of this pilot study suggest that the degree to which a patient can predict what others are thinking is an important measure that can estimate functional outcomes over 1 year following TBI. PMID:25395854

  4. Student Outcomes Assessment: What Makes it Work? Assessment Practices & Experiences in the California State University.

    ERIC Educational Resources Information Center

    California State Univ. and Colleges, Long Beach. Inst. for Teaching and Learning.

    This monograph is a collection of papers that emerged from a project evaluating the implementation of college outcomes assessment at the campuses of the California State University (CSU) system. Fifteen pilot projects integrated their outcomes assessment in the academic majors and in general education from 1986 to 1990 and the projects were then…

  5. Working memory as a predictor of negative symptoms and functional outcome in first episode psychosis.

    PubMed

    González-Ortega, Itxaso; de Los Mozos, Vanesa; Echeburúa, Enrique; Mezo, Maria; Besga, Ariadna; Ruiz de Azúa, Sonia; González-Pinto, Asunción; Gutierrez, Miguel; Zorrilla, Iñaki; González-Pinto, Ana

    2013-03-30

    The relationship of neurocognitive course with clinical and functional outcomes in psychosis is not well known, especially in the long term. The aim of the study was to examine the clinical and neuropsychological course of first-episode psychosis patients at 5-year follow-up and analyze the relationship of cognitive performance with clinical and functional outcome. The 5-year follow-up was conducted with 26 first-episode psychosis patients. Psychotic symptoms were measured by the Positive and Negative Syndrome Scale, manic and depressive symptoms by the Young Mania Rating Scale and Hamilton Depression Rating Scale respectively, and psychosocial functioning by the Functioning Assessment Short Test. The cognitive domains were assessed by the Wechsler Adult Intelligence Scale, the Wisconsin Card Sorting Test, the Trail Making Test, the Verbal Fluency Test, the Stroop Colour-Word Test and the Wechsler Memory Scale. Patients showed symptomatic improvement in the follow-up except in negative psychotic symptoms. There was also improvement in most cognitive domains except in working memory and processing speed in the follow-up. Working memory impairment was associated to negative psychotic symptoms and poor functional outcomes. Negative symptoms mediated the relationship between working memory and outcome. Therefore, negative symptoms should be a primary target of treatment to improve functional outcomes.

  6. Measuring functional and quality of life outcomes following major head injury: common scales and checklists.

    PubMed

    Nichol, A D; Higgins, A M; Gabbe, B J; Murray, L J; Cooper, D J; Cameron, P A

    2011-03-01

    Traumatic brain injury (TBI) is a major public health issue, which results in significant mortality and long term disability. The profound impact of TBI is not only felt by the individuals who suffer the injury but also their care-givers and society as a whole. Clinicians and researchers require reliable and valid measures of long term outcome not only to truly quantify the burden of TBI and the scale of functional impairment in survivors, but also to allow early appropriate allocation of rehabilitation supports. In addition, clinical trials which aim to improve outcomes in this devastating condition require high quality measures to accurately assess the impact of the interventions being studied. In this article, we review the properties of an ideal measure of outcome in the TBI population. Then, we describe the key components and performance of the measurement tools most commonly used to quantify outcome in clinical studies in TBI. These measurement tools include: the Glasgow Outcome Scale (GOS) and extended Glasgow Outcome Scale (GOSe); Disability Rating Scale (DRS); Functional Independence Measure (FIM); Functional Assessment Measure (FAM); Functional Status Examination (FSE) and the TBI-specific and generic quality of life measures used in TBI patients (SF-36 and SF-12, WHOQOL-BREF, SIP, EQ-5D, EBIQ, and QOLIBRI).

  7. A Comparison of Functional Behavioral Assessment and Functional Analysis Methodology among Students with Mild Disabilities

    ERIC Educational Resources Information Center

    Lewis, Timothy J.; Mitchell, Barbara S.; Harvey, Kristin; Green, Ambra; McKenzie, Jennifer

    2015-01-01

    Functional behavioral assessment (FBA) and functional analyses (FA) are grounded in the applied behavior analysis principle that posits problem behavior is functionally related to the environment in which it occurs and is maintained by either providing access to reinforcing outcomes or allowing the individual to avoid or escape that which they…

  8. Manual function outcome measures in children with developmental coordination disorder (DCD): Systematic review.

    PubMed

    Bieber, Eleonora; Smits-Engelsman, Bouwien C M; Sgandurra, Giuseppina; Cioni, Giovanni; Feys, Hilde; Guzzetta, Andrea; Klingels, Katrijn

    2016-08-01

    This study systematically reviewed the clinical and psychometric properties of manual function outcome measures for children with developmental coordination disorder (DCD) aged 3-18 years. Three electronic databases were searched to identify manual function tools at the ICF-CY body function, activity and participation level used in children with DCD. Study selection and data extraction was conducted by two blind assessors according to the CanChild Outcome Measures Rating Form. Nineteen clinical tests (seven fine hand use tools and 12 handwriting measures), three naturalistic observations and six questionnaires were identified. The fine-motor subdomain of the Movement Assessment Battery for Children, the Bruininks-Oseretsky Test of Motor Proficiency-2 and the Functional Strength Measurement, with adequate reliability and validity properties, might be useful for manual function capacity assessment. The Systematic Detection of Writing Problems (SOS) and the Detailed Assessment of Speed of Handwriting (DASH) could be adopted for handwriting assessment, respectively from 6 and 9 years old. Naturalistic observations and questionnaires, whose psychometric properties have been investigated into limited extent, offer an assessment of the daily performances. This review shows that a combination of different tools is needed for a comprehensive assessment of manual function in children with DCD including the three levels of the ICF-CY. Further investigation of psychometric properties of those tools in children with DCD is warranted. Tests validated in other populations should be explored for their applicability for assessing manual function in children with DCD.

  9. Prediction of Functional Outcome in Axonal Guillain-Barre Syndrome

    PubMed Central

    2016-01-01

    Objective To identify the factors that could predict the functional outcome in patients with the axonal type of Guillain-Barre syndrome (GBS). Methods Two hundred and two GBS patients admitted to our university hospital between 2003 and 2014 were reviewed retrospectively. We defined a good outcome as being "able to walk independently at 1 month after onset" and a poor outcome as being "unable to walk independently at 1 month after onset". We evaluated the factors that differed between the good and poor outcome groups. Results Twenty-four patients were classified into the acute motor axonal neuropathy type. There was a statistically significant difference between the good and poor outcome groups in terms of the GBS disability score at admission, and GBS disability score and Medical Research Council sum score at 1 month after admission. In an electrophysiologic analysis, the good outcome group showed greater amplitude of median, ulnar, deep peroneal, and posterior tibial nerve compound muscle action potentials (CMAP) and greater amplitude of median, ulnar, and superficial peroneal sensory nerve action potentials (SNAP) than the poor outcome group. Conclusion A lower GBS disability score at admission, high amplitude of median, ulnar, deep peroneal, and posterior tibial CMAPs, and high amplitude of median, ulnar, and superficial peroneal SNAPs were associated with being able to walk at 1 month in patients with axonal GBS. PMID:27446785

  10. Beyond the Basics of Clinical Outcomes Assessment: Selecting Appropriate Patient-Rated Outcomes Instruments for Patient Care

    ERIC Educational Resources Information Center

    Valier, Alison R.; Lam, Kenneth C.

    2015-01-01

    The fifth edition of the "Athletic Training Education Competencies" emphasizes the concepts of clinical outcomes assessment. In athletic training, clinical outcomes assessment, especially as it relates to patient-rated outcomes (PRO) instruments, is new, which produces uncertainty with regard to how to integrate PROs into athletic…

  11. Predicting functional remission in patients with schizophrenia: a cross-sectional study of symptomatic remission, psychosocial remission, functioning, and clinical outcome

    PubMed Central

    Valencia, Marcelo; Fresán, Ana; Barak, Yoram; Juárez, Francisco; Escamilla, Raul; Saracco, Ricardo

    2015-01-01

    Background New approaches to assess outcome in schizophrenia include multidimensional measures such as remission, cognition, psychosocial functioning, and quality of life. Clinical and psychosocial measures have been recently introduced to assess functional outcome. Objective The study presented here was designed to examine the rates of symptomatic remission, psychosocial remission, global functioning, and clinical global impressions in a sample of schizophrenia outpatients in order to assess functional remission and to identify predictive factors for functional remission. Methods A total of 168 consecutive Mexican outpatients receiving pharmacological treatment at the National Institute of Psychiatry in Mexico City were enrolled in a cross-sectional study. Symptomatic remission was assessed according to the definition and criteria proposed by the Remission in Schizophrenia Working Group using the Positive and Negative Symptom Scale. Psychosocial remission was assessed according to Barak criteria using the Psychosocial Remission in Schizophrenia scale. Functioning was measured with the Global Assessment of Functioning, and clinical outcome with the Clinical Global Impressions (CGI) Scale. Results Findings showed that 45.2% of patients fulfilled the symptomatic remission criteria, 32.1% achieved psychosocial remission, and 53% reported adequate functioning. However, the combination of these three outcome criteria – symptomatic, psychosocial remission, and functioning – indicated that 14.9% of the patients achieved our predefined functional remission outcome. The logistic regression model included five predictive variables for functional remission: (1) being employed, (2) use of atypical antipsychotics, (3) lower number of medications, (4) lower negative symptom severity, and (5) lower excitement symptom severity. Conclusion The study demonstrated that symptomatic remission, psychosocial remission, and functioning could be achievable goals for a considerable

  12. Assessment of Student Learning Outcomes in FCS Programs

    ERIC Educational Resources Information Center

    Weaver-Kaulis, Amy; Crutsinger, Christy

    2006-01-01

    Accreditation, budget, and accountability pressures at the institution and program levels lead to the involvement of faculty in assessment-based activities. Increasingly, programs are being expected to document student learning beyond traditional course grades. The use of outcomes as a tool to improve learning relies heavily on the active…

  13. Choosing Assessment Instruments for Bulimia Practice and Outcome Research

    ERIC Educational Resources Information Center

    Sandberg, Katie; Erford, Bradley T.

    2013-01-01

    Six commonly used instruments for assessment of eating disorders were analyzed. Effect size results from Erford et al.'s (2013) meta-analysis for the treatment of bulimia nervosa were used to compare each scale's ability to measure treatment outcomes for bulimia nervosa. Effect size comparisons indicated higher overall effect sizes using…

  14. The Reading Behavior Inventory: An Outcome Assessment Tool

    ERIC Educational Resources Information Center

    Goodrich, Gregory L.; Kirby, Jennine; Wood, Jennifer; Peters, Laura

    2006-01-01

    Many questionnaires attempt to assess the quality of life of individuals who are visually impaired (that is, those who are blind or have low vision), but few apply to those who are undergoing visual rehabilitation and hence are difficult to adapt as an outcome measure Massof & Rubin, 2001). The Reading Behavior Inventory (RBI) was developed as a…

  15. Learning about Learning Outcomes: A Liberal Arts Professor Assesses

    ERIC Educational Resources Information Center

    Fort, Andrew O.

    2011-01-01

    Although the author has been teaching for over a quarter century, he was never trained in, nor truly understood, "outcomes assessment." He regarded it as a task to be completed for an outside accreditor that had little relation to his real "liberal arts" goals for students. Those goals include teaching critical self-awareness, developing…

  16. Assessing Social Learning Outcomes through Participatory Mind Mapping

    ERIC Educational Resources Information Center

    Smith, Justin G.; DuBois, Bryce; Corwin, Jason

    2016-01-01

    This article presents a method for using mind mapping to assess social learning outcomes in collaborative environmental restoration and participatory natural resource management initiatives. Using mind mapping for preassessment and postassessment can reveal changes in individual and collective thinking about critical social and ecological issues.…

  17. Building Assessment Tools Aligned with Grade-Level Outcomes

    ERIC Educational Resources Information Center

    Martin, Caryl; Horton, Mel L.; Tarr, Susan J.

    2015-01-01

    This article focuses on the development of assessment tools to enhance the acquisition of the grade-level outcomes developed in the K-12 curriculum. Physical education is one of the few educational programs that does not have a multitude of available state and national tests to measure student progress. This distinction has been both a strength…

  18. Poststroke Shoulder Pain in Turkish Stroke Patients: Relationship with Clinical Factors and Functional Outcomes

    ERIC Educational Resources Information Center

    Barlak, Aysegul; Unsal, Sibel; Kaya, Kurtulus; Sahin-Onat, Sule; Ozel, Sumru

    2009-01-01

    The objective of this study was to assess the possible causes of hemiplegic shoulder pain (HSP) in Turkish patients with stroke, to identify the correlation between HSP and clinical factors, and to review the effects of HSP on functional outcomes. A total of 187 consecutive patients with stroke were evaluated for the presence of HSP and for the…

  19. The Relationship between Mental Health, Vocational Rehabilitation Interagency Functioning, and Outcome of Psychiatrically Disabled Persons.

    ERIC Educational Resources Information Center

    Dellario, Donald J.

    1985-01-01

    Conducted structured interviews of seven selected Mental Health (MH) and Vocational Rehabilitation (VR) dyads to assess interagency functioning, and compared results to selected interagency performance indicators. Results suggested that improved MH-VR linkages can increase the probability of successful rehabilitation outcomes for psychiatrically…

  20. Retrospective comparison of functional and radiological outcome, between two contemporary high flexion knee designs

    PubMed Central

    Kapoor, Vikash; Chatterjee, Daipayan; Hazra, Sutanu; Chatterjee, Anirban; Garg, Parag; Debnath, Kaustav; Mandal, Soham; Sarkar, Sudipto

    2016-01-01

    Introduction: Patient satisfaction after total knee replacement (TKR) depends on the amount of pain relief and the functional activities achieved. An important criterion of good functional outcome is the amount of flexion achieved and whether the patient can manage high flexion activities. In order to increase the amount of safe flexion, various implant designs have been developed. This study aims to compare the outcome after TKR using two contemporary high flexion knee designs: Sigma CR150 High Flex Knee prosthesis (Depuy, Warsaw, Indiana) and NexGen High Flex Knee prosthesis (Zimmer, Warsaw, Indiana). Material: A retrospective study was conducted with 100 cases of each design and their functional and radiological outcome was assessed after two years of follow-up. Results: The two groups had comparable results in terms of subjective satisfaction, range of motion achieved and radiological outcome. Depuy group fared better than Zimmer in terms of functional outcome (modified Oxford knee score). Conclusion: Depuy group was found to have fared better than Zimmer in terms of functional outcome. However, it is very difficult to rate one design above the other based on our small sample size and short duration of follow-up. PMID:27748254

  1. Functional Outcome Analysis: Do the Costs Outweigh the Benefits?

    ERIC Educational Resources Information Center

    Sheridan, Susan M.

    1993-01-01

    Responds to previous article (Noell and Gresham, this issue) on Functional Outcome Analysis (FOA) as important construct for evaluation of consultation and prereferral interventions. Notes that, practically speaking, one must wonder if information gleaned from FOA is worth costs. Addresses perceived scientific and practical merits of FOA. (NB)

  2. The Brief Symptom Inventory and the Outcome Questionnaire-45 in the Assessment of the Outcome Quality of Mental Health Interventions

    PubMed Central

    Schuetz, Christopher; Andreae, Andreas; Koemeda, Margit; Schulthess, Peter; Tschuschke, Volker; von Wyl, Agnes

    2016-01-01

    Self-report questionnaires are economical instruments for routine outcome assessment. In this study, the performance of the German version of the Outcome Questionnaire-45 (OQ-45) and the Brief Symptom Inventory (BSI) was evaluated when applied in analysis of the outcome quality of psychiatric and psychotherapeutic interventions. Pre-post data from two inpatient samples (N = 5711) and one outpatient sample (N = 239) were analyzed. Critical differences (reliable change index) and cut-off points between functional and dysfunctional populations were calculated using the Jacobson and Truax method of calculating clinical significance. Overall, the results indicated that the BSI was more accurate than the OQ-45 in correctly classifying patients as clinical subjects. Nonetheless, even with the BSI, about 25% of inpatients with schizophrenia attained a score at admission below the clinical cut-off. Both questionnaires exhibited the highest sensitivity to psychopathology with patients with personality disorders. When considering the differences in the prescores, both questionnaires showed the same sensitivity to change. The advantage of using these self-report measures is observed primarily in assessing outpatient psychotherapy outcome. In an inpatient setting two main problems—namely, the low response rate and the scarce sensitivity to psychopathology with severely ill patients—limit the usability of self-report questionnaires.

  3. The Brief Symptom Inventory and the Outcome Questionnaire-45 in the Assessment of the Outcome Quality of Mental Health Interventions

    PubMed Central

    Schuetz, Christopher; Andreae, Andreas; Koemeda, Margit; Schulthess, Peter; Tschuschke, Volker; von Wyl, Agnes

    2016-01-01

    Self-report questionnaires are economical instruments for routine outcome assessment. In this study, the performance of the German version of the Outcome Questionnaire-45 (OQ-45) and the Brief Symptom Inventory (BSI) was evaluated when applied in analysis of the outcome quality of psychiatric and psychotherapeutic interventions. Pre-post data from two inpatient samples (N = 5711) and one outpatient sample (N = 239) were analyzed. Critical differences (reliable change index) and cut-off points between functional and dysfunctional populations were calculated using the Jacobson and Truax method of calculating clinical significance. Overall, the results indicated that the BSI was more accurate than the OQ-45 in correctly classifying patients as clinical subjects. Nonetheless, even with the BSI, about 25% of inpatients with schizophrenia attained a score at admission below the clinical cut-off. Both questionnaires exhibited the highest sensitivity to psychopathology with patients with personality disorders. When considering the differences in the prescores, both questionnaires showed the same sensitivity to change. The advantage of using these self-report measures is observed primarily in assessing outpatient psychotherapy outcome. In an inpatient setting two main problems—namely, the low response rate and the scarce sensitivity to psychopathology with severely ill patients—limit the usability of self-report questionnaires. PMID:27699166

  4. Collaborative Development and Assessment of Student Learning Outcomes for LIS Electives

    ERIC Educational Resources Information Center

    Bishop, Bradley Wade; Grubesic, Tony H.; Parrish, Theresa

    2015-01-01

    In higher education's environment of accountability, the development and assessment of student learning outcomes (SLOs) are driven by both external stakeholder requirements for accreditation and internal institutional pressures to demonstrate student learning as the core function of universities and colleges. This paper presents a framework to…

  5. The Clinical Outcomes Assessment Toolkit: A Framework to Support Automated Clinical Records–based Outcomes Assessment and Performance Measurement Research

    PubMed Central

    D'Avolio, Leonard W.; Bui, Alex A.T.

    2008-01-01

    The Clinical Outcomes Assessment Toolkit (COAT) was created through a collaboration between the University of California, Los Angeles and Brigham and Women's Hospital to address the challenge of gathering, formatting, and abstracting data for clinical outcomes and performance measurement research. COAT provides a framework for the development of information pipelines to transform clinical data from its original structured, semi-structured, and unstructured forms to a standardized format amenable to statistical analysis. This system includes a collection of clinical data structures, reusable utilities for information analysis and transformation, and a graphical user interface through which pipelines can be controlled and their results audited by nontechnical users. The COAT architecture is presented, as well as two case studies of current implementations in the domain of prostate cancer outcomes assessment. PMID:18308990

  6. Leigh Syndrome in Childhood: Neurologic Progression and Functional Outcome

    PubMed Central

    Lee, Jin Sook; Kim, Hunmin; Lim, Byung Chan; Hwang, Hee; Choi, Jieun; Kim, Ki Joong; Hwang, Yong Seung

    2016-01-01

    Background and Purpose Few studies have analyzed the clinical course and functional outcome in Leigh syndrome (LS). The aim of this study was to determine the clinical, radiological, biochemical, and genetic features of patients with LS, and identify prognostic indicators of the disease progression and neurological outcome. Methods Thirty-nine patients who had been diagnosed with LS at the Seoul National University Children's Hospital were included. Their medical records, neuroimaging findings, and histological/biochemical findings of skeletal muscle specimens were reviewed. Targeted sequencing of mitochondrial DNA was performed based on mitochondrial respiratory chain (MRC) enzyme defects. Results Isolated complex I deficiency was the most frequently observed MRC defect (in 42% of 38 investigated patients). Mitochondrial DNA mutations were identified in 11 patients, of which 81.8% were MT-ND genes. The clinical outcome varied widely, from independent daily activity to severe disability. Poor functional outcomes and neurological deterioration were significantly associated with early onset (before an age of 1 year) and the presence of other lesions additional to basal ganglia involvement in the initial neuroimaging. Conclusions The neurological severity and outcome of LS may vary widely and be better than those predicted based on previous studies. We suggest that age at onset and initial neuroimaging findings are prognostic indicators in LS. PMID:27074294

  7. FUNCTIONAL OUTCOMES AFTER TORS FOR OROPHARYNGEAL CANCER: A SYSTEMATIC REVIEW

    PubMed Central

    Hutcheson, Katherine A.; Holsinger, F. Christopher; Kupferman, Michael E.; Lewin, Jan S.

    2014-01-01

    OBJECTIVE Summarize functional outcomes after transoral robotic surgery (TORS) ± adjuvant therapy for oropharyngeal cancer (OPC). STUDY DESIGN A systematic review was conducted. The MEDLINE database was searched (MeSH terms: transoral robotic surgery, pharyngeal neoplasms, oropharyngeal neoplasms). METHODS Peer-reviewed human subject papers published through December, 2013 were included. Exclusion criteria were: 1) case report design (n<10), 2) review article, or 3) technical, animal or cadaver studies. Functional outcomes extracted included feeding tube dependence, swallow examination findings, speech ratings, velopharyngeal insufficiency, pneumonia, and oral intake measures. RESULTS Twelve papers comprising 441 patients with OPC treated with TORS ± adjuvant therapy were included. Feeding tube rates were the most commonly reported functional outcome. Excluding prophylactic placement, 18% to 39% of patients required gastrostomy placement, typically during adjuvant therapy. Chronic gastrostomy dependence ranged from 0% to 7% (mean follow-up: 11–26 months), regardless of disease stage. Composite MD Anderson Dysphagia Inventory (MDADI) scores ranged from 65.2 to 78 (89 patients, 3 series, mean follow-up: 12–13 months). Videofluoroscopic swallowing studies were not systematically reported. Incidence of postoperative pneumonia was 0% to 7%. Predictors of swallowing function included baseline function, T-stage, N-stage, tongue base primary tumors, and adjuvant chemoradiation. Rates of transient hypernasality were 4% to 9%. A single study suggested dose-dependent effects of adjuvant therapy (none, radiation alone, chemoradiation) on diet scores at 6- and 12-months. CONCLUSIONS Crude endpoints of functional recovery after TORS ± adjuvant therapy suggest promising swallowing outcomes, depending on the functional measure reported. PMID:24643851

  8. Assessing outcome expectations in older adults: the multidimensional outcome expectations for exercise scale.

    PubMed

    Wójcicki, Thomas R; White, Siobhan M; McAuley, Edward

    2009-01-01

    Outcome expectations, an important element of social cognitive theory, have been associated with physical activity in older adults. Yet, the measurement of this construct has often adopted a unidimensional approach. We examined the validity of a theoretically consistent three-factor (physical, social, and self-evaluative) outcome expectations exercise scale in middle-aged and older adults (N = 320; M age = 63.8). Participants completed questionnaires assessing outcome expectations, physical activity, self-efficacy, and health status. Comparisons of the hypothesized factor structure with competing models indicated that a three-factor model provided the best fit for the data. Construct validity was further demonstrated by significant association with physical activity and self-efficacy and differential associations with age and health status. Further evidence of validity and application to social cognitive models of physical activity is warranted.

  9. Functional outcome measures for NF1-associated optic pathway glioma clinical trials

    PubMed Central

    Avery, Robert A.; Allen, Jeffrey C.; Ardern-Holmes, Simone L.; Bilaniuk, Larissa T.; Ferner, Rosalie E.; Gutmann, David H.; Listernick, Robert; Martin, Staci; Ullrich, Nicole J.; Liu, Grant T.

    2013-01-01

    Objective: The goal of the Response Evaluation in Neurofibromatosis and Schwannomatosis Visual Outcomes Committee is to define the best functional outcome measures for future neurofibromatosis type 1 (NF1)-associated optic pathway glioma (OPG) clinical trials. Methods: The committee considered the components of vision, other ophthalmologic parameters affected by OPG, potential biomarkers of visual function, and quality of life measures to arrive at consensus-based, evidence-driven recommendations for objective and measurable functional endpoints for OPG trials. Results: Visual acuity (VA) assessments using consistent quantitative testing methods are recommended as the main functional outcome measure for NF1-OPG clinical trials. Teller acuity cards are recommended for use as the primary VA endpoint, and HOTV as a secondary endpoint once subjects are old enough to complete it. The optic disc should be assessed for pallor, as this appears to be a contributory variable that may affect the interpretation of VA change over time. Given the importance of capturing patient-reported outcomes in clinical trials, evaluating visual quality of life using the Children's Visual Function Questionnaire as a secondary endpoint is also proposed. Conclusions: The use of these key functional endpoints will be essential for evaluating the efficacy of future OPG clinical trials. PMID:24249802

  10. Clinical Outcome Assessments: Conceptual Foundation–Report of the ISPOR Clinical Outcomes Assessment – Emerging Good Practices for Outcomes Research Task Force DOES THIS HAVE TO BE LABLED AS PART 1

    PubMed Central

    Walton, Marc K; Powers, John H; Hobart, Jeremy; Patrick, Donald L; Marquis, Patrick; Vamvakas, Sprios; Isaac, Maria; Molsen, Elizabeth; Cano, Stefan J; Burke, Laurie

    2015-01-01

    An outcome assessment, the patient assessment used in an endpoint, is the measuring instrument that provides a rating or score (categorical or continuous) that is intended to represent some aspect of the patient’s health status. Outcome assessments are used to define efficacy endpoints when developing a therapy for a disease or condition. Most efficacy endpoints are based on specified clinical assessments of patients. When clinical assessments are used as clinical trial outcomes, they are called clinical outcome assessments (COAs). COAs include any assessment that may be influenced by human choices, judgment, or motivation, COAs must be well-defined and possess adequate measurement properties in order to demonstrate (directly or indirectly) the benefits of a treatment. In contrast, a biomarker assessment is one that is subject to little, if any, patient motivational or rater judgmental influence. This is the first of two reports by the ISPOR Clinical Outcomes Assessment – Emerging Good Practices for Outcomes Research Task Force. This report provides foundational definitions important for an understanding of COA measurement principles. The foundation provided in this report includes what it means to demonstrate a beneficial effect, how assessments of patients relate to the objective of showing a treatment’s benefit, and how these assessments are used in clinical trial endpoints. In addition, this report describes intrinsic attributes of patient assessments and clinical trial factors that can affect the properties of the measurements. These factors should be considered when developing or refining assessments. These considerations will aid investigators designing trials in their choice of using an existing assessment or developing a new outcome assessment. Although the focus of this report is in the development of a new COA to define endpoints in a clinical trial, these principles may be applied more generally. A critical element in appraising or developing a

  11. Optimizing aesthetic and functional outcomes at donor sites.

    PubMed

    Jeng, Seng-Feng; Tan, Ngian-Chye

    2012-01-01

    In recent years, there has been increasing interest by reconstructive surgeons in improving the aesthetic and functional outcomes of donor sites. As the success rate of free tissue transfers has exceeded more than 95% in most microsurgical centers, more emphasis can be shifted to the donor site. However, morbidities of donor sites can occur not only in free tissue transfers, but in locoregional flaps as well. In reconstructive procedures, the main principle is to mobilize normal tissue and utilize it to reconstruct an area of defect. The donor site, of course has no pathology, but is a previously healthy area. Therefore, it is of paramount importance to not only minimize postoperative complications at recipient sites, but also pay attention to donor sites. Just as in organ transplantation where efforts are made to ensure the safety and a good outcome for a donor patient, outcomes should be improved and morbidity reduced at donor sites in reconstructive surgery.

  12. Functional Outcome in Bipolar Disorder: The Big Picture

    PubMed Central

    Levy, Boaz; Manove, Emily

    2012-01-01

    Previous research on functional outcome in bipolar disorder (BD) has uncovered various factors that exacerbate psychosocial disability over the course of illness, including genetics, illness severity, stress, anxiety, and cognitive impairment. This paper presents an integrated view of these findings that accounts for the precipitous decline in psychosocial functioning after illness onset. The proposed model highlights a number of reciprocal pathways among previously studied factors that trap people in a powerful cycle of ailing forces. The paper discusses implications to patient care as well as the larger social changes required for shifting the functional trajectory of people with BD from psychosocial decline to growth. PMID:21961062

  13. Assessing overall functioning with adolescent inpatients

    PubMed Central

    Haggerty, Greg; Forlenza, Nicholas; Poland, Charlotte; Ray, Sagarika; Zodan, Jennifer; Mehra, Ashwin; Goyal, Ajay; Baity, Matthew R.; Siefert, Caleb J.; Sobin, Sean; Leite, David; Sinclair, Samuel J.

    2014-01-01

    The current study looks to evaluate the validity and reliability of a brief measure of overall functioning for adolescents. Clinicians were asked to complete the Overall Functioning Scale for 72 adolescents consecutively admitted to the adolescent psychiatric inpatient service of a community safety net medical center. The results revealed that this new measure is related to the patients’ length of stay, clinician-rated measures of social cognition and object relations, Global Assessment of Functioning score at admission, and global rating of engagement in individual psychotherapy. Results also showed that the OFS was related to patients’ history of non-suicidal self-harm as well as treatment outcome as assessed by measures of psychological health and well-being and symtomatology. Hierarchical regressions reveal that the OFS shows incremental validity above the admission GAF score in predicting length of stay. The results also showed that the OFS demonstrates inter-rater reliability in the excellent range (ICC 1,2) of .88. Clinical implications of the use of this tool as well as areas of future research are discussed. PMID:25259948

  14. Protein-energy malnutrition impairs functional outcome in global ischemia.

    PubMed

    Bobyn, P Joan; Corbett, Dale; Saucier, Deborah M; Noyan-Ashraf, M Hossein; Juurlink, Bernhard H J; Paterson, Phyllis G

    2005-12-01

    We investigated whether protein-energy malnutrition (PEM) exacerbates brain injury in global ischemia. It was hypothesized that PEM would increase secondary brain damage by worsening ischemia-induced depletion of glutathione (GSH) and increasing oxidative stress. Adult male gerbils were fed an adequate protein (12.5%; C) or low protein (2%; PEM) diet for 4 weeks and subjected to 5 min of bilateral carotid artery occlusion (Ischemia) or sham surgery (Sham). At 12 h post-ischemia, GSH and markers of oxidative stress were measured in hippocampus and neocortex. The remaining gerbils were tested in the open field on days 3, 7, and 10, with viable hippocampal CA1 neurons assessed on day 10. Although the habituation of C-Ischemia gerbils in the open field was normal by day 7, PEM-Ischemia gerbils failed to habituate even by day 10 and spent greater time in the outer zone (P < 0.05). Mean (+/-SEM) total number of viable CA1 neurons at 10 days post-ischemia were C-Sham = 713 (13), C-Ischemia = 264 (48), PEM-Sham = 716 (12), and PEM-Ischemia = 286 (66). Although PEM did not increase CA1 neuron loss caused by ischemia, a subset (4/12) of PEM-Ischemia gerbils showed dramatic reactive gliosis accompanied by extensive neuronal loss. Hippocampal protein thiols were decreased by PEM and ischemia. Although the mechanism is yet to be established, the finding that PEM worsens functional outcome following global ischemia is clinically relevant since 16% of elderly are nutritionally compromised at the time of admission for stroke.

  15. Spinal meningiomas: clinicoradiological factors predicting recurrence and functional outcome.

    PubMed

    Maiti, Tanmoy K; Bir, Shyamal C; Patra, Devi Prasad; Kalakoti, Piyush; Guthikonda, Bharat; Nanda, Anil

    2016-08-01

    OBJECTIVE Spinal meningiomas are benign tumors with a wide spectrum of clinical and radiological features at presentation. The authors analyzed multiple clinicoradiological factors to predict recurrence and functional outcome in a cohort with a mean follow-up of more than 4 years. The authors also discuss the results of clinical studies regarding spinal meningiomas in the last 15 years. METHODS The authors retrospectively reviewed the clinical and radiological details of patients who underwent surgery for spinal tumors between 2001 and 2015 that were histopathologically confirmed as meningiomas. Demographic parameters, such as age, sex, race, and association with neurofibromatosis Type 2, were considered. Radiological parameters, such as tumor size, signal changes of spinal cord, spinal level, number of levels, location of tumor attachment, shape of tumor, and presence of dural tail/calcification, were noted. These factors were analyzed to predict recurrence and functional outcome. Furthermore, a pooled analysis was performed from 13 reports of spinal meningiomas in the last 15 years. RESULTS A total of 38 patients were included in this study. Male sex and tumors with radiological evidence of a dural tail were associated with an increased risk of recurrence at a mean follow-up of 51.2 months. Ventral or ventrolateral location, large tumors, T2 cord signal changes, and poor preoperative functional status were associated with poor functional outcome at 1-year follow-up. CONCLUSIONS Spine surgeons must be aware of the natural history and risk factors of spinal meningiomas to establish a prognosis for their patients.

  16. Three measures of functional outcome for lower limb amputees: a retrospective review.

    PubMed

    Treweek, S P; Condie, M E

    1998-12-01

    Outcome measures are becoming increasingly important in health care. Functional outcome measures are of particular importance for lower limb amputees since much of the rehabilitation process is concerned with increasing mobility and personal independence. The Scottish Physiotherapy Amputee Research Group (SPARG) has used three measures of functional outcome: the Barthel Index, Russek's classification and the Locomotor Index. The review reported here involves 938 patients having a primary amputation at the transtibial or transfemoral level between October 1992 and July 1997. Differences in function due to age and level of amputation are well known clinically and the measures were compared by looking at their ability to detect these differences. The Barthel Index lacked sensitivity because of ceiling effects and should not be considered as a suitable functional outcome measure for amputee patients. Russek's classification does detect significant differences but requires a large number of patients making it unsuitable for single hospital investigations. The Locomotor Index demonstrates significant differences due to age and amputation level despite fewer patients being assessed by this measure during the period covered by this paper. The range of the Locomotor Index can be extended to cover more active amputees by considering its 'advanced activities' subscale separately. The Locomotor Index is a promising measure and should be considered by rehabilitation teams looking for a valid, reliable and sensitive functional outcome measure for use with lower limb amputees. PMID:9881605

  17. Functional outcome of supracondylar elbow fractures in children: a 3- to 5-year follow-up

    PubMed Central

    Isa, Ahaoiza Diana; Furey, Andrew; Stone, Craig

    2014-01-01

    Background Long-term functional outcomes of supracondylar elbow fractures (SCEF) have not been well documented in the literature. We retrospectively evaluated functional outcomes of pediatric SCEF using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Methods We retrospectively reviewed the outcomes of patients who presented to our tertiary care pediatric emergency department with SCEF between January 2005 and December 2009. We reviewed their charts to assess several clinical parameters, including age, sex, Gartland classification of SCEF, weight, comorbidities, treatment intervention, physiotherapy and the extremity involved. The DASH questionnaire was administered in 2012. We performed a multiple linear regression analysis to determine the significance of these clinical parameters as they related to the DASH score for functional outcome. Results We included 94 patients with SCEF in our review. Pediatric SCEF had good functional outcomes based on the DASH questionnaire (mean score 0.77 ± 2.10). We obtained the following DASH scores: 0.45 ± 2.20 for type I, 1.09 ± 1.70 for type II and 1.43 ± 2.40 for type III fractures. There was no statistical difference in functional outcome, regardless of sex (p = 0.07), age at injury (p = 0.96), fracture type (p = 0.14), weight (p = 0.59), right/left extremity (p = 0.26) or surgery (p = 0.52). Conclusion Our results demonstrate that good functional outcomes can be expected with pediatric SCEF based on the DASH questionnaire, regardless of age at injury, sex, weight, right/left extremity or surgical/nonsurgical intervention, provided satisfactory reduction is achieved and maintained. PMID:25078928

  18. REDUCING AMBIGUITY IN THE FUNCTIONAL ASSESSMENT OF PROBLEM BEHAVIOR

    PubMed Central

    Rooker, Griffin W.; DeLeon, Iser G.; Borrero, Carrie S. W.; Frank-Crawford, Michelle A.; Roscoe, Eileen M.

    2015-01-01

    Severe problem behavior (e.g., self-injury and aggression) remains among the most serious challenges for the habilitation of persons with intellectual disabilities and is a significant obstacle to community integration. The current standard of behavior analytic treatment for problem behavior in this population consists of a functional assessment and treatment model. Within that model, the first step is to assess the behavior–environment relations that give rise to and maintain problem behavior, a functional behavioral assessment. Conventional methods of assessing behavioral function include indirect, descriptive, and experimental assessments of problem behavior. Clinical investigators have produced a rich literature demonstrating the relative effectiveness for each method, but in clinical practice, each can produce ambiguous or difficult-to-interpret outcomes that may impede treatment development. This paper outlines potential sources of variability in assessment outcomes and then reviews the evidence on strategies for avoiding ambiguous outcomes and/or clarifying initially ambiguous results. The end result for each assessment method is a set of best practice guidelines, given the available evidence, for conducting the initial assessment. PMID:26236145

  19. Assessing Treatment Outcomes in Attention-Deficit/Hyperactivity Disorder: A Narrative Review

    PubMed Central

    Weiss, Margaret D.

    2012-01-01

    Objective: To review measures used to assess treatment response in patients with attention-deficit/hyperactivity disorder (ADHD) across the life span. Data Sources: Keyword searches of English-language articles in the PubMed database up to and including the May 4, 2011, index date were performed with the search strings (1) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (outcome assessment [MeSH] OR adaptation of life skills OR executive function [MeSH]) and (2) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (function OR functioning OR quality of life [MeSH]). Study Selection: Articles found through this search were then selected based on relevance to the topic area; no specific quality criteria were applied. Data Extraction: Narrative review. Results: The vast majority of studies assessing ADHD treatments have measured treatment response using ADHD symptom measures. Additional domains relevant for assessing treatment response among children and adults with ADHD include functional impairment, quality of life, adaptive life skills, and executive function. Validated rating scales exist for assessing these additional domains, but there has been minimal research evaluating the sensitivity of these instruments for detecting treatment response in pediatric and adult samples. Conclusions: Assessment of treatment outcomes in ADHD should move beyond symptom assessment to incorporate measures of functioning, quality of life, adaptive skills, and executive function, especially when assessing long-term treatment response. The authors recommend a potential battery and schedule of measures that could be used to more comprehensively assess treatment response in patients with ADHD. PMID:23585986

  20. The effect of reinforcer preference on functional analysis outcomes.

    PubMed Central

    Lalli, J S; Kates, K

    1998-01-01

    We combined functional analyses and concurrent-schedule assessments to identify reinforcer preference during situations in which problem behavior may have been multiply controlled. Participants were 3 children with developmental delays who engaged in problem behavior during toy play with another child and one adult present, suggesting that problem behavior may have been maintained by adult attention or access to tangible reinforcement. Thus, conditions were designed to test attention and access-to-toys hypotheses. Initial functional analyses suggested multiple control. Subsequent concurrent-schedule assessments identified preference between the reinforcers, and treatments were based on these findings. Findings are discussed regarding the assessment of potentially multiply controlled problem behavior. PMID:9532752

  1. Using vaccinations to assess in vivo immune function in psychoneuroimmunology.

    PubMed

    Burns, Victoria E

    2012-01-01

    Finding clinically relevant measures of immune function is an important challenge in psychoneuroimmunological research. Here, we discuss the advantages of the vaccination model, and provide guidance on the methodological decisions that are important to consider in the use of this technique. These include the choice of vaccination, timing of assessments, and the available outcome measures.

  2. The Role of Stress Exposure and Family Functioning in Internalizing Outcomes of Urban Families

    PubMed Central

    Henry, David B.; Tolan, Patrick H.; Strachan, Martha K.

    2013-01-01

    Although research suggests that stress exposure and family functioning are associated with internalizing problems in adolescents and caregivers, surprisingly few studies have investigated the mechanisms that underlie this association. To determine whether family functioning buffers the development of internalizing problems in stress-exposed families, we assessed the relation between stress exposure, family functioning, and internalizing symptoms among a large sample of inner-city male youth and their caregivers living in poverty across five waves of data collection. We hypothesized that stress exposure and family functioning would predict development of subsequent youth and caregiver internalizing problems and that family functioning would moderate this relation, with higher functioning families demonstrating greater resiliency to stress exposure. We used a longitudinal, prospective design to evaluate whether family functioning (assessed at waves one through four) activated or buffered the effects of stress exposure (assessed at wave one) on subsequent internalizing symptoms (assessed at waves four and five). Stress from Developmental Transitions and family functioning were significant predictors of depressive symptoms and anxiety in youth; however, family functioning did not moderate the relation. Family functioning mediated the relation between stress from Daily Hassles and internalizing outcomes suggesting that poor parenting practices, low structure, and low emotional cohesion activate depression and anxiety in youth exposed to chronic and frequent everyday stressors. Surprisingly, only family functioning predicted depressive symptoms in caregivers. Results validate the use of a comprehensive, multi-informant assessment of stress when investigating internalizing outcomes in youth and support using family-based interventions in the treatment and prevention of internalizing. PMID:25601821

  3. Functional Performance Testing and Patient Reported Outcomes following ACL Reconstruction: A Systematic Scoping Review.

    PubMed

    Almangoush, Adel; Herrington, Lee

    2014-01-01

    Objective. A systematic scoping review of the literature to identify functional performance tests and patient reported outcomes for patients who undergo anterior cruciate ligament (ACL) reconstruction and rehabilitation that are used in clinical practice and research during the last decade. Methods. A literature search was conducted. Electronic databases used included Medline, PubMed, Cochrane Library, EMBASE, CINAHL, SPORTDiscus, PEDro, and AMED. The inclusion criteria were English language, publication between April 2004 and April 2014, and primary ACL reconstruction with objective and/or subjective outcomes used. Two authors screened the selected papers for title, abstract, and full-text in accordance with predefined inclusion and exclusion criteria. The methodological quality of all papers was assessed by a checklist of the Critical Appraisal Skills Programme (CASP). Results. A total of 16 papers were included with full-text. Different authors used different study designs for functional performance testing which led to different outcomes that could not be compared. All papers used a measurement for quantity of functional performance except one study which used both quantity and quality outcomes. Several functional performance tests and patient reported outcomes were identified in this review. Conclusion. No extensive research has been carried out over the past 10 years to measure the quality of functional performance testing and control stability of patients following ACL reconstruction. However this study found that the measurement of functional performance following ACL reconstruction consisting of a one-leg hop for a set distance or a combination of different hops using limb symmetry index (LSI) was a main outcome parameter of several studies. A more extensive series of tests is suggested to measure both the quantitative and qualitative aspects of functional performance after the ACL reconstruction. The KOOS and the IKDC questionnaires are both measures that

  4. Functional Performance Testing and Patient Reported Outcomes following ACL Reconstruction: A Systematic Scoping Review

    PubMed Central

    Herrington, Lee

    2014-01-01

    Objective. A systematic scoping review of the literature to identify functional performance tests and patient reported outcomes for patients who undergo anterior cruciate ligament (ACL) reconstruction and rehabilitation that are used in clinical practice and research during the last decade. Methods. A literature search was conducted. Electronic databases used included Medline, PubMed, Cochrane Library, EMBASE, CINAHL, SPORTDiscus, PEDro, and AMED. The inclusion criteria were English language, publication between April 2004 and April 2014, and primary ACL reconstruction with objective and/or subjective outcomes used. Two authors screened the selected papers for title, abstract, and full-text in accordance with predefined inclusion and exclusion criteria. The methodological quality of all papers was assessed by a checklist of the Critical Appraisal Skills Programme (CASP). Results. A total of 16 papers were included with full-text. Different authors used different study designs for functional performance testing which led to different outcomes that could not be compared. All papers used a measurement for quantity of functional performance except one study which used both quantity and quality outcomes. Several functional performance tests and patient reported outcomes were identified in this review. Conclusion. No extensive research has been carried out over the past 10 years to measure the quality of functional performance testing and control stability of patients following ACL reconstruction. However this study found that the measurement of functional performance following ACL reconstruction consisting of a one-leg hop for a set distance or a combination of different hops using limb symmetry index (LSI) was a main outcome parameter of several studies. A more extensive series of tests is suggested to measure both the quantitative and qualitative aspects of functional performance after the ACL reconstruction. The KOOS and the IKDC questionnaires are both measures that

  5. Processing speed mediates the relationship between verbal memory, verbal fluency, and functional outcome in chronic schizophrenia.

    PubMed

    Ojeda, Natalia; Peña, Javier; Sánchez, Pedro; Elizagárate, Edorta; Ezcurra, Jesús

    2008-04-01

    Verbal fluency and verbal memory have been reported to be diminished in patients with schizophrenia. These deficits could partially predict functional disability in this pathology. However, processing speed often mediates the relationship among cognitive processes in the disorder. Our goal was to analyse the influence of processing speed as mediator of the relation between verbal fluency-verbal memory and functional disability in chronic schizophrenia. We examined 90 hospitalized patients and 30 healthy controls (matched for gender, age and years of education). The neuropsychological battery included tests for verbal fluency, verbal memory, motor speed and processing speed. Outcome measures included Disability Assessment Schedule (DAS-WHO) and number of hospitalizations (NH). Results confirmed chronicity on clinical symptoms (PANSS total X=48.94+14.97 PANSS negative X=27.81+10.18, PANSS positive X=23.51+10.81) and impairment on functional disability (DAS-WHO X=13.62+4.28). As expected, verbal fluency was severely impaired in patients and significantly predicted functional outcome. Immediate and Delayed Verbal Memory were also severely impaired and predicted functional outcome. However, when processing speed was entered in the regression analyses the significance of verbal fluency and verbal memory decreased significantly. Sobel's equation was significant, suggesting full mediation. Our findings suggest that processing speed may be a central factor in the relation between cognitive symptoms and functional outcome in chronic schizophrenia. PMID:18261885

  6. Self-Conscious emotions’ role in functional outcomes within clinical populations

    PubMed Central

    Macaulay, Rebecca; Cohen, Alex

    2014-01-01

    Patients with severe mental illnesses (SMI) often experience dysfunction in their ability to efficiently carry out everyday roles and/or skills. These deficits are seen across many domains of daily functioning. We suggest that the “self-conscious emotions” of pride and shame play a role in these functional outcomes. Pride and shame appear to facilitate individuals’ ability to evaluate their group status, detect social threats, and to adjust their behaviors accordingly. This study utilized an objective performance measure of functional capacity and a self-report of quality of life (QoL) to examine the respective roles of pride and shame in functional outcomes within two SMI patient groups (schizophrenia and affective disorder) and a community control group. The influence of neurocognition, affect and symptomatology on functional outcomes was also assessed. The patient groups did not differ in cognitive functioning, QoL, or shame. The schizophrenia group reported significantly higher pride and displayed worse objective performance than the other groups. Within each of the groups, shame had an inverse relationship with QoL, while pride positively associated with QoL. Shame associated with worse functional capacity in the schizophrenia group. Shame associated with better functional capacity, while pride associated with worse functional capacity within the affective disorder group. PMID:24508025

  7. Knee Function Assessment in Patients With Meniscus Injury

    PubMed Central

    Naimark, Micah B.; Kegel, Gary; O’Donnell, Thomas; Lavigne, Stephanie; Heveran, Chelsea; Crawford, Dennis C.

    2014-01-01

    Background: Outcomes of meniscus surgery are typically assessed with patient questionnaires that help capture symptoms and functional limitations but may not provide an accurate representation of underlying joint health. There are currently no performance-based measures of knee function in patients with symptomatic meniscus injury. Purpose: To assess the reproducibility, response to partial meniscectomy, and correlation with patient-reported questionnaire outcomes of novel performance-based knee function tests. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A battery of 9 tests for activities that require knee movements essential for everyday living was developed. Intra- and interrater reproducibility was assessed in 50 meniscus tear patients completing the battery at 2 preoperative assessments with either the same or different examiners. Response to arthroscopic partial meniscectomy was evaluated in 35 of these patients 6 weeks after surgery. Subjects also completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaires pre- and postoperatively. Results: The intrarater intraclass correlation coefficients (ICCs) were excellent for all tests (ICC > 0.8). Interrater ICC > 0.8 was observed for step-down, stair descent, star lunges, and timed treadmill travel. Performance on all tests improved significantly with surgery (P < .05), with the greatest improvement in sit-to-stand and stair ascent and descent. A greater percentage response to surgery was seen on questionnaire outcomes (20%-65%) than on performance-based tests (3%-15%). Moderate to poor correlations existed between the KOOS activities of daily living subscale and the performance-based tests (all ICCs ≤ 0.4). Conclusion: Performance-based knee function tests demonstrated good reproducibility and responsiveness in patients undergoing partial meniscectomy. Clinical Relevance: As both patient perception and functional

  8. The Reliability and Validity of the MATRICS Functional Assessment Battery

    PubMed Central

    Velligan, Dawn I.; Fredrick, Megan; Mintz, Jim; Li, Xueying; Rubin, Maureen; Dube, Sanjay; Deshpande, Smita N.; Trivedi, Jitendra K.; Gautam, Shiv; Avasthi, Ajit; Kern, Robert S.; Marder, Stephen R.

