Integrative Discovery Doing Science.

ERIC Educational Resources Information Center

Harry, Vickie; Belzer, William

1990-01-01

The article details a program in which gifted upper elementary grade students used videomicroscopy in a study of microscopic life in pond water. Each child produced a narrated videotape of a specific species studied. Program evaluation confirmed the motivational benefits of early opportunities with scientific instrumentation and methodology. (DB)

Technical Feasibility Aspects of the Geothermal Resource Reporting Methodology (GRRM)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Badgett, Alex; Young, Katherine R; Dobson, Patrick F.

This paper reviews the technical assessment of the Geothermal Research Reporting Methodology (GRRM, http://en.openei.org/wiki/GRRM) being developed for reporting geothermal resources and project progress. The goal of the methodology is to provide the U.S. Department of Energy's Geothermal Technologies Office (GTO) with a consistent and comprehensible means of evaluating the impacts of its funding programs. The GRRM is designed to provide uniform assessment criteria for geothermal resource grades and developmental phases of geothermal resource exploration and development. This resource grade system provides information on twelve attributes of geothermal resource locations (e.g., temperature, permeability, land access) to indicate potential for geothermal development.more » The GTO plans to use these Protocols to help quantitatively identify the greatest barriers to geothermal development, develop measureable program goals that will have the greatest impact to geothermal deployment, objectively evaluate proposals based (in part) on a project's ability to contribute to program goals, monitor project progress, and report on GTO portfolio performance. The GRRM assesses three areas of geothermal potential: geological, socio-economic, and technical. Previous work and publications have discussed the work done on the geological aspects of this methodology (Young et al. 2015c); this paper details the development of the technical assessment of the GRRM. Technical development attributes considered include: reservoir management, drilling, logistics, and power conversion.« less

[Medical treatment for the management of painful endometriosis without infertility: CNGOF-HAS Endometriosis Guidelines].

PubMed

Sauvan, M; Chabbert-Buffet, N; Canis, M; Collinet, P; Fritel, X; Geoffron, S; Legendre, G; Wattier, J-M; Fernandez, H

2018-03-01

To provide clinical practice guidelines for the management of painful endometriosis in women without infertility. Systematic review of the literature literature since 2006, level of evidence rating, external proofreading and grading of the recommendation grade by an expert group according to HAS methodology. Combined hormonal contraceptives (COP) and the levonorgestrel-releasing intra-uterin system (LNG-IUS) are recommended as first-line hormonal therapies for the treatment of painful endometriosis (grade B). Second-line therapy relies on oral desogestrel microprogestative, etonogestrel-releasing implant, GnRH analogs (GnRHa) and dienogest (grade C). It is recommended to use add-back therapy containing estrogen in association with GnRHa (grade B). After endometriosis surgery, hormonal treatment relying on COP or LNG-IUS is recommended to prevent pain recurrence (grade B). COP is recommended to reduce the risk of endometrioma recurrence after surgery (grade B) but the prescription of GnRHa is not recommended (grade C). Continuous COP is recommended in case of dysmenorrhea (grade B). GnRHa is not recommended as first line endometriosis treatment for adolescent girl because of the risk of bone demineralization (grade B). The management of endometriosis-induced chronic pain requires an interdisciplinary evaluation. Physical therapies improving the quality of life such as yoga, relaxation or osteopathy can be proposed (expert agreement). Promising medical alternatives are currently under preclinical and clinical evaluation. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death-Summary Report.

PubMed

Weiss, Matthew J; Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, Sonny; Sivarajan, V Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D

2017-11-01

Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory determination of death, 7) cardiac and innovative pediatric donation after circulatory determination of death, and 8) implementation. For brevity, 48 Good Practice Statement and truncated justification are included in this summary report. The remaining recommendations, detailed methodology, full Grading of Recommendations Assessment, Development, and Evaluation tables, and expanded justifications are available in the full text report. This process showed that rigorous, transparent clinical practice guideline development is possible in the domain of pediatric deceased donation. Application of these recommendations will increase access to pediatric donation after circulatory determination of death across Canada and may serve as a model for future clinical practice guideline development in deceased donation.

Investigation of the effects of graded models on the biomechanical behavior of a bone-dental implant system under osteoporotic conditions

PubMed Central

Li, Ying; Shuang Liu, Zhong; Ming Bai, Xiao; Zhang, Bin

2013-01-01

Objective: To investigate the effects of graded models on the biomechanical behavior of a bone-implant system under osteoporotic conditions. Methodology : A finite element model (FEM) of the jawbone segments with a titanium implant is used. Two types of models (a graded model and a non-graded model) are established. The graded model is established based on the graded variation of the elastic modulus of the cortical bone and the non-graded model is defined by homogeneous cortical bone. The vertical and oblique loads are adopted. The max von Mises stresses and the max displacements of the cortical bone are evaluated. Results: Comparing the two types of models, the difference in the maximum von Mises stresses of the cortical bone is more than 20%. The values of the maximum displacements in the graded models are considerably less than in the non-graded models. Conclusions: These results indicate the significance of taking into account the actual graded properties of the cortical bone so that the biomechanical behavior of the bone-implant system can be analyzed accurately. PMID:24353590

Investigation of the effects of graded models on the biomechanical behavior of a bone-dental implant system under osteoporotic conditions.

PubMed

Li, Ying; Shuang Liu, Zhong; Ming Bai, Xiao; Zhang, Bin

2013-04-01

To investigate the effects of graded models on the biomechanical behavior of a bone-implant system under osteoporotic conditions. Methodology : A finite element model (FEM) of the jawbone segments with a titanium implant is used. Two types of models (a graded model and a non-graded model) are established. The graded model is established based on the graded variation of the elastic modulus of the cortical bone and the non-graded model is defined by homogeneous cortical bone. The vertical and oblique loads are adopted. The max von Mises stresses and the max displacements of the cortical bone are evaluated. Comparing the two types of models, the difference in the maximum von Mises stresses of the cortical bone is more than 20%. The values of the maximum displacements in the graded models are considerably less than in the non-graded models. These results indicate the significance of taking into account the actual graded properties of the cortical bone so that the biomechanical behavior of the bone-implant system can be analyzed accurately.

Assessing the Accuracy of Generalized Inferences From Comparison Group Studies Using a Within-Study Comparison Approach: The Methodology.

PubMed

Jaciw, Andrew P

2016-06-01

Various studies have examined bias in impact estimates from comparison group studies (CGSs) of job training programs, and in education, where results are benchmarked against experimental results. Such within-study comparison (WSC) approaches investigate levels of bias in CGS-based impact estimates, as well as the success of various design and analytic strategies for reducing bias. This article reviews past literature and summarizes conditions under which CGSs replicate experimental benchmark results. It extends the framework to, and develops the methodology for, situations where results from CGSs are generalized to untreated inference populations. Past research is summarized; methods are developed to examine bias in program impact estimates based on cross-site comparisons in a multisite trial that are evaluated against site-specific experimental benchmarks. Students in Grades K-3 in 79 schools in Tennessee; students in Grades 4-8 in 82 schools in Alabama. Grades K-3 Stanford Achievement Test (SAT) in reading and math scores; Grades 4-8 SAT10 reading scores. Past studies show that bias in CGS-based estimates can be limited through strong design, with local matching, and appropriate analysis involving pretest covariates and variables that represent selection processes. Extension of the methodology to investigate accuracy of generalized estimates from CGSs shows bias from confounders and effect moderators. CGS results, when extrapolated to untreated inference populations, may be biased due to variation in outcomes and impact. Accounting for effects of confounders or moderators may reduce bias. © The Author(s) 2016.

The Relevancy of Large-Scale, Quantitative Methodologies in Middle Grades Education Research

ERIC Educational Resources Information Center

Mertens, Steven B.

2006-01-01

This article examines the relevancy of large-scale, quantitative methodologies in middle grades education research. Based on recommendations from national advocacy organizations, the need for more large-scale, quantitative research, combined with the application of more rigorous methodologies, is presented. Subsequent sections describe and discuss…

Evaluating Sound Field Amplification Technology in New Brunswick Schools

ERIC Educational Resources Information Center

Rubin, Rhonda; Aquino-Russell, Catherine; Flagg-Williams, Joan

2007-01-01

(Purpose) The purpose of this study was to investigate the effects of classroom sound field amplification on communication in kindergarten through grade 3 classrooms. (Methodology) Sixty classrooms were involved in the study; half of the classrooms were provided with sound field amplification. The flow of communication was measured through…

Evaluation of a New Grading System for Clinical Skills in Dental Student Clinics.

PubMed

Bodenmann, Aurel D; Bühler, Julia M; Amato, Mauro; Weiger, Ronald; Zitzmann, Nicola U

2017-05-01

Several evaluation systems for clinical exams have been suggested over the years, but no systematic analysis of checklists or criteria-based exam forms has yet been undertaken. The aims of this study were to analyze criteria-based evaluation forms and to identify areas in the teaching process potentially requiring improvements. All evaluation forms introduced in 2012 at the Clinic for Periodontology, Endodontology, and Cariology at the University Center of Dental Medicine in Basel, Switzerland, and applied over a three-year period (n=1,093 in 2015) were analyzed using predefined criteria. The authors investigated how well clinical tasks were examined with the given criteria and which criteria were preferably evaluated with a grading system (0-2) or a yes/no choice. The average final grades ranged from 0.89 (n=92) for gold inlay preparation to 1.76 (n=46) for periodontal treatment. Comments were made in 38.5% (n=356) of all exams, mainly highlighting specific aspects of existing criteria. Overall, 13 criteria out of 66 should be checked instead of graded. This methodological analysis of exam forms assessing tasks in operative dentistry yielded valuable information on areas with potential for improvement in the dental curriculum and the evaluation process. Aspects that require more theoretical background and/or hands-on recommendations from experienced clinicians were identified, and ways of further refining and redesigning the evaluation forms were proposed.

Manufacturing. Evaluation Report from a Limited School Trial of a Teaching Unit of the High School Geography Project.

ERIC Educational Resources Information Center

Bogatz, Gerry Ann

The methodology used in the evaluation of this unit is the same as that described in SO 000 433. The same seventy teachers were involved along with 2,400 seventh through twelfth grade students. There were nine activities in this unit: 1) Geographic Patterns of Manufacturing in the United States; 2) Definition of Manufacturing; 3) and 4)…

The Minnesota Grading System Using Fundus Autofluorescence of Eye Bank Eyes: A Correlation To Age-Related Macular Degeneration (An AOS Thesis)

PubMed Central

Olsen, Timothy W.

2008-01-01

Purpose To establish a grading system of eye bank eyes using fundus autofluorescence (FAF) and identify a methodology that correlates FAF to age-related macular degeneration (AMD) with clinical correlation to the Age-Related Eye Disease Study (AREDS). Methods Two hundred sixty-two eye bank eyes were evaluated using a standardized analysis of FAF. Measurements were taken with the confocal scanning laser ophthalmoscope (cSLO). First, high-resolution, digital, stereoscopic, color images were obtained and graded according to AREDS criteria. With the neurosensory retina removed, mean FAF values were obtained from cSLO images using software analysis that excludes areas of atrophy and other artifact, generating an FAF value from a grading template. Age and AMD grade were compared to FAF values. An internal fluorescence reference standard was tested. Results Standardization of the cSLO machine demonstrated that reliable data could be acquired after a 1-hour warm-up. Images obtained prior to 1 hour had falsely elevated levels of FAF. In this initial analysis, there was no statistical correlation of age to mean FAF. There was a statistically significant decrease in FAF from AREDS grade 1, 2 to 3, 4 (P < .0001). An internal fluorescent standard may serve as a quantitative reference. Conclusions The Minnesota Grading System (MGS) of FAF (MGS-FAF) establishes a standardized methodology for grading eye bank tissue to quantify FAF compounds in the retinal pigment epithelium and correlate these findings to the AREDS. Future studies could then correlate specific FAF to the aging process, histopathology AMD phenotypes, and other maculopathies, as well as to analyze the biochemistry of autofluorescent fluorophores. PMID:19277247

The Minnesota Grading System using fundus autofluorescence of eye bank eyes: a correlation to age-related macular degeneration (an AOS thesis).

PubMed

Olsen, Timothy W

2008-01-01

To establish a grading system of eye bank eyes using fundus autofluorescence (FAF) and identify a methodology that correlates FAF to age-related macular degeneration (AMD) with clinical correlation to the Age-Related Eye Disease Study (AREDS). Two hundred sixty-two eye bank eyes were evaluated using a standardized analysis of FAF. Measurements were taken with the confocal scanning laser ophthalmoscope (cSLO). First, high-resolution, digital, stereoscopic, color images were obtained and graded according to AREDS criteria. With the neurosensory retina removed, mean FAF values were obtained from cSLO images using software analysis that excludes areas of atrophy and other artifact, generating an FAF value from a grading template. Age and AMD grade were compared to FAF values. An internal fluorescence reference standard was tested. Standardization of the cSLO machine demonstrated that reliable data could be acquired after a 1-hour warm-up. Images obtained prior to 1 hour had falsely elevated levels of FAF. In this initial analysis, there was no statistical correlation of age to mean FAF. There was a statistically significant decrease in FAF from AREDS grade 1, 2 to 3, 4 (P < .0001). An internal fluorescent standard may serve as a quantitative reference. The Minnesota Grading System (MGS) of FAF (MGS-FAF) establishes a standardized methodology for grading eye bank tissue to quantify FAF compounds in the retinal pigment epithelium and correlate these findings to the AREDS. Future studies could then correlate specific FAF to the aging process, histopathology AMD phenotypes, and other maculopathies, as well as to analyze the biochemistry of autofluorescent fluorophores.

Stress-Prevention in Secondary Schools: Online- versus Face-to-Face-Training

ERIC Educational Resources Information Center

Fridrici, Mirko; Lohaus, Arnold

2009-01-01

Purpose: The purpose of this paper is to focus on the evaluation of an internet-delivered stress-prevention program for adolescents as a possible alternative for school-based implementation of mental health promotion. Design/methodology/approach: A total of 904 adolescents in grades eight and nine were assigned to four treatment conditions…

Evidence-based interventions in pediatric psychology: progress over the decades.

PubMed

Palermo, Tonya M

2014-09-01

This introduction to the special issue on Evidence-Based Interventions in Pediatric Psychology provides background on the process used to develop the special issue, a summary of the key findings from the series of reviews, and discussion of the implications for evidence-based practice. Authors followed a three-phase approach to develop their systematic reviews using rigorous systematic review methodology drawn heavily from the Cochrane Collaboration. The strength of the evidence for each pediatric psychology intervention was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The introduction discusses the progress that has been made in the evidence base for pediatric psychology interventions since the first special series published in 1999. Recommendations to stimulate further research and expand and strengthen the quality of the evidence base are described. The introduction concludes with implications from the special issue for pediatric psychology training in evidence-based practice. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The impact of leading empowered organisations (LEO) on leadership development in nursing.

PubMed

Hancock, Helen; Campbell, Steve; Bignell, Pat; Kilgour, Julie

2005-01-01

This study sought to evaluate the impact and sustainability of the Leading Empowered Organisations (LEO) programme on the role of G Grade Nurse Managers, their colleagues and therefore on patient care at CHS. A qualitative, inductive research methodology, which employed 360-degree research evaluation, was used. A purposive sample of four G Grade Nurse Managers was included. Each G Grade and eight of each of their colleagues were interviewed. Data were analysed according to the principles of thematic analysis. There was evidence of a sustained impact of the LEO programme on G Grade Nurse Managers in relation to competence, action plans, delegation, communication strategies, problem solving, risk taking, leadership and management. The study also revealed a number of significant personal and contextual factors that affected the implementation of the LEO principles. Empowerment, or a lack of it, underpinned much of what occurred in the implementation of the LEO principles by the G Grades into practice. The findings indicated that both organisational and individual action is necessary to achieve leadership development. Organisations need to ensure that investment in leadership is not restricted to the LEO programme, but that it becomes a strategic priority.

Exploratory Factor Analysis and Multisection Validation by Correlation of Student Self-Reported Attitudes of Teacher Effectiveness with Student Achievement as Measured by Achievement Tests for Middle School Students

ERIC Educational Resources Information Center

Weber, David M.

2013-01-01

This study investigated the use of a student evaluation of teaching survey designed by a suburban school district. Several statistical methodologies were used to evaluate the validity and reliability of the instrument. One hundred sections of grades 6-8 reading and mathematics courses were used to examine the research question: Is the Student…

Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death—Summary Report*

PubMed Central

Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, ; Sonny; Sivarajan, V. Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A.; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D.

2017-01-01

Objectives: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. Methods: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature. Input from these sources drove drafting of actionable questions and Good Practice Statements, as defined by the Grading of Recommendations Assessment, Development, and Evaluation group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using Grading of Recommendations Assessment, Development, and Evaluation and then formulated into evidence profiles that informed recommendations through the evidence-to-decision framework. Recommendations were revised through consensus among members of seven topic-specific working groups and finalized during meetings of working group leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies and patient partners. Results: We generated 63 Good Practice Statements and seven Grading of Recommendations Assessment, Development, and Evaluation recommendations covering 1) ethics, consent, and withdrawal of life-sustaining therapy, 2) eligibility, 3) withdrawal of life-sustaining therapy practices, 4) ante and postmortem interventions, 5) death determination, 6) neonatal pediatric donation after circulatory determination of death, 7) cardiac and innovative pediatric donation after circulatory determination of death, and 8) implementation. For brevity, 48 Good Practice Statement and truncated justification are included in this summary report. The remaining recommendations, detailed methodology, full Grading of Recommendations Assessment, Development, and Evaluation tables, and expanded justifications are available in the full text report. Conclusions: This process showed that rigorous, transparent clinical practice guideline development is possible in the domain of pediatric deceased donation. Application of these recommendations will increase access to pediatric donation after circulatory determination of death across Canada and may serve as a model for future clinical practice guideline development in deceased donation. PMID:28925929

Classification and grading of muscle injuries: a narrative review

PubMed Central

Hamilton, Bruce; Valle, Xavier; Rodas, Gil; Til, Luis; Grive, Ricard Pruna; Rincon, Josep Antoni Gutierrez; Tol, Johannes L

2015-01-01

A limitation to the accurate study of muscle injuries and their management has been the lack of a uniform approach to the categorisation and grading of muscle injuries. The goal of this narrative review was to provide a framework from which to understand the historical progression of the classification and grading of muscle injuries. We reviewed the classification and grading of muscle injuries in the literature to critically illustrate the strengths, weaknesses, contradictions or controversies. A retrospective, citation-based methodology was applied to search for English language literature which evaluated or utilised a novel muscle classification or grading system. While there is an abundance of literature classifying and grading muscle injuries, it is predominantly expert opinion, and there remains little evidence relating any of the clinical or radiological features to an established pathology or clinical outcome. While the categorical grading of injury severity may have been a reasonable solution to a clinical challenge identified in the middle of the 20th century, it is time to recognise the complexity of the injury, cease trying to oversimplify it and to develop appropriately powered research projects to answer important questions. PMID:25394420

The GRADE approach is reproducible in assessing the quality of evidence of quantitative evidence syntheses.

PubMed

Mustafa, Reem A; Santesso, Nancy; Brozek, Jan; Akl, Elie A; Walter, Stephen D; Norman, Geoff; Kulasegaram, Mahan; Christensen, Robin; Guyatt, Gordon H; Falck-Ytter, Yngve; Chang, Stephanie; Murad, Mohammad Hassan; Vist, Gunn E; Lasserson, Toby; Gartlehner, Gerald; Shukla, Vijay; Sun, Xin; Whittington, Craig; Post, Piet N; Lang, Eddy; Thaler, Kylie; Kunnamo, Ilkka; Alenius, Heidi; Meerpohl, Joerg J; Alba, Ana C; Nevis, Immaculate F; Gentles, Stephen; Ethier, Marie-Chantal; Carrasco-Labra, Alonso; Khatib, Rasha; Nesrallah, Gihad; Kroft, Jamie; Selk, Amanda; Brignardello-Petersen, Romina; Schünemann, Holger J

2013-07-01

We evaluated the inter-rater reliability (IRR) of assessing the quality of evidence (QoE) using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. On completing two training exercises, participants worked independently as individual raters to assess the QoE of 16 outcomes. After recording their initial impression using a global rating, raters graded the QoE following the GRADE approach. Subsequently, randomly paired raters submitted a consensus rating. The IRR without using the GRADE approach for two individual raters was 0.31 (95% confidence interval [95% CI] = 0.21-0.42) among Health Research Methodology students (n = 10) and 0.27 (95% CI = 0.19-0.37) among the GRADE working group members (n = 15). The corresponding IRR of the GRADE approach in assessing the QoE was significantly higher, that is, 0.66 (95% CI = 0.56-0.75) and 0.72 (95% CI = 0.61-0.79), respectively. The IRR further increased for three (0.80 [95% CI = 0.73-0.86] and 0.74 [95% CI = 0.65-0.81]) or four raters (0.84 [95% CI = 0.78-0.89] and 0.79 [95% CI = 0.71-0.85]). The IRR did not improve when QoE was assessed through a consensus rating. Our findings suggest that trained individuals using the GRADE approach improves reliability in comparison to intuitive judgments about the QoE and that two individual raters can reliably assess the QoE using the GRADE system. Copyright © 2013 Elsevier Inc. All rights reserved.

A Literacy Exercise: An Extracurricular Reading Program as an Intervention to Enrich Student Reading Habits in Qatar

ERIC Educational Resources Information Center

Nasser, Ramzi

2013-01-01

This paper evaluates an extracurricular reading activity in Qatari schools. The paper presents a two-month extracurricular reading program designed for fourth grade students. The methodology used triangulation of the data to analyze, in detail, the students' primary perceptions towards reading, teacher self-efficacy, teacher instructional behavior…

Methodological Aspects of Evaluation in Primary Reading.

ERIC Educational Resources Information Center

Henry, G.; Grisay, A.

This paper develops a model for generating sets of replicable items for testing a range of reading skills in the primary grades. The procedure is particularly concerned with tests to identify a child's profile in reading achievement and to inform a teacher, principal, or district of the actual level of achievement in reading. Although the model is…

GRADE: Assessing the quality of evidence in environmental and occupational health.

PubMed

Morgan, Rebecca L; Thayer, Kristina A; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A; Rehfuess, Eva A; Rooney, Andrew A; Shea, Beverley; Silbergeld, Ellen K; Sutton, Patrice; Wolfe, Mary S; Woodruff, Tracey J; Verbeek, Jos H; Holloway, Alison C; Santesso, Nancy; Schünemann, Holger J

2016-01-01

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are to provide an overview of GRADE, discuss GRADE's applicability to environmental health, and identify priority areas for method assessment and development. Copyright © 2016 Elsevier Ltd. All rights reserved.

San Joaquin, California, High-Speed Rail Grade Crossing Data Acquisition Characteristics, Methodology, and Risk Assessment

DOT National Transportation Integrated Search

2006-11-01

This report discusses data acquisition and analysis for grade crossing risk analysis at the proposed San Joaquin High-Speed Rail Corridor in San Joaquin, California, and documents the data acquisition and analysis methodologies used to collect and an...

Senior GRADE methodologists encounter challenges as part of WHO guideline development panels: an inductive content analysis.

PubMed

Alexander, Paul E; Li, Shelly-Anne; Gionfriddo, Michael R; Stoltzfus, Rebecca J; Neumann, Ignacio; Brito, Juan P; Djulbegovic, Benjamin; Montori, Victor M; Schünemann, Holger J; Guyatt, Gordon H

2016-02-01

The World Health Organization (WHO) classifies a substantial proportion of their recommendations as strong despite low or very low confidence (certainty) in estimates of effect. Such discordant recommendations are often inconsistent with Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance. To gain the perspective of senior WHO methodology chairs regarding panels' use of GRADE, particularly regarding discordant recommendations. Senior active GRADE methodologists who had served on at least two WHO panels and were an author on at least one peer-reviewed published article on GRADE methodology. Five eligible methodologists participated in detailed semistructured interviews. Respondents answered questions regarding how they were viewed by other panelists and WHO leadership, and how they handled situations when panelists made discordant recommendations they felt were inappropriate. They also provided information on how the process can be improved. Interviews were recorded and transcribed, and inductive content analysis was used to derive codes, categories, and emergent themes. Three themes emerged from the interviews of five methodologists: (1) The perceived role of methodologists in the process, (2) Contributors to discordant recommendations, and (3) Strategies for improvement. Salient findings included (1) a perceived tension between methodologists and WHO panels as a result of panel members' resistance to adhering to GRADE guidance; (2) both financial and nonfinancial conflicts of interest among panel members as an explanation for discordant recommendations; and (3) the need for greater clarity of, and support for, the role of methodologists as co-chairs of panels. These findings suggest that the role of the GRADE methodologist as a co-chair needs to be clarified by the WHO leadership. They further suggest the need for additional training for panelists, quality monitoring, and feedback to ensure optimal use of GRADE in guideline development at WHO. Copyright © 2016 Elsevier Inc. All rights reserved.

The evaluation of reflective learning from the nursing student's point of view: A mixed method approach.

PubMed

Fernández-Peña, Rosario; Fuentes-Pumarola, Concepció; Malagón-Aguilera, M Carme; Bonmatí-Tomàs, Anna; Bosch-Farré, Cristina; Ballester-Ferrando, David

2016-09-01

Adapting university programmes to European Higher Education Area criteria has required substantial changes in curricula and teaching methodologies. Reflective learning (RL) has attracted growing interest and occupies an important place in the scientific literature on theoretical and methodological aspects of university instruction. However, fewer studies have focused on evaluating the RL methodology from the point of view of nursing students. To assess nursing students' perceptions of the usefulness and challenges of RL methodology. Mixed method design, using a cross-sectional questionnaire and focus group discussion. The research was conducted via self-reported reflective learning questionnaire complemented by focus group discussion. Students provided a positive overall evaluation of RL, highlighting the method's capacity to help them better understand themselves, engage in self-reflection about the learning process, optimize their strengths and discover additional training needs, along with searching for continuous improvement. Nonetheless, RL does not help them as much to plan their learning or identify areas of weakness or needed improvement in knowledge, skills and attitudes. Among the difficulties or challenges, students reported low motivation and lack of familiarity with this type of learning, along with concerns about the privacy of their reflective journals and about the grading criteria. In general, students evaluated RL positively. The results suggest areas of needed improvement related to unfamiliarity with the methodology, ethical aspects of developing a reflective journal and the need for clear evaluation criteria. Copyright © 2016 Elsevier Ltd. All rights reserved.

GRADE: Assessing the quality of evidence in environmental and occupational health

PubMed Central

Morgan, Rebecca L; Thayer, Kristina A; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A.; Rehfuess, Eva A; Rooney, Andrew A; Shea, Beverley; Silbergeld, Ellen K; Sutton, Patrice; Wolfe, Mary; Woodruff, Tracey J; Verbeek, Jos H; Holloway, Alison C.; Santesso, Nancy; Schünemann, Holger J

2016-01-01

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modelling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are to provide an overview of GRADE, discuss GRADE’s applicability to environmental health, and identify priority areas for method assessment and development. PMID:26827182

Methodology for Knowledge Synthesis of the Management of Vaccination Pain and Needle Fear.

PubMed

Taddio, Anna; McMurtry, C Meghan; Shah, Vibhuti; Yoon, Eugene W; Uleryk, Elizabeth; Pillai Riddell, Rebecca; Lang, Eddy; Chambers, Christine T; Noel, Melanie; MacDonald, Noni E

2015-10-01

A knowledge synthesis was undertaken to inform the development of a revised and expanded clinical practice guideline about managing vaccination pain in children to include the management of pain across the lifespan and the management of fear in individuals with high levels of needle fear. This manuscript describes the methodological details of the knowledge synthesis and presents the list of included clinical questions, critical and important outcomes, search strategy, and search strategy results. The Grading of Assessments, Recommendations, Development and Evaluation (GRADE) and Cochrane methodologies provided the general framework. The project team voted on clinical questions for inclusion and critically important and important outcomes. A broad search strategy was used to identify relevant randomized-controlled trials and quasi-randomized-controlled trials. Quality of research evidence was assessed using the Cochrane risk of bias tool and quality across studies was assessed using GRADE. Multiple measures of the same construct within studies (eg, observer-rated and parent-rated infant distress) were combined before pooling. The standardized mean difference and 95% confidence intervals (CI) or relative risk and 95% CI was used to express the effects of an intervention. Altogether, 55 clinical questions were selected for inclusion in the knowledge synthesis; 49 pertained to pain management during vaccine injections and 6 pertained to fear management in individuals with high levels of needle fear. Pain, fear, and distress were typically prioritized as critically important outcomes across clinical questions. The search strategy identified 136 relevant studies. This manuscript describes the methodological details of a knowledge synthesis about pain management during vaccination and fear management in individuals with high levels of needle fear. Subsequent manuscripts in this series will present the results for the included questions.

The Necessity of Company-Grade Air Defense Artillery Officers in the Air Defense and Airspace Management Cells Within the Brigade Combat Team

DTIC Science & Technology

2014-06-13

the role of ADAM Cell OIC. Utilizing the Army design methodology, the study compares the current training and performance of Air Defense officers to...junior company-grade officers to fulfill the role of ADAM Cell OIC. Utilizing the Army design methodology, the study compares the current training...Page Figure 1. Army design methodology ...............................................................................34 Figure 2. The cross-walk

Department of Defense Dependents Schools Comprehensive Social Studies Program Evaluation, Spring, 1980. Summary Report.

ERIC Educational Resources Information Center

National Evaluation Systems, Inc., Amherst, MA.

The methodology and results of an assessment designed to determine the status of educational quality in grades 4, 8, and 11 social studies programs of the Department of Defense Dependents Schools (DODDS) is summarized. The assessment was part of the DODDS five-year curriculum development cycle comprised of the following phases: (1) development of…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anthony, R.W.; Bodig, J.; Phillips, G.E.

This report describes the development of a nondestructive evaluation (NDE) methodology for assessing the bending strength of new wood utility poles. Fundamental concepts of stress wave propagation are presented. The development of a longitudinal stress wave methodology for predicting pole strength and the results of destructive tests on full-size poles are described. Mathematical correlations between stress wave parameters, geometric characteristics, and individual pole bending strengths form the basis of strength prediction models for western redcedar, Douglas-fir and southern pine poles. Models were developed for NDE in the whitewood stage and after preservative treatment of poles. For each species the twomore » most commonly used preservative types were evaluated. Excellent correlations were obtained for western redcedar and Douglas-fir poles, but high moisture content in the southern pine poles resulted in lower prediction accuracies for this species. Verification of the developed mathematical models demonstrates that improvement in classifying poles into the ANSI 05.1 tip-load capacities is technically feasible. The development and field trial of the prototype equipment for strength grading of new poles is also described. Research results can be used to benefit utilities by enabling the supply of strength graded poles with a higher accuracy than previously possible.« less

Nature-assisted therapy: systematic review of controlled and observational studies.

PubMed

Annerstedt, Matilda; Währborg, Peter

2011-06-01

Nature's potentially positive effect on human health may serve as an important public health intervention. While several scientific studies have been performed on the subject, no systematic review of existing evidence has until date been established. This article is a systematic evaluation of available scientific evidence for nature-assisted therapy (NAT). With the design of a systematic review relevant data sources were scrutinised to retrieve studies meeting predefined inclusion criteria. The methodological quality of studies and abstracted data were assessed for intervention studies on NAT for a defined disease. The final inclusion of a study was decided by the authors together. The included studies were heterogeneous for participant characteristics, intervention type, and methodological quality. Three meta-analyses, six studies of high evidence grade (four reporting significant improvement), and 29 studies of low to moderate evidence grade (26 reporting health improvements) were included. For the studies with high evidence grade, the results were generally positive, though somewhat ambiguous. Among the studies of moderate to low evidence grade, health improvements were reported in 26 cases out of 29. This review gives at hand that a rather small but reliable evidence base supports the effectiveness and appropriateness of NAT as a relevant resource for public health. Significant improvements were found for varied outcomes in diverse diagnoses, spanning from obesity to schizophrenia. Recommendations for specific areas of future research of the subject are provided.

The effectiveness of scoliosis screening programs: methods for systematic review and expert panel recommendations formulation

PubMed Central

2013-01-01

Background Literature on scoliosis screening is vast, however because of the observational nature of available data and methodological flaws, data interpretation is often complex, leading to incomplete and sometimes, somewhat misleading conclusions. The need to propose a set of methods for critical appraisal of the literature about scoliosis screening, a comprehensive summary and rating of the available evidence appeared essential. Methods To address these gaps, the study aims were: i) To propose a framework for the assessment of published studies on scoliosis screening effectiveness; ii) To suggest specific questions to be answered on screening effectiveness instead of trying to reach a global position for or against the programs; iii) To contextualize the knowledge through expert panel consultation and meaningful recommendations. The general methodological approach proceeds through the following steps: Elaboration of the conceptual framework; Formulation of the review questions; Identification of the criteria for the review; Selection of the studies; Critical assessment of the studies; Results synthesis; Formulation and grading of recommendations in response to the questions. This plan follows at best GRADE Group (Grades of Recommendation, Assessment, Development and Evaluation) requirements for systematic reviews, assessing quality of evidence and grading the strength of recommendations. Conclusions In this article, the methods developed in support of this work are presented since they may be of some interest for similar reviews in scoliosis and orthopaedic fields. PMID:23883346

Evaluation of color grading impact in restoration process of archive films

NASA Astrophysics Data System (ADS)

Fliegel, Karel; Vítek, Stanislav; Páta, Petr; Janout, Petr; Myslík, Jiří; Pecák, Josef; Jícha, Marek

2016-09-01

Color grading of archive films is a very particular task in the process of their restoration. The ultimate goal of color grading here is to achieve the same look of the movie as intended at the time of its first presentation. The role of the expert restorer, expert group and a digital colorist in this complicated process is to find the optimal settings of the digital color grading system so that the resulting image look is as close as possible to the estimate of the original reference release print adjusted by the expert group of cinematographers. A methodology for subjective assessment of perceived differences between the outcomes of color grading is introduced, and results of a subjective study are presented. Techniques for objective assessment of perceived differences are discussed, and their performance is evaluated using ground truth obtained from the subjective experiment. In particular, a solution based on calibrated digital single-lens reflex camera and subsequent analysis of image features captured from the projection screen is described. The system based on our previous work is further developed so that it can be used for the analysis of projected images. It allows assessing color differences in these images and predict their impact on the perceived difference in image look.

Risk of fatigue in cancer patients receiving anti-EGFR monoclonal antibodies: results from a systematic review and meta-analysis of randomized controlled trial.

PubMed

Zhu, Jianhong; Zhao, Wenxia; Liang, Dan; Li, Guocheng; Qiu, Kaifeng; Wu, Junyan; Li, Jianfang

2018-04-01

To evaluate the association between fatigue and anti-epidermal growth factor receptor monoclonal antibodies (anti-EGFR MAbs), we conducted the first meta-analysis to access the incidence and risk of fatigue associated with anti-EGFR MAbs. Electronic databases were searched for randomized controlled trials (RCTs) published up to February 2017. Eligible studies were selected according to PRISMA statement. Incidence rates, risk ratio (RRs), and 95% confidence intervals (CIs) were calculated using fixed-effects or random-effects models. Outcomes of quality were summarized in accordance with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. Thirty-five RCTs (including 15,622 patients) were included; median follow-up ranged from 8.1 to 71.4 months, and the fatigue events were recorded and graded according to the Common Toxicity Criteria for Adverse Events version 2.0 or 3.0 in most of the included trials. For patients receiving anti-EGFR MAbs, the overall incidence of all-grade and high-grade fatigue was 54.1% and 10.5%, respectively. Compared with control, anti-EGFR MAbs significantly increased the risk of all-grade fatigue (RR 1.10, 95% CI, 1.05-1.14, moderate-quality evidence) and high-grade fatigue (RR 1.31, 95% CI, 1.19-1.45, moderate-quality evidence). No significant differences among subgroup analyses (anti-EGFR MAbs, tumor type, and median follow-up) on high-grade fatigue were observed. No evidence of publication bias was observed. The present study suggested that anti-EGFR MAbs may increase the risk of fatigue in cancer patients.

The Minnesota Grading System of eye bank eyes for age-related macular degeneration.

PubMed

Olsen, Timothy W; Feng, Xiao

2004-12-01

The Minnesota Grading System (MGS) is a method to evaluate human eye bank eyes and determine the level of age-related macular degeneration (AMD), by using criteria and definitions from the Age-Related Eye Disease Study (AREDS). Donor eyes (108 pairs) from the Minnesota Lions Eye Bank were cut circumferentially at the pars plana to remove the anterior segment. A 1000 +/- 2.5-microm ruby sphere was placed on the optic nerve as a size reference. A digital, high-resolution, color macular photograph was taken through a dissecting microscope. The neurosensory retina was removed from one globe of the pair. The underlying retinal pigment epithelium was rephotographed, localizing the fovea with a proportional triangle. A grid was superimposed in the macular photographs and images were graded according to AREDS criteria. Twenty pairs were dissected bilaterally and graded for symmetry. Eighty-eight globes were graded into one of four MGS categories. Nineteen (95%) of 20 globes had symmetric grades. The MGS provides a methodology to grade donor tissue from eye bank eyes to correspond to the AREDS classification system. Donor tissue may be used for subsequent molecular analysis, including genomics and proteomics.

Bayesian methodology incorporating expert judgment for ranking countermeasure effectiveness under uncertainty: example applied to at grade railroad crossings in Korea.

PubMed

Washington, Simon; Oh, Jutaek

2006-03-01

Transportation professionals are sometimes required to make difficult transportation safety investment decisions in the face of uncertainty. In particular, an engineer may be expected to choose among an array of technologies and/or countermeasures to remediate perceived safety problems when: (1) little information is known about the countermeasure effects on safety; (2) information is known but from different regions, states, or countries where a direct generalization may not be appropriate; (3) where the technologies and/or countermeasures are relatively untested, or (4) where costs prohibit the full and careful testing of each of the candidate countermeasures via before-after studies. The importance of an informed and well-considered decision based on the best possible engineering knowledge and information is imperative due to the potential impact on the numbers of human injuries and deaths that may result from these investments. This paper describes the formalization and application of a methodology to evaluate the safety benefit of countermeasures in the face of uncertainty. To illustrate the methodology, 18 countermeasures for improving safety of at grade railroad crossings (AGRXs) in the Republic of Korea are considered. Akin to "stated preference" methods in travel survey research, the methodology applies random selection and laws of large numbers to derive accident modification factor (AMF) densities from expert opinions. In a full Bayesian analysis framework, the collective opinions in the form of AMF densities (data likelihood) are combined with prior knowledge (AMF density priors) for the 18 countermeasures to obtain 'best' estimates of AMFs (AMF posterior credible intervals). The countermeasures are then compared and recommended based on the largest safety returns with minimum risk (uncertainty). To the author's knowledge the complete methodology is new and has not previously been applied or reported in the literature. The results demonstrate that the methodology is able to discern anticipated safety benefit differences across candidate countermeasures. For the 18 at grade railroad crossings considered in this analysis, it was found that the top three performing countermeasures for reducing crashes are in-vehicle warning systems, obstacle detection systems, and constant warning time systems.

Integrating the 6+1 Writing Traits Model with Cross-Age Tutoring: An Investigation of Elementary Students' Writing Development

ERIC Educational Resources Information Center

Paquette, Kelli R.

2009-01-01

A mixed methodological approach was used to examine the effect of a cross-age tutoring writing program among second- and fourth-grade students in a rural elementary school in Delaware. Pre-test and post-test writing prompts were administered and evaluated using the 6+1 traits writing assessment rubric. Students were assessed qualitatively through…

Chinese herbal medicine for the treatment of primary hypertension: a methodology overview of systematic reviews.

PubMed

Xinke, Zhao; Yingdong, Li; Mingxia, Feng; Kai, Liu; Kaibing, Chen; Yuqing, Lu; Shaobo, Sun; Peng, Song; Bin, Liu

2016-10-20

Chinese herbal medicine has been used to treat hypertension in China and East Asia since centuries. In this study, we conduct an overview of systematic reviews of Chinese herbal medicine in the treatment of primary hypertension to 1) summarize the conclusions of these reviews, 2) evaluate the methodological quality of these reviews, and 3) rate the confidence in the effect on each outcome. We comprehensively searched six databases to retrieve systematic reviews of Chinese herbal medicine for primary hypertension from inception to December 31, 2015. We used AMSTAR to evaluate the methodological quality of included reviews, and we classified the quality of evidence for each outcome in included reviews using the GRADE approach. A total of 12 systematic reviews with 31 outcomes were included, among which 11 systematic reviews focus on the therapeutic effect of Chinese herbal medicine combined with conventional medicine or simple Chinese herbal medicine versus simple conventional medicine. Among the 11 items of AMSTAR, the lowest quality was "providing a priori design" item, none review conformed to this item, the next was "stating the conflict of interest" item, only three reviews conformed to this item. Five reviews scored less than seven in AMSTAR, which means that the overall methodological quality was fairly poor. For GRADE, of the 31 outcomes, the quality of evidence was high in none (0 %), moderate in three (10 %), low in 19 (61 %), and very low in nine (29 %). Of the five downgrading factors, risk of bias (100 %) was the most common downgrading factor in the included reviews, followed by imprecision (42 %), inconsistency (39 %), publication bias (39 %), and indirectness (0 %). The methodological quality of systematic reviews about Chinese herbal medicine for primary hypertension is fairly poor, and the quality of evidence level is low. Physicians should be cautious when applying the interventions in these reviews for primary hypertension patients in clinical practice.

A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews

PubMed Central

Jin, Ying-Hui; Wang, Guo-Hao; Sun, Yi-Rong; Li, Qi; Zhao, Chen; Li, Ge; Si, Jin-Hua; Li, Yan; Lu, Cui; Shang, Hong-Cai

2016-01-01

Objective To assess the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing (TCMN) interventions in Chinese journals. These interventions include acupressure, massage, Tai Chi, Qi Gong, electroacupuncture and use of Chinese herbal medicines—for example, in enemas, foot massage and compressing the umbilicus. Design A systematic literature search for systematic reviews and meta-analyses of TCMN interventions was performed. Review characteristics were extracted. The methodological quality and the quality of the evidence were evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. Result We included 20 systematic reviews and meta-analyses, and a total of 11 TCMN interventions were assessed in the 20 reviews. The compliance with AMSTAR checklist items ranged from 4.5 to 8 and systematic reviews/meta-analyses were, on average, of medium methodological quality. The quality of the evidence we assessed ranged from very low to moderate; no high-quality evidence was found. The top two causes for downrating confidence in effect estimates among the 31 bodies of evidence assessed were the risk of bias and inconsistency. Conclusions There is room for improvement in the methodological quality of systematic reviews/meta-analyses of TCMN interventions published in Chinese journals. Greater efforts should be devoted to ensuring a more comprehensive search strategy, clearer specification of the interventions of interest in the eligibility criteria and identification of meaningful outcomes for clinicians and patients (consumers). The overall quality of evidence among reviews remains suboptimal, which raise concerns about their roles in influencing clinical practice. Thus, the conclusions in reviews we assessed must be treated with caution and their roles in influencing clinical practice should be limited. A critical appraisal of systematic reviews/meta-analyses of TCMN interventions is particularly important to provide sound guidance for TCMN. PMID:28186925

Relationship between Active Learning Methodologies and Community College Students' STEM Course Grades

ERIC Educational Resources Information Center

Lesk, Cherish Christina Clark

2017-01-01

Active learning methodologies (ALM) are associated with student success, but little research on this topic has been pursued at the community college level. At a local community college, students in science, technology, engineering, and math (STEM) courses exhibited lower than average grades. The purpose of this study was to examine whether the use…

Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K): Third Grade Methodology Report. NCES 2005-018

ERIC Educational Resources Information Center

Tourangeau, Karen; Brick, Mike; Byrne, Lauren; Le, Thanh; Nord, Christine; West, Jerry; Hausken, Elvira Germino

2005-01-01

This methodology report provides technical information about the development, design, and conduct of the third grade data collection of the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K). Detailed information on the development of the instruments, sample design, data collection methods, data preparation and editing,…

Quantifying expert diagnosis variability when grading tumor-infiltrating lymphocytes

NASA Astrophysics Data System (ADS)

Toro, Paula; Corredor, Germán.; Wang, Xiangxue; Arias, Viviana; Velcheti, Vamsidhar; Madabhushi, Anant; Romero, Eduardo

2017-11-01

Tumor-infiltrating lymphocytes (TILs) have proved to play an important role in predicting prognosis, survival, and response to treatment in patients with a variety of solid tumors. Unfortunately, currently, there are not a standardized methodology to quantify the infiltration grade. The aim of this work is to evaluate variability among the reports of TILs given by a group of pathologists who examined a set of digitized Non-Small Cell Lung Cancer samples (n=60). 28 pathologists answered a different number of histopathological images. The agreement among pathologists was evaluated by computing the Kappa index coefficient and the standard deviation of their estimations. Furthermore, TILs reports were correlated with patient's prognosis and survival using the Pearson's correlation coefficient. General results show that the agreement among experts grading TILs in the dataset is low since Kappa values remain below 0.4 and the standard deviation values demonstrate that in none of the images there was a full consensus. Finally, the correlation coefficient for each pathologist also reveals a low association between the pathologists' predictions and the prognosis/survival data. Results suggest the need of defining standardized, objective, and effective strategies to evaluate TILs, so they could be used as a biomarker in the daily routine.

Lessons Learned With Laparoscopic Management of Complicated Grades of Acute Appendicitis

PubMed Central

Gomes, Carlos Augusto; Junior, Cleber Soares; Costa, Evandro de Freitas Campos; Alves, Paula de Assis Pereira; de Faria, Carolina Vieira; Cangussu, Igor Vitoi; Costa, Luisa Pires; Gomes, Camila Couto; Gomes, Felipe Couto

2014-01-01

Background Laparoscopy has not been consolidated as the approach of first choice in the management of complicated appendicitis. Methodological flaws and absence of disease stratification criteria have been implicated in that less evidence. The objective is to study the safe and effectiveness of laparoscopy in the management of complicated appendicitis according to laparoscopic grading system. Method From January 2008 to January 2011, 154 consecutive patients who underwent a laparoscopic appendectomy for complicated appendicitis were evaluated in the prospective way. The patient’s age ranged from 12 to 75 years old (31.7 ± 13.3) and 58.3% were male. Complicated appendicitis refers to gangrenous and/or perforated appendix and were graded as 3A (segmental necrosis), 3B (base necrosis), 4A (abscess), 4B (regional peritonitis) and 5 (diffuse peritonitis). The outcomes including operative time, infection complication, operative complications and conversion rate were chosen to evaluate the procedure. Results The grade 3A was the most frequent with 50 (32.4%) patients. The mean operative time was 69.4 ± 26.3 minutes. The grade 4A showed the highest mean operative time (80.1 ± 26.7 minutes). The wound and intra-abdominal infection rates were 2.6 and 4.6%, respectively. The base necrosis was the most important factor associated with the conversion (5.2%). The grades 4A and 5 were associated with greater possibility of intra-abdominal collection. There were no operative complications. Conclusion The laparoscopic management of all complicated grades of acute appendicitis is safe and effective and should be the procedure of first choice. The laparoscopic grading system allows us to assess patients in the same disease stage. PMID:24883151

Cyst fluid telomerase activity predicts the histologic grade of cystic neoplasms of the pancreas

PubMed Central

Hata, Tatsuo; Molin, Marco Dal; Suenaga, Masaya; Yu, Jun; Pittman, Meredith; Weiss, Matthew; Canto, Marcia I.; Wolfgang, Christopher; Lennon, Anne Marie; Hruban, Ralph H; Goggins, Michael

2016-01-01

Purpose Pancreatic cysts frequently pose clinical dilemmas. On one hand, cysts with high-grade dysplasia offer opportunities for cure, on the other hand, those with low-grade dysplasia are easily over treated. Cyst fluid markers have the potential to improve the evaluation of these cysts. Since telomerase activity is commonly activated in malignant cells, we evaluated the diagnostic performance of cyst fluid telomerase activity measurements for predicting histologic grade. Experimental design Telomerase activity was measured using telomerase repeat amplification with digital-droplet PCR in surgically-aspirated cyst fluid samples from 219 patients who underwent pancreatic resection for a cystic lesion (184, discovery, 35 validation) and 36 patients who underwent endoscopic ultrasound fine needle aspiration. Methodological and clinical factors associated with telomerase activity were examined. Results Telomerase activity was reduced in samples that had undergone prior thawing. Among 119 samples not previously thawed, surgical cyst fluids from cystic neoplasms with high-grade dysplasia +/− associated invasive cancer had higher telomerase activity (median [interquartile range], 1158 [295.9–13033] copies/μL of cyst fluid than those without (19.74 [2.58–233.6] copies/μL) (P < 0.001). Elevated cyst fluid telomerase activity had a diagnostic accuracy for invasive cancer/high-grade dysplasia of 88.1% (discovery), 88.6% (validation), and 88.2% (merged). Among cysts classified preoperatively as having “worrisome features”, cyst fluid telomerase activity had high diagnostic performance (sensitivity 73.7%, specificity 90.6%, accuracy, 86.1%). In multivariate analysis, telomerase activity independently predicted the presence of invasive cancer/high-grade dysplasia. Conclusion Cyst fluid telomerase activity can be a useful predictor of the neoplastic grade of pancreatic cysts. PMID:27230749

Can business and economics students perform elementary arithmetic?