    2014-01-01

    Objectives: The Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative was designed to encourage the development of cognitive enhancing agents for schizophrenia. For a medication to receive this indication, regulatory agencies require evidence of improvement in both cognition and functional outcome. Functional capacity measures typically used in clinical trials as intermediate measures of functional outcome must be adapted to fit different cultural contexts for use internationally. We examined the psychometric properties of the MATRICS Functional Assessment Battery (MFAB), comprised of 2 subtests from the UCSD Performance-based Skills Assessment (UPSA) and one from the Test of Adaptive Behavior in Schizophrenia (TABS) that were rated by experts in a previous study to be the most appropriate functional capacity assessments across different cultural contexts. Method: Four sites in India administered the MFAB, a brief version of the UPSA, the MATRICS Cognitive Consensus Battery, measures of symptomatology, and a measure of global functional outcome to 141 individuals with schizophrenia at a baseline assessment and at 4 weeks later. Results: Test-retest reliability based on the intraclass correlation coefficient was significantly better for the UCSD Performance-Based Skills Assessment-Brief (UPSA-B). Pearson correlation coefficients over time were not significantly different for the 2 measures. Only the MFAB was significantly correlated with functional outcome as measured by the Specific Levels of Functioning Scale. Conclusions: The psychometric properties of the MFAB and UPSA-B were similar. The MATRICS scientific board chose to translate the MFAB into multiple languages for potential use in studies of novel medications seeking an indication for improving cognition in schizophrenia. PMID:24214931

  9. To Assess the Effect of Maternal BMI on Obstetrical Outcome

    NASA Astrophysics Data System (ADS)

    Lakhanpal, Shuchi; Aggarwal, Asha; Kaur, Gurcharan

    2012-06-01

    AIMS: To assess the effect of maternal BMI on complications in pregnancy, mode of delivery, complications of labour and delivery.METHODS:A crossectional study was carried out in the Obst and Gynae department, Kasturba Hospital, Delhi. The study enrolled 100 pregnant women. They were divided into 2 groups based on their BMI, more than or equal to 30.0 kg/m2 were categorized as obese and less than 30 kg/m2 as non obese respectively. Maternal complications in both types of patients were studied.RESULTS:CONCLUSION: As the obstetrical outcome is significantly altered due to obesity, we can improve maternal outcome by overcoming obesity. As obesity is a modifiable risk factor, preconception counseling creating awareness regarding health risk associated with obesity should be encouraged and obstetrical complications reduced.

  10. Open Versus Arthroscopic Biceps Tenodesis: A Comparison of Functional Outcomes

    PubMed Central

    Duchman, Kyle R; DeMik, David E.; Uribe, Bastian; Wolf, Brian R; Bollier, Matthew

    2016-01-01

    Background The proximal aspect of the long head of the biceps brachii (LHB) is a frequent source of anterior shoulder pain. Multiple techniques for LHB tenodesis have been described. However, comparative outcomes are lacking. The present study aims to compare functional results, patient reported outcomes, complications, and clinical failures for patients undergoing open versus arthroscopic LHB tenodesis. Methods All patients who underwent open or arthroscopic LHB tenodesis from 2009-2012 at a single institution were identified. Patient demographics, comorbidities, and operative variables of interest, including concomitant procedures, were recorded. Minimum 1-year follow-up was required for inclusion. Outcomes, including patient reported outcomes, physical exam findings, and complications were compared between open and arthroscopic LHB tenodesis patients. Results Overall, 45 patients (25 open, 20 arthroscopic) were available for analysis. In total, there was a single clinical failure in a patient who underwent arthroscopic LHB tenodesis. No other complications or failures were noted. Active shoulder forward elevation was increased in the open tenodesis group as compared to the arthroscopic tenodesis group (177.8 ± 9.3° vs. 171.3 ± 11.7°; p = 0.049). Otherwise, there was no difference in range of motion or strength. For both groups, both the SF-36 and ASES scores improved significantly from preoperative values. Conclusion Both open and arthroscopic LHB tenodesis provide good to excellent outcomes with few complications. Given the recent increased utilization of LHB tenodesis, future studies should use randomization and prospective data collection in order to determine if discrete patient populations are better served by either open or arthroscopic LHB tenodesis techniques PMID:27528841

  11. Functional outcomes of very premature infants into adulthood.

    PubMed

    Saigal, Saroj

    2014-04-01

    The outcomes of very low birth weight survivors born in the early post-neonatal intensive care era have now been reported to young adulthood in several longitudinal cohort studies, and more recently from large Scandinavian national databases. The latter reports corroborate the findings that despite disabilities, a significant majority of very low birth weight survivors are leading productive lives, and are functioning better than expected. This is reassuring, but there are still concerns about future psychopathology, cardiovascular and metabolic problems as they approach middle age. Although these findings may not be directly applicable to the current survivors of modern neonatal intensive care, they do provide a yardstick by which to project the outcomes of future survivors until more contemporaneous data are available. PMID:24289905

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

    PubMed

    Cutter, G R; Baier, M L; Rudick, R A; Cookfair, D L; Fischer, J S; Petkau, J; Syndulko, K; Weinshenker, B G; Antel, J P; Confavreux, C; Ellison, G W; Lublin, F; Miller, A E; Rao, S M; Reingold, S; Thompson, A; Willoughby, E

    1999-05-01

    The primary clinical outcome measure for evaluating multiple sclerosis in clinical trials has been Kurtzke's expanded disability status scale (EDSS). New therapies appear to favourably impact the course of multiple sclerosis and render continued use of placebo control groups more difficult. Consequently, future trials are likely to compare active treatment groups which will most probably require increased sample sizes in order to detect therapeutic efficacy. Because more responsive outcome measures will be needed for active arm comparison studies, the National Multiple Sclerosis Society's Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis appointed a Task Force that was charged with developing improved clinical outcome measures. This Task Force acquired contemporary clinical trial and historical multiple sclerosis data for meta-analyses of primary and secondary outcome assessments to provide a basis for recommending a new outcome measure. A composite measure encompassing the major clinical dimensions of arm, leg and cognitive function was identified and termed the multiple sclerosis functional composite (MSFC). The MSFC consists of three objective quantitative tests of neurological function which are easy to administer. Change in this MSFC over the first year of observation predicted subsequent change in the EDSS, suggesting that the MSFC is more sensitive to change than the EDSS. This paper provides details concerning the development and testing of the MSFC.

  13. Family History and Functional Outcome in Korean Stroke Patients: A Preliminary Study

    PubMed Central

    Park, Hee Jung; Kim, Tae Uk; Hyun, Jung Keun

    2015-01-01

    Objective To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea. Methods A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the following: large vessel infarct, small vessel infarct, embolic infarct, subarachnoid hemorrhage, and intracranial hemorrhage. Stroke severity as assessed with the National Institutes of Health Stroke Scale (NIHSS), functional outcomes using the Korean version of the Modified Barthel index (K-MBI), Functional Independence Measurement (FIM), and cognitive function using the Korean version of Mini-Mental State Examination (K-MMSE) were assessed at admission and discharge. Results Subjects with a family history of stroke were more likely to have an ischemic stroke (90.7%) than were those without a family history (70.9%). The K-MBI, FIM, NIHSS, and K-MMSE scores did not show significant differences between patients with or without family history. Conclusion Family history of stroke was significantly associated with ischemic stroke, but not with functional outcomes. Other prognostic factors of stroke were not distributed differently between patients included in this study with or without a family history of stroke. PMID:26798613

  14. Functional outcomes of general medical patients with severe sepsis

    PubMed Central

    2013-01-01

    Background Severe sepsis is a common cause for admission to the general medical ward. Previous work has demonstrated substantial new long-term disability in patients with severe sepsis, but the short-term functional outcomes of patients admitted to the general medical floor -- where the majority of severe sepsis is treated -- are largely unknown. Methods A retrospective cohort study was performed of patients initially admitted to non-ICU medical wards at a tertiary care academic medical center. Severe sepsis was confirmed by three physician reviewers, using the International Consensus Conference definition of sepsis. Baseline functional status, disposition location, and receipt of post-acute skilled care were recorded using a structured abstraction instrument. Results 3,146 discharges had severe sepsis by coding algorithm; from a random sample of 111 patients, 64 had the diagnosis of severe sepsis confirmed by reviewers. The mean age of the 64 patients was 63.5 years +/- 18.0. Prior to admission, 80% of patients lived at home and 50.8% of patients were functionally independent. Inpatient mortality was 12.5% and 37.5% of patients were discharged to a nursing facility. Of all patients in the cohort, 50.0% were discharged home, and 66.7% of patients who were functionally independent at baseline were discharged to home. Conclusions New physical debility is a common feature of severe sepsis in patients initially cared for on the general medical floor. Debility occurs even in those with good baseline physical function. Interventions to improve the poor functional outcomes of this population are urgently needed. PMID:24330544

  15. Anterior cruciate ligament reconstruction and rehabilitation: predictors of functional outcome

    PubMed Central

    DELLA VILLA, FRANCESCO; RICCI, MARGHERITA; PERDISA, FRANCESCO; FILARDO, GIUSEPPE; GAMBERINI, JACOPO; CAMINATI, DANIELE; DELLA VILLA, STEFANO

    2015-01-01

    Surgical reconstruction of an injured anterior cruciate ligament (ACL) leads to full recovery of function and sports activity in a high percentage of cases. The aim of the present study was to analyze variables related to the patient, the surgical technique and the post-surgical rehabilitation methods, seeking to identify predictors of outcome and recovery time after ACL reconstruction. One hundred and four patients (81 M, 23 F) undergoing a step-based rehabilitation protocol after ACL reconstruction were evaluated. 43.2% of them had an isolated ACL lesion, whereas 56.8% had one or more concurrent injuries. Data relating to personal characteristics, surgery and post-operative management were collected and analyzed for correlation. Clinical outcome was evaluated with IKDC subjective score and the Tegner score, and the time to reach full recovery was noted as well. Young patients with a higher pre-injury Tegner activity level or who practice sport at professional level, no concurrent capsular lesions and no postoperative knee bracing had better clinical results and took shorter time to recover. Also, a higher percentage of on-the-field rehabilitation sessions, and absence of significant muscle strength deficits at the first knee isokinetic test emerged as rehabilitation-related factors leading to a better post-surgical outcome. Personal, surgical and rehabilitation factors should be considered in order to optimize patient management and maximize the expected results. Further studies are needed to find the strongest factors in different patients. Level of evidence Level IV, retrospective study. PMID:26904523

  16. Chondrosarcoma of the Pelvis: Oncologic and Functional Outcome

    PubMed Central

    Schulte, Michael; Maier, Bernd; Koschnik, Martin; Mutschler, Wolf E.

    2000-01-01

    Purpose. Chondrosarcoma (CS) most commonly involves the pelvis. The factors that influence local and systemic control of pelvic CS and the functional outcome should be evaluated. Patients. Fifty-one patients (37 males and 14 females; mean age, 39.4 years) with pelvic CS were included in this retrospective study. Methods. The tumor stage, surgical treatment, surgical margin achieved, complications, incidence of local recurrence (LR), incidence of distant metastases, and the oncologic and functional status were evaluated. Oncologic outcome was estimated by the method of Kaplan and Meier, and the functional status was scored according to Musculoskeleral Tumor Society (MSTS) criteria. Analysis of variance was used to determine the factors that influence the oncologic and functional outcome. Results. Surgical stages were IA in three cases, IB in 23, IIB in 23, and III in two. Hemipelvectomy (H) was performed in 13 cases, internal hemipelvectomy (IH) with endoprosthetic replacement in 17, and continuity resection (CR) in 23.Two patients received IH and CR, one due to LR, and one due to instability. Radical or wide margins were achieved in 27 cases, marginal margins in 16, and intralesional margins in eight. Local complication required additional surgery in 10 cases due to local infections and/or hematomas.Two patients died perioperatively. In 48 out of the 49 remaining patients, follow-up was available with a mean duration of 73.4 months (range, 4–229 months).Twenty patients died of the disease, two patients are alive with metastases, four patients are disease free after LR, and 22 patients show no evidence of the disease. LR occurred in 10 cases (20.4%), and 17 patients (34.6%) developed distant metastases. Functional evaluation of the 28 survivors revealed good and excellent results in 19 cases, fair in three and poor in six.The mean MSTS score of all survivors was 69.2%, after H it was 37.6%, after IH was 61.4%, and after CR was 79.5%. Conclusion. In pelvic

  17. False-Positive Tangible Outcomes of Functional Analyses

    ERIC Educational Resources Information Center

    Rooker, Griffin W.; Iwata, Brian A.; Harper, Jill M.; Fahmie, Tara A.; Camp, Erin M.

    2011-01-01

    Functional analysis (FA) methodology is the most precise method for identifying variables that maintain problem behavior. Occasionally, however, results of an FA may be influenced by idiosyncratic sensitivity to aspects of the assessment conditions. For example, data from several studies suggest that inclusion of a tangible condition during an FA…

  18. Air pollutants and health outcomes: Assessment of confounding by influenza

    NASA Astrophysics Data System (ADS)

    Thach, Thuan-Quoc; Wong, Chit-Ming; Chan, King-Pan; Chau, Yuen-Kwan; Neil Thomas, G.; Ou, Chun-Quan; Yang, Lin; Peiris, Joseph S. M.; Lam, Tai-Hing; Hedley, Anthony J.

    2010-04-01

    We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996-2002. Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus <2% of the annual positive isolates for ≥2 consecutive weeks. We examined effects of influenza on associations between nitrogen dioxide (NO 2), sulfur dioxide (SO 2), particulate matter with aerodynamic diameter ≤10 μm (PM 10) and ozone (O 3) and health outcomes including all natural causes mortality, cardiorespiratory mortality and hospitalization. Generalized additive Poisson regression model with natural cubic splines was fitted to control for time-varying covariates to estimate air pollution health effects. Confounding with influenza was assessed using an absolute difference of >0.1% between unadjusted and adjusted excess risks (ER%). Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO 2 and stroke hospitalization with O 3. Following adjustment, changes in ER% for all pollutants were <0.1% for all natural causes mortality, but >0.1% for mortality from stroke with NO 2 and SO 2, cardiac or heart disease with NO 2, PM 10 and O 3, lower respiratory infections with NO 2 and O 3 and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO 2, SO 2 and O 3 and acute lower respiratory infections hospitalization with PM 10. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants

  19. Functional Status Outcomes in Mothers with and without Postpartum Depression

    PubMed Central

    Posmontier, Barbara

    2008-01-01

    Objective To compare functional status between women with and without postpartum depression (PPD). Methods A two-group cross-sectional design compared functional status between 23 women with and 23 women without PPD. Participants were 6 to 26 weeks postpartum, and from obstetric practices in the Northeastern United States. Structured clinical interviews were used to establish diagnoses of PPD. Participants were matched on type of delivery, weeks postpartum, and parity. Participants compared current functioning to pre-pregnancy functioning utilizing the Inventory of Functional Status After Childbirth. The Postpartum Depression Screening Scale was used to measure PPD severity. Hierarchical multiple and logistic regression models were used to analyze data. Results Controlling for infant gender, number of nighttime infant awakenings, and income, PPD predicted lower personal (P<0.001), household (P<0.05), and social functioning (P<0.001), but no difference in infant care. Women with PPD were 12 times less likely to achieve pre-pregnancy functional levels. Conclusions Interventions are needed to address household, social, and personal functioning in women with PPD. Clinicians may find functional assessment is a useful adjunct and a less threatening way to screen and monitor treatment for PPD. PMID:18586183

  20. Intrinsic Functional Connectivity Patterns Predict Consciousness Level and Recovery Outcome in Acquired Brain Injury

    PubMed Central

    Wu, Xuehai; Zou, Qihong; Hu, Jin; Tang, Weijun; Mao, Ying; Gao, Liang; Zhu, Jianhong; Jin, Yi; Wu, Xin; Lu, Lu; Zhang, Yaojun; Zhang, Yao; Dai, Zhengjia; Gao, Jia-Hong; Weng, Xuchu; Northoff, Georg; Giacino, Joseph T.; He, Yong

    2015-01-01

    For accurate diagnosis and prognostic prediction of acquired brain injury (ABI), it is crucial to understand the neurobiological mechanisms underlying loss of consciousness. However, there is no consensus on which regions and networks act as biomarkers for consciousness level and recovery outcome in ABI. Using resting-state fMRI, we assessed intrinsic functional connectivity strength (FCS) of whole-brain networks in a large sample of 99 ABI patients with varying degrees of consciousness loss (including fully preserved consciousness state, minimally conscious state, unresponsive wakefulness syndrome/vegetative state, and coma) and 34 healthy control subjects. Consciousness level was evaluated using the Glasgow Coma Scale and Coma Recovery Scale-Revised on the day of fMRI scanning; recovery outcome was assessed using the Glasgow Outcome Scale 3 months after the fMRI scanning. One-way ANOVA of FCS, Spearman correlation analyses between FCS and the consciousness level and recovery outcome, and FCS-based multivariate pattern analysis were performed. We found decreased FCS with loss of consciousness primarily distributed in the posterior cingulate cortex/precuneus (PCC/PCU), medial prefrontal cortex, and lateral parietal cortex. The FCS values of these regions were significantly correlated with consciousness level and recovery outcome. Multivariate support vector machine discrimination analysis revealed that the FCS patterns predicted whether patients with unresponsive wakefulness syndrome/vegetative state and coma would regain consciousness with an accuracy of 81.25%, and the most discriminative region was the PCC/PCU. These findings suggest that intrinsic functional connectivity patterns of the human posteromedial cortex could serve as a potential indicator for consciousness level and recovery outcome in individuals with ABI. SIGNIFICANCE STATEMENT Varying degrees of consciousness loss and recovery are commonly observed in acquired brain injury patients, yet the

  1. Adult functional outcomes of common childhood psychiatric problems: A prospective, longitudinal study

    PubMed Central

    Copeland, William E.; Wolke, Dieter; Shanahan, Lilly; Costello, E. Jane

    2016-01-01

    Context Psychiatric problems are among the most common health problems of childhood. Objective To test whether these health problems adversely affect adult functioning even if the problems themselves do not persist. Design Prospective, population-based study of 1420 participants assessed with structured interviews up to 6 times in childhood (ages 9 to 16; 6674 observations) for common psychiatric diagnoses and subthreshold psychiatric problems. Setting and population Community sample. Main outcome measure Participants were then assessed 3 times in young adulthood (ages 19, 21, and 24–26; 3215 observations of 1273 subjects) for adverse outcomes related to health, legal, financial, and social functioning. Results Participants with a childhood disorder had 6 times higher odds of at least one adverse adult outcome as compared to those with no history of psychiatric problems and 9 times higher odds of 2 or more such indicators (1 indicator: 59.5% vs. 19.9%, p <0.001; 2+ indicators: 34.2% vs. 5.6%, p <0.001). These associations persisted after statistically controlling for childhood psychosocial hardships and adult psychiatric problems. Risk was not limited to those with a diagnosis: participants with subthreshold psychiatric problems had 3 times higher odds of adult adverse outcomes and 5 time higher odds of 2 or more outcomes (1 indicator: 41.9% vs. 19.9%, p <0.001; 2+ indicators: 23.2% vs. 5.6%, p <0.001). The best diagnostic predictor of adverse outcomes was cumulative childhood exposure to psychiatric disorders. Conclusions Common, typically moderately-impairing, childhood psychiatric problems are associated with a disrupted transition to adulthood even if the problems do not persist into adulthood and even if the problems are subthreshold. Such problems provide potential target for public health efforts to ameliorate adult suffering and morbidity. PMID:26176785

  2. Patient-Reported Outcome Assessments as Endpoints in Studies in Infectious Diseases.

    PubMed

    Powers, John H; Howard, Kellee; Saretsky, Todd; Clifford, Sarah; Hoffmann, Steve; Llorens, Lily; Talbot, George

    2016-08-15

    The goal of administering medical interventions is to help patients live longer or live better. In keeping with this goal, there has been increasing interest in taking the "voice" of the patient into account during the development process, specifically in the evaluation of treatment benefits of medical interventions, and use of patient-centered outcome data to justify reimbursement. Patient-reported outcomes (PROs) are outcome assessments (OAs) used to define endpoints that can provide direct evidence of treatment benefit on how patients feel or function. When PROs are appropriately developed, they can increase the efficiency and clinical relevance of clinical trials. Several PROs have been developed for OA in specific infectious diseases indications, and more are under development. PROs also hold promise for use in evaluating adherence, adverse effects, satisfaction with care, and routine clinical practice. PMID:27481954

  3. Assessment of Global Functioning in Adolescents with Autism Spectrum Disorders: Utility of the Developmental Disability-Child Global Assessment Scale

    ERIC Educational Resources Information Center

    White, Susan W.; Smith, Laura A.; Schry, Amie R.

    2014-01-01

    Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment…

  4. Training of affect recognition (TAR) in schizophrenia--impact on functional outcome.

    PubMed

    Sachs, G; Winklbaur, B; Jagsch, R; Lasser, I; Kryspin-Exner, I; Frommann, N; Wölwer, W

    2012-07-01

    Deficits in facial affect recognition as one aspect of social cognitive deficits are treatment targets to improve functional outcome in schizophrenia. According to preliminary results antipsychotics alone show little effects on affect recognition. A few randomized intervention studies have evaluated special psychosocial treatment programs on social cognition. In this study, the effects of a computer-based training of affect recognition were investigated as well as its impact on facial affect recognition and functional outcome, particularly on patients' quality of life. Forty clinically stabilized schizophrenic patients were randomized to a six-week training on affect recognition (TAR) or treatment as usual including occupational therapy (TAU) and completed pre- and post-treatment assessments of emotion recognition, cognition, quality of life and clinical symptoms. Between pre- and post treatment, the TAR group achieved significant improvements in facial affect recognition, in particular in recognizing sad faces and, in addition, in the quality of life domain social relationship. These changes were not found in the TAU group. Furthermore, the TAR training contributes to enhancing some aspects of cognitive functioning and negative symptoms. These improvements in facial affect recognition and quality of life were independent of changes in clinical symptoms and general cognitive functions. The findings support the efficacy of an affect recognition training for patients with schizophrenia and the generalization to social relationship. Further development is needed in the impact of a psychosocial intervention in other aspects of social cognition and functional outcome.

  5. Associations between preoperative functional status and functional outcomes of total joint replacement in the Dominican Republic

    PubMed Central

    Collins, Jamie E.; Ghazinouri, Roya; Alcantara, Luis; Thornhill, Thomas S.; Katz, Jeffrey N.

    2013-01-01

    Objective. In developed countries, the functional status scores of patients with poor preoperative scores undergoing total joint replacement (TJR) improve more following TJR than those for patients with better preoperative scores. However, those with better preoperative scores achieve the best postoperative functional outcomes. We determined whether similar associations exist in a developing country. Methods. Dominican patients undergoing total hip or knee replacement completed WOMAC and SF-36 surveys preoperatively and at 12-month follow-up. Patients were stratified into low-, medium- and high-scoring preoperative groups based on their preoperative WOMAC function scores. We examined the associations between the baseline functional status of these groups and two outcomes—improvement in functional status over 12 months and functional status at 12 months—using analysis of variance with multivariable linear regression. Results. Patients who scored the lowest preoperatively made the greatest gains in function and pain relief following their TJRs. However, there were no significant differences in pain or function at 12-month follow-up between patients who scored low and those who scored high on preoperative WOMAC and SF-36 surveys. Conclusion. Patients with poor preoperative functional status had greater improvement but similar 12-month functional outcomes compared with patients who had a higher level of function before surgery. These results suggest that a policy of focusing scarce resources on patients with worse functional status in developing countries may optimize improvement following TJR without threatening functional outcome. Additional research is needed to confirm these findings in other developing countries and to understand why these associations vary between patients in the Dominican Republic and patients from developed countries. PMID:23748412

  6. Curriculum Assessment as a Direct Tool in ABET Outcomes Assessment in a Chemical Engineering Programme

    ERIC Educational Resources Information Center

    Abu-Jdayil, Basim; Al-Attar, Hazim

    2010-01-01

    The chemical engineering programme at the United Arab Emirates University is designed to fulfil the Accreditation Board for Engineering and Technology (ABET) (A-K) EC2000 criteria. The Department of Chemical & Petroleum Engineering has established a well-defined process for outcomes assessment for the chemical engineering programme in order to…

  7. An evaluation of legal outcome following pretrial forensic assessment.

    PubMed

    Arboleda-Flórez, J; Holley, H L; Williams, J; Crisanti, A

    1994-04-01

    This paper constitutes the first stage of data analysis in a larger controlled study designed to assess the effect of a forensic psychiatric assessment on legal disposition defined in three ways: 1. the number of days spent in custody prior to trial; 2. the number of sentenced days of incarceration; and 3. the conviction rate. A historical cohort design was used to follow two cohorts of individuals remanded, pretrial, to Southern Alberta Provincial Correctional Centres between 1988 and 1989. The study cohort consisted of all offenders detained who received a forensic psychiatric assessment. The comparison cohort consisted of a random sample of persons detained who did not undergo a forensic assessment. Because of small numbers, individuals below the age of 18 and women were excluded from study. This paper compares socio-legal characteristics of study and comparison subjects in order to better understand forensic psychiatric referral patterns and identify potentially confounding factors that would need to be controlled in subsequent analyses of legal outcomes. No differences were noted with respect to educational level but forensic subjects were found to be slightly older (average of 31 years compared to 29 years). Aboriginal peoples (Native Indian, Inuit and Metis) were three times more common among non-forensic offenders. Forensic patients were more likely to have had a prior forensic assessment but less likely to have a prior criminal detention. In addition, forensic patients were three times more likely to be charged with a crime against a person and counted more offenses in the target episode than comparison subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Creating clinical trial designs that incorporate clinical outcome assessments.

    PubMed

    Gilbert, Mark R; Rubinstein, Lawrence; Lesser, Glenn

    2016-03-01

    Clinical outcome assessments (COAs) are increasingly being used in determining the efficacy of new treatment regimens. This was typified in the recent use of a symptom-based instrument combined with an organ-based measure of response for the approval of ruxolitinib in myelofibrosis. There are challenges in incorporating these COAs into clinical trials, including designating the level of priority, incorporating these measures into a combined or composite endpoint, and dealing with issues related to compliance and interpretation of results accounting for missing data. This article describes the results of a recent panel discussion that attempted to address these issues and provide guidance to the incorporation of COAs into clinical trials, including novel statistical designs, so that the testing of new treatments in patients with cancers of the central nervous system can incorporate these important clinical endpoints. PMID:26989129

  9. Functional outcomes in patients with Borrelia burgdorferi reinfection.

    PubMed

    Jares, Tyler M; Mathiason, Michelle A; Kowalski, Todd J

    2014-02-01

    When Lyme disease is treated with appropriate antibiotic therapy in the early stages, long-term outcomes are good. However, a few patients have persistent symptoms despite appropriate therapy. Whether these patients' symptoms are any different from those of patients with reinfection is unclear. Our objective was to compare long-term symptoms and functional outcomes of patients with Borrelia burgdorferi reinfection with those of patients with only 1 episode of infection and with no history of infection. We compared outcomes of Lyme reinfection patients, characterized by recurrent erythema migrans (EM) lesions, with those of patients with 1 episode of Lyme disease (Lyme control) and with no history of Lyme disease (non-Lyme control) by retrospective medical record review and a survey consisting of a 36-item Short-Form Health Survey (SF-36) and a 10-item symptom questionnaire. Analysis of variance (ANOVA) for continuous variables and χ(2) analysis for categorical variables were used. In cases of low cell counts, Fisher's exact tests were used. Bonferroni correction was used for multiple comparisons when ANOVA was significant. Reinfection was identified in 23/673 (3.4%) patients who had a diagnosis of Lyme disease in our health system during 2000-2004. Of the 23, 15 had long-term follow-up data and were age- and sex-matched to 45 Lyme control and 60 non-Lyme control group patients. Clinical characteristics were similar in the reinfection and Lyme control groups. SF-36 results were similar between groups for all domains except energy/vitality (VT). The SF-36 domain of VT was significantly different between groups: 63.0 vs. 54.5 vs. 64.5 in the reinfection, Lyme control, and non-Lyme control groups, respectively (p=0.047). Clinical features and long-term outcomes of patients with recurrent EM lesions were similar to those of the control groups and consistent with B. burgdorferi reinfection, not persistent infection. Patients with Lyme reinfection should be treated with

  10. Functional outcomes in patients with Borrelia burgdorferi reinfection.

    PubMed

    Jares, Tyler M; Mathiason, Michelle A; Kowalski, Todd J

    2014-02-01

    When Lyme disease is treated with appropriate antibiotic therapy in the early stages, long-term outcomes are good. However, a few patients have persistent symptoms despite appropriate therapy. Whether these patients' symptoms are any different from those of patients with reinfection is unclear. Our objective was to compare long-term symptoms and functional outcomes of patients with Borrelia burgdorferi reinfection with those of patients with only 1 episode of infection and with no history of infection. We compared outcomes of Lyme reinfection patients, characterized by recurrent erythema migrans (EM) lesions, with those of patients with 1 episode of Lyme disease (Lyme control) and with no history of Lyme disease (non-Lyme control) by retrospective medical record review and a survey consisting of a 36-item Short-Form Health Survey (SF-36) and a 10-item symptom questionnaire. Analysis of variance (ANOVA) for continuous variables and χ(2) analysis for categorical variables were used. In cases of low cell counts, Fisher's exact tests were used. Bonferroni correction was used for multiple comparisons when ANOVA was significant. Reinfection was identified in 23/673 (3.4%) patients who had a diagnosis of Lyme disease in our health system during 2000-2004. Of the 23, 15 had long-term follow-up data and were age- and sex-matched to 45 Lyme control and 60 non-Lyme control group patients. Clinical characteristics were similar in the reinfection and Lyme control groups. SF-36 results were similar between groups for all domains except energy/vitality (VT). The SF-36 domain of VT was significantly different between groups: 63.0 vs. 54.5 vs. 64.5 in the reinfection, Lyme control, and non-Lyme control groups, respectively (p=0.047). Clinical features and long-term outcomes of patients with recurrent EM lesions were similar to those of the control groups and consistent with B. burgdorferi reinfection, not persistent infection. Patients with Lyme reinfection should be treated with

  11. Meta-analysis of functional outcome in Parkinson patients treated with unilateral pallidotomy.

    PubMed

    Ahmad, S O; Mu, K; Scott, S A

    2001-10-26

    Parkinson's disease (PD) profoundly affects activities of daily living (ADL) and quality of human life. Although unilateral pallidotomy has become a common surgical treatment for persons with advanced PD, functional outcome data from previous reports have failed to uniformly support this procedure. In the present investigation, results from 12 studies meeting specific inclusion criteria were subjected to meta-analysis. Only reports featuring unilateral pallidotomy as the exclusive surgery, a sample size of at least five patients, explicit assessment of ADL, and sufficient quantitative data were subjected to analysis. Type of research design was not a factor in the selection process. The results of our analysis suggest that unilateral pallidotomy successfully enhances functional outcome in patients with clinically advanced PD. PMID:11602333

  12. Prediction of Functional Outcome in Individuals at Clinical High Risk for Psychosis

    PubMed Central

    Carrión, Ricardo E.; McLaughlin, Danielle; Goldberg, Terry E.; Auther, Andrea M.; Olsen, Ruth H.; Olvet, Doreen M.; Correll, Christoph U.; Cornblatt, Barbara A.

    2014-01-01

    Importance A major public health concern associated with schizophrenia and psychotic disorders is the long-term disability that involves impaired cognition, lack of social support, and an inability to function independently in the community. A critical goal of early detection and intervention studies in psychosis is therefore to understand the factors leading to this often profound impairment. Objective To develop a predictive model of functional (social and role) outcome in a clinical high-risk sample for psychosis. Design Prospective, naturalistic, longitudinal 3- to 5-year follow-up study. Setting The Recognition and Prevention Program in New York, a research clinic located in the Zucker Hillside Hospital in New York. Participants One hundred one treatment-seeking patients at clinical high risk for psychosis. Ninety-two (91%) were followed up prospectively for a mean (SD) of 3 (1.6) years. Intervention Neurocognitive and clinical assessment. Main Outcomes and Measures The primary outcome variables were social and role functioning at the last follow-up visit. Results Poor social outcome was predicted by reduced processing speed (odds ratio [OR], 1.38; 95% CI, 1.050-1.823; P = .02), impaired social functioning at baseline (OR, 1.85; 95% CI, 1.258-2.732; P = .002), and total disorganized symptoms (OR, 5.06; 95% CI, 1.548-16.527; P = .007). Reduced performance on tests for verbal memory (OR, 1.74; 95% CI, 1.169-2.594; P = .006), role functioning at baseline (OR, 1.34; 95% CI, 1.053-1.711; P = .02), and motor disturbances (OR, 1.77; 95% CI, 1.060-2.969; P = .03) predicted role outcome. The areas under the curve for the social and role prediction models were 0.824 (95% CI, 0.736-0.913; P < .001) and 0.77 (95% CI, 0.68-0.87; P < .001), respectively, demonstrating a high discriminative ability. In addition, poor functional outcomes were not entirely dependent on the development of psychosis, because 40.3% and 45.5% of nonconverters at clinical high risk had poor social

  13. Learning Outcomes Assessment: Extrapolating from Study Abroad to International Service-Learning

    ERIC Educational Resources Information Center

    Rubin, Donald L.; Matthews, Paul H.

    2013-01-01

    For international service-learning to thrive, it must document student learning outcomes that accrue to participants. The approaches to international service-learning assessment must be compelling to a variety of stakeholders. Recent large-scale projects in study abroad learning outcomes assessment--including the Georgia Learning Outcomes of…

  14. Do Curriculum Outcomes and Assessment Activities in Science Encourage Higher Order Thinking?

    ERIC Educational Resources Information Center

    FitzPatrick, Beverly; Schulz, Henry

    2015-01-01

    The curriculum for two science units in each of Grades 6 and 7 was analyzed to determine the cognitive levels of the outcomes and their cognitive alignment with the assessments that corresponded with these outcomes. This was done for British Columbia, Alberta, Ontario, and Atlantic Canada. The outcomes and assessments included a variety of higher…

  15. Assessing Educational Outcomes in Middle Childhood: Validation of the Teacher Academic Attainment Scale

    ERIC Educational Resources Information Center

    Johnson, Samantha; Marlow, Neil; Wolke, Dieter

    2012-01-01

    Aim: Assessing educational outcomes in high-risk populations is crucial for defining long-term outcomes. As standardized tests are costly and time-consuming, we assessed the use of the Teacher Academic Attainment Scale (TAAS) as an outcome measure. Method: Three hundred and forty three children in mainstream schools aged 10 to 11 years (144 males,…

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

    PubMed Central

    Dietz, Volker

    2016-01-01

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

  17. Self-assessment of functional status in schizophrenia☆

    PubMed Central

    Bowie, Christopher R.; Twamley, Elizabeth W.; Anderson, Hannah; Halpern, Brooke; Patterson, Thomas L.; Harvey, Philip D.

    2013-01-01

    With new treatments targeting features of schizophrenia associated with functional disability, there is a need to evaluate the validity of ratings of everyday outcomes. It is unknown whether patients can validly self-report on aspects of their functional status, which would be a potentially economical method for obtaining outcome data. In this study, 67 older schizophrenia outpatients provided self-ratings of everyday real-world functioning using the specific levels of functioning scale (SLOF). They were also administered assessments of neuropsychological performance, performance-based measures of functional capacity and social skills, clinical symptoms, and quality of life. Case managers, unaware of other ratings, also generated SLOF ratings. Based on discrepancy scores, participants were categorized as accurate raters (n = 24), underestimators (n = 16), or overestimators (n = 27) of their functional status as compared to case managers’ ratings. Patients’ self-rated functional status was correlated with their subjective quality of life, but remarkably unassociated with case manager ratings of functional status or their own performance on functional capacity or social skills measures. Case manager ratings, however, were highly correlated with performance on functional capacity and social skills measures. Patients who underestimated their real world performance had better cognitive skills and greater self-rated depression than those who overestimated. Accurate raters demonstrated greater social skills than both overestimators and underestimators, while overestimators were most cognitively and functionally impaired. Accurate ratings of everyday outcomes in schizophrenia may require systematic observation of real world outcomes or performance-based measures, as self-reports were inconsistent with objective information. PMID:17014866

  18. Regional analgesia for improvement of long-term functional outcome after elective large joint replacement

    PubMed Central

    Atchabahian, Arthur; Schwartz, Gary; Hall, Charles B; Lajam, Claudette M; Andreae, Michael H

    2015-01-01

    Background Regional analgesia is more effective than conventional analgesia for controlling pain and may facilitate rehabilitation after large joint replacement in the short term. It remains unclear if regional anaesthesia improves functional outcomes after joint replacement beyond three months after surgery. Objectives To assess the effects of regional anaesthesia and analgesia on long-term functional outcomes 3, 6 and 12 months after elective major joint (knee, shoulder and hip) replacement surgery. Search methods We performed an electronic search of several databases (CENTRAL, MEDLINE, EMBASE, CINAHL), and handsearched reference lists and conference abstracts. We updated our search in June 2015. Selection criteria We included randomized controlled trials (RCTs) comparing regional analgesia versus conventional analgesia in patients undergoing total shoulder, hip or knee replacement. We included studies that reported a functional outcome with a follow-up of at least three months after surgery. Data collection and analysis We used standard methodological procedures expected by Cochrane. We contacted study authors for additional information. Main results We included six studies with 350 participants followed for at least three months. All of these studies enrolled participants undergoing total knee replacement. Studies were at least partially blinded. Three studies had a high risk of performance bias and one a high risk of attrition bias, but the risk of bias was otherwise unclear or low. Only one study assessed joint function using a global score. Due to heterogeneity in outcome and reporting, we could only pool three out of six RCTs, with range of motion assessed at three months after surgery used as a surrogate for joint function. All studies had a high risk of detection bias. Using the random-effects model, there was no statistically significant difference between the experimental and control groups (mean difference 3.99 degrees, 95% confidence interval (CI)

  19. Comprehensive assessment of walking function after human spinal cord injury.

    PubMed

    Awai, Lea; Curt, Armin

    2015-01-01

    Regaining any locomotor function after spinal cord injury is not only of immediate importance for affected patients but also for clinical research as it allows to investigate mechanisms underlying motor impairment and locomotor recovery. Clinical scores inform on functional outcomes that are clinically meaningful to value effects of therapy while they all lack the ability to explain underlying mechanisms of recovery. For this purpose, more elaborate recordings of walking kinematics combined with assessments of spinal cord conductivity and muscle activation patterns are required. A comprehensive assessment framework comprising of multiple complementary modalities is necessary. This will not only allow for capturing even subtle changes induced by interventions that are likely missed by standard clinical outcome measures. It will be fundamental to attribute observed changes to naturally occurring spontaneous recovery in contrast to specific changes induced by novel therapeutic interventions beyond the improvements achieved by conventional therapy.

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

    PubMed

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

    2015-04-01

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

  1. Linking Mission, Strategy and Student Outcomes Assessment: A Cost-Effective Model

    ERIC Educational Resources Information Center

    Holoviak, Stephen J.; Verney, Thomas P.; Weigle, Jerry A.; Holoviak, Justin S.

    2010-01-01

    The purpose of this paper was to provide a demonstration of the assessment methods and processes that are used by the John L. Grove College of Business to assess student outcomes and how these assessments relate to mission and strategy.

  2. Assessment of Cognitive Outcome Measures in Teenagers with 15q13.3 Microdeletion Syndrome.

    PubMed

    Crutcher, Emeline; Ali, May; Harrison, John; Sovago, Judit; Gomez-Mancilla, Baltazar; Schaaf, Christian P

    2016-04-01

    15q13.3 microdeletion syndrome causes a spectrum of cognitive disorders, including intellectual disability and autism. We aimed to determine if any or all of three cognitive testing systems (the KiTAP, CogState, and Stanford-Binet) are suitable for assessment of cognitive function in affected individuals. These three tests were administered to ten individuals with 15q13.3 microdeletion syndrome (14-18 years of age), and the results were analyzed to determine feasibility of use, potential for improvement, and internal consistency. It was determined that the KiTAP, CogState, and Stanford-Binet are valid tests of cognitive function in 15q13.3 microdeletion patients. Therefore, these tests may be considered for use as objective outcome measures in future clinical trials, assessing change in cognitive function over a period of pharmacological treatment.

  3. Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates

    PubMed Central

    Prasad, G Thiruvengita; Kumar, T Suresh; Kumar, R Krishna; Murthy, Ganapathy K; Sundaram, Nandkumar

    2013-01-01

    Background: Dual plate fixation in comminuted bicondylar tibial plateau fractures remains controversial. Open reduction and internal fixation, specifically through compromised soft tissues, has historically been associated with major wound complications. Alternate methods of treatment have been described, each with its own merits and demerits. We performed a retrospective study to evaluate the functional outcome of lateral and medial plate fixation of Schatzker type V and VI fractures through an anterolateral approach, and a medial minimally invasive approach or a posteromedial approach. Materials and Methods: We treated 46 tibial plateau fractures Schatzker type V and VI with lateral and medial plates through an anterolateral approach and a medial minimal invasive approach over an 8 years period. Six patients were lost to followup. Radiographs in two planes were taken in all cases. Immediate postoperative radiographs were assessed for quality of reduction and fixation. The functional outcome was evaluated according to the Oxford Knee Score criteria on followup. Results: Forty patients (33 men and 7 women) who completed the followup were included in the study. There were 20 Schatzker type V fractures and 20 Schatzker type VI fractures. The mean duration of followup was 4 years (range 1-8 years). All patients had a satisfactory articular reduction defined as ≤2 mm step-off or gap as assessed on followup. All patients had a good coronal and sagittal plane alignment, and articular width as assessed on supine X-rays of the knee in the anteroposterior (AP) and lateral views. The functional outcome, as assessed by the Oxford Knee Score, was excellent in 30 patients and good in 10 patients. All patients returned to their pre-injury level of activity and employment. There were no instances of deep infection. Conclusions: Dual plate fixation of severe bicondylar tibial plateau fractures is an excellent treatment option as it provides rigid fixation and allows early knee

  4. Obstetrical outcomes and biomarkers to assess exposure to phthalates: A review.

    PubMed

    Marie, Cécile; Vendittelli, Françoise; Sauvant-Rochat, Marie-Pierre

    2015-10-01

    Studies of the effects on pregnancy outcomes of in utero exposure to phthalates, contaminants that are widely present in the environment, have yielded conflicting results. In addition, the mode of assessment of exposure varies between studies. The aim of this review was therefore to establish a current state of knowledge of the phthalates and metabolites involved in unfavorable pregnancy outcomes. Extant data were analyzed to determine which biomarker is the best suited to assess the relation between in utero exposure to phthalates and pregnancy outcomes. This review of the literature was conducted using the database of PubMed. A search was made of studies investigating exposure to phthalates and the following birth outcomes: preterm birth (gestational age <37 weeks), change in gestational age, change in body size at birth (birth weight, length, head circumference), anti-androgenic function, decreased anogenital distance, cryptorchidism, hypospadias and congenital malformation. The methodological approach adopted in each study was examined, in particular the methods used for exposure assessment (biomarkers and/or questionnaire). Thirty-five studies were included. Premature birth and decreased anogenital distance were the most commonly reported outcomes resulting from a moderate level of exposure to phthalates. The principal metabolites detected and involved were primary metabolites of di-2(ethylhexyl)-phthalate (DEHP) and di-n-butyl-phthalate (DnBP). No clear conclusion could be drawn with regard to gestational age at birth, body size at birth and congenital malformations. In epidemiological studies, maternal urine is the most suitable matrix to assess the association between in utero exposure to phthalates and pregnancy outcomes: in contrast to other matrices (cord blood, amniotic fluid, meconium and milk), sampling is easy, non-invasive and, can be repeated to assess exposure throughout pregnancy. Oxidative metabolites are the most relevant biomarkers since they

  5. Obstetrical outcomes and biomarkers to assess exposure to phthalates: A review.

    PubMed

    Marie, Cécile; Vendittelli, Françoise; Sauvant-Rochat, Marie-Pierre

    2015-10-01

    Studies of the effects on pregnancy outcomes of in utero exposure to phthalates, contaminants that are widely present in the environment, have yielded conflicting results. In addition, the mode of assessment of exposure varies between studies. The aim of this review was therefore to establish a current state of knowledge of the phthalates and metabolites involved in unfavorable pregnancy outcomes. Extant data were analyzed to determine which biomarker is the best suited to assess the relation between in utero exposure to phthalates and pregnancy outcomes. This review of the literature was conducted using the database of PubMed. A search was made of studies investigating exposure to phthalates and the following birth outcomes: preterm birth (gestational age <37 weeks), change in gestational age, change in body size at birth (birth weight, length, head circumference), anti-androgenic function, decreased anogenital distance, cryptorchidism, hypospadias and congenital malformation. The methodological approach adopted in each study was examined, in particular the methods used for exposure assessment (biomarkers and/or questionnaire). Thirty-five studies were included. Premature birth and decreased anogenital distance were the most commonly reported outcomes resulting from a moderate level of exposure to phthalates. The principal metabolites detected and involved were primary metabolites of di-2(ethylhexyl)-phthalate (DEHP) and di-n-butyl-phthalate (DnBP). No clear conclusion could be drawn with regard to gestational age at birth, body size at birth and congenital malformations. In epidemiological studies, maternal urine is the most suitable matrix to assess the association between in utero exposure to phthalates and pregnancy outcomes: in contrast to other matrices (cord blood, amniotic fluid, meconium and milk), sampling is easy, non-invasive and, can be repeated to assess exposure throughout pregnancy. Oxidative metabolites are the most relevant biomarkers since they

  6. Prestroke Antiplatelet Effect on Symptomatic Intracranial Hemorrhage and Functional Outcome in Intravenous Thrombolysis

    PubMed Central

    Choi, Jay Chol; Lee, Ji Sung; Park, Tai Hwan; Cho, Yong-Jin; Park, Jong-Moo; Kang, Kyusik; Lee, Kyung Bok; Lee, Soo Joo; Kim, Jae Guk; Lee, Jun; Park, Man-Seok; Choi, Kang-Ho; Kim, Joon-Tae; Yu, Kyung-Ho; Lee, Byung-Chul; Oh, Mi-Sun; Cha, Jae-Kwan; Kim, Dae-Hyun; Nah, Hyun-Wook; Kim, Dong-Eog; Ryu, Wi-Sun; Kim, Beom Joon; Bae, Hee-Joon; Kim, Wook-Joo; Shin, Dong-Ick; Yeo, Min-Ju; Sohn, Sung Il; Hong, Jeong-Ho; Lee, Juneyoung; Hong, Keun-Sik

    2016-01-01

    Background and Purpose About 30%-40% of stroke patients are taking antiplatelet at the time of their strokes, which might increase the risk of symptomatic intracranial hemorrhage (SICH) with intravenous tissue plasminogen activator (IV-TPA) therapy. We aimed to assess the effect of prestroke antiplatelet on the SICH risk and functional outcome in Koreans treated with IV-TPA. Methods From a prospective stroke registry, we identified patients treated with IV-TPA between October 2009 and November 2014. Prestroke antiplatelet use was defined as taking antiplatelet within 7 days before the stroke onset. The primary outcome was SICH. Secondary outcomes were discharge modified Rankin Scale (mRS) score and in-hospital mortality. Results Of 1,715 patients treated with IV-TPA, 441 (25.7%) were on prestroke antiplatelet. Prestroke antiplatelet users versus non-users were more likely to be older, to have multiple vascular risk factors. Prestroke antiplatelet use was associated with an increased risk of SICH (5.9% vs. 3.0%; adjusted odds ratio [OR] 1.79 [1.05-3.04]). However, at discharge, the two groups did not differ in mRS distribution (adjusted OR 0.90 [0.72-1.14]), mRS 0-1 outcome (34.2% vs. 33.7%; adjusted OR 1.27 [0.94-1.72), mRS 0-2 outcome (52.4% vs. 52.9%; adjusted OR 1.21 [0.90-1.63]), and in-hospital mortality (6.1% vs. 4.2%; adjusted OR 1.19 [0.71-2.01]). Conclusions Despite an increased risk of SICH, prestroke antiplatelet users compared to non-users had comparable functional outcomes and in-hospital mortality with IV-TPA therapy. Our results support the use of IV-TPA in eligible patients taking antiplatelet therapy before their stroke onset. PMID:27733024

  7. The Daily Activity Report (DAR) a Novel Measure of Functional Outcome for Serious Mental Illness

    PubMed Central

    Velligan, Dawn I.; Mintz, Jim; Sierra, Cynthia; Martin, Mona L.; Fredrick, Megan; Maglinte, Gregory A.; Corey-Lisle, Patricia K.

    2016-01-01

    The assessment of real-world functional outcomes in clinical trials for medications targeting negative symptoms and cognitive impairment is extremely important. We tested the psychometric properties of the Daily Activity Report (DAR), a novel assessment of productive daily activity. We administered the DAR and additional assessments of functional outcome, functional capacity, cognition and symptomatology to 50 individuals with schizophrenia at 2 time points, 1 month apart and to 25 healthy controls. The DAR records a person’s daily activity for 7 consecutive days based upon phone calls made 3 times a day. A total score and scores in 3 domains; instrumental activities (ie, independent living), social and work or school related activities are generated for the DAR. Inter-item consistency was high 0.89–0.94 for each domain and 0.88 overall. Test–retest reliability across 1 month for the total DAR score was 0.67, P < .0001. The total DAR score as well as scores for social activity and nondomestic work/school differed significantly between control and patient participants (P < .0001). DAR domain scores were associated with negative symptoms and functional outcomes, but the primary score related to these measures was the work/school dimension of the DAR. DAR scores were only weakly and nonsignificantly related to positive symptoms. This study provides preliminary support for the reliability and validity of the DAR using interviewer administration. The development of a patient reported version of the DAR using smart phone technology with automatic scoring is the next step. PMID:26712856

  8. Stereotype threat and executive functions: which functions mediate different threat-related outcomes?

    PubMed

    Rydell, Robert J; Van Loo, Katie J; Boucher, Kathryn L

    2014-03-01

    Stereotype threat research shows that women's math performance can be reduced by activating gender-based math stereotypes. Models of stereotype threat assert that threat reduces cognitive functioning, thereby accounting for its negative effects. This work provides a more detailed understanding of the cognitive processes through which stereotype threat leads women to underperform at math and to take risks, by examining which basic executive functions (inhibition, shifting, and updating) account for these outcomes. In Experiments 1 and 2, women under threat showed reduced inhibition, reduced updating, and reduced math performance compared with women in a control condition (or men); however, only updating accounted for women's poor math performance under threat. In Experiment 3, only updating accounted for stereotype threat's effect on women's math performance, whereas only inhibition accounted for the effect of threat on risk-taking, suggesting that distinct executive functions can account for different stereotype threat-related outcomes.

  9. Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease

    PubMed Central

    Douglas, Pamela S.; Hoffmann, Udo; Patel, Manesh R.; Mark, Daniel B.; Al-Khalidi, Hussein R.; Cavanaugh, Brendan; Cole, Jason; Dolor, Rowena J.; Fordyce, Christopher B.; Huang, Megan; Khan, Muhammad Akram; Kosinski, Andrzej S.; Krucoff, Mitchell W.; Malhotra, Vinay; Picard, Michael H.; Udelson, James E.; Velazquez, Eric J.; Yow, Eric; Cooper, Lawton S.; Lee, Kerry L.

    2015-01-01

    BACKGROUND Many patients have symptoms suggestive of coronary artery disease (CAD) and are often evaluated with the use of diagnostic testing, although there are limited data from randomized trials to guide care. METHODS We randomly assigned 10,003 symptomatic patients to a strategy of initial anatomical testing with the use of coronary computed tomographic angiography (CTA) or to functional testing (exercise electrocardiography, nuclear stress testing, or stress echocardiography). The composite primary end point was death, myocardial infarction, hospitalization for unstable angina, or major procedural complication. Secondary end points included invasive cardiac catheterization that did not show obstructive CAD and radiation exposure. RESULTS The mean age of the patients was 60.8±8.3 years, 52.7% were women, and 87.7% had chest pain or dyspnea on exertion. The mean pretest likelihood of obstructive CAD was 53.3±21.4%. Over a median follow-up period of 25 months, a primary end-point event occurred in 164 of 4996 patients in the CTA group (3.3%) and in 151 of 5007 (3.0%) in the functional-testing group (adjusted hazard ratio, 1.04; 95% confidence interval, 0.83 to 1.29; P = 0.75). CTA was associated with fewer catheterizations showing no obstructive CAD than was functional testing (3.4% vs. 4.3%, P = 0.02), although more patients in the CTA group underwent catheterization within 90 days after randomization (12.2% vs. 8.1%). The median cumulative radiation exposure per patient was lower in the CTA group than in the functional-testing group (10.0 mSv vs. 11.3 mSv), but 32.6% of the patients in the functional-testing group had no exposure, so the overall exposure was higher in the CTA group (mean, 12.0 mSv vs. 10.1 mSv; P<0.001). CONCLUSIONS In symptomatic patients with suspected CAD who required noninvasive testing, a strategy of initial CTA, as compared with functional testing, did not improve clinical outcomes over a median follow-up of 2 years. (Funded by the

  10. Poststroke shoulder pain in Turkish stroke patients: relationship with clinical factors and functional outcomes.

    PubMed

    Barlak, Aysegul; Unsal, Sibel; Kaya, Kurtulus; Sahin-Onat, Sule; Ozel, Sumru

    2009-12-01

    The objective of this study was to assess the possible causes of hemiplegic shoulder pain (HSP) in Turkish patients with stroke, to identify the correlation between HSP and clinical factors, and to review the effects of HSP on functional outcomes. A total of 187 consecutive patients with stroke were evaluated for the presence of HSP and for the possible causes. Each patient was evaluated by clinical, radiographic, and ultrasonographic examination. Daily living activities were assessed using the Functional Independence Measure at admission and at discharge. Patients were divided into two groups, one comprising patients with shoulder pain and the other comprising patients without shoulder pain. They were then compared with respect to clinical characteristics, radiologic findings, and Functional Independence Measure scores. Shoulder pain was present in 114 (61%) patients. Of the 114 patients with pain, 71 patients showed various grades of glenohumeral joint subluxation, 70 patients had complex regional pain syndrome-type I, 70 patients had impingement syndrome, 68 patients had spasticity, 49 patients had adhesive capsulitis, and 10 patients had thalamic pain. No correlation was found between shoulder pain and clinical factors (sex, hemiplegic side, hand dominance, etiologic cause, comorbidities). The relationship between shoulder pain and adhesive capsulitis was significant (P=0.01) and also complex regional pain syndrome-type I was statistically significant (P=0.001). The group without HSP showed significantly more improvement than the group with HSP in functional outcomes (P=0.01) and the hospitalization period was significantly shorter (P=0.03). Shoulder pain is a frequent problem in patients with stroke. It is, however, often difficult to isolate a specific cause and it causes a prolonged hospitalization period and can have a negative effect on functional outcomes.

  11. 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…

  12. Faculty Views on Developing and Assessing Learning Outcomes at the Tertiary Level

    ERIC Educational Resources Information Center

    Bahous, Rima; Nabhani, Mona

    2015-01-01

    Assessing students' learning outcomes is on the agenda of higher education institutions seeking improvement of student learning. Faculty members should be well versed in developing and assessing learning outcomes and involved in ensuring success in the assessment process; however, many claim that the process interferes with academic freedom,…

  13. Anticipating the future: assessment of occupational function.

    PubMed

    Trombly, C

    1993-03-01

    I believe that the occupational therapy assessment procedure should reflect our conceptualization of occupational functioning and that there should be a congruence among goals, assessments, and treatment. I believe that there should be a universal occupational therapy intake assessment procedure that follows a top-down approach to clarify for the client that the role of occupational therapy is to promote his or her occupational functioning. All the layers of function that we treat should be assessed, with the particulars of context incorporated into assessments at the activity and higher levels. Further and most important, occupational functioning should be fully conceptualized and the relevant constructs and their relationships verified and made clear to all. PMID:8456926

  14. Functional Outcome After Lower Limb Amputation: Is Hyperhomocysteinemia a Predictive Factor?

    PubMed Central

    Brunelli, Stefano; Fusco, Augusto; Iosa, Marco; Ricciardi, Elena; Traballesi, Marco

    2015-01-01

    Abstract Lower limb amputation (LLA) is the drastic stage of peripheral arterial disease (PAD) where the hyperhomocysteinemia (H-HCY) seems to be a risk factor. Surprisingly, in literature the levels and the role of homocysteinemia (HCY) in persons with LLA are understudied. This study aims to investigate the level of HCY and its correlation with the functional outcomes after LLA. A case–control study to analyze HCY levels in amputees admitted in a rehabilitation hospital during an investigation period of 1.5 years. Barthel Index was used to assess the functional outcome. We enrolled 91 dysvascular amputees and 44 amputees for other reasons than PAD (controls). The mean level of HCY was found higher in dysvascular amputees (15.2 ± 7.5) compared to controls (11.0 ± 5.0, P < 0.0001) with a risk related ratio of 4.78. Normal Gaussian distribution of HCY was observed in controls, whereas in dysvascular amputees the data follow a double Gaussian distribution. Finally, a significant negative correlation was found between HCY and the effectiveness of rehabilitation (R = −0.37, P = 0.001) only in dysvascular amputees. Dysvascular amputees had a level of HCY significantly higher than amputees without PAD. H-HCY seems to influence the functional outcomes of the rehabilitative treatment only in LLA due to PAD. PMID:26656344

  15. Development and Applications of an Outcomes Assessment Framework for Care Management Programs in Learning Health Systems

    PubMed Central

    Wang, Lin; Kuntz-Melcavage, Kara; Forrest, Christopher B.; Lu, Yanyan; Piet, Leslie; Evans, Kathy; Uriyo, Maria; Sherry, Melissa; Richardson, Regina; Hawkins, Michelle; Neale, Donna

    2015-01-01

    Purpose: To develop and apply an outcomes assessment framework (OAF) for care management programs in health care delivery settings. Background: Care management (CM) refers to a regimen of organized activities that are designed to promote health in a population with particular chronic conditions or risk profiles, with focus on the triple aim for populations: improving the quality of care, advancing health outcomes, and lowering health care costs. CM has become an integral part of a care continuum for population-based health care management. To sustain a CM program, it is essential to assure and improve CM effectiveness through rigorous outcomes assessment. To this end, we constructed the OAF as the foundation of a systematic approach to CM outcomes assessment. Innovations: To construct the OAF, we first systematically analyzed the operation process of a CM program; then, based on the operation analysis, we identified causal relationships between interventions and outcomes at various implementation stages of the program. This set of causal relationships established a roadmap for the rest of the outcomes assessment. Built upon knowledge from multiple disciplines, we (1) formalized a systematic approach to CM outcomes assessment, and (2) integrated proven analytics methodologies and industrial best practices into operation-oriented CM outcomes assessment. Conclusion: This systematic approach to OAF for assessing the outcomes of CM programs offers an opportunity to advance evidence-based care management. In addition, formalized CM outcomes assessment methodologies will enable us to compare CM effectiveness across health delivery settings. PMID:25992387

  16. Functional assessment of laser irradiation

    NASA Astrophysics Data System (ADS)

    Robbins, David O.

    1988-03-01

    Exposure of the fovea to intense coherent light can produce either transient or permanent changes in the eye's ability to resolve fine spatial detail. Permanent functional changes can occur in the absence of gross morphological damage and at power densities below the ED50 level. Furthermore, the eye may become increasingly susceptible to damage after repeated low-level exposures which initially produce only transient effects. Independent of any long-term hazards, laser exposures can also disrupt visual/motor behavior for periods of up to 96 hrs

  17. Functional outcome and the structural integrity of arthroscopic Bankart repair: a prospective trial

    PubMed Central

    Young, Simon W; Pinto, Clinton; Poon, Peter C

    2015-01-01

    Background Recurrent anterior shoulder dislocations are common in young patients with Bankart lesions. Arthroscopic repair is an established treatment; however, recurrent instability occurs in up to 35% of patients. It is unclear whether recurrence is the result of a failure of the surgical repair to heal or a repeat injury. The aim of the present pilot study was to assess radiographic healing of Bankart lesions 6 months post surgical repair and identify any correlations between radiographic findings and subsequent recurrent dislocations. Methods Eighteen patients underwent arthroscopic Bankart repair for recurrent instability. Magnetic resonance (MR) arthrograms were obtained both pre-operatively and 6 months postoperatively. Standard T1 and T2 views were obtained along with an abduction and external rotation (ABER) view. Patients were followed for a minimum of 4 years for the risk of recurrence, and functional outcomes were obtained, including the American Shoulder and Elbow Surgeons Subjective Shoulder Scale, Ontario Shoulder Instability Index, Oxford Shoulder Instability Score and 12-Item Short Form Health Survey. Scores were correlated with pre-operative and postoperative MR findings. Results Six of 18 patients developed recurrent instability. We could not identify correlations between reconstructed labrum (labral bumper) position, failure at suture sites and ABER findings with recurrent instability or functional outcome. Paradoxically, there was a nonstatistically significant trend for patients with no clefts between the labrum and the glenoid at any points along the repair to have worse outcomes than patients with partial or complete clefts. Conclusions In our pilot study, MR arthrogram was used to evaluate the labrum in detail 6 months postoperatively. Despite its proven ability to detect labral lesions, we were unable to demonstrate any features on postoperative MR arthrogram that predicted either functional outcome or recurrent instability. At 6 months

  18. The influence of rotator cuff pathology on functional outcome in total shoulder replacement

    PubMed Central

    Ahearn, Nathanael; McCann, Philip A; Tasker, Andrew; Sarangi, Partha P

    2013-01-01

    Introduction: Total shoulder replacement (TSR) is a reliable treatment for glenohumeral osteoarthritis. In addition to proper component orientation, successful arthroplasty requires accurate restoration of soft tissues forces around the joint to maximize function. We hypothesized that pathological changes within the rotator cuff on preoperative magnetic resonance imaging (MRI) adversely affect the functional outcome following TSR. Materials and Methods: A retrospective analysis of case notes and MRI of patients undergoing TSR for primary glenohumeral osteoarthritis over a 4-year period was performed. Patients were divided into three groups based upon their preoperative MRI findings: (1) normal rotator cuff, (2) the presence of tendonopathy within the rotator cuff, or (3) the presence of a partial thickness rotator cuff tear. Intra-operatively tendonopathy was addressed with debridement and partial thickness tears with repair. Functional outcome was assessed with the Oxford Shoulder Score (OSS), and quick disabilities of the arm, shoulder and hand score (quick-DASH). Results: We had a full dataset of complete case-notes, PACS images, and patient reported outcome measures available for 43 patients, 15 in group 1, 14 in group 2, and 14 in group 3. Quick-DASH and OSS were calculated at a minimum of 24 months following surgery. There was no statistically significant difference between the results obtained between the three groups of either the OSS (P = 0.45), or quick-DASH (P = 0.46). Conclusions: TSR is an efficacious treatment option for patients with primary glenohumeral osteoarthritis in the medium term, even in the presence of rotator cuff tendonopathy or partial tearing. Minor changes within the cuff do not significantly affect functional outcome following TSR. PMID:24403759

  19. Training Advanced Practice Providers to Collect Functional Outcomes After Fragility Fractures

    PubMed Central

    Wang, Tiffany L.; Ames, Tyler D.; Le, Khoi M.; Wee, Corinne; Phieffer, Laura S.

    2015-01-01

    Objective: The objective of this study was to determine whether advanced practice providers could learn to collect objective functional assessment data accurately and efficiently with commercially available devices that measure kinematics and kinetics (Nintendo Wii Balance Board [WBB] and Level Belt [LB]) to aid in the assessment of fall risk and outcomes after fragility fractures. Methods: Nine advanced practice providers participated in a 1-hour clinical assessment tools (CATs) training session on equipment use, providing standardized instructions, and practice of the testing procedures. Afterward, they participated in a skills demonstration evaluation and completed a postsession survey. Results: Participants successfully achieved a mean of 18.22 (standard deviation 1.56) of 20 performance measures. Of the incomplete or omitted tasks, the majority (10 of 16) occurred within the first of 3 CATs activities. Postsession survey results revealed that 9 of 9 participants reported that the 1 hour provided for training on the CATs was sufficient. All participants reported that after the training, they felt confident they could reliably carry out the tasks to test patients on both the WBB and the LB. The majority of participants reported that they believed that the WBB (7 of 9) and LB (8 out of 9) would be good assets to clinics in assessing patient functionality after fragility fractures. Conclusion: These results indicate that advanced practice providers can confidently learn and effectively test patients with the WBB and LB within 1 hour of training. In the future, adoption of CATs in the clinical setting may allow for objective, easy-to-use, portable, noninvasive, and relatively inexpensive measures to assess functional outcomes in patients with fragility fracture. PMID:26328225

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

    NASA Astrophysics Data System (ADS)

    LondoñO Cadavid, Catalina; Ando, Amy W.

    2013-07-01

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

  1. Tinnitus Functional Index: Development, validation, outcomes research, and clinical application.

    PubMed

    Henry, James A; Griest, Susan; Thielman, Emily; McMillan, Garnett; Kaelin, Christine; Carlson, Kathleen F

    2016-04-01

    The Tinnitus Research Consortium (TRC) issued a Request for Proposals in 2003 to develop a new tinnitus outcome measure that would: (1) be highly sensitive to treatment effects (validated for "responsiveness"); (2) address all major dimensions of tinnitus impact; and (3) be validated for scaling the negative impact of tinnitus. A grant was received by M. Meikle to conduct the study. In that observational study, all of the TRC objectives were met, with the final 25-item Tinnitus Functional Index (TFI) containing eight subscales. The study was published in 2012, and since then the TFI has received increasing international use and is being translated into at least 14 languages. The present study utilized data from a randomized controlled trial (RCT) that involved testing the efficacy of "telephone tinnitus education" as intervention for bothersome tinnitus. These data were used to confirm results from the original TFI study. Overall, the TFI performed well in the RCT with Cohen's d being 1.23. There were large differences between the eight different subscales, ranging from a mean 13.2-point reduction (for the Auditory subscale) to a mean 26.7-point reduction (for the Relaxation subscale). Comparison of TFI performance was made with the Tinnitus Handicap Inventory. All of the results confirmed sensitivity of the TFI along with its subscales. This article is part of a Special Issue entitled . PMID:26074306

  2. Patient reported outcomes in the assessment of premature ejaculation.

    PubMed

    Althof, Stanley E

    2016-08-01

    The term 'Patient Reported Outcome', abbreviated as PRO, was introduced by the US Food and Drug Administration (FDA) which proposed guidance on the development and validation of PROs. Previously PROs were known as self-report diaries, event-logs, self-administered questionnaires, and clinician administered rating scales. PROs seek to capture the subjective perceptions of patients and/or partner's related to their specific symptoms, degree of bother, efficacy of a medication or psychotherapy intervention, and quality of life issues related to a specific condition. This article reviews the essential psychometric and regulatory agency requirements in the development of PROs. The constructs of reliability, various forms of validity, sensitivity, and specificity as well as concerns with translating a PRO into a different language are reviewed. Three PROs, the Premature Ejaculation Profile (PEP), the Index of Premature Ejaculation (IPE) and the Premature Ejaculation Diagnostic Tool (PEDT) all used in the assessment of premature ejaculation (PE) are discussed. These questionnaires meet or exceed all the psychometric requirements and have been employed in clinical trials and observational studies of men with PE. The article concludes on discussing some of the limitations of PRO use and recommendations for the future. PMID:27652219

  3. Quantitative use of photography in orthognathic outcome assessment.

    PubMed

    Edler, R J; Wertheim, D; Greenhill, D; Jaisinghani, A

    2011-03-01

    This study reports an independent audit of two aspects of orthognathic surgery, namely control of inter-alar width and mandibular outline asymmetry. Measurements were taken from standardized photographs of a consecutive series of 27 patients, using an on-screen digitizing program (IPTool). All patients had undergone bimaxillary osteotomies involving maxillary impaction and/or advancement, by one surgeon, using a cinch suture for nasal width control. Nine-twelve months after surgery, inter-alar width had increased by just 0.08 cm mean (SD 0.3). Four patients showed an increase of just over 2mm, whilst six showed a small reduction. Based on ratios of size (area) and shape (compactness) of the right and left mandibular segments, there was a small overall improvement in mandibular symmetry (0.019 and 0.005 respectively). Whilst in most of the patients the need for surgery was primarily the correction of antero-posterior and vertical discrepancies, five patients with demonstrable asymmetry showed a clear improvement. In three patients whose asymmetry scores were very mild pre-treatment, there was a small, measured increase in asymmetry, but not to a degree that would be clinically noticeable. At a time when 3D imaging is still unavailable to many clinicians, the results of this study suggest that appropriate measurements taken from carefully standardized conventional photographs can provide a valid and objective means of assessing treatment outcome.

  4. Long-term outcome after cerebral venous thrombosis: analysis of functional and vocational outcome, residual symptoms, and adverse events in 161 patients.

    PubMed

    Hiltunen, Sini; Putaala, Jukka; Haapaniemi, Elena; Tatlisumak, Turgut

    2016-03-01

    Cerebral venous thrombosis (CVT) affects mainly working-aged individuals. Functional recovery after CVT is generally considered good with about 3/4 of patients achieving short-term independence. However, vascular events, long-term functional outcome, and employment after CVT remain poorly investigated. We identified consecutive adult CVT patients treated at the Helsinki University Hospital (1987-2013) and invited them to a follow-up visit. Each clinical examination was combined with interview. We also recorded recurrent venous thromboembolism (VTE) and hemorrhagic events during follow-up and antithrombotic medication use. A modified Rankin Scale (mRS) served to assess functional outcome. Logistic regression served to identify independent factors associated with unemployment and functional recovery. Of the 195 patients identified, 21 died, 9 declined to participate, and 4 were excluded from the study. Thus, 161 patients (106 women) underwent an examination after a median of 39 months (interquartile range 14-95). VTE (one of which was CVT) occurred in 9 (6%) patients, and severe hemorrhagic events in 10 (6%). Functional outcome was good, with 84% scoring 0-1 on the mRS; 42% reported residual symptoms. Altogether, 91 (57%) patients were employed. After adjusting for age and sex, a National Institutes of Health Stroke Scale score>2 at admission and low education level, associated with both unfavorable functional outcome and unemployment. Long-term functional outcome after CVT may appear good if measured with mRS, but patients often have residual symptoms and are frequently unable to return to their previous work. PMID:26725090

  5. Maternal 25-hydroxyvitamin D and its association with childhood atopic outcomes and lung function

    PubMed Central

    Wills, A K; Shaheen, S O; Granell, R; Henderson, A J; Fraser, W D; Lawlor, D A

    2013-01-01

    Background It has been suggested that maternal vitamin D status in pregnancy influences the risk of asthma and atopy in the offspring. The epidemiological evidence to support these claims is conflicting and may reflect chance findings and differences in how vitamin D was assessed. Objective To examine the association between blood total maternal 25-hydroxy vitamin D (25(OH)D) concentrations in pregnancy and offspring asthma, atopy and lung function in the largest birth cohort study to date. Methods Participants were largely of white European origin and resident in the South West of England. We examined the associations of maternal 25(OH)D concentrations in pregnancy with the following outcomes in the offspring: wheeze, asthma, atopy, eczema, hayfever, at mean age 7.5 years (n = 3652–4696 depending on outcome), IgE at 7 years (n = 2915) and lung function and bronchial responsiveness at mean age 8.7 years (n = 3728–3784). Results Sixty-eight per cent of mothers had sufficient (> 50 nmol/L) concentrations of 25(OH)D, 27% were insufficient (27.5–49.99 nmol/L) and 5% were deficient (< 27.5 nmol/L). There was no evidence to suggest that maternal 25(OH)D concentration in pregnancy was associated with any respiratory or atopic outcome in the offspring. These findings remained after adjustment for season of measurement and for potential confounders. There was also no evidence that these relationships followed a non-linear form and no evidence that either deficient or high concentrations of maternal 25(OH)D were associated with atopic or respiratory outcomes. Conclusions We found no evidence that maternal blood 25(OH)D concentration in pregnancy is associated with childhood atopic or respiratory outcomes. PMID:24074336

  6. Alteration of Thyroid-Related Hormones within Normal Ranges and Early Functional Outcomes in Patients with Acute Ischemic Stroke.

    PubMed

    Xu, Xiao-Yan; Li, Wen-Yu; Hu, Xing-Yue

    2016-01-01

    This study evaluated the prognostic value of thyroid-related hormones within normal ranges after acute ischemic stroke. This was a retrospective study and we reviewed 1072 ischemic stroke patients consecutively admitted within 72 h after symptom onset. Total triiodothyronine (T3), total thyroxine (T4), free T3, free T4, and thyroid-stimulating hormone (TSH) were assessed to determine their values for predicting functional outcome at the first follow-up clinic visits, which usually occurred 2 to 4 weeks after discharge from the hospital. 722 patients were finally included. On univariate analysis, poor functional outcome was associated with presence of atrial fibrillation as the index event. Furthermore, score of National Institutes of Health Stroke Scale (NIHSS), total T4, free T4, and C-reactive protein at admission were significantly higher in patients with poor functional outcome, whereas free T3 and total T3 were significantly lower. On multiple logistic regression analysis, lower total T3 concentrations remained independently associated with poor functional outcome [odds ratio (OR), 0.10; 95% confidence interval (CI), 0.01-0.84; P = 0.035]. The only other variables independently associated with poor functional outcome were NIHSS scores. In sum, lower total T3 concentrations that were within the normal ranges were independently associated with poor short-term outcomes. PMID:27375741

  7. Assessing the Utility of a Demand Assessment for Functional Analysis

    ERIC Educational Resources Information Center

    Roscoe, Eileen M.; Rooker, Griffin W.; Pence, Sacha T.; Longworth, Lynlea J.

    2009-01-01

    We evaluated the utility of an assessment for identifying tasks for the functional analysis demand condition with 4 individuals who had been diagnosed with autism. During the demand assessment, a therapist presented a variety of tasks, and observers measured problem behavior and compliance to identify demands associated with low levels of…

  8. Posterior shoulder instability in the athletic population: Variations in assessment, clinical outcomes, and return to sport

    PubMed Central

    DeLong, Jeffrey M; Bradley, James P

    2015-01-01

    Posterior instability of the shoulder is becoming an increasingly recognized shoulder injury in the athletic population. Diagnostic elements, such as etiology, directionality, and degree of instability are essential factors to assess in the unstable athletic shoulder. Concomitant injuries and associated pathologic lesions continue to be a significant challenge in the surgical management of posterior shoulder instability. Return to sport and previous level of play is ultimately the goal for every committed athlete and surgeon, thus subpopulations of athletes should be recognized as distinct entities requiring unique diagnostic, functional outcome measures, and surgical approaches. PMID:26716088

  9. Functional outcomes of adults with 22q11.2 deletion syndrome

    PubMed Central

    Butcher, Nancy J.; Chow, Eva W.C.; Costain, Gregory; Karas, Dominique; Ho, Andrew; Bassett, Anne S.

    2012-01-01

    Purpose The 22q11.2 deletion syndrome is a common multisystem genomic disorder with congenital and later-onset manifestations, including congenital heart disease, intellectual disability, and psychiatric illness, that may affect long-term functioning. There are limited data on adult functioning in 22q11.2 deletion syndrome. Methods We used the Vineland Adaptive Behavior Scales to assess functioning in 100 adults with 22q11.2 deletion syndrome (n = 46 male; mean age = 28.8 (standard deviation = 9.7) years) where intellect ranged from average to borderline (n = 57) to mild intellectual disability (n = 43). Results More than 75% of the subjects scored in the functional deficit range. Although personal, vocational, and financial demographics confirmed widespread functional impairment, daily living skills and employment were relative strengths. Intelligence quotient was a significant predictor (P < 0.001) of overall and domain-specific adaptive functioning skills. A diagnosis of schizophrenia was a significant predictor (P < 0.05) of overall adaptive functioning, daily living skills, and socialization scores. Notably, congenital heart disease, history of mood/anxiety disorders, sex, and age were not significant predictors of functioning. Conclusion Despite functional impairment in adulthood that is primarily mediated by cognitive and psychiatric phenotypes, relative strengths in activities of daily living and employment have important implications for services and long-term planning. These results may help to inform expectations about outcomes for patients with 22q11.2 deletion syndrome. PMID:22744446

  10. Methodological issues in measuring patient-reported outcomes: the agenda of the Work Group on Outcomes Assessment.

    PubMed

    Fowler, F J; Cleary, P D; Magaziner, J; Patrick, D L; Benjamin, K L

    1994-07-01

    The primary goal of the Inter-PORT work group on Outcomes Assessment is to foster methodological knowledge about the implications of various measure and design decisions for studies of the outcomes of treatment. A number of key methodological issues currently are unresolved and are in need of further study. These include: 1) the best questions to ask to assess how patients are affected by their treatments; 2) the comparative advantages of various study designs, including prospective cohorts, retrospective studies, and randomized clinical trials; 3) the way data collection decisions, such as mode of data collection and use of proxy respondents, affect study results; and 4) the best way to assess the significance of observed effects from patient, provider, and public policy perspectives. Studies conducted by the Patients Outcomes Research Teams (PORTs) are using diverse designs, measures, and data collection procedures. They provide a unique opportunity to further knowledge about methods of obtaining information about treatment outcomes. Through meetings, conferences, and publications, the Inter-PORT work group on Outcomes Assessment is trying to stimulate analyses aimed at methodological issues summarized in this paper and to ensure that new knowledge about methods is disseminated to a wide audience.

  11. Patient preference assessment reveals disease aspects not covered by recommended outcomes in polymyositis and dermatomyositis.

    PubMed

    Alemo Munters, Li; van Vollenhoven, Ronald F; Alexanderson, Helene

    2011-01-01

    Objectives. Polymyositis (PM) and dermatomyositis (DM) are characterized by impaired muscle function with a majority of patients developing sustained disability. The aim of this study was to evaluate the patient's individual priorities (patient preference) of disabilities most important to improve in PM/DM using the MacMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR), to correlate the MACTAR to myositis outcomes and to evaluate its test-retest reliability. Methods. Twenty-eight patients with PM/DM performed recommended outcomes as well as the MACTAR, which was performed twice with one week apart. Results. Sexual activity, walking, biking, social activities, and sleep constituted the predominating disabilities. Seventy-two and 33% of the identified disabilities were not covered by items of the Health Assessment Questionnaire and the Myositis Activities Profile. Correlations between the MACTAR and health-related quality of life measures were r(s) = -0.67-0.73, correlations with measures of activities of daily living and participation in society were r(s) = 0.51-0.60 with lower correlations for other outcomes. Intraclass correlation (ICC) and weighted Kappa (K(w)) coefficients were 0.83 and 0.68, respectively, for test-retest reliability of the MACTAR. Conclusions. The MACTAR interview had promising measurement properties and identified patient preference disabilities in PM/DM that were not covered by recommended outcomes. PMID:22389795

  12. Balancing the Dual Functions of Portfolio Assessment

    ERIC Educational Resources Information Center

    Lam, Ricky; Lee, Icy

    2010-01-01

    While research on portfolio assessment (PA) has focused largely on the summative aspects of writing assessment, not much has been done to find out its formative potential. Drawing upon student questionnaires and student and teacher interview data, this paper aims to explore the formative functions of PA and, specifically, how the formative…

  13. Effect of pre-operative neuromuscular training on functional outcome after total knee replacement: a randomized-controlled trial

    PubMed Central

    2013-01-01

    Background Total Knee Replacement (TKR) is the standard treatment for patients with severe knee osteoarthritis (OA). Significant improvement in pain and function are seen after TKR and approximately 80% of patients are very satisfied with the outcome. Functional status prior to TKR is a major predictor of outcome after the intervention. Thus, improving functional status prior to surgery through exercise may improve after surgery outcome. However, results from several previous trials testing the concept have been inconclusive after surgery. Methods/design In a randomized controlled trial (RCT) we will test the effect of a pre-operative neuromuscular trainingprogram versus an attention control program on lower extremity function – before and after surgery. We will enroll 80 participants, aged between 55–90 years, who are scheduled for TKR. In this single-blinded RCT, the intervention group will receive a minimum of 8 and a maximum of 24 training sessions plus 3 educational sessions of the knee school. The control group will receive the 3 educational sessions only. Assessments are performed immediately before and after the intervention (before surgery), at 6 weeks, 3 months and 12 months (after surgery). The primary outcome will include the Chair Stand Test as a measure of leg strength and reaction time. Secondary outcomes are knee function and pain assessed with the self-reported Knee Injury and Osteoarthritis Outcome Score (KOOS). All measurements will be carried out by a specially trained physical therapist, blinded to group allocation. Discussion To our knowledge this is the first single-blinded RCT to test the effect of pre-operative neuromuscular training plus knee school against knee school alone – on knee function and pain, assessed immediately after the interventions prior to surgery and repeatedly after surgery. Trial registration Clinical Trials NCT00913575 PMID:23641782

  14. Core Outcome Sets and Multidimensional Assessment Tools for Harmonizing Outcome Measure in Chronic Pain and Back Pain.

    PubMed

    Kaiser, Ulrike; Neustadt, Katrin; Kopkow, Christian; Schmitt, Jochen; Sabatowski, Rainer

    2016-01-01

    Core Outcome Sets (COSs) are a set of domains and measurement instruments recommended for application in any clinical trial to ensure comparable outcome assessment (both domains and instruments). COSs are not exclusively recommended for clinical trials, but also for daily record keeping in routine care. There are several COS recommendations considering clinical trials as well as multidimensional assessment tools to support daily record keeping in low back pain. In this article, relevant initiatives will be described, and implications for research in COS development in chronic pain and back pain will be discussed. PMID:27589816

  15. Core Outcome Sets and Multidimensional Assessment Tools for Harmonizing Outcome Measure in Chronic Pain and Back Pain

    PubMed Central

    Kaiser, Ulrike; Neustadt, Katrin; Kopkow, Christian; Schmitt, Jochen; Sabatowski, Rainer

    2016-01-01

    Core Outcome Sets (COSs) are a set of domains and measurement instruments recommended for application in any clinical trial to ensure comparable outcome assessment (both domains and instruments). COSs are not exclusively recommended for clinical trials, but also for daily record keeping in routine care. There are several COS recommendations considering clinical trials as well as multidimensional assessment tools to support daily record keeping in low back pain. In this article, relevant initiatives will be described, and implications for research in COS development in chronic pain and back pain will be discussed. PMID:27589816

  16. Recognition and Assessment of Eosinophilic Esophagitis: The Development of New Clinical Outcome Metrics.

    PubMed

    Nguyen, Nathalie; Furuta, Glenn T; Menard-Katcher, Calies

    2015-10-01

    Eosinophilic esophagitis (EoE) is a chronic, food-allergic disease manifest by symptoms of esophageal dysfunction and dense esophageal eosinophilia in which other causes have been excluded. Treatments include dietary restriction of the offending allergens, topical corticosteroids, and dilation of strictures. EoE has become increasingly prevalent over the past decade and has been increasingly recognized as a major health concern. Advancements in research and clinical needs have led to the development of novel pediatric- and adult-specific clinical outcome metrics (COMs). These COMs provide ways to measure clinically relevant features in EoE and set the stage for measuring outcomes in future therapeutic trials. In this article, we review novel symptom measurement assessments, the use of radiographic imaging to serve as a metric for therapeutic interventions, recently developed standardized methods for endoscopic assessment, novel techniques to evaluate esophageal mucosal inflammation, and methods for functional assessment of the esophagus. These advancements, in conjunction with current consensus recommendations, will improve the clinical assessment of patients with EoE. PMID:27330494

  17. Selected Science Educational Outcomes as a Function of South Dakota Educational Reform Policies 1995-2004

    NASA Astrophysics Data System (ADS)

    Hsu, T.; Tien, K. C.

    2005-05-01

    This research investigates selected South Dakota science educational outcomes as a function of selected educational reform policies. In the state of South Dakota, echoing divergent reform initiatives from "A Nation at Risk" to "No Child Left Behind," new guidelines and requirements have been instituted. Yet, very little effort has been made to assess the progress of these educational changes. In this study, selected educational outcomes-SAT8/9/10 scores-as a function of selected South Dakota educational reform policies were examined. School districts, ranked in the top and bottom five percent of socioeconomic status (SES) in the state, were selected for analysis. Comparison on student's science educational outcomes was also be made between the two major ethnic populations-Caucasians and Native Americans. All research questions were stated in the null form for hypothesis for statistical testing. Critical t was the statistic technique used to test the hypotheses. The findings revealed that the selected reform policies in South Dakota appeared to assist students from the higher socioeconomic backgrounds to perform better than pupils from the lower socioeconomic backgrounds. The academic performance for the ethnic and social class minorities remained unchanged within the study timeline for reform. Examined from the prism of Michael Apple's critical theory, the selected South Dakota reform policies have paid little attention to the issues of social equality. Continuing and collective efforts to promote equitable reform policies for enhancing the learning experience of all children in South Dakota seem necessary.

  18. Neuroprotective pentapeptide CN-105 improves functional and histological outcomes in a murine model of intracerebral hemorrhage

    PubMed Central

    Lei, Beilei; James, Michael L.; Liu, Ji; Zhou, Guanen; Venkatraman, Talaignair N.; Lascola, Christopher D.; Acheson, Shawn K.; Dubois, Laura G.; Laskowitz, Daniel T.; Wang, Haichen

    2016-01-01

    Presently, no pharmacological treatments have been demonstrated to improve long-term functional outcomes following intracerebral hemorrhage (ICH). Clinical evidence associates apolipoprotein E (apoE) genotype with ICH incidence and outcome. While apoE modifies neuroinflammatory responses through its adaptive role in glial downregulation, intact apoE holoprotein is too large to cross the blood-brain barrier (BBB). Therefore, we developed a 5-amino acid peptide – CN-105 – that mimics the polar face of the apoE helical domain involved in receptor interactions. In the current study, we investigated the therapeutic potential of CN-105 in a mouse model of ICH. Three doses of CN-105 (0.05 mg/kg) was administered by tail vein injection within 24 hours after ICH induction. Functional assessment showed durable improvement in vestibulomotor performance after CN-105 treatment, as quantified by increased Rotarod latencies on Days 1–5 post-ICH, and long-term improvement in neurocognitive performance, as quantified by reduced Morris water maze latencies on Days 29–32 post-ICH. Further, brain water content was significantly reduced, neuroinflammation was decreased and hippocampal CA3 neuronal survival was increased, although hemorrhage volume was not affected by CN-105. We concluded, therefore, that pentapeptide CN-105 improved short- and long-term neurobehavioral outcomes in a murine model of ICH, suggesting therapeutic potential for patients with acute ICH. PMID:27713572

  19. Decompressive hemicraniectomy: predictors of functional outcome in patients with ischemic stroke.

    PubMed

    Daou, Badih; Kent, Anthony P; Montano, Maria; Chalouhi, Nohra; Starke, Robert M; Tjoumakaris, Stavropoula; Rosenwasser, Robert H; Jabbour, Pascal

    2016-06-01

    OBJECT Patients presenting with large-territory ischemic strokes may develop intractable cerebral edema that puts them at risk of death unless intervention is performed. The purpose of this study was to identify predictors of outcome for decompressive hemicraniectomy (DH) in ischemic stroke. METHODS The authors conducted a retrospective electronic medical record review of 1624 patients from 2006 to 2014. Subjects were screened for DH secondary to ischemic stroke involving the middle cerebral artery, internal carotid artery, or both. Ninety-five individuals were identified. Univariate and multivariate analyses were performed for an array of clinical variables in relationship to functional outcome according to the modified Rankin Scale (mRS). Clinical outcome was assessed at 90 days and at the latest follow-up (mean duration 16.5 months). RESULTS The mean mRS score at 90 days and at the latest follow-up post-DH was 4. Good functional outcome was observed in 40% of patients at 90 days and in 48% of patient at the latest follow-up. The mortality rate at 90 days was 18% and at the last follow-up 20%. Univariate analysis identified a greater likelihood of poor functional outcome (mRS scores of 4-6) in patients with a history of stroke (OR 6.54 [95% CI1.39-30.66]; p = 0.017), peak midline shift (MLS) > 10 mm (OR 3.35 [95% CI 1.33-8.47]; p = 0.011), or a history of myocardial infarction (OR 8.95 [95% CI1.10-72.76]; p = 0.04). Multivariate analysis demonstrated elevated odds of poor functional outcome associated with a history of stroke (OR 9.14 [95% CI 1.78-47.05]; p = 0.008), MLS > 10 mm (OR 5.15 [95% CI 1.58-16.79; p = 0.007), a history of diabetes (OR 5.63 [95% CI 1.52-20.88]; p = 0.01), delayed time from onset of stroke to DH (OR 1.32 [95% CI 1.02-1.72]; p = 0.037), and evidence of pupillary dilation prior to DH (OR 4.19 [95% CI 1.06-16.51]; p = 0.04). Patients with infarction involving the dominant hemisphere had higher odds of unfavorable functional outcome at 90

  20. Similar impact of slow and delayed graft function on renal allograft outcome and function.

    PubMed

    Rodrigo, E; Fernández-Fresnedo, G; Ruiz, J C; Piñera, C; Palomar, R; González-Cotorruelo, J; Zubimendi, J A; De Francisco, A L M; Sanz de Castro, S; Arias, M

    2005-04-01

    Kidney transplant patients can be divided into three groups, according to the initial graft function. First-week dialyzed patients form the delayed graft function (DGF) group. Nondialyzed patients are divided into slow graft function (SGF) or immediate graft function (IGF) according to whether the day 5 serum creatinine was higher versus lower than 3 mg/dL, respectively. SGF patients showed worse graft survival, above higher incidence of acute rejection and lower renal function than IGF patients, although few reports have analyzed outcomes in these groups. We analyzed the impact of SGF on graft survival, first-year renal function, and incidence of acute rejection in 291 renal transplant patients. Creatinine was significantly worse at 12 months for SGF and DGF than for IGF patients (1.9 +/- 0.8 mg/dL, 1.8 +/- 0.7 mg/dL, 1.5 +/- 0.5 mg/dL, respectively; P < .05). There was no difference in first-year renal function between SGF and DGF. The acute rejection rate was higher among the SGF than the IGF group (45% vs 21%, P < .05), but not different from DGF patients (42%, P < .05). Graft survival was better among IGF than SGF or DGF patients, with no significant difference between the last two groups (3-year graft survival, 82%, 71%, 70%, respectively; log-rank test, P < .05). Kidney transplant recipients who develop SGF have a worse outcome than patients with IGF, similar to DGF patients. SGF patients show worse graft survival, worse renal function, and higher acute rejection rates than IGF patients, despite not needing dialysis.

  1. Prefrontal Function at Presentation Directly Related to Clinical Outcome in People at Ultrahigh Risk of Psychosis

    PubMed Central

    Fusar-Poli, P.; Broome, M.R.; Matthiasson, P.; Woolley, J.B.; Mechelli, A.; Johns, L.C.; Tabraham, P.; Bramon, E.; Valmaggia, L.; Williams, S.C.; McGuire, P.

    2011-01-01

    Background: The prodromal phase of psychosis is characterized by impaired executive function and altered prefrontal activation. The extent to which the severity of these deficits at presentation predicts subsequent clinical outcomes is unclear. Methods: We employed functional magnetic resonance imaging in a cohort of subjects at clinical risk for psychosis and in healthy controls. Images were acquired at clinical presentation and again after 1 year, using a 1.5-T Signa MRI scanner while subjects were performing a verbal fluency task. SPM5 was used for the analysis of imaging data. Psychopathological assessment of the “at-risk” symptoms was performed by using the Comprehensive Assessment for the At-Risk Mental State (CAARMS) and the Positive and Negative Symptom Scale (PANSS). Results: In the at-risk mental state (ARMS) group, between presentation and follow-up, the CAARMS (perceptual disorder and thought disorder subscales) and the PANSS general scores decreased, while the Global Assessment of Functioning (GAF) score increased. Both the ARMS and control groups performed the verbal fluency task with a high degree of accuracy. The ARMS group showed greater activation in the left inferior frontal gyrus but less activation in the anterior cingulate gyrus than controls. Within the ARMS group, the longitudinal normalization of neurofunctional response in the left inferior frontal gyrus was positively correlated with the improvement in severity of hallucination-like experiences. Conclusions: The normalization of the abnormal prefrontal response during executive functioning is associated with 12-month psychopathological improvement of prodromal symptoms. PMID:19666832

  2. Coordinating ecological restoration options analysis and risk assessment to improve environmental outcomes.

    PubMed

    Kapustka, Lawrence A; Bowers, Keith; Isanhart, John; Martinez-Garza, Cristina; Finger, Susan; Stahl, Ralph G; Stauber, Jenny

    2016-04-01

    Ecological risk assessment as currently practiced has hindered consideration of ecosystem services endpoints and restoration goals in the environmental management process. Practitioners have created barriers between procedures to clean up contaminated areas and efforts to restore ecosystem functions. In this article, we examine linkages between contaminant risk assessment approaches and restoration efforts with the aim of identifying ways to improve environmental outcomes. We advocate that project managers and other stakeholders use an ecological planning framework, with restoration options included upfront in the risk assessment. We also considered the opportunities to incorporate ecosystem services as potential assessment endpoints in the Problem Formulation stages of a risk assessment. Indeed, diverse perspectives of stakeholders are central to understand the relevance of social, cultural, economic, and regional ecology as influences on future use options for the landscape being restored. The measurement endpoints used to characterize the existing ecological conditions for selected ecosystem services can also be used to evaluate restoration success. A regional, landscape, or seascape focus is needed throughout the risk assessment process, so that restoration efforts play a more prominent role in enhancing ecosystem services. In short, we suggest that practitioners begin with the question of "how can the ecological risk assessment inform the decision on how best to restore the ecosystem?" PMID:26077395

  3. Obesity and long term functional outcomes following elective total hip replacement

    PubMed Central

    2012-01-01

    Introduction Obesity rates continue to rise and more total hip arthroplasty procedures are being performed in progressively younger, obese patients. Hence, maintenance of long term physical function will become very important for quality of life, functional independence and hip prosthesis survival. Presently, there are no reviews of the long term efficacy of total hip arthroplasty on physical function. This review: 1) synopsized available data regarding obesity effects on long term functional outcomes after total hip arthroplasty, and 2) suggested future directions for research. Methods A literature search was conducted from 1965 to January of 2011 for studies that evaluated long term functional outcomes at one year or longer after THA in obese (body mass index values ≥30 kg/m2) and non-obese patients (body mass index <30 kg/m2). Results Five retrospective studies and 18 prospective studies were identified as those that assessed physical function before surgery out to ≥ one year after total hip arthroplasty. Study sample sizes ranged from 108–18,968 and followed patients from one to twenty years. Total hip arthroplasty confers significant pain reduction and improvement in quality of life irrespective of body mass index. Functional improvement occurred after total hip arthroplasty among all studies, but obese patients generally did not attain the same level of physical function by the follow-up time point. Discussion Uncontrolled obesity after total hip arthroplasty is related to worsening of comorbidities and excessive health care costs over the long term. Aggressive and sustainable rehabilitation strategies that include physical exercise, psychosocial components and behavior modification may be highly useful in maximizing and maintaining weight loss after total hip arthroplasty. PMID:22533938

  4. Structural Equation Modeling of Motor Impairment, Gross Motor Function, and the Functional Outcome in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Park, Eun-Young; Kim, Won-Ho

    2013-01-01

    Physical therapy intervention for children with cerebral palsy (CP) is focused on reducing neurological impairments, improving strength, and preventing the development of secondary impairments in order to improve functional outcomes. However, relationship between motor impairments and functional outcome has not been proved definitely. This study…

  5. Assessment of Age-Related Differences in Functional Capacity Using the Virtual Reality Functional Capacity Assessment Tool (VRFCAT)

    PubMed Central

    Atkins, A.S.; Stroescu, I.; Spagnola, N.B.; Davis, V.G.; Patterson, T.D.; Narasimhan, M.; Harvey, P.D.; Keefe, R.S.E.

    2015-01-01

    Clinical trials for primary prevention and early intervention in preclinical AD require measures of functional capacity with improved sensitivity to deficits in healthier, non-demented individuals. To this end, the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) was developed as a direct performance-based assessment of functional capacity that is sensitive to changes in function across multiple populations. Using a realistic virtual reality environment, the VRFCAT assesses a subject's ability to complete instrumental activities associated with a shopping trip. The present investigation represents an initial evaluation of the VRFCAT as a potential co-primary measure of functional capacity in healthy aging and preclinical MCI/AD by examining test-retest reliability and associations with cognitive performance in healthy young and older adults. The VRFCAT was compared and contrasted with the UPSA-2-VIM, a traditional performance-based assessment utilizing physical props. Results demonstrated strong age-related differences in performance on each VRFCAT outcome measure, including total completion time, total errors, and total forced progressions. VRFCAT performance showed strong correlations with cognitive performance across both age groups. VRFCAT Total Time demonstrated good test-retest reliability (ICC=.80 in young adults; ICC=.64 in older adults) and insignificant practice effects, indicating the measure is suitable for repeated testing in healthy populations. Taken together, these results provide preliminary support for the VRFCAT as a potential measure of functionally relevant change in primary prevention and preclinical AD/MCI trials. PMID:26618145

  6. An Illustration of Diagnostic Classification Modeling in Student Learning Outcomes Assessment

    ERIC Educational Resources Information Center

    Jurich, Daniel P.; Bradshaw, Laine P.

    2014-01-01

    The assessment of higher-education student learning outcomes is an important component in understanding the strengths and weaknesses of academic and general education programs. This study illustrates the application of diagnostic classification models, a burgeoning set of statistical models, in assessing student learning outcomes. To facilitate…

  7. Institutional Effectiveness and Outcomes Assessment Implementation on Campus: A Practitioner's Handbook.

    ERIC Educational Resources Information Center

    Nichols, James O.

    A guidebook for the individual or group of persons on a college campus responsible for implementation of institutional effectiveness or outcomes assessment activities is presented in seven chapters. Chapter 1 explains the handbook's use in institutional effectiveness and outcomes assessment implementation, and Chapter 2 gives an overview of the…

  8. The Trauma Outcome Process Assessment Model: A Structural Equation Model Examination of Adjustment

    ERIC Educational Resources Information Center

    Borja, Susan E.; Callahan, Jennifer L.

    2009-01-01

    This investigation sought to operationalize a comprehensive theoretical model, the Trauma Outcome Process Assessment, and test it empirically with structural equation modeling. The Trauma Outcome Process Assessment reflects a robust body of research and incorporates known ecological factors (e.g., family dynamics, social support) to explain…

  9. The Status of Student Outcomes Assessment at NASULGC Member Institutions. AIR 1991 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Muffo, John A.

    A survey was conducted of the member institutions of the National Association of State Universities and Land Grant Colleges (NASULGC) to determine the status of outcomes assessment on their campuses, as well as the usefulness of the NASULGC "Statement of Principles on Outcomes Assessment." Seventy-three institutions (response rate = 49 percent)…

  10. Standardized Testing for Outcome Assessment: Analysis of the Educational Testing Systems MBA Tests

    ERIC Educational Resources Information Center

    Wright, Robert E.