PubMed

Standing, Lionel G; Sproule, Robert A; Leung, Ambrose

2006-04-01

Business and economics majors (N=146) were tested on the D'Amore Test of Elementary Arithmetic, which employs third-grade test items from 1932. Only 40% of the subjects passed the test by answering 10 out of 10 items correctly. Self-predicted scores were a good predictor of actual scores, but performance was not associated with demographic variables, grades in calculus courses, liking for science or computers, or mathematics anxiety. Scores decreased over the subjects' initial years on campus. The hardest test item, with an error rate of 23%, required the subject to evaluate (36 x 7) + (33 x 7). The results are similar to those of Standing in 2006, despite methodological changes intended to maximize performance.

Speech and language interventions for infants aged 0 to 2 years at high risk for cerebral palsy: a systematic review

PubMed Central

Chorna, Olena; Hamm, Ellyn; Cummings, Caitlin; Fetters, Ashley; Maitre, Nathalie L

2017-01-01

Aim We evaluated the level of evidence of speech, language, and communication interventions for infants at high-risk for, or with a diagnosis of, cerebral palsy (CP) from 0 to 2 years old. Method We performed a systematic review of relevant terms. Articles were evaluated based on the level of methodological quality and evidence according to A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. Results The search terms provided 17 publications consisting of speech or language interventions. There were no interventions in the high level of evidence category. The overall level of evidence was very low. Promising interventions included Responsivity and Prelinguistic Milieu Teaching and other parent–infant transaction frameworks. Interpretation There are few evidence-based interventions addressing speech, language, and communication needs of infants and toddlers at high risk for CP, and none for infants diagnosed with CP. Recommendation guidelines include parent–infant transaction programs. PMID:27897320

Automatic grading of appearance retention of carpets using intensity and range images

NASA Astrophysics Data System (ADS)

Orjuela Vargas, Sergio Alejandro; Ortiz-Jaramillo, Benhur; Vansteenkiste, Ewout; Rooms, Filip; De Meulemeester, Simon; de Keyser, Robain; Van Langenhove, Lieva; Philips, Wilfried

2012-04-01

Textiles are mainly used for decoration and protection. In both cases, their original appearance and its retention are important factors for customers. Therefore, evaluation of appearance parameters are critical for quality assurance purposes, during and after manufacturing, to determine the lifetime and/or beauty of textile products. In particular, appearance retention of textile products is commonly certified with grades, which are currently assigned by human experts. However, manufacturers would prefer a more objective system. We present an objective system for grading appearance retention, particularly, for textile floor coverings. Changes in appearance are quantified by using linear regression models on texture features extracted from intensity and range images. Range images are obtained by our own laser scanner, reconstructing the carpet surface using two methods that have been previously presented. We extract texture features using a variant of the local binary pattern technique based on detecting those patterns whose frequencies are related to the appearance retention grades. We test models for eight types of carpets. Results show that the proposed approach describes the degree of wear with a precision within the range allowed to human inspectors by international standards. The methodology followed in this experiment has been designed to be general for evaluating global deviation of texture in other types of textiles, as well as other surface materials.

Optimizing Caffeine Use and Risk of Bronchopulmonary Dysplasia in Preterm Infants: A Systematic Review, Meta-analysis, and Application of Grading of Recommendations Assessment, Development, and Evaluation Methodology.

PubMed

Pakvasa, Mitali Atul; Saroha, Vivek; Patel, Ravi Mangal

2018-06-01

Caffeine reduces the risk of bronchopulmonary dysplasia (BPD). Optimizing caffeine use could increase therapeutic benefit. We performed a systematic-review and random-effects meta-analysis of studies comparing different timing of initiation and dose of caffeine on the risk of BPD. Earlier initiation, compared to later, was associated with a decreased risk of BPD (5 observational studies; n = 63,049, adjusted OR 0.69; 95% CI 0.64-0.75, GRADE: low quality). High-dose caffeine, compared to standard-dose, was associated with a decreased risk of BPD (3 randomized trials, n = 432, OR 0.65; 95% CI 0.43-0.97; GRADE: low quality). Higher quality evidence is needed to guide optimal caffeine use. Copyright © 2018 Elsevier Inc. All rights reserved.

Using GRADE as a framework to guide research on the sexual and reproductive health and rights (SRHR) of women living with HIV - methodological opportunities and challenges.

PubMed

Siegfried, Nandi; Narasimhan, Manjulaa; Kennedy, Caitlin E; Welbourn, Alice; Yuvraj, Anandi

2017-09-01

In March 2016, WHO reviewed evidence to develop global recommendations on the sexual and reproductive health and rights (SRHR) of women living with HIV. Systematic reviews and a global survey of women living with HIV informed the guideline development decision-making process. New recommendations covered abortion, Caesarean section, safe disclosure, and empowerment and self-efficacy interventions. Identification of key research gaps is part of the WHO guidelines development process, but consistent methods to do so are lacking. Our method aimed to ensure consistency and comprised the systematic application of a framework based on GRADE (Grading of Recommendations, Assessment, Development and Evaluation) to the process. The framework incorporates the strength and quality rating of recommendations and the priorities reported by women in the survey to inform research prioritisation. For each gap, we also articulated: (1) the most appropriate and robust study design to answer the question; (2) alternative pragmatic designs if the ideal design is not feasible; and (3) the methodological challenges facing researchers through identifying potential biases. We found 12 research gaps and identified five appropriate study designs to address the related questions: (1) Cross-sectional surveys; (2) Qualitative interview-driven studies; (3) Registries; (4) Randomised controlled trials; and (5) Medical record audit. Methodological challenges included selection, recruitment, misclassification, measurement and contextual biases, and confounding. In conclusion, a framework based on GRADE can provide a systematic approach to identifying research gaps from a WHO guideline. Incorporation of the priorities of women living with HIV into the framework systematically ensures that women living with HIV can shape future policy decisions affecting their lives. Implementation science and participatory research are appropriate over-arching approaches to enhance uptake of interventions and to ensure inclusion of women living with HIV at all stages of the research process.

Summary of the Committee to Advise on Tropical Medicine and Travel (CATMAT) Statement on Travellers’ Diarrhea

PubMed Central

Libman, M

2015-01-01

Background Most travellers’ diarrhea (TD) infections occur during travel to low- and middle-income countries. Type of travel, duration of stay, age of traveller and presence of certain medical conditions are important factors to consider for risk of TD. The Committee to Advise on Tropical Medicine and Travel (CATMAT) assembled a TD working group to develop recommendations on prevention and treatment of TD in travellers. This document is a summary of the Statement on Travellers’ Diarrhea. Methods Following a systematic review of the literature, recommendations on the prevention and treatment of TD were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to evaluate data quality, benefits and harms of the intervention, and values and preferences of the traveller. Other recommendations were based on a review of the literature and expert opinion. Recommendations Using the GRADE methodology, CATMAT concluded that oral cholera vaccine should not be routinely recommended to prevent TD in Canadian travellers. This recommendation was based on moderate quality data that showed this vaccine was not effective in preventing TD in travellers compared to placebo. Bismuth subsalicylate (BSS), fluoroquinolones or rifaximin are options for the prevention of TD based on high-quality data for BSS and fluoroquinolones and moderate evidence for rifaximin. For the treatment of TD, loperamide (alone or in combination with antibiotics), fluoroquinolones, azithromycin and rifaximin are all options, with varying degrees of data quality. Based on available evidence and expert opinion, CATMAT recommends handwashing or the use of hand sanitizer, as well as prudent choice and preparation of food and beverages as best practices for preventing diarrhea while travelling. At this time, a recommendation cannot be made for either the use of probiotics and prebiotics to prevent TD or the use of BSS to treat TD due to insufficient available evidence. Conclusion With the exception of BSS for prevention of TD (strong recommendation for use), CATMAT conditionally recommends the use of each of the other GRADE-evaluated preventive and therapeutic products assessed in this Statement. These CATMAT recommendations should be considered as options in the prevention and treatment of TD based on the particular situation of the traveller. PMID:29769922

The efficacy of Jianpi Yiqi therapy for chronic atrophic gastritis: A systematic review and meta-analysis

PubMed Central

Dai, Yun-kai; Zhang, Yun-zhan; Li, Dan-yan; Ye, Jin-tong; Zeng, Ling-feng; Wang, Qi; Hu, Ling

2017-01-01

Jianpi Yiqi therapy (JYT) is a classical therapy in treating chronic atrophic gastritis (CAG), but the clinical effects of it are still contentious. The purpose of this article is to evaluate the efficacy and safety of JYT for CAG. Seven electronic databases including PubMed, Embase, Springer Link, CNKI (China National Knowledge Infrastructure), VIP (Chinese Scientific Journals Database), Wan-fang database, and CBM (Chinese Biomedicine Database) were searched from their inception to November 1, 2016. 13 randomized controlled trials (RCTs) with a total of 1119 participants were identified for analysis. Meta-analyses demonstrated that both JYT (RR 1.41; 95% CI 1.27, 1.57; P < 0.00001) and JYT + western medicine (RR 1.27; 95% CI 1.17, 1.38; P < 0.00001) were more efficacious than only western medicine. Furthermore, JYT had potential improvement on traditional Chinese medicine (TCM) symptoms scores such as stomachache, stomach distention, belching, fatigue, et al. In addition, no serious adverse events were reported in the selected trials. The Cochrane Collaboration’s risk of bias tool was evaluated for the weaknesses of methodological quality, while the quality level of Grades of Recommendations Assessment Development and Evaluation (GRADE) evidence classification indicated “Very low”. This meta-analysis indicates that JYT may have potential effects on the treatment of patients with CAG. However, due to limitations of methodological quality and small sample size of the included studies, further standardized research of rigorous design should be needed. PMID:28738092

Tracheotomy in the intensive care unit: Guidelines from a French expert panel: The French Intensive Care Society and the French Society of Anaesthesia and Intensive Care Medicine.

PubMed

Trouillet, Jean-Louis; Collange, Olivier; Belafia, Fouad; Blot, François; Capellier, Gilles; Cesareo, Eric; Constantin, Jean-Michel; Demoule, Alexandre; Diehl, Jean-Luc; Guinot, Pierre-Grégoire; Jegoux, Franck; L'Her, Erwan; Luyt, Charles-Edouard; Mahjoub, Yazine; Mayaux, Julien; Quintard, Hervé; Ravat, François; Vergez, Sébastien; Amour, Julien; Guillot, Max

2018-06-01

Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method. These guidelines were conducted by a group of experts from the French Intensive Care Society (Société de réanimation de langue française) and the French Society of Anesthesia and Intensive Care Medicine (Société francaise d'anesthésie réanimation) with the participation of the French Emergency Medicine Association (Société française de médecine d'urgence), the French Society of Otorhinolaryngology. Sixteen experts and two coordinators agreed to consider questions concerning tracheotomy and its practical implementation. Five topics were defined: indications and contraindications for tracheotomy in intensive care, tracheotomy techniques in intensive care, modalities of tracheotomy in intensive care, management of patients undergoing tracheotomy in intensive care, and decannulation in intensive care. The summary made by the experts and the application of GRADE methodology led to the drawing up of 8 formal guidelines, 10 recommendations, and 3 treatment protocols. Among the 8 formal guidelines, 2 have a high level of proof (Grade 1±) and 6 a low level of proof (Grade 2±). For the 10 recommendations, GRADE methodology was not applicable and instead 10 expert opinions were produced. Copyright © 2018 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

Practice Guideline Recommendations on Perioperative Fasting: A Systematic Review.

PubMed

Lambert, Eva; Carey, Sharon

2016-11-01

Traditionally, perioperative fasting consisted of being nil by mouth (NBM) from midnight before surgery and fasting postoperatively until recovery of bowel function. These outdated practices persist despite emerging evidence revealing that excessive fasting results in negative outcomes and delayed recovery. Various evidence-based, multimodal, enhanced recovery protocols incorporating minimized perioperative fasting have arisen to improve patient outcomes and streamline recovery, but implementation remains limited. This article aims to review current fasting guidelines, assess their quality, summarize relevant recommendations, and identify gaps in evidence. A systematic literature search of Medline and CINAHL and a manual search of relevant websites identified guidelines containing suitable grading systems and fasting recommendations. Guideline quality was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Grading systems were standardized to the American Society for Parenteral and Enteral Nutrition format and recommendations summarized based on grading and guideline quality. Nineteen guidelines were included. Rigor of development scores ranged from 29%-95%, with only 8 guidelines explicitly declaring the use of systematic methodology. Applicability scores were lowest, averaging 32%. Ten recommendation types were extracted and summarized. Strong and consistent evidence exists for the minimization of perioperative fasting, for a 2-hour preoperative fast after clear fluids, and for early recommencement of oral food and fluid intake postoperatively. This article presents several high-level recommendations ready for immediate implementation, while poorly graded and inconsistent recommendations reveal key areas for future research. Meanwhile, guideline quality requires improvement, especially regarding rigor of development and applicability, through systematic methodology, reporting transparency, and implementation strategies. © 2015 American Society for Parenteral and Enteral Nutrition.

Coupled structural/thermal/electromagnetic analysis/tailoring of graded composite structures

NASA Technical Reports Server (NTRS)

Mcknight, R. L.; Huang, H.; Hartle, M.

1992-01-01

Accomplishments are described for the third years effort of a 5-year program to develop a methodology for coupled structural/thermal/electromagnetic analysis/tailoring of graded composite structures. These accomplishments include: (1) structural analysis capability specialized for graded composite structures including large deformation and deformation position eigenanalysis technologies; (2) a thermal analyzer specialized for graded composite structures; (3) absorption of electromagnetic waves by graded composite structures; and (4) coupled structural thermal/electromagnetic analysis of graded composite structures.

Use of concept mapping as a facilitative tool to promote learning in pharmacology.

PubMed

Qadir, Farida; Zehra, Tabassum; Khan, Imrana

2011-08-01

To assess whether students find concept mapping a useful learning methodology to conceptualize and organize topics studied in CNS module of Pharmacology; and to evaluate whether addition of concept mapping assignment could help to improve examination scores. An analytical study. College of Dentistry, Jinnah Medical and Dental College, Karachi, Pakistan, from March to May 2009. A class of 50 BDS students was recruited for the study. Two randomly selected groups of 12 students each, prepared concept maps in topics from CNS pharmacology which were displayed and discussed during tutorial sessions. The other two groups (n = 25) following the traditional teaching methodology, served as controls. Scores from best choice questions and short essay questions were compared between the investigational and control groups using the student's t-test with significance at p < 0.05. Feedback obtained after completion of the study was evaluated as percent response. One-best-choice test of the control group showed a mean grade of 57.1 ± 16.7 vs. test group mean of 58.8 ± 13. For the short essay questions, control group obtained a mean of 52.3 ± 18.8 vs. test group mean grade of 53.8 ± 22.5. Both results were not significantly different (p > 0.05). However, feedback about concept mapping showed that the technique helped the students to conceptualize difficult topics in CNS pharmacology (86.36%). Concept mapping was particularly beneficial in preparing for exams as it provided a quick overview of the entire subject (68.68%). Students found concept mapping as a useful pedagogical tool which could potentially be used to acquire meaningful learning in Pharmacology as a supplement to traditional teaching techniques. It was not found beneficial in improving examination grades probably because standard examinations and concept mapping measure different cognitive domains.

Multifaceted Learning Objective Assessment in a Mechanical Engineering Capstone Design Course

NASA Astrophysics Data System (ADS)

Baker, Nicholas S.

This thesis details multi method research approaches that have been used to study student learning objective instruction and assessment in the mechanical engineering (ME) capstone course at the University of Nevada, Reno (UNR). A primary focus of the research is to evaluate the pilot implementation of a Writing Fellows (WF) program in the ME capstone course, which has been assessed using a variety of techniques. The assessment generally indicates positive results. In particular, students favor the continuation of the program and find it more helpful than group consultations within the University Writing Center (UWC) alone. Self-assessment by the students indicates higher confidence in their communication skills, while preliminary analysis suggests that the writing fellow improved the scores of graded assignments by approximately one-third of a letter grade overall. Assessment efforts also highlight the need for deeper interaction between the WF and engineering faculty. A secondary focus of this research presents a methodology that has been developed and used to analyze how the Accreditation Board for Engineering and Technology's (ABET's) current Criterion 3 Student Outcomes (SOs) have been assessed in UNR's ME capstone class over several academic years. The methodology generally finds levels of ABET SO assessment in agreement with departmental and industry-held expectations for capstone courses at large. Finally, an analysis of student grades in the capstone course finds significant differences across semesters and identifies several potential causes.

Joint simulation of stationary grade and non-stationary rock type for quantifying geological uncertainty in a copper deposit

NASA Astrophysics Data System (ADS)

Maleki, Mohammad; Emery, Xavier

2017-12-01

In mineral resources evaluation, the joint simulation of a quantitative variable, such as a metal grade, and a categorical variable, such as a rock type, is challenging when one wants to reproduce spatial trends of the rock type domains, a feature that makes a stationarity assumption questionable. To address this problem, this work presents methodological and practical proposals for jointly simulating a grade and a rock type, when the former is represented by the transform of a stationary Gaussian random field and the latter is obtained by truncating an intrinsic random field of order k with Gaussian generalized increments. The proposals concern both the inference of the model parameters and the construction of realizations conditioned to existing data. The main difficulty is the identification of the spatial correlation structure, for which a semi-automated algorithm is designed, based on a least squares fitting of the data-to-data indicator covariances and grade-indicator cross-covariances. The proposed models and algorithms are applied to jointly simulate the copper grade and the rock type in a Chilean porphyry copper deposit. The results show their ability to reproduce the gradual transitions of the grade when crossing a rock type boundary, as well as the spatial zonation of the rock type.

Grade Repetition and Primary School Dropout in Uganda

ERIC Educational Resources Information Center

Kabay, Sarah

2016-01-01

Research on education in low-income countries rarely focuses on grade repetition. When addressed, repetition is typically presented along with early school dropout as the "wasting" of educational resources. Simplifying grade repetition in this way often fails to recognize significant methodological concerns and also overlooks the unique…

Temporary ovarian suppression during chemotherapy to preserve ovarian function and fertility in breast cancer patients: A GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology.

PubMed

Lambertini, Matteo; Cinquini, Michela; Moschetti, Ivan; Peccatori, Fedro A; Anserini, Paola; Valenzano Menada, Mario; Tomirotti, Maurizio; Del Mastro, Lucia

2017-01-01

The development of premature ovarian failure and subsequent infertility are possible consequences of chemotherapy use in pre-menopausal women with early-stage breast cancer. Among the available strategies for fertility preservation, pharmacological protection of the ovaries using luteinising hormone-releasing hormone analogues (LHRHa) during chemotherapy has the potential to restore ovarian function and fertility after anticancer treatments; however, the possible efficacy and clinical application of this strategy has been highly debated in the last years. Following the availability of new data on this controversial topic, the Panel of the Italian Association of Medical Oncology (AIOM) Clinical Practice Guideline on fertility preservation in cancer patients decided to apply the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology around the relevant and current question on the clinical utility of temporary ovarian suppression with LHRHa during chemotherapy as a strategy to preserve ovarian function and fertility in breast cancer patients. To answer this question, preservation of ovarian function and fertility were judged as critical outcomes for the decision-making. Three possible outcomes of harm were identified: LHRHa-associated toxicities, potential antagonism between concurrent LHRHa and chemotherapy, and lack of the prognostic impact of chemotherapy-induced premature ovarian failure. According to the GRADE evaluation conducted, the result was a strong positive recommendation in favour of using this option to preserve ovarian function and fertility in breast cancer patients. The present manuscript aims to update and summarise the evidence for the use of this strategy in light of the new data published up to January 2016, according to the GRADE process. Copyright © 2016 Elsevier Ltd. All rights reserved.

Graded activation of the intrinsic laryngeal muscles for vocal fold posturing

PubMed Central

Chhetri, Dinesh K.; Neubauer, Juergen; Berry, David A.

2010-01-01

Previous investigations using in vivo models to study the role of intrinsic laryngeal muscles in phonation have used neuromuscular stimulation to study voice parameters. However, these studies used coarse stimulation techniques using limited levels of neuromuscular stimulation. In the current investigation, a technique for fine control of laryngeal posturing was developed using graded stimulation of the laryngeal nerves. Vocal fold strain history to graded stimulation and a methodology for establishing symmetric laryngeal activation is presented. This methodology has immediate applications for the study of laryngeal paralysis and paresis, as well as general questions of neuromuscular control of the larynx. PMID:20369979

Geothermal Resource Reporting Metric (GRRM) Developed for the U.S. Department of Energy's Geothermal Technologies Office

DOE Office of Scientific and Technical Information (OSTI.GOV)

Young, Katherine R.; Wall, Anna M.; Dobson, Patrick F.

This paper reviews a methodology being developed for reporting geothermal resources and project progress. The goal is to provide the U.S. Department of Energy's (DOE) Geothermal Technologies Office (GTO) with a consistent and comprehensible means of evaluating the impacts of its funding programs. This framework will allow the GTO to assess the effectiveness of research, development, and deployment (RD&D) funding, prioritize funding requests, and demonstrate the value of RD&D programs to the U.S. Congress and the public. Standards and reporting codes used in other countries and energy sectors provide guidance to develop the relevant geothermal methodology, but industry feedback andmore » our analysis suggest that the existing models have drawbacks that should be addressed. In order to formulate a comprehensive metric for use by the GTO, we analyzed existing resource assessments and reporting methodologies for the geothermal, mining, and oil and gas industries, and sought input from industry, investors, academia, national labs, and other government agencies. Using this background research as a guide, we describe a methodology for evaluating and reporting on GTO funding according to resource grade (geological, technical and socio-economic) and project progress. This methodology would allow GTO to target funding, measure impact by monitoring the progression of projects, or assess geological potential of targeted areas for development.« less

Adding value to the learning process by online peer review activities: towards the elaboration of a methodology to promote critical thinking in future engineers

NASA Astrophysics Data System (ADS)

Dominguez, Caroline; Nascimento, Maria M.; Payan-Carreira, Rita; Cruz, Gonçalo; Silva, Helena; Lopes, José; Morais, Maria da Felicidade A.; Morais, Eva

2015-09-01

Considering the results of research on the benefits and difficulties of peer review, this paper describes how teaching faculty, interested in endorsing the acquisition of communication and critical thinking (CT) skills among engineering students, has been implementing a learning methodology throughout online peer review activities. While introducing a new methodology, it is important to weight the advantages found and the conditions that might have restrained the activity outcomes, thereby modulating its overall efficiency. Our results show that several factors are decisive for the success of the methodology: the use of specific and detailed orientation guidelines for CT skills, the students' training on how to deliver a meaningful feedback, the opportunity to counter-argument, the selection of good assignments' examples, and the constant teacher's monitoring of the activity. Results also tackle other aspects of the methodology such as the thinking skills evaluation tools (grades and tests) that most suit our reality. An improved methodology is proposed taking in account the encountered limitations, thus offering the possibility to other interested institutions to use/test and/or improve it.

A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews.

PubMed

Jin, Ying-Hui; Wang, Guo-Hao; Sun, Yi-Rong; Li, Qi; Zhao, Chen; Li, Ge; Si, Jin-Hua; Li, Yan; Lu, Cui; Shang, Hong-Cai

2016-11-14

To assess the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing (TCMN) interventions in Chinese journals. These interventions include acupressure, massage, Tai Chi, Qi Gong, electroacupuncture and use of Chinese herbal medicines-for example, in enemas, foot massage and compressing the umbilicus. A systematic literature search for systematic reviews and meta-analyses of TCMN interventions was performed. Review characteristics were extracted. The methodological quality and the quality of the evidence were evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. We included 20 systematic reviews and meta-analyses, and a total of 11 TCMN interventions were assessed in the 20 reviews. The compliance with AMSTAR checklist items ranged from 4.5 to 8 and systematic reviews/meta-analyses were, on average, of medium methodological quality. The quality of the evidence we assessed ranged from very low to moderate; no high-quality evidence was found. The top two causes for downrating confidence in effect estimates among the 31 bodies of evidence assessed were the risk of bias and inconsistency. There is room for improvement in the methodological quality of systematic reviews/meta-analyses of TCMN interventions published in Chinese journals. Greater efforts should be devoted to ensuring a more comprehensive search strategy, clearer specification of the interventions of interest in the eligibility criteria and identification of meaningful outcomes for clinicians and patients (consumers). The overall quality of evidence among reviews remains suboptimal, which raise concerns about their roles in influencing clinical practice. Thus, the conclusions in reviews we assessed must be treated with caution and their roles in influencing clinical practice should be limited. A critical appraisal of systematic reviews/meta-analyses of TCMN interventions is particularly important to provide sound guidance for TCMN. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Value of Action Research in Middle Grades Education

ERIC Educational Resources Information Center

Caskey, Micki M.

2006-01-01

Action research is one of the relevant methodologies for addressing research questions and issues in middle grades education. Accounting for nearly 20% of published middle grades research studies (Hough, 2003), action research has emerged as an important and appropriate research method. In addition to reviewing the historical context, this article…

Non-invasive grading of astrocytic tumours from the relative contents of myo-inositol and glycine measured by in vivo MRS.

PubMed

Candiota, A P; Majós, C; Julià-Sapé, M; Cabañas, M; Acebes, J J; Moreno-Torres, A; Griffiths, J R; Arús, C

2011-01-01

MRI and MRS are established methodologies for evaluating intracranial lesions. One MR spectral feature suggested for in vivo grading of astrocytic tumours is the apparent myo-lnositol (ml) intensity (ca 3.55 ppm) at short echo times, although glycine (gly) may also contribute in vivo to this resonance. The purpose of this study was to quantitatively evaluate the ml + gly contribution to the recorded spectral pattern in vivo and correlate it with in vitro data obtained from perchloric acid extraction of tumour biopsies. Patient spectra (n = 95) at 1.5T at short (20-31 ms) and long (135-136 ms) echo times were obtained from the INTERPRET MRS database (http://gabrmn.uab.eslinterpretvalidateddbl). Phantom spectra were acquired with a comparable protocol. Spectra were automatically processed and the ratios of the (ml + gly) to Cr peak heights ((ml + gly)/Cr) calculated. Perchloric acid extracts of brain tumour biopsies were analysed by high-resolution NMR at 9.4T. The ratio (ml + gly)/Cr decreased significantly with astrocytic grade in vivo between low-grade astrocytoma (A2) and glioblastoma multiforme (GBM). In vitro results displayed a somewhat different tendency, with anaplastic astrocytomas having significantly higher (ml + gly)/Cr than A2 and GBM. The discrepancy between in vivo and in vitro data suggests that the NMR visibility of glycine in glial brain tumours is restricted in vivo.

School Obesity Prevention Policies and Practices in Minnesota and Student Outcomes: A Longitudinal Cohort Study.

PubMed

Nanney, Marilyn S; MacLehose, Richard F; Kubik, Martha Y; Davey, Cynthia S; O'Connell, Michael J; Grannon, Katherine Y; Nelson, Toben F

2016-11-01

The School Obesity-related Policy Evaluation (ScOPE) Study uses existing public surveillance data and applies a rigorous study design to evaluate effectiveness of school policies and practices impacting student behavioral and weight outcomes. The ScOPE Study used a cohort of 50 combined junior-senior and high schools in Minnesota to evaluate the change in weight-related policy environments in 2006 and 2012 and test the effect of policy change on students attending those schools in 2007 and 2013. Exposure variables included school practices about foods and beverages available in school vending machines and school stores, physical education requirements, and intramural opportunities. Primary study outcomes were average school-level ninth grade student BMI percentile, obesity prevalence, daily servings of fruits/vegetables, and daily glasses of soda. Availability of fruits/vegetables in schools was associated with a significant increase in total daily intake among ninth grade students by 0.4 servings. Availability of soda in schools was associated with a significant increase in total daily intake among ninth grade boys by 0.5 servings. Less-healthy snack and drink availability in schools was associated with a small, significant increase (1%) in student BMI percentile at the school level. Use of a school-level longitudinal cohort study design over a 6-year period uniquely adds to the methodologic rigor of school policy and practice evaluation studies. The ScOPE Study provides marginal evidence that school policies and practices, especially those that restrict vending and school store offerings, may have small effects on weight status among ninth grade students. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Awake surgery for hemispheric low-grade gliomas: oncological, functional and methodological differences between pediatric and adult populations.

PubMed

Trevisi, Gianluca; Roujeau, Thomas; Duffau, Hugues

2016-10-01

Brain mapping through a direct cortical and subcortical electrical stimulation during an awake craniotomy has gained an increasing popularity as a powerful tool to prevent neurological deficit while increasing extent of resection of hemispheric diffuse low-grade gliomas in adults. However, few case reports or very limited series of awake surgery in children are currently available in the literature. In this paper, we review the oncological and functional differences between pediatric and adult populations, and the methodological specificities that may limit the use of awake mapping in pediatric low-grade glioma surgery. This could be explained by the fact that pediatric low-grade gliomas have a different epidemiology and biologic behavior in comparison to adults, with pilocytic astrocytomas (WHO grade I glioma) as the most frequent histotype, and with WHO grade II gliomas less prone to anaplastic transformation than their adult counterparts. In addition, aside from the issue of poor collaboration of younger children under 10 years of age, some anatomical and functional peculiarities of children developing brain (cortical and subcortical myelination, maturation of neural networks and of specialized cortical areas) can influence direct electrical stimulation methodology and sensitivity, limiting its use in children. Therefore, even though awake procedure with cortical and axonal stimulation mapping can be adapted in a specific subgroup of children with a diffuse glioma from the age of 10 years, only few pediatric patients are nonetheless candidates for awake brain surgery.

Ward-based interventions for patients with hemispatial neglect in stroke rehabilitation: a systematic literature review.

PubMed

Klinke, Marianne E; Hafsteinsdóttir, Thóra B; Hjaltason, Haukur; Jónsdóttir, Helga

2015-08-01

To identify rehabilitation interventions that can be integrated into ward-based nursing for patients with hemispatial neglect following stroke in the right brain hemisphere. A systematic review of interdisciplinary literature. A preliminary literature search without time limits was conducted in the Cochrane Controlled Trials Register. We then searched the PubMed, CINAHL and PsychINFO databases for relevant articles published between January 2006 and June 2014. Selected journals were searched manually. Additional resources were explored by scrutinizing reference lists and tracking citations of the selected articles. Titles and abstracts were matched with the inclusion criteria. Articles were read in their entirety if the abstracts adhered to inclusion criteria or if there was any uncertainty. Two reviewers evaluated the risk of methodological bias independently by using quantitative appraisal forms from the Johanna Briggs Institute (JBI). Any disagreements were resolved by consensus. Authors of nine studies were contacted to acquire additional information. The JBI Reviewers' Manual was used to guide the overall procedure of the review. We used the PRISMA statement to ensure precise reporting of the results. The selected studies were graded according to the strength of their evidence (Levels 1-5); the proposed interventions were given recommendation grades (Grades A-D). Using 41 original studies, 11 interventions were identified. These comprise: (1) contralesional neck vibration (Grade C); (2) emotionally salient stimuli and reward (Grade D); (3) family participation and intensity of training (Grade C); (4) limb activation training (Grade C); (5) mental imagery training, (Grade D); (6) mirror therapy (Grade C); (7) music therapy (Grade D); (8) right half-field eye patching (Grade D); (9) smooth pursuit eye-movement training (Grade B); (10) virtual reality and computer-based training (Grade C); and (11) visual scanning training (Grade D). A total of 11 promising rehabilitation interventions were found. Encouraging results were, in particular, seen with smooth pursuit eye-movement training. It should be noted that the general low level of evidence and the diversity of interventions makes it difficult to endorse specific priorities and combinations for implementation. Instead, interventions should be applied after careful evaluation of each patient's unique capacities and problems. We include suggestions for operationalization into ward-based care in "Discussion" section. We also emphasize the need to integrate evidence-based interventions into nursing care to further stimulate rehabilitation outcomes and future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

To Know and Be Known: The Voices of Boys with Reading Disabilities

ERIC Educational Resources Information Center

Hill, Pamela Susan

2013-01-01

My research combined two qualitative narrative methods, autoethnography and portraiture. These methodologies were used to design word portraits of three second-grade boys, one second-grade and two third-grade teachers, and one special educator. This study's focus was twofold: exploring the literacy and learning perspectives of second-grade…

Process perspective on image quality evaluation

NASA Astrophysics Data System (ADS)

Leisti, Tuomas; Halonen, Raisa; Kokkonen, Anna; Weckman, Hanna; Mettänen, Marja; Lensu, Lasse; Ritala, Risto; Oittinen, Pirkko; Nyman, Göte

2008-01-01

The psychological complexity of multivariate image quality evaluation makes it difficult to develop general image quality metrics. Quality evaluation includes several mental processes and ignoring these processes and the use of a few test images can lead to biased results. By using a qualitative/quantitative (Interpretation Based Quality, IBQ) methodology, we examined the process of pair-wise comparison in a setting, where the quality of the images printed by laser printer on different paper grades was evaluated. Test image consisted of a picture of a table covered with several objects. Three other images were also used, photographs of a woman, cityscape and countryside. In addition to the pair-wise comparisons, observers (N=10) were interviewed about the subjective quality attributes they used in making their quality decisions. An examination of the individual pair-wise comparisons revealed serious inconsistencies in observers' evaluations on the test image content, but not on other contexts. The qualitative analysis showed that this inconsistency was due to the observers' focus of attention. The lack of easily recognizable context in the test image may have contributed to this inconsistency. To obtain reliable knowledge of the effect of image context or attention on subjective image quality, a qualitative methodology is needed.

S3-guideline "helicobacter pylori and gastroduodenal ulcer disease" of the German society for digestive and metabolic diseases (DGVS) in cooperation with the German society for hygiene and microbiology, society for pediatric gastroenterology and nutrition e. V., German society for rheumatology, AWMF-registration-no. 021 / 001.

PubMed

Fischbach, W; Malfertheiner, P; Hoffmann, J C; Bolten, W; Bornschein, J; Götze, O; Höhne, W; Kist, M; Koletzko, S; Labenz, J; Layer, P; Miehlke, St; Morgner, A; Peitz, U; Preiss, J; Prinz, C; Rosien, U; Schmidt, W; Schwarzer, A; Suerbaum, St; Timmer, A; Treiber, G; Vieth, M

2009-12-01

This guideline updates a prior consensus recommendation of the German Society for Digestive and Metabolic Diseases (DGVS) from 1996. It was developed by an interdisciplinary cooperation with representatives of the German Society for Hygiene and Microbiology, the Society for Pediatric Gastroenterology and Nutrition (GPGE), and the German Society for Rheumatology. The guideline is methodologically based on recommendations of the Association of the Scientific Medical Societies in Germany (AWMF) for providing a systematic evidence-based S 3 level consensus guideline and has also implemented grading criteria according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) process. Clinical applicability of study results as well as specifics for Germany in terms of epidemiology, antibiotic resistance status, diagnostics, and therapy were taken into account.

Validation of sterilizing grade filtration.

PubMed

Jornitz, M W; Meltzer, T H

2003-01-01

Validation consideration of sterilizing grade filters, namely 0.2 micron, changed when FDA voiced concerns about the validity of Bacterial Challenge tests performed in the past. Such validation exercises are nowadays considered to be filter qualification. Filter validation requires more thorough analysis, especially Bacterial Challenge testing with the actual drug product under process conditions. To do so, viability testing is a necessity to determine the Bacterial Challenge test methodology. Additionally to these two compulsory tests, other evaluations like extractable, adsorption and chemical compatibility tests should be considered. PDA Technical Report # 26, Sterilizing Filtration of Liquids, describes all parameters and aspects required for the comprehensive validation of filters. The report is a most helpful tool for validation of liquid filters used in the biopharmaceutical industry. It sets the cornerstones of validation requirements and other filtration considerations.

Eunkyosan for treatment of the common cold: A protocol for the systematic review of controlled trials.

PubMed

Lee, Hesol; Kang, Bohyung; Choi, Jun-Yong; Park, Sunju; Lee, Myeong Soo; Lee, Ju Ah

2018-05-01

Eunkyosan (EKS) is widely used for common colds in East Asian countries. Many clinical trials assessing the efficacy and safety of EKS formula for the treatment of common colds have been reported. This review will assess the clinical evidence for and against the use of EKS formula as a treatment for common colds. Fourteen databases will be searched from inception until March 2018. We will include randomized controlled trials (RCTs) assessing EKS decoctions for any type of common cold. All RCTs of decoctions or modified decoctions will be included. The methodological qualities of the RCTs will be assessed using the Cochrane Collaboration tool for assessing risk of bias, while confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. This systematic review will be published in a peer-reviewed journal and will also be disseminated electronically and in print. The review will be updated to inform and guide healthcare practices.Registration number: CRD42018087694.

Sprint mechanics return to competition follow-up after hamstring injury on a professional soccer player: A case study with an inertial sensor unit based methodological approach.

PubMed

Setuain, Igor; Lecumberri, Pablo; Izquierdo, Mikel

2017-10-03

The present research aimed to describe an inertial unit (IU)-based sprint mechanics evaluation model for assessing players' readiness to return to competition after suffering a grade I hamstring injury. A professional male football player (age 19years; height 177cm; weight 70kg, midfielder, Spanish, 3° Division) with a grade 1 biceps femoris injury was evaluated at pre-season, at return to play after injury and at the end of the competitive season. Sprint mechanics were analyzed via the use of an inertial orientation tracker (Xsens Technologies B.V. Enschede, Netherlands) attached over the L3-L4 region of the subject's lumbar spine. Sprint mechanics such as horizontal components of ground reaction force were assessed in both legs during sprinting actions. Findings and interpretation: Both the coefficient of the horizontal force application (SFV) and the ratio of forces (DRF) applied at increasing velocity were decreased in the injured limb compared with the contralateral healthy limb at the return to play evaluation (73% and 76% reductions, respectively) and returned to symmetrical levels at the end-season evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Systematic Review Methodology for the Fatigue in Emergency Medical Services Project.

PubMed

Patterson, P Daniel; Higgins, J Stephen; Weiss, Patricia M; Lang, Eddy; Martin-Gill, Christian

2018-02-15

Guidance for managing fatigue in the Emergency Medical Services (EMS) setting is limited. The Fatigue in EMS Project sought to complete multiple systematic reviews guided by seven explicit research questions, assemble the best available evidence, and rate the quality of that evidence for purposes of producing an Evidence Based Guideline (EBG) for fatigue risk management in EMS operations. We completed seven systematic reviews that involved searches of six databases for literature relevant to seven research questions. These questions were developed a priori by an expert panel and framed in the Population, Intervention, Comparison, and Outcome (PICO) format and pre-registered with PROSPERO. Our target population was defined as persons 18 years of age and older classified as EMS personnel or similar shift worker groups. A panel of experts selected outcomes for each PICO question as prescribed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. We pooled findings, stratified by study design (experimental vs. observational) and presented results of each systematic review in narrative and quantitative form. We used meta-analyses of select outcomes to generate pooled effects. We used the GRADE methodology and the GRADEpro software to designate a quality of evidence rating for each outcome. We present the results for each systematic review in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). More than 38,000 records were screened across seven systematic reviews. The median, minimum, and maximum inter-rater agreements (Kappa) between screeners for our seven systematic reviews were 0.66, 0.49, and 0.88, respectively. The median, minimum, and maximum number of records retained for the seven systematic reviews was 13, 1, and 100, respectively. We present key findings in GRADE Evidence Profile Tables in separate publications for each systematic review. We describe a protocol for conducting multiple, simultaneous systematic reviews connected to fatigue with the goal of creating an EBG for fatigue risk management in the EMS setting. Our approach may be informative to others challenged with the creation of EBGs that address multiple, inter-related systematic reviews with overlapping outcomes.

Emergent Gender Roles within Tween Popular Culture: Perspectives from Mexican American Students in a Fifth-Grade Classroom

ERIC Educational Resources Information Center

Godina, Heriberto; Soto-Ramirez, Cynthia

2017-01-01

This study examines fifth-grade Mexican American students' beliefs about emergent gender roles. We used participant-observation methodology to conduct research on six focal-student participants selected from the general fifth-grade population at an elementary school located in the Southwestern United States. Collected data included focal-student…

Optimisation of wire-cut EDM process parameter by Grey-based response surface methodology

NASA Astrophysics Data System (ADS)

Kumar, Amit; Soota, Tarun; Kumar, Jitendra

2018-03-01

Wire electric discharge machining (WEDM) is one of the advanced machining processes. Response surface methodology coupled with Grey relation analysis method has been proposed and used to optimise the machining parameters of WEDM. A face centred cubic design is used for conducting experiments on high speed steel (HSS) M2 grade workpiece material. The regression model of significant factors such as pulse-on time, pulse-off time, peak current, and wire feed is considered for optimising the responses variables material removal rate (MRR), surface roughness and Kerf width. The optimal condition of the machining parameter was obtained using the Grey relation grade. ANOVA is applied to determine significance of the input parameters for optimising the Grey relation grade.

A Method Based on Artificial Intelligence To Fully Automatize The Evaluation of Bovine Blastocyst Images.

PubMed

Rocha, José Celso; Passalia, Felipe José; Matos, Felipe Delestro; Takahashi, Maria Beatriz; Ciniciato, Diego de Souza; Maserati, Marc Peter; Alves, Mayra Fernanda; de Almeida, Tamie Guibu; Cardoso, Bruna Lopes; Basso, Andrea Cristina; Nogueira, Marcelo Fábio Gouveia

2017-08-09

Morphological analysis is the standard method of assessing embryo quality; however, its inherent subjectivity tends to generate discrepancies among evaluators. Using genetic algorithms and artificial neural networks (ANNs), we developed a new method for embryo analysis that is more robust and reliable than standard methods. Bovine blastocysts produced in vitro were classified as grade 1 (excellent or good), 2 (fair), or 3 (poor) by three experienced embryologists according to the International Embryo Technology Society (IETS) standard. The images (n = 482) were subjected to automatic feature extraction, and the results were used as input for a supervised learning process. One part of the dataset (15%) was used for a blind test posterior to the fitting, for which the system had an accuracy of 76.4%. Interestingly, when the same embryologists evaluated a sub-sample (10%) of the dataset, there was only 54.0% agreement with the standard (mode for grades). However, when using the ANN to assess this sub-sample, there was 87.5% agreement with the modal values obtained by the evaluators. The presented methodology is covered by National Institute of Industrial Property (INPI) and World Intellectual Property Organization (WIPO) patents and is currently undergoing a commercial evaluation of its feasibility.

School-based obesity prevention programs: an evidence-based review.

PubMed

Kropski, Jonathan A; Keckley, Paul H; Jensen, Gordon L

2008-05-01

This review seeks to examine the effectiveness of school-based programs for reducing childhood overweight or obesity. A systematic review of the research literature published since 1990 was conducted to identify experimental or quasi-experimental school-based curricular or environmental preventive interventions, with evaluation>or=6 months after baseline, which reported outcomes in terms of a measure of overweight. Fourteen studies were identified, including one involving a nutrition-only program, two physical activity promotion interventions and eleven studies combining nutrition and physical activity components. Most studies (n=10) offered weak (grade 2) quality evidence. One study offered strong (grade 4) evidence reducing the odds ratio for overweight in girls only, while four grade 2 studies reported significant improvements in BMI or at-risk-for overweight or overweight prevalence in boys, girls, or both. Twelve studies reported significant improvement in at least one measure of dietary intake, physical activity, and/or sedentary behavior. Our ability to draw strong conclusions as to the efficacy of school-based obesity prevention programs is limited by the small number of published studies and by methodological concerns. Qualitative analysis suggests programs grounded in social learning may be more appropriate for girls, while structural and environmental interventions enabling physical activity may be more effective for boys. High-quality evaluation protocols should be considered essential components of future programs.

The Impact of Letter Grades on Student Effort, Course Selection, and Major Choice: A Regression-Discontinuity Analysis

ERIC Educational Resources Information Center

Main, Joyce B.; Ost, Ben

2014-01-01

The authors apply a regression-discontinuity design to identify the causal impact of letter grades on student effort within a course, subsequent credit hours taken, and the probability of majoring in economics. Their methodology addresses key issues in identifying the causal impact of letter grades: correlation with unobservable factors, such as…

Roughness analysis of grade breaks at intersections : final report.

DOT National Transportation Integrated Search

1993-03-01

A method to analyze the roughness of grade breaks at highway intersections is proposed. Although there are a variety of instruments to physically measure the road roughness, there are no known methodologies to analyze profile roughness during the des...

Corrosion Effects on the Fatigue Crack Propagation of Giga-Grade Steel and its Heat Affected Zone in pH Buffer Solutions for Automotive Application

NASA Astrophysics Data System (ADS)

Lee, H. S.

2018-03-01

Corrosion fatigue crack propagation test was conducted of giga-grade steel and its heat affected zone in pH buffer solutions, and the results were compared with model predictions. Pure corrosion effect on fatigue crack propagation, particularly, in corrosive environment was evaluated by means of the modified Forman equation. As shown in results, the average corrosion rate determined from the ratio of pure corrosion induced crack length to entire crack length under a cycle load were 0.11 and 0.37 for base metal and heat affected zone, respectively, with load ratio of 0.5, frequency of 0.5 and pH 10.0 environment. These results demonstrate new interpretation methodology for corrosion fatigue crack propagation enabling the pure corrosion effects on the behavior to be determined.

[From Evidence to Health Policy Making: Pre-Exposure Prophylaxis for HIV Prevention].

PubMed

Ko, Nai-Ying

2016-12-01

Pre-exposure prophylaxis (PrEP), in combination with traditional prevention strategies (such as condom use, voluntary HIV counseling and testing, and treatment for sexually transmitted infections), has been shown to effectively prevent HIV infection. As of September 2015, the World Health Organization recommends that people at substantial risk of HIV infection should be offered PrEP as an additional prevention choice, as part of comprehensive prevention. This article introduces how to apply a systematic review using the methodology of Grading of Recommendations Assessment, Development and Evaluation (GRADE) to write clinical guidelines. With support from the Taiwan Centers for Disease Control, the Taiwan AIDS Society published clinical guidelines for oral pre-exposure prophylaxis in Taiwan. Nurses are responsible to apply evidence-based knowledge and to use their professional influence to shape health policies related to HIV prevention.

Evidence- and consensus-based (S3) Guidelines for the Treatment of Actinic Keratosis - International League of Dermatological Societies in cooperation with the European Dermatology Forum - Short version.

PubMed

Werner, R N; Stockfleth, E; Connolly, S M; Correia, O; Erdmann, R; Foley, P; Gupta, A K; Jacobs, A; Kerl, H; Lim, H W; Martin, G; Paquet, M; Pariser, D M; Rosumeck, S; Röwert-Huber, H-J; Sahota, A; Sangueza, O P; Shumack, S; Sporbeck, B; Swanson, N A; Torezan, L; Nast, A

2015-11-01

Actinic keratosis (AK) is a frequent health condition attributable to chronic exposure to ultraviolet radiation. Several treatment options are available and evidence based guidelines are missing. The goal of these evidence- and consensus-based guidelines was the development of treatment recommendations appropriate for different subgroups of patients presenting with AK. A secondary aim of these guidelines was the implementation of knowledge relating to the clinical background of AK, including consensus-based recommendations for the histopathological definition, diagnosis and the assessment of patients. The guidelines development followed a pre-defined and structured process. For the underlying systematic literature review of interventions for AK, the methodology suggested by the Cochrane Handbook for Systematic Reviews of Interventions, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was adapted. All recommendations were consented during a consensus conference using a formal consensus methodology. Strength of recommendations was expressed based on the GRADE approach. If expert opinion without external evidence was incorporated into the reasoning for making a certain recommendation, the rationale was provided. The Guidelines underwent open public review and approval by the commissioning societies. Various interventions for the treatment of AK have been assessed for their efficacy. The consenting procedure led to a treatment algorithm as shown in the guidelines document. Based on expert consensus, the present guidelines present recommendations on the classification of patients, diagnosis and histopathological definition of AK. Details on the methods and results of the systematic literature review and guideline development process have been published separately. International guidelines are intended to be adapted to national or regional circumstances (regulatory approval, availability and reimbursement of treatments). © 2015 European Academy of Dermatology and Venereology.