    2010-01-01

    The use of standardized tests for outcome assessment has grown dramatically in recent years. Two driving factors have been the No Child Left Behind legislation, and the increase in outcome assessment measures by accrediting agencies such as AACSB, the international accrediting body for business schools. Despite the growth in usage, little effort…

  11. Use of Adverse Outcome Pathways for Assessing Effects of the Fungicide Propiconazole on Fish Reproduction

    EPA Science Inventory

    Adverse outcome pathways (AOP) are used to describe the linkage of biological events from a molecular initiating point, to individual-level-endpoints relevant to risk assessment. This study was done to assess toxicity outcomes for the conazole fungicide propiconazole based on a p...

  12. Motivation Monitoring and Assessment Extension for Input-Process-Outcome Game Model

    ERIC Educational Resources Information Center

    Ghergulescu, Ioana; Muntean, Cristina Hava

    2014-01-01

    This article proposes a Motivation Assessment-oriented Input-Process-Outcome Game Model (MotIPO), which extends the Input-Process-Outcome game model with game-centred and player-centred motivation assessments performed right from the beginning of the game-play. A feasibility case-study involving 67 participants playing an educational game and…

  13. Assessing Outcomes of a Realistic Major Preview in an Introductory Sport Management Course

    ERIC Educational Resources Information Center

    Pierce, David; Wanless, Elizabeth; Johnson, James

    2014-01-01

    This paper assessed the outcomes of a field experience assignment (FEA) in an introductory sport management course designed as a realistic major preview. Student learning outcomes assessed were commitment to the major, intent to pursue the major, expectation of a career in sports, and perceived preparation for a career in sports. A…

  14. An outcomes evaluation of an emergency department early pregnancy assessment service and early pregnancy assessment protocol

    PubMed Central

    Wendt, Kim; Crilly, Julia; May, Chris; Bates, Kym; Saxena, Rakhee

    2014-01-01

    Background Complications in early pregnancy, such as threatened or actual miscarriage is a common occurrence resulting in many women presenting to the emergency department (ED). Early pregnancy service delivery models described in the literature vary in terms of approach, setting and outcomes. Our objective was to determine outcomes of women who presented to an Australian regional ED with diagnoses consistent with early pregnancy complications following the implementation of an early pregnancy assessment service (EPAS) and early pregnancy assessment protocol (EPAP) in July 2011. Methods A descriptive, comparative (6 months before and after) study was undertaken. Data were extracted from the hospital ED information system and medical healthcare records. Outcome measures included: time to see a clinician, ED length of stay, admission rate, re-presentation rate, hospital admission and types of pathology tests ordered. Results Over the 12 -month period, 584 ED presentations were made to the ED with complications of early pregnancy (268 PRE and 316 POST EPAS–EPAP). Outcomes that improved statistically and clinically following implementation included: time to see a clinician (decreased by 6 min from 35 to 29 min), admission rate (decreased 6% from 14.5% to 8.5%), increase in β-human chorionic gonadotrophin ordering by 10% (up to 80% POST), increase in ultrasound (USS) performed by 10% (up to 73% POST) and increase in pain score documentation by 23% (up to 36% POST). Conclusions The results indicate that patient and service delivery improvements can be achieved following the implementation of targeted service delivery models such as EPAS and EPAP in the ED. PMID:24136123

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

    PubMed

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

    2015-01-01

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

  16. Learning outcomes as a tool to assess progression.

    PubMed

    Harden, Ronald M

    2007-09-01

    In the move to outcome-based education (OBE) much of the attention has focussed on the exit learning outcomes-the outcomes expected of a student at the end of a course of studies. It is important also to plan for and monitor students progression to the exit outcomes. A model is described for considering this progression through the phases of undergraduate education. Four dimensions are included-increasing breadth, increasing depth, increasing utility and increasing proficiency. The model can also be used to develop a blueprint for a more seamless link between undergraduate education, postgraduate training and continuing professional development. The progression model recognises the complexities of medical practice and medical education. It supports the move to student-centred and adaptive approaches to learning in an OBE environment. PMID:18236255

  17. Issues and developments related to assessing function in serious mental illness

    PubMed Central

    Brown, Matt A.; Velligan, Dawn I.

    2016-01-01

    Serious mental illness (SMI) results in functional disability that imposes a significant burden on individuals, caregivers, and society. Development of novel treatments is under way in an effort to improve the illness domains of cognitive impairment and negative symptoms and subsequently to improve functional outcomes. The assessment of functional outcomes in SMI faces a number of challenges, including the proliferation of assessment instruments and the differential prioritization of functional goals among stakeholder groups. Functional assessments relying on self- and informant report present a number of limitations. Identifying alternative strategies to assess functioning that are reliable, valid, and sensitive to change is necessary for use in clinical trials. Measures of functional capacity have been proposed for clinical trials investigating compounds to treat cognitive impairment in schizophrenia. Alternative approaches employing effort-based decision making or daily activity recording using instruments such as the Daily Activity Report may be more appropriate for studies focused on improving negative symptoms. PMID:27489453

  18. Issues and developments related to assessing function in serious mental illness.

    PubMed

    Brown, Matt A; Velligan, Dawn I

    2016-06-01

    Serious mental illness (SMI) results in functional disability that imposes a significant burden on individuals, caregivers, and society. Development of novel treatments is under way in an effort to improve the illness domains of cognitive impairment and negative symptoms and subsequently to improve functional outcomes. The assessment of functional outcomes in SMI faces a number of challenges, including the proliferation of assessment instruments and the differential prioritization of functional goals among stakeholder groups. Functional assessments relying on self- and informant report present a number of limitations. Identifying alternative strategies to assess functioning that are reliable, valid, and sensitive to change is necessary for use in clinical trials. Measures of functional capacity have been proposed for clinical trials investigating compounds to treat cognitive impairment in schizophrenia. Alternative approaches employing effort-based decision making or daily activity recording using instruments such as the Daily Activity Report may be more appropriate for studies focused on improving negative symptoms.

  19. Issues and developments related to assessing function in serious mental illness.

    PubMed

    Brown, Matt A; Velligan, Dawn I

    2016-06-01

    Serious mental illness (SMI) results in functional disability that imposes a significant burden on individuals, caregivers, and society. Development of novel treatments is under way in an effort to improve the illness domains of cognitive impairment and negative symptoms and subsequently to improve functional outcomes. The assessment of functional outcomes in SMI faces a number of challenges, including the proliferation of assessment instruments and the differential prioritization of functional goals among stakeholder groups. Functional assessments relying on self- and informant report present a number of limitations. Identifying alternative strategies to assess functioning that are reliable, valid, and sensitive to change is necessary for use in clinical trials. Measures of functional capacity have been proposed for clinical trials investigating compounds to treat cognitive impairment in schizophrenia. Alternative approaches employing effort-based decision making or daily activity recording using instruments such as the Daily Activity Report may be more appropriate for studies focused on improving negative symptoms. PMID:27489453

  20. [Assessment of platelet function in man].

    PubMed

    Gaussem, Pascale

    2006-01-01

    Assessment of platelet function was primarily designed to explore patients with hemostatic disorders, but is becoming important for the monitoring of anti platelet agents, mostly aspirin and clopidogrel. Beside platelet counting, morphological analysis and bleeding time, a number of dedicated platelet function instruments are now available, generally allowing a rapid evaluation of platelet function in whole blood. The other tests including aggregometry and ELISA measurement of activation markers are generally restricted to specialized laboratories. Although aggregometry is still considered as the "gold standard", the recently developed flow cytometric-based platelet function analysis provides a wide choice of tests that assess the number of surface receptors, the measure of secretion and aggregation, the quantification of microparticules and leukocyte-platelet aggregates. It also allows the measure of the function of the ADP receptor P2Y12 by the phosphorylation level of the VASP protein, method currently under evaluation to monitor the platelet response to clopidogrel treatment. PMID:17243268

  1. Cognitive impairment and functional outcome after stroke associated with small vessel disease

    PubMed Central

    Mok, V; Wong, A; Lam, W; Fan, Y; Tang, W; Kwok, T; Hui, A; Wong, K

    2004-01-01

    Objectives: Although stroke associated with small vessel disease (SSVD) can induce both motor and cognitive impairment, the latter has received less attention. We aimed to evaluate the frequency of the varying severity levels of cognitive impairment, the determinants of severe cognitive impairment, and the association of cognitive impairment with functional outcome after SSVD. Methods: Consecutive patients admitted to hospital because of SSVD were assessed at 3 months after stroke. We performed a semi-structured clinical interview to screen for cognitive symptoms. Severity of cognitive symptoms was graded according to the Clinical Dementia Rating Scale (CDR). Performance on psychometric tests (Mini-Mental State Examination, Alzheimer's Disease Assessment Scale (cognition subscale), Mattis Dementia Rating Scale (initiation/perseverence subscale; MDRS I/P)) of patients of different CDR gradings was compared with that of 42 healthy controls. Basic demographic data, vascular risk factors, stroke severity (National Institute of Health Stroke Scale; NIHSS), pre-stroke cognitive decline (Informant Questionnaire on Cognitive Decline in the Elderly; IQCODE), functional outcome (Barthel index; BI), Instrumental Activities Of Daily Living; IADL), and neuroimaging features (site of recent small infarcts, number of silent small infarcts, white matter changes) were also compared among the groups. Regression analyses were performed to find predictors of severe cognitive impairment and poor functional outcome. Results: Among the 75 included patients, 39 (52%) complained of cognitive symptoms. The number of patients in each CDR grading was as follows: 39 (52%) had a CDR of 0, 26 (34.7%) had a CDR of 0.5, 10 (13.3%) had a CDR of ⩾1. Pre-stroke IQCODE and previous stroke predicted CDR⩾1. The NIHSS was associated with more impaired BI. The NIHSS and MDRS I/P contributed most to impaired IADL. Conclusions: Half of the patients with SSVD complained of varying severity of cognitive

  2. Functional status outcome measures in home health care patients with heart failure.

    PubMed

    Scharpf, Tanya Pollack; Madigan, Elizabeth A

    2010-10-01

    Elderly, chronically ill patients' ability to stay at home is dependent on their capacity to perform activities of daily living (ADLs). The Outcome and Assessment Information Set (OASIS) defines ADLs and can be evaluated in various ways. The purpose of this research was to evaluate these approaches and make recommendations for use in research. Several different approaches to the evaluation of functional status were done using ADLs (ambulation, bathing, dressing lower body, dressing upper body, feeding, grooming, toileting, and transferring) scored individually and as indices. Each approach has advantages and disadvantages depending on the research question being asked. The ADL change index score provided the most comprehensive analysis of functional status change although the categorical scores are useful for simple approaches.

  3. Functional status outcome measures in home health care patients with heart failure.

    PubMed

    Scharpf, Tanya Pollack; Madigan, Elizabeth A

    2010-10-01

    Elderly, chronically ill patients' ability to stay at home is dependent on their capacity to perform activities of daily living (ADLs). The Outcome and Assessment Information Set (OASIS) defines ADLs and can be evaluated in various ways. The purpose of this research was to evaluate these approaches and make recommendations for use in research. Several different approaches to the evaluation of functional status were done using ADLs (ambulation, bathing, dressing lower body, dressing upper body, feeding, grooming, toileting, and transferring) scored individually and as indices. Each approach has advantages and disadvantages depending on the research question being asked. The ADL change index score provided the most comprehensive analysis of functional status change although the categorical scores are useful for simple approaches. PMID:21153996

  4. Neurobiological Regret and Rejoice Functions for Aversive Outcomes

    PubMed Central

    Chandrasekhar, Pammi V.S.; Capra, C. Monica; Moore, Sara; Noussair, Charles; Berns, Gregory S.

    2008-01-01

    A decision maker may experience regret when a choice he makes results in a more adverse outcome than a different choice would have yielded. Analogously, he may experience rejoice when his choice resulted in better outcomes. We used fMRI to investigate the neural correlates of regret and rejoice where payoffs are in terms of a non-monetary medium. Incentives were created using painful outcomes in the form of mild electrical shocks to the foot and the possibility of avoiding them. We hypothesized that the neural response to a painful outcome resulting from an individual’s choice would also reflect the degree of regret as measured by the likelihood that alternative choices would have yielded the same adverse outcome. Similarly, when an individual avoids a potential shock, he would experience a degree of rejoice that correlates with the probability he had of receiving the shock. For example, winning a bet when winning was unlikely, even if the outcome is the same, evokes more rejoice than winning when it was highly probable. Our results suggest that activation of a cortical network, consisting of the medial orbitofrontal cortex, left superior frontal cortex, right angular gyrus, and left thalamus, correlates with the degree of regret. A different network, including the rostral anterior cingulate, left hippocampus, left ventral striatum, and brainstem/midbrain correlated with rejoice. The right inferior orbitofrontal cortex, pre-supplementary motor area, anterior cingulate, and posterior cingulate showed similar patterns of activation with both regret and rejoice, suggesting that these regions may be associated with surprise from the realization of relatively unlikely events. Our results suggest that distinct, but overlapping networks are involved in the experiences of regret and rejoice. PMID:18042401

  5. Integrating Outcomes Assessment into Optometry Education: A Strategic Guide for Enhancing Student Learning.

    ERIC Educational Resources Information Center

    Beck, Diane E.; Daum, Kent M.

    2003-01-01

    Outlines eight steps that will help optometry schools transition a faculty from "denial" of the need for assessment to "institutionalization": establish a collaborative environment, establish an infrastructure that makes assessment an integral activity, recruit a leader for full implementation of outcomes assessment, conduct a needs assessment,…

  6. Voice and Functional Outcomes of Transoral Laser Microsurgery for Early Glottic Cancer: Ventricular Fold Resection as a Surrogate

    PubMed Central

    Berania, Ilyes; Dagenais, Christophe; Moubayed, Sami P.; Ayad, Tareck; Olivier, Marie-Jo; Guertin, Louis; Bissada, Eric; Tabet, Jean-Claude; Christopoulos, Apostolos

    2015-01-01

    Background The aim of the study was to evaluate the oncological and functional outcomes with transoral laser microsurgery (TOLM) of patients with early glottic cancer. Methods We have prospectively evaluated patients treated with TOLM for Tis, T1 or T2 glottic squamous cell carcinoma. Evaluation of oncological outcomes, and voice and functional outcomes was assessed using voice-handicap index 10 (VHI-10) and performance status scale for head & neck cancer patients (PSS-H&N). Predictors of poor voice quality were evaluated using Student’s t-test. Results Thirty patients were included, with 17.7 months mean follow-up. There were no cases of locoregional recurrence. Twelve patients (40%) were considered as having a problematic voice outcome. Four subjects out of 30 (13.3%) had significant problems with understandability of speech. Significant differences (P < 0.05) in VHI-10 score were found with tumor stage and partial resection of the ventricular fold. Conclusions We report excellent oncological and functional outcomes in early glottic cancer treated with TOLM, with advanced tumors and partial resection of the ventricular fold as a surrogate predicting worse voice outcomes. PMID:26124910

  7. Assessment of brown adipose tissue function

    PubMed Central

    Virtue, Sam; Vidal-Puig, Antonio

    2013-01-01

    In this review we discuss practical considerations for the assessment of brown adipose tissue in rodent models, focusing on mice. The central aim of the review is to provide a critical appraisal of the utility of specialized techniques for assessing brown adipose tissue function in vivo. We cover several of the most common specialized methods for analysing brown adipose tissue function in vivo, including assessment of maximal thermogenic capacity by indirect calorimetry and the measurement of sympathetic tone to brown adipose tissue. While these techniques are powerful, they are not readily available to all laboratories; therefore we also cover several simple measurements that, particularly in combination, can be used to determine if a mouse model is likely to have alterations in brown adipose tissue function. Such techniques include: pair feeding, analysis of brown adipose tissue lipid content and mRNA and protein markers of brown adipose tissue activation. PMID:23760815

  8. Effects of Balance Control Training on Functional Outcomes in Subacute Hemiparetic Stroke Patients

    PubMed Central

    Huh, Jin Seok; Lee, Yang-Soo; Kim, Chul-Hyun; Min, Yu-Sun; Kang, Min-Gu

    2015-01-01

    Objective To investigate the efficacy of balance control training using a newly developed balance control trainer (BalPro) on the balance and gait of patients with subacute hemiparetic stroke. Methods Forty-three subacute stroke patients were assigned to either a balance control training (BCT) group or a control group. The BCT group (n=23) was trained with BalPro for 30 minutes a day, 5 days a week for 2 weeks, and received one daily session of conventional physical therapy. The control group (n=20) received two sessions of conventional physical therapy every day for 2 weeks. The primary outcome was assessment with the Berg Balance Scale (BBS). Secondary outcomes were Functional Ambulation Category (FAC), the 6-minute walking test (6mWT), Timed Up and Go (TUG), the Korean version of Modified Barthel Index (K-MBI), and the manual muscle test (MMT) of the knee extensor. All outcome measures were evaluated before and after 2 weeks of training in both groups. Results There were statistically significant improvements in all parameters except MMT and FAC after 2 weeks of treatment in both groups. After training, the BCT group showed greater improvements in the BBS and the 6mWT than did the control group. Conclusion Balance control training using BalPro could be a useful treatment for improving balance and gait in subacute hemiparetic stroke patients. PMID:26798615

  9. Assessment of Cognitive Functions in Methadone Maintenance Patients

    PubMed Central

    Mazhari, Shahrzad; Keshvari, Zeinab; Sabahi, Abdolreza; Mottaghian, Shirin

    2015-01-01

    Background Methadone maintenance has received little scientific attention regarding neurocognitive effects. This study is aimed to assess the neuropsychological performance of methadone maintenance patients (MMP) compared to those healthy controls. Methods Thirty-five MMP and 35 healthy controls, matched for age, gender, education and employment status, examined on a battery of tests aimed at assessing verbal fluency, executive functions, verbal memory, and working memory, using controlled oral word association test (COWAT), trial making test (TMT) Part A and B, Rey auditory verbal learning test (RAVLT), and backward digit span. Findings MMP performed significantly poorly than controls in cognitive domains of verbal fluency, executive function, and verbal memory. MMP did not exhibit impairment in working memory, and TMT Part A compared to controls. Conclusion These results suggest that methadone consumption induces significant cognitive impairment that could compromise drug-treatment outcomes in MMP. PMID:26885347

  10. IQ as a predictor of functional outcome in schizophrenia: a longitudinal, four-year study of first-episode psychosis.

    PubMed

    Leeson, Verity C; Barnes, Thomas R E; Hutton, Sam B; Ron, Maria A; Joyce, Eileen M

    2009-01-01

    Studies of established schizophrenia have consistently found that cognitive function predicts social and clinical outcomes. The findings from first-episode studies have been more variable, with only some studies reporting predictive relationships. We tested the possibility that an index of general cognitive ability, IQ, may be a more sensitive and reliable predictor of outcome in first-episode schizophrenia than specific measures of memory and executive function. Fifty-four patients with first-episode schizophrenia or schizoaffective disorder were assessed for cognitive and social function as well as symptoms at three time points over the four years following first presentation of their psychotic illness. Regression analyses were performed to determine whether IQ and specific neuropsychological measures at first episode and one-year follow-up predicted four-year social function and residual symptoms. The effects of premorbid and concurrent IQ on outcome were also assessed. Premorbid IQ and IQ at each assessment significantly predicted social function at four-year follow-up. This relationship remained significant after the social function or symptom scores at first presentation were accounted for in the regression. Specific measures predicted certain domains of social function, but these were weaker and less consistent than IQ. The predictive values of cognition on residual symptoms were less strong; the most consistent finding was a relationship between IQ and the negative syndrome. This study suggests that early in the course of schizophrenia, general cognitive ability, as measured by IQ, is a more sensitive and reliable predictor of functional outcome than measures of specific ability. PMID:18793828

  11. IQ as a predictor of functional outcome in schizophrenia: A longitudinal, four-year study of first-episode psychosis

    PubMed Central

    Leeson, Verity C.; Barnes, Thomas R.E.; Hutton, Sam B.; Ron, Maria A.; Joyce, Eileen M.

    2009-01-01

    Studies of established schizophrenia have consistently found that cognitive function predicts social and clinical outcomes. The findings from first-episode studies have been more variable, with only some studies reporting predictive relationships. We tested the possibility that an index of general cognitive ability, IQ, may be a more sensitive and reliable predictor of outcome in first-episode schizophrenia than specific measures of memory and executive function. Fifty-four patients with first-episode schizophrenia or schizoaffective disorder were assessed for cognitive and social function as well as symptoms at three time points over the four years following first presentation of their psychotic illness. Regression analyses were performed to determine whether IQ and specific neuropsychological measures at first episode and one-year follow-up predicted four-year social function and residual symptoms. The effects of premorbid and concurrent IQ on outcome were also assessed. Premorbid IQ and IQ at each assessment significantly predicted social function at four-year follow-up. This relationship remained significant after the social function or symptom scores at first presentation were accounted for in the regression. Specific measures predicted certain domains of social function, but these were weaker and less consistent than IQ. The predictive values of cognition on residual symptoms were less strong; the most consistent finding was a relationship between IQ and the negative syndrome. This study suggests that early in the course of schizophrenia, general cognitive ability, as measured by IQ, is a more sensitive and reliable predictor of functional outcome than measures of specific ability. PMID:18793828

  12. Outcomes-Based Education Reexamined: From Structural Functionalism to Poststructuralism.

    ERIC Educational Resources Information Center

    Capper, Colleen A.; Jamison, Michael T.

    1993-01-01

    Outcomes-based education (OBE) views itself as drastic break from current inequitable educational practices and means of providing educational success for all students. Reexamines OBE from a multiparadigm perspective of organizations and educational administration. Although certain OBE facets may be empowering to students and teachers, much of the…

  13. The importance of team functioning to natural resource planning outcomes.

    PubMed

    Stern, Marc J; Predmore, S Andrew

    2012-09-15

    In its recent history, the U.S. Forest Service is among many federal land management agencies struggling with questions concerning why its planning procedures are sometimes inefficient, perform poorly in the eyes of the public, and fail to deliver outputs that advance agency mission. By examining a representative sample of National Environmental Policy Act (NEPA) processes conducted by the agency between 2007 and 2009, we provide new insights into what drives outcomes in these planning processes. We examined team leaders' perceptions of the following outcomes: achievement of agency goals and NEPA mandates, process efficiency, public relations, and team outcomes. The most consistently important predictors of positive outcomes were team harmony and a clearly empowered team leader. Other factors, such as perceptions of the use of best science, a clear and unambiguous purpose and need, team turnover (personnel changes during the process), extra-agency engagement, and intra-agency relations, were also important, but played a less consistent role. The findings suggest the importance of empowering team leaders and team members through enhancing elements of discretion, responsibility, clear role definition, collaborative interdisciplinary deliberation, and perceived self-efficacy. The results also suggest the importance of genuine concern and respect for participating publics and effective inter-agency coordination.

  14. Reward Circuitry Function in Autism during Face Anticipation and Outcomes

    ERIC Educational Resources Information Center

    Dichter, Gabriel S.; Richey, J. Anthony; Rittenberg, Alison M.; Sabatino, Antoinette; Bodfish, James W.

    2012-01-01

    The aim of this study was to investigate reward circuitry responses in autism during reward anticipation and outcomes for monetary and social rewards. During monetary anticipation, participants with autism spectrum disorders (ASDs) showed hypoactivation in right nucleus accumbens and hyperactivation in right hippocampus, whereas during monetary…

  15. Exploring Posttraumatic Outcomes as a Function of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Shakespeare-Finch, Jane; de Dassel, Therese

    2009-01-01

    There is sparse systematic examination of the potential for growth as well as distress that may occur for some adult survivors of childhood sexual abuse. The presented study explored posttraumatic growth and its relationship with negative posttrauma outcomes within the specific population of survivors of childhood sexual abuse (N = 40). Results…

  16. Serum 25-hydroxyvitamin D and functional outcomes in the elderly

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this paper is to consider key evidence that treatment of vitamin D insufficiency has measurable clinical benefits for the musculoskeletal system in the elderly. The outcomes considered are increased bone mass, decreased rates of bone loss, improved muscle performance, reduced risk o...

  17. State Staff Perceptions of Vocational Education Outcomes. Identification and Assessment of Vocational Educational Outcomes.

    ERIC Educational Resources Information Center

    Wentling, Tim L.; Barnard, Wynette S.

    A study examined appropriate outcomes for students entering the work force after graduation from high school and for students going on to a community college for advanced training. Fifty-eight staff members of the Department fo Adult, Vocational, and Technical Education (DAVTE) of the Illinois State Board of Education were asked to write a profile…

  18. Older Age Does Not Affect Healing Time and Functional Outcomes After Fracture Nonunion Surgery

    PubMed Central

    Taormina, David P.; Shulman, Brandon S.; Karia, Raj; Spitzer, Allison B.; Konda, Sanjit R.

    2014-01-01

    Introduction: Elderly patients are at risk of fracture nonunion, given the potential setting of osteopenia, poorer fracture biology, and comorbid medical conditions. Risk factors predicting fracture nonunion may compromise the success of fracture nonunion surgery. The purpose of this study was to investigate the effect of patient age on clinical and functional outcome following long bone fracture nonunion surgery. Materials and Methods: A retrospective analysis of prospectively collected data identified 288 patients (aged 18-91) who were indicated for long bone nonunion surgery. Two-hundred and seventy-two patients satisfied study inclusion criteria and analyses were performed comparing elderly patients aged ≥65 years (n = 48) with patients <65 years (n = 224) for postoperative wound complications, Short Musculoskeletal Functional Assessment (SMFA) functional status, healing, and surgical revision. Regression analyses were performed to look for associations between age, smoking status, and history of previous nonunion surgery with healing and functional outcome. Twelve-month follow-up was obtained on 91.5% (249 of 272) of patients. Results: Despite demographic differences in the aged population, including a predominance of medical comorbidities (P < .01) and osteopenia (P = .02), there was no statistical differences in the healing rate of elderly patients (95.8% vs 95.1%, P = .6) or time to union (6.2 ± 4.1 months vs. 7.2 ± 6.6, P = .3). Rates of postoperative wound complications and surgical revision did not statistically differ. Elderly patients reported similar levels of function up to 12 months after surgery. Regression analyses failed to show any significant association between age and final union or time to union. There was a strong positive association between smoking and history of previous nonunion surgery with time to union. Age was associated (positively) with 12-month SMFA activity score. Conclusions: Smoking and failure of previous surgical

  19. [Distant functional outcomes of treatment and physiotherapy of tibial eminence fractures in adults].

    PubMed

    Nowak, Sebastian; Golec, Edward; Golec, Joanna; Szczygieł, Elzbieta; Ciszek, Elzbieta; Walocha, Jerzy; Mizia, Ewa

    2009-01-01

    Authors of paper present distant functional outcomes of treatment and physiotherapy of tibial eminence fractures basing on clinical material covering years from 1998 to 2006, that make up 15 patients, 7 women (46.7%) and 8 men (53.3%), aged between 18 and 57 years, on average 37.5-years-old. Subject fractures ware classified basing on Meyers i McKeever criteria, however obtained outcomes basing on IKDC (International Knee Documentation Committee) system. Obtained outcomes persuade authors to standpoint, that inoperative treatment of fractures type I leads to good functional outcomes, operative treatment of fracture type II leads to good functional outcomes too and operative treatment of fracture type III and III+ leads to sufficient outcomes. PMID:20201332

  20. Assessing Individual Support Needs to Enhance Personal Outcomes

    ERIC Educational Resources Information Center

    van Loon, Jos; Claes, Claudia; Vandevelde, Stijn; Van Hove, Geert; Schalock, Robert L.

    2010-01-01

    Education and human service organizations providing services to people with intellectual and closely related developmental disabilities are increasingly being impacted by the supports paradigm, the quality of life concept, and the evaluation of personal outcomes. In this article the authors discuss the relationship among these three areas,…

  1. Assessing Medication Effects in the MTA Study Using Neuropsychological Outcomes

    ERIC Educational Resources Information Center

    Epstein, Jeffery N.; Conners, C. Keith; Hervey, Aaron S.; Tonev, Simon T.; Arnold, L. Eugene; Abikoff, Howard B.; Elliott, Glen; Greenhill, Laurence L.; Hechtman, Lily; Hoagwood, Kimberly; Hinshaw, Stephen P.; Hoza, Betsy; Jensen, Peter S.; March, John S.; Newcorn, Jeffrey H.; Pelham, William E.; Severe, Joanne B.; Swanson, James M.; Wells, Karen; Vitiello, Benedetto; Wigal, Timothy

    2006-01-01

    Background: While studies have increasingly investigated deficits in reaction time (RT) and RT variability in children with attention deficit/hyperactivity disorder (ADHD), few studies have examined the effects of stimulant medication on these important neuropsychological outcome measures. Methods: 316 children who participated in the Multimodal…

  2. What Do They Measure? Comparing Three Learning Outcomes Assessments

    ERIC Educational Resources Information Center

    Steedle, Jeffrey; Kugelmass, Heather; Nemeth, Alex

    2010-01-01

    Many postsecondary institutions currently administer standardized tests of general college outcomes; more than a quarter of Association of American Colleges and Universities (AAC&U) member institutions do so. Using standardized tests for accountability purposes has been contentious mainly because these tests do not measure every important outcome…

  3. Assessment of Student Outcomes Using a Theoretical Framework.

    ERIC Educational Resources Information Center

    Levins, Lesley

    1997-01-01

    Examines the scientific concept of evaporation. Attempts to show how students develop their understanding through the levels of the Structure of the Observed Learning Outcome (SOLO) taxonomy. Shows how designing learning experiences to suit the learners' developmental stages in understanding a concept is paramount to the overall growth of the…

  4. Methodological Quandaries in Studying Process and Outcomes in Peer Assessment

    ERIC Educational Resources Information Center

    Topping, Keith J.

    2010-01-01

    Peer assessment is very various in its implementation. Six studies of peer assessment are reviewed, four of them in higher education. A literature review is followed by five empirical studies. Strengths and weaknesses of each study are considered and issues are raised. Variables in peer assessment needing further exploration are extricated--in…

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

    ERIC Educational Resources Information Center

    Hannah, John; James, Alex; Williams, Phillipa

    2014-01-01

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

  6. Differences in Functional Outcomes for Adult Patients with Prosthodontically-Treated and -Untreated Shortened Dental Arches: A Systematic Review

    PubMed Central

    Khan, Saadika; Musekiwa, Alfred; Chikte, Usuf M. E.; Omar, Ridwaan

    2014-01-01

    This review examined differences in functional outcomes and patient satisfaction when shortened dental arches are left untreated compared to their restoration to complete arch lengths with different prosthodontic interventions. Methods A protocol was developed according to the criteria for a systematic review. All relevant databases were searched to identify appropriate clinical trials regardless of language or publication status. Predetermined eligibility criteria were applied, trial quality assessed and data extracted for each study. Relevant outcomes assessed were: functioning ability, patient satisfaction and harmful effects on oral structures. Results Searches yielded 101 articles: 81 from electronic databases and 20 from reference lists of retrieved articles (PEARLing searches). Sixty-nine citations were assessed for eligibility after removing 32 duplicate records. After reading titles and abstracts, a total of 41 records were excluded and the full-texts of the remaining 28 records were read. Only 21 records were included for the SR because 7 records were excluded after reading the full-text reports. These 21 records report the outcomes of four randomized controlled trials (RCTs) and one non-randomized clinical trial (CT) which were pre-specified and used for this review. No on-going studies were found and no eligible studies were excluded for failure to report the reviewer’s pre-specified outcomes. Outcomes were reported in the retrieved 21 articles. A narrative explanation of the pre-specified outcomes is reported for the 3 comparison groups (which were based on the different interventions used for the individual clinical trials). The shortened dental arch as a treatment option is encouraging in terms of functioning, patient satisfaction and cost-effectiveness. By using only high quality studies it was expected that the results would be more reliable when making conclusions and recommendations, but some of the included studies had to be downgraded due to

  7. Comparison of measures to assess outcomes in total hip replacement surgery.

    PubMed Central

    Dawson, J; Fitzpatrick, R; Murray, D; Carr, A

    1996-01-01

    OBJECTIVES--To compare the performance of a disease specific and a general health questionnaire in assessing changes resulting from total hip replacement. DESIGN--Two stage prospective study of patients undergoing total hip replacement surgery involving an assessment at a clinic before and six months after surgery. 60(32%) patients were followed up by post. SETTING--Outpatient departments at a specialist orthopaedic hospital and peripheral clinics within Oxfordshire. PATIENTS--188 patients admitted for unilateral total hip replacement between February and mid-August 1994. MAIN MEASURES--Patients' self assessed scores with the 12 item Oxford hip score and SF-36 general health questionnaire together with surgeons' assessment with Charnley hip score obtained before and again at six months after surgery. RESULTS--186 patients were followed up six months after total hip replacement; a subsample (n=60) by post. Of the 60 postal patients, 59(98.3%) fully completed the Oxford hip score compared with 44(73.3%) who fully completed the SF-36. For the followup sample as a whole, post operative changes in scores produced a large effect size of 2.75 on the Oxford hip score, compared with -1.89 physical function (SF-36), -2.13 pain (SF-36). With the exception of physical function and role (physical), postoperative SF-36 scores were shown to be similar to or better than those found by two population surveys on patients of comparable age. The responsiveness of a disease specific questionnaire, the Oxford hip score, and relevant sections of a general questionnaire, SF-36, were found to be similar as assessed by three different criteria. CONCLUSIONS--A disease specific questionnaire, the Oxford hip score, and a general state of health questionnaire, SF-36, performed similarly in assessing outcomes of total hip replacement except that the disease specific questionnaire resulted in a higher completion rate and greater responsiveness in some sections. On the other hand the general

  8. Outcome of humeral shaft fractures treated by functional cast brace

    PubMed Central

    Pal, Jitendra Nath; Biswas, Prahas; Roy, Avik; Hazra, Sunit; Mahato, Somnath

    2015-01-01

    . Results: The results were assessed using 100 point scoring system where union allotted 30 points and 60 points allotted for angulations (10), elbow motion (10), shoulder abduction (10), shortening (5), rotation (5), absence of infection (10), absence of nerve palsy during treatment (10). Remaining 10 points were allotted for five items with two points each. They were the absence of skin sore, absence of vascular problem, absence of reflex sympathetic dystrophy (RSD), recovery of paralyzed nerve during injury and recovery of paralyzed nerve during treatment. Results were considered excellent with 90 and above, good with 80–89, fair with 70–79 and poor below 70 point. Results at 6 months were excellent in 43.94% (n = 29), good in 42.42% (n = 28), fair in 9.1% (n = 6), poor in 4.55% (n = 3). Union took place in 98.48% (n = 65) with an average of 10.3 weeks (range 6–16 weeks). 87.5% (n = 7) paralyzed radial nerve recovered. All wounds healed. Four patients had transient skin problem. One patient with mid shaft fracture had nonunion due to the muscle interposition. Conclusion: Modified functional cast brace is one of the options in treatment for humeral shaft fractures as it can be applied on the 1st day of the presentation in most of the situations. Simple objective scoring system was useful particularly in uneducated patients. PMID:26229161

  9. A Diagnostician's Primer on Functional Behavioral Assessment.

    ERIC Educational Resources Information Center

    Sutton, Joe P.; Walker, Steven C.

    1999-01-01

    This article synthesizes information from the special education literature about functional behavioral assessments (FBAs), including the law and FBA, working definitions, basic assumptions underlying FBA, the role of the diagnosticians, the role of special educators, the steps to conducting an FBA, the methods of FBA, and tools for the…

  10. Functional Assessment: Old Wine in New Bottles.

    ERIC Educational Resources Information Center

    Ervin, Ruth A.; Ehrhardt, Kristal E.; Poling, Alan

    2001-01-01

    Traces functional assessment (FA) in school settings to early contributions by B. F. Skinner. FA plays an important role in behavior analysis, and the value of this approach in dealing with behavior problems in many settings has long been evident. Although interest in FA in school settings has only recently become widespread, FA in education has a…

  11. A Multilevel Assessment of Differential Item Functioning.

    ERIC Educational Resources Information Center

    Shen, Linjun

    A multilevel approach was proposed for the assessment of differential item functioning and compared with the traditional logistic regression approach. Data from the Comprehensive Osteopathic Medical Licensing Examination for 2,300 freshman osteopathic medical students were analyzed. The multilevel approach used three-level hierarchical generalized…

  12. Functional outcomes after fibula locking nail for fragility fractures of the ankle.

    PubMed

    Rajeev, Aysha; Senevirathna, Shanaka; Radha, Sarkhell; Kashayap, N S

    2011-01-01

    The aim of the present study was to assess the functional outcome of fragility fractures of the ankle treated with a fibular locking nail. A retrospective review of 24 patients with fragility fractures treated with a fibular locking nail from January 2005 to December 2007 was performed. The fibular nail used in our study was Biomet SST (stainless steel taper) small bone locking nail for the fibula. The Olerud and Molander scale was used to assess the functional outcome at the end of 1 year. The domains of the Olerud and Molander scale are pain, stiffness, swelling, stair climbing, running, jumping, squatting, support, and the activities of daily living. The patients were interviewed by telephone or the questionnaire was send by mail. Of the 24 patients, 2 were men and 22 were women. The left side was affected in 15 patients. The age group ranged from 71 to 91 years (average, 79). Of the fractures, 10 were lateral alveolus, 8 were bimalleolar, and 6 were trimalleolar fractures. All the patients were followed up at 6 weeks, 12 weeks, and after 6 months. The average period to fracture union was 8.7 weeks. No wound breakdown or any deep infections developed. The average Olerud and Molander scale score was 57 (range 30 to 65). The use of fibular locking nails to treat these difficult fracture are quite crucial to achieve early mobilization and also to maintain a good fracture position. In our study, the use of fibular nails was a very useful and successful method of treating fragility fractures with a very low risk of complications. It also helps to restore function and results in patient satisfaction.

  13. Functional brain microstate predicts the outcome in a visuospatial working memory task.

    PubMed

    Muthukrishnan, Suriya-Prakash; Ahuja, Navdeep; Mehta, Nalin; Sharma, Ratna

    2016-11-01

    Humans have limited capacity of processing just up to 4 integrated items of information in the working memory. Thus, it is inevitable to commit more errors when challenged with high memory loads. However, the neural mechanisms that determine the accuracy of response at high memory loads still remain unclear. High temporal resolution of Electroencephalography (EEG) technique makes it the best tool to resolve the temporal dynamics of brain networks. EEG-defined microstate is the quasi-stable scalp electrical potential topography that represents the momentary functional state of brain. Thus, it has been possible to assess the information processing currently performed by the brain using EEG microstate analysis. We hypothesize that the EEG microstate preceding the trial could determine its outcome in a visuospatial working memory (VSWM) task. Twenty-four healthy participants performed a high memory load VSWM task, while their brain activity was recorded using EEG. Four microstate maps were found to represent the functional brain state prior to the trials in the VSWM task. One pre-trial microstate map was found to determine the accuracy of subsequent behavioural response. The intracranial generators of the pre-trial microstate map that determined the response accuracy were localized to the visuospatial processing areas at bilateral occipital, right temporal and limbic cortices. Our results imply that the behavioural outcome in a VSWM task could be determined by the intensity of activation of memory representations in the visuospatial processing brain regions prior to the trial.

  14. Brain immune cell composition and functional outcome after cerebral ischemia: comparison of two mouse strains

    PubMed Central

    Kim, Hyun Ah; Whittle, Stephanie C.; Lee, Seyoung; Chu, Hannah X.; Zhang, Shenpeng R.; Wei, Zihui; Arumugam, Thiruma V.; Vinh, Anthony; Drummond, Grant R.; Sobey, Christopher G.

    2014-01-01

    Inflammatory cells may contribute to secondary brain injury following cerebral ischemia. The C57Bl/6 mouse strain is known to exhibit a T helper 1-prone, pro-inflammatory type response to injury, whereas the FVB strain is relatively T helper 2-prone, or anti-inflammatory, in its immune response. We tested whether stroke outcome is more severe in C57Bl/6 than FVB mice. Male mice of each strain underwent sham surgery or 1 h occlusion of the middle cerebral artery followed by 23 h of reperfusion. Despite no difference in infarct size, C57Bl/6 mice displayed markedly greater functional deficits than FVB mice after stroke, as assessed by neurological scoring and hanging wire test. Total numbers of CD45+ leukocytes tended to be larger in the brains of C57Bl/6 than FVB mice after stroke, but there were marked differences in leukocyte composition between the two mouse strains. The inflammatory response in C57Bl/6 mice primarily involved T and B lymphocytes, whereas neutrophils, monocytes and macrophages were more prominent in FVB mice. Our data are consistent with the concept that functional outcome after stroke is dependent on the immune cell composition which develops following ischemic brain injury. PMID:25477780

  15. Functional brain microstate predicts the outcome in a visuospatial working memory task.

    PubMed

    Muthukrishnan, Suriya-Prakash; Ahuja, Navdeep; Mehta, Nalin; Sharma, Ratna

    2016-11-01

    Humans have limited capacity of processing just up to 4 integrated items of information in the working memory. Thus, it is inevitable to commit more errors when challenged with high memory loads. However, the neural mechanisms that determine the accuracy of response at high memory loads still remain unclear. High temporal resolution of Electroencephalography (EEG) technique makes it the best tool to resolve the temporal dynamics of brain networks. EEG-defined microstate is the quasi-stable scalp electrical potential topography that represents the momentary functional state of brain. Thus, it has been possible to assess the information processing currently performed by the brain using EEG microstate analysis. We hypothesize that the EEG microstate preceding the trial could determine its outcome in a visuospatial working memory (VSWM) task. Twenty-four healthy participants performed a high memory load VSWM task, while their brain activity was recorded using EEG. Four microstate maps were found to represent the functional brain state prior to the trials in the VSWM task. One pre-trial microstate map was found to determine the accuracy of subsequent behavioural response. The intracranial generators of the pre-trial microstate map that determined the response accuracy were localized to the visuospatial processing areas at bilateral occipital, right temporal and limbic cortices. Our results imply that the behavioural outcome in a VSWM task could be determined by the intensity of activation of memory representations in the visuospatial processing brain regions prior to the trial. PMID:27515287

  16. Mother-Child Discrepancy in Perceived Family Functioning and Adolescent Developmental Outcomes in Families Experiencing Economic Disadvantage in Hong Kong.

    PubMed

    Leung, Janet T Y; Shek, Daniel T L; Li, Lin

    2016-10-01

    Though growing attention has been devoted to examining informant discrepancies of family attributes in social science research, studies that examine how interactions between mother-reported and adolescent-reported family functioning predict adolescent developmental outcomes in underprivileged families are severely lacking. The current study investigated the difference between mothers and adolescents in their reports of family functioning, as well as the relationships between mother-reported and adolescent-reported family functioning and adolescent developmental outcomes in a sample of 432 Chinese single-mother families (mean age of adolescents = 13.7 years, 51.2 % girls, mean age of mothers = 43.5 years, 69.9 % divorced) experiencing economic disadvantage in Hong Kong. Polynomial regression analyses were conducted to assess whether discrepancy in family functioning between mother reports and adolescent reports predicted resilience, beliefs in the future, cognitive competence, self-efficacy and self-determination of adolescents. The results indicated that adolescents reported family functioning more negatively than did their mothers. Polynomial regression analyses showed that the interaction term between mothers' reports and adolescents' reports of family functioning predicted adolescent developmental outcomes in Chinese single-mother families living in poverty. Basically, under poor adolescent-reported family functioning, adolescent development would be relatively better if their mothers reported more positive family functioning. In contrast, under good adolescent-reported family functioning, adolescents expressed better developmental outcomes when mothers reported lower levels of family functioning than those mothers who reported higher levels of family functioning. The findings provide insights on how congruency and discrepancy between informant reports of family functioning would influence adolescent development. Theoretical and practical implications of

  17. Mother-Child Discrepancy in Perceived Family Functioning and Adolescent Developmental Outcomes in Families Experiencing Economic Disadvantage in Hong Kong.

    PubMed

    Leung, Janet T Y; Shek, Daniel T L; Li, Lin

    2016-10-01

    Though growing attention has been devoted to examining informant discrepancies of family attributes in social science research, studies that examine how interactions between mother-reported and adolescent-reported family functioning predict adolescent developmental outcomes in underprivileged families are severely lacking. The current study investigated the difference between mothers and adolescents in their reports of family functioning, as well as the relationships between mother-reported and adolescent-reported family functioning and adolescent developmental outcomes in a sample of 432 Chinese single-mother families (mean age of adolescents = 13.7 years, 51.2 % girls, mean age of mothers = 43.5 years, 69.9 % divorced) experiencing economic disadvantage in Hong Kong. Polynomial regression analyses were conducted to assess whether discrepancy in family functioning between mother reports and adolescent reports predicted resilience, beliefs in the future, cognitive competence, self-efficacy and self-determination of adolescents. The results indicated that adolescents reported family functioning more negatively than did their mothers. Polynomial regression analyses showed that the interaction term between mothers' reports and adolescents' reports of family functioning predicted adolescent developmental outcomes in Chinese single-mother families living in poverty. Basically, under poor adolescent-reported family functioning, adolescent development would be relatively better if their mothers reported more positive family functioning. In contrast, under good adolescent-reported family functioning, adolescents expressed better developmental outcomes when mothers reported lower levels of family functioning than those mothers who reported higher levels of family functioning. The findings provide insights on how congruency and discrepancy between informant reports of family functioning would influence adolescent development. Theoretical and practical implications of

  18. Functional Assessment for Congenital Heart Disease

    PubMed Central

    2014-01-01

    Significant improvement in survival of children with congenital cardiac malformations has resulted in an increasing population of adolescent and adult patients with congenital heart disease. Of the long-term cardiac problems, ventricular dysfunction remains an important issue of concern. Despite corrective or palliative repair of congenital heart lesions, the right ventricle, which may be the subpulmonary or systemic ventricular chamber, and the functional single ventricle are particularly vulnerable to functional impairment. Regular assessment of cardiac function constitutes an important aspect in the long-term follow up of patients with congenital heart disease. Echocardiography remains the most useful imaging modality for longitudinal monitoring of cardiac function. Conventional echocardiographic assessment has focused primarily on quantification of changes in ventricular size and blood flow velocities during the cardiac cycles. Advances in echocardiographic technologies including tissue Doppler imaging and speckle tracking echocardiography have enabled direct interrogation of myocardial deformation. In this review, the issues of ventricular dysfunction in congenital heart disease, conventional echocardiographic and novel myocardial deformation imaging techniques, and clinical applications of these techniques in the functional assessment of congenital heart disease are discussed. PMID:24653734

  19. Assessment of Cataract Surgery Outcome Using the Modified Catquest Short-Form Instrument in China

    PubMed Central

    Chen, Haisi; Chen, Chengwei; Gao, Rongrong; Bao, Fangjun; Zhang, Sifang; Wang, Qinmei; Pesudovs, Konrad

    2016-01-01

    Purpose To assess cataract surgery outcome using the Rasch scaled Chinese version of the Catquest short-form. Methods The Chinese translated and culturally adapted version of the Catquest-9SF was interviewer-administered to patients, pre and post cataract surgery. Rasch analysis was performed on the baseline data to revise the Catquest. For the surgical outcome assessment, we stacked pre- and post-surgical Catquest data to demonstrate improvement in visual function scores and responsiveness of the instrument to cataract surgery. Results A total of 247 cataract patients (median age, 70 yrs; male 51.0%) completed the Catquest 9SF at baseline.The Catquest-9SF possessed adequate measurement precision of 2.15. No disordering of response categories were observed and all the items perfectly fit to the Rasch model except item 7 (outfit >1.5). A slight reduction in precision was observed after removing misfitting item 7 (Catquest-8SF-CN), but the precision value was well above the acceptable value of 2.00. Notably, the instrument was well targeted (mean person location 0.30), demonstrated no evidence of multidimensionality and DIF. At 12 months post-surgery, 74 (30%) patients came for follow-up and completed the Catquest. There was a significant improvement in the Catquest scores post cataract surgery with a considerably large effect size. Conclusion The Catquest-8SF-CN demonstrated promising Rasch based psychometric properties and was highly responsive to cataract surgery. PMID:27736889

  20. ASCPRO Recommendations for the Assessment of Fatigue as an Outcome in Clinical Trials

    PubMed Central

    Barsevick, Andrea M.; Cleeland, Charles S.; Manning, Donald C.; O'Mara, Ann M.; Reeve, Bryce B.; Scott, Jane A.; Sloan, Jeff A.

    2010-01-01

    Context Development of pharmacologic and behavioral interventions for cancer-related fatigue (CRF) requires adequate measures of this symptom. A guidance document from the Food and Drug Administration offers criteria for the formulation and evaluation of patient-reported outcome measures used in clinical trials to support drug or device labeling claims. Methods An independent working group, ASCPRO (Assessing Symptoms of Cancer Using Patient-Reported Outcomes), has begun developing recommendations for the measurement of symptoms in oncology clinical trials. The recommendations of the Fatigue Task Force for measurement of CRF are presented here. Results There was consensus that CRF could be measured effectively in clinical trials as the sensation of fatigue or tiredness, impact of fatigue/tiredness on usual functioning or as both sensation and impact. The ASCPRO Fatigue Task Force constructed a definition and conceptual model to guide measurement of CRF. ASCPRO recommendations do not endorse a specific fatigue measure but clarify how to evaluate and implement fatigue assessments in clinical studies. The selection of a CRF measure should be tailored to the goals of the research. Measurement issues related to various research environments were also discussed. Conclusion There exist in the literature good measures of CRF for clinical trials with strong evidence of clarity and comprehensibility to patients, content and construct validity, reliability, sensitivity to change in conditions in which one would expect them to change (assay sensitivity), and sufficient evidence to establish guides for interpreting changes in scores. Direction for future research is discussed. PMID:20538190

  1. Neurocognitive and Social Cognitive Approaches for Improving Functional Outcome in Early Psychosis: Theoretical Considerations and Current State of Evidence

    PubMed Central

    Bartholomeusz, Cali F.; Allott, Kelly

    2012-01-01

    Improving functional outcome, in addition to alleviating psychotic symptoms, is now a major treatment objective in schizophrenia research. Given the large body of evidence suggesting pharmacological treatments generally have minimal effects on indices of functioning, research has turned to psychosocial rehabilitation programs. Among these, neurocognitive and social cognitive interventions are at the forefront of this field and are argued to target core deficits inherent to the schizophrenia illness. However, to date, research trials have primarily focused on chronic schizophrenia populations, neglecting the early psychosis groups who are often as severely impaired in social and occupational functioning. This theoretical paper will outline the rationale for investigating adjunctive cognitive-based interventions in the early phases of psychotic illness, critically examine the current approach strategies used in these interventions, and assess the evidence supporting certain training programs for improving functional outcome in early psychosis. Potential pathways for future research will be discussed. PMID:22966447

  2. Outcome assessment of the VADO approach in psychiatric rehabilitation: a partially randomised multicentric trial

    PubMed Central

    2006-01-01

    Background Recent studies on representative samples of psychiatric services have shown that low proportions of cases received effective rehabilitation interventions. The following are likely to be the most important causes: the scarcity of mental health workers trained in social and work skills strategies and the absence of a structured framework to formulate rehabilitation practices. The aim of this study was to assess if a specific structured planning and evaluation manual, called VADO (Valutazione delle Abilità e Definizione degli Obiettivi – in english: Skills Assessment and Definition of Goals), is more effective than routine interventions in reducing disability in patients with schizophrenia. Method Each of 10 mental health services were invited to recruit 10 patients with a schizophrenic disorder. Altogether 98 patients were recruited. Of these, 62 patients were randomly allocated to the intervention/experimental or a control group. The remaining group of 36 patients was not randomised and it was considered as a parallel effectiveness study. Assessment measures at the beginning of the study and at the one-year follow-up included the FPS scale of social functioning and the BPRS 4.0. Between group (VADO vs. Routine) and time effects were examined with ANOVA, Chi-square or Fisher exact. Clinical "improvement" was defined as an increase of at least ten points on the FPS or a decrease of at least 20% on BPRS scores. Results 31 of the 62 randomized patients received the experimental interventions, while 31 followed the routine ones. At follow-up, the experimental group showed statistically and clinically greater improvements in psychopathology and social functioning. Better outcomes of both social functioning and symptom severity were observed in non randomised patients (parallel effectiveness study). Conclusion The results suggest that setting personalised and measurable objectives, as recommended by the manual, can improve the outcome of rehabilitation of

  3. Standardized mastery content assessments for predicting NCLEX-RN outcomes.

    PubMed

    Emory, Jan

    2013-01-01

    Nurse educators need predictors of failure for early intervention. This study investigated the predictability of fundamentals, mental health, and pharmacology standardized assessment scores to identify the risk of baccalaureate students' failure on the NCLEX-RN. Using logistic regression the pharmacology assessment score was predictive with 73.7% accuracy. Use of the pharmacology assessment can assist in early identification of at-risk students in efforts to better prepare for the NCLEX-RN examination.

  4. Beyond Student Learning Outcomes: Developing Comprehensive, Strategic Assessment Plans for Advising Programmes

    ERIC Educational Resources Information Center

    McClellan, Jeffrey L.

    2011-01-01

    This article argues that while the importance of assessment in academic advising is clear and the current emphasis on defining and measuring student learning outcomes represents an essential component of any comprehensive advising assessment plan, an even more comprehensive understanding of programme assessment is needed. Drawing upon business…

  5. Outcomes Assessment of Computer-Assisted Behavioral Objectives for Accounting Graduates.

    ERIC Educational Resources Information Center

    Moore, John W.; Mitchem, Cheryl E.

    1997-01-01

    Presents behavioral objectives for accounting students and an outcomes assessment plan with five steps: (1) identification and definition of student competencies; (2) selection of valid instruments; (3) integration of assessment and instruction; (4) determination of levels of assessment; and (5) attribution of improvements to the program. (SK)

  6. Beyond Academic Outcomes: Expanding into Comprehensive Assessment while Preserving Faculty Ownership. AIR 1994 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Peacock, Dennis E.

    At Northeast Missouri State University, where faculty have directed student outcomes assessment for 20 years, assessment is expanding to include a broader university mission of developing the whole person. As assessment becomes more comprehensive, expanding into out-of-class experiences, there is a risk of losing faculty support. Three fundamental…

  7. Grade 3 open tibial shaft fractures treated with a circular frame, functional outcome and systematic review of literature.

    PubMed

    Dickson, D R; Moulder, E; Hadland, Y; Giannoudis, P V; Sharma, H K

    2015-04-01

    We report on the surgical and functional outcome of 22 patients with Grade 3 open tibial fractures treated with circular frame. All cases united and there were no re-fractures or amputations. All patients were assessed at a minimum of 1-year post frame removal. Assessment included clinical examination, IOWA ankle and knee scores, Olerud and Molander ankle score and EuroQol EQ-5D. Clinical scores were either good or excellent in over half of the patients in all knee and ankle scores. There was a significant positive correlation between functional outcomes and the EQ-5D score. The EQ-5D mean health state visual analogue score was comparable to the general UK population despite patients scoring less than the average UK population in three of the five domains. 36% reported some difficulties in walking and 41% had problems with pain. 14% had difficulties with self-care and 46% had difficulties with their usual activities. 14% had problems with anxiety or depression. Systematic review of the literature suggests, in the management of open tibial fractures, circular frames provide equivalent or superior surgical outcomes in comparison with other techniques. Our study finds the application of a circular frame also results in a good functional outcome in the majority of cases. PMID:25648287

  8. The measurement of outcomes in the assessment of educational program effectiveness.

    PubMed

    Kassebaum, D G

    1990-05-01

    Postsecondary accrediting agencies recognized by the U.S. Secretary of Education and the Council on Postsecondary Accreditation, including the Liaison Committee on Medical Education (LCME), are required to evaluate educational program effectiveness by determining that institutions and programs document the achievement of their students and graduates in verifiable and consistent ways, indicating that institutional and program purposes are met. For the assessment of medical education programs this represents a departure from the traditional method of inferring quality from institutional compliance with standards for program organization and function. In the new assessment calculus, success is measured as the integrated product of the outcomes, the indicators of achievement that medical schools already are collecting from many sources, for instance, data on premedical achievement and attributes, medical school performance, graduate education ratings and test results, specialty certification, licensure, and practice. Although a recent LCME enquiry showed that 80% of U.S. medical schools were collecting outcome data on students and graduates, there was a lack of coherence and system, little integrated analysis, rare longitudinal study, and limited use of the information to evaluate and revise the curriculum or to validate admissions, promotion, and graduation criteria. The longitudinal study of the quantified results of educational programs need not resurrect old controversies about the linkage between learning in medical school and the quality of doctors' later practice. The purpose of examining outcomes is to gain sharper focus on the achievement of distinctive institutional goals, to facilitate program improvement and renewal, and to better assure the competence of graduates within the boundaries of achievement that schools have drawn as their educational objectives.

  9. Assessing outcomes following arthroscopic labral debridement-what can the IHOT-33 reveal?

    PubMed

    Dwyer, Maureen K; Green, Marlon; McCarthy, Joseph C

    2015-07-01

    As the complexity of arthroscopic procedures continues to increase, assessing the success of these procedures is of utmost importance to determine appropriate treatment plans for patients. This study compares outcome scores on the International Hip Outcome Tool (IHOT-33) using an analysis of its four subscales to scores on the Modified Harris Hip Score (MHHS) in patients following hip arthroscopy. Patients who had undergone hip arthroscopy between 1 and 5 years ago were assessed using both the IHOT-33 and MHHS at their most recent follow-up visit. Total scores for each outcome measure were calculated. A composite score for each of the IHOT subscales was calculated by averaging the total points in each section. Total score on the MHHS was compared with total score on the IHOT-33 and its four subscales using separate wilcoxin signed ranks tests. In total, 44 patients met our inclusion criteria with an average follow-up of 24.8 ± 18.8 months. MHHS total score was greater than IHOT-33 total score (P = 0.04). Comparisons between MHHS total score and the IHOT-33 subscales revealed reductions in sport (P = 0.001) and social (P = 0.004), but no difference in symptoms (P = 0.74) and job (P = 0.84). Our findings demonstrated that scores on the MHHS are inflated when compared with scores on the IHOT-33 for patients following hip arthroscopy. Subscale analysis revealed that the reductions in IHOT-33 scores exist in the sport and recreational domain and social, emotional, lifestyle domain compared with the MHHS. Our results suggest that analysing the subscales of the IHOT-33 would provide a more thorough understanding of functional limitations in patients undergoing hip arthroscopy. PMID:27011832

  10. The Other Half: Non-Tenure Track Faculty Thoughts on Student Learning Outcomes Assessment

    ERIC Educational Resources Information Center

    Danley-Scott, Jennifer; Scott, Gray

    2014-01-01

    Articles on student learning outcomes assessment often treat faculty as one homogenous body. Yet the exponential growth of contingent faculty in universities and colleges has created two distinct faculty groups with varied concerns and thoughts on everything from the future of higher education to shared governance to student learning outcomes.…

  11. Methods for Assessing Single-Case School-Based Intervention Outcomes

    ERIC Educational Resources Information Center

    Busse, R. T.; McGill, Ryan J.; Kennedy, Kelly S.

    2015-01-01

    The purpose of this article is to present various single-case outcome assessment methods for evaluating school-based intervention effectiveness. We present several outcome methods, including goal attainment scaling, visual analysis, trend analysis, percentage of non-overlapping data, single-case mean difference effect size, reliable change index,…

  12. Longitudinal Assessment of Comprehensive School Reform Program Implementation and Outcomes: First-Year Report

    ERIC Educational Resources Information Center

    Tushnet, Naida C., Flaherty, John, Jr., Smith, And

    2004-01-01

    The Longitudinal Assessment of Comprehensive School Reform Implementation and Outcomes (LACIO) responds to the No Child Left Behind Act's requirement for an evaluation of the federal Comprehensive School Reform (CSR) program. The legislation stipulates two broad goals for the evaluation: (1) to evaluate the implementation and outcomes achieved by…

  13. Using a University-Wide Syllabus Study to Examine Learning Outcomes and Assessment

    ERIC Educational Resources Information Center

    Willingham-McLain, Laurel

    2011-01-01

    This cross-disciplinary study examined syllabus quality (n = 280) and the connection of learning outcomes to the Dimensions of a Duquesne Education for two purposes: informing instructional development and writing an accreditation self-study. Three researchers coded the syllabi for learning outcomes, assessment, and the presence of these…

  14. Early functional magnetic resonance imaging activations predict language outcome after stroke.

    PubMed

    Saur, Dorothee; Ronneberger, Olaf; Kümmerer, Dorothee; Mader, Irina; Weiller, Cornelius; Klöppel, Stefan

    2010-04-01

    An accurate prediction of system-specific recovery after stroke is essential to provide rehabilitation therapy based on the individual needs. We explored the usefulness of functional magnetic resonance imaging scans from an auditory language comprehension experiment to predict individual language recovery in 21 aphasic stroke patients. Subjects with an at least moderate language impairment received extensive language testing 2 weeks and 6 months after left-hemispheric stroke. A multivariate machine learning technique was used to predict language outcome 6 months after stroke. In addition, we aimed to predict the degree of language improvement over 6 months. 76% of patients were correctly separated into those with good and bad language performance 6 months after stroke when based on functional magnetic resonance imaging data from language relevant areas. Accuracy further improved (86% correct assignments) when age and language score were entered alongside functional magnetic resonance imaging data into the fully automatic classifier. A similar accuracy was reached when predicting the degree of language improvement based on imaging, age and language performance. No prediction better than chance level was achieved when exploring the usefulness of diffusion weighted imaging as well as functional magnetic resonance imaging acquired two days after stroke. This study demonstrates the high potential of current machine learning techniques to predict system-specific clinical outcome even for a disease as heterogeneous as stroke. Best prediction of language recovery is achieved when the brain activation potential after system-specific stimulation is assessed in the second week post stroke. More intensive early rehabilitation could be provided for those with a predicted poor recovery and the extension to other systems, for example, motor and attention seems feasible. PMID:20299389

  15. The importance of functional impairment to mental health outcomes: A case for reassessing our goals in depression treatment research

    PubMed Central

    McKnight, Patrick E.; Kashdan, Todd B.

    2009-01-01

    Outcomes in depression treatment research include both changes in symptom severity and functional impairment. Symptom measures tend to be the standard outcome but we argue that there are benefits to considering functional outcomes. An exhaustive literature review shows that the relationship between symptoms and functioning remains unexpectedly weak and often bidirectional. Changes in functioning often lag symptom changes. As a result, functional outcomes might offer depression researchers more critical feedback and better guidance when studying depression treatment outcomes. The paper presents a case for the necessity of both functional and symptom outcomes in depression treatment research by addressing three aims–1) review the research relating symptoms and functioning, 2) provide a rationale for measuring both outcomes, and 3) discuss potential artifacts in measuring functional outcomes. The three aims are supported by an empirical review of the treatment outcome and epidemiological literatures. PMID:19269076

  16. Reporting of IMMPACT-recommended core outcome domains among trials assessing opioids for chronic non-cancer pain.

    PubMed

    Mulla, Sohail M; Maqbool, Amna; Sivananthan, Laxsanaa; Lopes, Luciane C; Schandelmaier, Stefan; Kamaleldin, Mostafa; Hsu, Sandy; Riva, John J; Vandvik, Per Olav; Tsoi, Ludwig; Lam, Tommy; Ebrahim, Shanil; Johnston, Bradley C; Olivieri, Lori; Montoya, Luis; Kunz, Regina; Scheidecker, Anne; Buckley, D Norman; Sessler, Daniel I; Guyatt, Gordon H; Busse, Jason W

    2015-09-01

    The Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) has recommended that trialists evaluating treatments for chronic pain should consider reporting 9 patient-important outcome domains. We examined the extent to which clinical trials evaluating the effect of opioids for chronic non-cancer pain (CNCP) report outcome domains recommended by IMMPACT. We systematically searched electronic databases for English-language studies that randomized patients with CNCP to receive an opioid or a non-opioid control. In duplicate and independently, reviewers established the eligibility of each identified study and recorded all reported outcome domains from eligible trials. We conducted a priori regression analyses to explore factors that may be associated with IMMPACT-recommended outcome domains. Among 156 eligible trials, reporting of IMMPACT-recommended outcome domains was highly variable, ranging from 99% for pain to 7% for interpersonal functioning. Recently published trials were more likely to report the effect of treatment on physical functioning, emotional functioning, role functioning, sleep and fatigue, and participant disposition. Trials for which the corresponding author was from North America were more likely to report treatment effects on physical functioning and participant ratings of improvement and satisfaction with treatment. Trials published in higher impact journals were more likely to report treatment effects on emotional function, but less likely to report participant ratings of improvement and satisfaction with treatment. Most IMMPACT domains showed an increased rate of reporting over time, although many patient-important outcome domains remained unreported by over half of all trials evaluating the effects of opioids for CNCP.

  17. [Endothelial function: role, assessment and limits].

    PubMed

    Puissant, C; Abraham, P; Durand, S; Humeau-Heurtier, A; Faure, S; Rousseau, P; Mahé, G

    2014-02-01

    For several years, detecting and preventing cardiovascular diseases have become a major issue. Different methods have been developed to evaluate endothelial function. Endothelial dysfunction is one of the first steps leading to atherosclerosis. This review presents an insight into endothelial function, the interests of its assessment and methods for studying endothelial function. To date, the vascular endothelium must be considered as a specific organ with its own functions that contribute to the homeostasis of the cardiovascular system. Endothelial dysfunction typically corresponds to a decrease of nitric oxide NO bioavailability. Biological or physico-chemical methods may be used to assess dysfunction. Biological methods allow measuring NO metabolites and pro-inflammatory and vasoconstrictor mediators released by the endothelium. The physico-chemical methods include intra-coronary injections, plethysmography, flow-mediated dilation (FMD), digital plethysmography and optical techniques using laser (laser Doppler single-point, laser Doppler imager, laser speckle contrast imaging) that can be coupled with provocation tests (iontophoresis, microdialysis, post-ischemic hyperemia, local heating). The principle of each technique and its use in clinical practice are discussed. Studying endothelial dysfunction is a particularly promising field because of new drugs being developed. Nevertheless, assessment methodology still needs further development to enable reliable, non-invasive, reproducible, and inexpensive ways to analyze endothelial dysfunction.

  18. Alternative Perspectives on Learning Outcomes: Challenges for Assessment

    ERIC Educational Resources Information Center

    Daugherty, Richard; Black, Paul; Ecclestone, Kathryn; James, Mary; Newton, Paul

    2008-01-01

    In discussing the relationship between curriculum and assessment it is commonly argued that assessment should be aligned to curriculum or, alternatively, that they should be congruent with each other. This article explores that relationship in five educational contexts in the UK and in Europe, ranging across school education, workplace learning,…

  19. Assessing Student Learning Outcomes in Teaching Organizational Communication.

    ERIC Educational Resources Information Center

    Crawford, C. B.; Brungardt, Curt

    As administrators, students, and the political machinery make higher education more accountable, assessment has become a relevant and timely topic. Recent interest in assessment and evaluation have brought significant changes in the way that educators in the field of organizational communication judge their students' work. The lecture method is…

  20. Outcomes of Synergetic Peer Assessment: First-Year Experience

    ERIC Educational Resources Information Center

    Hodgson, Paula; Chan, Kitty; Liu, Justina

    2014-01-01

    Active participation in learning activities and reviewing assessment activity can facilitate learners engaged in these processes. This case study reports student experiences of the process of peer assessment with teacher guidance in a group project for a first-year nursing course with 153 students. Twenty groups of students were assigned roles in…

  1. A Quantitative Synthesis of Developmental Disability Research: The Impact of Functional Assessment Methodology on Treatment Effectiveness

    ERIC Educational Resources Information Center

    Delfs, Caitlin H.; Campbell, Jonathan M.

    2010-01-01

    Methods and outcomes from functional behavioral assessment have been researched widely over the past twenty-five years. However, several important research questions have yet to be examined sufficiently. This quantitative review of developmental disability research aims to make comparisons of different functional behavioral assessment…

  2. Longitudinal Associations Between Internalizing and Externalizing Comorbidities and Functional Outcomes for Children with ADHD.

    PubMed

    Armstrong, Daniel; Lycett, Kate; Hiscock, Harriet; Care, Esther; Sciberras, Emma

    2015-10-01

    This study examined functional outcomes for children with ADHD by comorbidity status. Children with ADHD (5-13 years) were recruited from 21 pediatric practices and followed up 12 months later (n = 199). Parent and teacher-reported baseline and 12 month surveys measured peer problems, daily functioning, quality of life (QoL), parent mental health, and family QoL. The Anxiety Disorders Interview Schedule for Children IV assessed mental health comorbidities at baseline. Linear regression models were conducted, adjusting for socio-demographics, ADHD severity, and baseline functioning (where possible). In adjusted analyses, children with ADHD and co-occurring internalizing and externalizing comorbidities had poorer QoL, greater peer problems, and poorer family QoL, compared to children with ADHD alone. The parents of children with ADHD and internalizing and externalizing comorbidities alone, also reported poorer family QoL, compared to children with ADHD alone. Children with ADHD and co-occurring internalizing and externalizing comorbidities appear particularly vulnerable to poorer functioning.

  3. Assessing performance outcomes of new graduates utilizing simulation in a military transition program.

    PubMed

    Hughes, Robie V; Smith, Sherrill J; Sheffield, Clair M; Wier, Grady

    2013-01-01

    This multi-site, quasi-experimental study examined the performance outcomes of nurses (n = 152) in a military nurse transition program. A modified-performance instrument was used to assess participants in two high-fidelity simulation scenarios. Although results indicated a significant increase in scores posttraining, only moderate interrater reliability results were found for the new instrument. These findings have implications for nurse educators assessing performance-based outcomes of new nurses completing transition programs. PMID:23703274

  4. Assessing performance outcomes of new graduates utilizing simulation in a military transition program.

    PubMed

    Hughes, Robie V; Smith, Sherrill J; Sheffield, Clair M; Wier, Grady

    2013-01-01

    This multi-site, quasi-experimental study examined the performance outcomes of nurses (n = 152) in a military nurse transition program. A modified-performance instrument was used to assess participants in two high-fidelity simulation scenarios. Although results indicated a significant increase in scores posttraining, only moderate interrater reliability results were found for the new instrument. These findings have implications for nurse educators assessing performance-based outcomes of new nurses completing transition programs.

  5. Comparison of Select Health Outcomes by Deployment Health Assessment Completion.

    PubMed

    Luse, Tina M; Slosek, Jean; Rennix, Christopher

    2016-02-01

    The Department of Defense (DoD) requires service members to complete regular health assessments for identification of deployment-related physical/behavioral issues and environmental/occupational exposures. Compliance among active duty Department of the Navy personnel varies; however, and the impact of incomplete assessments on generalizability of results is unclear. This study examines the differences between Navy and Marine Corps service members who completed both the Post-Deployment Health Assessment and Post-Deployment Health Reassessment (n = 9,452) as compared to service members who never attempted either form (n = 5,603) in fiscal year 2010. Deployment rosters, assessments, and clinical data were analyzed to determine certified assessment completion rates and incidence of certain health conditions in these populations. Only 38.9% of applicable personnel met the completion and certification criteria for the required assessments. Service members who did not complete the forms were distinctly different demographically and at increased risk for psychotropic drug use, post-traumatic stress disorder diagnosis, and traumatic brain injury diagnosis following deployment. The prevailing assumption that the risk of adverse health effects on operational forces can be estimated using the population that completed the required assessments is incorrect, and the true operational impact and medical burden of these conditions may be underestimated. PMID:26837080

  6. Psychosocial and Functional Outcomes in Long-Term Survivors of Osteosarcoma: A Comparison of Limb-Salvage Surgery and Amputation

    PubMed Central

    Robert, Rhonda S.; Ottaviani, Giulia; Huh, Winston W.; Palla, Shana; Jaffe, Norman

    2009-01-01

    Background Traditionally, physicians have believed that limb-salvage surgery has functional and cosmetic advantages over amputation, yet the literature is equivocal. Therefore, we sought to compare the psychosocial and functional outcomes in osteosarcoma survivors after limb-salvage surgery and amputation. We hypothesized there to be neither psychosocial nor functional outcome differences between groups. Procedure Participants received treatment of extremity osteosarcoma, had received their cancer diagnosis at least 2 years prior, and were at least 16 years old. A comprehensive set of validated psychosocial and functional measures was used to assess outcome. Results Fifty-seven patients participated in this study (33 who underwent limb-salvage surgery and 24 who underwent amputation). Participants had gone 12–24 years since diagnosis and were 16–52 years old at study participation. We used multiple linear regression models to examine differences in quality of life, body image, self-esteem, and social support between the two groups and found no differences. Lower limb function was a significant predictor of quality of life (p < 0.001), whereas surgery type did not impact this relationship. Body image was rated significantly worse by those who underwent late amputation, amputation after failed limb salvage, than by those who did not. Conclusions Participants with more functional lower limbs had better quality of life than did those with less functional lower limbs regardless of whether they underwent amputation or limb-salvage surgery. PMID:20135700

  7. Implementation of Mock Competency Skill Assessments to Improve Student Outcomes.

    PubMed

    Payne, Camille; Ziegler, M Penny; Baughman, Diana M; Jones, Jackie

    2015-01-01

    A primary responsibility for nurse educators is to provide students with theoretical knowledge and clinical skills for professional nursing. In this study, laboratory faculty developed a creative pedagogical strategy to reduce nursing student stress during assessment of skill performance. Mock competencies were structured so that students participated in peer-to-peer evaluations in simulated competency assessments. The purpose of this study was to determine whether this pedagogical strategy had an impact on first-round pass rates for skills competency assessments. PMID:25950797

  8. Some implications of the technology assessment function for the effective public decision-making process

    NASA Technical Reports Server (NTRS)

    Mayo, L. H.

    1971-01-01

    A preliminary provisional assessment of the prospects for the establishment of an adequate technology assessment function and the implications of the assessment function for the public decision process are presented. Effects of the technology assessment function on each phase of the public decision process and briefly explored. Significant implications during the next decade are projected with respect to the following phases: invention and development of alternative means (technological configurations); evaluation, selection and promotion of preferred courses of action; and modification of statutory scheme or social action program as an outcome of continuing monitoring and appraisal.

  9. [Arterial baroreflex--physiological role and assessment of functioning].

    PubMed

    Tkaczyszyn, Michał; Rydlewska, Agnieszka; Ponikowska, Beata; Borodulin-Nadzieja, Ludmiła; Banasiak, Waldemar; Ponikowski, Piotr; Jankowska, Ewa A

    2013-08-01

    Arterial baroreflex is one of the key mechanisms responsible for the homeostasis maintenance within the cardiovascular system. Through the modulation of sympathetic and parasympathetic drive within the autonomic nervous system, baroreflex enables to stabilize arterial blood pressure and maintain perfusion within critical organs (e.g. brain, heart). This review provides the physiological background of the baroreflex functioning and describes the methodology for assessing the arterial baroreflex sensitivity (BRS). Decreased BRS reflects autonomic imbalance and predicts unfavorable outcome in cardiovascular diseases accompanied by the autonomic dysfunction, such as arterial hypertension and heart failure. BRS assessment methods can be divided into those that are performed in resting conditions (the measurements of spontaneous BRS, e.g. the sequence or spectral analysis method) and methods with the application of the external stimuli, which may be either non-invasive (e.g. the controlled breathing method) or invasive (e.g. the phenylephrine method). PMID:24052991

  10. Nonlinear Neurobiological Probability Weighting Functions For Aversive Outcomes

    PubMed Central

    Berns, Gregory S.; Capra, C. Monica; Chappelow, Jonathan; Moore, Sara; Noussair, Charles

    2008-01-01

    While mainstream economic models assume that individuals treat probabilities objectively, many people tend to overestimate the likelihood of improbable events and underestimate the likelihood of probable events. However, a biological account for why probabilities would be treated this way does not yet exist. While undergoing fMRI, we presented individuals with a series of lotteries, defined by the voltage of an impending cutaneous electric shock and the probability with which the shock would be received. During the prospect phase, neural activity that tracked the probability of the expected outcome was observed in a circumscribed network of brain regions that included the anterior cingulate, visual, parietal, and temporal cortices. Most of these regions displayed responses to probabilities consistent with nonlinear probability weighting. The neural responses to passive lotteries predicted 79% of subsequent decisions when individuals were offered choices between different lotteries, and exceeded that predicted by behavior alone near the indifference point. PMID:18060809

  11. Outcomes Assessment at Tufts University School of Veterinary Medicine.

    ERIC Educational Resources Information Center

    Kleine, Lawrence J.; Terkla, Dawn Geronimo; Kimball, Grayson

    2002-01-01

    Using a survey, compared relative values assigned by Tufts veterinary alumni to questions about skills, training, attitudes, and behaviors with those of veterinary employers and faculty. Also assessed their perceptions of future employment opportunities. (EV)

  12. Clinical assessment tools identify functional deficits in fragility fracture patients

    PubMed Central

    Ames, Tyler D; Wee, Corinne E; Le, Khoi M; Wang, Tiffany L; Bishop, Julie Y; Phieffer, Laura S; Quatman, Carmen E

    2016-01-01

    Purpose To identify inexpensive, noninvasive, portable, clinical assessment tools that can be used to assess functional performance measures that may put older patients at risk for falls such as balance, handgrip strength, and lumbopelvic control. Patients and methods Twenty fragility fracture patients and 21 healthy control subjects were evaluated using clinical assessment tools (Nintendo Wii Balance Board [WBB], a handheld dynamometer, and an application for the Apple iPod Touch, the Level Belt) that measure functional performance during activity of daily living tasks. The main outcome measurements were balance (WBB), handgrip strength (handheld dynamometer), and lumbopelvic control (iPod Touch Level Belt), which were compared between fragility fracture patients and healthy controls. Results Fragility fracture patients had lower scores on the vertical component of the WBB Torso Twist task (P=0.042) and greater medial–lateral lumbopelvic sway during a 40 m walk (P=0.026) when compared to healthy controls. Unexpectedly, the fracture patients had significantly higher scores on the left leg (P=0.020) and total components (P=0.010) of the WBB Single Leg Stand task as well as less faults during the left Single Leg Stand task (P=0.003). Conclusion The clinical assessment tools utilized in this study are relatively inexpensive and portable tools of performance measures capable of detecting differences in postural sway between fragility fracture patients and controls. PMID:27217738

  13. [Patient-relevant outcomes and surrogates in the early benefit assessment of drugs: first experiences].

    PubMed

    Kvitkina, Tatjana; ten Haaf, Anette; Reken, Stefanie; McGauran, Natalie; Wieseler, Beate

    2014-01-01

    The Act on the Reform of the Market for Medicinal Products (AMNOG) became effective in Germany on January 1, 2011. Since then, the assessment of the added benefit of new drugs versus a therapeutic standard on the basis of dossiers submitted by pharmaceutical companies has been required by law. The Federal Joint Committee (G-BA) generally commissions the Institute for Quality and Efficiency in Health Care (IQWiG) with this task. The added benefit is primarily to be demonstrated on the basis of patient-relevant outcomes. The aim of this paper is to describe the feasibility of the early benefit assessment on the basis of patient-relevant outcomes by systematically characterising the outcomes available in company dossiers and comparing the companies' and IQWiG's evaluations regarding patient relevance and surrogate validity. Dossier assessments published between October 2011 and June 2012 were used for this purpose. The outcomes available and the respective evaluations were extracted and compared. 12 out of 22 submitted dossiers contained sufficient data to assess outcomes; all 12 assessable dossiers provided data on patient-relevant outcomes. Data on mortality and adverse events were available in all dossiers, except that one dossier did not contain adverse event data on the relevant subpopulation. In contrast, data on morbidity and health-related quality of life were available in 8 and 7 dossiers, respectively. Of a total of 214 outcomes extracted by IQWiG, 124 patient-relevant and 3 surrogate outcomes were included in IQWiG's assessment (companies: a total of 183 outcomes included, of which 172 were patient-relevant and 11 were surrogates). The first experiences with AMNOG have shown that in principle an early benefit assessment of drugs based on patient-relevant outcomes is feasible. The companies' and IQWiG's evaluations regarding patient relevance and surrogate validity of outcomes partly deviated from each other. By increasingly considering patient

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

    PubMed Central

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

    2001-01-01

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

  15. Association of Psychological Characteristics and Functional Dyspepsia Treatment Outcome: A Case-Control Study

    PubMed Central

    Wang, Caihua

    2016-01-01

    This study was to investigate the association of psychological characteristics and functional dyspepsia treatment outcome. 109 patients who met the criteria for FD were enrolled. Eysenck Personality Questionnaire (EPQ), Symptom Checklist 90 (SCL90), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure personality, psychological symptoms, and sleep quality in our patients. Leeds Dyspepsia Questionnaire (LDQ) was used to assess dyspeptic symptoms at baseline and after eight weeks of treatment. The LDQ scores change after therapy, and the degraded rate of LDQ was used to assess the prognosis of patients. Logistic regression model was used to assess the effect of the personality, psychological symptoms, and sleep quality on the prognosis of patients. Our result revealed that poor sleep quality (OR = 7.68, 95% CI 1.83–32.25) and bad marriage status (OR = 1.22, 95% CI 1.10–1.36) had the negative effect on the prognosis of FD, while extroversion in personality traits (OR = 0.86, 95% CI 0.76–0.96) had positive effect on the prognosis of FD. We should pay attention to the sleep quality, the personality, and the marriage status of FD patients; psychological intervention may have benefit in refractory FD. PMID:27547220

  16. Evaluation of functional outcomes and complications following modified Latarjet reconstruction in athletes with anterior shoulder instability

    PubMed Central

    van der Watt, Christelle; de Beer, Joe F

    2015-01-01

    Background The optimal management of anterior shoulder instability in athletes continues to be a challenge. The present study aimed to evaluate the functional outcomes of athletes with anterior shoulder instability following modified Latarjet reconstruction through assessing the timing of return to sport and complications. Methods Retrospective assessment was performed of athletes (n = 56) who presented with recurrent anterior shoulder instability and were treated with modified congruent arc Latarjet reconstruction over a 1-year period. Rugby union was the predominant sport performed. Pre-operative instability severity index scores were assessed. Postoperative complications were recorded as was the time taken for the athlete to return to sport. Results Arthroscopic evaluation revealed that 86% of patients had associated bony lesions affecting the glenohumeral joint. The overall complication rate relating to the Latarjet reconstruction was 7%. No episodes of recurrent shoulder instability were noted. Of the patients, 89% returned to competitive sport at the same level as that prior to surgery. The mean time post surgery to returning to full training was 3.2 months. Conclusions The modified congruent arc Latarjet procedure facilitates early rehabilitation and return to sport. These results support our systematic management protocol of performing modified Latarjet surgery in contact sport athletes with recurrent anterior instability. PMID:27582973

  17. Association of Psychological Characteristics and Functional Dyspepsia Treatment Outcome: A Case-Control Study.

    PubMed

    Chen, Yiping; Wang, Caihua; Wang, Jinyu; Zheng, Leilei; Liu, Weibo; Li, Huichun; Yu, Shaohua; Pan, Bin; Yu, Hualiang; Yu, Risheng

    2016-01-01

    This study was to investigate the association of psychological characteristics and functional dyspepsia treatment outcome. 109 patients who met the criteria for FD were enrolled. Eysenck Personality Questionnaire (EPQ), Symptom Checklist 90 (SCL90), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure personality, psychological symptoms, and sleep quality in our patients. Leeds Dyspepsia Questionnaire (LDQ) was used to assess dyspeptic symptoms at baseline and after eight weeks of treatment. The LDQ scores change after therapy, and the degraded rate of LDQ was used to assess the prognosis of patients. Logistic regression model was used to assess the effect of the personality, psychological symptoms, and sleep quality on the prognosis of patients. Our result revealed that poor sleep quality (OR = 7.68, 95% CI 1.83-32.25) and bad marriage status (OR = 1.22, 95% CI 1.10-1.36) had the negative effect on the prognosis of FD, while extroversion in personality traits (OR = 0.86, 95% CI 0.76-0.96) had positive effect on the prognosis of FD. We should pay attention to the sleep quality, the personality, and the marriage status of FD patients; psychological intervention may have benefit in refractory FD. PMID:27547220

  18. Assessing Assessment: Evaluating Outcomes and Reliabilities of Grammar, Math, and Writing Skill Measures in an Introductory Journalism Course

    ERIC Educational Resources Information Center

    Farwell, Tricia M.; Alligood, Leon; Fitzgerald, Sharon; Blake, Ken

    2016-01-01

    This article introduces an objective grammar and math assessment and evaluates the assessment's outcome and reliability when fielded among eighty-one students in media writing courses. In addition, the article proposes a rubric for grading straight news leads and compares the rubric's reliability with the reliability of rating straight news leads…

  19. Relationship between Sleep Disturbance and Functional Outcomes in Daily Life Habits of Children with Down Syndrome

    PubMed Central

    Churchill, Shervin S.; Kieckhefer, Gail M.; Bjornson, Kristie F.; Herting, Jerald R.

    2015-01-01

    Objectives: The goal of this study was to describe sleep patterns and accomplishment of daily life habits in children with Down syndrome (DS) and to investigate the relationship between subjective indicators of sleep disturbance with functional outcomes in daily life. Design: Cross-sectional study with an Internet sample Setting: Online survey filled out at home Participants: 110 parents of children with DS and 29 parents of children with typical development (TD), age 5 to 18 years. Interventions: N/A. Measurements and Results: Children's Sleep Habits Questionnaire was employed to collect information about sleep disturbances in 8 domains (subscales) and a total score. The Life Habits questionnaire (Life-H) sampled information about daily life habits in 11 domains. Multivariable regression modeling was used to assess the associations between sleep disturbances and the accomplishment of daily life habits. Sleep disordered breathing (SDB) was a significant explanatory factor in 10 of 11 daily life habits and the total Life-H score. Sleep anxiety and parasomnias significantly influenced the accomplishment of life habits in children with DS as compared to children with typical development. When evaluated in multivariable models in conjunction with the other 7 domains of sleep disturbances, SDB was the most dominant explanatory factor for accomplishment of life habits. Conclusions: Sleep disturbances are negatively related to accomplishment of daily life functions. Prevention and treatment of sleep problems, particularly sleep disordered breathing, in children with Down syndrome may lead to enhanced accomplishment of daily life habits and activities. Citation: Churchill SS, Kieckhefer GM, Bjornson KF, Herting JR. Relationship between sleep disturbance and functional outcomes in daily life habits of children with Down syndrome. SLEEP 2015;38(1):61–71. PMID:25325444

  20. The Effect of Perioperative Anemia on Clinical and Functional Outcomes in Patients With Hip Fracture

    PubMed Central

    Halm, Ethan A.; Wang, Jason J.; Boockvar, Kenneth; Penrod, Joan; Silberzweig, Stacey B.; Magaziner, Jay; Koval, Kenneth J.; Siu, Albert L.

    2006-01-01

    Objectives To describe the epidemiology of perioperative anemia in patients with hip fracture and assess the relationship between the hemoglobin measurements and clinical outcomes. Design Prospective observational cohort study. Setting Four university and community teaching hospitals. Patients A consecutive cohort of 550 patients who underwent surgery for hip fracture and survived to discharge from August 1997 and August 1998 were evaluated and followed prospectively. Main Outcome Measures Deaths, readmissions and Functional Independence Motor mobility scores within 60 days of discharge. Results Anemia (defined as hemoglobin <12.0 g/dL) was present in 40.4% of patients on admission, 45.6% at the presurgery nadir, 93.0% at the postsurgery nadir, and 84.6% near discharge. The mean drop in hemoglobin after surgery was 2.8 ± 1.6 g/dL. In multivariate analyses, higher hemoglobin levels on admission were associated with shorter lengths of hospital stay and lower odds of death and readmission even after controlling for a broad range of prefracture patient characteristics, clinical status on discharge, and use of blood transfusion. Admission and preoperative anemia was not associated with risk-adjusted Functional Independence Motor mobility scores. In multivariable analyses, higher postoperative hemoglobin was associated with shorter length of stay and lower readmission rates, but did not effect rates of death or Functional Independence Motor mobility scores. Conclusions Substantial declines in hemoglobin were common in patients with hip fracture. Higher preoperative hemoglobin was associated with shorter length of stay and lower odds of death and readmission within 60 days of discharge. Postoperative hemoglobin was also related to length of stay and readmission rates. PMID:15213502

  1. Quantitative assessment of protein function prediction programs.

    PubMed

    Rodrigues, B N; Steffens, M B R; Raittz, R T; Santos-Weiss, I C R; Marchaukoski, J N

    2015-12-21

    Fast prediction of protein function is essential for high-throughput sequencing analysis. Bioinformatic resources provide cheaper and faster techniques for function prediction and have helped to accelerate the process of protein sequence characterization. In this study, we assessed protein function prediction programs that accept amino acid sequences as input. We analyzed the classification, equality, and similarity between programs, and, additionally, compared program performance. The following programs were selected for our assessment: Blast2GO, InterProScan, PANTHER, Pfam, and ScanProsite. This selection was based on the high number of citations (over 500), fully automatic analysis, and the possibility of returning a single best classification per sequence. We tested these programs using 12 gold standard datasets from four different sources. The gold standard classification of the databases was based on expert analysis, the Protein Data Bank, or the Structure-Function Linkage Database. We found that the miss rate among the programs is globally over 50%. Furthermore, we observed little overlap in the correct predictions from each program. Therefore, a combination of multiple types of sources and methods, including experimental data, protein-protein interaction, and data mining, may be the best way to generate more reliable predictions and decrease the miss rate.

  2. Quantitative assessment of protein function prediction programs.

    PubMed

    Rodrigues, B N; Steffens, M B R; Raittz, R T; Santos-Weiss, I C R; Marchaukoski, J N

    2015-01-01

    Fast prediction of protein function is essential for high-throughput sequencing analysis. Bioinformatic resources provide cheaper and faster techniques for function prediction and have helped to accelerate the process of protein sequence characterization. In this study, we assessed protein function prediction programs that accept amino acid sequences as input. We analyzed the classification, equality, and similarity between programs, and, additionally, compared program performance. The following programs were selected for our assessment: Blast2GO, InterProScan, PANTHER, Pfam, and ScanProsite. This selection was based on the high number of citations (over 500), fully automatic analysis, and the possibility of returning a single best classification per sequence. We tested these programs using 12 gold standard datasets from four different sources. The gold standard classification of the databases was based on expert analysis, the Protein Data Bank, or the Structure-Function Linkage Database. We found that the miss rate among the programs is globally over 50%. Furthermore, we observed little overlap in the correct predictions from each program. Therefore, a combination of multiple types of sources and methods, including experimental data, protein-protein interaction, and data mining, may be the best way to generate more reliable predictions and decrease the miss rate. PMID:26782400

  3. Perceptual assessment of resonance and velopharyngeal function.

    PubMed

    Kummer, Ann W

    2011-05-01

    Cleft lip is an anomaly that primarily affects aesthetics, whereas cleft palate is an anomaly that primarily affects function, particularly speech. In fact, the main reason for repairing the palate is to provide adequate structure and function for normal speech production. Despite undergoing palatoplasty surgery, 20 to 30% of children with repaired cleft palate will demonstrate some degree of velopharyngeal dysfunction, resulting in abnormal speech. Velopharyngeal dysfunction is also seen in individuals without a history of cleft palate for various reasons. Because the symptoms of velopharyngeal dysfunction have a variety of causes, a comprehensive evaluation is very important to make the appropriate recommendations for treatment. The purpose of this article is to discuss the clinical assessment of velopharyngeal function for speech, using low-tech and "no-tech" procedures.

  4. Methods for Assessing Mitochondrial Function in Diabetes

    PubMed Central

    Kane, Daniel A.; Lanza, Ian R.; Neufer, P. Darrell

    2013-01-01

    A growing body of research is investigating the potential contribution of mitochondrial function to the etiology of type 2 diabetes. Numerous in vitro, in situ, and in vivo methodologies are available to examine various aspects of mitochondrial function, each requiring an understanding of their principles, advantages, and limitations. This review provides investigators with a critical overview of the strengths, limitations and critical experimental parameters to consider when selecting and conducting studies on mitochondrial function. In vitro (isolated mitochondria) and in situ (permeabilized cells/tissue) approaches provide direct access to the mitochondria, allowing for study of mitochondrial bioenergetics and redox function under defined substrate conditions. Several experimental parameters must be tightly controlled, including assay media, temperature, oxygen concentration, and in the case of permeabilized skeletal muscle, the contractile state of the fibers. Recently developed technology now offers the opportunity to measure oxygen consumption in intact cultured cells. Magnetic resonance spectroscopy provides the most direct way of assessing mitochondrial function in vivo with interpretations based on specific modeling approaches. The continuing rapid evolution of these technologies offers new and exciting opportunities for deciphering the potential role of mitochondrial function in the etiology and treatment of diabetes. PMID:23520284

  5. First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting

    PubMed Central

    Lin, Chih-Ming; Chang, Yu-Jun; Liu, Chi-Kuang; Yu, Cheng-Sheng; Lu, Henry Horng-Shing

    2016-01-01

    Age is an important risk factor for stroke, and carotid artery stenosis is the primary cause of first-ever ischemic stroke. Timely intervention with stenting procedures can effectively prevent secondary stroke; however, the impact of stenting on various periprocedural physical functionalities has never been thoroughly investigated. The primary aim of this study was to investigate whether prestenting characteristics were associated with long-term functional outcomes in patients presenting with first-ever ischemic stroke. The secondary aim was to investigate whether patient age was an important factor in outcomes following stenting, measured by the modified Rankin scale (mRS). In total, 144 consecutive patients with first-ever ischemic stroke who underwent carotid artery stenting from January 2010 to November 2014 were included. Clinical data were obtained by review of medical records. The Barthel index (BI) and mRS were used to assess disability before stenting and at 12-month follow-up. In total, 72/144 patients showed improvement (mRS[+]), 71 showed stationary and one showed deterioration in condition (mRS[−]). The prestenting parameters, ratio of cerebral blood volume (1.41 vs 1.2 for mRS[−] vs mRS[+]), BI (75 vs 85), and high-sensitivity C-reactive protein (hsCRP 5.0 vs 3.99), differed significantly between the two outcome groups (P<0.05). The internal carotid artery/common carotid artery ratio (P=0.011), BI (P=0.019), ipsilateral internal carotid artery resistance index (P=0.003), and HbA1c (P=0.039) were all factors significantly associated with patient age group. There was no significant association between age and poststenting outcome measured by mRS with 57% of patients in the ≥75 years age group showing mRS(−) and 43% showing mRS(+) (P=0.371). Our findings indicate that in our elderly patient series, carotid artery stenting may benefit a significant proportion of carotid stenotic patients regardless of age. Ratio of cerebral blood volume, BI, and

  6. First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting.

    PubMed

    Lin, Chih-Ming; Chang, Yu-Jun; Liu, Chi-Kuang; Yu, Cheng-Sheng; Lu, Henry Horng-Shing

    2016-01-01

    Age is an important risk factor for stroke, and carotid artery stenosis is the primary cause of first-ever ischemic stroke. Timely intervention with stenting procedures can effectively prevent secondary stroke; however, the impact of stenting on various periprocedural physical functionalities has never been thoroughly investigated. The primary aim of this study was to investigate whether prestenting characteristics were associated with long-term functional outcomes in patients presenting with first-ever ischemic stroke. The secondary aim was to investigate whether patient age was an important factor in outcomes following stenting, measured by the modified Rankin scale (mRS). In total, 144 consecutive patients with first-ever ischemic stroke who underwent carotid artery stenting from January 2010 to November 2014 were included. Clinical data were obtained by review of medical records. The Barthel index (BI) and mRS were used to assess disability before stenting and at 12-month follow-up. In total, 72/144 patients showed improvement (mRS[+]), 71 showed stationary and one showed deterioration in condition (mRS[-]). The prestenting parameters, ratio of cerebral blood volume (1.41 vs 1.2 for mRS[-] vs mRS[+]), BI (75 vs 85), and high-sensitivity C-reactive protein (hsCRP 5.0 vs 3.99), differed significantly between the two outcome groups (P<0.05). The internal carotid artery/common carotid artery ratio (P=0.011), BI (P=0.019), ipsilateral internal carotid artery resistance index (P=0.003), and HbA1c (P=0.039) were all factors significantly associated with patient age group. There was no significant association between age and poststenting outcome measured by mRS with 57% of patients in the ≥75 years age group showing mRS(-) and 43% showing mRS(+) (P=0.371). Our findings indicate that in our elderly patient series, carotid artery stenting may benefit a significant proportion of carotid stenotic patients regardless of age. Ratio of cerebral blood volume, BI, and

  7. Predicting Functional Performance and Range of Motion Outcomes After Total Knee Arthroplasty

    PubMed Central

    Bade, Michael J.; Kittelson, John M.; Kohrt, Wendy M.; Stevens-Lapsley, Jennifer E.

    2015-01-01

    Objective The aim of this study was to assess the predictive value of functional performance and range of motion measures on outcomes after total knee arthroplasty. Design This is a secondary analysis of two pooled prospective randomized controlled trials. Sixty-four subjects (32 men and 32 women) with end-stage knee osteoarthritis scheduled to undergo primary total knee arthroplasty were enrolled. Active knee flexion and extension range of motion, Timed Up and Go (TUG) test time, and 6-min walk test distance were assessed. Results Preoperative measures of knee flexion and extension were predictive of long-term flexion (β = 0.44, P < 0.001) and extension (β = 0.46, P < 0.001). Acute measures of knee flexion and extension were not predictive of long-term flexion (β= 0.09, P = 0.26) or extension (β = 0.04, P = 0.76). Preoperative TUG performance was predictive of long-term 6-min walk performance (β = −21, P < 0.001). Acute TUG performance was predictive of long-term functional performance on the 6-min walk test, after adjusting for the effects of sex and age (P = 0.02); however, once adjusted for preoperative TUG performance, acute TUG was no longer related to long-term 6-min walk performance (P = 0.65). Conclusions Acute postoperative measures of knee range of motion are of limited prognostic value, although preoperative measures have some prognostic value. However, acute measures of functional performance are of useful prognostic value, especially when preoperative functional performance data are unavailable. PMID:24508937

  8. Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians.

    PubMed

    Cadore, Eduardo L; Casas-Herrero, Alvaro; Zambom-Ferraresi, Fabricio; Idoate, Fernando; Millor, Nora; Gómez, Marisol; Rodriguez-Mañas, Leocadio; Izquierdo, Mikel

    2014-04-01

    This randomized controlled trial examined the effects of multicomponent training on muscle power output, muscle mass, and muscle tissue attenuation; the risk of falls; and functional outcomes in frail nonagenarians. Twenty-four elderly (91.9 ± 4.1 years old) were randomized into intervention or control group. The intervention group performed a twice-weekly, 12-week multicomponent exercise program composed of muscle power training (8-10 repetitions, 40-60 % of the one-repetition maximum) combined with balance and gait retraining. Strength and power tests were performed on the upper and lower limbs. Gait velocity was assessed using the 5-m habitual gait and the time-up-and-go (TUG) tests with and without dual-task performance. Balance was assessed using the FICSIT-4 tests. The ability to rise from a chair test was assessed, and data on the incidence and risk of falls were assessed using questionnaires. Functional status was assessed before measurements with the Barthel Index. Midthigh lower extremity muscle mass and muscle fat infiltration were assessed using computed tomography. The intervention group showed significantly improved TUG with single and dual tasks, rise from a chair and balance performance (P < 0.01), and a reduced incidence of falls. In addition, the intervention group showed enhanced muscle power and strength (P < 0.01). Moreover, there were significant increases in the total and high-density muscle cross-sectional area in the intervention group. The control group significantly reduced strength and functional outcomes. Routine multicomponent exercise intervention should be prescribed to nonagenarians because overall physical outcomes are improved in this population.