Is there a relationship between psychological stress or anxiety and chronic nonspecific neck-arm pain in adults? A systematic review and meta-analysis.

PubMed

Ortego, Gorka; Villafañe, Jorge Hugo; Doménech-García, Victor; Berjano, Pedro; Bertozzi, Lucia; Herrero, Pablo

2016-11-01

To systematically review and analyze the research evidence linking stress or anxiety to chronic nonspecific neck-arm pain (NSNAP) in adults. Data were obtained from Pubmed, Scopus, PsycInfo, Web of Science, Physiotherapy Evidence Database (PEDro) and The Cochrane library database from their inception to July 2015. Two authors independently conducted the searches, extracted data, and completed methodological quality assessments. The methodological quality of the cohort and case-control studies was evaluated using the Newcastle-Ottawa scale, whilst the quality of the Randomized Controlled Trial (RCT) was evaluated using the PEDro scale. Twenty-eight studies involving 39,166 participants met the inclusion criteria. Four studies, including 5 pair-wise comparisons, were included in the meta-analysis: Three were cohort studies and 1 was a cross-sectional study. The meta-analysis outcome demonstrated a relationship between chronic NSNAP and psychological stress. The estimate odds ratio for all studies combined was 2.33 (95% CI, 1.04-5.18; p=0.039). A high heterogeneity of the findings appeared (Q=28.94, I 2 =86% p=0.00). This study shows that there is a strong relationship between stress and chronic NSNAP. Despite this finding, we cannot support that stress is a risk factor for chronic NSNAP due to the low quality of the results according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). It was not possible to make a quantitative analysis comparing the relationship between anxiety and chronic NSNAP. However, according to the qualitative analysis there is a strong relationship between anxiety and chronic NSNAP. Copyright © 2016 Elsevier Inc. All rights reserved.

Scandinavian guidelines for initial management of minor and moderate head trauma in children.

PubMed

Astrand, Ramona; Rosenlund, Christina; Undén, Johan

2016-02-18

The management of minor and moderate head trauma in children differs widely between countries. Presently, there are no existing guidelines for management of these children in Scandinavia. The purpose of this study was to produce new evidence-based guidelines for the initial management of head trauma in the paediatric population in Scandinavia. The primary aim was to detect all children in need of neurosurgical intervention. Detection of any traumatic intracranial injury on CT scan was an important secondary aim. General methodology according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used. Systematic evidence-based review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology and based upon relevant clinical questions with respect to patient-important outcomes. Quality ratings of the included studies were performed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 and Centre of Evidence Based Medicine (CEBM)-2 tools. Based upon the results, GRADE recommendations, a guideline, discharge instructions and in-hospital observation instructions were drafted. For elements with low evidence, a modified Delphi process was used for consensus, which included relevant clinical stakeholders. The guidelines include criteria for selecting children for CT scans, in-hospital observation or early discharge, and suggestions for monitoring routines and discharge advice for children and guardians. The guidelines separate mild head trauma patients into high-, medium- and low-risk categories, favouring observation for mild, low-risk patients as an attempt to reduce CT scans in children. We present new evidence and consensus based Scandinavian Neurotrauma Committee guidelines for initial management of minor and moderate head trauma in children. These guidelines should be validated before extensive clinical use and updated within four years due to rapid development of new diagnostic tools within paediatric neurotrauma.

Advancing Resident Assessment in Graduate Medical Education

PubMed Central

Swing, Susan R.; Clyman, Stephen G.; Holmboe, Eric S.; Williams, Reed G.

2009-01-01

Background The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. Intervention The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007–2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. Outcome The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008. PMID:21975993

International lessons in new methods for grading and integrating cost effectiveness evidence into clinical practice guidelines.

PubMed

Antioch, Kathryn M; Drummond, Michael F; Niessen, Louis W; Vondeling, Hindrik

2017-01-01

Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor. New economic evaluation checklists, Multi-Criteria Decision Analyses (MCDA) and other decision criteria enable health economists to impact on decision making world-wide. We analyse the methodologies for integrating economic evidence into CPG agencies globally, including the Agency of Health Research and Quality (AHRQ) in the USA, National Health and Medical Research Council (NHMRC) and Australian political reforms. The Guidelines and Economists Network International (GENI) Board members from Australia, UK, Canada and Denmark presented the findings at the conference of the International Health Economists Association (IHEA) and we report conclusions and developments since. The Consolidated Guidelines for the Reporting of Economic Evaluations (CHEERS) 24 item check list can be used by AHRQ, NHMRC, other CPG and health organisations, in conjunction with the Drummond ten-point check list and a questionnaire that scores that checklist for grading studies, when assessing economic evidence. Cost-effectiveness Analysis (CEA) thresholds, opportunity cost and willingness-to-pay (WTP) are crucial issues for decision rules in CEA generally, including end-of-life therapies. Limitations of inter-rater reliability in checklists can be addressed by including more than one assessor to reach a consensus, especially when impacting on treatment decisions. We identify priority areas to generate economic evidence for CPGs by NHMRC, AHRQ, and other agencies. The evidence may cover demand for care issues such as involved time, logistics, innovation price, price sensitivity, substitutes and complements, WTP, absenteeism and presentism. Supply issues may include economies of scale, efficiency changes, and return on investment. Involved equity and efficiency measures may include cost-of-illness, disease burden, quality-of-life, budget impact, cost-effective ratios, net benefits and disparities in access and outcomes. Priority setting remains essential and trade-off decisions between policy criteria can be based on MCDA, both in evidence based clinical medicine and in health planning.

A counterfactual impact evaluation of a bilingual program on students' grade point average at a spanish university.

PubMed

Arco-Tirado, J L; Fernández-Martín, F; Ramos-García, A M; Littvay, L; Villoria, J; Naranjo, J A

2018-06-01

This observational study intends to estimate the causal effects of an English as a Medium of Instruction (EMI) program (as predictor) on students Grade Point Average (GPA) (as outcome) at a particular University in Spain by using a Counterfactual Impact Evaluation (CIE). The need to address the crucial question of causal inferences in EMI programs to produce credible evidences of successful interventions contrasts, however, with the absence of experimental or quasi-experimental research and evaluation designs in the field. CIE approach is emerging as a methodologically viable solution to bridge that gap. The program evaluated here consisted in delivering an EMI program in a Primary Education Teacher Training Degree group. After achieving balance on the observed covariates and recreating a situation that would have been expected in a randomized experiment, three matching approaches such as genetic matching, nearest neighbor matching and Coarsened Exact Matching were used to analyze observational data from a total of 1288 undergraduate students, including both treatment and control group. Results show unfavorable effects of the bilingual group treatment condition. Potential interpretations and recommendations are provided in order to strengthen future causal evidences of bilingual education programs' effectiveness in Higher Education. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Intra-articular Hyaluronic Acid (HA) and Platelet Rich Plasma (PRP) injection versus Hyaluronic acid (HA) injection alone in Patients with Grade III and IV Knee Osteoarthritis (OA): A Retrospective Study on Functional Outcome.

PubMed

Saturveithan, C; Premganesh, G; Fakhrizzaki, S; Mahathir, M; Karuna, K; Rauf, K; William, H; Akmal, H; Sivapathasundaram, N; Jaspreet, K

2016-07-01

Introduction: Intra-articular hyaluronic acid (HA) is widely utilized in the treatment of knee osteoarthritis whereas platelet rich plasma (PRP) enhances the regeneration of articular cartilage. This study analyses the efficacy of HA and PRP in grade III and IV knee osteoarthritis. Methodology: This is a cross sectional study with retrospective review of 64 patients (101 knees) which includes 56 knees injected with HA+ PRP, and 45 knees with HA only. Results: During the post six months International Knee Documentation Committee (IKDC) evaluation, HA+PRP group showed marked improvement of 24.33 compared to 12.15 in HA group. Decrement in visual analogue score (VAS) in HA+PRP was 1.9 compared to 0.8 in HA group. Conclusion: We propose intra-articular HA and PRP injections as an optional treatment modality in Grade III and IV knee osteoarthritis in terms of functional outcome and pain control for up to six months when arthroplasty is not an option.

Intra-articular Hyaluronic Acid (HA) and Platelet Rich Plasma (PRP) injection versus Hyaluronic acid (HA) injection alone in Patients with Grade III and IV Knee Osteoarthritis (OA): A Retrospective Study on Functional Outcome

PubMed Central

Premganesh, G; Fakhrizzaki, S; Mahathir, M; Karuna, K; Rauf, K; William, H; Akmal, H; Sivapathasundaram, N; Jaspreet, K

2016-01-01

Introduction: Intra-articular hyaluronic acid (HA) is widely utilized in the treatment of knee osteoarthritis whereas platelet rich plasma (PRP) enhances the regeneration of articular cartilage. This study analyses the efficacy of HA and PRP in grade III and IV knee osteoarthritis. Methodology: This is a cross sectional study with retrospective review of 64 patients (101 knees) which includes 56 knees injected with HA+ PRP, and 45 knees with HA only. Results: During the post six months International Knee Documentation Committee (IKDC) evaluation, HA+PRP group showed marked improvement of 24.33 compared to 12.15 in HA group. Decrement in visual analogue score (VAS) in HA+PRP was 1.9 compared to 0.8 in HA group. Conclusion: We propose intra-articular HA and PRP injections as an optional treatment modality in Grade III and IV knee osteoarthritis in terms of functional outcome and pain control for up to six months when arthroplasty is not an option. PMID:28435559

Appending High-Resolution Elevation Data to GPS Speed Traces for Vehicle Energy Modeling and Simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wood, E.; Burton, E.; Duran, A.

Accurate and reliable global positioning system (GPS)-based vehicle use data are highly valuable for many transportation, analysis, and automotive considerations. Model-based design, real-world fuel economy analysis, and the growing field of autonomous and connected technologies (including predictive powertrain control and self-driving cars) all have a vested interest in high-fidelity estimation of powertrain loads and vehicle usage profiles. Unfortunately, road grade can be a difficult property to extract from GPS data with consistency. In this report, we present a methodology for appending high-resolution elevation data to GPS speed traces via a static digital elevation model. Anomalous data points in the digitalmore » elevation model are addressed during a filtration/smoothing routine, resulting in an elevation profile that can be used to calculate road grade. This process is evaluated against a large, commercially available height/slope dataset from the Navteq/Nokia/HERE Advanced Driver Assistance Systems product. Results will show good agreement with the Advanced Driver Assistance Systems data in the ability to estimate road grade between any two consecutive points in the contiguous United States.« less

Results From Spain's 2016 Report Card on Physical Activity for Children and Youth.

PubMed

Roman-Viñas, Blanca; Marin, Jorge; Sánchez-López, Mairena; Aznar, Susana; Leis, Rosaura; Aparicio-Ugarriza, Raquel; Schroder, Helmut; Ortiz-Moncada, Rocío; Vicente, German; González-Gross, Marcela; Serra-Majem, Lluís

2016-11-01

The first Active Healthy Kids Spanish Report Card aims to gather the most robust information about physical activity (PA) and sedentary behavior of children and adolescents. A Research Working Group of experts on PA and sport sciences was convened. A comprehensive data search, based on a review of the literature, dissertations, gray literature, and experts' nonpublished data, was conducted to identify the best sources to grade each indicator following the procedures and methodology outlined by the Active Healthy Kids Canada Report Card model. Overall PA (based on objective and self-reported methods) was graded as D-, Organized Sports Participation as B, Active Play as C+, Active Transportation as C, Sedentary Behavior as D, School as C, and Family and Peers as Incomplete, Community and the Built Environment as Incomplete, and Government as Incomplete. Spanish children and adolescents showed low levels of adherence to PA and sedentary behavior guidelines, especially females and adolescents. There is a need to achieve consensus and harmonize methods to evaluate PA and sedentary behavior to monitor changes over time and to evaluate the effectiveness of policies to promote PA.

Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum.

PubMed

Meissner, Mark H; Gloviczki, Peter; Comerota, Anthony J; Dalsing, Michael C; Eklof, Bo G; Gillespie, David L; Lohr, Joann M; McLafferty, Robert B; Murad, M Hassan; Padberg, Frank; Pappas, Peter; Raffetto, Joseph D; Wakefield, Thomas W

2012-05-01

The anticoagulant treatment of acute deep venous thrombosis (DVT) has been historically directed toward the prevention of recurrent venous thromboembolism. However, such treatment imperfectly protects against late manifestations of the postthrombotic syndrome. By restoring venous patency and preserving valvular function, early thrombus removal strategies can potentially decrease postthrombotic morbidity. A committee of experts in venous disease was charged by the Society for Vascular Surgery and the American Venous Forum to develop evidence-based practice guidelines for early thrombus removal strategies, including catheter-directed pharmacologic thrombolysis, pharmacomechanical thrombolysis, and surgical thrombectomy. Evidence-based recommendations are based on a systematic review and meta-analysis of the relevant literature, supplemented when necessary by less rigorous data. Recommendations are made according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, incorporating the strength of the recommendation (strong: 1; weak: 2) and an evaluation of the level of the evidence (A to C). On the basis of the best evidence currently available, we recommend against routine use of the term "proximal venous thrombosis" in favor of more precise characterization of thrombi as involving the iliofemoral or femoropopliteal venous segments (Grade 1A). We further suggest the use of early thrombus removal strategies in ambulatory patients with good functional capacity and a first episode of iliofemoral DVT of <14 days in duration (Grade 2C) and strongly recommend their use in patients with limb-threatening ischemia due to iliofemoral venous outflow obstruction (Grade 1A). We suggest pharmacomechanical strategies over catheter-directed pharmacologic thrombolysis alone if resources are available and that surgical thrombectomy be considered if thrombolytic therapy is contraindicated (Grade 2C). Most data regarding early thrombus removal strategies are of low quality but do suggest patient-important benefits with respect to reducing postthrombotic morbidity. We anticipate revision of these guidelines as additional evidence becomes available. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Evidence-based guidelines for supportive care of patients with Ebola virus disease.

PubMed

Lamontagne, François; Fowler, Robert A; Adhikari, Neill K; Murthy, Srinivas; Brett-Major, David M; Jacobs, Michael; Uyeki, Timothy M; Vallenas, Constanza; Norris, Susan L; Fischer, William A; Fletcher, Thomas E; Levine, Adam C; Reed, Paul; Bausch, Daniel G; Gove, Sandy; Hall, Andrew; Shepherd, Susan; Siemieniuk, Reed A; Lamah, Marie-Claude; Kamara, Rashida; Nakyeyune, Phiona; Soka, Moses J; Edwin, Ama; Hazzan, Afeez A; Jacob, Shevin T; Elkarsany, Mubarak Mustafa; Adachi, Takuya; Benhadj, Lynda; Clément, Christophe; Crozier, Ian; Garcia, Armando; Hoffman, Steven J; Guyatt, Gordon H

2018-02-17

The 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive care to patients admitted to Ebola treatment units. Key recommendations include administration of oral and, as necessary, intravenous hydration; systematic monitoring of vital signs and volume status; availability of key biochemical testing; adequate staffing ratios; and availability of analgesics, including opioids, for pain relief. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Effectiveness and Risks of Fluoroscopically-Guided Cervical Medial Branch Thermal Radiofrequency Neurotomy: A Systematic Review with Comprehensive Analysis of the Published Data.

PubMed

Engel, Andrew; Rappard, George; King, Wade; Kennedy, David J

2016-04-01

To determine the effectiveness and risks of fluoroscopically-guided cervical medial branch thermal radiofrequency neurotomy (CMBTRFN) for treating chronic neck pain of zygapophysial joint origin. Systematic review of the literature with comprehensive analysis of the published data. Four reviewers formally trained in evidence-based medicine searched the literature on CMBTRFN. Each assessed the methodologies of studies found and appraised the quality of evidence presented. The primary outcomes assessed were 100% relief of pain 6 and 12 months after treatment. Other outcomes were noted if reported. The evidence was evaluated in accordance with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system. The searches yielded eight primary publications on the effectiveness of the procedure. The evidence shows a majority of patients were pain free at 6 months and over a third were pain free at 1 year. The number needed to treat for complete pain relief at 6 months is 2. The evidence of effectiveness is of high quality according to the GRADE system. Twelve papers were found reporting unwanted effects, most of which are minor and temporary. No serious complications have ever been reported from procedures performed according to the published guidelines. The evidence of risks is of low quality according to the GRADE system. If performed as described in the International Spine Intervention Society Guidelines, fluoroscopically-guided CMBTRFN is effective for abolishing zygapophysial joint pain and carries only minor risks. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PSYCHOLOGICAL CONCEPTIONS OF TEACHING.

ERIC Educational Resources Information Center

GAGE, N.L.

A CONCEPTUAL FRAMEWORK WAS PROPOSED FOR AN EDUCATIONAL PSYCHOLOGY COURSE IN THE GENERAL METHODOLOGY OF TEACHING. THIS COURSE WOULD TRANSCEND THE SPECIAL REQUIREMENTS OF ANY GIVEN SUBJECT MATTER OR GRADE LEVEL AND SERVE AS THE BASIS FOR DERIVING THE SPECIAL METHODS OF TEACHING THAT WOULD APPLY TO ANY PARTICULAR GRADE LEVEL OR SUBJECT MATTER.…

The Effects of Issue Investigation and Action Training on Eighth-Grade Students' Environmental Behavior.

ERIC Educational Resources Information Center

Ramsey, John M.

1993-01-01

Reports the instructional effects of a formal environmental education methodology, issue investigation and action training (IIAT), on eighth-grade students. Focuses on whether IIAT can improve responsible environmental behavior in middle school students and whether variables associated with responsible adult environmental behavior will be…

An adaptive corridor-wide signal timing optimization methodology for traffic network with multiple highway-rail grade crossings.

DOT National Transportation Integrated Search

2016-06-01

Highway-rail grade crossings (HRGCs) and the intersections in their proximity are areas where potential problems in terms of safety and efficiency often arise if only simple or outdated treatments, such as normal signal timing or passive railroad war...

Systematic Method for Establishing Officer Grade Requirements Based Upon Job Demands.

ERIC Educational Resources Information Center

Christal, Raymond E.

This report presents interim results of a study developing a methodology for management engineering teams to determine the appropriate grade requirements for officer positions based on job content and responsibilities. The technology reported represents a modification and extension of methods developed between 1963 and 1966. Results indicated that…

Strike Four! Do-Over Policies Institutionalize GPA Distortion

ERIC Educational Resources Information Center

Marx, Jonathan; Meeler, David

2013-01-01

Purpose: The aim of this paper is to illustrate how universities play an institutional role in inflating student grade point averages (GPA) by modifying academic polices such as course withdraw, repeats, and satisfactory/unsatisfactory grade options. Design/methodology/approach: Three research strategies are employed: an examination of eight…

Results of Two Tenth-Grade Biology Teaching Procedures.

ERIC Educational Resources Information Center

Purser, Roger K.; Renner, John W.

1983-01-01

Examined influence of teaching methods on content achievement of concrete and formal concepts by students differing in level of operational thought and influence of concrete/formal teaching on the intellectural development of students (N=86 grade 9-10 biology students). Methodology, results, conclusions, and implications are discussed. (Author/JN)

A methodological survey identified eight proposed frameworks for the adaptation of health related guidelines.

PubMed

Darzi, Andrea; Abou-Jaoude, Elias A; Agarwal, Arnav; Lakis, Chantal; Wiercioch, Wojtek; Santesso, Nancy; Brax, Hneine; El-Jardali, Fadi; Schünemann, Holger J; Akl, Elie A

2017-06-01

Our objective was to identify and describe published frameworks for adaptation of clinical, public health, and health services guidelines. We included reports describing methods of adaptation of guidelines in sufficient detail to allow its reproducibility. We searched Medline and EMBASE databases. We also searched personal files, as well manuals and handbooks of organizations and professional societies that proposed methods of adaptation and adoption of guidelines. We followed standard systematic review methodology. Our search captured 12,021 citations, out of which we identified eight proposed methods of guidelines adaptation: ADAPTE, Adapted ADAPTE, Alberta Ambassador Program adaptation phase, GRADE-ADOLOPMENT, MAGIC, RAPADAPTE, Royal College of Nursing (RCN), and Systematic Guideline Review (SGR). The ADAPTE framework consists of a 24-step process to adapt guidelines to a local context taking into consideration the needs, priorities, legislation, policies, and resources. The Alexandria Center for Evidence-Based Clinical Practice Guidelines updated one of ADAPTE's tools, modified three tools, and added three new ones. In addition, they proposed optionally using three other tools. The Alberta Ambassador Program adaptation phase consists of 11 steps and focused on adapting good-quality guidelines for nonspecific low back pain into local context. GRADE-ADOLOPMENT is an eight-step process based on the GRADE Working Group's Evidence to Decision frameworks and applied in 22 guidelines in the context of national guideline development program. The MAGIC research program developed a five-step adaptation process, informed by ADAPTE and the GRADE approach in the context of adapting thrombosis guidelines. The RAPADAPTE framework consists of 12 steps based on ADAPTE and using synthesized evidence databases, retrospectively derived from the experience of producing a high-quality guideline for the treatment of breast cancer with limited resources in Costa Rica. The RCN outlines five key steps strategy for adaptation of guidelines to the local context. The SGR method consists of nine steps and takes into consideration both methodological gaps and context-specific normative issues in source guidelines. We identified through searching personal files two abandoned methods. We identified and described eight proposed frameworks for the adaptation of health-related guidelines. There is a need to evaluate these different frameworks to assess rigor, efficiency, and transparency of their proposed processes. Copyright © 2017 Elsevier Inc. All rights reserved.

Luminal-like HER2-negative stage IA breast cancer: a multicenter retrospective study on long-term outcome with propensity score analysis

PubMed Central

De Angelis, Carmine; Di Maio, Massimo; Crispo, Anna; Giuliano, Mario; Schettini, Francesco; Bonotto, Marta; Gerratana, Lorenzo; Iacono, Donatella; Cinausero, Marika; Riccardi, Ferdinando; Ciancia, Giuseppe; De Laurentiis, Michelino; Puglisi, Fabio; De Placido, Sabino; Arpino, Grazia

2017-01-01

The benefit of adding chemotherapy (CT) to adjuvant hormone therapy (HT) in stage IA luminal-like HER2-negative breast cancer (BC) is unclear. We retrospectively evaluated predictive factors and clinical outcome of 1,222 patients from 4 oncologic centers. Three hundred and eighty patients received CT and HT (CT-cohort) and 842 received HT alone (HT-cohort). Disease-free survival (DFS) and overall survival (OS) were evaluated with univariate and multivariate analyses. We also applied the propensity score methodology. Compared with the HT-cohort, patients in the CT-cohort were more likely to be younger, have larger tumors of a higher histological grade that were Ki67-positive, and lower estrogen and progesterone receptor expression. At univariate analysis, a higher histological grade and Ki67 were significantly associated to a lower DFS. At multivariable analysis, only histological grade was predictive of DFS. The CT-cohort had a worse outcome than the HT-cohort in terms of DFS and OS, but differences disappeared when matched according to propensity score. In summary, patients with stage IA luminal-like BC had an excellent prognosis, however relapse and mortality were higher in the CT-cohort than in the HT-cohort. Longer use of adjuvant HT or other therapeutic strategies may be needed to improve outcome. PMID:29348868

Story Telling: Research and Action to Improve 6th Grade Students' Views about Certain Aspects of Nature of Science

ERIC Educational Resources Information Center

Kahraman, Feray; Karatas, Faik Özgür

2015-01-01

This study is a four-week section of ongoing attempts that aim to improve 6th grade students' understandings of the nature of science. The study was carried out in a sixth grade science and technology class at a rural middle school with 15 students on the basis of action research methodology. During the study, four different stories based on the…

Validity of High-School Grades in Predicting Student Success beyond the Freshman Year: High-School Record vs. Standardized Tests as Indicators of Four-Year College Outcomes. Research & Occasional Paper Series: CSHE.6.07

ERIC Educational Resources Information Center

Geiser, Saul; Santelices, Maria Veronica

2007-01-01

High-school grades are often viewed as an unreliable criterion for college admissions, owing to differences in grading standards across high schools, while standardized tests are seen as methodologically rigorous, providing a more uniform and valid yardstick for assessing student ability and achievement. The present study challenges that…

Brachytherapy for cervix cancer: low-dose rate or high-dose rate brachytherapy – a meta-analysis of clinical trials

PubMed Central

Viani, Gustavo A; Manta, Gustavo B; Stefano, Eduardo J; de Fendi, Ligia I

2009-01-01

Background The literature supporting high-dose rate brachytherapy (HDR) in the treatment of cervical carcinoma derives primarily from retrospective series. However, controversy still persists regarding the efficacy and safety of HDR brachytherapy compared to low-dose rate (LDR) brachytherapy, in particular, due to inadequate tumor coverage for stage III patients. Whether LDR or HDR brachytherapy produces better results for these patients in terms of survival rate, local control rate and the treatment complications remain controversial. Methods A meta-analysis of RCT was performed comparing LDR to HDR brachytherapy for cervix cancer treated for radiotherapy alone. The MEDLINE, EMBASE, CANCERLIT and Cochrane Library databases, as well as abstracts published in the annual proceedings were systematically searched. We assessed methodological quality for each outcome by grading the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. We used "recommend" for strong recommendations, and "suggest" for weak recommendations. Results Pooled results from five randomized trials (2,065 patients) of HDR brachytherapy in cervix cancer showed no significant increase of mortality (p = 0.52), local recurrence (p = 0.68), or late complications (rectal; p = 0.7, bladder; p = 0.95 or small intestine; p = 0.06) rates as compared to LDR brachytherapy. In the subgroup analysis no difference was observed for overall mortality and local recurrence in patients with clinical stages I, II and III. The quality of evidence was low for mortality and local recurrence in patients with clinical stage I, and moderate for other clinical stages. Conclusion Our meta-analysis shows that there are no differences between HDR and LDR for overall survival, local recurrence and late complications for clinical stages I, II and III. By means of the GRADE system, we recommend the use of HDR for all clinical stages of cervix cancer. PMID:19344527

Supporting elementary science education for English learners: An evaluation instrument to promote constructivist teaching

NASA Astrophysics Data System (ADS)

Gibbons, Beatrice Lowney

2002-01-01

The purpose of this study was to develop an evaluation instrument to be used by elementary school administrators in the promotion of constructivist teaching of elementary science for English Learners using a qualitative and quantitative design that identified effective instructional strategies to be included on the evaluation instrument. This study was conducted in fifth grade classrooms of predominately English Learners whose teachers are CLAD-certified, tenured teachers with at least three years of teaching experience. The classroom observations took place within a multicultural school district with predominantly Hispanic and Filipino students in the Southern San Joaquin Valley of California. The evaluation instrument was used to observe these teachers teach elementary science lessons to classrooms of predominately English Learners. The frequency of the use of the ELD/SDAIE instructional strategies were noted on the evaluation instrument with a check mark, indicating the fact that an instructional technique was employed by the teacher. These observation visits revealed what type of instructional strategies were being utilized in the teaching of science to fifth grade English Learners, whether these CLAD-certified teachers were using ELD strategies, and whether the incidence of ELD/SDAIE constructivist instructional techniques increased with the repeated use of the evaluation instrument. As a result of this study, an evaluation instrument to be utilized by school administrators in the evaluation of elementary science instruction to English Learners was developed. The repeated use of this evaluation instrument coupled with preobservation and postobservation conferences may result in the increase in frequency of ELD/SDAIE methodology and constructivist strategies listed on the evaluation instrument in the elementary science classroom.

Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review.

PubMed

Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans; Søgaard, Karen

2014-10-01

The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. From 50 articles, 54 method names were identified and categorized into three groups: (1) Static positioning assessment (n = 19); (2) Semi-dynamic (n = 13); and (3) Dynamic functional assessment (n = 22). Fifteen studies were excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was "fair" (57%) to "poor" (43%), with only one study rated as "good". The reliability domain was most often investigated. Few of the assessment methods in the included studies that had "fair" or "good" measurement property ratings demonstrated acceptable results for both reliability and validity. We found a substantially larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general "fair" to "poor". None were examined for all three domains: (1) reliability; (2) validity; and (3) responsiveness. Observational evaluation systems and assessment of scapular upward rotation seem suitably evidence-based for clinical use. Future studies should test and improve the clinimetric properties, and especially diagnostic accuracy and responsiveness, to increase utility for clinical practice.

Improving image segmentation performance and quantitative analysis via a computer-aided grading methodology for optical coherence tomography retinal image analysis.

PubMed

Debuc, Delia Cabrera; Salinas, Harry M; Ranganathan, Sudarshan; Tátrai, Erika; Gao, Wei; Shen, Meixiao; Wang, Jianhua; Somfai, Gábor M; Puliafito, Carmen A

2010-01-01

We demonstrate quantitative analysis and error correction of optical coherence tomography (OCT) retinal images by using a custom-built, computer-aided grading methodology. A total of 60 Stratus OCT (Carl Zeiss Meditec, Dublin, California) B-scans collected from ten normal healthy eyes are analyzed by two independent graders. The average retinal thickness per macular region is compared with the automated Stratus OCT results. Intergrader and intragrader reproducibility is calculated by Bland-Altman plots of the mean difference between both gradings and by Pearson correlation coefficients. In addition, the correlation between Stratus OCT and our methodology-derived thickness is also presented. The mean thickness difference between Stratus OCT and our methodology is 6.53 microm and 26.71 microm when using the inner segment/outer segment (IS/OS) junction and outer segment/retinal pigment epithelium (OS/RPE) junction as the outer retinal border, respectively. Overall, the median of the thickness differences as a percentage of the mean thickness is less than 1% and 2% for the intragrader and intergrader reproducibility test, respectively. The measurement accuracy range of the OCT retinal image analysis (OCTRIMA) algorithm is between 0.27 and 1.47 microm and 0.6 and 1.76 microm for the intragrader and intergrader reproducibility tests, respectively. Pearson correlation coefficients demonstrate R(2)>0.98 for all Early Treatment Diabetic Retinopathy Study (ETDRS) regions. Our methodology facilitates a more robust and localized quantification of the retinal structure in normal healthy controls and patients with clinically significant intraretinal features.

Improving image segmentation performance and quantitative analysis via a computer-aided grading methodology for optical coherence tomography retinal image analysis

NASA Astrophysics Data System (ADS)

Cabrera Debuc, Delia; Salinas, Harry M.; Ranganathan, Sudarshan; Tátrai, Erika; Gao, Wei; Shen, Meixiao; Wang, Jianhua; Somfai, Gábor M.; Puliafito, Carmen A.

2010-07-01

We demonstrate quantitative analysis and error correction of optical coherence tomography (OCT) retinal images by using a custom-built, computer-aided grading methodology. A total of 60 Stratus OCT (Carl Zeiss Meditec, Dublin, California) B-scans collected from ten normal healthy eyes are analyzed by two independent graders. The average retinal thickness per macular region is compared with the automated Stratus OCT results. Intergrader and intragrader reproducibility is calculated by Bland-Altman plots of the mean difference between both gradings and by Pearson correlation coefficients. In addition, the correlation between Stratus OCT and our methodology-derived thickness is also presented. The mean thickness difference between Stratus OCT and our methodology is 6.53 μm and 26.71 μm when using the inner segment/outer segment (IS/OS) junction and outer segment/retinal pigment epithelium (OS/RPE) junction as the outer retinal border, respectively. Overall, the median of the thickness differences as a percentage of the mean thickness is less than 1% and 2% for the intragrader and intergrader reproducibility test, respectively. The measurement accuracy range of the OCT retinal image analysis (OCTRIMA) algorithm is between 0.27 and 1.47 μm and 0.6 and 1.76 μm for the intragrader and intergrader reproducibility tests, respectively. Pearson correlation coefficients demonstrate R2>0.98 for all Early Treatment Diabetic Retinopathy Study (ETDRS) regions. Our methodology facilitates a more robust and localized quantification of the retinal structure in normal healthy controls and patients with clinically significant intraretinal features.

Transmutation of singularities and zeros in graded index optical instruments: a methodology for designing practical devices.

PubMed

Hooper, I R; Philbin, T G

2013-12-30

We describe a design methodology for modifying the refractive index profile of graded-index optical instruments that incorporate singularities or zeros in their refractive index. The process maintains the device performance whilst resulting in graded profiles that are all-dielectric, do not require materials with unrealistic values, and that are impedance matched to the bounding medium. This is achieved by transmuting the singularities (or zeros) using the formalism of transformation optics, but with an additional boundary condition requiring the gradient of the co-ordinate transformation be continuous. This additional boundary condition ensures that the device is impedance matched to the bounding medium when the spatially varying permittivity and permeability profiles are scaled to realizable values. We demonstrate the method in some detail for an Eaton lens, before describing the profiles for an "invisible disc" and "multipole" lenses.

Proposal of a Video-recording System for the Assessment of Bell's Palsy: Methodology and Preliminary Results.

PubMed

Monini, Simonetta; Marinozzi, Franco; Atturo, Francesca; Bini, Fabiano; Marchelletta, Silvia; Barbara, Maurizio

2017-09-01

To propose a new objective video-recording procedure to assess and monitor over time the severity of facial nerve palsy. No objective methods for facial palsy (FP) assessment are universally accepted. The face of subjects presenting with different degrees of facial nerve deficit, as measured by the House-Brackmann (HB) grading system, was videotaped after positioning, at specific points, 10 gray circular markers made of a retroreflective material. Video-recording included the resting position and six ordered facial movements. Editing and data elaboration was performed using a software instructed to assess marker distances. From the differences of the marker distances between the two sides was then extracted a score. The higher the FP degree, the higher the score registered during each movement. The statistical significance differed during the various movements between the different FP degrees, being uniform when closing the eyes gently; whereas when wrinkling the nose, there was no difference between the HB grade III and IV groups and, when smiling, no difference was evidenced between the HB grade IV and V groups.The global range index, which represents the overall degree of FP, was between 6.2 and 7.9 in the normal subjects (HB grade I); between 10.6 and 18.91 in HB grade II; between 22.19 and 33.06 in HB grade III; between 38.61 and 49.75 in HB grade IV; and between 50.97 and 66.88 in HB grade V. The proposed objective methodology could provide numerical data that correspond to the different degrees of FP, as assessed by the subjective HB grading system. These data can in addition be used singularly to score selected areas of the paralyzed face when recovery occurs with a different timing in the different face regions.

Elevated Temperature Testing and Modeling of Advanced Toughened Ceramic Materials

NASA Technical Reports Server (NTRS)

Keith, Theo G.

2005-01-01

The purpose of this report is to provide a final report for the period of 12/1/03 through 11/30/04 for NASA Cooperative Agreement NCC3-776, entitled "Elevated Temperature Testing and Modeling of Advanced Toughened Ceramic Materials." During this final period, major efforts were focused on both the determination of mechanical properties of advanced ceramic materials and the development of mechanical test methodologies under several different programs of the NASA-Glenn. The important research activities made during this period are: 1. Mechanical properties evaluation of two gas-turbine grade silicon nitrides. 2) Mechanical testing for fuel-cell seal materials. 3) Mechanical properties evaluation of thermal barrier coatings and CFCCs and 4) Foreign object damage (FOD) testing.

Delphi Research Methodology Applied to Place-Based Watershed Education

ERIC Educational Resources Information Center

Vallor, Rosanna R.; Yates, Kimberly A.; Brody, Michael

2016-01-01

This research focuses on the results of the Flathead Watershed Delphi survey, a consensus-building methodology used to establish foundational knowledge, skills and dispositions for the Flathead Watershed Educators Guide, a place-based watershed curriculum for middle school grades based on the Flathead Watershed Sourcebook. Survey participants (n =…

Kohlberg's Moral Judgment Scale: Some Methodological Considerations

ERIC Educational Resources Information Center

Rubin, Kenneth H.; Trotter, Kristin T.

1977-01-01

Examined 3 methodological issues in the use of Kohlberg's Moral Judgment Scale: (1) test-retest reliability, (2) consistency of moral judgment stages from one dilemma to the next, and (3) influence of subject's verbal facility on the projective test scores. Forty children in grades 3 and 5 participated. (JMB)

Low- and High-Achieving Sixth-Grade Students' Access to Participation during Mathematics Discourse

ERIC Educational Resources Information Center

Lack, Brian; Swars, Susan Lee; Meyers, Barbara

2014-01-01

A descriptive, holistic, multiple-case methodology was applied to examine the nature of participation in discourse of two low- and two high-achieving grade 6 students while solving mathematical tasks in a standards-based classroom. Data collected via classroom observations and student interviews were analyzed through a multiple-cycle coding…

Development of an Occupational Orientation Program for Grades K-6. Final Report.

ERIC Educational Resources Information Center

Kesler, Ray M.; Brown, Sandra

This report presents the development, methodology, and findings of an Occupational Orientation Program for Grades K-6 in Monongalia County, West Virginia. The objectives of the program were to develop a curriculum for an elementary school that would give students the assistance needed to make realistic, attainable career choices, to assist…

Students Using Handheld Computers to Learn Collaboratively in a First Grade Classroom

ERIC Educational Resources Information Center

Fritz, Megan Lynne

2005-01-01

This ethnographic study investigated how first grade students used handheld computers to learn in collaboration with others throughout the learning process. This research focused specifically on how the use of handheld computers impacts students' learning outcomes and relates to technology standards. A qualitative methodology was used to capture…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Toro, Javier, E-mail: jjtoroca@unal.edu.co; Requena, Ignacio, E-mail: requena@decsai.ugr.es; Duarte, Oscar, E-mail: ogduartev@unal.edu.co

In environmental impact assessment, qualitative methods are used because they are versatile and easy to apply. This methodology is based on the evaluation of the strength of the impact by grading a series of qualitative attributes that can be manipulated by the evaluator. The results thus obtained are not objective, and all too often impacts are eliminated that should be mitigated with corrective measures. However, qualitative methodology can be improved if the calculation of Impact Importance is based on the characteristics of environmental factors and project activities instead on indicators assessed by evaluators. In this sense, this paper proposes themore » inclusion of the vulnerability of environmental factors and the potential environmental impact of project activities. For this purpose, the study described in this paper defined Total Impact Importance and specified a quantification procedure. The results obtained in the case study of oil drilling in Colombia reflect greater objectivity in the evaluation of impacts as well as a positive correlation between impact values, the environmental characteristics at and near the project location, and the technical characteristics of project activities. -- Highlights: • Concept of vulnerability has been used to calculate the importance impact assessment. • This paper defined Total Impact Importance and specified a quantification procedure. • The method includes the characteristics of environmental and project activities. • The application has shown greater objectivity in the evaluation of impacts. • Better correlation between impact values, environment and the project has been shown.« less

ACR Appropriateness Criteria® Chronic Extremity Joint Pain-Suspected Inflammatory Arthritis.

PubMed

Jacobson, Jon A; Roberts, Catherine C; Bencardino, Jenny T; Appel, Marc; Arnold, Erin; Baccei, Steven J; Cassidy, R Carter; Chang, Eric Y; Fox, Michael G; Greenspan, Bennett S; Gyftopoulos, Soterios; Hochman, Mary G; Mintz, Douglas N; Newman, Joel S; Rosenberg, Zehava S; Shah, Nehal A; Small, Kirstin M; Weissman, Barbara N

2017-05-01

Evaluation for suspected inflammatory arthritis as a cause for chronic extremity joint pain often relies on imaging. This review first discusses the characteristic osseous and soft tissue abnormalities seen with inflammatory arthritis and how they may be imaged. It is essential that imaging results are interpreted in the context of clinical and serologic results to add specificity as there is significant overlap of imaging findings among the various types of arthritis. This review provides recommendations for imaging evaluation of specific types of inflammatory arthritis, including rheumatoid arthritis, seronegative spondyloarthropathy, gout, calcium pyrophosphate dihydrate disease (or pseudogout), and erosive osteoarthritis. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Platelet-rich plasma in arthroscopic rotator cuff repair: a meta-analysis of randomized controlled trials.

PubMed

Zhao, Jia-Guo; Zhao, Li; Jiang, Yan-Xia; Wang, Zeng-Liang; Wang, Jia; Zhang, Peng

2015-01-01

The purpose of this study was to appraise the retear rate and clinical outcomes of platelet-rich plasma use in patients undergoing arthroscopic full-thickness rotator cuff repair. We searched the Cochrane Library, PubMed, and EMBASE databases for randomized controlled trials comparing the outcomes of arthroscopic rotator cuff surgery with or without the use of platelet-rich plasma. Methodological quality was assessed by the Detsky quality scale. When there was no high heterogeneity, we used a fixed-effects model. Dichotomous variables were presented as risk ratios (RRs) with 95% confidence intervals (CIs), and continuous data were measured as mean differences with 95% CIs. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the quality of evidence for each individual outcome. Eight randomized controlled trials were included, with the sample size ranging from 28 to 88. Overall methodological quality was high. Fixed-effects analysis showed that differences were not significant between the 2 groups in retear rate (RR, 0.94; 95% CI, 0.70 to 1.25; P = .66), Constant score (mean difference, 1.12; 95% CI, -1.38 to 3.61; P = .38), and University of California at Los Angeles (UCLA) score (mean difference, -0.68; 95% CI, -2.00 to 0.65; P = .32). The strength of GRADE evidence was categorized respectively as low for retear, moderate for Constant score, and low for UCLA shoulder score. Our meta-analysis does not support the use of platelet-rich plasma in the arthroscopic repair of full-thickness rotator cuff tears over repairs without platelet-rich plasma because of similar retear rates and clinical outcomes. Level II, meta-analysis of Level I and II randomized controlled trials. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Healthy together Victoria and childhood obesity-a methodology for measuring changes in childhood obesity in response to a community-based, whole of system cluster randomized control trial.

PubMed

Strugnell, Claudia; Millar, Lynne; Churchill, Andrew; Jacka, Felice; Bell, Colin; Malakellis, Mary; Swinburn, Boyd; Allender, Steve

2016-01-01

Healthy Together Victoria (HTV) - a complex 'whole of system' intervention, including an embedded cluster randomized control trial, to reduce chronic disease by addressing risk factors (physical inactivity, poor diet quality, smoking and harmful alcohol use) among children and adults in selected communities in Victoria, Australia (Healthy Together Communities). To describe the methodology for: 1) assessing changes in the prevalence of measured childhood obesity and associated risks between primary and secondary school students in HTV communities, compared with comparison communities; and 2) assessing community-level system changes that influence childhood obesity in HTC and comparison communities. Twenty-four geographically bounded areas were randomized to either prevention or comparison (2012). A repeat cross-sectional study utilising opt-out consent will collect objectively measured height, weight, waist and self-reported behavioral data among primary [Grade 4 (aged 9-10y) and Grade 6 (aged 11-12y)] and secondary [Grade 8 (aged 13-14y) and Grade 10 (aged 15-16y)] school students (2014 to 2018). Relationships between measured childhood obesity and system causes, as defined in the Foresight obesity systems map, will be assessed using a range of routine and customised data. This research methodology describes the beginnings of a state-wide childhood obesity monitoring system that can evolve to regularly inform progress on reducing obesity, and situate these changes in the context of broader community-level system change.

L'enseignement d'une langue (non-maternelle ou maternelle) aux apprenants en difficulté et aux enfants issus de milieux socialement défavorisés

NASA Astrophysics Data System (ADS)

Wambach, Michel

1986-06-01

Official statistics reveal a high percentage of school failure at primary-school level in Belgium, notably among children from socially disadvantaged backgrounds, be they francophone or foreign. Furthermore, the percentage of adult illiteracy is rising. These situations share a common root: the methodology of the mother tongue at school and the approach to the written language in particular. After defining the psychological objective of a language course the present study proposes a methodology, a synthesis of up-to-date psycho-pedagogical, linguistic and (neuro) biological trends. The data from this research make it possible to verify the working hypotheses which have been elaborated and revised over the last twenty years. Within the recommended methodology, the libération de la parole (`liberation of speech') occupies an important place. This initial stage increases and reinforces the creative dispositions in the child and prepares for real language activities. These help the child to communicate and enable a functional learning of the language. The methodology of reading takes into account research conducted on the operation of the memory and the selective activity of the brain. A first evaluation of the methodology has verified the working hypotheses. Moreover, the pupils in the experimental classes obtained markedly higher grades in tests such as reading comprehension, elaborating texts and in those tests calling for imagination and creativity.

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review.

PubMed

Yang, Min; Jiang, Li; Wang, Qing; Chen, Hao; Xu, Guihua

2017-01-01

Traditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown. To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis. Five electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach. Ten SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from "very low" to "low," mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes. TCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice.

Proposed Risk-Informed Seismic Hazard Periodic Reevaluation Methodology for Complying with DOE Order 420.1C

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kammerer, Annie

Department of Energy (DOE) nuclear facilities must comply with DOE Order 420.1C Facility Safety, which requires that all such facilities review their natural phenomena hazards (NPH) assessments no less frequently than every ten years. The Order points the reader to Standard DOE-STD-1020-2012. In addition to providing a discussion of the applicable evaluation criteria, the Standard references other documents, including ANSI/ANS-2.29-2008 and NUREG-2117. These documents provide supporting criteria and approaches for evaluating the need to update an existing probabilistic seismic hazard analysis (PSHA). All of the documents are consistent at a high level regarding the general conceptual criteria that should bemore » considered. However, none of the documents provides step-by-step detailed guidance on the required or recommended approach for evaluating the significance of new information and determining whether or not an existing PSHA should be updated. Further, all of the conceptual approaches and criteria given in these documents deal with changes that may have occurred in the knowledge base that might impact the inputs to the PSHA, the calculated hazard itself, or the technical basis for the hazard inputs. Given that the DOE Order is aimed at achieving and assuring the safety of nuclear facilities—which is a function not only of the level of the seismic hazard but also the capacity of the facility to withstand vibratory ground motions—the inclusion of risk information in the evaluation process would appear to be both prudent and in line with the objectives of the Order. The purpose of this white paper is to describe a risk-informed methodology for evaluating the need for an update of an existing PSHA consistent with the DOE Order. While the development of the proposed methodology was undertaken as a result of assessments for specific SDC-3 facilities at Idaho National Laboratory (INL), and it is expected that the application at INL will provide a demonstration of the methodology, there is potential for general applicability to other facilities across the DOE complex. As such, both a general methodology and a specific approach intended for INL are described in this document. The general methodology proposed in this white paper is referred to as the “seismic hazard periodic review methodology,” or SHPRM. It presents a graded approach for SDC-3, SDC-4 and SDC-5 facilities that can be applied in any risk-informed regulatory environment by once risk-objectives appropriate for the framework are developed. While the methodology was developed for seismic hazard considerations, it can also be directly applied to other types of natural hazards.« less

Proposed Risk-Informed Seismic Hazard Periodic Reevaluation Methodology for Complying with DOE Order 420.1C

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kammerer, Annie

Department of Energy (DOE) nuclear facilities must comply with DOE Order 420.1C Facility Safety, which requires that all such facilities review their natural phenomena hazards (NPH) assessments no less frequently than every ten years. The Order points the reader to Standard DOE-STD-1020-2012. In addition to providing a discussion of the applicable evaluation criteria, the Standard references other documents, including ANSI/ANS-2.29-2008 and NUREG-2117. These documents provide supporting criteria and approaches for evaluating the need to update an existing probabilistic seismic hazard analysis (PSHA). All of the documents are consistent at a high level regarding the general conceptual criteria that should bemore » considered. However, none of the documents provides step-by-step detailed guidance on the required or recommended approach for evaluating the significance of new information and determining whether or not an existing PSHA should be updated. Further, all of the conceptual approaches and criteria given in these documents deal with changes that may have occurred in the knowledge base that might impact the inputs to the PSHA, the calculated hazard itself, or the technical basis for the hazard inputs. Given that the DOE Order is aimed at achieving and assuring the safety of nuclear facilities—which is a function not only of the level of the seismic hazard but also the capacity of the facility to withstand vibratory ground motions—the inclusion of risk information in the evaluation process would appear to be both prudent and in line with the objectives of the Order. The purpose of this white paper is to describe a risk-informed methodology for evaluating the need for an update of an existing PSHA consistent with the DOE Order. While the development of the proposed methodology was undertaken as a result of assessments for specific SDC-3 facilities at Idaho National Laboratory (INL), and it is expected that the application at INL will provide a demonstration of the methodology, there is potential for general applicability to other facilities across the DOE complex. As such, both a general methodology and a specific approach intended for INL are described in this document. The general methodology proposed in this white paper is referred to as the “seismic hazard periodic review methodology,” or SHPRM. It presents a graded approach for SDC-3, SDC-4 and SDC-5 facilities that can be applied in any risk-informed regulatory environment once risk-objectives appropriate for the framework are developed. While the methodology was developed for seismic hazard considerations, it can also be directly applied to other types of natural hazards.« less

Amniotic fluid embolism: diagnosis and management.

PubMed

Pacheco, Luis D; Saade, George; Hankins, Gary D V; Clark, Steven L

2016-08-01

We sought to provide evidence-based guidelines regarding the diagnosis and management of amniotic fluid embolism. A systematic literature review was performed using MEDLINE, PubMed, EMBASE, and the Cochrane Library. The search was restricted to English-language articles published from 1966 through March 2015. Priority was given to articles reporting original research, in particular randomized controlled trials, although review articles and commentaries were consulted. Abstracts of research presented at symposia and scientific conferences were not considered adequate for inclusion. Evidence reports and published guidelines were also reviewed, and additional studies were located by reviewing bibliographies of identified articles. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used for defining the strength of recommendations and rating quality of the evidence. Consistent with US Preventive Task Force guidelines, references were evaluated for quality based on the highest level of evidence. We recommend the following: (1) we recommend consideration of amniotic fluid embolism in the differential diagnosis of sudden cardiorespiratory collapse in the laboring or recently delivered woman (GRADE 1C); (2) we do not recommend the use of any specific diagnostic laboratory test to either confirm or refute the diagnosis of amniotic fluid embolism; at the present time, amniotic fluid embolism remains a clinical diagnosis (GRADE 1C); (3) we recommend the provision of immediate high-quality cardiopulmonary resuscitation with standard basic cardiac life support and advanced cardiac life support protocols in patients who develop cardiac arrest associated with amniotic fluid embolism (GRADE 1C); (4) we recommend that a multidisciplinary team including anesthesia, respiratory therapy, critical care, and maternal-fetal medicine should be involved in the ongoing care of women with AFE (Best Practice); (5) following cardiac arrest with amniotic fluid embolism, we recommend immediate delivery in the presence of a fetus ≥23 weeks of gestation (GRADE 2C); (6) we recommend the provision of adequate oxygenation and ventilation and, when indicated by hemodynamic status, the use of vasopressors and inotropic agents in the initial management of amniotic fluid embolism. Excessive fluid administration should be avoided (GRADE 1C); and (7) because coagulopathy may follow cardiovascular collapse with amniotic fluid embolism, we recommend the early assessment of clotting status and early aggressive management of clinical bleeding with standard massive transfusion protocols (GRADE 1C). Copyright © 2016 Elsevier Inc. All rights reserved.

Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure

PubMed Central

Brochard, Laurent; Elliott, Mark W.; Hess, Dean; Hill, Nicholas S.; Navalesi, Paolo; Antonelli, Massimo; Brozek, Jan; Conti, Giorgio; Ferrer, Miquel; Guntupalli, Kalpalatha; Jaber, Samir; Keenan, Sean; Mancebo, Jordi; Mehta, Sangeeta; Raoof, Suhail

2017-01-01

Noninvasive mechanical ventilation (NIV) is widely used in the acute care setting for acute respiratory failure (ARF) across a variety of aetiologies. This document provides European Respiratory Society/American Thoracic Society recommendations for the clinical application of NIV based on the most current literature. The guideline committee was composed of clinicians, methodologists and experts in the field of NIV. The committee developed recommendations based on the GRADE (Grading, Recommendation, Assessment, Development and Evaluation) methodology for each actionable question. The GRADE Evidence to Decision framework in the guideline development tool was used to generate recommendations. A number of topics were addressed using technical summaries without recommendations and these are discussed in the supplementary material. This guideline committee developed recommendations for 11 actionable questions in a PICO (population–intervention–comparison–outcome) format, all addressing the use of NIV for various aetiologies of ARF. The specific conditions where recommendations were made include exacerbation of chronic obstructive pulmonary disease, cardiogenic pulmonary oedema, de novo hypoxaemic respiratory failure, immunocompromised patients, chest trauma, palliation, post-operative care, weaning and post-extubation. This document summarises the current state of knowledge regarding the role of NIV in ARF. Evidence-based recommendations provide guidance to relevant stakeholders. PMID:28860265

Scoring nuclear pleomorphism using a visual BoF modulated by a graph structure

NASA Astrophysics Data System (ADS)

Moncayo-Martínez, Ricardo; Romo-Bucheli, David; Arias, Viviana; Romero, Eduardo

2017-11-01

Nuclear pleomorphism has been recognized as a key histological criterium in breast cancer grading systems (such as Bloom Richardson and Nothingham grading systems). However, the nuclear pleomorphism assessment is subjective and presents high inter-reader variability. Automatic algorithms might facilitate quantitative estimation of nuclear variations in shape and size. Nevertheless, the automatic segmentation of the nuclei is difficult and still and open research problem. This paper presents a method using a bag of multi-scale visual features, modulated by a graph structure, to grade nuclei in breast cancer microscopical fields. This strategy constructs hematoxylin-eosin image patches, each containing a nucleus that is represented by a set of visual words in the BoF. The contribution of each visual word is computed by examining the visual words in an associated graph built when projecting the multi-dimensional BoF to a bi-dimensional plane where local relationships are conserved. The methodology was evaluated using 14 breast cancer cases of the Cancer Genome Atlas database. From these cases, a set of 134 microscopical fields was extracted, and under a leave-one-out validation scheme, an average F-score of 0.68 was obtained.

Pharmacologic Therapy for Pulmonary Arterial Hypertension in Adults

PubMed Central

Taichman, Darren B.; Chung, Lorinda; Klinger, James R.; Lewis, Sandra; Mandel, Jess; Palevsky, Harold I.; Rich, Stuart; Sood, Namita; Rosenzweig, Erika B.; Trow, Terence K.; Yung, Rex; Elliott, C. Gregory; Badesch, David B.

2014-01-01

OBJECTIVE: Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS: This guideline was based on systematic reviews of English language evidence published between 1990 and November 2013, identified using the MEDLINE and Cochrane Library databases. The strength of available evidence was graded using the Grades of Recommendations, Assessment, Development, and Evaluation methodology. Guideline recommendations, or consensus statements when available evidence was insufficient to support recommendations, were developed using a modified Delphi technique to achieve consensus. RESULTS: Available evidence is limited in its ability to support high-level recommendations. Therefore, we drafted consensus statements to address many clinical questions regarding pharmacotherapy for patients with PAH. A total of 79 recommendations or consensus statements were adopted and graded. CONCLUSIONS: Clinical decisions regarding pharmacotherapy for PAH should be guided by high-level recommendations when sufficient evidence is available. Absent higher level evidence, consensus statements based upon available information must be used. Further studies are needed to address the gaps in available knowledge regarding optimal pharmacotherapy for PAH. PMID:24937180

Evidence-based veterinary dermatology: a systematic review of interventions for Malassezia dermatitis in dogs.

PubMed

Negre, Amélie; Bensignor, Emmanuel; Guillot, Jacques

2009-02-01

The aim of this systematic review was to evaluate the efficacy of antifungal treatments for Malassezia dermatitis in dogs and, when possible, to propose recommendation for or against their use. Electronic searches were carried out using PubMed MEDLINE(R), CABDirect and CONSULTANT database. The volumes of Advances in Veterinary Dermatology, the proceedings of ESVD/ECVD and AAVD/ACVD congresses were hand-searched for studies relevant to this review. All articles and book chapters discussing treatment of Malassezia dermatitis were scanned for additional citations. Lastly, a request was sent to the Vetderm Listserv to share recent clinical trials. The analysis evaluated study design, methodology quality, subject enrolment quality, type of interventions and outcome measures. The searches identified 35 articles, and 14 trials that fulfilled the following selection criteria: (i) in vivo clinical trials, (ii) dogs showing clinical lesions of Malassezia dermatitis and (iii) enrolment of at least five dogs. Among these, only eight studies fulfilled the following additional criterion: (iv) prospective in vivo clinical trials reporting clinical and mycological outcome measures. A total number of 14 different treatment protocols included four blinded, randomized and controlled trials (quality of evidence grade A), four controlled studies lacking blinding and/or randomization (grade B), five open uncontrolled trials (grade C) and one descriptive study (grade D). This systematic review allowed us to recommend, with good evidence, the use of only one topical treatment of Malassezia dermatitis (2% miconazole nitrate +2% chlorhexidine, twice a week for 3 weeks) and with fair evidence the use of two systemic treatments with azole derivatives (ketoconazole, 10 mg kg(-1) day(-1) and itraconazole, 5 mg kg(-1) day(-1) for 3 weeks).

Analisi dell'Interazione Verbale Nella Discussione Matematica: Un Approccio Vygotskiano (A Verbal Analysis of Interaction in Mathematics Discussion: The Vygotskiano Approach).

ERIC Educational Resources Information Center

Bussi, Maria G. Bartolini; Boni, Mara

1995-01-01

Presents a methodology for analyzing verbal interaction in mathematical discussion which is both a product and an instrument of a research project in grades one through eight. Analyzes an example of discussion from a first-grade classroom about point of view. (Author/MKR)

Successful Principalship in Norway: Sustainable Ethos and Incremental Changes?

ERIC Educational Resources Information Center

Moller, Jorunn; Vedoy, Gunn; Presthus, Anne Marie; Skedsmo, Guri

2009-01-01

Purpose: The purpose of this paper is to explore whether and how success has been sustained over time in schools which were identified as being successful five years ago. Design/methodology/approach: Three schools were selected for a revisit, and the sample included two combined schools (grade 1-10) and one upper secondary school (grade 11-13). In…

Methodology in Reading Instruction as a Controlling Variable in the Constructive or Destructive Channeling of Aggression.

ERIC Educational Resources Information Center

Grobler, C. van Eyk

Fourth grade students (half of whom received reading instruction through the Language Experience Approach and the other half through the Basal Reader Approach since the first grade) were observed to determine the behavioral channeling of aggression when influenced by method of instruction. The methods were: (1) a Directed Reading-Thinking Activity…

Improving Second Grade Student's Reading Fluency and Comprehension Using Teacher-Guided iPad® App Instruction

ERIC Educational Resources Information Center

Redcay, Jessica D.; Preston, Sean M.

2016-01-01

Purpose: This study aims to examine the differences in second grade students' reading fluency and comprehension scores when using varying levels of teacher-guided iPad® app instruction to determine effective reading practices. Design/methodology/approach: This study reports the results of the quasi-experimental pre-post study by providing…

Using Theory of Planned Behavior to Predict Healthy Eating among Danish Adolescents

ERIC Educational Resources Information Center

Gronhoj, Alice; Bech-Larsen, Tino; Chan, Kara; Tsang, Lennon

2013-01-01

Purpose: The purpose of the study was to apply the theory of planned behavior to predict Danish adolescents' behavioral intention for healthy eating. Design/methodology/approach: A cluster sample survey of 410 students aged 11 to 16 years studying in Grade 6 to Grade 10 was conducted in Denmark. Findings: Perceived behavioral control followed by…

Pluralist Discourses of Bilingualism and Translanguaging Talk in Classrooms

ERIC Educational Resources Information Center

Durán, Leah; Palmer, Deborah

2014-01-01

This paper examines student and teacher talk in a first grade classroom in a two-way immersion school in Central Texas. Drawing on audio and video data from a year-long study in a first grade two-way classroom and using a methodology that fuses ethnography and discourse analysis, the authors explore how pluralist discourses are constructed and…

Reading Comprehension of Sixth Grade, Good and Poor Readers: A Developmental and Methodological Investigation.

ERIC Educational Resources Information Center

Sawyer, Myrtie L.; And Others

To understand better how readers learn and recall text information, a study examined one prose learning approach--the selective attention strategy (SAS)--in which text elements are processed, given various degrees of attention, and learned according to their perceived importance. Fifty sixth grade students from an inner city school in a large…

76 FR 7856 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

... study methodology in selected AI/AN communities that currently use the Eagle Books as well as the DETS... discussion (focus) groups with children: One group with younger children (grades K-1) and one group with older children (grades 2-4); (v) Two discussion (focus) groups with parents: One group with parents of...

46 CFR Appendix A to Part 404 - Ratemaking Analyses and Methodology

Code of Federal Regulations, 2011 CFR

2011-10-01

... preceding year's average annual rate of return for new issues of high grade corporate securities. (3) Assets... 46 Shipping 8 2011-10-01 2011-10-01 false Ratemaking Analyses and Methodology A Appendix A to Part 404 Shipping COAST GUARD (GREAT LAKES PILOTAGE), DEPARTMENT OF HOMELAND SECURITY GREAT LAKES PILOTAGE...

46 CFR Appendix A to Part 404 - Ratemaking Analyses and Methodology

Code of Federal Regulations, 2013 CFR

2013-10-01

... preceding year's average annual rate of return for new issues of high grade corporate securities. (3) Assets... 46 Shipping 8 2013-10-01 2013-10-01 false Ratemaking Analyses and Methodology A Appendix A to Part 404 Shipping COAST GUARD (GREAT LAKES PILOTAGE), DEPARTMENT OF HOMELAND SECURITY GREAT LAKES PILOTAGE...

46 CFR Appendix A to Part 404 - Ratemaking Analyses and Methodology

Code of Federal Regulations, 2014 CFR

2014-10-01

... preceding year's average annual rate of return for new issues of high grade corporate securities. (3) Assets... 46 Shipping 8 2014-10-01 2014-10-01 false Ratemaking Analyses and Methodology A Appendix A to Part 404 Shipping COAST GUARD (GREAT LAKES PILOTAGE), DEPARTMENT OF HOMELAND SECURITY GREAT LAKES PILOTAGE...

46 CFR Appendix A to Part 404 - Ratemaking Analyses and Methodology

Code of Federal Regulations, 2012 CFR

2012-10-01

... preceding year's average annual rate of return for new issues of high grade corporate securities. (3) Assets... 46 Shipping 8 2012-10-01 2012-10-01 false Ratemaking Analyses and Methodology A Appendix A to Part 404 Shipping COAST GUARD (GREAT LAKES PILOTAGE), DEPARTMENT OF HOMELAND SECURITY GREAT LAKES PILOTAGE...

46 CFR Appendix A to Part 404 - Ratemaking Analyses and Methodology

Code of Federal Regulations, 2010 CFR

2010-10-01

... preceding year's average annual rate of return for new issues of high grade corporate securities. (3) Assets... 46 Shipping 8 2010-10-01 2010-10-01 false Ratemaking Analyses and Methodology A Appendix A to Part 404 Shipping COAST GUARD (GREAT LAKES PILOTAGE), DEPARTMENT OF HOMELAND SECURITY GREAT LAKES PILOTAGE...

An Umbrella Review of Nuts Intake and Risk of Cardiovascular Disease.

PubMed

Schwingshackl, Lukas; Hoffmann, Georg; Missbach, Benjamin; Stelmach-Mardas, Marta; Boeing, Heiner

2017-01-01

Nuts have been an indispensable component of the human diet for hundreds because of their unique nutrient composition and are thought to play a beneficial part in the prevention of cardiovascular diseases. To evaluate the extent, validity and presence of evidence for studies investigating the impact of nuts intake on biomarkers of cardiovascular disease and cardiovascular events, we performed an umbrella review of all published meta-analyses synthesizing data from both observational studies and randomized controlled trials. PubMed (between 1966 and April 2016) was searched for systematic reviews and meta-analyses. Methodological quality was assessed by applying the AMSTAR score (0-11 points), and the meta-evidence by applying NutriGrade, our recently developed scoring system (0-10 points). In total, 14 meta-analyses were included in the umbrella review. Only 4 out of 14 reported an AMSTAR score ≥8 (high methodological quality), whereas NutriGrade meta-evidence score varied between 2 (very low meta-evidence) and 7.9 (moderate meta-evidence). There is consistent evidence from intervention trials, reporting significant reductions for total cholesterol, and from observational studies that higher intakes of nuts were associated with reduced risk of cardiovascular disease and hypertension. On the other side no effect could be observed for stroke, HDL-cholesterol, and blood pressure in the normal range. In summary, the present umbrella review showed that nuts intake was associated with reduced risk of cardiovascular disease and hypertension, and lower levels of total cholesterol. The observed evidence is limited by the moderate methodological quality and very low to moderate quality of evidence. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The Saudi clinical practice guideline for the diagnosis of the first deep venous thrombosis of the lower extremity

PubMed Central

Al-Hameed, Fahad; Al-Dorzi, Hasan M; Shamy, Abdulrahman; Qadi, Abdulelah; Bakhsh, Ebtisam; Aboelnazar, Essam; Abdelaal, Mohamad; Al Khuwaitir, Tarig; Al-Moamary, Mohamed S.; Al-Hajjaj, Mohamed S.; Brozek, Jan; Schünemann, Holger; Mustafa, Reem; Falavigna, Maicon

2015-01-01

The diagnosis of deep venous thrombosis (DVT) may be challenging due to the inaccuracy of clinical assessment and diversity of diagnostic tests. On one hand, missed diagnosis may result in life-threatening conditions. On the other hand, unnecessary treatment may lead to serious complications. As a result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia (KSA), an expert panel led by the Saudi Association for Venous Thrombo-Embolism (SAVTE; a subsidiary of the Saudi Thoracic Society) with the methodological support of the McMaster University Working Group, produced this clinical practice guideline to assist healthcare providers in evidence-based clinical decision-making for the diagnosis of a suspected first DVT of the lower extremity. Twenty-four questions were identified and corresponding recommendations were made following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. These recommendations included assessing the clinical probability of DVT using Wells criteria before requesting any test and undergoing a sequential diagnostic evaluation, mainly using highly sensitive D-dimer by enzyme-linked immunosorbent assay (ELISA) and compression ultrasound. Although venography is the reference standard test for the diagnosis of DVT, its use was not recommended. PMID:25593601

A particle swarm-based algorithm for optimization of multi-layered and graded dental ceramics.

PubMed

Askari, Ehsan; Flores, Paulo; Silva, Filipe

2018-01-01

The thermal residual stresses (TRSs) generated owing to the cooling down from the processing temperature in layered ceramic systems can lead to crack formation as well as influence the bending stress distribution and the strength of the structure. The purpose of this study is to minimize the thermal residual and bending stresses in dental ceramics to enhance their strength as well as to prevent the structure failure. Analytical parametric models are developed to evaluate thermal residual stresses in zirconia-porcelain multi-layered and graded discs and to simulate the piston-on-ring test. To identify optimal designs of zirconia-based dental restorations, a particle swarm optimizer is also developed. The thickness of each interlayer and compositional distribution are referred to as design variables. The effect of layers number constituting the interlayer between two based materials on the performance of graded prosthetic systems is also investigated. The developed methodology is validated against results available in literature and a finite element model constructed in the present study. Three different cases are considered to determine the optimal design of graded prosthesis based on minimizing (a) TRSs; (b) bending stresses; and (c) both TRS and bending stresses. It is demonstrated that each layer thickness and composition profile have important contributions into the resulting stress field and magnitude. Copyright © 2017 Elsevier Ltd. All rights reserved.

Diagnosis and treatment of posterior sacroiliac complex pain: a systematic review with comprehensive analysis of the published data.

PubMed

King, Wade; Ahmed, Shihab U; Baisden, Jamie; Patel, Nileshkumar; Kennedy, David J; Duszynski, Belinda; MacVicar, John

2015-02-01

To assess the evidence on the validity of sacral lateral branch blocks and the effectiveness of sacral lateral branch thermal radiofrequency neurotomy in managing sacroiliac complex pain. Systematic review with comprehensive analysis of all published data. Six reviewers searched the literature on sacral lateral branch interventions. Each assessed the methodologies of studies found and the quality of the evidence presented. The outcomes assessed were diagnostic validity and effectiveness of treatment for sacroiliac complex pain. The evidence found was appraised in accordance with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system of evaluating scientific evidence. The searches yielded two primary publications on sacral lateral branch blocks and 15 studies of the effectiveness of sacral lateral branch thermal radiofrequency neurotomy. One study showed multisite, multidepth sacral lateral branch blocks can anesthetize the posterior sacroiliac ligaments. Therapeutic studies show sacral lateral branch thermal radiofrequency neurotomy can relieve sacroiliac complex pain to some extent. The evidence of the validity of these blocks and the effectiveness of this treatment were rated as moderate in accordance with the GRADE system. The literature on sacral lateral branch interventions is sparse. One study demonstrates the face validity of multisite, multidepth sacral lateral branch blocks for diagnosis of posterior sacroiliac complex pain. Some evidence of moderate quality exists on therapeutic procedures, but it is insufficient to determine the indications and effectiveness of sacral lateral branch thermal radiofrequency neurotomy, and more research is required. Wiley Periodicals, Inc.

Constructing post-surgical discharge instructions through a Delphi consensus methodology.

PubMed

Scott, Aaron R; Sanderson, Cody J; Rush, Augustus J; Alore, Elizabeth A; Naik, Aanand D; Berger, David H; Suliburk, James W

2018-05-01

Patient education materials are a crucial part of physician-patient communication. We hypothesize that available discharge instructions are difficult to read and fail to address necessary topics. Our objective is to evaluate readability and content of surgical discharge instructions using thyroidectomy to develop standardized discharge materials. Thyroidectomy discharge materials were analyzed for readability and assessed for content. Fifteen endocrine surgeons participated in a modified Delphi consensus panel to select necessary topics. Using readability best practices, we created standardized discharge instructions which included all selected topics. The panel evaluated 40 topics, selected 23, deemed 4 inappropriate, consolidated 5, and did not reach consensus on 8 topics after 4 rounds. The evaluated instructions' reading levels ranged from grade 6.5 to 13.2; none contained all consensus topics. Current post surgical thyroidectomy discharge instructions are more difficult to read than recommended by literacy standards and omit consensus warning signs of major complications. Our easy-to-read discharge instructions cover pertinent topics and may enhance patient education. Delphi methodology is useful for developing post-surgical instructions. Patient education materials need appropriate readability levels and content. We recommend the Delphi method to select content using consensus expert opinion whenever higher level data is lacking. Copyright © 2017 Elsevier B.V. All rights reserved.

Results From Qatar's 2016 Active Healthy Kids Report Card on Physical Activity for Children and Youth.

PubMed

Al-Kuwari, Mohamed G; Ibrahim, Izzeldin A; Hammadi, Eiman M Al; Reilly, John J

2016-11-01

The first Qatar Active Healthy Kids (QAHK) Report Card was developed in 2015-2016. It is a synthesis of the available evidence on physical activity in children and youth in the state of Qatar-an assessment of the state of the nation. The report card is important for future physical activity advocacy, policy, and program development. The QAHK Report Card was inspired by the Active Healthy Kids Scotland 2013 Report Card. The methodology used in Scotland's report card was adapted for Qatar. A Working Group identified indicators for physical activity and related health behaviors, and evaluated the available data on these indicators. The card grades were determined by the percentage of children meeting guidelines or recommendations. The 2016 QAHK Report Card consisted of 9 indicators: 6 Physical Activity and Health Behaviors and Outcomes, and 3 Settings and Influences on these health behaviors and outcomes. The indicator National Policy, Strategy, and Investment was assigned the highest grade (B). Four indicators were assigned D grades: Sedentary Behavior, Dietary Habits, Organized Sports Participation, and Family and Peer Influence. Physical Activity and Obesity were both graded F. Two indicators could not be graded due to insufficient data and/or absence of a recommendation: Active and Outdoor Play, and Community and School Influence. The QAHK Report Card identified weaknesses and gaps in the evidence on physical activity and health in children and youth in Qatar. The quality of evidence was poor for some indicators, with some data collection methods of limited validity and reliability, or only available for a limited age range, so the grades are best estimates of the current situation in Qatar. Future surveys and research using objective physical activity measures will support the development of a second QAHK Report Card by 2018.

Which sociodemographic factors are important on smoking behaviour of high school students? The contribution of classification and regression tree methodology in a broad epidemiological survey.

PubMed

Ozge, C; Toros, F; Bayramkaya, E; Camdeviren, H; Sasmaz, T

2006-08-01

The purpose of this study is to evaluate the most important sociodemographic factors on smoking status of high school students using a broad randomised epidemiological survey. Using in-class, self administered questionnaire about their sociodemographic variables and smoking behaviour, a representative sample of total 3304 students of preparatory, 9th, 10th, and 11th grades, from 22 randomly selected schools of Mersin, were evaluated and discriminative factors have been determined using appropriate statistics. In addition to binary logistic regression analysis, the study evaluated combined effects of these factors using classification and regression tree methodology, as a new statistical method. The data showed that 38% of the students reported lifetime smoking and 16.9% of them reported current smoking with a male predominancy and increasing prevalence by age. Second hand smoking was reported at a 74.3% frequency with father predominance (56.6%). The significantly important factors that affect current smoking in these age groups were increased by household size, late birth rank, certain school types, low academic performance, increased second hand smoking, and stress (especially reported as separation from a close friend or because of violence at home). Classification and regression tree methodology showed the importance of some neglected sociodemographic factors with a good classification capacity. It was concluded that, as closely related with sociocultural factors, smoking was a common problem in this young population, generating important academic and social burden in youth life and with increasing data about this behaviour and using new statistical methods, effective coping strategies could be composed.

An Integrated Model of Academic Self-Concept Development: Academic Self-Concept, Grades, Test Scores, and Tracking over 6 Years

ERIC Educational Resources Information Center

Marsh, Herbert W.; Pekrun, Reinhard; Murayama, Kou; Arens, A. Katrin; Parker, Philip D.; Guo, Jiesi; Dicke, Theresa

2018-01-01

Our newly proposed integrated academic self-concept model integrates 3 major theories of academic self-concept formation and developmental perspectives into a unified conceptual and methodological framework. Relations among math self-concept (MSC), school grades, test scores, and school-level contextual effects over 6 years, from the end of…

Supporting First Grade Students' Understanding of Addition up to 20 Using Traditional Game

ERIC Educational Resources Information Center

Nursyahidah, Farida; Putri, Ratu Ilma Indra; Somakim

2013-01-01

This research aim is to know the students' understanding in adding number up to 20 using traditional game of dakocan and to acquire learning trajectory of adding number up to 20 using traditional game of dakocan for the first grade of primary school. This research used methodology of design research that consists of three phases, there are…

The Emergent Charter School Model for Ninth Grade Mildly Disabled United States Students: Extending to Africa

ERIC Educational Resources Information Center

Vincent, Emmanuel Teah

2009-01-01

An ethnographic, descriptive research methodology was used to explore the service delivery of three U.S. charter schools (one independent and two dependent secondary public charter schools) in Southern New England, United States as they relate to grade nine mildly disabled special needs students. Field research was also conducted in Costa Rica and…

The Development of a Model for Creative Writing Instruction for Mattayomsuksa Three Students (Grade 9)

ERIC Educational Resources Information Center

Chaiyadejkamjorn, Natsuchawirang; Soonthonrojana, Wimonrat; Sangkhaphanthanon, Thanya

2017-01-01

The research aimed to construct an instructional model for creative writing for Mattayomsueksa Three students (Grade 9), to develop the model according to a criterion of 80/80, and to examine the results of the model in use. The research methodology consisted of three phases: phase one studied the current states, problems and needs for teaching…

One Good Look Deserves Another: Combining Methodologies to Describe Classrooms. Report No. 5084.

ERIC Educational Resources Information Center

Kugle, C. L.; Clements, R. O.

Qualitative and quantitative methodology in classroom observation were combined in this study that examined nine second grade reading classes. Each classroom was observed by an ethnographer and a classroom coder ten times throughout the year, and each observation lasted 90 minutes. For each classroom, four of the ten observations were also…

Postoperative pain treatment after total knee arthroplasty: A systematic review

PubMed Central

Wetterslev, Mik; Hansen, Signe Elisa; Hansen, Morten Sejer; Mathiesen, Ole; Dahl, Jørgen B.

2017-01-01

Introduction The aim of this systematic review was to document efficacy, safety and quality of evidence of analgesic interventions after total knee arthroplasty (TKA). Methods This PRISMA-compliant and PROSPERO-registered review includes all-language randomized controlled trials of medication-based analgesic interventions after TKA. Bias was evaluated according to Cochrane methodology. Outcomes were opioid consumption (primary), pain scores at rest and during mobilization, adverse events, and length of stay. Interventions investigated in three or more trials were meta-analysed. Outcomes were evaluated using forest plots, Grading of Recommendations Assessment, Development and Evaluation (GRADE), L’Abbe Plots and trial sequential analysis. Results The included 113 trials, investigating 37 different analgesic interventions, were characterized by unclear/high risk of bias, low assay sensitivity and considerable differences in pain assessment tools, basic analgesic regimens, and reporting of adverse events. In meta-analyses single and continuous femoral nerve block (FNB), intrathecal morphine, local infiltration analgesia, intraarticular injection of local anaesthetics, non-steroidal anti-inflammatory drugs, and gabapentinoids demonstrated significant analgesic effects. The 24-hour morphine-sparing effects ranged from 4.2 mg (CI: 1.3, 7.2; intraarticular local anaesthetics), to 16.6 mg (CI: 11.2, 22; single FNB). Pain relieving effects at rest at 6 hours ranged from 4 mm (CI: -10, 2; gabapentinoids), to 19 mm (CI: 8, 31; single FNB), and at 24 hours from 3 mm (CI: -2, 8; gabapentinoids), to 16 mm (CI: 8, 23; continuous FNB). GRADE-rated quality of evidence was generally low. Conclusion A low quality of evidence, small sample sizes and heterogeneity of trial designs prohibit designation of an optimal procedure-specific analgesic regimen after TKA. PMID:28273133

ACR Appropriateness Criteria® Chronic Ankle Pain.

PubMed

Chang, Eric Y; Tadros, Anthony S; Amini, Behrang; Bell, Angela M; Bernard, Stephanie A; Fox, Michael G; Gorbachova, Tetyana; Ha, Alice S; Lee, Kenneth S; Metter, Darlene F; Mooar, Pekka A; Shah, Nehal A; Singer, Adam D; Smith, Stacy E; Taljanovic, Mihra S; Thiele, Ralf; Kransdorf, Mark J

2018-05-01

Chronic ankle pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic ankle pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

ACR Appropriateness Criteria® Chronic Hip Pain.

PubMed

Mintz, Douglas N; Roberts, Catherine C; Bencardino, Jenny T; Baccei, Steven J; Caird, Michelle S; Cassidy, R Carter; Chang, Eric Y; Fox, Michael G; Gyftopoulos, Soterios; Kransdorf, Mark J; Metter, Darlene F; Morrison, William B; Rosenberg, Zehava S; Shah, Nehal A; Small, Kirstin M; Subhas, Naveen; Tambar, Siddharth; Towers, Jeffrey D; Yu, Joseph S; Weissman, Barbara N

2017-05-01

Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic hip pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Impact of Increasing Inter-pregnancy Interval on Maternal and Infant Health

PubMed Central

Wendt, Amanda; Gibbs, Cassandra M.; Peters, Stacey; Hogue, Carol J.

2015-01-01

Short inter-pregnancy intervals (IPIs) have been associated with adverse maternal and infant health outcomes in the literature. However, many studies in this area have been lacking in quality and appropriate control for confounders known to be associated with both short IPIs and poor outcomes. The objective of this systematic review was to assess this relationship using more rigorous criteria, based on GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. We found too few higher-quality studies of the impact of IPIs (measured as the time between the birth of a previous child and conception of the next child) on maternal health to reach conclusions about maternal nutrition, morbidity or mortality. However, the evidence for infant effects justified meta-analyses. We found significant impacts of short IPIs for extreme preterm birth [<6 m adjusted odds ratio (aOR): 1.58 [95% confidence interval (CI) 1.40, 1.78], 6–11 m aOR: 1.23 [1.03, 1.46

Developmental changes in coping: situational and methodological influences.

PubMed

Vierhaus, Marc; Lohaus, Arnold; Ball, Juliane

2007-09-01

Previous studies on the development of coping have shown rather inconsistent findings regarding the developmental trajectories for different coping dimensions. The aim of this study is to search for possible influences that might explain these inconsistencies. The analysis focuses on methodological influences (longitudinal vs. cross-sectional assessments) and situational influences. Two samples of children were traced longitudinally with yearly assessments from grade 2 to 5 (sample 1, N =432) and from grade 4 to 7 (sample 2, N =366). A third sample (N =849) was added with cross-sectional assessments from grade 2 to 7. The assessed coping dimensions were related to (a) problem solving, (b) seeking social support, (c) palliative coping, (d) externalizing emotional coping, and (e) avoidant coping. The use of the coping strategies had to be assessed for six stress-evoking situations. The results show only small differences between the longitudinal and the cross-sectional coping assessments. There are, however, clear situational influences on the choice of the coping strategies and also on the resulting developmental trajectories.

Treatment and Prevention of Heparin-Induced Thrombocytopenia

PubMed Central

Dans, Antonio L.; Moores, Lisa K.; Bona, Robert; Davidson, Bruce L.; Schulman, Sam; Crowther, Mark

2012-01-01

Background: Heparin-induced thrombocytopenia (HIT) is an antibody-mediated adverse drug reaction that can lead to devastating thromboembolic complications, including pulmonary embolism, ischemic limb necrosis necessitating limb amputation, acute myocardial infarction, and stroke. Methods: The methods of this guideline follow the Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: Among the key recommendations for this article are the following: For patients receiving heparin in whom clinicians consider the risk of HIT to be > 1%, we suggest that platelet count monitoring be performed every 2 or 3 days from day 4 to day 14 (or until heparin is stopped, whichever occurs first) (Grade 2C). For patients receiving heparin in whom clinicians consider the risk of HIT to be < 1%, we suggest that platelet counts not be monitored (Grade 2C). In patients with HIT with thrombosis (HITT) or isolated HIT who have normal renal function, we suggest the use of argatroban or lepirudin or danaparoid over other nonheparin anticoagulants (Grade 2C). In patients with HITT and renal insufficiency, we suggest the use of argatroban over other nonheparin anticoagulants (Grade 2C). In patients with acute HIT or subacute HIT who require urgent cardiac surgery, we suggest the use of bivalirudin over other nonheparin anticoagulants or heparin plus antiplatelet agents (Grade 2C). Conclusions: Further studies evaluating the role of fondaparinux and the new oral anticoagulants in the treatment of HIT are needed. PMID:22315270

Coupled structural/thermal/electromagnetic analysis/tailoring of graded composite structures

NASA Technical Reports Server (NTRS)

Hartle, M. S.; Mcknight, R. L.; Huang, H.; Holt, R.

1992-01-01

Described here are the accomplishments of a 5-year program to develop a methodology for coupled structural, thermal, electromagnetic analysis tailoring of graded component structures. The capabilities developed over the course of the program are the analyzer module and the tailoring module for the modeling of graded materials. Highlighted accomplishments for the past year include the addition of a buckling analysis capability, the addition of mode shape slope calculation for flutter analysis, verification of the analysis modules using simulated components, and verification of the tailoring module.

Single Event Test Methodologies and System Error Rate Analysis for Triple Modular Redundant Field Programmable Gate Arrays

NASA Technical Reports Server (NTRS)

Allen, Gregory; Edmonds, Larry D.; Swift, Gary; Carmichael, Carl; Tseng, Chen Wei; Heldt, Kevin; Anderson, Scott Arlo; Coe, Michael

2010-01-01

We present a test methodology for estimating system error rates of Field Programmable Gate Arrays (FPGAs) mitigated with Triple Modular Redundancy (TMR). The test methodology is founded in a mathematical model, which is also presented. Accelerator data from 90 nm Xilins Military/Aerospace grade FPGA are shown to fit the model. Fault injection (FI) results are discussed and related to the test data. Design implementation and the corresponding impact of multiple bit upset (MBU) are also discussed.

Grading Rigor in Counselor Education: A Specifications Grading Framework

ERIC Educational Resources Information Center

Bonner, Matthew W.

2016-01-01

According to accreditation and professional bodies, evaluation and grading are a high priority in counselor education. Specifications grading, an evaluative tool, can be used to increase grading rigor. This article describes the components of specifications grading and applies the framework of specifications grading to a counseling theories course.

Using Design Thinking to Improve Psychological Interventions: The Case of the Growth Mindset During the Transition to High School

PubMed Central

Yeager, David S.; Romero, Carissa; Paunesku, Dave; Hulleman, Christopher S.; Schneider, Barbara; Hinojosa, Cintia; Lee, Hae Yeon; O’Brien, Joseph; Flint, Kate; Roberts, Alice; Trott, Jill; Greene, Daniel; Walton, Gregory M.; Dweck, Carol S.

2016-01-01

There are many promising psychological interventions on the horizon, but there is no clear methodology for preparing them to be scaled up. Drawing on design thinking, the present research formalizes a methodology for redesigning and tailoring initial interventions. We test the methodology using the case of fixed versus growth mindsets during the transition to high school. Qualitative inquiry and rapid, iterative, randomized “A/B” experiments were conducted with ~3,000 participants to inform intervention revisions for this population. Next, two experimental evaluations showed that the revised growth mindset intervention was an improvement over previous versions in terms of short-term proxy outcomes (Study 1, N=7,501), and it improved 9th grade core-course GPA and reduced D/F GPAs for lower achieving students when delivered via the Internet under routine conditions with ~95% of students at 10 schools (Study 2, N=3,676). Although the intervention could still be improved even further, the current research provides a model for how to improve and scale interventions that begin to address pressing educational problems. It also provides insight into how to teach a growth mindset more effectively. PMID:27524832

The relationship between return on investment and quality of study methodology in workplace health promotion programs.

PubMed

Baxter, Siyan; Sanderson, Kristy; Venn, Alison J; Blizzard, C Leigh; Palmer, Andrew J

2014-01-01

To determine the relationship between return on investment (ROI) and quality of study methodology in workplace health promotion programs. Data were obtained through a systematic literature search of National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Database (HTA), Cost Effectiveness Analysis (CEA) Registry, EconLit, PubMed, Embase, Wiley, and Scopus. Included were articles written in English or German reporting cost(s) and benefit(s) and single or multicomponent health promotion programs on working adults. Return-to-work and workplace injury prevention studies were excluded. Methodological quality was graded using British Medical Journal Economic Evaluation Working Party checklist. Economic outcomes were presented as ROI. ROI was calculated as ROI = (benefits - costs of program)/costs of program. Results were weighted by study size and combined using meta-analysis techniques. Sensitivity analysis was performed using two additional methodological quality checklists. The influences of quality score and important study characteristics on ROI were explored. Fifty-one studies (61 intervention arms) published between 1984 and 2012 included 261,901 participants and 122,242 controls from nine industry types across 12 countries. Methodological quality scores were highly correlated between checklists (r = .84-.93). Methodological quality improved over time. Overall weighted ROI [mean ± standard deviation (confidence interval)] was 1.38 ± 1.97 (1.38-1.39), which indicated a 138% return on investment. When accounting for methodological quality, an inverse relationship to ROI was found. High-quality studies (n = 18) had a smaller mean ROI, 0.26 ± 1.74 (.23-.30), compared to moderate (n = 16) 0.90 ± 1.25 (.90-.91) and low-quality (n = 27) 2.32 ± 2.14 (2.30-2.33) studies. Randomized control trials (RCTs) (n = 12) exhibited negative ROI, -0.22 ± 2.41(-.27 to -.16). Financial returns become increasingly positive across quasi-experimental, nonexperimental, and modeled studies: 1.12 ± 2.16 (1.11-1.14), 1.61 ± 0.91 (1.56-1.65), and 2.05 ± 0.88 (2.04-2.06), respectively. Overall, mean weighted ROI in workplace health promotion demonstrated a positive ROI. Higher methodological quality studies provided evidence of smaller financial returns. Methodological quality and study design are important determinants.

Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review

PubMed Central

Wang, Qing; Chen, Hao

2017-01-01

Background Traditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown. Objective To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis. Methods Five electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach. Results Ten SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from “very low” to “low,” mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes. Conclusions TCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice. PMID:29267324

Evaluating the Quality of Evidence from a Network Meta-Analysis

PubMed Central

Salanti, Georgia; Del Giovane, Cinzia; Chaimani, Anna; Caldwell, Deborah M.; Higgins, Julian P. T.

2014-01-01

Systematic reviews that collate data about the relative effects of multiple interventions via network meta-analysis are highly informative for decision-making purposes. A network meta-analysis provides two types of findings for a specific outcome: the relative treatment effect for all pairwise comparisons, and a ranking of the treatments. It is important to consider the confidence with which these two types of results can enable clinicians, policy makers and patients to make informed decisions. We propose an approach to determining confidence in the output of a network meta-analysis. Our proposed approach is based on methodology developed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group for pairwise meta-analyses. The suggested framework for evaluating a network meta-analysis acknowledges (i) the key role of indirect comparisons (ii) the contributions of each piece of direct evidence to the network meta-analysis estimates of effect size; (iii) the importance of the transitivity assumption to the validity of network meta-analysis; and (iv) the possibility of disagreement between direct evidence and indirect evidence. We apply our proposed strategy to a systematic review comparing topical antibiotics without steroids for chronically discharging ears with underlying eardrum perforations. The proposed framework can be used to determine confidence in the results from a network meta-analysis. Judgements about evidence from a network meta-analysis can be different from those made about evidence from pairwise meta-analyses. PMID:24992266

Coupled structural/thermal/electromagnetic analysis/tailoring of graded composite structures

NASA Technical Reports Server (NTRS)

Mcknight, R. L.; Huang, H.; Hartle, M.

1992-01-01

Accomplishments are described for the fourth years effort of a 5-year program to develop a methodology for coupled structural/thermal/electromagnetic analysis/tailoring of graded component structures. These accomplishments include: (1) demonstration of coupled solution capability; (2) alternate CSTEM electromagnetic technology; (3) CSTEM acoustic capability; (4) CSTEM tailoring; (5) CSTEM composite micromechanics using ICAN; and (6) multiple layer elements in CSTEM.

Opportunity To Learn: Instructional Practices in Eighth-Grade Mathematics: Data from the 1990 NAEP Trial State Assessment. CPRE Research Report Series Report #32.

ERIC Educational Resources Information Center

Goertz, Margaret E.

This paper uses data from the 1990 National Assessment of Educational Progress (NAEP) Trial State Assessment to describe educational opportunities for students in eighth-grade mathematics in 1990. The first section of the paper summarizes the methodology used here and in the 1990 NAEP Trial State Assessment. The second section summarizes findings…

An Exploration of What Happens when Second and Third Graders in Two Countries Interact through a Technology Enhanced Multicultural Collaboration

ERIC Educational Resources Information Center

Richards, Brenda Eklund

2010-01-01

This study used qualitative methodology to document what happened when two groups of children--a second grade class in Columbia, South Carolina, U.S.A. and a third grade class in Amman, Jordan--collaborated on a technology enhanced cultural exchange. Key aspects of this project included dialogic collaboration based upon Short's (2003) model of…

Immersion francaise precoce: Arts plastiques 1-7 (Early French Immersion: Plastic Arts for Grades 1-7).

ERIC Educational Resources Information Center

Burt, Andy; And Others

This curriculum guide in art education is intended for use in grades 1-7 in the early French immersion program. An introductory chapter describes the educational objectives of the art program, the role of art education in child development, general and terminal objectives, methodology, the steps in graphic evolution, and an outline of the program.…

When Going Hybrid Is Not Enough: Statistical Analysis of Effectiveness of Blended Courses Piloted within Tempus BLATT Project

ERIC Educational Resources Information Center

Jovanovic, Aleksandar; Jankovic, Anita; Jovanovic, Snezana Markovic; Peric, Vladan; Vitosevic, Biljana; Pavlovic, Milos

2015-01-01

The paper describes the delivery of the courses in the framework of the project implementation and presents the effect the change in the methodology had on student performance as measured by final grade. Methodology: University of Pristina piloted blended courses in 2013 under the framework of the Tempus BLATT project. The blended learning…

Diverse and participative learning methodologies: a remedial teaching intervention for low marks dental students in Chile.

PubMed

Alcota, Marcela; Muñoz, Andrea; González, Fermín E

2011-10-01

The purpose of this educational intervention was to diagnose the learning style of a group of low marks (i.e., grades) dental students in Chile and improve their academic achievement by means of remedial teaching. The intervention group was composed of ten students in endodontics and eleven in pedodontics with low marks. These two groups were mutually exclusive. The Kolb test of learning styles was applied to the low mark students group and to the rest of the class (n=72). Diverse methodologies were applied to the low marks students, such as seminars, case-based learning and problem-based learning, directed study, plenary discussions and debate, integration and questions, and web-based learning in an effort to cover all learning styles. Students' perceptions of the educational intervention were assessed by means of a questionnaire. The learning styles of the low marks group were mainly divergent (52.4 percent) and convergent (19 percent). Accommodators and assimilators were 14.3 percent each. The rest of the class showed a very distinct frequencies distribution: divergent 18 percent, convergent 20 percent, accommodators 28 percent, and assimilators 34 percent. After the educational intervention, the mean of the scores obtained by the intervention group in formal evaluations was higher than the average scores obtained before the intervention for both courses. Students' perceptions of the activities were that they were effective for their learning process (76 percent) and that the teaching methodologies were useful mainly to clarify concepts and contents from both courses (82 percent). We can conclude that the use of diverse and participative teaching methodologies in a remedial teaching intervention, to cover all the different learning styles of the students, contributes to improve their marks in formal evaluations.

Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults.

PubMed

Aschner, Pablo M; Muñoz, Oscar Mauricio; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel Gerardo; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; Arango T, Clara María; Carvajal, Liliana; Ramírez, Doris Amanda; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; Correa G, Néstor Fabián; Alarcón R, Pilar; Bustamante S, Álvaro Andrés

2016-06-30

In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes.

Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults

PubMed Central

Muñoz, Oscar Mauricio; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel Gerardo; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; Arango T, Clara María; Carvajal, Liliana; Ramírez, Doris Amanda; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; Correa G, Néstor Fabián; Alarcón R, Pilar; Bustamante S, Álvaro Andrés

2016-01-01

In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes. PMID:27546934

Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes.

PubMed

Dyson, P A; Twenefour, D; Breen, C; Duncan, A; Elvin, E; Goff, L; Hill, A; Kalsi, P; Marsland, N; McArdle, P; Mellor, D; Oliver, L; Watson, K

2018-05-01

A summary of the latest evidence-based nutrition guidelines for the prevention and management of diabetes is presented. These guidelines are based on existing recommendations last published in 2011, and were formulated by an expert panel of specialist dietitians after a literature review of recent evidence. Recommendations have been made in terms of foods rather than nutrients wherever possible. Guidelines for education and care delivery, prevention of Type 2 diabetes, glycaemic control for Type 1 and Type 2 diabetes, cardiovascular disease risk management, management of diabetes-related complications, other considerations including comorbidities, nutrition support, pregnancy and lactation, eating disorders, micronutrients, food supplements, functional foods, commercial diabetic foods and nutritive and non-nutritive sweeteners are included. The sections on pregnancy and prevention of Type 2 diabetes have been enlarged and the weight management section modified to include considerations of remission of Type 2 diabetes. A section evaluating detailed considerations in ethnic minorities has been included as a new topic. The guidelines were graded using adapted 'GRADE' methodology and, where strong evidence was lacking, grading was not allocated. These 2018 guidelines emphasize a flexible, individualized approach to diabetes management and weight loss and highlight the emerging evidence for remission of Type 2 diabetes. The full guideline document is available at www.diabetes.org.uk/nutrition-guidelines. © 2018 Diabetes UK.

Cochrane Qualitative and Implementation Methods Group guidance series-paper 3: methods for assessing methodological limitations, data extraction and synthesis, and confidence in synthesized qualitative findings.

PubMed

Noyes, Jane; Booth, Andrew; Flemming, Kate; Garside, Ruth; Harden, Angela; Lewin, Simon; Pantoja, Tomas; Hannes, Karin; Cargo, Margaret; Thomas, James

2018-05-01

The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method implementation evidence. Choice of appropriate methodologies, methods, and tools is essential when developing a rigorous protocol and conducting the synthesis. Cochrane authors who conduct qualitative evidence syntheses have thus far used a small number of relatively simple methods to address similarly written questions. Cochrane has invested in methodological work to develop new tools and to encourage the production of exemplar reviews to show the value of more innovative methods that address a wider range of questions. In this paper, in the series, we report updated guidance on the selection of tools to assess methodological limitations in qualitative studies and methods to extract and synthesize qualitative evidence. We recommend application of Grades of Recommendation, Assessment, Development, and Evaluation-Confidence in the Evidence from Qualitative Reviews to assess confidence in qualitative synthesized findings. This guidance aims to support review authors to undertake a qualitative evidence synthesis that is intended to be integrated subsequently with the findings of one or more Cochrane reviews of the effects of similar interventions. The review of intervention effects may be undertaken concurrently with or separate to the qualitative evidence synthesis. We encourage further development through reflection and formal testing. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical staging: its importance in therapeutic decisions and clinical trials.