  9. Long-Term Intellectual Functioning and School-Related Behavioural Outcomes in Children and Adolescents after Invasive Treatment for Congenital Heart Disease

    ERIC Educational Resources Information Center

    Spijkerboer, A. W.; Utens, E. M. W. J.; Bogers, A. J. J. C.; Verhulst, F. C.; Helbing, W. A.

    2008-01-01

    In this study, long-term intellectual functioning and school-related behavioural outcomes were assessed in a patient sample that underwent invasive treatment for congenital heart disease (ConHD) between 1990 and 1995. The Wechsler Intelligence Scale for Children-Revised was used to measure intellectual functioning and the Teacher's Report Form to…

  10. Methylprednisolone fails to improve functional and histological outcome following spinal cord injury in rats.

    PubMed

    Pereira, José E; Costa, Luís M; Cabrita, António M; Couto, Pedro A; Filipe, Vítor M; Magalhães, Luís G; Fornaro, Michele; Di Scipio, Federica; Geuna, Stefano; Maurício, Ana C; Varejão, Artur S P

    2009-11-01

    Currently, methylprednisolone sodium succinate (MPSS) is the standard treatment following acute spinal cord injury (SCI) as a consequence of the results obtained from the National Acute Spinal Cord Injury Studies. However, many have questioned the efficacy of MPSS because of its marginal effects. Additionally there has been criticism of both study design and statistical interpretation. The functional consequences of experimental SCI have been assessed in many ways. The purpose of this investigation was to determine the effects of MPSS vs. saline solution (SS) following moderate T10 contusion injury in rat. Functional recovery was evaluated using the 21-point Basso, Beattie and Bresnahan (BBB) locomotor recovery scale, the inclined plane, the beam walk, footprint analysis and the horizontal ladder. To optimize the precision and accuracy of functional results we examined the locomotion on a treadmill using three-dimensional (3D) analysis. Stereology was used to estimate the amount of damaged tissue. The results of the traditional functional methods showed that administration of the NASCIS dosage of MPSS following acute spinal cord contusion did not lead to any significant differences in the functional recovery of MPSS- vs. SS-treated animals. More importantly, the results of the 3D kinematic showed that the MPSS administration did not affect the flexion/extension of the hip, knee and ankle joints during the step cycle. Finally, stereological results revealed no statistically significant differences between the two experimental groups. Altogether, our results support data previously reported by several authors, suggesting that MPSS does not lead to improved functional outcome following experimental acute SCI. PMID:19665461

  11. Assessment and Its Outcomes: The Influence of Disciplines and Institutions

    ERIC Educational Resources Information Center

    Simpson, Adrian

    2016-01-01

    Existing research provides evidence at the module level of systematic differences in patterns of assessment, marks achieved and distributions of marks between different disciplines. This paper examines those issues at the degree course level, and suggests reasons for the presence or absence of those module-level relationships at this higher level.…

  12. Assessing the Dimensions and Outcomes of an Effective Teammate

    ERIC Educational Resources Information Center

    Crutchfield, Tammy N.; Klamon, Kimberly

    2014-01-01

    Though teamwork is a mainstay of corporate America and business academia, individual assessment and compensation are problematic in disciplining and removing teammates who are free-riders and rewarding high performing team members who bear a disproportionate burden of the project. Therefore, the authors set out to develop and test an assessment…

  13. Research on AT Outcomes and Large Scale Assessments

    ERIC Educational Resources Information Center

    Thurlow, Martha; Tindal, Gerald; Powers, Richard; Lewis, Preston; Laitusis, Cara Cahalan; Breslin-Larson, Joan

    2007-01-01

    Current educational policies require the participation of students with disabilities in state assessments. Their participation has raised a number of issues, among them the need for accommodations. In this article we consider the role that assistive technology (AT) can play to alleviate current accommodations demands, and highlight research and…

  14. The Alaska Statewide Assessment: Implementation and Outcome, 1989.

    ERIC Educational Resources Information Center

    Stofflet, Frederick P.; And Others

    In October 1989 Alaska conducted its statewide student assessment. Over 23,000 students in grades 4, 6, and 8 completed the reading, mathematics, and language arts sections of the Iowa Tests of Basic Skills (ITBS). At the same time, a series of questionnaires asked building principals about their schools' philosophy, climate, and problems; asked…

  15. Biochemical Visual Literacy with Constructive Alignment: Outcomes, Assessment, and Activities

    ERIC Educational Resources Information Center

    Herraez, Angel; Costa, Manuel Joao

    2013-01-01

    Several contributions in "Biochemistry and Molecular Biology Education" have highlighted the role of visualization tools and the importance of developing students' visual literacy in biochemistry education. In this forum, the authors suggest that more focus is needed on the assessment of student learning, and they advance…

  16. Assessing Student Learning Outcomes Internationally: Insights and Frontiers

    ERIC Educational Resources Information Center

    Coates, Hamish

    2016-01-01

    As higher education systems and institutions expand, more energy is being invested in ensuring that sufficient learning has been achieved to warrant the award of a qualification. Many commonly used assessment approaches do not scale well, and there remains a pressing need for reform. This paper distils insights from international investigations of…

  17. Gross Motor Function Outcome After Intensive Rehabilitation in Children With Bilateral Spastic Cerebral Palsy

    PubMed Central

    Lee, Seung Hoon; Shim, Jae Sun; Kim, Kiyoung; Moon, Jinkyoo

    2015-01-01

    Objective To compare gross motor function outcomes in children with moderate to severe degrees of bilateral spastic cerebral palsy (CP) who received either intensive inpatient rehabilitation or intermittent rehabilitation on an outpatient basis. Methods A non-biased retrospective chart review was done for patients diagnosed with bilateral spastic CP who received rehabilitation therapy. The intensive rehabilitation group (inpatient group) agreed to be hospitalized to receive 22 sessions of physical and occupational therapy per week for 1 month. The intermittent rehabilitation group (outpatient group) received four sessions of physical and occupational therapy per week for 3 months in an outpatient setting. Changes in the total score on the Gross Motor Function Measure (GMFM) between baseline and the follow-up period were analyzed. Results Both groups showed significant improvements in total GMFM scores at the follow-up assessment compared to that at baseline (p=0.000 for inpatient group, p=0.001 for outpatient group). The increase in mean total GMFM score after 1 month was significantly greater in the inpatient group than that in the outpatient group (p=0.020). Higher increase in GMFM score was observed in younger subjects as revealed by the negative correlation between age and the increase in GMFM score after 1 month (p=0.002, r=-0.460). Conclusion Intensive inpatient rehabilitation therapy for patients with bilateral spastic CP of moderate to severe degree was more effective for improving gross motor function than intermittent rehabilitation therapy on an outpatient basis. PMID:26361600

  18. Mismatch negativity, social cognition, and functional outcomes in patients after traumatic brain injury

    PubMed Central

    Sun, Hui-yan; Li, Qiang; Chen, Xi-ping; Tao, Lu-yang

    2015-01-01

    Mismatch negativity is generated automatically, and is an early monitoring indicator of neuronal integrity impairment and functional abnormality in patients with brain injury, leading to decline of cognitive function. Antipsychotic medication cannot affect mismatch negativity. The present study aimed to explore the relationships of mismatch negativity with neurocognition, daily life and social functional outcomes in patients after brain injury. Twelve patients with traumatic brain injury and 12 healthy controls were recruited in this study. We examined neurocognition with the Wechsler Adult Intelligence Scale-Revised China, and daily and social functional outcomes with the Activity of Daily Living Scale and Social Disability Screening Schedule, respectively. Mismatch negativity was analyzed from electroencephalogram recording. The results showed that mismatch negativity amplitudes decreased in patients with traumatic brain injury compared with healthy controls. Mismatch negativity amplitude was negatively correlated with measurements of neurocognition and positively correlated with functional outcomes in patients after traumatic brain injury. Further, the most significant positive correlations were found between mismatch negativity in the fronto-central region and measures of functional outcomes. The most significant positive correlations were also found between mismatch negativity at the FCz electrode and daily living function. Mismatch negativity amplitudes were extremely positively associated with Social Disability Screening Schedule scores at the Fz electrode in brain injury patients. These experimental findings suggest that mismatch negativity might efficiently reflect functional outcomes in patients after traumatic brain injury. PMID:26170824

  19. Mismatch negativity, social cognition, and functional outcomes in patients after traumatic brain injury.

    PubMed

    Sun, Hui-Yan; Li, Qiang; Chen, Xi-Ping; Tao, Lu-Yang

    2015-04-01

    Mismatch negativity is generated automatically, and is an early monitoring indicator of neuronal integrity impairment and functional abnormality in patients with brain injury, leading to decline of cognitive function. Antipsychotic medication cannot affect mismatch negativity. The present study aimed to explore the relationships of mismatch negativity with neurocognition, daily life and social functional outcomes in patients after brain injury. Twelve patients with traumatic brain injury and 12 healthy controls were recruited in this study. We examined neurocognition with the Wechsler Adult Intelligence Scale-Revised China, and daily and social functional outcomes with the Activity of Daily Living Scale and Social Disability Screening Schedule, respectively. Mismatch negativity was analyzed from electroencephalogram recording. The results showed that mismatch negativity amplitudes decreased in patients with traumatic brain injury compared with healthy controls. Mismatch negativity amplitude was negatively correlated with measurements of neurocognition and positively correlated with functional outcomes in patients after traumatic brain injury. Further, the most significant positive correlations were found between mismatch negativity in the fronto-central region and measures of functional outcomes. The most significant positive correlations were also found between mismatch negativity at the FCz electrode and daily living function. Mismatch negativity amplitudes were extremely positively associated with Social Disability Screening Schedule scores at the Fz electrode in brain injury patients. These experimental findings suggest that mismatch negativity might efficiently reflect functional outcomes in patients after traumatic brain injury. PMID:26170824

  20. Supratentorial Ependymoma: Disease Control, Complications, and Functional Outcomes After Irradiation

    SciTech Connect

    Landau, Efrat; Boop, Frederick A.; Conklin, Heather M.; Wu, Shengjie; Xiong, Xiaoping; Merchant, Thomas E.

    2013-03-15

    Purpose: Ependymoma is less commonly found in the supratentorial brain and has known clinical and molecular features that are unique. Our single-institution series provides valuable information about disease control for supratentorial ependymoma and the complications of supratentorial irradiation in children. Methods and Materials: A total of 50 children with newly diagnosed supratentorial ependymoma were treated with adjuvant radiation therapy (RT); conformal methods were used in 36 after 1996. The median age at RT was 6.5 years (range, 1-18.9 years). The entire group was characterized according to sex (girls 27), race (white 43), extent of resection (gross-total 46), and tumor grade (anaplastic 28). The conformal RT group was prospectively evaluated for neurologic, endocrine, and cognitive effects. Results: With a median follow-up time of 9.1 years from the start of RT for survivors (range, 0.2-23.2 years), the 10-year progression-free and overall survival were 73% + 7% and 76% + 6%, respectively. None of the evaluated factors was prognostic for disease control. Local and distant failures were evenly divided among the 16 patients who experienced progression. Eleven patients died of disease, and 1 of central nervous system necrosis. Seizure disorders were present in 17 patients, and 4 were considered to be clinically disabled. Clinically significant cognitive effects were limited to children with difficult-to-control seizures. The average values for intelligence quotient and academic achievement (reading, spelling, and math) were within the range of normal through 10 years of follow-up. Central hypothyroidism was the most commonly treated endocrinopathy. Conclusion: RT may be administered with acceptable risks for complications in children with supratentorial ependymoma. These results suggest that outcomes for these children are improving and that complications may be limited by use of focal irradiation methods.

  1. Assessing Patient-Reported Outcomes Following Orthognathic Surgery and Osseous Genioplasty.

    PubMed

    Schwitzer, Jonathan A; Albino, Frank P; Mathis, Ryan K; Scott, Amie M; Gamble, Laurie; Baker, Stephen B

    2015-11-01

    Primary outcomes for orthognathic surgery and genioplasty patients include satisfaction with appearance, improved motor function, and enhanced quality of life. The goal of this study was to assess outcomes among patients undergoing these procedures, and to highlight the potential use of FACE-Q instrument for use in patients with dentofacial deformities. A total of 56 patients presenting for orthognathic surgery and/or osseous genioplasty completed the FACE-Q during preoperative and/or at postoperative visits. FACE-Q scores increased following surgery in satisfaction with facial appearance overall (+24.5, P < 0.01), satisfaction with lower face and jawline (+40.7, P < 0.01), and in all satisfaction with chin items (profile, prominence, shape, and overall). Patients also demonstrated increased social confidence (+8.9, P = 0.29). There was no improvement in psychologic well-being (-0.8, P = 0.92). All 3 surgical groups of patients experienced gains in satisfaction with appearance following surgery. Patients who underwent orthognathic surgery either alone or in combination with genioplasty demonstrated statistically significant improvements in satisfaction with facial appearance overall (P < 0.01 for both groups), whereas patients who underwent genioplasty alone did not (P = 0.13). In addition, patients who underwent orthognathic surgery combined with genioplasty demonstrated greater improvement in satisfaction with chin than patients who underwent genioplasty alone. In conclusion, patients who underwent orthognathic surgery and/or genioplasty demonstrated improvement in appearance and social confidence. The use of this model supports the successful outcomes possible for patients undergoing these procedures.

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

    PubMed Central

    VanDevanter, Donald R; Konstan, Michael W

    2015-01-01

    Cystic fibrosis (CF) is a complex genetic disease characterized by death from loss of lung function. Therapies target pathophysiologic changes associated with pulmonary disease progression. Although therapeutic mechanisms differ, efficacy demonstration is limited to a few accepted outcome measures, each with shortcomings that are becoming more pronounced as CF population health improves. Pulmonary function improvement (as forced expiratory volume in 1 s [FEV1]) and reduction of pulmonary exacerbation risk are commonly used outcomes. Changes in FEV1 decline rate, quality of life, linear growth and/or weight gain are less utilized outcomes. Validated outcomes tend to work best in subjects with more aggressive or advanced lung disease and less so in healthier subjects. Assays of effects on primary therapeutic targets have yet to be validated as surrogate measures of clinical efficacy. As CF population health improves, it will become increasingly difficult to employ current clinical outcome measures to demonstrate efficacy. PMID:26146539

  3. A physiotherapy triage assessment service for people with low back disorders: evaluation of short-term outcomes

    PubMed Central

    Bath, Brenna; Pahwa, Punam

    2012-01-01

    Purpose: To determine the short-term effects of physiotherapy triage assessments on self-reported pain, functioning, and general well-being and quality of life in people with low back-related disorders. Methods: Participants with low back–related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists (PTs). Before undergoing the triage assessment, the participants completed a battery of questionnaires covering a range of sociodemographic, clinical, and psychosocial features. The study used the Numeric Pain Rating Scale (NPRS), the Oswestry Disability Index (ODI), and the Medical Outcomes Survey 36-item short-form version 2 (SF-36v2) to assess self-reported pain, function, and quality of life. Baseline measures and variables were analyzed using a descriptive analysis method (ie, proportions, means, medians). Paired samples t-tests or Wilcoxon matched-pair signed-rank tests were used to analyze the overall group differences between the pretest and posttest outcome measures where appropriate. Results: A total of 108 out of 115 (93.9%) participants completed the posttest survey. The Physical Component Summary of the SF36v2 was the only measure that demonstrated significant improvement (P < 0.001). Conclusion: A spinal triage assessment program delivered by PTs can be viewed as a complex intervention that may have the potential to affect a wide range of patient-related outcomes. Further research is needed to examine the long-term outcomes and explore potential mechanisms of improvement using a biopsychosocial framework. PMID:22915980

  4. Active Flexion in Weight Bearing Better Correlates with Functional Outcomes of Total Knee Arthroplasty than Passive Flexion

    PubMed Central

    Song, Young Dong; Jain, Nimash; Kang, Yeon Gwi; Kim, Tae Yune

    2016-01-01

    Purpose Correlations between maximum flexion and functional outcomes in total knee arthroplasty (TKA) patients are reportedly weak. We investigated whether there are differences between passive maximum flexion in nonweight bearing and other types of maximum flexion and whether the type of maximum flexion correlates with functional outcomes. Materials and Methods A total of 210 patients (359 knees) underwent preoperative evaluation and postoperative follow-up evaluations (6, 12, and 24 months) for the assessment of clinical outcomes including maximum knee flexion. Maximum flexion was measured under five conditions: passive nonweight bearing, passive weight bearing, active nonweight bearing, and active weight bearing with or without arm support. Data were analyzed for relationships between passive maximum flexion in nonweight bearing by Pearson correlation analyses, and a variance comparison between measurement techniques via paired t test. Results We observed substantial differences between passive maximum flexion in nonweight bearing and the other four maximum flexion types. At all time points, passive maximum flexion in nonweight bearing correlated poorly with active maximum flexion in weight bearing with or without arm support. Active maximum flexion in weight bearing better correlated with functional outcomes than the other maximum flexion types. Conclusions Our study suggests active maximum flexion in weight bearing should be reported together with passive maximum flexion in nonweight bearing in research on the knee motion arc after TKA. PMID:27274468

  5. Towards a Model and Methodology for Assessing Student Learning Outcomes and Satisfaction

    ERIC Educational Resources Information Center

    Duque, Lola C.; Weeks, John R.

    2010-01-01

    Purpose: The purpose of this paper is threefold: first, to introduce a conceptual model for assessing undergraduate student learning outcomes and satisfaction that involves concepts drawn from the services marketing and assessment literatures; second, to illustrate the utility of the model as implemented in an academic department (geography)…

  6. A Web-Based Course Assessment Tool with Direct Mapping to Student Outcomes

    ERIC Educational Resources Information Center

    Ibrahim, Walid; Atif, Yacine; Shuaib, Khaled; Sampson, Demetrios

    2015-01-01

    The assessment of curriculum outcomes is an essential element for continuous academic improvement. However, the collection, aggregation and analysis of assessment data are notoriously complex and time-consuming processes. At the same time, only few developments of supporting electronic processes and tools for continuous academic program assessment…

  7. Assessing Educational Outcomes: Are We Doing Good, Can We Do Better? IHE Newsletter.

    ERIC Educational Resources Information Center

    Fincher, Cameron

    The United States is not doing as well as it could in assessing educational outcomes in the 1980s. The assessment movement of the 1980s indicates that its institutional memory is poor, and when coping with outside pressures, it is slow to recall how it coped the last time it was under pressure. It is important to remember such events and pressures…

  8. Evaluating the Student Learning Outcomes Assessment Process in Undergraduate Parks and Recreation Academic Programs

    ERIC Educational Resources Information Center

    Ross, Craig M.; Young, Sarah J.; Sturts, Jill R.

    2012-01-01

    Institutions of higher education are increasingly being held more accountable for assessing student learning both in and out of their classrooms along with reporting results to their stakeholders. The purpose of this study, which examined assessment of student learning outcomes in undergraduate park and recreation academic programs, was two-fold:…

  9. Combining the Tasks of Grading Individual Assignments and Assessing Student Outcomes in Project-Based Courses

    ERIC Educational Resources Information Center

    Dahm, Kevin

    2014-01-01

    ABET requires that engineering programs demonstrate continuous assessment and continuous improvement in order to be accredited. Central to the process is establishing and assessing measurable "student outcomes" that reflect whether the goals and objectives of the program are being met. This paper examines effective strategies for…

  10. Community College Faculty Attitudes and Concerns about Student Learning Outcomes Assessment

    ERIC Educational Resources Information Center

    Fontenot, Janet Smith

    2012-01-01

    The purpose of this study was to identify the attitudes and concerns community college faculty have about student learning outcomes assessment and to further explore the relationship between these factors and faculty levels of involvement in assessment activities. Combining the conceptual frameworks of the concerns-based adoption Model (CBAM) and…

  11. The Importance of Assessment Procedures to Student Learning Outcomes in Religious Education.

    ERIC Educational Resources Information Center

    Cox, Philip; Godfrey, John R.

    In Perth, Western Australia, summative assessment has not been a teaching tool in the teaching of religious education courses in the Catholic schools. This study investigated whether the use of formal assessment procedures in the teaching of religion had an effect on student learning outcomes. Subjects were 128 students (4 classes) in year 8 of an…

  12. Faculty Engagement with Learning Outcomes Assessment: A Study of Public Two-Year Colleges in Colorado

    ERIC Educational Resources Information Center

    Williams, Jennifer L.

    2013-01-01

    The problem addressed in this study was the assumption that faculty at the postsecondary level in the U. S. are not sufficiently or effectively engaged with student learning outcomes assessment (LOA) activities and/or practices. This issue emerged in two primary ways within the Scholarship of Assessment (SoA) body of literature: (1) as a…

  13. Using Mobile Technologies for Assessment and Learning in Practice Settings: Outcomes of Five Case Studies

    ERIC Educational Resources Information Center

    Dearnley, Christine; Taylor, Jill; Hennessy, Scott; Parks, Maria; Coates, Catherine; Haigh, Jackie; Fairhall, John; Riley, Kevin; Dransfield, Mark

    2009-01-01

    This article presents the outcomes of the Mobile Technologies Pilot Project for the Assessment and Learning in Practice Settings (ALPS) Centre for Excellence in Teaching and Learning (CETL). ALPS is a partnership of five Higher Education Institutions (HEI) that aims to develop and improve assessment, and thereby learning, in practice settings for…

  14. Can Assessment Reactivity Predict Treatment Outcome among Adolescents with Alcohol and Other Substance Use Disorders?

    ERIC Educational Resources Information Center

    Kaminer, Yifrah; Burleson, Joseph A.; Burke, Rebecca H.

    2008-01-01

    The objectives of this paper are two-fold: to examine first, if the change from positive to negative alcohol and any other substance use status from baseline assessment to the onset of the first session (i.e., pre-treatment phase) occurs in adolescents, that is, Assessment Reactivity (AR); second, whether AR predicts treatment outcome.…

  15. Are Outcomes of Extremely Preterm Infants Improving? Impact of Bayley Assessment on Outcomes

    PubMed Central

    Vohr, Betty R.; Stephens, Bonnie E.; Higgins, Rosemary D.; Bann, Carla M.; Hintz, Susan R.; Epi, MS; Das, Abhik; Newman, Jamie E.; Peralta-Carcelen, Myriam; Yolton, Kimberly; Dusick, Anna M.; Evans, Patricia W.; Goldstein, Ricki F.; Ehrenkranz, Richard A.; Pappas, Athina; Adams-Chapman, Ira; Wilson-Costello, Deanne E.; Bauer, Charles R.; Bodnar, Anna; Heyne, Roy J.; Vaucher, Yvonne E.; Dillard, Robert G.; Acarregui, Michael J.; McGowan, Elisabeth C.; Myers, Gary J.; Fuller, Janell

    2013-01-01

    Objectives To compare 18- to 22-month cognitive scores and neurodevelopmental impairment (NDI) in 2 time periods using the National Institute of Child Health and Human Development’s Neonatal Research Network assessment of extremely low birth weight infants with the Bayley Scales of Infant Development, Second Edition (Bayley II) in 2006–2007 (period 1) and using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), with separate cognitive and language scores, in 2008–2011 (period 2). Study design Scores were compared with bivariate analysis, and regression analyses were run to identify differences in NDI rates. Results Mean Bayley III cognitive scores were 11 points higher than mean Bayley II cognitive scores. The NDI rate was reduced by 70% (from 43% in period 1 to 13% in period 2; P < .0001). Multivariate analyses revealed that Bayley III contributed to a decreased risk of NDI by 5 definitions: cognitive score <70 and <85, cognitive or language score <70; cognitive or motor score <70, and cognitive, language, or motor score <70 (P < .001). Conclusion Whether the Bayley III is overestimating cognitive performance or whether it is a more valid assessment of emerging cognitive skills than the Bayley II is uncertain. Because the Bayley III identifies significantly fewer children with disability, it is recommended that all extremely low birth weight infants be offered early intervention services at the time of discharge from the neonatal intensive care unit, and that Bayley scores be interpreted with caution. PMID:22421261

  16. Left Ventricular Diastolic Dysfunction in Ischemic Stroke: Functional and Vascular Outcomes

    PubMed Central

    Park, Hong-Kyun; Kim, Beom Joon; Yoon, Chang-Hwan; Yang, Mi Hwa; Han, Moon-Ku; Bae, Hee-Joon

    2016-01-01

    Background and Purpose Left ventricular (LV) diastolic dysfunction, developed in relation to myocardial dysfunction and remodeling, is documented in 15%-25% of the population. However, its role in functional recovery and recurrent vascular events after acute ischemic stroke has not been thoroughly investigated. Methods In this retrospective observational study, we identified 2,827 ischemic stroke cases with adequate echocardiographic evaluations to assess LV diastolic dysfunction within 1 month after the index stroke. The peak transmitral filling velocity/mean mitral annular velocity during early diastole (E/e’) was used to estimate LV diastolic dysfunction. We divided patients into 3 groups according to E/e’ as follows: <8, 8-15, and ≥15. Recurrent vascular events and functional recovery were prospectively collected at 3 months and 1 year. Results Among included patients, E/e’ was 10.6±6.4: E/e’ <8 in 993 (35%), 8-15 in 1,444 (51%), and ≥15 in 378 (13%) cases. Functional dependency or death (modified Rankin Scale score ≥2) and composite vascular events were documented in 1,298 (46%) and 187 (7%) patients, respectively, at 3 months. In multivariable analyses, ischemic stroke cases with E/e’ ≥15 had increased odds of functional dependence or death at 3 months (adjusted OR [95% CI]: 1.73 [1.27-2.35]) or 1 year (1.47 [1.06-2.06]) and vascular events within 1 year (1.65 [1.08-2.51]). Subgroups with normal ejection fraction or sinus rhythm exhibited a similar overall pattern and direction. Conclusions LV diastolic dysfunction was associated with poor functional outcomes and composite vascular events up to 1 year. PMID:27283279

  17. Functional Plasticity in Childhood Brain Disorders: When, What, How, and Whom to Assess

    PubMed Central

    Dennis, Maureen; Spiegler, Brenda J.; Simic, Nevena; Sinopoli, Katia J.; Wilkinson, Amy; Yeates, Keith Owen; Taylor, H. Gerry; Bigler, Erin D.; Fletcher, Jack M.

    2014-01-01

    At every point in the lifespan, the brain balances malleable processes representing neural plasticity that promote change with homeostatic processes that promote stability. Whether a child develops typically or with brain injury, his or her neural and behavioral outcome is constructed through transactions between plastic and homeostatic processes and the environment. In clinical research with children in whom the developing brain has been malformed or injured, behavioral outcomes provide an index of the result of plasticity, homeostasis, and environmental transactions. When should we assess outcome in relation to age at brain insult, time since brain insult, and age of the child at testing? What should we measure? Functions involving reacting to the past and predicting the future, as well as social-affective skills, are important. How should we assess outcome? Information from performance variability, direct measures and informants, overt and covert measures, and laboratory and ecological measures should be considered. In whom are we assessing outcome? Assessment should be cognizant of individual differences in gene, socio-economic status (SES), parenting, nutrition, and interpersonal supports, which are moderators that interact with other factors influencing functional outcome. PMID:24821533

  18. Imbalanced Learning for Functional State Assessment

    NASA Technical Reports Server (NTRS)

    Li, Feng; McKenzie, Frederick; Li, Jiang; Zhang, Guangfan; Xu, Roger; Richey, Carl; Schnell, Tom

    2011-01-01

    This paper presents results of several imbalanced learning techniques applied to operator functional state assessment where the data is highly imbalanced, i.e., some function states (majority classes) have much more training samples than other states (minority classes). Conventional machine learning techniques usually tend to classify all data samples into majority classes and perform poorly for minority classes. In this study, we implemented five imbalanced learning techniques, including random undersampling, random over-sampling, synthetic minority over-sampling technique (SMOTE), borderline-SMOTE and adaptive synthetic sampling (ADASYN) to solve this problem. Experimental results on a benchmark driving lest dataset show thai accuracies for minority classes could be improved dramatically with a cost of slight performance degradations for majority classes,

  19. A state-wide assessment: marital stability and client outcomes.

    PubMed

    Hartmann, D J; Sullivan, W P; Wolk, J L

    1991-12-01

    This paper presents results of Missouri's first statewide evaluation of alcohol and drug treatment programs. The study utilized a 1-year follow-up sample of 242 respondents to explore the nature and patterns of post-treatment functioning. This paper focuses on the impact of client marital stability on post-treatment substance use. The data supported the expected result that marital status was related to post-treatment relapse. Further analysis suggests that transitional periods between marriage and divorce are especially important in understanding the pattern of relapse after treatment. Multivariate analysis indicates that the marital status effect is important both directly and in interaction with program completion. The data suggest that attention to transitional states and interpersonal functioning should be incorporated into client follow-up.

  20. Strong correlation between the 6-minute walk test and accelerometry functional outcomes in boys with Duchenne muscular dystrophy.

    PubMed

    Davidson, Zoe E; Ryan, Monique M; Kornberg, Andrew J; Walker, Karen Z; Truby, Helen

    2015-03-01

    Accelerometry provides information on habitual physical capability that may be of value in the assessment of function in Duchenne muscular dystrophy. This preliminary investigation describes the relationship between community ambulation measured by the StepWatch activity monitor and the current standard of functional assessment, the 6-minute walk test, in ambulatory boys with Duchenne muscular dystrophy (n = 16) and healthy controls (n = 13). All participants completed a 6-minute walk test and wore the StepWatch™ monitor for 5 consecutive days. Both the 6-minute walk test and StepWatch accelerometry identified a decreased capacity for ambulation in boys with Duchenne compared to healthy controls. There were strong, significant correlations between 6-minute walk distance and all StepWatch parameters in affected boys only (r = 0.701-0.804). These data proffer intriguing observations that warrant further exploration. Specifically, accelerometry outcomes may compliment the 6-minute walk test in assessment of therapeutic interventions for Duchenne muscular dystrophy.

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

    PubMed

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

    2011-02-01

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

  2. [Long-term functional outcomes of cochlear implants in children].

    PubMed

    Laszig, R; Aschendorff, A; Beck, R; Schild, C; Kröger, S; Wesarg, T; Arndt, S

    2009-07-01

    The treatment of deaf and hearing-impaired children with cochlear implants has been established for several years. Nonetheless, no long-term results exist for studies of a representatively large number of children in the German-speaking area. These are necessary in order to formulate prognoses regarding the development and results of children undergoing implantation at various ages. In a retrospective study, we assessed the data of 156 children with various implantation ages and a minimum follow-up period of 5 years for whom speech and audiological data (Oldenburg Sentence Test, Freiburg words/numbers test) were available. Our findings confirm the assumption that early-implanted children (<2 years) achieve the best speech-comprehension results. For this reason, support for a sufficient universal neonate hearing screen should be emphatically given so that implantation, after a hearing test phase, can be targeted in the first year of life. The surgical, anesthesiological, and rehabilitation conditions must be fulfilled, and surgical experience is required for operation on infants and small children. PMID:19517077

  3. Practical framework for Bloom's based teaching and assessment of engineering outcomes

    NASA Astrophysics Data System (ADS)

    Mead, Patricia F.; Bennett, Mary M.

    2009-06-01

    ABET's outcomes-based assessment and evaluation requirements for engineering school accreditation has been a catalyst for curricular reform for engineering programs across the U.S. and around the world. Norfolk State University launched programs in Electronics and Optical Engineering in 2003. In 2007, Norfolk State became one of only six accredited Optical Engineering programs in the United States. In preparation for their first ABET evaluation in fall 2007, the faculty initiated an embedded-assessment program to insure continuous improvement toward the desired learning outcomes. The initial program design includes embedded assessments that have been generated using a practical framework for the creation of course activities based on Bloom's Learning Taxonomy. The framework includes specific performance criteria for each ABET-defined learning outcome. The embedded assessments are generated by individual faculty for courses that they are assigned to teach, and the performance criteria provide sufficient information to guide the faculty as they generate the embedded assignments. The assignments are typically administered through course exams, projects, electronic portfolio assignments, and other structured educational activities. The effectiveness of the assessment design is being evaluated through faculty surveys, faculty group discussions, and student performance. This paper outlines the assessment and evaluation plan, and the integrated processes that have been used to support the evaluation of learning outcomes using embedded assessment instruments.

  4. Assessing cognitive function and capacity in older adults with cancer.

    PubMed

    McKoy, June M; Burhenn, Peggy S; Browner, Ilene S; Loeser, Kari L; Tulas, Katrina M; Oden, Megan R; Rupper, Randall W

    2014-01-01

    The number of older individuals with cancer is increasing exponentially, mandating that oncologists contemplate more comprehensive and multidisciplinary approaches to treatment of this cohort. Recruitment of assessment instruments validated in older patients can be invaluable for guiding treatment and decision-making by both patients and providers, and can arguably contribute to improving outcomes and health-related quality of life. The Comprehensive Geriatric Assessment is one such validated instrument that can be used by oncologists to assess patient readiness and appropriateness for prescribed cancer therapy. As a multidisciplinary diagnostic and treatment process, it comprises functional status, cognitive status, social support, and advance care preferences, and is an ideal instrument for evaluating complex older individuals. It is well established that many older individuals with cancer travel with multiple comorbid illnesses, including cognitive impairment, and when presented with a cancer diagnosis struggle to choose from multiple treatment options. In addition to the complete medical history, the ability of patients to decide on a course of therapy in concert with their oncologist is critically important. Alternatively, many oncologists are conflicted as to whether true informed consent for treatment can be obtained from many older patients. Having a roadmap to decision-making capacity is therefore an inescapable imperative in geriatric oncology, because careful attention must be directed at identifying older patients with cancer who might benefit from these assessments and the individualized treatment plans that emerge.

  5. Improvements in Negative Symptoms and Functional Outcome After a New Generation Cognitive Remediation Program: A Randomized Controlled Trial

    PubMed Central

    Ojeda, Natalia

    2014-01-01

    Cognitive remediation improves cognition in patients with schizophrenia, but its effect on other relevant factors such as negative symptoms and functional outcome has not been extensively studied. In this hospital-based study, 84 inpatients with chronic schizophrenia were recruited from Alava Hospital (Spain). All of the subjects underwent a baseline and a 3-month assessment that examined neurocognition, clinical symptoms, insight, and functional outcome according to the Global Assessment of Functioning (GAF) scale and Disability Assessment Schedule from World Health Organization (DAS-WHO). In addition to receiving standard treatment, patients were randomly assigned either to receive neuropsychological rehabilitation (REHACOP) or to a control group. REHACOP is an integrative program that taps all basic cognitive functions. The program included experts’ latest suggestions about positive feedback and activities of daily living in the patients’ environment. The REHACOP group showed significantly greater improvements at 3 months in the areas of neurocognition, negative symptoms, disorganization, and emotional distress compared with the control group (Cohen’s effect size for these changes ranged from d = 0.47 for emotional distress to d = 0.58 for disorganization symptoms). The REHACOP group also improved significantly in both the GAF (d = 0.61) and DAS-WHO total scores (d = 0.57). Specifically, the patients showed significant improvement in vocational outcomes (d = 0.47), family contact (d = 0.50), and social competence (d = 0.56). In conclusion, neuropsychological rehabilitation may be useful for the reduction of negative symptoms and functional disability in schizophrenia. These findings support the integration of neuropsychological rehabilitation into standard treatment programs for patients with schizophrenia. PMID:23686130

  6. Assessing the impact of obesity on labor market outcomes.

    PubMed

    Lindeboom, Maarten; Lundborg, Petter; van der Klaauw, Bas

    2010-12-01

    We study the effect of obesity on employment, using rich data from the British National Child Development Study (NCDS). The results show a significant negative association between obesity and employment even after controlling for a rich set of demographic, socioeconomic, environmental and behavioral variables. In order to account for the endogeneity of obesity, we use and assess instruments introduced by Cawley (2004); the obesity status of biological relatives. Using parental obesity as an instrument, we show that the association between obesity and employment is no longer significant. Similar results are obtained in a model of first differences. We provide a number of different checks on the instruments, by exploiting the richness of the NCDS data. The results show mixed evidence regarding the validity of the instruments.

  7. Functional Status Assessment of Patients With COPD

    PubMed Central

    Liu, Yang; Li, Honghe; Ding, Ning; Wang, Ningning; Wen, Deliang

    2016-01-01

    Abstract Presently, there is no recommendation on how to assess functional status of chronic obstructive pulmonary disease (COPD) patients. This study aimed to summarize and systematically evaluate these measures. Studies on measures of COPD patients’ functional status published before the end of January 2015 were included using a search filters in PubMed and Web of Science, screening reference lists of all included studies, and cross-checking against some relevant reviews. After title, abstract, and main text screening, the remaining was appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) 4-point checklist. All measures from these studies were rated according to best-evidence synthesis and the best-rated measures were selected. A total of 6447 records were found and 102 studies were reviewed, suggesting 44 performance-based measures and 14 patient-reported measures. The majority of the studies focused on internal consistency, reliability, and hypothesis testing, but only 21% of them employed good or excellent methodology. Their common weaknesses include lack of checks for unidimensionality, inadequate sample sizes, no prior hypotheses, and improper methods. On average, patient-reported measures perform better than performance-based measures. The best-rated patient-reported measures are functional performance inventory (FPI), functional performance inventory short form (FPI-SF), living with COPD questionnaire (LCOPD), COPD activity rating scale (CARS), University of Cincinnati dyspnea questionnaire (UCDQ), shortness of breath with daily activities (SOBDA), and short-form pulmonary functional status scale (PFSS-11), and the best-rated performance-based measures are exercise testing: 6-minute walk test (6MWT), endurance treadmill test, and usual 4-meter gait speed (usual 4MGS). Further research is needed to evaluate the reliability and validity of performance-based measures since present studies failed to

  8. Behavioral, Brain Imaging and Genomic Measures to Predict Functional Outcomes Post - Bed Rest and Spaceflight

    NASA Technical Reports Server (NTRS)

    Mulavara, A. P.; DeDios, Y. E.; Gadd, N. E.; Caldwell, E. E.; Batson, C. D.; Goel, R.; Seidler, R. D.; Oddsson, L.; Zanello, S.; Clarke, T.; Peters, B.; Cohen, H. S.; Reschke, M.; Wood, S.; Bloomberg, J. J.

    2016-01-01

    Astronauts experience sensorimotor disturbances during their initial exposure to microgravity and during the re-adaptation phase following a return to an Earth-gravitational environment. These alterations may disrupt crewmembers' ability to perform mission critical functional tasks requiring ambulation, manual control and gaze stability. Interestingly, astronauts who return from spaceflight show substantial differences in their abilities to readapt to a gravitational environment. The ability to predict the manner and degree to which individual astronauts would be affected would improve the effectiveness of countermeasure training programs designed to enhance sensorimotor adaptability. For such an approach to succeed, we must develop predictive measures of sensorimotor adaptability that will allow us to foresee, before actual spaceflight, which crewmembers are likely to experience the greatest challenges to their adaptive capacities. The goals of this project are to identify and characterize this set of predictive measures. Our approach includes: 1) behavioral tests to assess sensory bias and adaptability quantified using both strategic and plastic-adaptive responses; 2) imaging to determine individual brain morphological and functional features, using structural magnetic resonance imaging (MRI), diffusion tensor imaging, resting state functional connectivity MRI, and sensorimotor adaptation task-related functional brain activation; and 3) assessment of genotypic markers of genetic polymorphisms in the catechol-O-methyl transferase, dopamine receptor D2, and brain-derived neurotrophic factor genes and genetic polymorphisms of alpha2-adrenergic receptors that play a role in the neural pathways underlying sensorimotor adaptation. We anticipate that these predictive measures will be significantly correlated with individual differences in sensorimotor adaptability after long-duration spaceflight and exposure to an analog bed rest environment. We will be conducting a

  9. Are well functioning civil registration and vital statistics systems associated with better health outcomes?

    PubMed

    Phillips, David E; AbouZahr, Carla; Lopez, Alan D; Mikkelsen, Lene; de Savigny, Don; Lozano, Rafael; Wilmoth, John; Setel, Philip W

    2015-10-01

    In this Series paper, we examine whether well functioning civil registration and vital statistics (CRVS) systems are associated with improved population health outcomes. We present a conceptual model connecting CRVS to wellbeing, and describe an ecological association between CRVS and health outcomes. The conceptual model posits that the legal identity that civil registration provides to individuals is key to access entitlements and services. Vital statistics produced by CRVS systems provide essential information for public health policy and prevention. These outcomes benefit individuals and societies, including improved health. We use marginal linear models and lag-lead analysis to measure ecological associations between a composite metric of CRVS performance and three health outcomes. Results are consistent with the conceptual model: improved CRVS performance coincides with improved health outcomes worldwide in a temporally consistent manner. Investment to strengthen CRVS systems is not only an important goal for individuals and societies, but also a development imperative that is good for health.

  10. Are well functioning civil registration and vital statistics systems associated with better health outcomes?

    PubMed

    Phillips, David E; AbouZahr, Carla; Lopez, Alan D; Mikkelsen, Lene; de Savigny, Don; Lozano, Rafael; Wilmoth, John; Setel, Philip W

    2015-10-01

    In this Series paper, we examine whether well functioning civil registration and vital statistics (CRVS) systems are associated with improved population health outcomes. We present a conceptual model connecting CRVS to wellbeing, and describe an ecological association between CRVS and health outcomes. The conceptual model posits that the legal identity that civil registration provides to individuals is key to access entitlements and services. Vital statistics produced by CRVS systems provide essential information for public health policy and prevention. These outcomes benefit individuals and societies, including improved health. We use marginal linear models and lag-lead analysis to measure ecological associations between a composite metric of CRVS performance and three health outcomes. Results are consistent with the conceptual model: improved CRVS performance coincides with improved health outcomes worldwide in a temporally consistent manner. Investment to strengthen CRVS systems is not only an important goal for individuals and societies, but also a development imperative that is good for health. PMID:25971222

  11. The impact of renal function on outcomes of bariatric surgery.

    PubMed

    Turgeon, Nicole A; Perez, Sebastian; Mondestin, Max; Davis, S Scott; Lin, Edward; Tata, Sudha; Kirk, Allan D; Larsen, Christian P; Pearson, Thomas C; Sweeney, John F

    2012-05-01

    The effect of CKD on the risks of bariatric surgery is not well understood. Using the American College of Surgeons National Surgical Quality Improvement Program Participant Use File, we analyzed 27,736 patients who underwent bariatric surgery from 2006 through 2008. Before surgery, 34 (0.12%) patients were undergoing long-term dialysis. Among those not undergoing dialysis, 20,806 patients (75.0%) had a normal estimated GFR or stage 1 CKD, 5011 (18.07%) had stage 2 CKD, 1734 (6.25%) had stage 3 CKD, 94 (0.34%) had stage 4 CKD, and 91 (0.33%) had stage 5 CKD. In an unadjusted analysis, CKD stage was directly associated with complication rate, ranging from 4.6% for those with stage 1 CKD or normal estimated GFR to 9.9% for those with stage 5 CKD (test for trend, P<0.001). Multivariable logistic regression demonstrated that CKD stage predicts higher complication rates (odds ratio for each higher CKD stage, 1.30) after adjustment for diabetes and hypertension. Although patients with higher CKD stage had higher complication rates, the absolute incidence of complications remained <10%. In conclusion, these data demonstrate higher risks of bariatric surgery among patients with worse renal function, but whether the potential benefits outweigh the risks in this population requires further study.

  12. Oncological and Functional Outcome after Surgical Treatment of Early Glottic Carcinoma without Anterior Commissure Involvement

    PubMed Central

    Milovanovic, Jovica; Jotic, Ana; Djukic, Vojko; Pavlovic, Bojan; Trivic, Aleksandar; Krejovic-Trivic, Sanja; Milovanovic, Andjela; Milovanovic, Aleksandar; Artiko, Vera; Banko, Bojan

    2014-01-01

    Introduction. Glottic carcinoma can be successfully diagnosed in its early stages and treated with high percentage of success. Organ preservation and optimal functional outcomes could be achieved with wide array of surgical techniques for early glottic cancer, including endoscopic approaches or open laryngeal preserving procedures, making surgery the preferred method of treatment of early glottic carcinoma in the last few years. Material and Methods. Prospective study was done on 59 patients treated for Tis and T1a glottic carcinoma over a one-year time period in a tertiary medical center. Patients were treated with endoscopic laser cordectomy (types II–IV cordectomies according to European Laryngological Society classification of endoscopic cordectomies) and open cordectomy through laryngofissure. Follow-up period was 60 months. Clinical and oncological results were followed postoperatively. Voice quality after the treatment was assessed using multidimensional voice analysis 12 months after the treatment. Results. There were no significant differences between oncological and functional results among two groups of patients, though complications were more frequent in patients treated with open cordectomy. Conclusion. Endoscopic laser surgery should be the first treatment of choice in treatment of early glottic carcinomas, though open approach through laryngofissure should be available for selected cases where anatomical factors present limiting adequate tumor removal. PMID:24991554

  13. A Psychiatric Assessment-Treatment-Outcome Information System: Evaluation with Computer Simulation

    PubMed Central

    Angle, Hugh V.; Ellinwood, Everett H.

    1978-01-01

    The prediction of treatment outcome will require a clinically dedicated and comprehensive information system to gather a sizable data file on each individual, covering patient assessment, treatment and treatment outcome. The computer interview represents an information system capable of routinely gathering a large portion of this information. However, current methods of data analysis cannot adequately handle the information complexity associated with psychiatric treatment. Computer simulation is a method ideally suited to the investigation of complex subject matter and is proposed as a means to forecast the treatment outcome of actual patients under various conditions of treatment.

  14. Assessing the relationship between volume and outcome in hospital services: implications for service centralization.

    PubMed

    Harrison, Anthony

    2012-02-01

    Proposals for centralizing services are often justified on the basis of studies linking the volume of activity to the outcomes achieved. However, the evidence of such studies is far from demonstrating a causal link between volume and outcome. This article assesses the main reasons why volume and outcome studies do not in themselves demonstrate a causal link, and therefore do not provide adequate support for proposals for centralizing hospital services. It then sets out a number of precepts to guide those responsible for proposing centralization of services.

  15. Disparities in Functional Outcomes during Inpatient Rehabilitation between American Indian/Alaska Native and White Children.

    PubMed

    Fuentes, Molly M; Bjornson, Kristie; Christensen, Ana; Harmon, Rachel; Apkon, Susan D

    2016-01-01

    American Indian/Alaska Native (AI/AN) children have a high risk for poor health outcomes. Race/ethnicity and functional impairments are linked with health care disparities. While data exist for other race/ethnicity groups, little is known about outcomes for AI/AN children with functional impairments. In this study the Functional Independence Measure for Children (WeeFIM®) was used to determine differences in outcomes between AI/AN and White children receiving inpatient rehabilitation for functional impairments at one pediatric rehabilitation facility. American Indian/Alaska Native and White children had similar impairment types and functional levels at admission to inpatient rehabilitation. Both groups experienced functional improvement during rehabilitation. At discharge, AI/AN children had lower total functional scores and had less improvement in mobility scores compared with White children, with more impairment in physical mobility at discharge. This is one of the first studies to show a disparity in functional outcomes for AI/AN children compared with White children during inpatient rehabilitation.

  16. Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism.

    PubMed

    MacDonald, Rebecca; Parry-Cruwys, Diana; Dupere, Sally; Ahearn, William

    2014-12-01

    Intensive behavioral intervention for young children diagnosed with autism can produce large gains in social, cognitive, and language development. Although several studies have identified behaviors that are possible indicators of best outcome, changes in performance are typically measured using norm-referenced standardized scores referencing overall functioning level rather than via repeated observational measures of autism-specific deficits (i.e., social behavior). In the current study, 83 children with autism (CWA), aged 1, 2 and 3 years, and 58 same-aged typically developing children (TDC) were directly observed in the areas of cognitive skills, joint attention (JA), play, and stereotypic behavior using a measure called the Early Skills Assessment Tool (ESAT; MacDonald et al., 2006). CWA were assessed at entry into an EIBI program and again after 1 year of treatment. Changes in performance were compared pre- and post-treatment as well as to the normative data by age. Results indicate significant gains on the ESAT across all age groups with the greatest gains seen in the children who entered treatment prior to their second birthday. Increases were seen on direct measures of JA, play, imitation and language while decreases were seen in stereotypy regardless of level of performance at entry into EIBI. The ESAT, a direct measurement tool, served as a sensitive tool to measure changes in autism symptomatology following EIBI treatment.

  17. Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism.

    PubMed

    MacDonald, Rebecca; Parry-Cruwys, Diana; Dupere, Sally; Ahearn, William

    2014-12-01

    Intensive behavioral intervention for young children diagnosed with autism can produce large gains in social, cognitive, and language development. Although several studies have identified behaviors that are possible indicators of best outcome, changes in performance are typically measured using norm-referenced standardized scores referencing overall functioning level rather than via repeated observational measures of autism-specific deficits (i.e., social behavior). In the current study, 83 children with autism (CWA), aged 1, 2 and 3 years, and 58 same-aged typically developing children (TDC) were directly observed in the areas of cognitive skills, joint attention (JA), play, and stereotypic behavior using a measure called the Early Skills Assessment Tool (ESAT; MacDonald et al., 2006). CWA were assessed at entry into an EIBI program and again after 1 year of treatment. Changes in performance were compared pre- and post-treatment as well as to the normative data by age. Results indicate significant gains on the ESAT across all age groups with the greatest gains seen in the children who entered treatment prior to their second birthday. Increases were seen on direct measures of JA, play, imitation and language while decreases were seen in stereotypy regardless of level of performance at entry into EIBI. The ESAT, a direct measurement tool, served as a sensitive tool to measure changes in autism symptomatology following EIBI treatment. PMID:25241118

  18. Is the Physical Functioning of Older Adults with Diabetes Associated with the Processes and Outcomes of Care? Evidence from Translating Research Into Action for Diabetes (TRIAD)

    PubMed Central

    Lee, Pearl G.; McEwen, Laura N.; Waitzfelder, Beth; Subramanian, Usha; Karter, Andrew J.; Mangione, Carol M.; Herman, William H.