PubMed

Denis, L J

1992-02-01

International collaboration has resulted in a revised and unified 1987 formulation for the TNM classification in solid tumors. The simplification and eliminations of most variables caused difficulties for the clinical use of the system in some tumors such as bladder cancer. The approval of the proposed adaptation covering the tumor mass, subdividing the T4 category and adapting the stage grouping, resolves these difficulties. Published reports demonstrate support for the TNM system as a clinical base for treatment decisions and prognosis. The TNMG stage and grade are important basic prognostic factors, but other prognostic factors, especially biologic tumor activity, are under clinical investigation. The TNM classification is the initial evaluation after histologic confirmation of cancer to guide treatment and prognosis. The quality of the evaluation is enhanced by precise communication on the employed methodology.

Meta-analytic Evaluation of a Virtual Field Trip to Connect Middle School Students with University Scientists

NASA Astrophysics Data System (ADS)

Adedokun, Omolola A.; Liu, Jia; Parker, Loran Carleton; Burgess, Wilella

2015-02-01

Although virtual field trips are becoming popular, there are few empirical studies of their impacts on student outcomes. This study reports on a meta-analytic evaluation of the impact of a virtual field trip on student perceptions of scientists. Specifically, the study examined the summary effect of zipTrips broadcasts on evaluation participants' perceptions of scientists, as well as the moderating effect of program type on program impact. The results showed statistically significant effect of each broadcast, as well as statistically significant summary (combined) effect of zipTrips on evaluation participants' perceptions of scientists. Results of the moderation analysis showed that the effect was greater for the students that participated in the evaluation of the 8th grade broadcasts, providing additional insight into the role of program variation in predicting differential program impact. This study illustrates how meta-analysis, a methodology that should be of interest to STEM education researchers and evaluation practitioners, can be used to summarize the effects of multiple offerings of the same program. Other implications for STEM educators are discussed.

Why Good Teaching Evaluations May Reward Bad Teaching: On Grade Inflation and Other Unintended Consequences of Student Evaluations.

PubMed

Stroebe, Wolfgang

2016-11-01

In this article, I address the paradox that university grade point averages have increased for decades, whereas the time students invest in their studies has decreased. I argue that one major contributor to this paradox is grading leniency, encouraged by the practice of university administrators to base important personnel decisions on student evaluations of teaching. Grading leniency creates strong incentives for instructors to teach in ways that would result in good student evaluations. Because many instructors believe that the average student prefers courses that are entertaining, require little work, and result in high grades, they feel under pressure to conform to those expectations. Evidence is presented that the positive association between student grades and their evaluation of teaching reflects a bias rather than teaching effectiveness. If good teaching evaluations reflected improved student learning due to effective teaching, they should be positively related to the grades received in subsequent courses that build on knowledge gained in the previous course. Findings that teaching evaluations of concurrent courses, though positively correlated with concurrent grades, are negatively related to student performance in subsequent courses are more consistent with the assumption that concurrent evaluations are the result of lenient grading rather than effective teaching. Policy implications are discussed. © The Author(s) 2016.

Automated detection of prostate cancer in digitized whole-slide images of H and E-stained biopsy specimens

NASA Astrophysics Data System (ADS)

Litjens, G.; Ehteshami Bejnordi, B.; Timofeeva, N.; Swadi, G.; Kovacs, I.; Hulsbergen-van de Kaa, C.; van der Laak, J.

2015-03-01

Automated detection of prostate cancer in digitized H and E whole-slide images is an important first step for computer-driven grading. Most automated grading algorithms work on preselected image patches as they are too computationally expensive to calculate on the multi-gigapixel whole-slide images. An automated multi-resolution cancer detection system could reduce the computational workload for subsequent grading and quantification in two ways: by excluding areas of definitely normal tissue within a single specimen or by excluding entire specimens which do not contain any cancer. In this work we present a multi-resolution cancer detection algorithm geared towards the latter. The algorithm methodology is as follows: at a coarse resolution the system uses superpixels, color histograms and local binary patterns in combination with a random forest classifier to assess the likelihood of cancer. The five most suspicious superpixels are identified and at a higher resolution more computationally expensive graph and gland features are added to refine classification for these superpixels. Our methods were evaluated in a data set of 204 digitized whole-slide H and E stained images of MR-guided biopsy specimens from 163 patients. A pathologist exhaustively annotated the specimens for areas containing cancer. The performance of our system was evaluated using ten-fold cross-validation, stratified according to patient. Image-based receiver operating characteristic (ROC) analysis was subsequently performed where a specimen containing cancer was considered positive and specimens without cancer negative. We obtained an area under the ROC curve of 0.96 and a 0.4 specificity at a 1.0 sensitivity.

Relationship Between Active Learning Methodologies and Community College Students' STEM Course Grades

NASA Astrophysics Data System (ADS)

Clark Lesko, Cherish Christina

Active learning methodologies (ALM) are associated with student success, but little research on this topic has been pursued at the community college level. At a local community college, students in science, technology, engineering, and math (STEM) courses exhibited lower than average grades. The purpose of this study was to examine whether the use of ALM predicted STEM course grades while controlling for academic discipline, course level, and class size. The theoretical framework was Vygotsky's social constructivism. Descriptive statistics and multinomial logistic regression were performed on data collected through an anonymous survey of 74 instructors of 272 courses during the 2016 fall semester. Results indicated that students were more likely to achieve passing grades when instructors employed in-class, highly structured activities, and writing-based ALM, and were less likely to achieve passing grades when instructors employed project-based or online ALM. The odds ratios indicated strong positive effects (greater likelihoods of receiving As, Bs, or Cs in comparison to the grade of F) for writing-based ALM (39.1-43.3%, 95% CI [10.7-80.3%]), highly structured activities (16.4-22.2%, 95% CI [1.8-33.7%]), and in-class ALM (5.0-9.0%, 95% CI [0.6-13.8%]). Project-based and online ALM showed negative effects (lower likelihoods of receiving As, Bs, or Cs in comparison to the grade of F) with odds ratios of 15.7-20.9%, 95% CI [9.7-30.6%] and 16.1-20.4%, 95% CI [5.9-25.2%] respectively. A white paper was developed with recommendations for faculty development, computer skills assessment and training, and active research on writing-based ALM. Improving student grades and STEM course completion rates could lead to higher graduation rates and lower college costs for at-risk students by reducing course repetition and time to degree completion.

Gender and Minority Achievement Gaps in Science in Eighth Grade: Item Analyses of Nationally Representative Data. Research Report. ETS RR-17-36

ERIC Educational Resources Information Center

Qian, Xiaoyu; Nandakumar, Ratna; Glutting, Joseoph; Ford, Danielle; Fifield, Steve

2017-01-01

In this study, we investigated gender and minority achievement gaps on 8th-grade science items employing a multilevel item response methodology. Both gaps were wider on physics and earth science items than on biology and chemistry items. Larger gender gaps were found on items with specific topics favoring male students than other items, for…

Coupled structural/thermal/electromagnetic analysis/tailoring of graded composite structures

NASA Technical Reports Server (NTRS)

Mcknight, R. L.; Chen, P. C.; Dame, L. T.; Huang, H.

1992-01-01

Accomplishments are described for the first year effort of a 5-year program to develop a methodology for coupled structural/thermal/electromagnetic analysis/tailoring of graded composite structures. These accomplishments include: (1) the results of the selective literature survey; (2) 8-, 16-, and 20-noded isoparametric plate and shell elements; (3) large deformation structural analysis; (4) eigenanalysis; (5) anisotropic heat transfer analysis; and (6) anisotropic electromagnetic analysis.

Effects of the Helping Early Literacy with Practice Strategies (HELPS) on Reading Fluency with Secondary Level Students Attending an Alternative Education Program

ERIC Educational Resources Information Center

Breault, Holly

2017-01-01

The purpose of this study was to investigate the effect of the HELPS Program on the reading fluency skills of secondary level students attending an alternative education program using single case design methodology. Participants in this study included one 8th grade student and two 9th grade students attending an alternative education program in…

Which sociodemographic factors are important on smoking behaviour of high school students? The contribution of classification and regression tree methodology in a broad epidemiological survey

PubMed Central

Özge, C; Toros, F; Bayramkaya, E; Çamdeviren, H; Şaşmaz, T

2006-01-01

Background The purpose of this study is to evaluate the most important sociodemographic factors on smoking status of high school students using a broad randomised epidemiological survey. Methods Using in‐class, self administered questionnaire about their sociodemographic variables and smoking behaviour, a representative sample of total 3304 students of preparatory, 9th, 10th, and 11th grades, from 22 randomly selected schools of Mersin, were evaluated and discriminative factors have been determined using appropriate statistics. In addition to binary logistic regression analysis, the study evaluated combined effects of these factors using classification and regression tree methodology, as a new statistical method. Results The data showed that 38% of the students reported lifetime smoking and 16.9% of them reported current smoking with a male predominancy and increasing prevalence by age. Second hand smoking was reported at a 74.3% frequency with father predominance (56.6%). The significantly important factors that affect current smoking in these age groups were increased by household size, late birth rank, certain school types, low academic performance, increased second hand smoking, and stress (especially reported as separation from a close friend or because of violence at home). Classification and regression tree methodology showed the importance of some neglected sociodemographic factors with a good classification capacity. Conclusions It was concluded that, as closely related with sociocultural factors, smoking was a common problem in this young population, generating important academic and social burden in youth life and with increasing data about this behaviour and using new statistical methods, effective coping strategies could be composed. PMID:16891446

Indicators of Student Flow Rates in Honduras: An Assessment of an Alternative Methodology, with Two Methodologies for Estimating Student Flow Rates. BRIDGES Research Report No. 6.

ERIC Educational Resources Information Center

Cuadra, Ernesto; Crouch, Luis

Student promotion, repetition, and dropout rates constitute the basic data needed to forecast future enrollment and new resources. Information on student flow is significantly related to policy formulation aimed at improving internal efficiency, because dropping out and grade repetition increase per pupil cost, block access to eligible school-age…

Middle Level Science: A Mixed-Methodology Study of the Impact of the Pennsylvania System of School Assessment (PSSA) on Curriculum and Instruction

ERIC Educational Resources Information Center

Britton, Patricia Sarappo

2013-01-01

Using a mixed methodology approach, this study examined the impact of the implementation of the science PSSA on the curriculum and instructional practice of eighth-grade teachers. It was hypothesized that despite the specter of PSSA influence on the academic climate, teachers are not necessarily influenced to change instructional practices, even…

Pharmacological Interventions Including Medical Injections for Neck Pain: An Overview as Part of the ICON§ Project

PubMed Central

Peloso, Paul M; Khan, Mahweesh; Gross, Anita R; Carlesso, Lisa; Santaguida, Lina; Lowcock, Janet; MacDermid, Joy C; Walton, Dave; Goldsmith, Charlie H; Langevin, Pierre; Shi, Qiyun

2013-01-01

Objectives: To conduct an overview (review-of-reviews) on pharmacological interventions for neck pain. Search Strategy: Computerized databases and grey literature were searched from 2006 to 2012. Selection Criteria: Systematic reviews of randomized controlled trials (RCT) in adults with acute to chronic neck pain reporting effects of pharmacological interventions including injections on pain, function/disability, global perceived effect, quality of life and patient satisfaction. Data Collection & Analysis: Two independent authors selected articles, assessed risk of bias and extracted data The GRADE tool was used to evaluate the body of evidence and an external panel provided critical review. Main Results: We found 26 reviews reporting on 47 RCTs. Most pharmacological interventions had low to very low quality methodologic evidence with three exceptions. For chronic neck pain, there was evidence of: a small immediate benefit for eperison hydrochloride (moderate GRADE, 1 trial, 157 participants);no short-term pain relieving benefit for botulinum toxin-A compared to saline (strong GRADE; 5 trial meta-analysis, 258 participants) nor for subacute/chronic whiplash (moderate GRADE; 4 trial meta-analysis, 183 participants) including reduced pain, disability or global perceived effect; andno long-term benefit for medial branch block of facet joints with steroids (moderate GRADE; 1 trial, 120 participants) over placebo to reduce pain or disability; Reviewers' Conclusions: While in general there is a lack of evidence for most pharmacological interventions, current evidence is against botulinum toxin-A for chronic neck pain or subacute/chronic whiplash; against medial branch block with steroids for chronic facet joint pain; but in favour of the muscle relaxant eperison hydrochloride for chronic neck pain. PMID:24155805

Which interventions are cost-effective for the management of whiplash-associated and neck pain-associated disorders? A systematic review of the health economic literature by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

PubMed

van der Velde, Gabrielle; Yu, Hainan; Paulden, Mike; Côté, Pierre; Varatharajan, Sharanya; Shearer, Heather M; Wong, Jessica J; Randhawa, Kristi; Southerst, Danielle; Mior, Silvano; Sutton, Deborah; Jacobs, Craig; Taylor-Vaisey, Anne

2016-12-01

Whiplash-associated disorders (WAD) and neck pain and associated disorders (NAD) are prevalent conditions that impact society and impose a significant economic burden on health-care systems. Health economic evidence on WAD and NAD interventions has been sparse: only three economic evaluations of interventions for NAD were identified by the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (NPTF). An updated overview is needed to inform health-care policy and guidelines. This study aimed to determine the cost-effectiveness of interventions for grades I-III WAD and NAD in children and adults. Systematic review of health economic literature, best-evidence synthesis. We systematically searched CINAHL, the Cochrane economic databases (Health Technology Assessment, NHS Economic Evaluation Database), EconLit, EMBASE, MEDLINE, PsycINFO, and Tufts CEA Registry from 2000 to 2015 for economic evaluations of WAD and NAD interventions. We appraised relevant evaluations using the Scottish Intercollegiate Guidelines Network Methodology Criteria for Economic Evaluations. We extracted data, including mean costs (standardized to 2013 Canadian dollars [CAD]) and quality-adjusted life years (QALYs), from studies with adequate methodological quality. We recalculated cost-effectiveness statistics based on the standardized currency using a willingness-to-pay of CAD $50,000 per additional QALY. Funding was provided by the Ministry of Finance. Our search identified 1,616 citations. Six studies fulfilled our selection criteria, including three studies previously reviewed by the NPTF. Structured education appears cost-effective for adults with WAD. For adults with NAD, acupuncture added to routine medical care; manual therapy; multimodal care that includes manual therapy; advice and exercise; and psychological care using cognitive-behavioral therapy appear cost-effective. In contrast, adding manual therapy or diathermy to advice and exercise; multimodal care by a physiotherapist or physician; and behavioral-graded activity do not appear cost-effective for adults with NAD. Our review adds to the findings of the NPTF. Recent evidence suggests that structured education is cost-effective for WAD, whereas advice and exercise and multimodal care that include manual therapy are cost-effective for NAD. Obtaining more robust health economic evidence for non-invasive interventions for WAD and NAD in children and adults remains an essential research priority. Copyright © 2015 Elsevier Inc. All rights reserved.

Vertical Articulation of Cut Scores across the Grades: Current Practices and Methodological Implications in the Light of the Next Generation of K-12 Assessments. Research Report. ETS RR-16-29

ERIC Educational Resources Information Center

Kannan, Priya

2016-01-01

Federal accountability requirements after the No Child Left Behind (NCLB) Act of 2001 and the need to report progress for various disaggregated subgroups of students meant that the methods used to set and articulate performance standards across the grades must be revisited. Several solutions that involve either "a priori" deliberations…

The Impact of a Cooperative Learning Program on the Academic Achievement in Mathematics and Language in Fourth Grade Students and Its Relation to Cognitive Style

ERIC Educational Resources Information Center

Vega, Mery Luz; Hederich M., Christian

2015-01-01

This study is expected to determine the impact of a program based on the cooperative learning methodology. This, in comparison to a traditional learning situation in both mathematics and language achievement. The study was carried out on a group of fourth grade students of primary school. In addition, it tried to find the differential impact…

[Grades evaluation of Scutellariae Radix slices based on quality constant].

PubMed

Deng, Zhe; Zhang, Jun; Jiao, Meng-Jiao; Zhong, Wen; Cui, Wen-Jin; Cheng, Jin-Tang; Chen, Sha; Wang, Yue-Sheng; Liu, An

2017-05-01

By measuring the morphological indexes and the marker components content of 22 batches of Scutellariae Radix slices as well as calculating the quality constant, this research was aimed to establish a new method of evaluating the specifications and grades of Scutellariae Radix slices. The quality constants of these samples were in the range of 0.04-0.49, which can be divided into several grades based on the real requirement. If they were divided into three grades, the quality constant was ≥0.39 for the first grade, <0.39 but ≥0.24 for the second grade, and <0.24 for the third grade. This work indicated that the quality constants characterizing both apparent parameters and intrinsic quality can be used as a comprehensive evaluation index to classify the grades of traditional Chinese medicine quantitatively, clearly and objectively. The research results in this paper would provide new ideas and references for evaluating the specifications and grades of traditional Chinese medicines. Copyright© by the Chinese Pharmaceutical Association.

Melaleuca alternifolia and its application against dental plaque and periodontal diseases: A systematic review.

PubMed

Casarin, Maísa; Pazinatto, Josiele; Santos, Roberto Christ Vianna; Zanatta, Fabricio Batistin

2018-02-01

This is a systematic review of clinical and laboratory studies evaluating the effect of Melaleuca alternifolia on periodontopathogens, dental plaque, gingivitis, periodontitis, and inflammatory responses. The PubMed, Cochrane, Web of science, Bireme, Lilacs, Prospero, Open Grey, and Clinical Trials databases were searched to identify potentially eligible studies through October 2016. Of 1,654 potentially eligible studies, 25 were included in the systematic review. Their methodology was evaluated through the Cochrane Handbook for clinical studies and the GRADE system for in vivo/in vitro studies. Although clinical studies must be interpreted with caution due to methodological limitations, laboratory studies have found promising results. In vitro evidences showed that M. alternifolia has bactericidal and bacteriostatic effects against the most prevalent periodontopathogens. Clinical studies found comparable effects to chlorhexidine 0.12% in reducing gingival inflammation, although the antiplaque effect was lower. M. alternifolia also showed antioxidant properties, which are beneficial to the host, allied to the reduction on immune-inflammatory responses to pathogens. This systematic review suggests that the M. alternifolia has potential anti-inflammatory and antimicrobial properties, which can be easily applied to the periodontal tissues. However, further clinical trials are needed to elucidate the clinical relevance of its application. Copyright © 2017 John Wiley & Sons, Ltd.

Experimental Investigation of Gas/Slag/Matte/Tridymite Equilibria in the Cu-Fe-O-S-Si System in Controlled Gas Atmospheres: Experimental Results at 1473 K (1200 °C) and P(SO2) = 0.25 atm

NASA Astrophysics Data System (ADS)

Fallah-Mehrjardi, Ata; Hidayat, Taufiq; Hayes, Peter C.; Jak, Evgueni

2017-12-01

Experimental studies were undertaken to determine the gas/slag/matte/tridymite equilibria in the Cu-Fe-O-S-Si system at 1473 K (1200 °C), P(SO2) = 0.25 atm, and a range of P(O2)'s. The experimental methodology involved high-temperature equilibration using a substrate support technique in controlled gas atmospheres (CO/CO2/SO2/Ar), rapid quenching of equilibrium phases, followed by direct measurement of the chemical compositions of the phases with Electron Probe X-ray Microanalysis (EPMA). The experimental data for slag and matte were presented as a function of copper concentration in matte (matte grade). The data provided are essential for the evaluation of the effect of oxygen potential under controlled atmosphere on the matte grade, liquidus composition of slag and chemically dissolved copper in slag. The new data provide important accurate and reliable quantitative foundation for improvement of the thermodynamic databases for copper-containing systems.

ACR Appropriateness Criteria® Headache-Child.

PubMed

Hayes, Laura L; Palasis, Susan; Bartel, Twyla B; Booth, Timothy N; Iyer, Ramesh S; Jones, Jeremy Y; Kadom, Nadja; Milla, Sarah S; Myseros, John S; Pakalnis, Ann; Partap, Sonia; Robertson, Richard L; Ryan, Maura E; Saigal, Gaurav; Soares, Bruno P; Tekes, Aylin; Karmazyn, Boaz K

2018-05-01

Headaches in children are not uncommon and have various causes. Proper neuroimaging of these children is very specific to the headache type. Care must be taken to choose and perform the most appropriate initial imaging examination in order to maximize the ability to properly determine the cause with minimum risk to the child. This evidence-based report discusses the different headache types in children and provides appropriate guidelines for imaging these children. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

ACR Appropriateness Criteria® Tinnitus.

PubMed

Kessler, Marcus M; Moussa, Marwan; Bykowski, Julie; Kirsch, Claudia F E; Aulino, Joseph M; Berger, Kevin L; Choudhri, Asim F; Fife, Terry D; Germano, Isabelle M; Kendi, A Tuba; Kim, Jeffrey H; Luttrull, Michael D; Nunez, Diego; Shah, Lubdha M; Sharma, Aseem; Shetty, Vilaas S; Symko, Sophia C; Cornelius, Rebecca S

2017-11-01

Tinnitus is the perception of sound in the absence of an external source. It is a common symptom that can be related to hearing loss and other benign causes. However, tinnitus may be disabling and can be the only symptom in a patient with a central nervous system process disorder. History and physical examination are crucial first steps to determine the need for imaging. CT and MRI are useful in the setting of pulsatile tinnitus to evaluate for an underlying vascular anomaly or abnormality. If there is concomitant asymmetric hearing loss, neurologic deficit, or head trauma, imaging should be guided by those respective ACR Appropriateness Criteria ® documents, rather than the presence of tinnitus. Imaging is not usually appropriate in the evaluation of subjective, nonpulsatile tinnitus that does not localize to one ear. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

UK guidelines on oesophageal dilatation in clinical practice

PubMed Central

Sami, Sarmed S; Haboubi, Hasan N; Ang, Yeng; Boger, Philip; Bhandari, Pradeep; de Caestecker, John; Griffiths, Helen; Haidry, Rehan; Patel, Praful; Paterson, Stuart; Ragunath, Krish; Watson, Peter; Siersema, Peter D; Attwood, Stephen E

2018-01-01

These are updated guidelines which supersede the original version published in 2004. This work has been endorsed by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG) under the auspices of the oesophageal section of the BSG. The original guidelines have undergone extensive revision by the 16 members of the Guideline Development Group with representation from individuals across all relevant disciplines, including the Heartburn Cancer UK charity, a nursing representative and a patient representative. The methodological rigour and transparency of the guideline development processes were appraised using the revised Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Dilatation of the oesophagus is a relatively high-risk intervention, and is required by an increasing range of disease states. Moreover, there is scarcity of evidence in the literature to guide clinicians on how to safely perform this procedure. These guidelines deal specifically with the dilatation procedure using balloon or bougie devices as a primary treatment strategy for non-malignant narrowing of the oesophagus. The use of stents is outside the remit of this paper; however, for cases of dilatation failure, alternative techniques—including stents—will be listed. The guideline is divided into the following subheadings: (1) patient preparation; (2) the dilatation procedure; (3) aftercare and (4) disease-specific considerations. A systematic literature search was performed. The Grading of Recommendations Assessment, Develop­ment and Evaluation (GRADE) tool was used to evaluate the quality of evidence and decide on the strength of recommendations made. PMID:29478034

Factors Influencing Students' Peer Evaluation in Cooperative Learning.

ERIC Educational Resources Information Center

Persons, Obeua S.

1998-01-01

In an accounting class in which 25% of grades were derived from group work, students completed peer evaluations. Regression analyses revealed that accounting majors and students with higher grade point averages received higher peer evaluations. Higher group homework and class participation grades were associated with higher peer evaluations. (SK)

The Evaluation of Pre­-Service Preschool Teachers' Knowledge about the Concept of Environment

ERIC Educational Resources Information Center

Ahi, Berat; Alisinanoglu, Fatma

2015-01-01

The purpose of the research is to evaluate pre-­service preschool teachers' knowledge about environment by analyzing their drawings about it. 70 first grade, 99 second grade, 56 third grade and 44 fourth grade, with a total of 269 students have been evaluated in this research. This qualitative research was made with social structuralism vision.…

[Application of relative quality constant in grades evaluation of Glycyrrizae Radix et Rhizome pieces].

PubMed

Deng, Zhe; Jiao, Meng-Jiao; Zhang, Jun; Xian, Jing; Zhang, Qing; Chen, Chang; Wang, Yue-Sheng; Liu, An

2017-07-01

Quality constant evaluation is a comprehensive method for grades evaluation of traditional Chinese medicine pieces, but when it comes to Glycyrrizae Radix et Rhizome pieces, grades evaluation is diverged due to significant difference in contents of liquiritin and glycyrrhizic acid and unreasonable weight of index. To solve this problem, we have established a relative quality constant method in this paper to evaluate grades of Glycyrrizae Radix et Rhizome pieces. Twenty-nine batches of different quality samples were collected and tested, and finally, 17 batches of them were chosen as researcher objects. The results revealed that the range of the relative quality constant of these samples was from 1.78 to 11.49. When Glycyrrizae Radix et Rhizome pieces are divided into three grades: the relative quality constant of first grade is greater than or equal to 9.19; the second grade is greater than or equal to 5.75 but less than 9.19; while the third grade is less than 5.75. This research indicates that relative quality constant can divide the grades of herbal pieces in a scientific, reasonable, objective and specific way and remedy the shortage of quality constant perfectly. It provides a novel mode for grading pieces of Chinese medicine that contains multi-target ingredients. Copyright© by the Chinese Pharmaceutical Association.

U.S. Army Officer Graduate Education: New Methodology for Establishing Requirements and Utilizing Assets

DTIC Science & Technology

1986-12-01

grade, discipline (or since 1983, a discipline from a set which supports the required specialty) and degree level (master’s or doctorate ) who is...Education Goals Proponents should set master’s and doctoral goals by specialty and grade (captain through colonel, OPMD managed officers). Army...and doctorate levels. Transit, Holding and Student (THS) Account--The account that contains all Army personnel not actually occupying a position in the

Clinical Performance Evaluations of Third-Year Medical Students and Association With Student and Evaluator Gender.

PubMed

Riese, Alison; Rappaport, Leah; Alverson, Brian; Park, Sangshin; Rockney, Randal M

2017-06-01

Clinical performance evaluations are major components of medical school clerkship grades. But are they sufficiently objective? This study aimed to determine whether student and evaluator gender is associated with assessment of overall clinical performance. This was a retrospective analysis of 4,272 core clerkship clinical performance evaluations by 829 evaluators of 155 third-year students, within the Alpert Medical School grading database for the 2013-2014 academic year. Overall clinical performance, assessed on a three-point scale (meets expectations, above expectations, exceptional), was extracted from each evaluation, as well as evaluator gender, age, training level, department, student gender and age, and length of observation time. Hierarchical ordinal regression modeling was conducted to account for clustering of evaluations. Female students were more likely to receive a better grade than males (adjusted odds ratio [AOR] 1.30, 95% confidence interval [CI] 1.13-1.50), and female evaluators awarded lower grades than males (AOR 0.72, 95% CI 0.55-0.93), adjusting for department, observation time, and student and evaluator age. The interaction between student and evaluator gender was significant (P = .03), with female evaluators assigning higher grades to female students, while male evaluators' grading did not differ by student gender. Students who spent a short time with evaluators were also more likely to get a lower grade. A one-year examination of all third-year clerkship clinical performance evaluations at a single institution revealed that male and female evaluators rated male and female students differently, even when accounting for other measured variables.

Application of hazard analysis and critical control point methodology and risk-based grading to consumer food safety surveys.

PubMed

Røssvoll, Elin Halbach; Ueland, Øydis; Hagtvedt, Therese; Jacobsen, Eivind; Lavik, Randi; Langsrud, Solveig

2012-09-01

Traditionally, consumer food safety survey responses have been classified as either "right" or "wrong" and food handling practices that are associated with high risk of infection have been treated in the same way as practices with lower risks. In this study, a risk-based method for consumer food safety surveys has been developed, and HACCP (hazard analysis and critical control point) methodology was used for selecting relevant questions. We conducted a nationally representative Web-based survey (n = 2,008), and to fit the self-reported answers we adjusted a risk-based grading system originally developed for observational studies. The results of the survey were analyzed both with the traditional "right" and "wrong" classification and with the risk-based grading system. The results using the two methods were very different. Only 5 of the 10 most frequent food handling violations were among the 10 practices associated with the highest risk. These 10 practices dealt with different aspects of heat treatment (lacking or insufficient), whereas the majority of the most frequent violations involved storing food at room temperature for too long. Use of the risk-based grading system for survey responses gave a more realistic picture of risks associated with domestic food handling practices. The method highlighted important violations and minor errors, which are performed by most people and are not associated with significant risk. Surveys built on a HACCP-based approach with risk-based grading will contribute to a better understanding of domestic food handling practices and will be of great value for targeted information and educational activities.

Grading smart sensors: Performance assessment and ranking using familiar scores like A+ to D-

NASA Astrophysics Data System (ADS)

Kessel, Ronald T.

2005-03-01

Starting with the supposition that the product of smart sensors - whether autonomous, networked, or fused - is in all cases information, it is shown here using information theory how a metric Q, ranging between 0 and 100%, can be derived to assess the quality of the information provided. The analogy with student grades is immediately evident and elaborated. As with student grades, numerical percentages suggest more precision than can be justified, so a conversion to letter grades A+ to D- is desirable. Owing to the close analogy with familiar academic grades, moreover, the new grade is a measure of effectiveness (MOE) that commanders and decision makers should immediately appreciate and find quite natural, even if they do not care to follow the methodology behind the performance test, as they focus on higher-level strategic matters of sensor deployment or procurement. The metric is illustrated by translating three specialist performance tests - the Receiver Operating Characteristic (ROC) curve, the Constant False Alarm Rate (CFAR) approach, and confusion matrices - into letter grades for use then by strategists. Actual military and security systems are included among the examples.

High School Students' Accuracy in Estimating the Cost of College: A Proposed Methodological Approach and Differences among Racial/Ethnic Groups and College Financial-Related Factors

ERIC Educational Resources Information Center

Nienhusser, H. Kenny; Oshio, Toko

2017-01-01

High school students' accuracy in estimating the cost of college (AECC) was examined by utilizing a new methodological approach, the absolute-deviation-continuous construct. This study used the High School Longitudinal Study of 2009 (HSLS:09) data and examined 10,530 11th grade students in order to measure their AECC for 4-year public and private…

Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children

PubMed Central

Murad, Mohammad H.; Pringsheim, Tamara; Feinstein, Anthony; Chang, Anne B.; Newcombe, Peter A.; Rubin, Bruce K.; McGarvey, Lorcan P.; Weir, Kelly; Altman, Kenneth W.; Weinberger, Miles; Irwin, Richard S.; Adams, Todd M.; Altman, Kenneth W.; Barker, Alan F.; Birring, Surinder S.; Blackhall, Fiona; Bolser, Donald C.; Boulet, Louis-Philippe; Braman, Sidney S.; Brightling, Christopher; Callahan-Lyon, Priscilla; Canning, Brendan J.; Chang, Anne B.; Coeytaux, Remy; Cowley, Terrie; Davenport, Paul; Diekemper, Rebecca L.; Ebihara, Satoru; El Solh, Ali A.; Escalante, Patricio; Feinstein, Anthony; Field, Stephen K.; Fisher, Dina; French, Cynthia T.; Gibson, Peter; Gold, Philip; Gould, Michael K.; Grant, Cameron; Harding, Susan M.; Harnden, Anthony; Hill, Adam T.; Irwin, Richard S.; Kahrilas, Peter J.; Keogh, Karina A.; Lane, Andrew P.; Lim, Kaiser; Malesker, Mark A.; Mazzone, Peter; Mazzone, Stuart; McCrory, Douglas C.; McGarvey, Lorcan; Molasiotis, Alex; Murad, M. Hassan; Newcombe, Peter; Nguyen, Huong Q.; Oppenheimer, John; Prezant, David; Pringsheim, Tamara; Restrepo, Marcos I.; Rosen, Mark; Rubin, Bruce; Ryu, Jay H.; Smith, Jaclyn; Tarlo, Susan M.; Vertigan, Anne E.; Wang, Gang; Weinberger, Miles; Weir, Kelly; Wiener, Renda Soylemez

2015-01-01

BACKGROUND: We conducted a systematic review on the management of psychogenic cough, habit cough, and tic cough to update the recommendations and suggestions of the 2006 guideline on this topic. METHODS: We followed the American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework. The Expert Cough Panel based their recommendations on data from the systematic review, patients’ values and preferences, and the clinical context. Final grading was reached by consensus according to Delphi methodology. RESULTS: The results of the systematic review revealed only low-quality evidence to support how to define or diagnose psychogenic or habit cough with no validated diagnostic criteria. With respect to treatment, low-quality evidence allowed the committee to only suggest therapy for children believed to have psychogenic cough. Such therapy might consist of nonpharmacologic trials of hypnosis or suggestion therapy, or combinations of reassurance, counseling, and referral to a psychologist, psychotherapy, and appropriate psychotropic medications. Based on multiple resources and contemporary psychologic, psychiatric, and neurologic criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition and tic disorder guidelines), the committee suggests that the terms psychogenic and habit cough are out of date and inaccurate. CONCLUSIONS: Compared with the 2006 CHEST Cough Guidelines, the major change in suggestions is that the terms psychogenic and habit cough be abandoned in favor of somatic cough syndrome and tic cough, respectively, even though the evidence to do so at this time is of low quality. PMID:25856777

A methodology based on the "anterior chamber of rabbit eyes" model for noninvasively determining the biocompatibility of biomaterials in an immune privileged site.

PubMed

Lu, Pei-Lin; Lai, Jui-Yang; Tabata, Yasuhiko; Hsiue, Ging-Ho

2008-07-01

In this study, a novel methodology based on the anterior chamber of rabbit eyes model was developed to evaluate the in vivo biocompatibility of biomaterials in an immune privileged site. The 7-mm-diameter membrane implants made from either a biological tissue material (amniotic membrane, AM group) or a biomedical polymeric material (gelatin, GM group) were inserted in rabbit anterior chamber for 36 months and characterized by biomicroscopic examinations, intraocular pressure measurements, and corneal thickness measurements. The noninvasive ophthalmic parameters were scored to provide a quantitative grading system. In this animal model, both AM and GM implants were visible in an ocular immune privileged site during clinical observations. The implants of the AM group appeared as soft tissue patches and have undergone a slow dissolution process resulting in a partial reduction of their size. Additionally, the AM implants did not induce any foreign body reaction or change in ocular tissue response for the studied period. By contrast, in the GM groups, significant corneal edema, elevated intraocular pressure, and increased corneal thickness were noted in the early postoperative phase (within 3 days), but resolved rapidly with in vivo dissolution of the gelatin. The results from the ocular grading system showed that both implants had good long-term biocompatibility in an ocular immune privileged site for up to 3 years. It is concluded that the anterior chamber of rabbit eyes model is an efficient method for noninvasively determining the immune privileged tissue/biomaterial interactions. (c) 2007 Wiley Periodicals, Inc.

[Reevaluation of the methodological quality in meta-analyses of accelerated rehabilitation on recovery after surgery for colorectal cancer].

PubMed

Ding, S N; Pan, H Y; Zhang, J G

2017-03-14

Objective: To evaluate the methodological quality and impacts on outcomes for systematic reviews (SRs) of accelerated rehabilitation versus traditional control for colorectal surgery. Methods: We comprehensively searched six databases and additional websites to collect SRs, or meta-analysis from inception to July 2016. The Overview Quality Assessment Questionnaire (OQAQ) was applied for quality assessment of the included studies, the tools recommended by the Cochrane Collaboration was applied for quality assessment for RCT and CCT and the Newcastle-Ottawa Scale (NOS) was applied to assess observational study. The relative ratios (RRs) and 95% confidence intervals (CIs) were integrated using Review Manager 5.3 software. Results: Fourteen meta-analyses were included in total. The mean OQAQ score was 3.8 with 95% CI 3.2 to 4.3. Only three meta-analyses were assessed as good quality. Two studies misused statistical models. A total of 42 primary studies referenced by meta-analyses were included, of which, 25 RCTs were levelled grade B and 1 CCT was levelled grade C. An estimated mean NOS score of 16 observation studies was 6.75 (totally scored 9 with 95% CI 6.4 to 7.1), of which, 10 studies scored ≥7 were high quality, 6 studies scored 6 were moderate quality. Conclusions: Currently, the overall quality of meta-analyses about comparing the effects and safety between accelerated rehabilitation and traditional control for colorectal surgery is fairly poor and the evidence level is lower. Health providers should apply the evidence with caution in clinical practice.

Beginning without a Conclusion.

ERIC Educational Resources Information Center

Frazier, Richard

1988-01-01

Describes a series of activities without conclusions to introduce scientific reasoning in a ninth grade physical science course. Uses popcorn popping to get students to think about the concepts of graphing, histograms, frequency, probability, and scientific methodology. (CW)

Evaluation and Management of Traumatic Diaphragmatic Injuries: A Practice Management Guideline from the Eastern Association for the Surgery of Trauma.

PubMed

McDonald, Amy A; Robinson, Bryce R H; Alarcon, Louis; Bosarge, Patrick L; Dorion, Heath; Haut, Elliott R; Juern, Jeremy; Madbak, Firas; Reddy, Srinivas; Weiss, Patricia; Como, John J

2018-04-02

Traumatic diaphragm injuries (TDI) pose both diagnostic and therapeutic challenges in both the acute and chronic phases. There are no published practice management guidelines to date for TDI. We aim to formulate a practice management guideline for TDI using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group formulated five Patient, Intervention, Comparator, Outcome (PICO) questions regarding the following topics: 1) diagnostic approach (laparoscopy vs. computed tomography); 2) non-operative management of penetrating right-sided injuries; 3) surgical approach (abdominal or thoracic) for acute TDI, including 4) the use of laparoscopy; and 5) surgical approach (abdominal or thoracic) for delayed TDI. A systematic review was undertaken and last updated December 2016. RevMan 5 (Cochran Collaboration) and GRADEpro (Grade Working Group) software were utilized. Recommendations were voted on by working group members. Consensus was obtained for each recommendation. A total of 56 articles were utilized to formulate the recommendations. Most studies were retrospective case series with variable reporting of outcomes measures and outcomes frequently not stratified to intervention or comparator. The overall quality of the evidence was very low for all PICOs. Therefore, only conditional recommendations could be made. Recommendations were made in favor of laparoscopy over CT for diagnosis, non-operative vs. operative approach for right-sided penetrating injuries, abdominal vs. thoracic approach for acute TDI, and laparoscopy (with the appropriate skill set and resources) vs. open approach for isolated TDI. No recommendation could be made for the preferred operative approach for delayed TDI. Very low-quality evidence precluded any strong recommendations. Further study of the diagnostic and therapeutic approaches to TDI is warranted. Guideline LEVEL OF EVIDENCE: 4.

A Learner-led, Discussion-based Elective on Emerging Infectious Disease

PubMed Central

2015-01-01

Objective. To implement a learner-led, discussion-based course aimed at exposing second-year pharmacy learners to the study of emerging infectious diseases from a global health perspective and to assess the role and importance of pharmacists in the management of disease outbreaks. Design. Learners examined literature pertinent to an emerging infectious disease in a 3-credit, discussion-based course and participated in peer discussion led by a designated learner. Instructional materials included journal articles, audio-visual presentations, documentaries, book chapters, movies, newspaper/magazine articles, and other materials. Learning outcomes were measured based on the ability of learners to perform critical thinking and analysis, communicate with their peers, and participate in class discussions. Assessment. The course was offered to 2 consecutive cohorts consisting of 14 and 16 learners, respectively. Overall, every learner in the first cohort achieved a final grade of A for the course. In the second cohort, the overall grade distribution consisted of grades of A, B, and C for the course. Learner evaluations indicated that the active-learning, discussion-based environment significantly enhanced interest in the topic and overall performance in the course. Conclusion. The elective course on emerging infectious diseases provided in-depth exposure to disease topics normally not encountered in the pharmacy curriculum. Learners found the material and format valuable, and the course enhanced their appreciation of infectious diseases, research methodology, critical thinking and analysis, and their roles as pharmacists. PMID:26430268

Preliminary display comparison for dental diagnostic applications

NASA Astrophysics Data System (ADS)

Odlum, Nicholas; Spalla, Guillaume; van Assche, Nele; Vandenberghe, Bart; Jacobs, Reinhilde; Quirynen, Marc; Marchessoux, Cédric

2012-02-01

The aim of this study is to predict the clinical performance and image quality of a display system for viewing dental images. At present, the use of dedicated medical displays is not uniform among dentists - many still view images on ordinary consumer displays. This work investigated whether the use of a medical display improved the perception of dental images by a clinician, compared to a consumer display. Display systems were simulated using the MEdical Virtual Imaging Chain (MEVIC). Images derived from two carefully performed studies on periodontal bone lesion detection and endodontic file length determination, were used. Three displays were selected: a medical grade one and two consumer displays (Barco MDRC-2120, Dell 1907FP and Dell 2007FPb). Some typical characteristics of the displays are evaluated by measurements and simulations like the Modulation Function (MTF), the Noise Power Spectrum (NPS), backlight stability or calibration. For the MTF, the display with the largest pixel pitch has logically the worst MTF. Moreover, the medical grade display has a slightly better MTF and the displays have similar NPS. The study shows the instability effect for the emitted intensity of the consumer displays compared to the medical grade one. Finally the study on the calibration methodology of the display shows that the signal in the dental images will be always more perceivable on the DICOM GSDF display than a gamma 2,2 display.

A Learner-led, Discussion-based Elective on Emerging Infectious Disease.

PubMed

Mathias, Clinton

2015-08-25

Objective. To implement a learner-led, discussion-based course aimed at exposing second-year pharmacy learners to the study of emerging infectious diseases from a global health perspective and to assess the role and importance of pharmacists in the management of disease outbreaks. Design. Learners examined literature pertinent to an emerging infectious disease in a 3-credit, discussion-based course and participated in peer discussion led by a designated learner. Instructional materials included journal articles, audio-visual presentations, documentaries, book chapters, movies, newspaper/magazine articles, and other materials. Learning outcomes were measured based on the ability of learners to perform critical thinking and analysis, communicate with their peers, and participate in class discussions. Assessment. The course was offered to 2 consecutive cohorts consisting of 14 and 16 learners, respectively. Overall, every learner in the first cohort achieved a final grade of A for the course. In the second cohort, the overall grade distribution consisted of grades of A, B, and C for the course. Learner evaluations indicated that the active-learning, discussion-based environment significantly enhanced interest in the topic and overall performance in the course. Conclusion. The elective course on emerging infectious diseases provided in-depth exposure to disease topics normally not encountered in the pharmacy curriculum. Learners found the material and format valuable, and the course enhanced their appreciation of infectious diseases, research methodology, critical thinking and analysis, and their roles as pharmacists.

Reconnaissance investigation of the placer gold deposits in the Zarkashan Area of Interest, Ghazni Province, Afghanistan

USGS Publications Warehouse

Malpeli, Katherine C.; Chirico, Peter G.; McLoughlin, Isabel H.

2013-01-01

This study is a reconnaissance investigation of the placer gold deposits in the Zarkashan Area of Interest (AOI) in Ghazni Province, Afghanistan. Detailed investigations of the Zarkashan gold deposits were conducted by Soviet and Afghan geologists in the 1960s and 1970s, prior to the development of satellite-based remote-sensing platforms and new methods of geomorphic mapping. The purpose of this study was to integrate new mapping techniques with previously collected concentration and borehole sampling data and geomorphologic interpretations to reassess the placer gold deposits in the Zarkashan AOI. A methodology combining the collection and analysis of historical sampling data, digital database development, hydrologic analysis, and geomorphic modeling was used. The analysis led to the reinterpretation of four gold-bearing seams along the Zarkashan River, and the calculation of an estimated gold reserve of approximately 3,000 kilograms (kg). This estimate is approximately 1,500 kg greater than the Soviet estimate. The result differs in large part due to the reinterpretation of the seams based on a much lower cutoff grade of 100 mg/m3. Because cutoff grade is dependent in part on the price of gold, the sevenfold increase in the price of gold since the undertaking of the Soviet investigation warranted our re-evaluation of their 500 mg/m3 cutoff grade.

Redesign of a pediatric pharmacotherapy elective course to accommodate budget reductions.

PubMed

Williams, Jennifer; Motycka, Carol; St Onge, Erin

2011-12-15

To redesign a pediatric elective pharmacotherapy course and determine whether the redesign resulted in changes in outcome measures. Active learning activities were moved to an online format. Prerecorded lectures continued to be used. Peer evaluation was incorporated to give the students more feedback on their performance. ASSESSMENT; Presentation grades, average examination grades, course grades, and evaluation scores from each student who completed University course evaluations were documented for students during the 2 semesters before and the 2 semesters after the course redesign. Although for undetermined reasons a drop in examination grades occurred after the course redesign, no significant differences in presentation grades, final grades, or course evaluation grades occurred. A strategic course redesign successfully reduced the costs and faculty time required to offer an elective course viewed as essential to the curriculum, allowing the course to be continued in the face of state budget cuts.

[Grades evaluation of Phellodendri chinensis cortex pieces based on quality constant].

PubMed

Deng, Zhe; Jiao, Meng-Jiao; Zhang, Jun; Zhang, Qing; Cui, Wen-Jin; Shen, Li; Cheng, Jin-Tang; Liu, An

2017-09-01

Quality constant is a comprehensive grades evaluation method for traditional Chinese medicine decoction pieces, which is better but based on traditional way. In this paper, a new grading mode for Phellodendri chinensis pieces was established based on quality constant evaluation method. The results showed that the range of relative quality constant for 15 batches of different samples was from 0.41 to 0.96. As customary, if these samples were divided into three grades: the relative quality constant shall be ≥0.77 for first grade; <0.77 but ≥0.48 for the second grade; and ＜0.48 for the third grade. This research indicated that the quality constant mode can be used to effectively grade the P. chinensis pieces in a scientific, reasonable, objective and specific way. Simultaneously, it provided a beneficial reference for grading cortex herbal pieces or medicines. Copyright© by the Chinese Pharmaceutical Association.

Probabilistic Modeling of Settlement Risk at Land Disposal Facilities - 12304

DOE Office of Scientific and Technical Information (OSTI.GOV)

Foye, Kevin C.; Soong, Te-Yang

2012-07-01

The long-term reliability of land disposal facility final cover systems - and therefore the overall waste containment - depends on the distortions imposed on these systems by differential settlement/subsidence. The evaluation of differential settlement is challenging because of the heterogeneity of the waste mass (caused by inconsistent compaction, void space distribution, debris-soil mix ratio, waste material stiffness, time-dependent primary compression of the fine-grained soil matrix, long-term creep settlement of the soil matrix and the debris, etc.) at most land disposal facilities. Deterministic approaches to long-term final cover settlement prediction are not able to capture the spatial variability in the wastemore » mass and sub-grade properties which control differential settlement. An alternative, probabilistic solution is to use random fields to model the waste and sub-grade properties. The modeling effort informs the design, construction, operation, and maintenance of land disposal facilities. A probabilistic method to establish design criteria for waste placement and compaction is introduced using the model. Random fields are ideally suited to problems of differential settlement modeling of highly heterogeneous foundations, such as waste. Random fields model the seemingly random spatial distribution of a design parameter, such as compressibility. When used for design, the use of these models prompts the need for probabilistic design criteria. It also allows for a statistical approach to waste placement acceptance criteria. An example design evaluation was performed, illustrating the use of the probabilistic differential settlement simulation methodology to assemble a design guidance chart. The purpose of this design evaluation is to enable the designer to select optimal initial combinations of design slopes and quality control acceptance criteria that yield an acceptable proportion of post-settlement slopes meeting some design minimum. For this specific example, relative density, which can be determined through field measurements, was selected as the field quality control parameter for waste placement. This technique can be extended to include a rigorous performance-based methodology using other parameters (void space criteria, debris-soil mix ratio, pre-loading, etc.). As shown in this example, each parameter range, or sets of parameter ranges can be selected such that they can result in an acceptable, long-term differential settlement according to the probabilistic model. The methodology can also be used to re-evaluate the long-term differential settlement behavior at closed land disposal facilities to identify, if any, problematic facilities so that remedial action (e.g., reinforcement of upper and intermediate waste layers) can be implemented. Considering the inherent spatial variability in waste and earth materials and the need for engineers to apply sound quantitative practices to engineering analysis, it is important to apply the available probabilistic techniques to problems of differential settlement. One such method to implement probability-based differential settlement analyses for the design of landfill final covers has been presented. The design evaluation technique presented is one tool to bridge the gap from deterministic practice to probabilistic practice. (authors)« less

Development of self-handicapping tendencies.