    2013-01-01

    Aims To examine the relationship between physical function limitations and diabetes self-management, processes of care, and intermediate outcomes in adults ≥65 years of age with type 2 diabetes. Methods We studied 1,796 participants 65 years of age and older in managed care health plans enrolled in Translating Research into Action for Diabetes (TRIAD). Physical functioning was assessed at baseline with the Physical Component Summary of the Short Form-12 (SF-12) Health Survey. Diabetes self-management was assessed with follow-up surveys, and processes of care (eye exams, urine microalbumin testing, foot exams, etc.) and intermediate health outcomes (HbA1c, blood pressure, LDL-c) were assessed with medical chart reviews. Multivariate regression models were constructed to examine the associations between physical function limitations and outcomes. Results Frequency of eye exams (OR 0.69, 95% CI 0.49 - 0.99) was the only process of care that was worse for participants with physical function limitations (n=573) compared to those without limitations (n=618). Neither self-management nor intermediate outcomes differed by whether patients had or did not have physical function limitations. Conclusion Limitations in physical functioning as assessed by the SF-12 were not associated with substantial difference in diabetes care in adults ≥65 years of age enrolled in managed care health plans. PMID:22268866

  19. Patients’ Expectations of Functional Outcomes Following Rectal Cancer Surgery: a Qualitative Study

    PubMed Central

    Park, Jason; Neuman, Heather B.; Bennett, Antonia V.; Polskin, Lily; Phang, P. Terry; Wong, W. Douglas; Temple, Larissa K.

    2014-01-01

    Background Rectal cancer patients’ expectations of health and function may affect their disease- and treatment-related experience, but how patients form expectations of post-surgery function has received little study. Objective We used a qualitative approach to explore patients’ expectations of outcomes related to bowel function following sphincter-preserving surgery (SPS) for rectal cancer. Design and Setting Individual telephone interviews with patients who were about to undergo SPS for rectal cancer. Patients 26 patients (14 men, 12 women) with clinical stage (cTNM) I to III disease. Main Outcome Measures The semi-structured interview script contained open-ended questions on patients’ expectations of post-operative bowel function and its perceived impact on daily function and life. Two researchers analyzed the interview transcripts for emergent themes using a grounded theory approach. Results Participants’ expectations of bowel function reflected three major themes: (1) information sources, (2) personal attitudes, and (3) expected outcomes. The expected outcomes theme contained references to specific symptoms and participants’ descriptions of the certainty, importance and imminence of expected outcomes. Despite multiple information sources and attempts at maintaining a positive personal attitude, participants expressed much uncertainty about their long term bowel function. They were more focused on what they considered more important and imminent concerns about being cancer-free and getting through surgery. Limitations This study is limited by context in terms of the timing of interviews (relative to the treatment course). The transferability to other contexts requires further study. Conclusions Patients’ expectations of long term functional outcomes cannot be considered outside of the overall context of the cancer-experience and the relative importance and imminence of cancer- and treatment-related events. Recognizing the complexities of the

  20. Patient reported outcomes in the assessment of premature ejaculation

    PubMed Central

    2016-01-01

    The term ‘Patient Reported Outcome’, abbreviated as PRO, was introduced by the US Food and Drug Administration (FDA) which proposed guidance on the development and validation of PROs. Previously PROs were known as self-report diaries, event-logs, self-administered questionnaires, and clinician administered rating scales. PROs seek to capture the subjective perceptions of patients and/or partner’s related to their specific symptoms, degree of bother, efficacy of a medication or psychotherapy intervention, and quality of life issues related to a specific condition. This article reviews the essential psychometric and regulatory agency requirements in the development of PROs. The constructs of reliability, various forms of validity, sensitivity, and specificity as well as concerns with translating a PRO into a different language are reviewed. Three PROs, the Premature Ejaculation Profile (PEP), the Index of Premature Ejaculation (IPE) and the Premature Ejaculation Diagnostic Tool (PEDT) all used in the assessment of premature ejaculation (PE) are discussed. These questionnaires meet or exceed all the psychometric requirements and have been employed in clinical trials and observational studies of men with PE. The article concludes on discussing some of the limitations of PRO use and recommendations for the future.

  1. Outcomes assessment of a residency program in laboratory medicine.

    PubMed

    Morse, E E; Pisciotto, P T; Hopfer, S M; Makowski, G; Ryan, R W; Aslanzadeh, J

    1997-01-01

    During a down-sizing of residency programs at a State University Medical School, hospital based residents' positions were eliminated. It was determined to find out the characteristics of the residents who graduated from the Laboratory Medicine Program, to compare women graduates with men graduates, and to compare IMGs with United States Graduates. An assessment of a 25 year program in laboratory medicine which had graduated 100 residents showed that there was no statistically significant difference by chi 2 analysis in positions (laboratory directors or staff), in certification (American Board of Pathology [and subspecialties], American Board of Medical Microbiology, American Board of Clinical Chemistry) nor in academic appointments (assistant professor to full professor) when the male graduates were compared with the female graduates or when graduates of American medical schools were compared with graduates of foreign medical schools. There were statistically significant associations by chi 2 analysis between directorship positions and board certification and between academic appointments and board certification. Of 100 graduates, there were 57 directors, 52 certified, and 41 with academic appointments. Twenty-two graduates (11 women and 11 men) attained all three.

  2. Patient reported outcomes in the assessment of premature ejaculation

    PubMed Central

    2016-01-01

    The term ‘Patient Reported Outcome’, abbreviated as PRO, was introduced by the US Food and Drug Administration (FDA) which proposed guidance on the development and validation of PROs. Previously PROs were known as self-report diaries, event-logs, self-administered questionnaires, and clinician administered rating scales. PROs seek to capture the subjective perceptions of patients and/or partner’s related to their specific symptoms, degree of bother, efficacy of a medication or psychotherapy intervention, and quality of life issues related to a specific condition. This article reviews the essential psychometric and regulatory agency requirements in the development of PROs. The constructs of reliability, various forms of validity, sensitivity, and specificity as well as concerns with translating a PRO into a different language are reviewed. Three PROs, the Premature Ejaculation Profile (PEP), the Index of Premature Ejaculation (IPE) and the Premature Ejaculation Diagnostic Tool (PEDT) all used in the assessment of premature ejaculation (PE) are discussed. These questionnaires meet or exceed all the psychometric requirements and have been employed in clinical trials and observational studies of men with PE. The article concludes on discussing some of the limitations of PRO use and recommendations for the future. PMID:27652219

  3. Outcomes of Proton Therapy for Patients With Functional Pituitary Adenomas

    SciTech Connect

    Wattson, Daniel A.; Tanguturi, Shyam K.; Spiegel, Daphna Y.; Niemierko, Andrzej; Biller, Beverly M.K.; Nachtigall, Lisa B.; Bussière, Marc R.; Swearingen, Brooke; Chapman, Paul H.; Loeffler, Jay S.; Shih, Helen A.

    2014-11-01

    Purpose/Objective(s): This study evaluated the efficacy and toxicity of proton therapy for functional pituitary adenomas (FPAs). Methods and Materials: We analyzed 165 patients with FPAs who were treated at a single institution with proton therapy between 1992 and 2012 and had at least 6 months of follow-up. All but 3 patients underwent prior resection, and 14 received prior photon irradiation. Proton stereotactic radiosurgery was used for 92% of patients, with a median dose of 20 Gy(RBE). The remainder received fractionated stereotactic proton therapy. Time to biochemical complete response (CR, defined as ≥3 months of normal laboratory values with no medical treatment), local control, and adverse effects are reported. Results: With a median follow-up time of 4.3 years (range, 0.5-20.6 years) for 144 evaluable patients, the actuarial 3-year CR rate and the median time to CR were 54% and 32 months among 74 patients with Cushing disease (CD), 63% and 27 months among 8 patients with Nelson syndrome (NS), 26% and 62 months among 50 patients with acromegaly, and 22% and 60 months among 9 patients with prolactinomas, respectively. One of 3 patients with thyroid stimulating hormone—secreting tumors achieved CR. Actuarial time to CR was significantly shorter for corticotroph FPAs (CD/NS) compared with other subtypes (P=.001). At a median imaging follow-up time of 43 months, tumor control was 98% among 140 patients. The actuarial 3-year and 5-year rates of development of new hypopituitarism were 45% and 62%, and the median time to deficiency was 40 months. Larger radiosurgery target volume as a continuous variable was a significant predictor of hypopituitarism (adjusted hazard ratio 1.3, P=.004). Four patients had new-onset postradiosurgery seizures suspected to be related to generously defined target volumes. There were no radiation-induced tumors. Conclusions: Proton irradiation is an effective treatment for FPAs, and hypopituitarism remains the primary

  4. Cascading and combined effects of cognitive deficits and residual symptoms on functional outcome in schizophrenia - A path-analytical approach.

    PubMed

    Bhagyavathi, Haralahalli D; Mehta, Urvakhsh Meherwan; Thirthalli, Jagadisha; Kumar, C Naveen; Kumar, J Keshav; Subbakrishna, D K; Gangadhar, Bangalore N

    2015-09-30

    Understanding the complex relationship among determinants of real-world functioning in schizophrenia patients in remission is important in planning recovery-oriented interventions. We explored two path-analytical models of functioning in schizophrenia. 170 Schizophrenia patients remitted from positive symptoms underwent fairly comprehensive assessments of cognition - neurocognition (NC) and social cognition (SC), residual symptoms - insight, motivation and other negative symptoms, and socio-occupational functioning. We explored (a) a cascading model, where NC predicted functional outcome through its effects on other determinants and (b) a combined model, incorporating additional direct paths from each of the determinants. The combined model, and not the cascading model demonstrated a good fit. Post-hoc trimming of the combined model by elimination of non-significant paths maintained the goodness-of-fit and was retained as the final model. In addition to the direct paths, this final model demonstrated that (a) NC influenced functioning through SC and insight and (b) SC influenced functioning through motivation and negative symptoms. This suggests that NC and SC may influence functional outcome directly, as well as indirectly, via specific impact on insight, and motivation and negative symptoms respectively.

  5. Psychosocial problem assessment and end-stage renal disease patient outcomes.

    PubMed

    Vourlekis, B S; Rivera-Mizzoni, R A

    1997-04-01

    The diagnostic process of psychosocial problem assessment enhances the end-stage renal disease (ESRD) treatment team's ability to identify or rule out in a timely and consistent way problematic circumstances that may contribute to poorer patient outcomes, both psychosocial and medical. Psychosocial diagnostic reasoning is informed by empirical and clinical knowledge concerning the characteristic impact of psychosocial factors in illness generally and ESRD specifically. The focus and process of problem assessment is explained and illustrated with four signal medical conditions-anemia, low albumin level, inadequate dialysis, and high blood pressure-that are negative indicators for chronic dialysis (CD) patient medical outcomes. Use of a norm-referenced assessment tool and a standardized psychosocial problem list aids clinicians both in systematic identification of priority concerns and in documenting circumstances and changes for outcomes monitoring.

  6. Femoro Patella Vialla patellofemoral arthroplasty: An independent assessment of outcomes at minimum 2-year follow-up

    PubMed Central

    Halai, Mansur; Ker, Andrew; Anthony, Iain; Holt, Graeme; Jones, Bryn; Blyth, Mark

    2016-01-01

    AIM To determine outcomes using the Femoro-Patella Vialla (FPV) arthroplasty and if there is an ideal patient for this implant. METHODS A total of 41 FPV patellofemoral joint replacements were performed in 31 patients (22 females, 9 males, mean age 65 years). Mean follow-up was 3.2 years (minimum 2 years). Radiographs were reviewed preoperatively and postoperatively. We assessed whether gender, age, previous surgery, patella atla or trochlear dysplasia influenced patient satisfaction or patient functional outcome. RESULTS The median Oxford Knee Score was 40 and the median Melbourne Patellofemoral Score was 21 postoperatively. Seventy-six percent of patients were satisfied, 10% unsure and 14% dissatisfied postoperatively. There was no radiological progression of tibiofemoral joint arthritis, using the Ahlback grading, in any patient. One patient, who was diagnosed with rheumatoid arthritis postoperatively, underwent revision to total knee replacement. There were no intraoperative lateral releases and no implant failures. Gender, age, the presence of trochlear dysplasia, patella alta or bilateral surgery did not influence patient outcome. Previous surgery did not correlate with outcome. CONCLUSION In contrast to the current literature, the FPV shows promising early results. However, we cannot identify a subgroup of patients with superior outcomes.

  7. Femoro Patella Vialla patellofemoral arthroplasty: An independent assessment of outcomes at minimum 2-year follow-up

    PubMed Central

    Halai, Mansur; Ker, Andrew; Anthony, Iain; Holt, Graeme; Jones, Bryn; Blyth, Mark

    2016-01-01

    AIM To determine outcomes using the Femoro-Patella Vialla (FPV) arthroplasty and if there is an ideal patient for this implant. METHODS A total of 41 FPV patellofemoral joint replacements were performed in 31 patients (22 females, 9 males, mean age 65 years). Mean follow-up was 3.2 years (minimum 2 years). Radiographs were reviewed preoperatively and postoperatively. We assessed whether gender, age, previous surgery, patella atla or trochlear dysplasia influenced patient satisfaction or patient functional outcome. RESULTS The median Oxford Knee Score was 40 and the median Melbourne Patellofemoral Score was 21 postoperatively. Seventy-six percent of patients were satisfied, 10% unsure and 14% dissatisfied postoperatively. There was no radiological progression of tibiofemoral joint arthritis, using the Ahlback grading, in any patient. One patient, who was diagnosed with rheumatoid arthritis postoperatively, underwent revision to total knee replacement. There were no intraoperative lateral releases and no implant failures. Gender, age, the presence of trochlear dysplasia, patella alta or bilateral surgery did not influence patient outcome. Previous surgery did not correlate with outcome. CONCLUSION In contrast to the current literature, the FPV shows promising early results. However, we cannot identify a subgroup of patients with superior outcomes. PMID:27622149

  8. Learning Outcomes with Linked Assessments – an Essential Part of our Regular Teaching Practice

    PubMed Central

    Smith, Ann C.; Marbach-Ad, Gili

    2010-01-01

    Setting up learning outcomes with linked assessments is a best practice in science education. In biology teaching, faculty are beginning to establish learning outcomes and assessments in the style of concept inventories. At a recent meeting of biology faculty who have designed concept inventories, the characteristics and uses of concept inventories were defined. Concept inventories used as pre- and post-measures of student learning provide a window into students’ understanding of key concepts of a discipline and serve as a tool to motivate faculty toward evidence-based teaching habits. A movement for the development of a microbiology concept inventory is suggested. PMID:23653711

  9. The Relationship between Preoperative Expectations and the Short-Term Postoperative Satisfaction and Functional Outcome in Lumbar Spine Surgery: A Systematic Review

    PubMed Central

    Ellis, Daniel J.; Mallozzi, Scott S.; Mathews, Jacob E.; Moss, Isaac L.; Ouellet, Jean A.; Jarzem, Peter; Weber, Michael H.

    2015-01-01

    Study Design Systematic review. Objective To examine the relationship between the patient's preoperative expectations and short-term postoperative satisfaction and functional outcome in lumbar spine surgery. Methods The Medline, Embase, and Cochrane databases were queried using a predefined search algorithm to identify all lumbar spine studies analyzing the influence of preoperative expectations on postoperative satisfaction and functional outcome. Two independent reviewers and a third independent mediator reviewed the literature and performed study screening, selection, methodological assessment, and data extraction using an objective protocol. Results Of 444 studies identified, 13 met the inclusion criteria. Methodological quality scores ranged from 59 to 100% with the greatest variability in defining patient characteristics and the methods of assessing patient expectations. Patient expectations were assessed in 22 areas, most frequently back and leg pain expectations and general expectations. Functional outcome was assessed by 13 tools; the most common were the visual analog scale, Oswestry Disability Index (ODI), and Short Form Health Survey (SF-36). Positive expectations for symptomatology, activity, general health, and recovery correlated with satisfaction. General expectations correlated with higher SF-36 Physical Subcomponent scores, better global function, and lower ODI outcome. Conclusions on the influence of the expectations for pain were limited due to the study heterogeneity, but the evidence suggests a positive correlation between the expectation and outcome for back and leg pain. Conclusions Positive expectations correlated significantly with short-term postoperative satisfaction and functional outcome, including higher SF-36 scores, earlier return to work, and decreased ODI scores. Future expectation-based investigations will benefit from implementation of the standardized methods of expectation, satisfaction, and outcome analysis

  10. Improving Preservice Teachers' Knowledge and Application of Functional Behavioral Assessments Using Multimedia

    ERIC Educational Resources Information Center

    Hirsch, Shanna Eisner; Kennedy, Michael J.; Haines, Shana J.; Thomas, Cathy Newman; Alves, Kat D.

    2015-01-01

    Functional behavioral assessment (FBA) is an empirically supported intervention associated with decreasing problem behavior and increasing appropriate behavior. To date, few studies have examined multimedia approaches to FBA training. This paper provides the outcomes of a randomized controlled trial across three university sites and evaluates…

  11. Assessing the outcome of rehabilitation in patients with end-stage renal disease.

    PubMed

    Porter, G A

    1994-07-01

    Assessing the rehabilitative/restorative process requires the definition of desired outcome. Traditionally, medicine has defined the desired outcome of treatment as curing disease. End-stage renal disease (ESRD) cannot be cured by applying current biotechnology. Thus, to assess treatment interventions in patients with ESRD, the desired outcome must be expanded to incorporate the broader components of health, which include physical, mental, and social well-being or quality of life. Based on this expanded definition of health, desirable treatment outcomes in patients with ESRD include employment of those able to work, individual control over the effects of kidney disease and dialysis, enhanced fitness, improved communications with caregivers and family, improved compliance with the dialysis regimen, and resumption of many activities enjoyed before the initiation of dialysis. Broadening the definition of desired outcome requires new measurement techniques. Measurement instruments for health status must evaluate fixed disease, which imposes certain limits on expected outcome; mutable health status, which represents the focus of intervention; and factors unrelated to healthcare, which will modify the scope of intervention that can be prescribed. Health-care status involves both self-reported evaluation and physical assessment. The reporting forms should be comprehensive, convenient, controlled, and valid. Such forms can be targeted to gain information about the natural evolution of a disease or disability process, to evaluate the effectiveness of treatment or other intervention on altering the disease or disability outcome, and to measure the quality of care. Two examples of the application of health status assessment will be reviewed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8023836

  12. Genital Sparing Cystectomy for Female Bladder Cancer and its Functional Outcome; a Seven Years' Experience with 24 Cases.

    PubMed

    Roshdy, Sameh; Senbel, Ahmed; Khater, Ashraf; Farouk, Omar; Fathi, Adel; Hamed, EmadEldeen; Denewer, Adel

    2016-09-01

    The surgical treatment of bladder cancer is the curative treatment especially in early cases. In this study, our aim was to assess the outcome of preservation of internal genital organs in selected females both oncologically and functionally, and to assess the feasibility of technique and its complication. 24 females with clinically and radiologically diagnosed T2 bladder cancer underwent gynecologic-tract sparing cystectomy (GTSC). Age ranged from 45 to 60 years. Patients with diffuse carcinoma-in-situ, those with tumors involving the bladder neck, those with poor general condition and those with preoperative incontinence were excluded. 1 patient, who developed local recurrence after 6 months. One patient lost follow up after 15 months. No recurrence developed in the retained genital organs. The remaining 20 patients remained free of disease. Among women who were eligible for functional evaluation, Daytime and nighttime continence were satisfactory in 21/22 (95.4 %) and in 20/22 (90.9 %) respectively. Chronic urinary retention, pouch-vaginal fistula was not noted. Most of patients showed superior Sexual Function index. Cystectomy with preservation of the internal genital organs is feasible in female with early, solitary or T2 bladder cancer with satisfactory functional and oncologic outcomes with proper case selection. PMID:27651690

  13. Assessing cognitive function after intracerebral hemorrhage in rats.

    PubMed

    MacLellan, Crystal L; Langdon, Kristopher D; Churchill, Kayla P; Granter-Button, Shirley; Corbett, Dale

    2009-03-17

    Preclinical studies must rigorously assess whether putative therapies improve motor and cognitive function following brain injury. Intracerebral hemorrhage (ICH) causes significant sensory-motor and cognitive deficits in humans. However, no study has evaluated cognition in rodent ICH models. Thus, we used a battery of tests to comprehensively examine whether a striatal ICH causes cognitive impairments in rats. Bacterial collagenase (or sterile saline for SHAM surgery) was injected into the striatum to create an ICH. Two days later, functional deficits were assessed using a neurological deficit scale (NDS), which is most sensitive to ICH injury. Sensory and/or motor deficits may confound cognitive testing; thus, we waited until these had resolved before testing learning and memory. Testing was conducted 1-7 months after ICH and included spontaneous alternation, elevated plus maze, open-field, Morris water maze, T-maze (win-shift and win-stay paradigms), and the radial arm maze (eight and four arms baited protocols). Significant motor deficits at 2 days completely resolved by 1 month, at which time cognitive testing began. In contrast to persistent cognitive deficits that occur after ICH in humans, we did not detect significant learning or memory deficits after ICH in rats. Our results suggest that these tests will not likely be useful for assessing outcome in experimental ICH studies. In conclusion, animal models that better mimic clinical ICH (both motor and cognitive deficits) must be developed. This may include increasing ICH severity or injuring other functional subdivisions within the striatum that may lead to more profound cognitive deficits.

  14. Lipoic Acid Use and Functional Outcomes after Thrombolysis in Patients with Acute Ischemic Stroke and Diabetes

    PubMed Central

    Choi, Kang-Ho; Kim, Joon-Tae; Kim, Hyung-Seok; Kim, Ja-Hae; Nam, Tai-Seung; Choi, Seong-Min; Lee, Seung-Han; Kim, Byeong-Chae; Kim, Myeong-Kyu; Cho, Ki-Hyun

    2016-01-01

    Background Alpha-lipoic acid (aLA) is a strong antioxidant commonly used for treating diabetic polyneuropathy. Previously, we demonstrated the neurorestorative effects of aLA after cerebral ischemia in rats. However, its effects on patients with stroke remain unknown. We investigated whether patients treated with aLA have better functional outcomes after acute ischemic stroke (AIS) and reperfusion therapy than patients not receiving aLA. Methods In this retrospective study of 172 prospectively registered patients with diabetes and AIS treated with tissue plasminogen activator (tPA), we investigated the relationship between aLA use and functional outcome both after 3 months and after 1 year. The functional outcomes included occurrence of hemorrhagic transformation (HT), early neurological deterioration (END), and early clinical improvement (ECI). Favorable outcomes were defined as modified Rankin Scale (mRS) scores of 0–2. Results Of the 172 patients with AIS and diabetes, 47 (27.3%) used aLA. In the entire cohort, favorable outcomes occurred at significantly higher rates both at 3 months and at 1 year in those treated with aLA. The risks for END and HT were lower and the occurrence of ECI was higher in patients treated with aLA. In multivariable analysis, aLA use was associated with favorable outcomes both at 3 months and at 1 year. Age, HT, and increased National Institutes of Health Stroke Scale scores were negative predictors of a favorable outcome. Conclusions The use of aLA in patients with AIS and diabetes who are treated with tPA is associated with favorable outcomes. These results indicate that aLA could be a useful intervention for the treatment of AIS after reperfusion therapy. PMID:27677185

  15. Social Work Assessment Notes: A Comprehensive Outcomes-Based Hospice Documentation System.

    PubMed

    Hansen, Angela Gregory; Martin, Ellen; Jones, Barbara L; Pomeroy, Elizabeth C

    2015-08-01

    This article describes the development of an integrated psychosocial patient and caregiver assessment and plan of care for hospice social work documentation. A team of hospice social workers developed the Social Work Assessment Notes as a quality improvement project in collaboration with the information technology department. Using the Social Work Assessment Tool as an organizing framework, this comprehensive hospice social work documentation system is designed to integrate assessment, planning, and outcomes measurement. The system was developed to guide the assessment of patients' and caregivers' needs related to end-of-life psychosocial issues, to facilitate collaborative care plan development, and to measure patient- and family-centered outcomes. Goals established with the patient and the caregiver are documented in the plan of care and become the foundation for patient-centered, strengths-based interventions. Likert scales are used to assign numerical severity levels for identified issues and progress made toward goals and to track the outcome of social work interventions across nine psychosocial constructs. The documentation system was developed for use in an electronic health record but can be used for paper charting. Future plans include automated aggregate outcomes measurement to identify the most effective interventions and best practices in end-of-life care.

  16. MRI of the wrist in early rheumatoid arthritis can be used to predict functional outcome at 6 years

    PubMed Central

    Benton, N; Stewart, N; Crabbe, J; Robinson, E; Yeoman, S; McQueen, F

    2004-01-01

    Objectives: To determine whether magnetic resonance (MR) scans of the dominant wrist of patients with early rheumatoid arthritis (RA) can be used to predict functional outcome at 6 years' follow up. Methods: Dominant wrist MR scans were obtained in 42 patients with criteria for RA at first presentation. Patients were followed up prospectively for 6 years, and further scans obtained at 1 year (42 patients) and 6 years (31 patients). Two radiologists scored scans for synovitis, tendonitis, bone oedema, and erosions. The Stanford Health Assessment Questionnaire (HAQ) score, indicating functional outcome, and standard measures of disease activity were assessed at 0, 1, 2, and 6 years. The physical function component of the SF-36 score (PF-SF36) was also used as a functional outcome measure at 6 years. Results: Baseline MR parameters, including bone oedema score and the total baseline MR score, were predictive of the PF-SF36 at 6 years (R2 = 0.22, p = 0.005 and R2 = 0.16, p = 0.02, respectively). The PF-SF36 score correlated strongly with the HAQ score at 6 years (rs = –0.725, p<0.0001); none of the baseline MR parameters predicted the 6 year HAQ score. The total MR score obtained at 1 year was predictive of the 6 year HAQ (R2 = 0.04, p = 0.01). Standard clinical and radiographic measures at baseline were not predictive of the 6 year PF-SF36, but when combined in a model with baseline MR oedema score, prediction increased from 0.09 to 0.23, or 23% of the 6 year variance. Conclusion: MR imaging of the wrist in patients with early RA can help to predict function at 6 years and could be used to plan aggressive management at an earlier stage. PMID:15082487

  17. Association between Functional Severity and Amputation Type with Rehabilitation Outcomes in Patients with Lower Limb Amputation.

    PubMed

    Karmarkar, Amol M; Graham, James E; Reistetter, Timothy A; Kumar, Amit; Mix, Jacqueline M; Niewczyk, Paulette; Granger, Carl V; Ottenbacher, Kenneth J

    2014-01-01

    The purpose of this study was to determine independent influences of functional level and lower limb amputation type on inpatient rehabilitation outcomes. We conducted a secondary data analysis for patients with lower limb amputation who received inpatient medical rehabilitation (N = 26,501). The study outcomes included length of stay, discharge functional status, and community discharge. Predictors included the 3-level case mix group variable and a 4-category amputation variable. Age of the sample was 64.5 years (13.4) and 64% were male. More than 75% of patients had a dysvascular-related amputation. Patients with bilateral transfemoral amputations and higher functional severity experienced longest lengths of stay (average 13.7 days) and lowest functional rating at discharge (average 79.4). Likelihood of community discharge was significantly lower for those in more functionally severe patients but did not differ between amputation categories. Functional levels and amputation type are associated with rehabilitation outcomes in inpatient rehabilitation settings. Patients with transfemoral amputations and those in case mix group 1003 (admission motor score less than 36.25) generally experience poorer outcomes than those in other case mix groups. These relationships may be associated with other demographic and/or health factors, which should be explored in future research. PMID:25400948

  18. The Impact of a Proficiency-Based Assessment and Reassessment of Learning Outcomes System on Student Achievement and Attitudes

    ERIC Educational Resources Information Center

    Posner, Michael A.

    2011-01-01

    This research compares a student-centered, proficiency-based assessment and reassessment of learning outcomes (PARLO) system to traditional assessment in a college-level introductory statistics class. The PARLO class was assessed on learning outcomes using a three-tiered proficiency scale and given the opportunity to resubmit assignments to…

  19. [Assessment and evaluation of cardiac function].

    PubMed

    Yazaki, Y

    1993-05-01

    Assessment and evaluation of cardiac function have become commonplace in the care of cardiac patients with acute or chronic disorders, since therapy of most cardiac diseases is designed specifically to improve ventricular function. Now, various techniques are available for quantitative measurements of the size, shape and motion of the ventricle. Ventricular dysfunction is defined with two components, systolic and diastolic dysfunction, and can be described hemodynamically in terms of the ventricular pressure-volume diagram. Pure systolic dysfunction is associated with a depression in the end-systolic pressure-volume relation, using the Frank-Starling relation to restore cardiac output toward normal. In contrast, pure diastolic dysfunction is associated with preservation of the end-systolic pressure-volume relation but distortion of the diastolic relation, showing higher diastolic pressure at any given volume. However, in patients presenting clinically with heart failure, both systolic and diastolic dysfunction are usually observed. In this context, factors and disorders that influence ventricular dysfunction are described, considering extrinsic or intrinsic to the ventricular chambers.

  20. Functional Behavior Assessment in Schools: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Anderson, Cynthia M.; Rodriguez, Billie Jo; Campbell, Amy

    2015-01-01

    Functional behavior assessment is becoming a commonly used practice in school settings. Accompanying this growth has been an increase in research on functional behavior assessment. We reviewed the extant literature on documenting indirect and direct methods of functional behavior assessment in school settings. To discern best practice guidelines…

  1. Determinants of Adult Functional Outcome in Adolescents Receiving Special Educational Assistance

    ERIC Educational Resources Information Center

    McGeown, H. R.; Johnstone, E. C.; McKirdy, J.; Owens, D. C.; Stanfield, A. C.

    2013-01-01

    Background: This study investigates the role of IQ, autistic traits and challenging behaviours in affecting adult outcomes among adolescents who receive special educational assistance. Methods: A total of 58 participants were recruited from an ongoing longitudinal study. All received assessments of IQ, behavioural patterns (using the Childhood…

  2. Assessing the reproducibility of discriminant function analyses.

    PubMed

    Andrew, Rose L; Albert, Arianne Y K; Renaut, Sebastien; Rennison, Diana J; Bock, Dan G; Vines, Tim

    2015-01-01

    Data are the foundation of empirical research, yet all too often the datasets underlying published papers are unavailable, incorrect, or poorly curated. This is a serious issue, because future researchers are then unable to validate published results or reuse data to explore new ideas and hypotheses. Even if data files are securely stored and accessible, they must also be accompanied by accurate labels and identifiers. To assess how often problems with metadata or data curation affect the reproducibility of published results, we attempted to reproduce Discriminant Function Analyses (DFAs) from the field of organismal biology. DFA is a commonly used statistical analysis that has changed little since its inception almost eight decades ago, and therefore provides an opportunity to test reproducibility among datasets of varying ages. Out of 100 papers we initially surveyed, fourteen were excluded because they did not present the common types of quantitative result from their DFA or gave insufficient details of their DFA. Of the remaining 86 datasets, there were 15 cases for which we were unable to confidently relate the dataset we received to the one used in the published analysis. The reasons ranged from incomprehensible or absent variable labels, the DFA being performed on an unspecified subset of the data, or the dataset we received being incomplete. We focused on reproducing three common summary statistics from DFAs: the percent variance explained, the percentage correctly assigned and the largest discriminant function coefficient. The reproducibility of the first two was fairly high (20 of 26, and 44 of 60 datasets, respectively), whereas our success rate with the discriminant function coefficients was lower (15 of 26 datasets). When considering all three summary statistics, we were able to completely reproduce 46 (65%) of 71 datasets. While our results show that a majority of studies are reproducible, they highlight the fact that many studies still are not the

  3. Assessing the reproducibility of discriminant function analyses

    PubMed Central

    Andrew, Rose L.; Albert, Arianne Y.K.; Renaut, Sebastien; Rennison, Diana J.; Bock, Dan G.

    2015-01-01

    Data are the foundation of empirical research, yet all too often the datasets underlying published papers are unavailable, incorrect, or poorly curated. This is a serious issue, because future researchers are then unable to validate published results or reuse data to explore new ideas and hypotheses. Even if data files are securely stored and accessible, they must also be accompanied by accurate labels and identifiers. To assess how often problems with metadata or data curation affect the reproducibility of published results, we attempted to reproduce Discriminant Function Analyses (DFAs) from the field of organismal biology. DFA is a commonly used statistical analysis that has changed little since its inception almost eight decades ago, and therefore provides an opportunity to test reproducibility among datasets of varying ages. Out of 100 papers we initially surveyed, fourteen were excluded because they did not present the common types of quantitative result from their DFA or gave insufficient details of their DFA. Of the remaining 86 datasets, there were 15 cases for which we were unable to confidently relate the dataset we received to the one used in the published analysis. The reasons ranged from incomprehensible or absent variable labels, the DFA being performed on an unspecified subset of the data, or the dataset we received being incomplete. We focused on reproducing three common summary statistics from DFAs: the percent variance explained, the percentage correctly assigned and the largest discriminant function coefficient. The reproducibility of the first two was fairly high (20 of 26, and 44 of 60 datasets, respectively), whereas our success rate with the discriminant function coefficients was lower (15 of 26 datasets). When considering all three summary statistics, we were able to completely reproduce 46 (65%) of 71 datasets. While our results show that a majority of studies are reproducible, they highlight the fact that many studies still are not the

  4. Association between number of prostate biopsies and patient-reported functional outcomes after radical prostatectomy: implications for active surveillance protocols

    PubMed Central

    Anderson, Christopher B.; Tin, Amy L.; Sjoberg, Daniel D.; Mulhall, John P.; Sandhu, Jaspreet; Laudone, Vincent P.; Eastham, James A.; Scardino, Peter T.; Ehdaie, Behfar

    2016-01-01

    Purpose Men with prostate cancer who progress on active surveillance (AS) are subject to multiple prostate biopsies prior to radical prostatectomy (RP). Our objective was to evaluate whether the number of preoperative prostate biopsies affects functional outcomes after RP. Materials and methods We identified men treated with RP at our institution between 2008 and 2011. At 6 and 12 months post-operatively, patients completed questionnaires assessing erectile and urinary function. Men with preoperative incontinence or erectile dysfunction or who did not complete the questionnaire were excluded. Primary outcomes were urinary and erectile function at 12 months postoperatively. We used logistic regression to estimate the impact of number of prostate biopsies on functional outcomes after adjusting for demographic and clinical factors. Results We identified 2,712 men treated with RP between 2008 and 2011. Most men (80%) had 1 preoperative prostate biopsy, 16% had 2, and 4% had at least 3. On adjusted analysis, erectile function at 12 months was not significantly different for men with 2 (OR 1.25; 95% CI 0.90, 1.75) or 3 or more (OR 1.52; 95% CI 0.84, 2.78) biopsies, compared to those with 1. Similarly, urinary function at 12 months was not significantly different for men with 2 (0.84, 95% CI 0.64, 1.10) or 3 or more (0.99, 95% CI 0.60, 1.61) biopsies compared to those with 1. Conclusions We did not find evidence that more preoperative prostate biopsies adversely affected erectile or urinary function at 12 months following RP. PMID:26118438

  5. A global assessment of the social and conservation outcomes of protected areas.

    PubMed

    Oldekop, J A; Holmes, G; Harris, W E; Evans, K L

    2016-02-01

    Protected areas (PAs) are a key strategy for protecting biological resources, but they vary considerably in their effectiveness and are frequently reported as having negative impacts on local people. This has contributed to a divisive and unresolved debate concerning the compatibility of environmental and socioeconomic development goals. Elucidating the relationship between positive and negative social impacts and conservation outcomes of PAs is key for the development of more effective and socially just conservation. We conducted a global meta-analysis on 165 PAs using data from 171 published studies. We assessed how PAs affect the well-being of local people, the factors associated with these impacts, and crucially the relationship between PAs' conservation and socioeconomic outcomes. Protected areas associated with positive socioeconomic outcomes were more likely to report positive conservation outcomes. Positive conservation and socioeconomic outcomes were more likely to occur when PAs adopted comanagement regimes, empowered local people, reduced economic inequalities, and maintained cultural and livelihood benefits. Whereas the strictest regimes of PA management attempted to exclude anthropogenic influences to achieve biological conservation objectives, PAs that explicitly integrated local people as stakeholders tended to be more effective at achieving joint biological conservation and socioeconomic development outcomes. Strict protection may be needed in some circumstances, yet our results demonstrate that conservation and development objectives can be synergistic and highlight management strategies that increase the probability of maximizing both conservation performance and development outcomes of PAs.

  6. How measurement artifacts affect cerebral autoregulation outcomes: A technical note on transfer function analysis.

    PubMed

    Meel-van den Abeelen, Aisha S S; de Jong, Daan L K; Lagro, Joep; Panerai, Ronney B; Claassen, Jurgen A H R

    2016-05-01

    Cerebral autoregulation (CA) is the mechanism that aims to maintain adequate cerebral perfusion during changes in blood pressure (BP). Transfer function analysis (TFA), the most reported method in literature to quantify CA, shows large between-study variability in outcomes. The aim of this study is to investigate the role of measurement artifacts in this variation. Specifically, the role of distortion in the BP and/or CBFV measurementon TFA outcomes was investigated. The influence of three types of artifacts on TFA outcomes was studied: loss of signal, motion artifacts, and baseline drifts. TFA metrics of signals without the simulated artifacts were compared with those of signals with artifacts. TFA outcomes scattered highly when more than 10% of BP signal or over 8% of the CBFV signal was lost, or when measurements contained one or more artifacts resulting from head movement. Furthermore, baseline drift affected interpretation of TFA outcomes when the power in the BP signal was 5 times the power in the LF band. In conclusion, loss of signal in BP and loss in CBFV, affects interpretation of TFA outcomes. Therefore, it is vital to validate signal quality to the defined standards before interpreting TFA outcomes. PMID:26935320

  7. Assessing English literacy as a predictor of postschool outcomes in the lives of deaf individuals.

    PubMed

    Garberoglio, Carrie Lou; Cawthon, Stephanie W; Bond, Mark

    2014-01-01

    Lower English literacy achievement of deaf students is often hypothesized to be an impediment for successful adult life experiences. Yet, literacy practices that individuals engage in throughout their daily lives are much more complex than what school-based measures of English can capture and particularly so for deaf individuals. A national large-scale data set with a sample of over 1,000 deaf youths was used to assess what, precisely, standardized measures of literacy may predict in terms of postschool outcomes in three domains: life, employment, and education. Regression analyses indicate that these measures predicted some postschool outcomes, but not all, and if significant, only a small amount of variation in the outcomes was explained. Findings suggest that English literacy, particularly the narrow conceptualization of English literacy skills that are measured through school-based assessments, may not play a significant role in the lives of deaf individuals, contrary to expectations. PMID:24077877

  8. Using Formative Assessments to Improve Student Learning Outcomes: A Study of the Different Types of Formative Assessments Teachers Use to Drive Instruction and Their Effects on Student Learning

    ERIC Educational Resources Information Center

    Alzina, Amy

    2016-01-01

    Understanding the difference between summative and formative assessments is still unclear for many teachers and principals as well as the effects formative assessments have on student learning outcomes. This quantitative study was conducted to explicitly explore formative assessments as a means to improve student learning outcomes, while examining…

  9. Assessing Students' Understanding of Human Behavior: A Multidisciplinary Outcomes Based Approach for the Design and Assessment of an Academic Program Goal.

    ERIC Educational Resources Information Center

    Keith, Bruce; Meese, Michael J.; Efflandt, Scott; Malinowski, Jon C.; LeBoeuf, Joseph; Gallagher, Martha; Hurley, John; Green, Charles

    2002-01-01

    Presents a strategy for the curricular design and assessment of one multidisciplinary program goal: understanding human behavior. Discusses how to assess a desired outcome based on four specific areas: (1) organizational context; (2) articulation of a learning model; (3) program design and implementation; and (4) outcomes assessment. (Author/KDR)

  10. Retrospective agreement and consent to neurocritical care is influenced by functional outcome

    PubMed Central

    2010-01-01

    Introduction Only limited data are available on consent and satisfaction of patients receiving specialized neurocritical care. In this study we (i) analyzed the extent of retrospective consent to neurocritical care--given by patients or their relatives--depending on functional outcome one year after hospital stay, and (ii) identified predisposing factors for retrospective agreement to neurocritical care. Methods We investigated 704 consecutive patients admitted to a nonsurgical neurocritical care unit over a period of 2 years (2006 through 2007). Demographic and clinical parameters were analyzed, and the patients were grouped according to their diagnosis. Functional outcome, retrospective consent to neurocritical care, and satisfaction with hospital stay was obtained by mailed standardized questionnaires. Logistic regression analyses were calculated to determine independent predictors for consent. Results High consent and satisfaction after neurointensive care (91% and 90%, respectively) was observed by those patients who reached an independent life one year after neurointensive care unit (ICU) stay. However, only 19% of surviving patients who were functionally dependent retrospectively agreed to neurocritical care. Unfavorable functional outcome and the diagnosis of stroke were independent predictors for missing retrospective consent. Conclusions Retrospective agreement to neurocritical care is influenced by functional outcome. Especially in severely affected stroke patients who cannot communicate their preferences regarding life-sustaining therapy, neurocritical care physicians should balance the expected burdens and benefits of treatment to meet the patients' putative wishes. Efforts should be undertaken to identify predictors for severe disability after neurocritical care. PMID:20673358

  11. Recommendations for Implementing an Effective, Efficient, and Enduring Outcomes-Based Assessment Program

    ERIC Educational Resources Information Center

    Bresciani, Marilee J.

    2012-01-01

    To propose recommendations to implement outcomes-based assessment program review in a California Community College District, a grounded theory analysis was performed within the district. The findings generated were cross-referenced with findings from a multi-institutional case study analysis. A key finding from the cross-reference was the need for…

  12. A User-Based Response System for the Applied Research Needs of Comprehensive Outcomes Assessment Activities.

    ERIC Educational Resources Information Center

    Chatman, Steve; Sprengel, Archie

    The development of a computer-based decision support system for outcomes assessment at Southeast Missouri State University is described. A menu-driven, user-based retrieval and analysis and reporting system, the Statistical Analysis System (SAS) was designed. The decision support system incorporates two major components, research group…

  13. Wave of the Future?: Integrating IR, Outcomes Assessment, Planning, Program Review, and Accreditation

    ERIC Educational Resources Information Center

    Leimer, Christina

    2010-01-01

    Integrating institutional research, outcomes assessment, program review, strategic planning, and accreditation can be a powerful means of creating a culture of evidence-based decision making and continuous improvement. This study examined how this "integrated" model is organized in practice, how such offices began, why this approach was chosen,…

  14. Outcomes Assessment in Postsecondary Occupational Programs: A Consortial Approach. Project Report.

    ERIC Educational Resources Information Center

    State Univ. of New York, Albany. Two Year Coll. Development Center.

    Outcome assessment has come to mean documentation, beyond grades and numbers of graduates, of higher education's results as proof of quality and evidence of improving undergraduate education. This document describes a consortium formed by the Two-Year College Development Center of the State University of New York, the Bureau of Postsecondary…

  15. Faculty and Administrator Beliefs Regarding Assessment of Student Learning Outcomes: A Community College Case Study

    ERIC Educational Resources Information Center

    Strollo, Toni Marie

    2011-01-01

    This study examined higher education faculty and academic administrator (AO) beliefs regarding the value of assessment of student learning outcomes (ASLO) as a means for improving teaching and learning at a Southeastern community college known for its commitment as a learning college and as an exemplar for such efforts. Faculty and AOs at this…

  16. Effect of Continuous Assessment on Learning Outcomes on Two Chemical Engineering Courses: Case Study

    ERIC Educational Resources Information Center

    Tuunila, R.; Pulkkinen, M.

    2015-01-01

    In this paper, the effect of continuous assessment on the learning outcomes of two chemical engineering courses is studied over a several-year period. Average grades and passing percentages of courses after the final examination are reported and also student feedback on the courses is collected. The results indicate significantly better learning…

  17. The Integration of Outcomes Assessment Information in the Management of Arizona Community Colleges

    ERIC Educational Resources Information Center

    Fleishman, Joseph H.

    2009-01-01

    Colleges and universities throughout the country are increasingly coming under pressure from accrediting institutions and legislative bodies to implement comprehensive outcomes assessment initiatives designed to measure and document student performance. Over the past ten years pressure has been directed towards colleges to reshape their current…

  18. An Outcomes-Based Assessment of Quality of Life in Social Services

    ERIC Educational Resources Information Center

    Gomez, Laura Elisabet; Arias, Benito; Verdugo, Miguel Angel; Navas, Patricia

    2012-01-01

    The goal of this article consists of describing the calibration of an instrument to assess quality of life-related personal outcomes using Rasch analysis. The sample was composed of 3.029 recipients of social services from Catalonia (Spain) and was selected using a probabilistic polietapic sample design. Results related to unidimensionality, item…

  19. A Practitioner's Handbook for Institutional Effectiveness and Student Outcomes Assessment Implementation. Third Edition.

    ERIC Educational Resources Information Center

    Nichols, James O.

    This guide is intended for college and university administrators responsible for designing and implementing a model for assessment of student outcomes and institutional effectiveness. The first chapter explains use of the handbook and introduces the institutional effectiveness paradigm on which it is based. The second chapter explains the model…

  20. Identifying Barriers in Implementing Outcomes-Based Assessment Program Review: A Grounded Theory Analysis

    ERIC Educational Resources Information Center

    Bresciani, Marilee J.

    2011-01-01

    The purpose of this grounded theory study was to identify the typical barriers encountered by faculty and administrators when implementing outcomes-based assessment program review. An analysis of interviews with faculty and administrators at nine institutions revealed a theory that faculty and administrators' promotion, tenure (if applicable),…

  1. Two Loops That Need Closing: Contingent Faculty Perceptions of Outcomes Assessment

    ERIC Educational Resources Information Center

    Scott, Gray; Danley-Scott, Jennifer

    2015-01-01

    The existing literature on non-tenure-track (NTT) faculty focuses largely on whether relying on contingent faculty is harmful to students. However, studies rarely survey contingent faculty or explore how to increase NTT faculty participation in outcomes assessment, even though contingent faculty teach most general education courses. Our survey of…

  2. Experiences of Higher Education Faculty Engaged in Undergraduate Student Learning Outcomes Assessment

    ERIC Educational Resources Information Center

    Evans, Elizabeth L.

    2010-01-01

    This qualitative phenomenological study sought to describe the lived experiences of full- time faculty engaged in undergraduate learning outcomes assessment at the program or general education level in baccalaureate or master's nonprofit or public institutions of higher education regionally accredited by the Higher Learning Commission. The ten…

  3. Can Institutions Have Quality Programming without Utilizing a Systematic Outcomes-Based Assessment Process?

    ERIC Educational Resources Information Center

    Weiner, Lauren; Bresciani, Marilee J.

    2011-01-01

    The researchers explored whether implementation of a systematic outcomes-based assessment process is necessary for demonstrating quality in service learning programs at a two-year and a four-year institution. The findings revealed that Western Community College and the University of the Coast maintained quality service-learning programs, which met…

  4. Creating an Outcomes-Based Tool for Learning Barrier Assessment in an Outpatient Education Program.

    ERIC Educational Resources Information Center

    Hernandez, Teri L.; Rupnow, Jana M.; Currie, Kristi A.; Procious, James K.; Adams, Jenny

    2003-01-01

    An outcomes-based assessment instrument was devised to screen patients for learning problems that would impede patient education in cardiac rehabilitation. Criteria for seven barriers were established: hearing, language, cultural, religious, vision, cognitive, emotional). Points of data collection and a rationale for collection were identified.…

  5. Motivating Learning and Assessing Outcomes in Continuing Medical Education Using a Personal Learning Plan

    ERIC Educational Resources Information Center

    Reed, Virginia A.; Schifferdecker, Karen E.; Turco, Mary G.

    2012-01-01

    Introduction: Although there is increasing focus on provider behavior change as an outcome of continuing medical education (CME), it has long been known that an increase in knowledge alone is rarely sufficient to induce such change. The Personal Learning Plan (PLP), designed to motivate and assess CME learning, was partly derived from SMART goals…

  6. Developing a Rubric to Assess Student Learning Outcomes Using a Class Assignment

    ERIC Educational Resources Information Center

    Thaler, Nicholas; Kazemi, Ellie; Huscher, Crystal

    2009-01-01

    We developed a rubric to assess several of our department's undergraduate student learning outcomes (SLOs). Target SLOs include applications of principles of research methodology, using appropriate statistics, adherence to the Publication Manual of the American Psychological Association, and written communication skills. We randomly sampled 20…

  7. Assessing Quality Experience and Learning Outcomes: Part II--Findings and Discussion

    ERIC Educational Resources Information Center

    Tam, Maureen

    2007-01-01

    Purpose: This paper is the second part of a comprehensive report about a research study that aims to assess the relationship between the university experience and student outcomes as a means of determining a university's success in meeting its educational goals. Design/methodology/approach: While Part I has described the process of how data were…

  8. Assessing the Relationship between Prosody and Reading Outcomes in Children Using the PEPS-C

    ERIC Educational Resources Information Center

    Lochrin, Margaret; Arciuli, Joanne; Sharma, Mridula

    2015-01-01

    This study investigated the relationship between both receptive and expressive prosody and each of three reading outcomes: accuracy of reading aloud words, accuracy of reading aloud nonwords, and comprehension. Participants were 63 children aged 7 to 12 years. To assess prosody, we used the Profiling Elements of Prosody in Speech Communication…

  9. Applying Social Cognitive Theory to Academic Advising to Assess Student Learning Outcomes

    ERIC Educational Resources Information Center

    Erlich, Richard J.; Russ-Eft, Darlene

    2011-01-01

    Review of social cognitive theory constructs of self-efficacy and self-regulated learning is applied to academic advising for the purposes of assessing student learning. A brief overview of the history of student learning outcomes in higher education is followed by an explanation of self-efficacy and self-regulated learning constructs and how they…

  10. An Outcome Evaluation of an Inpatient Crisis Stabilization and Assessment Program for Youth

    ERIC Educational Resources Information Center

    Greenham, Stephanie L.; Bisnaire, Lise

    2008-01-01

    Objective: To describe characteristics and outcomes of youth aged 7 to 17 who received inpatient psychiatric and mental health services along different clinical pathways of a new service delivery model. Method: Participants included 211 admissions to an inpatient crisis stabilization and assessment program over a one-year period. Standardized…

  11. Peer-Assessed Outcomes in the Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Hoza, Betsy; Gerdes, Alyson C.; Mrug, Sylvie; Hinshaw, Stephen P.; Bukowski, William M.; Gold, Joel A.; Arnold, L. Eugene; Abikoff, Howard B.; Conners, C. Keith; Elliott, Glen R.; Greenhill, Laurence L.; Hechtman, Lily; Jensen, Peter S.; Kraemer, Helena C.; March, John S.; Newcorn, Jeffrey H.; Severe, Joanne B.; Swanson, James M.; Vitiello, Benedetto; Wells, Karen C.; Wigal, Timothy

    2005-01-01

    Peer-assessed outcomes were examined at the end of treatment (14 months after study entry) for 285 children (226 boys, 59 girls) with attention deficit hyperactivity disorder (ADHD) who were rated by their classmates (2,232 classmates total) using peer sociometric procedures. All children with ADHD were participants in the Multimodal Treatment…

  12. Identifying Low-Effort Examinees on Student Learning Outcomes Assessment: A Comparison of Two Approaches

    ERIC Educational Resources Information Center

    Rios, Joseph A.; Liu, Ou Lydia; Bridgeman, Brent

    2014-01-01

    This chapter describes a study that compares two approaches (self-reported effort [SRE] and response time effort [RTE]) for identifying low-effort examinees in student learning outcomes assessment. Although both approaches equally discriminated from measures of ability (e.g., SAT scores), RTE was found to have a stronger relationship with test…

  13. Learning Outcomes Afforded by Self-Assessed, Segmented Video-Print Combinations

    ERIC Educational Resources Information Center

    Koumi, Jack

    2015-01-01

    Learning affordances of video and print are examined in order to assess the learning outcomes afforded by hybrid video-print learning packages. The affordances discussed for print are: navigability, surveyability and legibility. Those discussed for video are: design for constructive reflection, provision of realistic experiences, presentational…

  14. Effect of Teacher Specialized Training on Limited English Speaking Students' Assessment Outcomes: Quantitative Study

    ERIC Educational Resources Information Center

    Palaroan, Michelle A.

    2009-01-01

    The quantitative study was a comparison of Limited English Proficient (LEP) students' assessment outcomes when taught by a teacher with specialized training and when taught by teachers with no specialized training. The comparison of 2007-2008 Northern Nevada LEP third grade student scores in the content areas of English language arts and…

  15. Institutionalizing Student Outcomes Assessment: The Need for Better Research to Inform Practice

    ERIC Educational Resources Information Center

    Kezar, Adrianna

    2013-01-01

    This article explores the organizational impediments and facilitators that influence the implementation of student learning outcomes assessment (SLOA). This review points to the importance of culture, leadership, and organizational policies to the implementation of SLOA. However, we need to approach research differently, both conceptually and…

  16. Career Preparedness Survey Outcomes of Food Science Graduates--A Follow-Up Assessment

    ERIC Educational Resources Information Center

    Bohlscheid, Jeffri; Clark, Stephanie

    2012-01-01

    Fifty-eight recent graduates (1998-2008) from the joint Washington State University (WSU) and University of Idaho (UI) BiState School of Food Science program and 27 of their employers participated in a survey assessing learning outcomes based on the 2001 Institute of Food Technologists (IFT) core competencies for undergraduate food science…

  17. Towards a Framework for Aligning Learning Outcomes, Academic Literacies and Assessment Criteria

    ERIC Educational Resources Information Center

    Dew, Robert; Goscinski, Andrzej; Coldwell-Neilson, Jo

    2016-01-01

    Although Australian students spend three or more years studying they can seem quite unaware of any of the expected learning outcomes of their course. They are often single unit focused, paying most attention to individual assessment items thus not developing a holistic view of their course. This paper presents a theoretical framework to support…

  18. Sleeping with the Enemy: Making Outcomes Assessment Work in the Classroom.

    ERIC Educational Resources Information Center

    Schueler, Paul

    In 1991, the New Jersey Board of Higher Education's College Outcomes Evaluation Program (COEP) was canceled due to lack of state funding. Despite the cancellation, 17 community colleges formed the New Jersey County College Project on General Education to develop goals, objectives, and assessment criteria for general education. The Project grounds…

  19. Student Affairs Preparation Programs: A Competency Based Approach to Assessment and Outcomes

    ERIC Educational Resources Information Center

    Kuk, Linda; Banning, James

    2009-01-01

    The focus and purpose of master's degree student affairs preparation programs is to prepare students to become competent student affairs practitioners. Program assessments, especially those focused on outcomes are important metrics for understanding the role and impact of student affairs professional preparation programs. A well designed…

  20. A Qualitative Assessment of the Learning Outcomes of Teaching Introductory American Politics in Comparative Perspective

    ERIC Educational Resources Information Center

    Gelbman, Shamira M.

    2011-01-01

    This article discusses the findings of an ethnographic content analysis of students' written reflections as a means for assessing the learning outcomes of teaching introductory American politics in comparative perspective. It focuses especially on determining whether and how this approach enhanced students' understanding and retention of knowledge…

  1. What We Learned about Our Assessment Program that Has Nothing to Do with Student Learning Outcomes

    ERIC Educational Resources Information Center

    Cole, Alexandra; De Maio, Jennifer

    2009-01-01

    The various assessment methods available to Political Science Departments each have their pros and cons. Standardized tests may be seen as an efficient and a less labor-intensive way to collect data on student-learning outcomes (SLOs), but these lack contextual information. Exit interviews and works collected from capstone courses may provide…

  2. Functional Assessment of Problem Behaviors in Adults with Mental Retardation

    ERIC Educational Resources Information Center

    Paclawskyj, Theodosia R.; Kurtz, Patricia F.; O'Connor, Julia T.

    2004-01-01

    Functional assessment has significantly improved the success of behavioral treatment of problem behaviors in adults with mental retardation. Functional assessment methods (i.e., techniques that yield a hypothesis of functional relationships) include direct observation, interviews, and checklists. Functional analysis consists of empirical methods…

  3. Clinical and functional outcomes of acute lower extremity compartment syndrome at a Major Trauma Hospital

    PubMed Central

    Lollo, Loreto; Grabinsky, Andreas

    2016-01-01

    Background: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy. Methods: Retrospective chart analysis for patients with a discharge diagnosis of CS was performed. Physical demographics, employment status, activity at time of injury, injury severity score, fracture types, pain scores, hours to fasciotomy, iCP, serum creatine kinase levels, wound treatment regimen, length of hospital stay, and discharge facility were collected. Lower extremity neurologic examination, pain scores, orthopedic complications, and employment status at 30 days and 12 months after discharge were noted. Results: One hundred twenty-four patients were enrolled in this study. One hundred and eight patients were assessed at 12 months. Eighty-one percent were male. Motorized vehicles caused 51% of injuries in males. Forty-one percent of injuries were tibia fractures. Acute kidney injury occurred in 2.4%. Mean peak serum creatine kinase levels were 58,600 units/ml. Gauze dressing was used in 78.9% of nonfracture patients and negative pressure wound vacuum therapy in 78.2% of fracture patients. About 21.6% of patients with CS had prior surgery. Nearly 12.9% of patients required leg amputation. Around 81.8% of amputees were male. Sixty-seven percent of amputees had associated vascular injuries. Foot numbness occurred in 20.5% of patients and drop foot palsy in 18.2%. Osteomyelitis developed in 10.2% of patients and fracture nonunion in 6.8%. About 14.7% of patients

  4. Registry-based outcome assessment in haemophilia: a scoping study to explore the available evidence.

    PubMed

    Osooli, M; Berntorp, E

    2016-06-01

    Haemophilia is a congenital disorder with bleeding episodes as its primary symptom. These episodes can result in negative outcomes including joint damage, loss of active days due to hospitalization and reduced quality of life. Effective treatment, however, can improve the outcome. Registries have been used as a valuable source of information regarding the monitoring of treatment and outcome. The two main aims of this exploratory study were to establish which haemophilia registries publish peer-reviewed outcome assessment research and then to extract, classify and report the treatment outcomes and their extent of use in the retrieved registries. Using relevant keywords, we searched PubMed and Web of Science databases for publications during the period 1990-2015. Retrieved references were screened in a stepwise process. Eligible papers were original full articles on haemophilia outcomes that used data from a computerized patient database. Descriptive results were summarized. Of 2352 references reviewed, 25 full texts were eligible for inclusion in the study. These papers were published by 11 registries ranging from local to international in coverage. It is still relatively rare for registries to produce peer-reviewed publications about outcomes, and most that currently do produce such papers are located in Europe and North America. More information is available on traditional outcomes such as comorbidities and arthropathy than on health-related quality of life or the social and developmental impact of haemophilia on patients. Inhibitors, HIV and viral hepatitis are amongst the most commonly reported comorbidities. Research has focused more on factor consumption and less on hospitalization or time lost at school or work due to haemophilia. Haemophilia registries, especially those at the national level, are valuable resources for the delivery of effective health care to patients. Validated outcome measurement instruments are essential for the production of reliable and

  5. Mechanomyogram for Muscle Function Assessment: A Review

    PubMed Central

    Islam, Md. Anamul; Sundaraj, Kenneth; Ahmad, R. Badlishah; Ahamed, Nizam Uddin

    2013-01-01

    Background Mechanomyography (MMG) has been extensively applied in clinical and experimental practice to examine muscle characteristics including muscle function (MF), prosthesis and/or switch control, signal processing, physiological exercise, and medical rehabilitation. Despite several existing MMG studies of MF, there has not yet been a review of these. This study aimed to determine the current status on the use of MMG in measuring the conditions of MFs. Methodology/Principal Findings Five electronic databases were extensively searched for potentially eligible studies published between 2003 and 2012. Two authors independently assessed selected articles using an MS-Word based form created for this review. Several domains (name of muscle, study type, sensor type, subject's types, muscle contraction, measured parameters, frequency range, hardware and software, signal processing and statistical analysis, results, applications, authors' conclusions and recommendations for future work) were extracted for further analysis. From a total of 2184 citations 119 were selected for full-text evaluation and 36 studies of MFs were identified. The systematic results find sufficient evidence that MMG may be used for assessing muscle fatigue, strength, and balance. This review also provides reason to believe that MMG may be used to examine muscle actions during movements and for monitoring muscle activities under various types of exercise paradigms. Conclusions/Significance Overall judging from the increasing number of articles in recent years, this review reports sufficient evidence that MMG is increasingly being used in different aspects of MF. Thus, MMG may be applied as a useful tool to examine diverse conditions of muscle activity. However, the existing studies which examined MMG for MFs were confined to a small sample size of healthy population. Therefore, future work is needed to investigate MMG, in examining MFs between a sufficient number of healthy subjects and

  6. Does percutaneous nephrolithotomy and its outcomes have an impact on renal function? Quantitative analysis using SPECT-CT DMSA.

    PubMed

    Pérez-Fentes, Daniel; Cortés, Julia; Gude, Francisco; García, Camilo; Ruibal, Alvaro; Aguiar, Pablo

    2014-10-01

    To assess the functional effects of percutaneous nephrolithotomy (PCNL) and its outcomes in the operated kidney, we prospectively studied 30 consecutive cases undergoing PCNL. Kidney function was evaluated preoperatively and 3 months after surgery with serum creatinine, glomerular filtration rate (GFR), and with (99m)Tc-DMSA SPECT-CT scans to determine the differential renal function (DRF). PCNL effects in the operated kidney DRF were considered globally (DRFPLANAR, DRFSPECT) and in the region of percutaneous access (DRFACCESS). PCNL functional impact was also assessed depending on its outcomes, namely success (stone-free status) and the development of perioperative complications. PCNL has rendered 73 % of the cases completely stone free with a 33 % complication rate. After PCNL, serum creatinine and GFR did not change significantly, whereas DRFPLANAR and DRFSPECT dropped 1.2 % (p = 0.014) and 1.0 % (p = 0.041), respectively. The highest decrease was observed in DRFACCESS (1.8 %, p = 0.012). Stone-free status after PCNL did not show any impact on kidney function. Conversely, cases that suffered from a complication showed impairment in serum creatinine (0.1 mg/dL, p = 0.028), in GFR (11.1 mL/min, p = 0.036) as well as in DRFPLANAR (2.7 %, p = 0.018), DRFSPECT (2.2 %, p = 0.023) and DRFACCESS (2.7 %, p = 0.049). We conclude that PCNL has a minimal impact on global kidney function, which is mainly located in the region of percutaneous access. The advent of perioperative complications increased PCNL functional damage, whereas the stone-free status did not show any meaningful effect.

  7. Functional Outcomes After Double-Row Versus Single-Row Rotator Cuff Repair

    PubMed Central

    Nicholas, Stephen J.; Lee, Steven J.; Mullaney, Michael J.; Tyler, Timothy F.; Fukunaga, Takumi; Johnson, Christopher D.; McHugh, Malachy P.

    2016-01-01

    Background: The functional benefits of double-row (DR) versus single-row (SR) rotator cuff repair are not clearly established. Purpose: To examine the effect of DR versus SR rotator cuff repair on functional outcomes and strength recovery in patients with full-thickness tears. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Forty-nine patients were randomized to DR or SR repairs; 36 patients (13 women, 23 men; mean age, 62 ± 7 years; 20 SR, 16 DR) were assessed at a mean 2.2 ± 1.6 years after surgery (range, 1-7 years; tear size: 17 medium, 13 large, 9 massive). The following data were recorded prior to surgery and at follow-up: Penn shoulder score, American Shoulder and Elbow Surgeons (ASES), and Simple Shoulder Test (SST) results; range of motion (ROM) for shoulder flexion, external rotation (ER) at 0° and 90° of abduction, and internal rotation (IR) at 90° of abduction; and shoulder strength (Lafayette manual muscle tester) in empty- and full-can tests, abduction, and ER at 0° of abduction. Treatment (SR vs DR) × time (pre- vs postoperative) mixed-model analysis of variance was used to assess the effect of rotator cuff repair. Results: Rotator cuff repair markedly improved Penn, ASES, and SST scores (P < .001), with similar improvement between SR and DR repairs (treatment × time, P = .38-.10) and excellent scores at follow-up (DR vs SR: Penn, 91 ± 11 vs 92 ± 11 [P = .73]; ASES, 87 ± 12 vs 92 ± 12 [P = .21]; SST, 11.4 ± 1.0 vs 11.3 ± 1.0 [P = .76]). Patients with DR repairs lost ER ROM at 0° of abduction (preoperative to final follow-up, 7° ± 10° loss [P = .013]). ER ROM did not significantly change with SR repair (5° ± 14° gain, P = .16; treatment by time, P = .008). This effect was not apparent for ER ROM at 90° of abduction (treatment × time, P = .26). IR ROM improved from preoperative to final follow-up (P < .01; SR, 17° ± 27°; DR, 7° ± 21°; treatment × time, P = .23). Rotator cuff repair markedly

  8. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis.

    PubMed

    Sebio Garcia, Raquel; Yáñez Brage, Maria Isabel; Giménez Moolhuyzen, Esther; Granger, Catherine L; Denehy, Linda

    2016-09-01

    Lung cancer is the leading cause of cancer-related death worldwide. For early stages of the disease, lung resection surgery remains the best treatment with curative intent, but significant morbidity is associated, especially among patients with poor pulmonary function and cardiorespiratory fitness. In those cases, the implementation of a preoperative exercise-based intervention could optimize patient's functional status before surgery and improve postoperative outcomes and enhance recovery. The aim of this systematic review is to provide the current body of knowledge regarding the effectiveness of a preoperative exercise-based intervention on postoperative and functional outcomes in patients with lung cancer submitted to lung resection surgery. A systematic review of the literature using CINAHL, EMBASE, MEDLINE, Pubmed, PEDro and SCOPUS was undertaken in September 2015 yielding a total of 1656 references. Two independent reviewers performed the assessment of the potentially eligible records against the inclusion criteria and finally, 21 articles were included in the review. Articles were included if they examined the effects of an exercise-based intervention on at least one of the selected outcomes: pulmonary function, (functional) exercise capacity, health-related quality of life (HRQoL) and postoperative outcomes (length of stay and postoperative complications). Fourteen studies were further selected for a meta-analysis to quantify the mean effect of the intervention and generate 95% confidence intervals (CIs) using the Cochrane Review Manager 5.0.25. For two of the outcomes included (exercise capacity and HRQoL), studies showed large heterogeneity and thus, a meta-analysis was considered inappropriate. Pulmonary function (forced vital capacity and forced expiratory volume in 1 s) was significantly enhanced after the intervention [standardized mean difference (SMD) = 0.38; 95% CI 0.14, 0.63 and SMD = 0.27, 95% CI 0.11, 0.42, respectively]. In comparison with the

  9. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis.

    PubMed

    Sebio Garcia, Raquel; Yáñez Brage, Maria Isabel; Giménez Moolhuyzen, Esther; Granger, Catherine L; Denehy, Linda

    2016-09-01

    Lung cancer is the leading cause of cancer-related death worldwide. For early stages of the disease, lung resection surgery remains the best treatment with curative intent, but significant morbidity is associated, especially among patients with poor pulmonary function and cardiorespiratory fitness. In those cases, the implementation of a preoperative exercise-based intervention could optimize patient's functional status before surgery and improve postoperative outcomes and enhance recovery. The aim of this systematic review is to provide the current body of knowledge regarding the effectiveness of a preoperative exercise-based intervention on postoperative and functional outcomes in patients with lung cancer submitted to lung resection surgery. A systematic review of the literature using CINAHL, EMBASE, MEDLINE, Pubmed, PEDro and SCOPUS was undertaken in September 2015 yielding a total of 1656 references. Two independent reviewers performed the assessment of the potentially eligible records against the inclusion criteria and finally, 21 articles were included in the review. Articles were included if they examined the effects of an exercise-based intervention on at least one of the selected outcomes: pulmonary function, (functional) exercise capacity, health-related quality of life (HRQoL) and postoperative outcomes (length of stay and postoperative complications). Fourteen studies were further selected for a meta-analysis to quantify the mean effect of the intervention and generate 95% confidence intervals (CIs) using the Cochrane Review Manager 5.0.25. For two of the outcomes included (exercise capacity and HRQoL), studies showed large heterogeneity and thus, a meta-analysis was considered inappropriate. Pulmonary function (forced vital capacity and forced expiratory volume in 1 s) was significantly enhanced after the intervention [standardized mean difference (SMD) = 0.38; 95% CI 0.14, 0.63 and SMD = 0.27, 95% CI 0.11, 0.42, respectively]. In comparison with the

  10. A Meta-Analysis of Emotion Perception and Functional Outcomes in Schizophrenia

    PubMed Central

    Irani, Farzin; Seligman, Sarah; Kamath, Vidyulata; Kohler, Christian; Gur, Ruben C.

    2012-01-01

    Introduction Emotion perception (EP) is impaired in schizophrenia, is stable across clinical state, resistant to antipsychotic treatment and linked to symptom severity. Given its pervasive nature, there is a need to quantitatively examine whether this dysfunction impacts functional outcomes. We used a meta-analytic strategy to combine results from several studies and examine synthesized effect sizes. Methods A Meta-analysis Of Observational Studies in Epidemiology standard was used to extract data following a PubMed and PsychInfo search. Studies reporting correlations between measures of EP and functional outcomes in schizophrenia spectrum disorders were selected. The impact of potential methodological (task type), demographic (sex, age, race, education, marital status) and clinical (age of onset, duration of illness, setting, symptoms, anti-psychotic medication) moderators on effect sizes were examined. Results Twenty-five studies met inclusion criteria and included 1306 patients who were 37 years old, with 12 years of education, 64% male and 63% Caucasian. There was a significant relationship between EP and functional outcomes in individuals with schizophrenia or schizoaffective disorder, with effect sizes in the medium range. Medium to large range positive correlations were observed between emotion identification and functional outcome domains involving social problem solving, social skills and community functioning. Significant moderators included task type (emotion identification tasks), sex (% male in sample), race (% Caucasian in sample) and clinical symptoms (negative and positive). Conclusions Emotion identification deficits are associated with functional impairments in schizophrenia and moderated by sex, race and symptoms. This has implications for treatment efforts to improve outcomes. PMID:22341200

  11. Galectin-3, Renal Function, and Clinical Outcomes: Results from the LURIC and 4D Studies.

    PubMed

    Drechsler, Christiane; Delgado, Graciela; Wanner, Christoph; Blouin, Katja; Pilz, Stefan; Tomaschitz, Andreas; Kleber, Marcus E; Dressel, Alexander; Willmes, Christoph; Krane, Vera; Krämer, Bernhard K; März, Winfried; Ritz, Eberhard; van Gilst, Wiek H; van der Harst, Pim; de Boer, Rudolf A

    2015-09-01

    Galectin-3 has been linked to incident renal disease, experimental renal fibrosis, and nephropathy. However, the association among galectin-3, renal function, and adverse outcomes has not been described. We studied this association in two large cohorts of patients over a broad range of renal function. We measured galectin-3 concentrations in baseline samples from the German Diabetes mellitus Dialysis (4D) study (1168 dialysis patients with type 2 diabetes mellitus) and the Ludwigshafen Risk and Cardiovascular Health (LURIC) study (2579 patients with coronary angiograms). Patients were stratified into three groups: eGFR of ≥90 ml/min per 1.73 m(2), 60-89 ml/min per 1.73 m(2), and <60 ml/min per 1.73 m(2). We correlated galectin-3 concentrations with demographic, clinical, and biochemical parameters. The association of galectin-3 with clinical end points was assessed by Cox proportional hazards regression within 10 years (LURIC) or 4 years (4D) of follow-up. Mean±SD galectin-3 concentrations were 12.8±4.0 ng/ml (eGFR≥90 ml/min per 1.73 m(2)), 15.6±5.4 ng/ml (eGFR 60-89 ml/min per 1.73 m(2)), 23.1±9.9 ng/ml (eGFR<60 ml/min per 1.73 m(2)), and 54.1±19.6 ng/ml (dialysis patients of the 4D study). Galectin-3 concentration was significantly associated with clinical end points in participants with impaired kidney function, but not in participants with normal kidney function. Per SD increase in log-transformed galectin-3 concentration, the risks of all-cause mortality, cardiovascular mortality, and fatal infection increased significantly. In dialysis patients, galectin-3 was associated with the combined end point of cardiovascular events. In conclusion, galectin-3 concentrations increased with progressive renal impairment and independently associated with cardiovascular end points, infections, and all-cause death in patients with impaired renal function. PMID:25568176

  12. Functions, Targets, and Outcomes of Specific Forms of Social Aggression: A Daily Diary Study

    ERIC Educational Resources Information Center

    Dyches, Karmon D.; Mayeux, Lara

    2012-01-01

    The authors investigated 8 specific forms of social aggression (SA) in terms of the functions they serve, the characteristics of the peers targeted by them, and the outcomes associated with using the behaviors. Two hundred and seventeen fifth- and seventh-grade boys and girls completed a structured daily diary for 5 consecutive days in their…

  13. Functional Outcomes and Consumer Satisfaction in the Independent Living Program for Older Individuals Who Are Blind

    ERIC Educational Resources Information Center

    Moore, J. Elton; Steinman, Bernard A.; Giesen, J. Martin; Frank, John J.

    2006-01-01

    This study of a national sample of elders served by the Independent Living Program for Older Individuals Who Are Blind found that, overall, they were highly satisfied with the quality and timeliness of services and help in achieving independent living goals. A slight improvement was found in their perceptions of functional outcomes from 1999 to…

  14. Health, Functioning, and Participation of Adolescents and Adults with Cerebral Palsy: A Review of Outcomes Research

    ERIC Educational Resources Information Center

    Frisch, Dana; Msall, Michael E.

    2013-01-01

    With medical advances, more individuals with cerebral palsy (CP) syndromes who reside in developed countries are surviving to adolescence and adulthood. However, there continues to be a paucity of research examining long-term health, functional activities, and participatory outcomes over their life-course. This article reviews the current…

  15. Student and Teacher Outcomes of the Class-Wide Function-Related Intervention Team Efficacy Trial

    ERIC Educational Resources Information Center

    Wills, Howard; Kamps, Debra; Fleming, Kandace; Hansen, Blake

    2016-01-01

    Schools continue to strive for the use of evidenced-based interventions and policies to foster well-managed classrooms that promote improved student outcomes. The present study examined the effects of the Class-Wide Function-related Intervention Teams (CW-FIT), a group contingency intervention, on the on-task and disruptive behavior of elementary…

  16. Effects of a summer treatment program on functional sports outcomes in young children with ADHD

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Participation in youth sports can be very beneficial, but children with Attention Deficit Hyperactivity Disorder (ADHD) may participate less often and less successfully. The current study evaluated functional sports outcomes for children with ADHD who attended an intensive behavioral treatment that...

  17. Functional Outcome Analysis: A Good Heuristic That Went a Bridge Too Far.

    ERIC Educational Resources Information Center

    Barnett, David; Lentz, Francis E., Jr.

    1993-01-01

    Responds to previous article (Noell and Gresham, this issue) on Functional Outcome Analysis (FOA) as important construct for evaluation of consultation and prereferral interventions. Sees core question being utility of most prominent alternative service delivery model for school psychologists, that of prereferral interventions/problem-solving…

  18. Functional Outcomes of Child and Adolescent Oppositional Defiant Disorder Symptoms in Young Adult Men

    ERIC Educational Resources Information Center

    Burke, Jeffrey D.; Rowe, Richard; Boylan, Khrista

    2014-01-01

    Background: Oppositional defiant disorder (ODD) is considered to be a disorder of childhood, yet evidence suggests that prevalence rates of the disorder are stable into late adolescence and trajectories of symptoms persist into young adulthood. Functional outcomes associated with ODD through childhood and adolescence include conflict within…

  19. Does Surgical Management of the Hand in Children with Spastic Unilateral Cerebral Palsy Affect Functional Outcome?

    ERIC Educational Resources Information Center

    van Munster, Judith C.; Maathuis, Karel G. B.; Haga, Nienke; Verheij, Nienke P.; Nicolai, Jean-Philippe A.; Hadders-Algra, Mijna

    2007-01-01

    The aim of this review was to examine the literature on the effects of surgery of the spastic hand in children with cerebral palsy on functional outcome and muscle coordination. We performed a search of the relevant literature in Medline, Embase, and Biological Abstracts from 1966 to June 2006. The search resulted in eight studies on the effect of…

  20. Anterior Temporal Lobe Connectivity Correlates with Functional Outcome after Aphasic Stroke

    ERIC Educational Resources Information Center

    Warren, Jane E.; Crinion, Jennifer T.; Ralph, Matthew A. Lambon; Wise, Richard J. S.

    2009-01-01

    Focal brain lesions are assumed to produce language deficits by two basic mechanisms: local cortical dysfunction at the lesion site, and remote cortical dysfunction due to disruption of the transfer and integration of information between connected brain regions. However, functional imaging studies investigating language outcome after aphasic…

  1. Functional measures of stream impact assessment

    SciTech Connect

    Hill, B.H.

    1994-12-31

    The effects of elevated metals (primarily Zn) in a Rocky Mountain stream were assessed using measures of primary productivity, community respiration, and phosphatase activity. Primary productivity was measured as rates of mass and chlorophyll a accumulation on ceramic tiles, and as O{sub 2}, evolution from natural substrates incubated in situ in closed chambers. Community respiration was measured in situ by incubating fine-grained sediments, collected and composited along each stream study reach, in closed chambers and measuring O{sub 2} depletion. Alkaline and acid phosphatase activity were measured for periphyton scraped from ceramic tiles and natural substrates. Primary productivity, measured as chlorophyll accretion rates and O{sup 2} evolution, were depressed by increasing Zn concentrations. Productivity measured as mass accretion rates did not show significant Zn effects. Community respiration was depressed by increasing Zn concentrations, as was alkaline phosphatase activity. Acid phosphatase activity was higher at the more impacted sites. Overall, functional measures were able to discern those sites receiving greater metal impacts from less impacted sites.

  2. Programmatic assessment of a university-based implant training program using patient-reported outcomes.

    PubMed

    Al-Sabbagh, Mohanad; Jenkins, Diane W; de Leeuw, Reny; Nihill, Patricia; Robinson, Fonda G; Thomas, Mark V

    2014-11-01

    The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

  3. Understanding Cognitive Presence in an Online and Blended Community of Inquiry: Assessing Outcomes and Processes for Deep Approaches to Learning

    ERIC Educational Resources Information Center

    Akyol, Zehra; Garrison, D. Randy

    2011-01-01

    This paper focuses on deep and meaningful learning approaches and outcomes associated with online and blended communities of inquiry. Applying mixed methodology for the research design, the study used transcript analysis, learning outcomes, perceived learning, satisfaction, and interviews to assess learning processes and outcomes. The findings for…

  4. Defining, Valuing, and Teaching Clinical Outcomes Assessment in Professional and Post-Professional Athletic Training Education Programs

    ERIC Educational Resources Information Center

    Snyder, Alison R.; McLeod, Tamara C. Valovich; Sauers, Eric L.

    2007-01-01

    Objective: To provide a basic introduction for athletic training educators about the importance of clinical outcomes measures and to recommend strategies for implementing clinical outcomes assessment education in professional and post-professional athletic training education programs. Background: Outcomes is a frequently used term amongst…

  5. Functional Outcomes of the Surgery and Rehabilitation in a Challenging Case of Heterotopic Ossification after Encephalitis

    PubMed Central

    Ekiz, T; Aslan, M Doğan; Demir, S Özbudak; Altay, M; Özgirgin, N

    2015-01-01

    ABSTRACT Heterotopic ossification is the formation of the lamellar bone where normally osseous tissue does not exist. Since heterotopic ossification can cause severe functional loss, it is a challenging condition for both clinicians and patients. Neurogenic heterotopic ossification is a rare condition after encephalitis. Likewise, in this paper, we have presented a challenging case of heterotopic ossification after viral encephalitis and functional outcomes after the management of heterotopic ossification. PMID:26426185

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

    PubMed Central

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

    2015-01-01

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

  7. New Dental Accreditation Standard on Critical Thinking: A Call for Learning Models, Outcomes, Assessments.

    PubMed

    Johnsen, David C; Williams, John N; Baughman, Pauletta Gay; Roesch, Darren M; Feldman, Cecile A

    2015-10-01

    This opinion article applauds the recent introduction of a new dental accreditation standard addressing critical thinking and problem-solving, but expresses a need for additional means for dental schools to demonstrate they are meeting the new standard because articulated outcomes, learning models, and assessments of competence are still being developed. Validated, research-based learning models are needed to define reference points against which schools can design and assess the education they provide to their students. This article presents one possible learning model for this purpose and calls for national experts from within and outside dental education to develop models that will help schools define outcomes and assess performance in educating their students to become practitioners who are effective critical thinkers and problem-solvers.

  8. Assessing psychiatric rehabilitation service (PRS) outcomes in Israel: conceptual, professional and social issues.

    PubMed

    Roe, David; Gross, Raz; Kravetz, Shlomo; Baloush-Kleinman, Vered; Rudnick, Abraham

    2009-01-01

    Since the implementation of the legislation in Israel concerning rehabilitation of people with psychiatric disabilities in the community in 2001, an increasing number of individuals, currently estimated at nearly 15,000, have been receiving the psychiatric rehabilitation "basket of services." A systematic investigation of the extent to which these services have had a positive impact on the intended outcome is required, to evaluate the effectiveness of the newly developed psychiatric rehabilitation basket of services. This evaluation has become a priority item on the mental health agenda in Israel. This opinion paper, based on a conceptual analysis and selective review of the relevant literature, discusses concepts and principles that seem important for the development of strategies to constructively assess the outcome of psychiatric rehabilitation services (PRS) in Israel. More specifically, several fundamental issues related to outcome monitoring are reviewed, such as what outcome domains should be assessed, who should conduct the assessments and from whom should data be collected and with whom and how should it be shared. The complexity of these issues are reviewed and possible strategies to deal with them are discussed. PMID:19827693

  9. Interventions for postnatal depression assessing the mother–infant relationship and child developmental outcomes: a systematic review

    PubMed Central

    Tsivos, Zoe-Lydia; Calam, Rachel; Sanders, Matthew R; Wittkowski, Anja

    2015-01-01

    Postnatal depression (PND) has negative effects on maternal well-being as well as implications for the mother–infant relationship, subsequent infant development, and family functioning. There is growing evidence demonstrating that PND impacts on a mother’s ability to interact with sensitivity and responsiveness as a caregiver, which may have implications for the infant’s development of self-regulatory skills, making the infant more vulnerable to later psychopathology. Given the possible intergenerational transmission of risk to the infant, the mother–infant relationship is a focus for treatment and research. However, few studies have assessed the effect of treatment on the mother–infant relationship and child developmental outcomes. The main aim of this paper was to conduct a systematic review and investigate effect sizes of interventions for PND, which assess the quality of the mother–infant dyad relationship and/or child outcomes in addition to maternal mood. Nineteen studies were selected for review, and their methodological quality was evaluated, where possible, effect sizes across maternal mood, quality of dyadic relationship, and child developmental outcomes were calculated. Finally, clinical implications in the treatment of PND are highlighted and recommendations made for further research. PMID:25960678

  10. Longitudinal Cognitive and Neurobehavioral Functional Outcomes Before and After Repairing Otic Capsule Dehiscence

    PubMed Central

    Wackym, P. Ashley; Balaban, Carey D.; Mackay, Heather T.; Wood, Scott J.; Lundell, Christopher J.; Carter, Dale M.; Siker, David A.

    2016-01-01

    Objective: Patients with peripheral vestibular dysfunction because of gravitational receptor asymmetries display signs of cognitive dysfunction and are assumed to have neurobehavioral sequelae. This was tested with pre- and postoperatively quantitative measurements in three cohort groups with superior semicircular canal dehiscence syndrome (SSCDS) symptoms with: 1) superior canal dehiscence (SCD) repaired via a middle cranial fossa craniotomy and canal plugging only; 2) otic capsule defects not visualized with imaging (no-iOCD) repaired with round window reinforcement (RWR) only; or 3) both SCD plugging and subsequent development of no-iOCD followed by RWR. Study Design: Prospective patient series. Setting: Tertiary referral center. Patients: There were 13 adult and 4 pediatric patients with SSCDS who had completion of neuropsychology test batteries pre- and every 3 months postoperatively. Eight patients had no-iOCD and RWR exclusively, 5 had SCD and plugging exclusively, and 4 had both SCD plugging and then development of no-iOCD with RWR. These cohorts included SSCDS with 2 different dehiscence locations. Interventions: Completion of a neuropsychology test battery preoperatively and at 3, 6, 9, and 12 months postoperatively that included: Beck Depression Inventory-II (BDI); Wide Range Intelligence Test (WRIT FSIQ) including average verbal (crystallized intelligence) and visual (fluid intelligence); Wide Range Assessment of Memory and Learning (WRAML), including the four domains of verbal memory, visual memory, attention/concentration, and working memory; and Delis–Kaplan Executive Function System (D-KEFS). The Dizziness Handicap Inventory (DHI) and the Headache Impact Test (HIT-6) were also completed to assess the impact of their disease on activities pre- and postoperatively. Main Outcome Measures: Quantitative and statistical analysis of their cognitive and neurobehavioral function. Results: The pattern of differences between the SCD group and the no

  11. Gait analysis at multiple speeds reveals differential functional and structural outcomes in response to graded spinal cord injury.

    PubMed

    Krizsan-Agbas, Dora; Winter, Michelle K; Eggimann, Linda S; Meriwether, Judith; Berman, Nancy E; Smith, Peter G; McCarson, Kenneth E

    2014-05-01

    Open-field behavioral scoring is widely used to assess spinal cord injury (SCI) outcomes, but has limited usefulness in describing subtle changes important for posture and locomotion. Additional quantitative methods are needed to increase the resolution of locomotor outcome assessment. This study used gait analysis at multiple speeds (GAMS) across a range of mild-to-severe intensities of thoracic SCI in the rat. Overall, Basso, Beattie, and Bresnahan (BBB) scores and subscores were assessed, and detailed automated gait analysis was performed at three fixed walking speeds (3.5, 6.0, and 8.5 cm/sec). Variability in hindpaw brake, propel, and stance times were analyzed further by integrating across the stance phase of stepping cycles. Myelin staining of spinal cord sections was used to quantify white matter loss at the injury site. Varied SCI intensity produced graded deficits in BBB score, BBB subscores, and spinal cord white matter and total volume loss. GAMS measures of posture revealed decreased paw area, increased limb extension, altered stance width, and decreased values for integrated brake, propel, and stance. Measures of coordination revealed increased stride frequency concomitant with decreased stride length, resulting in deviation from consistent forelimb/hindlimb coordination. Alterations in posture and coordination were correlated to impact severity. GAMS results correlated highly with functional and histological measures and revealed differential relationships between sets of GAMS dynamics and cord total volume loss versus epicenter myelin loss. Automated gait analysis at multiple speeds is therefore a useful tool for quantifying nuanced changes in gait as an extension of histological and observational methods in assessing SCI outcomes.

  12. Progression free survival and functional outcome after surgical resection of intramedullary ependymomas.

    PubMed

    Abdullah, Kalil G; Lubelski, Daniel; Miller, Jacob; Steinmetz, Michael P; Shin, John H; Krishnaney, Ajit; Mroz, Thomas E; Benzel, Edward C

    2015-12-01

    We present a 15 year institutional analysis of the factors affecting progression free survival (PFS) and overall survival (OS) in patients undergoing attempted resection of adult intramedullary spinal cord ependymomas. Intramedullary spinal cord tumors are rare but important clinical entities, and ependymomas are the most commonly encountered intramedullary tumor. In total, 53 adult patients over the span of 15 years were analyzed for OS, PFS, and the effects of plane of dissection (POD) and gross total resection (GTR) on functional and long term outcomes. The mean age was 45 years and median follow-up was 54 months. The follow-up neurological outcome and modified McCormick scale were used to determine the functional outcome. Kaplan-Meier curves were used to calculate progression and survival. The overall ability to achieve GTR was significantly correlated to identification of an intraoperative POD (p<0.001). There was a trend towards increased PFS with the ability to achieve a GTR. There was no significant difference in the pre- and postoperative functional outcome scores. The ability to achieve a GTR is strongly correlated to the identification of a POD in ependymomas. There is a trend towards an increased probability of PFS in intramedullary spinal cord tumors when GTR is achieved. The resection of these tumors is likely to halt, but not reverse, neurological deterioration. PMID:26234635

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

    PubMed Central

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

    2014-01-01

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

  14. Consideration of the use of health status, functional outcome, and quality-of-life to monitor neonatal intensive care practice.

    PubMed

    Hack, M

    1999-01-01

    Measures of health status, functional abilities, and quality-of-life are being used increasingly to evaluate health care practice, and to measure outcomes from the patient's perspective. There is thus a need to reassess the use of growth and neurodevelopmental status that have traditionally been used as measures of outcome after neonatal intensive care. The quality of neonatal intensive care constitutes only one factor among many that determine the functional health and quality-of-life of survivors of neonatal intensive care. These include genetic disposition, intrauterine events, the effects of sociodemographic factors on the health and development of the child, and on the parents' assessment of their child's functioning. To obtain health status, functional and quality-of-life measures, parents need to act as proxy for the child during infancy and childhood. The parents' cultural, social, and educational background and the specific experience of the parent with children may influence their responses. Furthermore, their perspective may differ from that of the child. Measures that have been used or have the potential to measure health status, functioning, and quality-of-life include the National Health Interview Survey, the National Health Insurance Study, the Functional Status II, the Multi-Attribute Health System, the Functional Independence Measure for Children, the Vineland Adaptive Behavior Scales, the Adolescent Child Health and Illness Profile, and the Child Health Questionnaire for children, infants, and toddlers. Knowledge of the validity of the use of these measures among survivors of neonatal intensive care is, however, sparse. Studies have shown that the collection of a standard core of data from various national sources with specific criteria for defining severe disability at 2 years of age is feasible in Great Britain. However, questionnaires or available national databases provide global and epidemiologic information on outcomes rather than

  15. Assessment of murine lung mechanics outcome measures: alignment with those made in asthmatics

    PubMed Central

    Walker, Julia K. L.; Kraft, Monica; Fisher, John T.

    2013-01-01

    Although asthma is characterized as an inflammatory disease, recent reports highlight the importance of pulmonary physiology outcome measures to the clinical assessment of asthma control and risk of asthma exacerbation. Murine models of allergic inflammatory airway disease have been widely used to gain mechanistic insight into the pathogenesis of asthma; however, several aspects of murine models could benefit from improvement. This review focuses on aligning lung mechanics measures made in mice with those made in humans, with an eye toward improving the translational utility of these measures. A brief description of techniques available to measure murine lung mechanics is provided along with a methodological consideration of their utilization. How murine lung mechanics outcome measures relate to pulmonary physiology measures conducted in humans is discussed and we recommend that, like human studies, outcome measures be standardized for murine models of asthma. PMID:23408785

  16. Combining Costs and Benefits of Animal Activities to Assess Net Yield Outcomes in Apple Orchards.

    PubMed

    Saunders, Manu E; Luck, Gary W

    2016-01-01

    Diverse animal communities influence ecosystem function in agroecosystems through positive and negative plant-animal interactions. Yet, past research has largely failed to examine multiple interactions that can have opposing impacts on agricultural production in a given context. We collected data on arthropod communities and yield quality and quantity parameters (fruit set, yield loss and net outcomes) in three major apple-growing regions in south-eastern Australia. We quantified the net yield outcome (accounting for positive and negative interactions) of multiple animal activities (pollination, fruit damage, biological control) across the entire growing season on netted branches, which excluded vertebrate predators of arthropods, and open branches. Net outcome was calculated as the number of undamaged fruit at harvest as a proportion of the number of blossoms (i.e., potential fruit yield). Vertebrate exclusion resulted in lower levels of fruit set and higher levels of arthropod damage to apples, but did not affect net outcomes. Yield quality and quantity parameters (fruit set, yield loss, net outcomes) were not directly associated with arthropod functional groups. Model variance and significant differences between the ratio of pest to beneficial arthropods between regions indicated that complex relationships between environmental factors and multiple animal interactions have a combined effect on yield. Our results show that focusing on a single crop stage, species group or ecosystem function/service can overlook important complexity in ecological processes within the system. Accounting for this complexity and quantifying the net outcome of ecological interactions within the system, is more informative for research and management of biodiversity and ecosystem services in agricultural landscapes. PMID:27391022

  17. Combining Costs and Benefits of Animal Activities to Assess Net Yield Outcomes in Apple Orchards.

    PubMed

    Saunders, Manu E; Luck, Gary W

    2016-01-01

    Diverse animal communities influence ecosystem function in agroecosystems through positive and negative plant-animal interactions. Yet, past research has largely failed to examine multiple interactions that can have opposing impacts on agricultural production in a given context. We collected data on arthropod communities and yield quality and quantity parameters (fruit set, yield loss and net outcomes) in three major apple-growing regions in south-eastern Australia. We quantified the net yield outcome (accounting for positive and negative interactions) of multiple animal activities (pollination, fruit damage, biological control) across the entire growing season on netted branches, which excluded vertebrate predators of arthropods, and open branches. Net outcome was calculated as the number of undamaged fruit at harvest as a proportion of the number of blossoms (i.e., potential fruit yield). Vertebrate exclusion resulted in lower levels of fruit set and higher levels of arthropod damage to apples, but did not affect net outcomes. Yield quality and quantity parameters (fruit set, yield loss, net outcomes) were not directly associated with arthropod functional groups. Model variance and significant differences between the ratio of pest to beneficial arthropods between regions indicated that complex relationships between environmental factors and multiple animal interactions have a combined effect on yield. Our results show that focusing on a single crop stage, species group or ecosystem function/service can overlook important complexity in ecological processes within the system. Accounting for this complexity and quantifying the net outcome of ecological interactions within the system, is more informative for research and management of biodiversity and ecosystem services in agricultural landscapes.

  18. Combining Costs and Benefits of Animal Activities to Assess Net Yield Outcomes in Apple Orchards

    PubMed Central

    Luck, Gary W.

    2016-01-01

    Diverse animal communities influence ecosystem function in agroecosystems through positive and negative plant-animal interactions. Yet, past research has largely failed to examine multiple interactions that can have opposing impacts on agricultural production in a given context. We collected data on arthropod communities and yield quality and quantity parameters (fruit set, yield loss and net outcomes) in three major apple-growing regions in south-eastern Australia. We quantified the net yield outcome (accounting for positive and negative interactions) of multiple animal activities (pollination, fruit damage, biological control) across the entire growing season on netted branches, which excluded vertebrate predators of arthropods, and open branches. Net outcome was calculated as the number of undamaged fruit at harvest as a proportion of the number of blossoms (i.e., potential fruit yield). Vertebrate exclusion resulted in lower levels of fruit set and higher levels of arthropod damage to apples, but did not affect net outcomes. Yield quality and quantity parameters (fruit set, yield loss, net outcomes) were not directly associated with arthropod functional groups. Model variance and significant differences between the ratio of pest to beneficial arthropods between regions indicated that complex relationships between environmental factors and multiple animal interactions have a combined effect on yield. Our results show that focusing on a single crop stage, species group or ecosystem function/service can overlook important complexity in ecological processes within the system. Accounting for this complexity and quantifying the net outcome of ecological interactions within the system, is more informative for research and management of biodiversity and ecosystem services in agricultural landscapes. PMID:27391022

  19. Facial functional outcome in monitored versus not-monitored patients in vestibular schwannomas surgery

    PubMed Central

    Taddei, Graziano; Marrelli, Alfonso; Trovarelli, Donatella; Ricci, Alessandro; Galzio, Renato J.

    2016-01-01

    Objective: Even though advances in surgical techniques have improved facial nerve outcomes, functional preservation is still an issue because injury to the facial nerve has significant physical and psychological consequences for the patient. We retrospectively review our data in VS surgery to compare the facial outcome in intraoperative facial monitored versus not-monitored patients. Materials and Methods: 51 consecutive patients with unilateral vestibular schwannoma in the period from 2005 to 2010 were treated in our Institution. In according to the type of neurophysiological tool used during surgical procedures, two patients groups were identified: Group 1 (facial stimulator only) and Group 2 (stimulator and facial monitoring). Statistical comparison of the two groups was made with the t- test, and facial function results were evaluated with the Fisher's exact test. Results: In the Group 1, of the 22 patients with anatomically preserved facial nerves, 3 (13.6%) showed excellent facial nerve function, 14 (63.6%) showed intermediate function, and 5 (22.7%) showed poor function. In the Group 2, all the 27 patients got anatomically preserved facial nerves, and 18 (66.7%) showed excellent facial nerve function, 9 (33.3%) showed intermediate function, and no one showed poor function. Conclusions: We found that retrosigmoid approach associated with continuous EMG facial monitoring combined with the use of bipolar stimulation is a safe and effective treatment for vestibular schwannomas. PMID:27695545

  20. Facial functional outcome in monitored versus not-monitored patients in vestibular schwannomas surgery

    PubMed Central

    Taddei, Graziano; Marrelli, Alfonso; Trovarelli, Donatella; Ricci, Alessandro; Galzio, Renato J.

    2016-01-01

    Objective: Even though advances in surgical techniques have improved facial nerve outcomes, functional preservation is still an issue because injury to the facial nerve has significant physical and psychological consequences for the patient. We retrospectively review our data in VS surgery to compare the facial outcome in intraoperative facial monitored versus not-monitored patients. Materials and Methods: 51 consecutive patients with unilateral vestibular schwannoma in the period from 2005 to 2010 were treated in our Institution. In according to the type of neurophysiological tool used during surgical procedures, two patients groups were identified: Group 1 (facial stimulator only) and Group 2 (stimulator and facial monitoring). Statistical comparison of the two groups was made with the t- test, and facial function results were evaluated with the Fisher's exact test. Results: In the Group 1, of the 22 patients with anatomically preserved facial nerves, 3 (13.6%) showed excellent facial nerve function, 14 (63.6%) showed intermediate function, and 5 (22.7%) showed poor function. In the Group 2, all the 27 patients got anatomically preserved facial nerves, and 18 (66.7%) showed excellent facial nerve function, 9 (33.3%) showed intermediate function, and no one showed poor function. Conclusions: We found that retrosigmoid approach associated with continuous EMG facial monitoring combined with the use of bipolar stimulation is a safe and effective treatment for vestibular schwannomas.