PubMed

Kimble, C E; Kimble, E A; Croy, N A

1998-08-01

This study was undertaken to determine when U.S. children begin to self-handicap, that is, to reduce preparation effort before evaluations rather than applying themselves to do their best. The personal variables examined for their impact on practice behavior were gender, grade level, and self-esteem. The situational variables were time of the self-esteem test (before or after the evaluation task) and importance of the evaluation task. The results showed that (a) the 6th-grade boys were more likely than the 6th-grade girls to self-handicap, (b) the 3rd-grade children were not as affected as the 6th-grade children by the self-evaluation implications of performance evaluations, (c) self-handicapping by low-self-esteem and high-self-esteem 6th graders depended on recent experiences, and (d) the self-affirming experience of a self-esteem test reduced the motivation to self-handicap among high-self-esteem 6th-grade boys.

Development of an in vitro mechanical gastric system (IMGS) with realistic peristalsis to assess lipid digestibility.

PubMed

Barros, Lorena; Retamal, Christian; Torres, Héctor; Zúñiga, Rommy N; Troncoso, Elizabeth

2016-12-01

A new in vitro mechanical gastric system (IMGS) was fabricated which incorporates: a J-shaped stomach, a mechanical system with realistic peristaltic frequency and force magnitude, and a reproduction of the gastric pH curve. To evaluate the impact of a more realistic gastric peristalsis on the intestinal lipolysis of protein-stabilized O/W emulsions, the emulsions were subjected to two different in vitro digestion methodologies: (i) gastric digestion in the IMGS and intestinal digestion in a stirred beaker (SB), and (ii) gastric and intestinal digestion assays carried out in SBs. At the end of the intestinal digestion, the total amount of free fatty acids released was significantly higher for the first methodology (IMGS-SB) in comparison with the second one (27.5% vs. 23.0%), probably due to the higher physical instability induced by the IMGS in the gastric contents. These results reaffirm that O/W emulsion stability plays a crucial role in controlling the final extent of lipolysis of this kind of food-grade emulsions. Copyright © 2016 Elsevier Ltd. All rights reserved.

The effectiveness of manual therapy in treating cervicogenic dizziness: a systematic review.

PubMed

Yaseen, Khalid; Hendrick, Paul; Ismail, Ayah; Felemban, Mohannad; Alshehri, Mansour Abdullah

2018-01-01

[Purpose] This review provides an evaluation of the evidence for the effectiveness of using manual therapy to treat cervicogenic dizziness. [Subjects and Methods] The literature was systematically searched on the May 2, 2016 using the following online databases: Medline, EMBASE, CINAHL and PEDro. This review included randomised controlled trials and compared the efficacy of manual therapy for the treatment of cervicogenic dizziness, compared to other types of intervention. This study measured changes based on dizziness intensity and frequency. [Results] The primary search found 30 articles, but only four articles met the inclusion criteria. Assessment of methodological quality was performed by two researchers using the PEDro scale. The level of evidence was determined using a recognised grading scale. Three out of the four articles were deemed to have high methodological quality, while the fourth was rated as moderate quality. The attributed level of evidence was moderate (level 2). [Conclusion] Manual therapy is potentially effective for managing cervicogenic dizziness. However, due to the heterogeneity of the results and techniques and the low number of studies, further research is recommended to provide conclusive evidence.

Results from Scotland's 2013 Report Card on Physical Activity for Children and Youth.

PubMed

Reilly, John J; Dick, Smita; McNeill, Geraldine; Tremblay, Mark S

2014-05-01

The Active Healthy Kids Scotland Report Card aims to consolidate existing evidence, facilitate international comparisons, encourage more evidence-informed physical activity and health policy, and improve surveillance of physical activity. Application of the Active Healthy Kids Canada Report Card process and methodology to Scotland, adapted to Scottish circumstances and availability of data. The Active Healthy Kids Scotland Report Card 2013 consists of indicators of 7 Health Behaviors and Outcomes and 3 Influences on Health Behaviors and Outcomes. Grades of F were assigned to Overall Physical Activity, Sedentary Behavior (recreational screen time), and Obesity Prevalence. A C was assigned to Active Transportation and a D- was assigned to Diet. Two indicators, Active and Outdoor Play and Organized Sport Participation, could not be graded. Among the Influences, Family Influence received a D, while Perceived Safety, Access, and Availability of Spaces for Physical Activity and the National Policy Environment graded more favorably with a B. The Active Healthy Kids Canada process and methodology was readily generalizable to Scotland. The report card illustrated low habitual physical activity and extremely high levels of screen-based sedentary behavior, and highlighted several opportunities for improved physical activity surveillance and promotion strategies.

Optimization of Mineral Separator for Recovery of Total Heavy Minerals of Bay of Bengal using Central Composite Design

NASA Astrophysics Data System (ADS)

Routray, Sunita; Swain, Ranjita; Rao, Raghupatruni Bhima

2017-04-01

The present study is aimed at investigating the optimization of a mineral separator for processing of beach sand minerals of Bay of Bengal along Ganjam-Rushikulya coast. The central composite design matrix and response surface methodology were applied in designing the experiments to evaluate the interactive effects of the three most important operating variables, such as feed quantity, wash water rate and Shake amplitude of the deck. The predicted values were found to be in good agreement with the experimental values (R2 = 0.97 for grade and 0.98 for recovery). To understand the impact of each variable, three dimensional (3D) plots were also developed for the estimated responses.

The International Liver Transplantation Society Living Donor Liver Transplant Recipient Guideline

PubMed Central

Miller, Charles M.; Quintini, Cristiano; Dhawan, Anil; Durand, Francois; Heimbach, Julie K.; Kim-Schluger, Hyung Leona; Kyrana, Eirini; Lee, Sung-Gyu; Lerut, Jan; Lo, Chung-Mau; Pomfret, Elizabeth Anne

2017-01-01

Abstract Living donor liver transplantation (LDLT) has been increasingly embraced around the world as an important strategy to address the shortage of deceased donor livers. The aim of this guideline, approved by the International Liver Transplantation Society (ILTS), is to provide a collection of expert opinions, consensus, and best practices surrounding LDLT. Recommendations were developed from an analysis of the National Library of Medicine living donor transplantation indexed literature using the Grading of Recommendations Assessment, Development and Evaluation methodology. Writing was guided by the ILTS Policy on the Development and Use of Practice Guidelines (www.ilts.org). Intended for use by physicians, these recommendations support specific approaches to the diagnostic, therapeutic, and preventive aspects of care of living donor liver transplant recipients. PMID:28437386

Accountancy, teaching methods, sex, and American College Test scores.

PubMed

Heritage, J; Harper, B S; Harper, J P

1990-10-01

This study examines the significance of sex, methodology, academic preparation, and age as related to development of judgmental and problem-solving skills. Sex, American College Test (ACT) Mathematics scores, Composite ACT scores, grades in course work, grade point average (GPA), and age were used in studying the effects of teaching method on 96 students' ability to analyze data in financial statements. Results reflect positively on accounting students compared to the general college population and the women students in particular.

Liberal Grading Improves Evaluations but Not Performance.

ERIC Educational Resources Information Center

Vasta, Ross; Sarmiento, Robert F.

1979-01-01

The effects of examination grades on undergraduates' study behaviors, attendance, and evaluations of instruction were examined. Liberal grading was found to result in higher evaluations of course and instructor but had no demonstrable effect on studying or attendance. The implications of these findings and alternative interpretations are…

Lidocaine for Status Epilepticus in Pediatrics.

PubMed

Zeiler, Frederick A; Zeiler, Kaitlin J; Teitelbaum, Jeanne; Gillman, Lawrence M; West, Michael; Kazina, Colin J

2015-11-01

Our goal was to perform a systematic review of the literature on the use of intravenous lidocaine in pediatrics for status epilepticus (SE) and refractory status epilepticus (RSE) to determine its impact on seizure control. All articles from MEDLINE, BIOSIS, EMBASE, Global Health, HealthStar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to November 2014), and gray literature were searched. The strength of evidence was adjudicated using both the Oxford and Grading of Recommendations Assessment, Development, and Evaluation methodologies by two independent reviewers. Overall, 20 original studies were identified, with 19 manuscripts and one meeting abstract. Two hundred and thirty-five pediatric patients were treated for 252 episodes of SE/RSE. Patients had varying numbers of antiepileptic drugs (two to eight) on board before lidocaine therapy. During 20 of the 252 (7.9%) episodes of SE/RSE, phenytoin was on board. The dose regimen of lidocaine varied, with some using bolus dosing alone; others used a combination of bolus and infusion therapy. Overall, 60.0% of seizures responded to lidocaine, with complete cessation and greater than 50% reduction seen in 57.6% and 12.3%, respectively. Patient outcomes were sparingly reported. There currently exists Oxford level 2b, Grading of Recommendations Assessment Development, and Evaluation C evidence to support the consideration of lidocaine for SE and RSE in the pediatric population. Further prospective studies of lidocaine administration in this setting are warranted.

News in early intervention in autism.

PubMed

Geoffray, Marie-Maude; Thevenet, Marion; Georgieff, Nicolas

2016-09-01

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental trouble which prevents the child from socio-communicative interaction, and learning from his environment. Non-medical early intervention attempts to improve prognosis. We will review the main current hypothesis, intervention models and scientific supports about early intervention. We conducted a search of the literature published on Medline between 2010 and 2015 related to intervention models provided to children with ASD aged less than 3 years. Data were extracted from systematic reviews and recent randomized controlled trials with moderate to high GRADE quality of evidence. Early intervention refers to brain plasticity theory. With the epidemiological studies of infant "at risk" there is an attempt to intervene earlier before full syndrome is present. Interventions tend to follow more on a developmental hierarchy of socio-communicative skills and to focus on the dyadic relation between the child and the caregivers to improve the core autistic symptoms. Over the last 6 years, there's been news and fine-tuned ways about early intervention, and more and more systematic evaluation. However, there are only few interventions which were evaluated in trial with a strong GRADE recommendation and all of them have methodological concerns. It is important to be cautious in recommendations for mental health politic, even if it is important to improve access to services for all children and their families, hence finance and design rigorous project in research.

Assessment of weld quality of aerospace grade metals by using ultrasonic matrix phased array technology

NASA Astrophysics Data System (ADS)

Na, Jeong K.; Gleeson, Sean T.

2014-03-01

Advantages of two dimensional electronic ultrasonic beam focusing, steering and scanning with the matrix phased array (MPA) technology has been used to visualize the conditions of resistance spot welds in auto vehicle grade advanced high strength steel carbon steels nondestructively. Two of the commonly used joining techniques, resistance spot welding and resistance seam welding, for thin aerospace grade plates made of aluminum, titanium, and stainless steels have also been inspected with the same MPA NDE system. In this study, a detailed discussions of the current MPA based ultrasonic real time imaging methodology has been made followed by some of the NDT results obtained with various welded test coupons.

Quantitative Mineral Resource Assessment of Copper, Molybdenum, Gold, and Silver in Undiscovered Porphyry Copper Deposits in the Andes Mountains of South America

USGS Publications Warehouse

Cunningham, Charles G.; Zappettini, Eduardo O.; Vivallo S., Waldo; Celada, Carlos Mario; Quispe, Jorge; Singer, Donald A.; Briskey, Joseph A.; Sutphin, David M.; Gajardo M., Mariano; Diaz, Alejandro; Portigliati, Carlos; Berger, Vladimir I.; Carrasco, Rodrigo; Schulz, Klaus J.

2008-01-01

Quantitative information on the general locations and amounts of undiscovered porphyry copper resources of the world is important to exploration managers, land-use and environmental planners, economists, and policy makers. This publication contains the results of probabilistic estimates of the amounts of copper (Cu), molybdenum (Mo), gold (Au), and silver (Ag) in undiscovered porphyry copper deposits in the Andes Mountains of South America. The methodology used to make these estimates is called the 'Three-Part Form'. It was developed to explicitly express estimates of undiscovered resources and associated uncertainty in a form that allows economic analysis and is useful to decisionmakers. The three-part form of assessment includes: (1) delineation of tracts of land where the geology is permissive for porphyry copper deposits to form; (2) selection of grade and tonnage models appropriate for estimating grades and tonnages of the undiscovered porphyry copper deposits in each tract; and (3) estimation of the number of undiscovered porphyry copper deposits in each tract consistent with the grade and tonnage model. A Monte Carlo simulation computer program (EMINERS) was used to combine the probability distributions of the estimated number of undiscovered deposits, the grades, and the tonnages of the selected model to obtain the probability distributions for undiscovered metals in each tract. These distributions of grades and tonnages then can be used to conduct economic evaluations of undiscovered resources in a format usable by decisionmakers. Economic evaluations are not part of this report. The results of this assessment are presented in two principal parts. The first part identifies 26 regional tracts of land where the geology is permissive for the occurrence of undiscovered porphyry copper deposits of Phanerozoic age to a depth of 1 km below the Earth's surface. These tracts are believed to contain most of South America's undiscovered resources of copper. The second part presents probabilistic estimates of the amounts of copper, molybdenum, gold, and silver in undiscovered porphyry copper deposits in each tract. The study also provides tables showing the location, tract number, and age (if available) of discovered deposits and prospects. For each of the 26 permissive tracts delineated in this study, summary information is provided on: (1) the rationale for delineating the tract; (2) the rationale for choosing the mineral deposit model used to assess the tract; (3) discovered deposits and prospects; (4) exploration history; and (5) the distribution of undiscovered deposits in the tract. The scale used to evaluate geologic information and draw tracts is 1:1,000,000.

Evaluation of Life Sciences and Social Sciences Course Books in Term of Societal Sexuality

ERIC Educational Resources Information Center

Aykac, Necdet

2012-01-01

This study aims to evaluate primary school Life Sciences (1st, 2nd, and 3rd grades) and Social Sciences (4th, 5th, and 6th grades) course books in terms of gender discrimination. This study is a descriptive study aiming to evaluate the primary school Life Sciences (1st, 2nd, 3rd grades) and Social Sciences (4th, 5th, and 6th grades) course books…

Developmental differences in prosocial motives and behavior in children from low-socioeconomic status families.

PubMed

McGrath, Marianne P; Brown, Bethany C

2008-03-01

Developmental theories of prosocial reasoning and behavior posit a transition from concrete (e.g., give a toy to receive one) to abstract (e.g., spend time to make someone happy) forms and have been supported with research on middle-socioeconomic status (SES), White samples. The methodology that researchers have used to date has restricted the responses that children can offer. In the present study, 122 Grade 2 and Grade 4 children from low-SES families described different types of motives and behavior and whether a conflict existed between self- and other-serving behaviors. The authors found developmental differences for both abstract and tangible motives that focused on the benefactor of prosocial behavior. Grade 2 girls and Grade 4 boys were the most likely to spontaneously describe a conflict between self- and other-serving behaviors.

Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review

PubMed Central

Desmeules, François; Boudreault, Jennifer; Dionne, Clermont E.; Frémont, Pierre; Lowry, Véronique; MacDermid, Joy C.; Roy, Jean-Sébastien

2016-01-01

Objective: To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. Methods: A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventions under study included exercises. The methodological quality of the studies was evaluated with the Cochrane Risk of Bias Assessment tool. Results: The mean methodological score of the ten included studies was 54.4%±17.2%. Types of workers included were often not defined, and work-related outcome measures were heterogeneous and often not validated. Three RCTs of moderate methodological quality concluded that exercises were superior to a placebo or no intervention in terms of function and return-to-work outcomes. No significant difference was found between surgery and exercises based on the results of two studies of low to moderate methodological quality. One study of low methodological quality, comparing a workplace-based exercise program focusing on the participants' work demands to an exercise program delivered in a clinical setting, concluded that the work-based intervention was superior in terms of function and return-to-work outcomes. Conclusion: There is low to moderate-grade evidence that therapeutic exercises provided in a clinical setting are an effective modality to treat workers suffering from RC tendinopathy and to promote return-to-work. Further high quality studies comparing different rehabilitation programs including exercises in different settings with defined workers populations are needed to draw firm conclusions on the optimal program to treat workers. PMID:27488037

Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review.

PubMed

Desmeules, François; Boudreault, Jennifer; Dionne, Clermont E; Frémont, Pierre; Lowry, Véronique; MacDermid, Joy C; Roy, Jean-Sébastien

2016-09-30

To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventions under study included exercises. The methodological quality of the studies was evaluated with the Cochrane Risk of Bias Assessment tool. The mean methodological score of the ten included studies was 54.4%±17.2%. Types of workers included were often not defined, and work-related outcome measures were heterogeneous and often not validated. Three RCTs of moderate methodological quality concluded that exercises were superior to a placebo or no intervention in terms of function and return-to-work outcomes. No significant difference was found between surgery and exercises based on the results of two studies of low to moderate methodological quality. One study of low methodological quality, comparing a workplace-based exercise program focusing on the participants' work demands to an exercise program delivered in a clinical setting, concluded that the work-based intervention was superior in terms of function and return-to-work outcomes. There is low to moderate-grade evidence that therapeutic exercises provided in a clinical setting are an effective modality to treat workers suffering from RC tendinopathy and to promote return-to-work. Further high quality studies comparing different rehabilitation programs including exercises in different settings with defined workers populations are needed to draw firm conclusions on the optimal program to treat workers.

A hybrid neural networks-fuzzy logic-genetic algorithm for grade estimation

NASA Astrophysics Data System (ADS)

Tahmasebi, Pejman; Hezarkhani, Ardeshir

2012-05-01

The grade estimation is a quite important and money/time-consuming stage in a mine project, which is considered as a challenge for the geologists and mining engineers due to the structural complexities in mineral ore deposits. To overcome this problem, several artificial intelligence techniques such as Artificial Neural Networks (ANN) and Fuzzy Logic (FL) have recently been employed with various architectures and properties. However, due to the constraints of both methods, they yield the desired results only under the specific circumstances. As an example, one major problem in FL is the difficulty of constructing the membership functions (MFs).Other problems such as architecture and local minima could also be located in ANN designing. Therefore, a new methodology is presented in this paper for grade estimation. This method which is based on ANN and FL is called "Coactive Neuro-Fuzzy Inference System" (CANFIS) which combines two approaches, ANN and FL. The combination of these two artificial intelligence approaches is achieved via the verbal and numerical power of intelligent systems. To improve the performance of this system, a Genetic Algorithm (GA) - as a well-known technique to solve the complex optimization problems - is also employed to optimize the network parameters including learning rate, momentum of the network and the number of MFs for each input. A comparison of these techniques (ANN, Adaptive Neuro-Fuzzy Inference System or ANFIS) with this new method (CANFIS-GA) is also carried out through a case study in Sungun copper deposit, located in East-Azerbaijan, Iran. The results show that CANFIS-GA could be a faster and more accurate alternative to the existing time-consuming methodologies for ore grade estimation and that is, therefore, suggested to be applied for grade estimation in similar problems.

A hybrid neural networks-fuzzy logic-genetic algorithm for grade estimation

PubMed Central

Tahmasebi, Pejman; Hezarkhani, Ardeshir

2012-01-01

The grade estimation is a quite important and money/time-consuming stage in a mine project, which is considered as a challenge for the geologists and mining engineers due to the structural complexities in mineral ore deposits. To overcome this problem, several artificial intelligence techniques such as Artificial Neural Networks (ANN) and Fuzzy Logic (FL) have recently been employed with various architectures and properties. However, due to the constraints of both methods, they yield the desired results only under the specific circumstances. As an example, one major problem in FL is the difficulty of constructing the membership functions (MFs).Other problems such as architecture and local minima could also be located in ANN designing. Therefore, a new methodology is presented in this paper for grade estimation. This method which is based on ANN and FL is called “Coactive Neuro-Fuzzy Inference System” (CANFIS) which combines two approaches, ANN and FL. The combination of these two artificial intelligence approaches is achieved via the verbal and numerical power of intelligent systems. To improve the performance of this system, a Genetic Algorithm (GA) – as a well-known technique to solve the complex optimization problems – is also employed to optimize the network parameters including learning rate, momentum of the network and the number of MFs for each input. A comparison of these techniques (ANN, Adaptive Neuro-Fuzzy Inference System or ANFIS) with this new method (CANFIS–GA) is also carried out through a case study in Sungun copper deposit, located in East-Azerbaijan, Iran. The results show that CANFIS–GA could be a faster and more accurate alternative to the existing time-consuming methodologies for ore grade estimation and that is, therefore, suggested to be applied for grade estimation in similar problems. PMID:25540468

Reliability and Validity of Survey Instruments to Measure Work-Related Fatigue in the Emergency Medical Services Setting: A Systematic Review.

PubMed

Patterson, P Daniel; Weaver, Matthew D; Fabio, Anthony; Teasley, Ellen M; Renn, Megan L; Curtis, Brett R; Matthews, Margaret E; Kroemer, Andrew J; Xun, Xiaoshuang; Bizhanova, Zhadyra; Weiss, Patricia M; Sequeira, Denisse J; Coppler, Patrick J; Lang, Eddy S; Higgins, J Stephen

2018-02-15

This study sought to systematically search the literature to identify reliable and valid survey instruments for fatigue measurement in the Emergency Medical Services (EMS) occupational setting. A systematic review study design was used and searched six databases, including one website. The research question guiding the search was developed a priori and registered with the PROSPERO database of systematic reviews: "Are there reliable and valid instruments for measuring fatigue among EMS personnel?" (2016:CRD42016040097). The primary outcome of interest was criterion-related validity. Important outcomes of interest included reliability (e.g., internal consistency), and indicators of sensitivity and specificity. Members of the research team independently screened records from the databases. Full-text articles were evaluated by adapting the Bolster and Rourke system for categorizing findings of systematic reviews, and the rated data abstracted from the body of literature as favorable, unfavorable, mixed/inconclusive, or no impact. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology was used to evaluate the quality of evidence. The search strategy yielded 1,257 unique records. Thirty-four unique experimental and non-experimental studies were determined relevant following full-text review. Nineteen studies reported on the reliability and/or validity of ten different fatigue survey instruments. Eighteen different studies evaluated the reliability and/or validity of four different sleepiness survey instruments. None of the retained studies reported sensitivity or specificity. Evidence quality was rated as very low across all outcomes. In this systematic review, limited evidence of the reliability and validity of 14 different survey instruments to assess the fatigue and/or sleepiness status of EMS personnel and related shift worker groups was identified.

A Study of the Correlation of the Improvement of Teaching Evaluation Scores Based on Student Performance Grades

ERIC Educational Resources Information Center

Chen, Chi Yuan; Wang, Shu-Yin; Yang, Yi-Fang

2017-01-01

The purpose of the study is to explore the influence of teaching evaluations on teachers in that they might try to please their students by giving higher grades in order to get higher teaching evaluation scores. To achieve this purpose, the study analyzed the correlations between teaching evaluation scores, student's final grades and course fail…

[Early recurrent miscarriage: Evaluation and management].

PubMed

Gallot, V; Nedellec, S; Capmas, P; Legendre, G; Lejeune-Saada, V; Subtil, D; Nizard, J; Levêque, J; Deffieux, X; Hervé, B; Vialard, F

2014-12-01

To establish recommendations for early recurrent miscarriages (≥3 miscarriages before 14weeks of amenorrhea). Literature review, establishing levels of evidence and recommendations for grades of clinical practice. Women evaluation includes the search for a diabetes (grade A), an antiphospholipid syndrome (APS) (grade A), a thyroid dysfunction (grade A), a hyperprolactinemia (grade B), a vitamin deficiency and a hyperhomocysteinemia (grade C), a uterine abnormality (grade C), an altered ovarian reserve (grade C), and a couple chromosome analysis (grade A). For unexplained early recurrent miscarriages, treatment includes folic acid and progesterone supplementation, and a reinsurance policy in the first quarter (grade C). It is recommended to prescribe the combination of aspirin and low-molecular-weight heparin when APS (grade A), glycemic control in diabetes (grade A), L-Thyroxine in case of hypothyroidism (grade A) or the presence of thyroid antibodies (grade B), bromocriptine if hyperprolactinemia (grade B), a substitution for vitamin deficiency or hyperhomocysteinemia (grade C), sectionning a uterine septum (grade C) and treating an uterine acquired abnormality (grade C). These recommendations should improve the management of couples faced with early recurrent miscarriages. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

ACR Appropriateness Criteria® Urinary Tract Infection-Child.

PubMed

Karmazyn, Boaz K; Alazraki, Adina L; Anupindi, Sudha A; Dempsey, Molly E; Dillman, Jonathan R; Dorfman, Scott R; Garber, Matthew D; Moore, Sheila G; Peters, Craig A; Rice, Henry E; Rigsby, Cynthia K; Safdar, Nabile M; Simoneaux, Stephen F; Trout, Andrew T; Westra, Sjirk J; Wootton-Gorges, Sandra L; Coley, Brian D

2017-05-01

Urinary tract infection (UTI) is common in young children and may cause pyelonephritis and renal scarring. Long-term complications from renal scarring are low. The role of imaging is to evaluate for underlying urologic abnormalities and guide treatment. In neonates there is increased risk for underlying urologic abnormalities. Evaluation for vesicoureteral reflux (VUR) may be appropriate especially in boys because of higher prevalence of VUR and to exclude posterior urethral valve. In children older than 2 months with first episode of uncomplicated UTI, there is no clear benefit of prophylactic antibiotic. Ultrasound is the only study that is usually appropriate. After the age of 6 years, UTIs are infrequent. There is no need for routine imaging as VUR is less common. In children with recurrent or complicated UTI, in addition to ultrasound, imaging of VUR is usually appropriate. Renal cortical scintigraphy may be appropriate in children with VUR, as renal scarring may support surgical intervention. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults.

PubMed

Lucendo, Alfredo J; Molina-Infante, Javier; Arias, Ángel; von Arnim, Ulrike; Bredenoord, Albert J; Bussmann, Christian; Amil Dias, Jorge; Bove, Mogens; González-Cervera, Jesús; Larsson, Helen; Miehlke, Stephan; Papadopoulou, Alexandra; Rodríguez-Sánchez, Joaquín; Ravelli, Alberto; Ronkainen, Jukka; Santander, Cecilio; Schoepfer, Alain M; Storr, Martin A; Terreehorst, Ingrid; Straumann, Alex; Attwood, Stephen E

2017-04-01

Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE. General methodology according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted up to August 2015 and periodically updated. The working group consisted of gastroenterologists, allergists, pediatricians, otolaryngologists, pathologists, and epidemiologists. Systematic evidence-based reviews were performed based upon relevant clinical questions with respect to patient-important outcomes. The guidelines include updated concept of EoE, evaluated information on disease epidemiology, risk factors, associated conditions, and natural history of EoE in children and adults. Diagnostic conditions and criteria, the yield of diagnostic and disease monitoring procedures, and evidence-based statements and recommendation on the utility of the several treatment options for patients EoE are provided. Recommendations on how to choose and implement treatment and long-term management are provided based on expert opinion and best clinical practice. Evidence-based recommendations for EoE diagnosis, treatment modalities, and patients' follow up are proposed in the guideline.

Serous tubal intraepithelial carcinomas associated with high-grade serous ovarian carcinomas: a systematic review.

PubMed

Chen, F; Gaitskell, K; Garcia, M J; Albukhari, A; Tsaltas, J; Ahmed, A A

2017-05-01

Serous tubal intraepithelial carcinomas (STICs) have been documented in high-grade serous ovarian carcinomas (HGSOCs). However, the rate of association between STICs and HGSOCs and, therefore, the fraction of HGSOCs that are likely to have originated from the fallopian tube (FT), has remained unclear. To appraise the literature describing the association between STICs and established HGSOCs. Ovid MEDLINE and EMBASE were searched. Studies were included if they evaluated the frequency of STICs in HGSOCs, and were published in an English peer-reviewed journal. Appropriate studies were evaluated for their compliance with the 'Strengthening and Reporting of Observational Studies in Epidemiology (STROBE)' criteria. Ten articles met the study selection criteria. The reported coexistence between STICs and HGSOCs ranged from 11% to 61% (mean: 31%, 95% CI: 17-46%). STICs were rarely found in other gynaecological cancers. Small sample size, lack of objective criteria to identify STICs and the retrospective nature of the studies contributed to the variability in reporting the rate of the association. STICs were identified commonly in the FTs of women with HGSOC. Finding the true rate of association between STICs and HGSOCs will require further investigations. While there is evidence that a fraction of HGSOCs arise from the FTs, an accurate estimate of that fraction remains to be determined. The lack of an accurate estimate of the association makes it difficult to evaluate the potential magnitude of reduction of HGSOCs following prophylactic salpingectomy. A systematic review of the incidence of STICs in HGSOCs identifies significant methodological inconsistencies. © 2017 Royal College of Obstetricians and Gynaecologists.

Footwear interventions for foot pain, function, impairment and disability for people with foot and ankle arthritis: A literature review.

PubMed

Frecklington, Mike; Dalbeth, Nicola; McNair, Peter; Gow, Peter; Williams, Anita; Carroll, Matthew; Rome, Keith

2017-11-03

To conduct a literature review on the effectiveness of footwear on foot pain, function, impairment and disability for people with foot and ankle arthritis. A search of the electronic databases Scopus, Medline, CINAHL, SportDiscus and the Cochrane Library was undertaken in September 2017. The key inclusion criteria were studies reporting on findings of footwear interventions for people with arthritis with foot pain, function, impairment and/or disability. The Quality Index Tool was used to assess the methodological quality of studies included in the qualitative synthesis. The methodological variation of the included studies was assessed to determine the suitability of meta-analysis and the grading of recommendations, assessment, development and evaluation (GRADE) system. Between and within group effect sizes were calculated using Cohen's d. 1440 studies were identified for screening with 11 studies included in the review. Mean (range) quality scores were 67% (39-96%). The majority of studies investigated rheumatoid arthritis (n = 7), but also included gout (n = 2), and 1st metatarsophalangeal joint osteoarthritis (n = 2). Meta-analysis and GRADE assessment were not deemed appropriated based on methodological variation. Footwear interventions included off-the-shelf footwear, therapeutic footwear and therapeutic footwear with foot orthoses. Key footwear characteristics included cushioning and a wide toe box for rheumatoid arthritis; cushioning, midsole stability and a rocker-sole for gout; and a rocker-sole for 1st metatarsophalangeal joint osteoarthritis. Between group effect sizes for outcomes ranged from 0.01 to 1.26. Footwear interventions were associated with reductions in foot pain, impairment and disability for people with rheumatoid arthritis. Between group differences were more likely to be observed in studies with shorter follow-up periods in people with rheumatoid arthritis (12 weeks). Footwear interventions improved foot pain, function and disability in people with gout and foot pain and function in 1st metatarsophalangeal joint osteoarthritis. Footwear interventions were associated with changes to plantar pressure in people with rheumatoid arthritis, gout and 1st metatarsophalangeal joint osteoarthritis and walking velocity in people with rheumatoid arthritis and gout. Footwear interventions are associated with reductions in foot pain, impairment and disability in people with rheumatoid arthritis, improvements to foot pain, function and disability in people with gout and improvements to foot pain and function in people with 1st metatarsophalangeal joint osteoarthritis. Footwear interventions have been shown to reduce plantar pressure rheumatoid arthritis, gout and 1st metatarsophalangeal joint osteoarthritis and improve walking velocity in rheumatoid arthritis and gout. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

An Evaluation of Grades 9 and 10 Mathematics Textbooks vis-a-vis Fostering Problem Solving Skills

ERIC Educational Resources Information Center

Buishaw, Alemayehu; Ayalew, Assaye

2013-01-01

This study sought to evaluate the adequacy of integration of problematic situations and general problem-solving strategies (heuristics) in grades 9 and 10 mathematics textbooks. Grade 9 and grade 10 mathematics textbooks were used for analysis. Document analysis and interview were used as data gathering instruments. Document analysis was carried…

A cost-comparison methodology for selecting appropriate hot-mix asphalt materials.

DOT National Transportation Integrated Search

2007-01-01

The Virginia Department of Transportation's (VDOT) Road and Bridge Specifications lists 9 dense-graded hot-mix asphalt (HMA) surface mixes (three aggregate gradations x three binder types) that could be used on Virginia's highways. VDOT's Special Pro...

Children's Preferences for Film Form and Technique.

ERIC Educational Resources Information Center

Cox, Carole

1982-01-01

Describes the methodology and results of a study of the preferences of fourth- and fifth-grade children for film form and technique. Indicates that children prefer narrative/live action films, followed by narrative/animation, nonnarrative/live action, and nonnarrative/animation. (HTH)

Symptomatic spinal metastasis: A systematic literature review of the preoperative prognostic factors for survival, neurological, functional and quality of life in surgically treated patients and methodological recommendations for prognostic studies

PubMed Central

Nater, Anick; Martin, Allan R.; Sahgal, Arjun; Choi, David

2017-01-01

Purpose While several clinical prediction rules (CPRs) of survival exist for patients with symptomatic spinal metastasis (SSM), these have variable prognostic ability and there is no recognized CPR for health related quality of life (HRQoL). We undertook a critical appraisal of the literature to identify key preoperative prognostic factors of clinical outcomes in patients with SSM who were treated surgically. The results of this study could be used to modify existing or develop new CPRs. Methods Seven electronic databases were searched (1990–2015), without language restriction, to identify studies that performed multivariate analysis of preoperative predictors of survival, neurological, functional and HRQoL outcomes in surgical patients with SSM. Individual studies were assessed for class of evidence. The strength of the overall body of evidence was evaluated using GRADE for each predictor. Results Among 4,818 unique citations, 17 were included; all were in English, rated Class III and focused on survival, revealing a total of 46 predictors. The strength of the overall body of evidence was very low for 39 and low for 7 predictors. Due to considerable heterogeneity in patient samples and prognostic factors investigated as well as several methodological issues, our results had a moderately high risk of bias and were difficult to interpret. Conclusions The quality of evidence for predictors of survival was, at best, low. We failed to identify studies that evaluated preoperative prognostic factors for neurological, functional, or HRQoL outcomes in surgical patients with SSM. We formulated methodological recommendations for prognostic studies to promote acquiring high-quality evidence to better estimate predictor effect sizes to improve patient education, surgical decision-making and development of CPRs. PMID:28225772

Facilitating healthcare decisions by assessing the certainty in the evidence from preclinical animal studies.

PubMed

Hooijmans, Carlijn R; de Vries, Rob B M; Ritskes-Hoitinga, Merel; Rovers, Maroeska M; Leeflang, Mariska M; IntHout, Joanna; Wever, Kimberley E; Hooft, Lotty; de Beer, Hans; Kuijpers, Ton; Macleod, Malcolm R; Sena, Emily S; Ter Riet, Gerben; Morgan, Rebecca L; Thayer, Kristina A; Rooney, Andrew A; Guyatt, Gordon H; Schünemann, Holger J; Langendam, Miranda W

2018-01-01

Laboratory animal studies are used in a wide range of human health related research areas, such as basic biomedical research, drug research, experimental surgery and environmental health. The results of these studies can be used to inform decisions regarding clinical research in humans, for example the decision to proceed to clinical trials. If the research question relates to potential harms with no expectation of benefit (e.g., toxicology), studies in experimental animals may provide the only relevant or controlled data and directly inform clinical management decisions. Systematic reviews and meta-analyses are important tools to provide robust and informative evidence summaries of these animal studies. Rating how certain we are about the evidence could provide important information about the translational probability of findings in experimental animal studies to clinical practice and probably improve it. Evidence summaries and certainty in the evidence ratings could also be used (1) to support selection of interventions with best therapeutic potential to be tested in clinical trials, (2) to justify a regulatory decision limiting human exposure (to drug or toxin), or to (3) support decisions on the utility of further animal experiments. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach is the most widely used framework to rate the certainty in the evidence and strength of health care recommendations. Here we present how the GRADE approach could be used to rate the certainty in the evidence of preclinical animal studies in the context of therapeutic interventions. We also discuss the methodological challenges that we identified, and for which further work is needed. Examples are defining the importance of consistency within and across animal species and using GRADE's indirectness domain as a tool to predict translation from animal models to humans.

Evidence for minimally invasive therapies in the management of chronic calcific tendinopathy of the rotator cuff: a systematic review and meta-analysis.

PubMed

Louwerens, Jan K G; Sierevelt, Inger N; van Noort, Arthur; van den Bekerom, Michel P J

2014-08-01

This meta-analysis assessed the short-term to midterm effectiveness of minimally invasive treatments in the management of calcifying tendinopathy of the shoulder cuff, a common source of chronic shoulder pain that leads to pain, a decreased active range of motion, and loss of muscular strength. When conservative therapies fail, minimally invasive treatment options can be considered before resulting to surgery. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to conduct this review. A systematic literature search was conducted in May 2013 to identify all studies that examined the short-term to midterm effectiveness of minimally invasive treatments for chronic calcifying tendinopathy. The primary end points were identified as function, pain, and total resorption rates. Grades of Recommendation Assessment, Development and Evaluation (GRADE) was used to assess the quality of evidence. Included were 20 studies (1544 participants). Common methodological flaws were related to randomization. In general, there is moderate-quality GRADE evidence that high-energy extracorporeal shockwave therapy has a significant effect on pain relief and functional status compared with other interventions. There is variable-quality GRADE evidence on the efficiency of other interventions. High-energy extracorporeal shockwave therapy is the most thoroughly investigated minimally invasive treatment option in the short-term to midterm and has proven to be a safe and effective treatment. Ultrasound-guided needling is safe but has not been proven to be more effective than an ultrasound-guided subacromial corticosteroid injection in recent level I research, and further research will have to prove its effectiveness. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Determining Surgical Complications in the Overweight (DISCOVER): a multicentre observational cohort study to evaluate the role of obesity as a risk factor for postoperative complications in general surgery.

PubMed

Nepogodiev, Dmitri; Chapman, Stephen J; Glasbey, James; Kelly, Michael; Khatri, Chetan; Drake, Thomas M; Kong, Chia Yew; Mitchell, Harriet; Harrison, Ewen M; Fitzgerald, J Edward; Bhangu, Aneel

2015-07-20

Obesity is increasingly prevalent among patients undergoing surgery. Conflicting evidence exists regarding the impact of obesity on postoperative complications. This multicentre study aims to determine whether obesity is associated with increased postoperative complications following general surgery. This prospective, multicentre cohort study will be performed utilising a collaborative methodology. Consecutive adults undergoing open or laparoscopic, elective or emergency, gastrointestinal, bariatric or hepatobiliary surgery will be included. Day case patients will be excluded. The primary end point will be the overall 30-day major complication rate (Clavien-Dindo grade III-V complications). Data will be collected to risk-adjust outcomes for potential confounding factors, such as preoperative cardiac risk. This study will be disseminated through structured medical student networks using established collaborative methodology. The study will be powered to detect a two-percentage point increase in the major postoperative complication rate in obese versus non-obese patients. Following appropriate assessment, an exemption from full ethics committee review has been received, and the study will be registered as a clinical audit or service evaluation at each participating hospital. Dissemination will take place through national and local research collaborative networks. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Evaluation of Team-Based Learning and Traditional Instruction in Teaching Removable Partial Denture Concepts.

PubMed

Echeto, Luisa F; Sposetti, Venita; Childs, Gail; Aguilar, Maria L; Behar-Horenstein, Linda S; Rueda, Luis; Nimmo, Arthur

2015-09-01

The aim of this study was to evaluate the effectiveness of team-based learning (TBL) methodology on dental students' retention of knowledge regarding removable partial denture (RPD) treatment. The process of learning RPD treatment requires that students first acquire foundational knowledge and then use critical thinking skills to apply that knowledge to a variety of clinical situations. The traditional approach to teaching, characterized by a reliance on lectures, is not the most effective method for learning clinical applications. To address the limitations of that approach, the teaching methodology of the RPD preclinical course at the University of Florida was changed to TBL, which has been shown to motivate student learning and improve clinical performance. A written examination was constructed to compare the impact of TBL with that of traditional teaching regarding students' retention of knowledge and their ability to evaluate, diagnose, and treatment plan a partially edentulous patient with an RPD prosthesis. Students taught using traditional and TBL methods took the same examination. The response rate (those who completed the examination) for the class of 2013 (traditional method) was 94% (79 students of 84); for the class of 2014 (TBL method), it was 95% (78 students of 82). The results showed that students who learned RPD with TBL scored higher on the examination than those who learned RPD with traditional methods. Compared to the students taught with the traditional method, the TBL students' proportion of passing grades was statistically significantly higher (p=0.002), and 23.7% more TBL students passed the examination. The mean score for the TBL class (0.758) compared to the conventional class (0.700) was statistically significant with a large effect size, also demonstrating the practical significance of the findings. The results of the study suggest that TBL methodology is a promising approach to teaching RPD with successful outcomes.

Grading Practices and Distributions Across Internal Medicine Clerkships.

PubMed

Fazio, Sara B; Torre, Dario M; DeFer, Thomas M

2016-01-01

Clerkship evaluation and grading practices vary widely between U.S. medical schools. Grade inflation continues to exist, and grade distribution is likely to be different among U.S. medical schools. Increasing the number of available grades curtails "grade inflation." A national survey of all Clerkship Directors in Internal Medicine members was administered in 2011. The authors assessed key aspects of grading. Response rate was 76%. Among clerkship directors (CDs), 61% of respondents agreed that grade inflation existed in the internal medicine clerkship at their school, and 43% believed that it helped students obtain better residency positions. With respect to grading practices, 79% of CDs define specific behaviors needed to achieve each grade, and 36% specify an ideal grade distribution. In addition, 44% have a trained core faculty responsible for evaluating students, 35% describe formal grading meetings, and 39% use the Reporter-Interpreter-Manager-Educator (RIME) scheme. Grading scales were described as follows: 4% utilize a pass/fail system, 13% a 3-tier (e.g., Honors/Pass/Fail), 45% 4-tier, 35% 5-tier, and 4% 6+-tier system. There was a trend to higher grades with more tiers available. Grade inflation continues in the internal medicine clerkship. Almost half of CDs feel that this practice assists students to obtain better residency positions. A minority of programs have a trained core faculty who are responsible for evaluation. About one third have formal grading meetings and use the RIME system; both have been associated with more robust and balanced grading practices. In particular, there is a wide variation between schools in the percentage of students who are awarded the highest grade, which has implications for residency applications. Downstream users of clinical clerkship grades must be fully aware of these variations in grading in order to appropriately judge medical student performance.

[First line management without IVF of infertility related to endometriosis: Result of medical therapy? Results of ovarian superovulation? Results of intrauterine insemination? CNGOF-HAS Endometriosis Guidelines].

PubMed

Boujenah, J; Santulli, P; Mathieu-d'Argent, E; Decanter, C; Chauffour, C; Poncelet, P

2018-03-01

Using the structured methodology of French guidelines (HAS-CNGOF), the aim of this chapter was to formulate good practice points (GPP), in relation to optimal non-ART management of endometriosis related to infertility, based on the best available evidence in the literature. This guideline was produced by a group of experts in the field including a thorough systematic search of the literature (from January 1980 to March 2017). Were included only women with endometriosis related to infertility. For each recommendation, a grade (A-D, where A is the highest quality) was assigned based on the strength of the supporting evidence. Management of endometriosis related to infertility should be multidisciplinary and take account into the pain, the global evaluation of infertile couple and the different phenotypes of endometriotic lesions (good practice point). Hormonal treatment for suppression of ovarian function should not prescribe to improve fertility (grade A). After laproscopy for endometriosis related to infertility, the Endometriosis Fertility Index should be used to counsel patients regarding duration of conventional treatments before undergoing ART (grade C). After laparoscopy surgery for infertile women with AFS/ASRM stage I/II endometriosis or superficial peritoneal endometriosis, controlled ovarian stimulation with or without intrauterine insemination could be used to enhance non-ART pregnancy rate (grade C). Gonadotrophins should be the first line therapy for the stimulation (grade B). The number of cycles before referring ART should not exceed up to 6 cycles (good practice point). No recommendation can be performed for non-ART management of deep infiltrating endometriosis or endometrioma, as suitable evidence is lacking. Non-ART management is a possible option for the management of endometriosis related to infertility. Endometriosis Fertilty Index could be a useful tool for subsequent postoperative fertility management. Controlled ovarian stimulation can be proposed. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Use of Management Pathways or Algorithms in Children With Chronic Cough: CHEST Guideline and Expert Panel Report.

PubMed

Chang, Anne B; Oppenheimer, John J; Weinberger, Miles M; Rubin, Bruce K; Weir, Kelly; Grant, Cameron C; Irwin, Richard S

2017-04-01

Using management algorithms or pathways potentially improves clinical outcomes. We undertook systematic reviews to examine various aspects in the generic approach (use of cough algorithms and tests) to the management of chronic cough in children (aged ≤ 14 years) based on key questions (KQs) using the Population, Intervention, Comparison, Outcome format. We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development and Evaluation framework. Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain the final grading. Combining data from systematic reviews addressing five KQs, we found high-quality evidence that a systematic approach to the management of chronic cough improves clinical outcomes. Although there was evidence from several pathways, the highest evidence was from the use of the CHEST approach. However, there was no or little evidence to address some of the KQs posed. Compared with the 2006 Cough Guidelines, there is now high-quality evidence that in children aged ≤ 14 years with chronic cough (> 4 weeks' duration), the use of cough management protocols (or algorithms) improves clinical outcomes, and cough management or testing algorithms should differ depending on the associated characteristics of the cough and clinical history. A chest radiograph and, when age appropriate, spirometry (pre- and post-β 2 agonist) should be undertaken. Other tests should not be routinely performed and undertaken in accordance with the clinical setting and the child's clinical symptoms and signs (eg, tests for tuberculosis when the child has been exposed). Copyright © 2017 American College of Chest Physicians. All rights reserved.

Management of Children With Chronic Wet Cough and Protracted Bacterial Bronchitis: CHEST Guideline and Expert Panel Report.

PubMed

Chang, Anne B; Oppenheimer, John J; Weinberger, Miles M; Rubin, Bruce K; Grant, Cameron C; Weir, Kelly; Irwin, Richard S

2017-04-01

Wet or productive cough is common in children with chronic cough. We formulated recommendations based on systematic reviews related to the management of chronic wet cough in children (aged ≤ 14 years) based on two key questions: (1) how effective are antibiotics in improving the resolution of cough? If so, what antibiotic should be used and for how long? and (2) when should children be referred for further investigations? We used the CHEST expert cough panel's protocol for systematic reviews and the American College of Chest Physicians (CHEST) methodologic guidelines and GRADE framework (the Grading of Recommendations Assessment, Development and Evaluation). Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus for the recommendations/suggestions made. Combining data from the systematic reviews, we found high-quality evidence in children aged ≤ 14 years with chronic (> 4 weeks' duration) wet/productive cough that using appropriate antibiotics improves cough resolution, and further investigations (eg, flexible bronchoscopy, chest CT scans, immunity tests) should be undertaken when specific cough pointers (eg, digital clubbing) are present. When the wet cough does not improve following 4 weeks of antibiotic treatment, there is moderate-quality evidence that further investigations should be considered to look for an underlying disease. New recommendations include the recognition of the clinical diagnostic entity of protracted bacterial bronchitis. Compared with the 2006 Cough Guidelines, there is now high-quality evidence for some, but not all, aspects of the management of chronic wet cough in specialist settings. However, further studies (particularly in primary health) are required. Copyright © 2017 American College of Chest Physicians. All rights reserved.

Systematic review of multidisciplinary rehabilitation in patients with multiple trauma.

PubMed

Khan, F; Amatya, B; Hoffman, K

2012-01-01

Multiple trauma is a cause of significant disability in adults of working age. Despite the implementation of trauma systems for improved coordination and organization of care, rehabilitation services are not yet routinely considered integral to trauma care processes. MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Physiotherapy Evidence Database, Latin American and Caribbean Literature on Health Sciences and Cochrane Library databases were searched up to May 2011 for randomized clinical trials, as well as observational studies, reporting outcomes of injured patients following multidisciplinary rehabilitation that addressed functional restoration and societal reintegration based on the International Classification of Functioning, Disability and Health. No randomized and/or controlled clinical trials were identified. Fifteen observational studies involving 2386 participants with injuries were included. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach assessed methodological quality as 'poor' in all studies, with selection and observer bias. Although patients with low functional scores showed improvement after rehabilitation, they were unable to resume their pretrauma level of activity. Their functional ability was significantly associated with motor independence on admission and early acute rehabilitation, which contributed to a shorter hospital stay. Injury location, age, co-morbidity and education predicted long-term functional consequences. Trauma care systems were associated with reduced mortality. The gaps in evidence include: rehabilitation settings, components, intensity, duration and types of therapy, and long-term outcomes for survivors of multiple trauma. Rehabilitation is an expensive resource and the evidence to support its justification is needed urgently. The issues in study design and research methodology in rehabilitation are challenging. Opportunities to prioritize trauma rehabilitation, disability management and social reintegration of multiple injury survivors are discussed. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

ACR Appropriateness Criteria® Abdominal Aortic Aneurysm: Interventional Planning and Follow-Up.

PubMed

Francois, Christopher J; Skulborstad, Erik P; Majdalany, Bill S; Chandra, Ankur; Collins, Jeremy D; Farsad, Khashayar; Gerhard-Herman, Marie D; Gornik, Heather L; Kendi, A Tuba; Khaja, Minhajuddin S; Lee, Margaret H; Sutphin, Patrick D; Kapoor, Baljendra S; Kalva, Sanjeeva P

2018-05-01

Abdominal aortic aneurysms (AAAs) are a relatively common vascular problem that can be treated with either open, surgical repair or endovascular aortic aneurysm repair (EVAR). Both approaches to AAA repair require dedicated preoperative imaging to minimize adverse outcomes. After EVAR, cross-sectional imaging has an integral role in confirming the successful treatment of the AAA and early detection of complications related to EVAR. CT angiography is the primary imaging modality for both preoperative planning and follow-up after repair. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

No. 360-Induced Abortion: Surgical Abortion and Second Trimester Medical Methods.

PubMed

Costescu, Dustin; Guilbert, Édith

2018-06-01

This guideline reviews evidence relating to the provision of surgical induced abortion (IA) and second trimester medical abortion, including pre- and post-procedural care. Gynaecologists, family physicians, nurses, midwives, residents, and other health care providers who currently or intend to provide and/or teach IAs. Women with an unintended or abnormal first or second trimester pregnancy. PubMed, Medline, and the Cochrane Database were searched using the key words: first-trimester surgical abortion, second-trimester surgical abortion, second-trimester medical abortion, dilation and evacuation, induction abortion, feticide, cervical preparation, cervical dilation, abortion complications. Results were restricted to English or French systematic reviews, randomized controlled trials, clinical trials, and observational studies published from 1979 to July 2017. National and international clinical practice guidelines were consulted for review. Grey literature was not searched. The quality of evidence in this document was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology framework. The summary of findings is available upon request. IA is safe and effective. The benefits of IA outweigh the potential harms or costs. No new direct harms or costs identified with these guidelines. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. All rights reserved.

Canadian Cardiovascular Society/Canadian Society of Cardiac Surgeons/Canadian Society for Vascular Surgery Joint Position Statement on Open and Endovascular Surgery for Thoracic Aortic Disease.

PubMed

Appoo, Jehangir J; Bozinovski, John; Chu, Michael W A; El-Hamamsy, Ismail; Forbes, Thomas L; Moon, Michael; Ouzounian, Maral; Peterson, Mark D; Tittley, Jacques; Boodhwani, Munir

2016-06-01

In 2014, the Canadian Cardiovascular Society (CCS) published a position statement on the management of thoracic aortic disease addressing size thresholds for surgery, imaging modalities, medical therapy, and genetics. It did not address issues related to surgical intervention. This joint Position Statement on behalf of the CCS, Canadian Society of Cardiac Surgeons, and the Canadian Society for Vascular Surgery provides recommendations about thoracic aortic disease interventions, including: aortic valve repair, perfusion strategies for arch repair, extended arch hybrid reconstruction for acute type A dissection, endovascular management of arch and descending aortic aneurysms, and type B dissection. The position statement is constructed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and has been approved by the primary panel, an international secondary panel, and the CCS Guidelines Committee. Advent of endovascular technology has improved aortic surgery safety and extended the indications of minimally invasive thoracic aortic surgery. The combination of safer open surgery with endovascular treatment has improved patient outcomes in this rapidly evolving subspecialty field of cardiovascular surgery. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

[Psychotherapeutic Interventions in Acute and Maintenance Treatment of Adult Patients Diagnosed With Schizophrenia].

PubMed

García Valencia, Jenny; Ahunca Velásquez, Luisa Fernanda; Bohórquez Peñaranda, Adriana; Gómez Restrepo, Carlos; Jaramillo González, Luis Eduardo; Palacio Acosta, Carlos

2014-01-01

To determine the effectiveness of the psychotherapeutic strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of disease. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia. A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The cognitive behavioral therapy showed higher efficacy, compared with the usual treatment, to reduce positive symptoms, prevent relapses and hospital readmissions and to improve the occupational stats. However, the quality of evidence was low. There was not enough evidence about the efficacy of adherence, psychodynamic and support therapy. Psychotherapeutic management must be offered to the patients with schizophrenia according to their needs and clinical characteristics. Among the different psychotherapeutic modalities, cognitive behavioral therapy is recommended. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Family and school spillover in adolescents' daily lives.

PubMed

Flook, Lisa; Fuligni, Andrew J

2008-01-01

This study examined spillover between daily family stressors and school problems among 589 ninth-grade students (mean age = 14.9 years) from Mexican, Chinese, and European backgrounds. Spillover was examined using a daily diary methodology in which adolescents reported on their school and family experiences each day for 2 weeks. Analyses using hierarchical linear modeling revealed reciprocal spillover effects between adolescents' daily functioning in the family and school domains that spanned several days. Longitudinal analyses indicated that spillover between family stressors and school problems also occurs across the high school years, from 9th to 12th grade, and that both are predictive of poorer academic performance in 12th grade. These findings have practical implications for adolescents' academic achievement trajectories and general well-being.

In-place oil shale resources examined by grade in the major basins of the Green River Formation, Colorado, Utah, and Wyoming

USGS Publications Warehouse

Birdwell, Justin E.; Mercier, Tracey J.; Johnson, Ronald C.; Brownfield, Michael E.

2013-01-01

Using a geology-based assessment methodology, the U.S. Geological Survey estimated a total of 4.285 trillion barrels of oil in-place in the oil shale of the three principal basins of the Eocene Green River Formation. Using oil shale cutoffs of potentially viable (15 gallons per ton) and high grade (25 gallons per ton), it is estimated that between 353 billion and 1.146 trillion barrels of the in-place resource have a high potential for development.

Proposal for a Novel Severity Grading System for Pterygia Based on Corneal Topographic Data.

PubMed

Miyata, Kazunori; Minami, Keiichiro; Otani, Atsushi; Tokunaga, Tadatoshi; Tokuda, Shouta; Amano, Shiro

2017-07-01

To propose a grading system of pterygium severity based on corneal higher-order irregularity (HOI) and to evaluate postoperative changes in corneal irregularity of the graded pterygia. In 268 eyes of 226 patients undergoing excision surgery of primary nasal pterygium, Placido corneal topography images were taken before and until 6 months after surgery. The best-corrected visual acuity (BCVA) and pterygium size with respect to the corneal diameter were also measured. HOI components within 1.0-, 3.0-, and 5.0-mm diameters were obtained using Fourier harmonic analysis of corneal topography data. With threshold levels when the HOIs for 3 diameters steeply increased, 4 levels of grading from 0 (mild) to 3 (severe) were determined. Associations of the grades with the preoperative surface regularity index (SRI), irregular components (IRRs) obtained from the 3.0-mm diameter Fourier analysis, and BCVA were examined. Time-course changes in the indexes after surgery were evaluated for each grade. There were 62, 65, 41, and 100 eyes in grades 0 to 3, respectively. Preoperatively, the SRI in grade 3 was significantly higher than in the other grades (P < 0.001), and the IRR and BCVA varied with the grade (P < 0.001). Between 1 and 6 months postoperatively, grade 3 pterygia showed significant changes in the SRI and IRR (P = 0.013 and 0.017, respectively), whereas there was no change after 3 months postoperatively in the SRI, IRR, and BCVA for all other grades. The proposed grading effectively classified the severity of pterygia and evaluated postoperative restoration of corneal irregularity. Using corneal topographic data allowed for objective evaluation of pterygium severity.

Studying Sex Prejudice in Children.

ERIC Educational Resources Information Center

Olsen, Nancy J.; Willemsen, Eleanor W.

1978-01-01

Explores a methodology for studying sex prejudice in children. First-, third-, and fifth-grade students were asked to rate the performance of an eight-year-old child identified as a girl for half of the subjects and as a boy for the remaining half. (BD)

Effectiveness of functional training on cardiorespiratory parameters: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Rezende Barbosa, Marianne Penachini da Costa de; Oliveira, Vinicius Cunha; Silva, Anne Kastelianne França da; Pérez-Riera, Andrés Ricardo; Vanderlei, Luiz Carlos

2017-07-28

Functional training is a new training vision that was prepared from the gesture imitation of daily activities. Although your use has become popular in clinical practice, the influence of the several cardiorespiratory adjustments performed during the functional training in different populations and conditions is unknown. So, the aim of this systematic review was to gather information in the literature regarding the influence of functional training on cardiorespiratory parameters. We conducted search strategies on MEDLINE, PEDro, EMBASE, SportDiscus and Cochrane to identify randomized controlled trials investigating the effects of functional training on cardiorespiratory parameters. Methodological quality of the included studies was assessed using the PEDro scale. Grading of Recommendations Assessment, Development and Evaluation (GRADE) summarized the evidence. Five original studies were included. Effects favoured functional training on oxygen consumption (VO 2 ) at intermediate-term follow-up: weighted mean difference -1·0 (95% CI: 5·4-3·3), P = 0·642, and a small and not clinically important effect observed on VO 2 favouring control at intermediate-term follow-up (i.e. mean difference of 1·30 (95% CI 1·07-1·53), P<0·001). According to the GRADE system, there is very low quality evidence that functional training is better than other interventions to improve cardiovascular parameters. This result encourages new searches about the theme. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Multi-response optimization of T300/epoxy prepreg tape-wound cylinder by grey relational analysis coupled with the response surface method

NASA Astrophysics Data System (ADS)

Kang, Chao; Shi, Yaoyao; He, Xiaodong; Yu, Tao; Deng, Bo; Zhang, Hongji; Sun, Pengcheng; Zhang, Wenbin

2017-09-01

This study investigates the multi-objective optimization of quality characteristics for a T300/epoxy prepreg tape-wound cylinder. The method integrates the Taguchi method, grey relational analysis (GRA) and response surface methodology, and is adopted to improve tensile strength and reduce residual stress. In the winding process, the main process parameters involving winding tension, pressure, temperature and speed are selected to evaluate the parametric influences on tensile strength and residual stress. Experiments are conducted using the Box-Behnken design. Based on principal component analysis, the grey relational grades are properly established to convert multi-responses into an individual objective problem. Then the response surface method is used to build a second-order model of grey relational grade and predict the optimum parameters. The predictive accuracy of the developed model is proved by two test experiments with a low prediction error of less than 7%. The following process parameters, namely winding tension 124.29 N, pressure 2000 N, temperature 40 °C and speed 10.65 rpm, have the highest grey relational grade and give better quality characteristics in terms of tensile strength and residual stress. The confirmation experiment shows that better results are obtained with GRA improved by the proposed method than with ordinary GRA. The proposed method is proved to be feasible and can be applied to optimize the multi-objective problem in the filament winding process.

A lymphocyte spatial distribution graph-based method for automated classification of recurrence risk on lung cancer images

NASA Astrophysics Data System (ADS)

Garciá-Arteaga, Juan D.; Corredor, Germán.; Wang, Xiangxue; Velcheti, Vamsidhar; Madabhushi, Anant; Romero, Eduardo

2017-11-01

Tumor-infiltrating lymphocytes occurs when various classes of white blood cells migrate from the blood stream towards the tumor, infiltrating it. The presence of TIL is predictive of the response of the patient to therapy. In this paper, we show how the automatic detection of lymphocytes in digital H and E histopathological images and the quantitative evaluation of the global lymphocyte configuration, evaluated through global features extracted from non-parametric graphs, constructed from the lymphocytes' detected positions, can be correlated to the patient's outcome in early-stage non-small cell lung cancer (NSCLC). The method was assessed on a tissue microarray cohort composed of 63 NSCLC cases. From the evaluated graphs, minimum spanning trees and K-nn showed the highest predictive ability, yielding F1 Scores of 0.75 and 0.72 and accuracies of 0.67 and 0.69, respectively. The predictive power of the proposed methodology indicates that graphs may be used to develop objective measures of the infiltration grade of tumors, which can, in turn, be used by pathologists to improve the decision making and treatment planning processes.

Combining morphometric features and convolutional networks fusion for glaucoma diagnosis

NASA Astrophysics Data System (ADS)

Perdomo, Oscar; Arevalo, John; González, Fabio A.

2017-11-01

Glaucoma is an eye condition that leads to loss of vision and blindness. Ophthalmoscopy exam evaluates the shape, color and proportion between the optic disc and physiologic cup, but the lack of agreement among experts is still the main diagnosis problem. The application of deep convolutional neural networks combined with automatic extraction of features such as: the cup-to-disc distance in the four quadrants, the perimeter, area, eccentricity, the major radio, the minor radio in optic disc and cup, in addition to all the ratios among the previous parameters may help with a better automatic grading of glaucoma. This paper presents a strategy to merge morphological features and deep convolutional neural networks as a novel methodology to support the glaucoma diagnosis in eye fundus images.

[Metabolic Control, Evaluation and Follow-up Interventions in Patients With Schizophrenia].

PubMed

Oviedo, Gabriel Fernando; Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana; García Valencia, Jenny; Jaramillo, Luis Eduardo; Tamayo, Nathalie; Arenas, María Luisa; Vélez Fernández, Carolina

2015-01-01

To determine the laboratory tests, related to metabolic risk that should be practiced to adult patients diagnosed with schizophrenia. To assist the clinician decision-making process about complementary diagnostic evaluation strategies in adult diagnosed with schizophrenia. A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. The evidence of NICE guide 82 was adopted and updated. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The risk of overall mortality in schizophrenia is higher than in the general population excluding suicide. Results related with mortality associated to antipsychotics showed contradictory results. Metabolic outcomes showed a higher incidence and association with schizophrenia and treatment with antipsychotics (AP). The diagnosis of dyslipidemia in men with schizophrenia appears to be lower in comparison with the general population. However, changes in weight, blood sugar levels, HDL cholesterol and triglycerides are influenced by the use of antipsychotics in general there is a higher risk of developing diabetes mellitus in adults with schizophrenia. Based on the evidence found a plan was formulated for the evaluation of physiological and paraclinical variables during and before the management with AP in adult diagnosed with schizophrenia. The overall quality of evidence is low considering that most of the reports come from observational studies that have risk of bias and some designs have methodological limitations. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Evaluation of ground granulated iron blast-furnace slag : grade-100.

DOT National Transportation Integrated Search

2002-09-01

Currently, the use of grade-120 Granulated Ground Blast Furnace Slag (GGBFS) is incorporated into the specifications of LA DOTD concrete mixes. This study evaluates grade-100 GGBFS and its effect on the properties of hydraulic cement concretes used i...

Advanced soft computing diagnosis method for tumour grading.

PubMed

Papageorgiou, E I; Spyridonos, P P; Stylios, C D; Ravazoula, P; Groumpos, P P; Nikiforidis, G N

2006-01-01

To develop an advanced diagnostic method for urinary bladder tumour grading. A novel soft computing modelling methodology based on the augmentation of fuzzy cognitive maps (FCMs) with the unsupervised active Hebbian learning (AHL) algorithm is applied. One hundred and twenty-eight cases of urinary bladder cancer were retrieved from the archives of the Department of Histopathology, University Hospital of Patras, Greece. All tumours had been characterized according to the classical World Health Organization (WHO) grading system. To design the FCM model for tumour grading, three experts histopathologists defined the main histopathological features (concepts) and their impact on grade characterization. The resulted FCM model consisted of nine concepts. Eight concepts represented the main histopathological features for tumour grading. The ninth concept represented the tumour grade. To increase the classification ability of the FCM model, the AHL algorithm was applied to adjust the weights of the FCM. The proposed FCM grading model achieved a classification accuracy of 72.5%, 74.42% and 95.55% for tumours of grades I, II and III, respectively. An advanced computerized method to support tumour grade diagnosis decision was proposed and developed. The novelty of the method is based on employing the soft computing method of FCMs to represent specialized knowledge on histopathology and on augmenting FCMs ability using an unsupervised learning algorithm, the AHL. The proposed method performs with reasonably high accuracy compared to other existing methods and at the same time meets the physicians' requirements for transparency and explicability.

Evaluation of the environmental epidemiologic data and methodology for the air quality standard in Beijing

NASA Astrophysics Data System (ADS)

Li, Xu; Jiang, Yanfeng; Yin, Ling; Liu, Bo; Du, Pengfei; Hassan, Mujtaba; Wang, Shigong; Li, Tanshi

2017-09-01

To evaluate the relationship between exposure to air pollutants and respiratory emergency room visits, a generalized additive model (GAM) was used to analyze the exposure-effect relationship between air pollutants and respiratory emergency room visits. The results showed that NO2, SO2, and PM10 have positive relationships with respiratory disease. Concentration increases of 10 μg/m3 in NO2, SO2, and PM10 corresponded to 3.90% (95%CI 3.56-4.25), 0.81% (95%CI -0.09-1.72), and 0.64% (95%CI 0.55-0.74) increases in respiratory emergency room visits. In addition, there is a strong synergic effect of PM10 and NO2 on respiratory diseases. The threshold values of the national standard grade II limits used in Beijing should be adjusted. An appropriate standard could effectively promote a significant decline in respiratory room visits and would eventually be beneficial to air quality management in residential areas.

The Italian Society of Physical and Rehabilitation Medicine (SIMFER) recommendations for neck pain.

PubMed

Monticone, Marco; Iovine, Roberto; de Sena, Giampaolo; Rovere, Giancarlo; Uliano, Domenico; Arioli, Giovanni; Bonaiuti, Donatella; Brugnoni, Guido; Ceravolo, Gabriella; Cerri, Cesare; Dalla Toffola, Elena; Fiore, Pietro; Foti, Calogero

2013-01-01

The paper represents the Italian Society of Physical " and Rehabilitation Medicine (SIMFER) recommendations to Neck Pain. We searched the principal scientific databases for papers concerning the main approaches to NP, including international guidelines, clinical trials of high methodological value and systematic reviews without any temporal limits. The recommendations were graded on the basis of the National Plan for Guidelines of the Italian Istituto Superiore di Sanità, which includes the level of evidence and strength of the recommendation. The principal sections of the recommendations deal with the Evaluation and Therapy for Neck Pain. The first describes the main evidence concerning the evaluation of patients with NP with or without limb involvement and/or headache: medical history, physical examination, neurological examination, laboratory tests, electrodiagnostics, diagnostic imaging and self-administered questionnaires. The second describes the best evidence synthesis concernig the therapy for Neck Pain: education, exercise, medical therapy, manual therapy, traction, physical therapy, acupuncture, orthoses, multimodal treatment, behavioural treatment.

Enhancing course grades and evaluations using distance education technologies.

PubMed

Carpenter, Roger; Theeke, Laurie; Smothers, Angel

2013-01-01

Delivering appropriate amounts of course content using appropriate methods is a concern for nursing faculty. To address this problem, webcasting, Camtasia, and Wimba Live Classroom were evaluated for impact on course grades and student evaluations in a medical-surgical nursing course. The addition of Camtasia resulted in improved final grades and Student Evaluations of Instruction scores that reflected enhanced critical thinking, teacher effectiveness, and overall learning. Students preferred recorded content that could be viewed on mobile devices.

An Analysis of Grades, Class Level and Faculty Evaluation Scores in the United Arab Emirates

ERIC Educational Resources Information Center

Waller, Lee

2016-01-01

This study examined the results of a student evaluation of faculty against the grades awarded and the level of the course for a higher education institution in the United Arab Emirates. The purpose of the study was to determine if the grades awarded in the course and/or level of the course impacted the evaluation scores awarded to the faculty…

Development of a Methodology for Assessment of Crash Costs at Highway-Rail Grade Crossings in Nebraska

DOT National Transportation Integrated Search

2012-05-01

An accurate measure of crash costs is required to support effective decision-making about transportation investments. In particular, underinvestment will occur if measurement fails to capture the full cost of crashes. Such mis-measurement and underin...

Research on Internet-Supported Learning: A Review

ERIC Educational Resources Information Center

Bekele, Teklu Abate; Menchaca, Michael Paul

2008-01-01

How did the Internet affect learning in higher education? What methodological and theoretical issues characterized research on Internet-Supported Learning (ISL)? What implications existed for future research? A constant comparative, qualitative analysis of 29 studies indicated grade achievement was the prime measure of effectiveness in ISL…

Methodology for Determination of Grade Crossing Resource-Allocation Guidelines

DOT National Transportation Integrated Search

1975-04-01

The primary objective of this study was to determine the most effective method of reducing emissions of oxides of nitrogen from a two-cylinder version of an EMD series 567C locomotive engine. The NOx control techniques selected for use in this study ...

Standards-Based Grading and Reporting Will Improve Education

ERIC Educational Resources Information Center

Muñoz, Marco A.; Guskey, Thomas R.

2015-01-01

Grading and reporting are foundational elements in nearly every educational system. Grading represents teachers' evaluations, formative or summative, of students' performance. Reporting is how the results of those evaluations are communicated to students, parents, or others. Because of their fundamental nature, educators must ensure that grading…

Danish guidelines on management of otitis media in preschool children.

PubMed

Heidemann, C H; Lous, J; Berg, J; Christensen, J J; Håkonsen, S J; Jakobsen, M; Johansen, C J; Nielsen, L H; Hansen, M P; Poulsen, A; Schousboe, L P; Skrubbeltrang, C; Vind, A B; Homøe, P

2016-08-01

Otitis media is one of the most common diseases in small children. This underlines the importance of optimizing diagnostics and treatment of the condition. Recent literature points toward a stricter approach to diagnosing acute otitis media (AOM). Moreover, ventilating tube treatment for recurrent AOM (RAOM) and chronic otitis media with effusion (COME) has become the most frequently performed surgical procedure in pre-school children. Therefore, the Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology, Head and Neck Surgery deemed it necessary to update the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME. The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted between July and December 2014. The quality of the existing literature was assessed using AGREE II (Appraisal of Guidelines for Research & Evaluation), AMSTAR (assessing the Methodological Quality of Systematic Reviews), QUADAS-2 (Quality of Diagnostic Accuracy Studies), Cochrane Risk of Bias Tool for randomized trials and ACROBAT-NRSI (A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies). The working group consisted of otolaryngologists, general practitioners, pediatricians, microbiologists and epidemiologists. Recommendations for AOM diagnosis, surgical management for RAOM and COME, including the role of adenoidectomy and treatment of ventilating tube otorrhea, are proposed in the guideline. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Middle school science curriculum design and 8th grade student achievement in Massachusetts public schools

NASA Astrophysics Data System (ADS)

Clifford, Betsey A.

The Massachusetts Department of Elementary and Secondary Education (DESE) released proposed Science and Technology/Engineering standards in 2013 outlining the concepts that should be taught at each grade level. Previously, standards were in grade spans and each district determined the method of implementation. There are two different methods used teaching middle school science: integrated and discipline-based. In the proposed standards, the Massachusetts DESE uses grade-by-grade standards using an integrated approach. It was not known if there is a statistically significant difference in student achievement on the 8th grade science MCAS assessment for students taught with an integrated or discipline-based approach. The results on the 8th grade science MCAS test from six public school districts from 2010 -- 2013 were collected and analyzed. The methodology used was quantitative. Results of an ANOVA showed that there was no statistically significant difference in overall student achievement between the two curriculum models. Furthermore, there was no statistically significant difference for the various domains: Earth and Space Science, Life Science, Physical Science, and Technology/Engineering. This information is useful for districts hesitant to make the change from a discipline-based approach to an integrated approach. More research should be conducted on this topic with a larger sample size to better support the results.

Grading of Student's Attainment: Purposes and Functions.

ERIC Educational Resources Information Center

Lysne, Anders

1984-01-01

Traces the history of grading and discusses the complex problem of evaluation and grading of student achievement. Reviews the various reference measures and notes the type of functions grades are supposed to serve. Cites seven alternatives to traditional grading. Concludes that "grades are the tail that wags the dog." (BRR)

METHODOLOGICAL QUALITY OF ECONOMIC EVALUATIONS ALONGSIDE TRIALS OF KNEE PHYSIOTHERAPY.

PubMed

García-Pérez, Lidia; Linertová, Renata; Arvelo-Martín, Alejandro; Guerra-Marrero, Carolina; Martínez-Alberto, Carlos Enrique; Cuéllar-Pompa, Leticia; Escobar, Antonio; Serrano-Aguilar, Pedro

2017-01-01

The methodological quality of an economic evaluation performed alongside a clinical trial can be underestimated if the paper does not report key methodological features. This study discusses methodological assessment issues on the example of a systematic review on cost-effectiveness of physiotherapy for knee osteoarthritis. Six economic evaluation studies included in the systematic review and related clinical trials were assessed using the 10-question check-list by Drummond and the Physiotherapy Evidence Database (PEDro) scale. All economic evaluations were performed alongside a clinical trial but the studied interventions were too heterogeneous to be synthesized. Methodological quality of the economic evaluations reported in the papers was not free of drawbacks, and in some cases, it improved when information from the related clinical trial was taken into account. Economic evaluation papers dedicate little space to methodological features of related clinical trials; therefore, the methodological quality can be underestimated if evaluated separately from the trials. Future economic evaluations should follow more strictly the recommendations about methodology and the authors should pay special attention to the quality of reporting.

Comparative study of the vapor analytes of trinitrotoluene (TNT)

NASA Astrophysics Data System (ADS)

Edge, Cindy C.; Gibb, Julie; Dugan, Regina E.

1998-12-01

Trinitrotoluene (TNT) is a high explosive used in most antipersonnel and antitank landmines. The Institute for Biological Detection Systems (IBDS) has developed a quantitative vapor delivery system, termed olfactometer, for conducting canine olfactory research. The research is conducted utilizing dynamic conditions, therefore, it is imperative to evaluate the headspace of TNT to ensure consistency with the dynamic generation of vapor. This study quantified the vapor headspace of military- grade TNT utilizing two different vapor generated methodologies, static and dynamic, reflecting differences between field and laboratory environments. Static vapor collection, which closely mimics conditions found during field detection, is defined as vapor collected in an open-air environment at ambient temperature. Dynamic vapor collection incorporates trapping of gases from a high flow vapor generation cell used during olfactometer operation. Analysis of samples collected by the two methodologies was performed by gas chromatography/mass spectrometry and the results provided information with regard to the constituents detected. However, constituent concentration did vary between the sampling methods. This study provides essential information regarding the vapor constituents associated with the TNT sampled using different sampling methods. These differences may be important in determining the detection signature dogs use to recognize TNT.

Eighth Grade Social Studies. An Experimental Program in Geography and Anthropology.

ERIC Educational Resources Information Center

Hanson, James; And Others

GRADES OR AGES: Grade 8. SUBJECT MATTER: Geography and Anthropology. ORGANIZATION AND PHYSICAL APPEARANCE: The introductory material includes descriptions of geography and anthropology as disciplines, the basic course objectives, techniques for evaluating objectives and a student self-evaluation form. The guide covers six units: 1) "What Kind of…

Breast Carcinoma, Intratumour Heterogeneity and Histological Grading, Using Geostatistics

PubMed Central

Sharifi‐Salamatian, Vénus; de Roquancourt, Anne; Rigaut, Jean Paul

2000-01-01

Tumour progression is currently believed to result from genetic instability. Chromosomal patterns specific of a type of cancer are frequent even though phenotypic spatial heterogeneity is omnipresent. The latter is the usual cause of histological grading imprecision, a well documented problem, without any fully satisfactory solution up to now. The present article addresses this problem in breast carcinoma. The assessment of a genetic marker for human tumours requires quantifiable measures of intratumoral heterogeneity. If any invariance paradigm representing a stochastic or geostatistic function could be discovered, this might help in solving the grading problem. A novel methodological approach using geostatistics to measure heterogeneity is used. Twenty tumours from the three usual (Scarff‐Bloom and Richardson) grades were obtained and paraffin sections stained by MIB‐1 (Ki‐67) and peroxidase staining. Whole two‐dimensional sections were sampled. Morphometric grids of variable sizes allowed a simple and fast recording of positions of epithelial nuclei, marked or not by MIB‐1. The geostatistical method is based here upon the asymptotic behaviour of dispersion variance. Measure of asymptotic exponent of dispersion variance shows an increase from grade 1 to grade 3. Preliminary results are encouraging: grades 1 and 3 on one hand and 2 and 3 on the other hand are totally separated. The final proof of an improved grading using this measure will of course require a confrontation with the results of survival studies. PMID:11153611

Breast carcinoma, intratumour heterogeneity and histological grading, using geostatistics.

PubMed

Sharifi-Salamatian, V; de Roquancourt, A; Rigaut, J P

2000-01-01

Tumour progression is currently believed to result from genetic instability. Chromosomal patterns specific of a type of cancer are frequent even though phenotypic spatial heterogeneity is omnipresent. The latter is the usual cause of histological grading imprecision, a well documented problem, without any fully satisfactory solution up to now. The present article addresses this problem in breast carcinoma. The assessment of a genetic marker for human tumours requires quantifiable measures of intratumoral heterogeneity. If any invariance paradigm representing a stochastic or geostatistic function could be discovered, this might help in solving the grading problem. A novel methodological approach using geostatistics to measure heterogeneity is used. Twenty tumours from the three usual (Scarff-Bloom and Richardson) grades were obtained and paraffin sections stained by MIB-1 (Ki-67) and peroxidase staining. Whole two-dimensional sections were sampled. Morphometric grids of variable sizes allowed a simple and fast recording of positions of epithelial nuclei, marked or not by MIB-1. The geostatistical method is based here upon the asymptotic behaviour of dispersion variance. Measure of asymptotic exponent of dispersion variance shows an increase from grade 1 to grade 3. Preliminary results are encouraging: grades 1 and 3 on one hand and 2 and 3 on the other hand are totally separated. The final proof of an improved grading using this measure will of course require a confrontation with the results of survival studies.

Evaluating the Predictive Validity of Academic and Social-Emotional Screening Assessments for Measuring Academic and Social-Emotional Success at the End of First Grade

ERIC Educational Resources Information Center

Erhart, Amber C.

2013-01-01

By the end of the kindergarten, students are expected to possess early academic skills as well as the social maturity to be successful in first grade. Students leaving kindergarten without these readiness skills are sometimes held back in first grade or referred for a special education evaluation in later grades if they fail to make adequate…

Using the Title I Control Group Model for Evaluation Research and Development of a Supplemental Mathematics Project for Third and Fifth Grade Students.

ERIC Educational Resources Information Center

Slaughter, Helen B.

Mathematics achievement of Elementary Secondary Education Act Title I students was evaluated, using RMC Model B, the control group model. The third-grade students in 8 of 17 Title I elementary schools and the fifth-grade students in the remaining 9 schools were chosen for the pilot project. The remaining third-and fifth-grade students served as…

Study on a pattern classification method of soil quality based on simplified learning sample dataset

USGS Publications Warehouse

Zhang, Jiahua; Liu, S.; Hu, Y.; Tian, Y.

2011-01-01

Based on the massive soil information in current soil quality grade evaluation, this paper constructed an intelligent classification approach of soil quality grade depending on classical sampling techniques and disordered multiclassification Logistic regression model. As a case study to determine the learning sample capacity under certain confidence level and estimation accuracy, and use c-means algorithm to automatically extract the simplified learning sample dataset from the cultivated soil quality grade evaluation database for the study area, Long chuan county in Guangdong province, a disordered Logistic classifier model was then built and the calculation analysis steps of soil quality grade intelligent classification were given. The result indicated that the soil quality grade can be effectively learned and predicted by the extracted simplified dataset through this method, which changed the traditional method for soil quality grade evaluation. ?? 2011 IEEE.

Enrichment 2.0 Gifted and Talented Education for the 21st Century

ERIC Educational Resources Information Center

Eckstein, Michelle

2009-01-01

Enrichment clusters, a component of the Schoolwide Enrichment Model, are multigrade investigative groups based on constructivist learning methodology. Enrichment clusters are organized around major disciplines, interdisciplinary themes, or cross-disciplinary topics. Within clusters, students are grouped across grade levels by interests and focused…

Southeast Asian Refugee Parent Survey.

ERIC Educational Resources Information Center

Blakely, Mary M.

This paper summarizes the findings of a descriptive research project conducted among Southeast Asian parents in an Oregon school district, and discusses the issue of fieldwork methodology among refugee populations. The district studied had a student population of 18,000 (kindergarten through grade 12), with Southeast Asian refugees accounting for…

How credible are the study results? Evaluating and applying internal validity tools to literature-based assessments of environmental health hazards

PubMed Central

Rooney, Andrew A.; Cooper, Glinda S.; Jahnke, Gloria D.; Lam, Juleen; Morgan, Rebecca L.; Boyles, Abee L.; Ratcliffe, Jennifer M.; Kraft, Andrew D.; Schünemann, Holger J.; Schwingl, Pamela; Walker, Teneille D.; Thayer, Kristina A.; Lunn, Ruth M.

2016-01-01

Environmental health hazard assessments are routinely relied upon for public health decision-making. The evidence base used in these assessments is typically developed from a collection of diverse sources of information of varying quality. It is critical that literature-based evaluations consider the credibility of individual studies used to reach conclusions through consistent, transparent and accepted methods. Systematic review procedures address study credibility by assessing internal validity or “risk of bias” — the assessment of whether the design and conduct of a study compromised the credibility of the link between exposure/intervention and outcome. This paper describes the commonalities and differences in risk-of-bias methods developed or used by five groups that conduct or provide methodological input for performing environmental health hazard assessments: the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group, the Navigation Guide, the National Toxicology Program’s (NTP) Office of Health Assessment and Translation (OHAT) and Office of the Report on Carcinogens (ORoC), and the Integrated Risk Information System of the U.S. Environmental Protection Agency (EPA-IRIS). Each of these groups have been developing and applying rigorous assessment methods for integrating across a heterogeneous collection of human and animal studies to inform conclusions on potential environmental health hazards. There is substantial consistency across the groups in the consideration of risk-of-bias issues or “domains” for assessing observational human studies. There is a similar overlap in terms of domains addressed for animal studies; however, the groups differ in the relative emphasis placed on different aspects of risk of bias. Future directions for the continued harmonization and improvement of these methods are also discussed. PMID:26857180

Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults

PubMed Central

Molina-Infante, Javier; Arias, Ángel; von Arnim, Ulrike; Bredenoord, Albert J; Bussmann, Christian; Amil Dias, Jorge; Bove, Mogens; González-Cervera, Jesús; Larsson, Helen; Miehlke, Stephan; Papadopoulou, Alexandra; Rodríguez-Sánchez, Joaquín; Ravelli, Alberto; Ronkainen, Jukka; Santander, Cecilio; Schoepfer, Alain M; Storr, Martin A; Terreehorst, Ingrid; Straumann, Alex; Attwood, Stephen E

2017-01-01

Introduction Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE. Methods General methodology according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted up to August 2015 and periodically updated. The working group consisted of gastroenterologists, allergists, pediatricians, otolaryngologists, pathologists, and epidemiologists. Systematic evidence-based reviews were performed based upon relevant clinical questions with respect to patient-important outcomes. Results The guidelines include updated concept of EoE, evaluated information on disease epidemiology, risk factors, associated conditions, and natural history of EoE in children and adults. Diagnostic conditions and criteria, the yield of diagnostic and disease monitoring procedures, and evidence-based statements and recommendation on the utility of the several treatment options for patients EoE are provided. Recommendations on how to choose and implement treatment and long-term management are provided based on expert opinion and best clinical practice. Conclusion Evidence-based recommendations for EoE diagnosis, treatment modalities, and patients’ follow up are proposed in the guideline. PMID:28507746

ACR Appropriateness Criteria® Multiple Gestations.

PubMed

Glanc, Phyllis; Nyberg, David A; Khati, Nadia J; Deshmukh, Sandeep Prakash; Dudiak, Kika M; Henrichsen, Tara Lynn; Poder, Liina; Shipp, Thomas D; Simpson, Lynn; Weber, Therese M; Zelop, Carolyn M

2017-11-01

Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Chorionicity and amnionicity should be determined as early as possible when a twin pregnancy is identified to permit triage of the monochorionic group into a closer surveillance model. Screening for congenital heart disease is warranted in monochorionic twins because they have an increased rate of congenital cardiac anomalies. In addition, monochorionic twins have a higher risk of developing cardiac abnormalities in later gestation related to right ventricular outflow obstruction, in particular the subgroups with twin-twin transfusion syndrome or selective intrauterine growth restriction. Monochorionic twins have unique complications including twin-to-twin transfusion syndrome, twin embolization syndrome, and acardius, or twin-reversed arterial perfusion sequence. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

How credible are the study results? Evaluating and applying internal validity tools to literature-based assessments of environmental health hazards.

PubMed

Rooney, Andrew A; Cooper, Glinda S; Jahnke, Gloria D; Lam, Juleen; Morgan, Rebecca L; Boyles, Abee L; Ratcliffe, Jennifer M; Kraft, Andrew D; Schünemann, Holger J; Schwingl, Pamela; Walker, Teneille D; Thayer, Kristina A; Lunn, Ruth M

2016-01-01

Environmental health hazard assessments are routinely relied upon for public health decision-making. The evidence base used in these assessments is typically developed from a collection of diverse sources of information of varying quality. It is critical that literature-based evaluations consider the credibility of individual studies used to reach conclusions through consistent, transparent and accepted methods. Systematic review procedures address study credibility by assessing internal validity or "risk of bias" - the assessment of whether the design and conduct of a study compromised the credibility of the link between exposure/intervention and outcome. This paper describes the commonalities and differences in risk-of-bias methods developed or used by five groups that conduct or provide methodological input for performing environmental health hazard assessments: the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group, the Navigation Guide, the National Toxicology Program's (NTP) Office of Health Assessment and Translation (OHAT) and Office of the Report on Carcinogens (ORoC), and the Integrated Risk Information System of the U.S. Environmental Protection Agency (EPA-IRIS). Each of these groups have been developing and applying rigorous assessment methods for integrating across a heterogeneous collection of human and animal studies to inform conclusions on potential environmental health hazards. There is substantial consistency across the groups in the consideration of risk-of-bias issues or "domains" for assessing observational human studies. There is a similar overlap in terms of domains addressed for animal studies; however, the groups differ in the relative emphasis placed on different aspects of risk of bias. Future directions for the continued harmonization and improvement of these methods are also discussed. Published by Elsevier Ltd.

Methodologies for semiquantitative evaluation of hip osteoarthritis by magnetic resonance imaging: approaches based on the whole organ and focused on active lesions.

PubMed

Jaremko, Jacob L; Lambert, Robert G W; Zubler, Veronika; Weber, Ulrich; Loeuille, Damien; Roemer, Frank W; Cibere, Jolanda; Pianta, Marcus; Gracey, David; Conaghan, Philip; Ostergaard, Mikkel; Maksymowych, Walter P

2014-02-01

As a wider variety of therapeutic options for osteoarthritis (OA) becomes available, there is an increasing need to objectively evaluate disease severity on magnetic resonance imaging (MRI). This is more technically challenging at the hip than at the knee, and as a result, few systematic scoring systems exist. The OMERACT (Outcome Measures in Rheumatology) filter of truth, discrimination, and feasibility can be used to validate image-based scoring systems. Our objective was (1) to review the imaging features relevant to the assessment of severity and progression of hip OA; and (2) to review currently used methods to grade these features in existing hip OA scoring systems. A systematic literature review was conducted. MEDLINE keyword search was performed for features of arthropathy (such as hip + bone marrow edema or lesion, synovitis, cyst, effusion, cartilage, etc.) and scoring system (hip + OA + MRI + score or grade), with a secondary manual search for additional references in the retrieved publications. Findings relevant to the severity of hip OA include imaging markers associated with inflammation (bone marrow lesion, synovitis, effusion), structural damage (cartilage loss, osteophytes, subchondral cysts, labral tears), and predisposing geometric factors (hip dysplasia, femoral-acetabular impingement). Two approaches to the semiquantitative assessment of hip OA are represented by Hip OA MRI Scoring System (HOAMS), a comprehensive whole organ assessment of nearly all findings, and the Hip Inflammation MRI Scoring System (HIMRISS), which selectively scores only active lesions (bone marrow lesion, synovitis/effusion). Validation is presently confined to limited assessment of reliability. Two methods for semiquantitative assessment of hip OA on MRI have been described and validation according to the OMERACT Filter is limited to evaluation of reliability.

Methodological adaptations for investigating the perceptions of language-impaired adolescents regarding the relative importance of selected communication skills.

PubMed

Reed, Vicki A; Brammall, Helen

2006-01-01

This article describes the systematic and detailed processes undertaken to modify a research methodology for use with language-impaired adolescents. The original methodology had been used previously with normally achieving adolescents and speech pathologists to obtain their opinions about the relative importance of selected communication skills for adolescents' positive peer relationships. Modifications attempted to address language-impaired adolescents' characteristic metalinguistic, literacy, cognitive, and information processing weaknesses. Revising the original wording of the communication skills, reducing the reading level of the skills from grade 10 to 4.6, using a Q-sort approach to ranking the importance of the skills, and revising the instructions and administration procedures led to what pilot testing results indicated was a valid methodology for use with language-impaired adolescents. Results of a preliminary study using the revised methodology suggested that language-impaired adolescents may perceive the relative importance of some communication skills differently from their normally achieving peers.

Resource utilization and costs associated with the diagnostic evaluation of nonrefluxing primary hydronephrosis in infants.

PubMed

Akhavan, Ardavan; Shnorhavorian, Margarett; Garrison, Louis P; Merguerian, Paul A

2014-09-01

Long-term evaluation of postnatal nonrefluxing primary hydronephrosis presents a dilemma for urologists since most cases resolve without surgery. We report longitudinal resource utilization and costs associated with diagnostic evaluation of infants with isolated primary nonrefluxing hydronephrosis to determine the costs associated with diagnosing a surgical case, and we assess the implications using a cost-consequences analysis. A retrospective chart review was used to capture resource utilization for all patients younger than 6 months with hydronephrosis evaluated at our institution during a 5-year period. Infants with confounding urological diagnoses were excluded. Payer and societal perspectives were used. Costs were estimated from resource utilization, including radiographic imaging and clinical encounter types. Data were collected from first clinic visit until surgery or resolution or 3 years, whichever was shortest. Of 165 included patients surgical rates for hydronephrosis were 0% for grade I, 5% for grade II, 21% for grade III and 74% for grade IV. Median respective costs of identifying a single surgical case per increasing hydronephrosis grade 0 to IV were infinite, $37,600, $11,741 and $2,124 (p <0.001), respectively. Diagnostic evaluation of higher grades of hydronephrosis is significantly more productive in terms of identifying patients requiring surgery vs evaluation of patients with lower grade disease. In patients with grades I and II hydronephrosis a more abbreviated diagnostic strategy than the current standard of care may be warranted. For the population in this analysis we project that a less intensive approach could save about 24% of costs. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Evaluation of Eleventh Grade Turkish Pupils' Comprehension of General Chemistry Concepts

ERIC Educational Resources Information Center

Belge Can, Hatice; Boz, Yezdan

2011-01-01

The main purpose of this study is to evaluate eleventh grade Turkish pupils' comprehension of various general chemistry concepts which in turn enables to investigate chemistry concepts which are easier and harder for students to comprehend. Examining the effect of gender and last semester chemistry course grades on pupils' comprehension of general…

NEW EDUCATIONAL MATERIALS, PRE-KINDERGARTEN THROUGH GRADE TWELVE.

ERIC Educational Resources Information Center

ALLISON, MARY L., COMP.

THIS IS A COMPILATION OF EVALUATIONS AND REVIEWS WRITTEN BY TEACHERS, LIBRARIANS, AND CURRICULUM SPECIALISTS WHO HAVE TESTED THE MATERIALS. FROM PRE-KINDERGARTEN TO GRADE 12, BOOKS AND INSTRUCTIONAL MATERIALS FOR LANGUAGE ARTS, SOCIAL STUDIES, AND SCIENCE ARE REVIEWED. FOR GRADES 7 TO 12, MATERIALS ARE EVALUATED FOR ART AND MUSIC, HEALTH AND…

Results From Scotland's 2016 Report Card on Physical Activity for Children and Youth.

PubMed

Reilly, John J; Johnstone, Avril; McNeill, Geraldine; Hughes, Adrienne R

2016-11-01

The 2016 Active Healthy Kids Scotland Report Card aims to improve surveillance of physical activity (PA), facilitate international comparisons, and encourage evidence-informed PA and health policy. Active Healthy Kids Canada Report Card methodology was used: a search for data on child and adolescent PA and health published after the 2013 Scottish Report Card was carried out. Data sources were considered for grading if based on representative samples with prevalence estimates made using methods with low bias. Ten health behaviors/outcomes were graded on an A to F scale based on quintiles (prevalence meeting recommendations ≥80% graded A down to <20% graded F). Three of the seven Health Behaviors and Outcomes received F or F- grades: Overall PA, Sedentary Behavior, and Obesity. Active and Outdoor Play and Organized Sport Participation could not be graded. Active Commuting to School was graded C, and Diet was graded D-. Family and Peer Influence was graded D-; Perceived Safety and Availability of Space for PA as well as the National Policy Environment were more favorable (both B). Grades were identical to those in 2013. Scotland has a generally favorable environment for PA, but children and adolescents have low PA and high sedentary behavior. Gaps in surveillance included lack of objectively measured PA, no surveillance of moderate-to-vigorous PA in children, summary surveillance data not expressed in ways which match recommendations (eg, for PA in young children; for screen-time), and no surveillance of Sport Participation, Active and Outdoor Play, or Sitting. Scottish policy does not include sedentary behavior at present.

Experimental Evaluation Methodology for Spacecraft Proximity Maneuvers in a Dynamic Environment

DTIC Science & Technology

2017-06-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA DISSERTATION EXPERIMENTAL EVALUATION METHODOLOGY FOR SPACECRAFT PROXIMITY MANEUVERS IN A DYNAMIC...29, 2014 – June 16, 2017 4. TITLE AND SUBTITLE EXPERIMENTAL EVALUATION METHODOLOGY FOR SPACECRAFT PROXIMITY MANEUVERS IN A DYNAMIC ENVIRONMENT 5...LEFT BLANK ii Approved for public release. Distribution is unlimited. EXPERIMENTAL EVALUATION METHODOLOGY FOR SPACECRAFT PROXIMITY MANEUVERS IN A

Can teaching research methodology influence students' attitude toward science? Cohort study and nonrandomized trial in a single medical school.

PubMed

Vujaklija, Ana; Hren, Darko; Sambunjak, Dario; Vodopivec, Ivana; Ivanis, Ana; Marusić, Ana; Marusić, Matko

2010-02-01

Medical teaching aims to develop attitudes and behaviors underlying professional competence of future physicians. We investigated whether a mandatory course on scientific methodology in the second study year could affect students' attitudes toward science in medicine. In a longitudinal study, students (n = 241) enrolling in 2001-2002 academic year at a single medical school were followed up until graduation in 2006-2007. Each year, they filled out a Likert-type questionnaire of 18 statements evaluating attitude toward science. Direct influence of the course on students' attitudes was tested in a nonrandomized controlled trial with the 2006-2007 second year student cohort. Positive students' attitudes toward science increased during study years (mean [SD] score of the maximum score of 90): from 57.6 (6.0) in the first to 69.8 (10.4) in the sixth year. There was a significant trend of increase in attitudes with the years of study (cubic trend by polynomial contrasts analysis, P = 0.011). Attendance of a course on research methodology significantly increased positive attitudes (score, 67.0 [7.0] before and 70.8 [7.5] after course, P = 0.032 vs control group), regardless of grade point average. The intervention had an effect even when the influence of the initial attitude was accounted for (F1,140 = 9.25, P = 0.003; analysis of covariance). The attitude changes after the course was greatest in students with low initial attitude scores (Spearman rinitial score, score difference, -0.44). Medical students have positive attitudes toward science and scientific method in medicine. Attendance of a course on research methodology had positive short-term effect on students' attitudes toward science. This positive effect should be maintained by vertical integration of the course in the medical curriculum.

Using multiple methods to assess learning and outcomes in an online degree-granting dental hygiene program.

PubMed

Springfield, Emily; Gwozdek, Anne E; Peet, Melissa; Kerschbaum, Wendy E

2012-04-01

Program evaluation is a necessary component of curricular change and innovation. It ascertains whether an innovation has met benchmarks and contributes to the body of knowledge about educational methodologies and supports the use of evidence-based practice in teaching. Education researchers argue that rigorous program evaluation should utilize a mixed-method approach, triangulating both qualitative and quantitative methods to understand program effectiveness. This approach was used to evaluate the University of Michigan Dental Hygiene Degree Completion E-Learning (online) Program. Quantitative data included time spent on coursework, grades, publications, course evaluation results, and survey responses. Qualitative data included student and faculty responses in focus groups and on surveys as well as students' portfolio reflections. The results showed the program was academically rigorous, fostering students' ability to connect theory with practice and apply evidence-based practice principles. These results also demonstrated that the students had learned to critically reflect on their practice and develop expanded professional identities; going beyond the role of clinician, they began to see themselves as educators, advocates, and researchers. This evaluation model is easily adaptable and is applicable to any health science or other professional degree program. This study also raised important questions regarding the effect of meta-reflection on student confidence and professional behavior.

Implications of Blood Pressure Measurement Technique for Implementation of Systolic Blood Pressure Intervention Trial (SPRINT).

PubMed

Agarwal, Rajiv

2017-02-03

Cardiovascular morbidity and mortality was reduced by 25% when blood pressure (BP) was targeted to 120 mm Hg systolic compared with 140 mm Hg systolic in Systolic Blood Pressure Intervention Trial (SPRINT); however, BP was measured using a research technique. SPRINT specified 5 minutes of seated rest in a quiet room followed by 3 oscillometric measurements without an observer in the room. The relationship of this research-grade methodology to routine BP measurements is not known. Among 275 people with chronic kidney disease who had BP <140/90 mm Hg when they came to the clinic, we measured BP as in SPRINT and recorded BP on the same day without specification of seated rest. Compared with routine measurement, the research-grade systolic BP was 12.7 mm Hg lower with wide limits of agreement (-46.1 to 20.7 mm Hg). Research grade systolic BP was 7.9 mm Hg lower than daytime ambulatory systolic BP and had wide agreement limits (-33.2 to 17.4 mm Hg). Whereas the routine, research-grade, and daytime ambulatory systolic BP were all related to echocardiographic left ventricular hypertrophy, the strength of the relationship between research-grade and daytime ambulatory systolic BP to left ventricular hypertrophy was similar and stronger than the strength of the relationship between routine systolic BP and left ventricular hypertrophy. Taken together, these results suggest that translation of the SPRINT results will require measurement of BP as performed in that trial. Instead of an algebraic manipulation of routine clinic measurements, the SPRINT methodology of BP measurement would be needed at minimum if implementation of the SPRINT results were to be deployed in the population at large. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Boredom Transcended: Adolescent Survival in the Suburban High School.

ERIC Educational Resources Information Center

Linton, Thomas E.

This paper discusses the American educational system as a quiet and nondeliberate destroyer of the adolescent's spirit in terms of stifling the development of cognitive, social, cultural, and intellectual growth. This phenomenon has been produced by the content, structure, and teaching methodology used in schools, beginning with fourth grade and…

First City, Anti-City: Cain, Heterotopia, and Study Abroad

ERIC Educational Resources Information Center

Kenney, Lance

2011-01-01

Cross-/inter-cultural development, language acquisition, employment potential, and the impact of homestays, program duration, direct enrollment, even grading policies have been analyzed in the pages of "Frontiers" and other journals. This analysis more often than not utilizes methodologies particular to social science research. What has been…

Job Satisfaction and Career Persistence of Beginning Teachers

ERIC Educational Resources Information Center

Mau, Wei-Cheng J.; Ellsworth, Randy; Hawley, Donna

2008-01-01

Purpose: The purpose of this research is to examine career persistence and job satisfaction of beginning teachers. Design/methodology/approach: Four hundred and fifty-one tenth grade students from a nationally representative sample, who aspired to be teachers, were examined over a ten year period regarding their career choices. Students who…

76 FR 66917 - Privacy Act of 1974; Notice To Amend an Existing System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-28

... methodologies. DATES: The proposed amendment to this existing system of records will become effective without... that this amendment should not become effective on that date. Comments regarding this amendment must be...: Name, date and place of birth, social security number, citizenship status, grade, organization...

The Effects of Academic Optimism on Elementary Reading Achievement

ERIC Educational Resources Information Center

Bevel, Raymona K.; Mitchell, Roxanne M.

2012-01-01

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

Robotic Cooperative Learning Promotes Student STEM Interest

ERIC Educational Resources Information Center

Mosley, Pauline; Ardito, Gerald; Scollins, Lauren

2016-01-01

The principal purpose of this investigation is to study the effect of robotic cooperative learning methodologies on middle school students' critical thinking, and STEM interest. The semi-experimental inquiry consisted of ninety four six-grade students (forty nine students in the experimental group, forty five students in the control group), chosen…

Screen-Related Sedentary Behaviors: Children's and Parents' Attitudes, Motivations, and Practices

ERIC Educational Resources Information Center

He, Meizi; Piche, Leonard; Beynon, Charlene; Harris, Stewart

2010-01-01

Objective: To investigate school-aged children's and parents' attitudes, social influences, and intentions toward excessive screen-related sedentary behavior (S-RSB). Design: A cross-sectional study using a survey methodology. Setting: Elementary schools in London, Ontario, Canada. Participants: All grades 5 and 6 students, their parents, and…

Construct Definition Methodology and Generalizability Theory Applied to Career Education Measurement.

ERIC Educational Resources Information Center

Stenner, A. Jackson; Rohlf, Richard J.

The merits of generalizability theory in the formulation of construct definitions and in the determination of reliability estimates are discussed. The broadened conceptualization of reliability brought about by Cronbach's generalizability theory is reviewed. Career Maturity Inventory data from a sample of 60 ninth grade students is used to…

Demography and Environment Earth: Teacher Edition.

ERIC Educational Resources Information Center

McCrea, Lester C.; And Others

This document is one in a series of instructional materials on population education developed for the Baltimore public schools. The unit, designed for elementary grades 5 and 6, focuses on demography and human factors and consequences. The first part of the resource unit presents basic information, methodology, and understandings of demography and…

ICT-Based, Cross-Cultural Communication: A Methodological Perspective

ERIC Educational Resources Information Center

Larsen, Niels; Bruselius-Jensen, Maria; Danielsen, Dina; Nyamai, Rachael; Otiende, James; Aagaard-Hansen, Jens

2014-01-01

The article discusses how cross-cultural communication based on information and communication technologies (ICT) may be used in participatory health promotion as well as in education in general. The analysis draws on experiences from a health education research project with grade 6 (approx. 12 years) pupils in Nairobi (Kenya) and Copenhagen…

Thinking Levels of Questions in Christian Reading Textbooks

ERIC Educational Resources Information Center

Lee, Heather A.

2015-01-01

If Christian schools desire students to achieve higher-level thinking, then the textbooks that teachers use should reflect such thinking. Using Risner's (1987) methodology, raters classified questions from two Christian publishers' fifth grade reading textbooks based on the revised Bloom's taxonomy (Anderson et al., 2001). The questions in the A…

Predicting Academic Success for Students of Color within STEM Majors

ERIC Educational Resources Information Center

Gipson, John

2016-01-01

Purpose: The aim of this study is to determine what pre-college characteristics predict college success for students of color enrolled within science, technology, engineering and mathematics programs, as measured by cumulative grade point average (GPA) after three years of initial enrollment. Design/methodology/approach: To increase the…

Introduction to CAD/Computers. High-Technology Training Module.

ERIC Educational Resources Information Center

Lockerby, Hugh

This learning module for an eighth-grade introductory technology course is designed to help teachers introduce students to computer-assisted design (CAD) in a communications unit on graphics. The module contains a module objective and five specific objectives, a content outline, suggested instructor methodology, student activities, a list of six…

The Macro and Micro Structure of the Foreign Language Curriculum.

ERIC Educational Resources Information Center

Politzer, Robert L.

A representative six-year foreign language curriculum (grades 7-12) is analyzed and noted to be based on several underlying principles. Difficulties which arise from rigid adherence to certain methodological principles are discussed, particularly those concerning the relationship between audiolingual and writing skills. Suggestions on ways to…

Comprehension Literacy Improvement Program Implementation and Balanced Literacy Impact on Elementary Students

ERIC Educational Resources Information Center

Gough, Timothy Jerome

2017-01-01

The purpose of this study was to determine how teachers in an urban school district implemented Comprehensive Literacy Improvement Program (CLIP) and balanced literacy framework in second through fifth grade classrooms by exploring the evidence of implementation of guided reading strategies. Instructional delivery, training methodology, phonemic…

Designing Knowledge Scaffolds to Support Mathematical Problem Solving

ERIC Educational Resources Information Center

Rittle-Johnson, Bethany; Koedinger, Kenneth R.

2005-01-01

We present a methodology for designing better learning environments. In Phase 1, 6th-grade students' (n = 223) prior knowledge was assessed using a difficulty factors assessment (DFA). The assessment revealed that scaffolds designed to elicit contextual, conceptual, or procedural knowledge each improved students' ability to add and subtract…

Middle Grade Students' Concept Images of Algebraic Concepts

ERIC Educational Resources Information Center

Tekin-Sitrava, Reyhan

2017-01-01

This study investigates middle school students' concept images of algebraic concepts which are term, constant term, variable, and coefficient. Also, the study aimed to explore their performances in defining these concepts correctly. A phenomenological method was used to support methodological perspective and to reveal the findings of the study.…

The impact of a developmental science course on college success for underprepared health science students

NASA Astrophysics Data System (ADS)

Johnson, Candace A.

Developmental education for the academically underprepared college student has been aimed at helping students succeed in college. However, developmental education courses have traditionally focused on reading, writing and math. This quantitative study examined the relationship between a developmental science course for underprepared health science students on grades achieved in college level medical terminology courses. The effect was measured by analyzing student grades retrieved from a college database of official school records through the use of correlation research methodology during a previous 2-year academic period at a selected independent 4-year right-to-try college. The results yielded a weakly positive correlation, but not statistically significant coefficient of 0.325 between grades for students who successfully completed the developmental science course and their subsequent success in a college-level science course. The study added to the gap in knowledge in terms of the effect a developmental science course has on grades in college-level science courses.

Does the patient-held record improve continuity and related outcomes in cancer care: a systematic review.

PubMed

Gysels, Marjolein; Richardson, Alison; Higginson, Irene J

2007-03-01

To assess the effectiveness of the patient-held record (PHR) in cancer care. Patients with cancer may receive care from different services resulting in gaps. A PHR could provide continuity and patient involvement in care. Relevant literature was identified through five electronic databases (Medline, Embase, Cinahl, CCTR and CDSR) and hand searches. Patient-held records in cancer care with the purpose of improving communication and information exchange between and within different levels of care and to promote continuity of care and patients' involvement in their own care. Data extraction recorded characteristics of intervention, type of study and factors that contributed to methodological quality of individual studies. Data were then contrasted by setting, objectives, population, study design, outcome measures and changes in outcome, including knowledge, satisfaction, anxiety and depression. Methodological quality of randomized control trials and non-experimental studies were assessed with separate standard grading scales. Seven randomized control trials and six non-experimental studies were identified. Evaluations of the PHR have reached equivocal findings. Randomized trials found an absence of effect, non-experimental evaluations shed light on the conditions for its successful use. Most patients welcomed introduction of a PHR. Main problems related to its suitability for different patient groups and the lack of agreement between patients and health professionals regarding its function. Further research is required to determine the conditions under which the PHR can realize its potential as a tool to promote continuity of care and patient participation.

Application of Response Surface Methodology for Modeling of Postweld Heat Treatment Process in a Pressure Vessel Steel ASTM A516 Grade 70.

PubMed

Peasura, Prachya

2015-01-01

This research studied the application of the response surface methodology (RSM) and central composite design (CCD) experiment in mathematical model and optimizes postweld heat treatment (PWHT). The material of study is a pressure vessel steel ASTM A516 grade 70 that is used for gas metal arc welding. PWHT parameters examined in this study included PWHT temperatures and time. The resulting materials were examined using CCD experiment and the RSM to determine the resulting material tensile strength test, observed with optical microscopy and scanning electron microscopy. The experimental results show that using a full quadratic model with the proposed mathematical model is YTS = -285.521 + 15.706X1 + 2.514X2 - 0.004X1(2) - 0.001X2(2) - 0.029X1X2. Tensile strength parameters of PWHT were optimized PWHT time of 5.00 hr and PWHT temperature of 645.75°C. The results show that the PWHT time is the dominant mechanism used to modify the tensile strength compared to the PWHT temperatures. This phenomenon could be explained by the fact that pearlite can contribute to higher tensile strength. Pearlite has an intensity, which results in increased material tensile strength. The research described here can be used as material data on PWHT parameters for an ASTM A516 grade 70 weld.

The perceived impact of No Child Left Behind on third- through fifth-grade elementary science classrooms

NASA Astrophysics Data System (ADS)

Kinsler, Angela V.

The purpose of this study was to describe the perceived impact of No Child Left Behind on elementary science classrooms in 3 Northeast Tennessee school districts. Quantitative descriptive methodology was used to document how No Child Left Behind impacts instructional methodology, professional development, administrative support, materials and resources, and assessment in 3rd through 5th grades. Data were collected using a survey developed by the researcher. The survey consisted of a demographic section, 28 statements, and 2 open-ended questions. The 51 participants included elementary-school science teachers in 8 schools in 3 upper East Tennessee school districts. Data analysis was based on the following demographics: differing levels of teaching experience, No Child Left Behind school status, and small and large schools. Findings included: The 3 greatest concerns of the impact of the No Child Left Behind Act were the pressures felt by teachers to increase test scores, the manner in which it impacted at-risk or disadvantaged students, and the lack of inservice, specifically for science. Findings also revealed that low-scoring schools or grades were receiving extra assistance and teachers reported they feel that their school or district fosters and supports change. An analysis of the open-ended questions emphasized the stress teachers reported feeling along with the loss of science instruction time to math and language arts.

Awarding global grades in OSCEs: evaluation of a novel eLearning resource for OSCE examiners.

PubMed

Gormley, Gerard J; Johnston, Jenny; Thomson, Clare; McGlade, Kieran

2012-01-01

A novel online resource has been developed to aid OSCE examiner training comprising a series of videos of OSCE performances that allow inter-examiner comparison of global grade decisions. To evaluate this training resource in terms of usefulness and ability to improve examiner confidence in awarding global grades in OSCEs. Data collected from the first 200 users included global grades awarded, willingness to change grades following peer comparison and confidence in awarding grades before and after training. Most (86.5%) agreed that the resource was useful in developing global grade scoring ability in OSCEs, with a significant improvement in confidence in awarding grades after using the training package (p<0.001). This is a useful and effective online training package. As an adjunct to traditional training it offers a practical solution to the problem of availability of examiners.

Students' Perceptions of Peer Evaluation: An Expectancy Perspective

ERIC Educational Resources Information Center

Chen, Yining; Lou, Hao

2004-01-01

Because of the difficulty of evaluating uneven performance among group members, many researchers suggest incorporating peer evaluations in a grading system that permits an instructor to evaluate and grade individual performance more equitably within a group. In this study, the authors employ expectancy theory to assess key factors that may…

Effects of Repeated Intraperitoneal Injection of Pharmaceutical-grade and Nonpharmaceutical-grade Corn Oil in Female C57BL/6J Mice.

PubMed

Hubbard, Jennifer S; Chen, Patty H; Boyd, Kelli L

2017-11-01

Due to potential adverse effects on animal wellbeing, the use of nonpharmaceutical-grade substances in animal research must be scientifically justified in cases where a pharmaceutical-grade version of the substance exists. This requirement applies to all substances, including vehicles used to solubilize experimental drugs. To date, no studies have evaluated the direct effect of the pharmaceutical classification of a compound on animal wellbeing. In this study, we evaluated intraperitoneal administration of pharmaceutical-grade corn oil, nonpharmaceutical-grade corn oil, and saline in female C57BL/6J mice. Compounds were administered every 48 h for a total of 4 injections. Mice were evaluated clinically by using body weight, body condition score, visual assessment score, CBC, and serum chemistries. Animals were euthanized at 24 h and 14 d after the final injection. Inflammation of the peritoneal wall and mesenteric fat was assessed microscopically by using a semiquantitative scoring system. Saline-dosed groups had lower pathology scores at both time points. At day 21, pharmaceutical-grade corn oil had a significantly higher pathology score compared with nonpharmaceutical-grade corn oil. No other significant differences between the corn oil groups were observed. The use of nonpharmaceutical grade corn oil did not result in adverse clinical consequences and is presumed safe to use for intraperitoneal injection in mice. Differences in inflammation between the 2 groups suggest that the use of either pharmaceutical-grade or nonpharmaceutical-grade corn oil should be consistent within a study.

Grade inflation at a north american college of veterinary medicine: 1985-2006.

PubMed

Rush, Bonnie R; Elmore, Ronnie G; Sanderson, Michael W

2009-01-01

Grade inflation, an upward shift in student grade-point averages without a similar rise in achievement, is considered pervasive by most experts in post-secondary education in the United States. Grade-point averages (GPAs) at US universities have increased by roughly 0.15 points per decade since the 1960s, with a 0.6-point increase since 1967. In medical education, grade inflation has been documented and is particularly evident in the clinical setting. The purpose of this study was to evaluate grade inflation over a 22-year period in a college of veterinary medicine. Academic records from 2,060 students who graduated from the College of Veterinary Medicine at Kansas State University between 1985 and 2006 were evaluated, including cumulative GPAs earned during pre-clinical professional coursework, during clinical rotations, and at graduation. Grade inflation was documented at a rate of approximately 0.2 points per decade at this college of veterinary medicine. The difference in mean final GPA between the minimum (1986) and maximum (2003) years of graduation was 0.47 points. Grade inflation was similar for didactic coursework (years 1-3) and clinical rotations (final year). Demographic shifts, student qualifications, and tuition do not appear to have contributed to grade inflation over time. A change in academic standards and student evaluation of teaching may have contributed to relaxed grading standards, and technology in the classroom may have led to higher (earned) grades as a result of improved student learning.

Metacognitive Prediction and Evaluation Skills and Mathematical Learning in Third-Grade Students

ERIC Educational Resources Information Center

Desoete, Annemie

2009-01-01

In a 2-year longitudinal study, 66 children were assessed in Grades 3 and 4 with a within-method-and-time design on metacognition (including the computerized Evaluation and Prediction Assessment [EPA2000]) and mathematics. Moreover, half of the children were trained in Grade 3 in the metacognitive skill of predicting their abilities in solving…

An Evaluation of Teachers' Perceptions of a State Developed Educational Portal

ERIC Educational Resources Information Center

Caraccio, Beth Katz

2009-01-01

The purpose of this study was to investigate teachers' perceptions use of a state developed educational portal. The research evaluated the differences in the quality, usefulness, and relevance of learning objects found on the website based on teachers' gender and grade level they taught. Grade level taught referred to those grades that are the…

The Long and Winding Road: Grades, Psychological Disengagement and Motivation among Female Students in (Non-)Traditional Career Paths

ERIC Educational Resources Information Center

Rinfret, Natalie; Tougas, Francine; Beaton, Ann M.; Laplante, Joelle; Ngo Manguelle, Christiane; Lagacé, Marie Claude

2014-01-01

The purpose of this study was to evaluate the links between grades, psychological disengagement mechanisms (discounting evaluative feedback and devaluing school), and motivation among female students in traditional and non-traditional career paths. We predicted that the association between grades and discounting is affected by the importance of…

English-French Bilingual Education in the Early Grades: The Elgin Study through Grade Four

ERIC Educational Resources Information Center

Barik, Henri C.; Swain, Merrill

1976-01-01

This paper presents the results of an evaluation of a bilingual education program for English-speaking pupils, grades 1-4, in Ontario. It is a partial French immersion program, with instruction in French or English half of each day. Evaluative tests are described, and English and French language skills examined. (CHK)

Evaluating the Impact and Determinants of Student Team Performance: Using LMS and CATME Data

ERIC Educational Resources Information Center

Braender, Lynn M.; Naples, Michele I.

2013-01-01

Practitioners find it difficult to allocate grades to individual students based on their contributions to the team project. They often use classroom observation of teamwork and student peer evaluations to differentiate an individual's grade from the group's grade, which can be subjective and imprecise. We used objective data from student activity…

Do Student Evaluations of Teaching Depend on the Distribution of Expected Grade?

ERIC Educational Resources Information Center

Matos-Diaz, Horacio; Ragan, James F., Jr.

2010-01-01

Prior research suggests that student evaluations of teaching may depend on the average grade expected in a class. We hypothesize that, because of risk aversion, student ratings also depend on the distribution of expected grades. As predicted, student ratings at the University of Puerto Rico at Bayamon are significantly and negatively related to…

An Evaluation of a Comprehensive Mentoring Program on Selected At-Risk Students with Specific School Problems

ERIC Educational Resources Information Center

Washington, Taren L.

2015-01-01

This study evaluated a comprehensive mentoring program on selected at-risk students with specific school problems (attendance, discipline referrals, and core area grades). The sample included youths in Grades 4-8 who differed on some characteristics including grade-level, ethnicity, and gender. For the purpose of this mixed methods study, the…

Grade Inflation and Student Individual Differences as Systematic Bias in Faculty Evaluations

ERIC Educational Resources Information Center

Germain, Marie-Line; Scandura, Terri A.

2005-01-01

The media has recently exposed that grade inflation is a concern for higher education in North America. Grade inflation may be due to consumerism by universities that now compete for students. Keeping students happy (and paying) may have been emphasized more than learning. We review the literature on faculty evaluation and present a model that…

Plus and Minus Grading Options: Toward Accurate Student Performance Evaluations.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Academic Senate.

Although both the University of California and the California State University systems have the option to use plus or minus grades in student evaluations, the Board of Governors of the California Community Colleges (CCC) does not allow the use of such a grading system. Since 1985, the CCC's Academic Senate has lobbied the Board to allow local…

Impact of the Surgical Research Methodology Program on surgical residents' research profiles.

PubMed

Farrokhyar, Forough; Amin, Nalin; Dath, Deepak; Bhandari, Mohit; Kelly, Stephan; Kolkin, Ann M; Gill-Pottruff, Catherine; Skot, Martina; Reid, Susan

2014-01-01

To evaluate whether implementing the formal Surgical Research Methodology (SRM) Program in the surgical residency curriculum improved research productivity compared with the preceding informal Research Seminar Series (RSS). The SRM Program replaced the RSS in July 2009. In the SRM Program, the curriculum in Year-1 consisted of 12 teaching sessions on the principles of clinical epidemiology and biostatistics, whereas the focus in Year-2 was on the design, conduct, and presentation of a research project. The RSS consisted of 8 research methodology sessions repeated annually for 2 years along with the design, conduct, and presentation of a research project. Research productivity was measured as the number of peer-reviewed publications and the generation of studies with higher levels of evidence. Outcome measures were independently assessed by 2 authors to avoid bias. Student t test and chi-square test were used for the analysis. Frequencies, mean differences with 95% CI, and effect sizes have been reported. In this study, 81 SRM residents were compared with 126 RSS residents. The performance of the SRM residents was superior on all metrics in our evaluation. They were significantly more productive and published more articles than the RSS residents (mean difference = 1.0 [95% CI: 0.5-1.5], p < 0.001) with an effect size of 0.26. The SRM residents presented significantly more projects that were of higher levels of evidence (systematic reviews/meta-analyses, randomized controlled trials, and prospective cohorts) than the RSS residents (52.5% vs 29%, p = 0.005). In addition, the research performance improved 11.0 grades (95% CI: 8.5%-13.5%, p < 0.001) with an effect size of 0.51 in favor of the SRM Program. Although not all surgeons opt for a career as surgeon-scientist, knowledge of research methodology is crucial to appropriately apply evidence-based findings in clinical practice. The SRM Program has significantly improved the research productivity and performance of the surgical residents from all disciplines. The implementation of a similar research methodology program is highly recommended for the benefit of residents' future careers and ultimately, evidence-based patient care. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Evaluation of grades 3 and 4 chondromalacia of the knee using T2*-weighted 3D gradient-echo articular cartilage imaging.

PubMed

Murphy, B J

2001-06-01

To determine the accuracy of T2*-weighted three-dimensional (3D) gradient-echo articular cartilage imaging in the identification of grades 3 and 4 chondromalacia of the knee. A retrospective evaluation of 80 patients who underwent both arthroscopic and MRI evaluation was performed. The 3D images were interpreted by one observer without knowledge of the surgical results. The medial and lateral femoral condyles, the medial and lateral tibial plateau, the patellar cartilage and trochlear groove were evaluated. MR cartilage images were considered positive if focal reduction of cartilage thickness was present (grade 3 chondromalacia) or if complete loss of cartilage was present (grade 4 chondromalacia). Comparison of the 3D MR results with the arthroscopic findings was performed. Eighty patients were included in the study group. A total of 480 articular cartilage sites were evaluated with MRI and arthroscopy. Results of MR identification of grades 3 and 4 chondromalacia, all sites combined, were: sensitivity 83%, specificity 97%, false negative rate 17%, false positive rate 3%, positive predictive value 87%, negative predictive value 95%, overall accuracy 93%. The results demonstrate that T2*-weighted 3D gradient-echo articular cartilage imaging can identify grades 3 and 4 chondromalacia of the knee.

An Official American Thoracic Society Clinical Practice Guideline: Pediatric Chronic Home Invasive Ventilation

PubMed Central

Collaco, Joseph M.; Baker, Christopher D.; Carroll, John L.; Sharma, Girish D.; Brozek, Jan L.; Finder, Jonathan D.; Ackerman, Veda L.; Arens, Raanan; Boroughs, Deborah S.; Carter, Jodi; Daigle, Karen L.; Dougherty, Joan; Gozal, David; Kevill, Katharine; Kravitz, Richard M.; Kriseman, Tony; MacLusky, Ian; Rivera-Spoljaric, Katherine; Tori, Alvaro J.; Ferkol, Thomas; Halbower, Ann C.

2016-01-01

Background: Children with chronic invasive ventilator dependence living at home are a diverse group of children with special health care needs. Medical oversight, equipment management, and community resources vary widely. There are no clinical practice guidelines available to health care professionals for the safe hospital discharge and home management of these complex children. Purpose: To develop evidence-based clinical practice guidelines for the hospital discharge and home/community management of children requiring chronic invasive ventilation. Methods: The Pediatric Assembly of the American Thoracic Society assembled an interdisciplinary workgroup with expertise in the care of children requiring chronic invasive ventilation. The experts developed four questions of clinical importance and used an evidence-based strategy to identify relevant medical evidence. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to formulate and grade recommendations. Results: Clinical practice recommendations for the management of children with chronic ventilator dependence at home are provided, and the evidence supporting each recommendation is discussed. Conclusions: Collaborative generalist and subspecialist comanagement is the Medical Home model most likely to be successful for the care of children requiring chronic invasive ventilation. Standardized hospital discharge criteria are suggested. An awake, trained caregiver should be present at all times, and at least two family caregivers should be trained specifically for the child’s care. Standardized equipment for monitoring, emergency preparedness, and airway clearance are outlined. The recommendations presented are based on the current evidence and expert opinion and will require an update as new evidence and/or technologies become available. PMID:27082538

Methodological criteria for the assessment of moderators in systematic reviews of randomised controlled trials: a consensus study

PubMed Central

2011-01-01

Background Current methodological guidelines provide advice about the assessment of sub-group analysis within RCTs, but do not specify explicit criteria for assessment. Our objective was to provide researchers with a set of criteria that will facilitate the grading of evidence for moderators, in systematic reviews. Method We developed a set of criteria from methodological manuscripts (n = 18) using snowballing technique, and electronic database searches. Criteria were reviewed by an international Delphi panel (n = 21), comprising authors who have published methodological papers in this area, and researchers who have been active in the study of sub-group analysis in RCTs. We used the Research ANd Development/University of California Los Angeles appropriateness method to assess consensus on the quantitative data. Free responses were coded for consensus and disagreement. In a subsequent round additional criteria were extracted from the Cochrane Reviewers' Handbook, and the process was repeated. Results The recommendations are that meta-analysts report both confirmatory and exploratory findings for sub-groups analysis. Confirmatory findings must only come from studies in which a specific theory/evidence based a-priori statement is made. Exploratory findings may be used to inform future/subsequent trials. However, for inclusion in the meta-analysis of moderators, the following additional criteria should be applied to each study: Baseline factors should be measured prior to randomisation, measurement of baseline factors should be of adequate reliability and validity, and a specific test of the interaction between baseline factors and interventions must be presented. Conclusions There is consensus from a group of 21 international experts that methodological criteria to assess moderators within systematic reviews of RCTs is both timely and necessary. The consensus from the experts resulted in five criteria divided into two groups when synthesising evidence: confirmatory findings to support hypotheses about moderators and exploratory findings to inform future research. These recommendations are discussed in reference to previous recommendations for evaluating and reporting moderator studies. PMID:21281501

Systematic Review of the Application of Lean and Six Sigma Quality Improvement Methodologies in Radiology.

PubMed

Amaratunga, Thelina; Dobranowski, Julian

2016-09-01

Preventable yet clinically significant rates of medical error remain systemic, while health care spending is at a historic high. Industry-based quality improvement (QI) methodologies show potential for utility in health care and radiology because they use an empirical approach to reduce variability and improve workflow. The aim of this review was to systematically assess the literature with regard to the use and efficacy of Lean and Six Sigma (the most popular of the industrial QI methodologies) within radiology. MEDLINE, the Allied & Complementary Medicine Database, Embase Classic + Embase, Health and Psychosocial Instruments, and the Ovid HealthStar database, alongside the Cochrane Library databases, were searched on June 2015. Empirical studies in peer-reviewed journals were included if they assessed the use of Lean, Six Sigma, or Lean Six Sigma with regard to their ability to improve a variety of quality metrics in a radiology-centered clinical setting. Of the 278 articles returned, 23 studies were suitable for inclusion. Of these, 10 assessed Six Sigma, 7 assessed Lean, and 6 assessed Lean Six Sigma. The diverse range of measured outcomes can be organized into 7 common aims: cost savings, reducing appointment wait time, reducing in-department wait time, increasing patient volume, reducing cycle time, reducing defects, and increasing staff and patient safety and satisfaction. All of the included studies demonstrated improvements across a variety of outcomes. However, there were high rates of systematic bias and imprecision as per the Grading of Recommendations Assessment, Development and Evaluation guidelines. Lean and Six Sigma QI methodologies have the potential to reduce error and costs and improve quality within radiology. However, there is a pressing need to conduct high-quality studies in order to realize the true potential of these QI methodologies in health care and radiology. Recommendations on how to improve the quality of the literature are proposed. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A systematic review of recent clinical practice guidelines and best practice statements for the evaluation of the infertile male.

PubMed

Esteves, Sandro C; Chan, Peter

2015-09-01

We systematically identified and reviewed the methods and consistency of recommendations of recently developed clinical practice guidelines (CPG) and best practice statements (BPS) on the evaluation of the infertile male. MEDLINE and related engines as well as guidelines' Web sites were searched for CPG and BPS written in English on the general evaluation of male infertility published between January 2008 and April 2015. Four guidelines were identified, all of which reported to have been recently updated. Systematic review was not consistently used in the BPS despite being reported in the CPG. Only one of them reported having a patient representative in its development team. The CPG issued by the European Association of Urology (EAU) graded some recommendations and related that to levels (but not quality) of evidence. Overall, the BPS issued respectively by the American Urological Association and American Society for Reproductive Medicine concurred with each other, but both differed from the EAU guidelines with regard to methods of collection, extraction and interpretation of data. None of the guidelines incorporated health economics. Important specific limitations of conventional semen analysis results were ignored by all guidelines. Besides variation in the methodological quality, implementation strategies were not reported in two out of four guidelines. While the various panels of experts who contributed to the development of the CPG and BPS reviewed should be commended on their tremendous efforts aiming to establish a clinical standard in both the evaluation and management of male infertility, we recognized inconsistencies in the methodology of their synthesis and in the contents of their final recommendations. These discrepancies pose a barrier in the general implementation of these guidelines and may limit their utility in standardizing clinical practice or improving health-related outcomes. Continuous efforts are needed to generate high-quality evidence to allow further development of these important guidelines for the evaluation and management of males suffering from infertility.

Voice quality outcomes of idiopathic Parkinson's disease medical treatment: A systematic review.

PubMed

Lechien, J R; Blecic, S; Huet, K; Delvaux, V; Piccaluga, M; Roland, V; Harmegnies, B; Saussez, S

2018-06-01

To investigate voice quality (VQ) impairments in idiopathic Parkinson's disease (IPD) and to explore the impact of medical treatments and L-Dopa challenge testing on voice. Relevant studies published between January 1980 and June 2017 describing VQ evaluations in IPD were retrieved using PubMed, Scopus, Biological Abstracts, BioMed Central and Cochrane databases. Issues of clinical relevance, including IPD treatment efficiency and voice quality outcomes, were evaluated for each study. The grade of recommendation for each publication was determined according to the Oxford Centre for Evidence-Based Medicine evidence levels. The database research yielded 106 relevant publications, of which 33 studies met the inclusion criteria, for a total of 964 patients with IPD. Data were extracted by 3 independent physicians who identified 21, 11 and 1 trials with IIIb, IIb and IIa evidence levels, respectively. The main VQ assessment tools used were acoustic testing (N = 27), aerodynamic testing (N = 10), subjective measurements (N = 8) and videolaryngostroboscopy (N = 3). The majority of trials (N = 32/33) identified subjective or objective VQ improvements after medical treatment (N = 10) or better VQ evaluations in healthy subjects compared to patients with IPD (N = 22). Especially, our analysis supports that VQ overall improves during the L-Dopa challenge testing, making the VQ evaluation an additional tool for the IPD diagnosis. The methodology used to assess subjective and objective VQ substantially varied from 1 study to another. All of the included studies took into consideration the patient's clinical profile in the VQ analysis. The majority of studies supported that VQ assessments remain useful as outcome measures of the effectiveness of medical treatment and could be helpful for the IPD diagnosis based on L-Dopa challenge testing. Further controlled studies using standardised and transparent methodology for measuring acoustic parameters are necessary to confirm the place of each tool in both IPD diagnosis and treatment evaluation. © 2018 John Wiley & Sons Ltd.

Evaluation Methodology. The Evaluation Exchange. Volume 11, Number 2, Summer 2005

ERIC Educational Resources Information Center

Coffman, Julia, Ed.

2005-01-01

This is the third issue of "The Evaluation Exchange" devoted entirely to the theme of methodology, though every issue tries to identify new methodological choices, the instructive ways in which people have applied or combined different methods, and emerging methodological trends. For example, lately "theories of change" have gained almost…

Selection and evaluation of performance-graded asphalt binders for Virginia.

DOT National Transportation Integrated Search

1999-06-01

This study recommended performance-graded (PG) binders to be used in hot-mix asphalt in Virginia. Ten conventional viscosity-graded asphalt cements, representing the asphalt typically available in Virginia, were graded under the PG system to develop ...

The Cylindrical Component Methodology Evaluation Module for MUVES-S2

DTIC Science & Technology

2017-04-01

ARL-TR-7990 ● APR 2017 US Army Research Laboratory The Cylindrical Component Methodology Evaluation Module for MUVES-S2 by...Laboratory The Cylindrical Component Methodology Evaluation Module for MUVES-S2 by David S Butler, Marianne Kunkel, and Brian G Smith...Methodology Evaluation Module for MUVES-S2 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) David S Butler, Marianne

Diagnosis of DVT

PubMed Central

Jaeschke, Roman; Stevens, Scott M.; Goodacre, Steven; Wells, Philip S.; Stevenson, Matthew D.; Kearon, Clive; Schunemann, Holger J.; Crowther, Mark; Pauker, Stephen G.; Makdissi, Regina; Guyatt, Gordon H.

2012-01-01

Background: Objective testing for DVT is crucial because clinical assessment alone is unreliable and the consequences of misdiagnosis are serious. This guideline focuses on the identification of optimal strategies for the diagnosis of DVT in ambulatory adults. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Results: We suggest that clinical assessment of pretest probability of DVT, rather than performing the same tests in all patients, should guide the diagnostic process for a first lower extremity DVT (Grade 2B). In patients with a low pretest probability of first lower extremity DVT, we recommend initial testing with D-dimer or ultrasound (US) of the proximal veins over no diagnostic testing (Grade 1B), venography (Grade 1B), or whole-leg US (Grade 2B). In patients with moderate pretest probability, we recommend initial testing with a highly sensitive D-dimer, proximal compression US, or whole-leg US rather than no testing (Grade 1B) or venography (Grade 1B). In patients with a high pretest probability, we recommend proximal compression or whole-leg US over no testing (Grade 1B) or venography (Grade 1B). Conclusions: Favored strategies for diagnosis of first DVT combine use of pretest probability assessment, D-dimer, and US. There is lower-quality evidence available to guide diagnosis of recurrent DVT, upper extremity DVT, and DVT during pregnancy. PMID:22315267

ACR Appropriateness Criteria® Colorectal Cancer Screening.

PubMed

Moreno, Courtney; Kim, David H; Bartel, Twyla B; Cash, Brooks D; Chang, Kevin J; Feig, Barry W; Fowler, Kathryn J; Garcia, Evelyn M; Kambadakone, Avinash R; Lambert, Drew L; Levy, Angela D; Marin, Daniele; Peterson, Christine M; Scheirey, Christopher D; Smith, Martin P; Weinstein, Stefanie; Carucci, Laura R

2018-05-01

This review summarizes the relevant literature regarding colorectal screening with imaging. For individuals at average or moderate risk for colorectal cancer, CT colonography is usually appropriate for colorectal cancer screening. After positive results on a fecal occult blood test or immunohistochemical test, CT colonography is usually appropriate for colorectal cancer detection. For individuals at high risk for colorectal cancer (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), optical colonoscopy is preferred because of its ability to obtain biopsies to detect dysplasia. After incomplete colonoscopy, CT colonography is usually appropriate for colorectal cancer screening for individuals at average, moderate, or high risk. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The Effect of Financial Compensation on Health Outcomes following Musculoskeletal Injury: Systematic Review

PubMed Central

Murgatroyd, Darnel F.; Casey, Petrina P.; Cameron, Ian D.; Harris, Ian A.

2015-01-01

The effect of financial compensation on health outcomes following musculoskeletal injury requires further exploration because results to date are varied and controversial. This systematic review identifies compensation related factors associated with poorer health outcomes following musculoskeletal injury. Searches were conducted using electronic medical journal databases (Medline, CINAHL, Embase, Informit, Web of Science) for prospective studies published up to October 2012. Selection criteria included: prognostic factors associated with validated health outcomes; six or more months follow up; and multivariate statistical analysis. Studies solely measuring return to work outcomes were excluded. Twenty nine articles were synthesised and then assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to determine evidence levels. The results were mixed. There was strong evidence of an association between compensation status and poorer psychological function; and legal representation and poorer physical function. There was moderate evidence of an association between compensation status and poorer physical function; and legal representation and poorer psychological function. There was limited evidence of an association between compensation status and increased pain. In seven studies the association depended on the outcome measured. No studies reported an association between compensation related factors and improved health outcomes. Further research is needed to find plausible reasons why compensation related factors are associated with poorer health following musculoskeletal injury. PMID:25680118

A three-year study of the impact of instructor attitude, enthusiasm, and teaching style on student learning in a medicinal chemistry course.

PubMed

Alsharif, Naser Z; Qi, Yongyue

2014-09-15

To determine the effect of instructor attitude, enthusiasm, and teaching style on learning for distance and campus pharmacy students. Over a 3-year period, distance and campus students enrolled in the spring semester of a medicinal chemistry course were asked to complete a survey instrument with questions related to instructor attitude, enthusiasm, and teaching style, as well as items to measure student intrinsic motivation and vitality. More positive responses were observed among distance students and older students. Gender did not impact student perspectives on 25 of the 26 survey questions. Student-related items were significantly correlated with instructor-related items. Also, student-related items and second-year cumulative grade point average were predictive of students' final course grades. Instructor enthusiasm demonstrated the highest correlation with student intrinsic motivation and vitality. While this study addresses the importance of content mastery and instructional methodologies, it focuses on issues related to instructor attitude, instructor enthusiasm, and teaching style, which all play a critical role in the learning process. Thus, instructors have a responsibility to evaluate, reevaluate, and analyze the above factors to address any related issues that impact the learning process, including their influence on professional students' intrinsic motivation and vitality, and ability to meet educational outcomes.

ACR Appropriateness Criteria® Suspected Liver Metastases.

PubMed

Kaur, Harmeet; Hindman, Nicole M; Al-Refaie, Waddah B; Arif-Tiwari, Hina; Cash, Brooks D; Chernyak, Victoria; Farrell, James; Grajo, Joseph R; Horowitz, Jeanne M; McNamara, Michelle M; Noto, Richard B; Qayyum, Aliya; Lalani, Tasneem; Kamel, Ihab R

2017-05-01

Liver metastases are the most common malignant liver tumors. The accurate and early detection and characterization of liver lesions is the key to successful treatment strategies. Increasingly, surgical resection in combination with chemotherapy is effective in significantly improving survival if all metastases are successfully resected. MRI and multiphase CT are the primary imaging modalities in the assessment of liver metastasis, with the relative preference toward multiphase CT or MRI depending upon the clinical setting (ie, surveillance or presurgical planning). The optimization of imaging parameters is a vital factor in the success of either modality. PET/CT, intraoperative ultrasound are used to supplement CT and MRI. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

2015 recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative.

PubMed

Dejaco, Christian; Singh, Yogesh P; Perel, Pablo; Hutchings, Andrew; Camellino, Dario; Mackie, Sarah; Abril, Andy; Bachta, Artur; Balint, Peter; Barraclough, Kevin; Bianconi, Lina; Buttgereit, Frank; Carsons, Steven; Ching, Daniel; Cid, Maria; Cimmino, Marco; Diamantopoulos, Andreas; Docken, William; Duftner, Christina; Fashanu, Billy; Gilbert, Kate; Hildreth, Pamela; Hollywood, Jane; Jayne, David; Lima, Manuella; Maharaj, Ajesh; Mallen, Christian; Martinez-Taboada, Victor; Maz, Mehrdad; Merry, Steven; Miller, Jean; Mori, Shunsuke; Neill, Lorna; Nordborg, Elisabeth; Nott, Jennifer; Padbury, Hannah; Pease, Colin; Salvarani, Carlo; Schirmer, Michael; Schmidt, Wolfgang; Spiera, Robert; Tronnier, David; Wagner, Alexandre; Whitlock, Madeline; Matteson, Eric L; Dasgupta, Bhaskar

2015-10-01

Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients' and clinicians' values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow-up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti-rheumatic drugs (DMARDs), as well as the roles of non-steroidal anti-rheumatic drugs and non-pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR. © 2015, American College of Rheumatology.

Symptomatic Treatment of Cough Among Adult Patients With Lung Cancer: CHEST Guideline and Expert Panel Report.

PubMed

Molassiotis, Alex; Smith, Jaclyn A; Mazzone, Peter; Blackhall, Fiona; Irwin, Richard S

2017-04-01

Cough among patients with lung cancer is a common but often undertreated symptom. We used a 2015 Cochrane systematic review, among other sources of evidence, to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic. The CHEST methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework were used. The Expert Cough Panel based their recommendations on data from the Cochrane systematic review on the topic, uncontrolled studies, case studies, and the clinical context. Final grading was reached by consensus according to the Delphi method. The Cochrane systematic review identified 17 trials of primarily low-quality evidence. Such evidence was related to both nonpharmacologic (cough suppression) and pharmacologic (demulcents, opioids, peripherally acting antitussives, or local anesthetics) treatments, as well as endobronchial brachytherapy. Compared with the 2006 CHEST Cough Guideline, the current recommendations and suggestions are more specific and follow a step-up approach to the management of cough among patients with lung cancer, acknowledging the low-quality evidence in the field and the urgent need to develop more effective, evidence-based interventions through high-quality research. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Inference of Low and High-Grade Glioma Gene Regulatory Networks Delineates the Role of Rnd3 in Establishing Multiple Hallmarks of Cancer

PubMed Central

Turan, Nil; Soulet, Fabienne; Mohd Zahari, Maihafizah; Ryan, Katie R.; Durant, Sarah; He, Shan; Herbert, John; Ankers, John; Heath, John K.; Bjerkvig, Rolf; Bicknell, Roy; Hotchin, Neil A.; Bikfalvi, Andreas; Falciani, Francesco

2015-01-01

Gliomas are a highly heterogeneous group of brain tumours that are refractory to treatment, highly invasive and pro-angiogenic. Glioblastoma patients have an average survival time of less than 15 months. Understanding the molecular basis of different grades of glioma, from well differentiated, low-grade tumours to high-grade tumours, is a key step in defining new therapeutic targets. Here we use a data-driven approach to learn the structure of gene regulatory networks from observational data and use the resulting models to formulate hypothesis on the molecular determinants of glioma stage. Remarkably, integration of available knowledge with functional genomics datasets representing clinical and pre-clinical studies reveals important properties within the regulatory circuits controlling low and high-grade glioma. Our analyses first show that low and high-grade gliomas are characterised by a switch in activity of two subsets of Rho GTPases. The first one is involved in maintaining normal glial cell function, while the second is linked to the establishment of multiple hallmarks of cancer. Next, the development and application of a novel data integration methodology reveals novel functions of RND3 in controlling glioma cell migration, invasion, proliferation, angiogenesis and clinical outcome. PMID:26132659

National Beef Quality Audit-2011: Survey of instrument grading assessments of beef carcass characteristics

USDA-ARS?s Scientific Manuscript database

The instrument grading assessments for the 2011 National Beef Quality Audit evaluated seasonal trends of beef carcass quality and yield attributes over the course of the year. One week of instrument grading data, HCW, gender, USDA quality grade (QG), and yield grade (YG) factors, were collected ever...

First Grade Baseline Evaluation

ERIC Educational Resources Information Center

Center for Innovation in Assessment (NJ1), 2013

2013-01-01

The First Grade Baseline Evaluation is an optional tool that can be used at the beginning of the school year to help teachers get to know the reading and language skills of each student. The evaluation is composed of seven screenings. Teachers may use the entire evaluation or choose to use those individual screenings that they find most beneficial…

Evaluation of a Randomized Intervention to Delay Sexual Initiation among Fifth-Graders Followed through the Sixth Grade

ERIC Educational Resources Information Center

Koo, Helen P.; Rose, Allison; El-Khorazaty, M. Nabil; Yao, Qing; Jenkins, Renee R.; Anderson, Karen M.; Davis, Maurice; Walker, Leslie R.

2011-01-01

US adolescents initiate sex at increasingly younger ages, yet few pregnancy prevention interventions for children as young as 10-12 years old have been evaluated. Sixteen Washington, DC schools were randomly assigned to intervention versus control conditions. Beginning in 2001/02 with fifth-grade students and continuing during the sixth grade,…

Evaluation of Project RACE. Weatherford Independent School District, Weatherford, Texas. Final Report.

ERIC Educational Resources Information Center

Belcher, Mary H.; And Others

The third party evaluation of the K-12 career education project RACE (Researched Activities for Career Education) focused on test results of students in four selected grades. A career education questionnaire was administered as a pre-test and again as a post-test to students in the third and sixth grades. Ninth and twelfth grade students were…

Effects of Grading Leniency and Low Workload on Students' Evaluations of Teaching: Popular Myth, Bias, Validity, or Innocent Bystanders?

ERIC Educational Resources Information Center

Marsh, Herbert W.; Roche, Lawrence A.

2000-01-01

Discusses two studies that debunk the popular myths that student evaluations of teaching (SETs) are substantially biased by low workload and grading leniency. Results imply teaching effects were related to SETs. Contrary to predictions workload, expected grades, and their relations to SETs were stable over 12 years. (Author/MKA)

A SCIENCE PROGRAM FOR THE ELEMENTARY SCHOOLS OF LOWER MERION SCHOOL DISTRICT.

ERIC Educational Resources Information Center

Lower Merion Township School District, Ardmore, PA.

AFTER AN EVALUATION MADE BY THE TEACHERS OF KINDERGARTEN THROUGH GRADE 6, THE FOLLOWING AREAS OF CLARIFICATION, REWRITING, OR ADDITIONS WERE INDICATED--THE PURPOSE AND USE OF THE SCIENCE GUIDE, EVALUATION OF THE UNITS BY GRADES, ADDITIONAL MATERIALS FOR THE UNITS, A REWRITING OF PARTICULAR UNITS, HEALTH UNITS FOR GRADES 1 THROUGH 5, THE USE OF…

A New Strategy for Dealing with Social Loafers on the Group Project: The Segment Manager Method

ERIC Educational Resources Information Center

Dommeyer, Curt J.

2012-01-01

Professors often give members of a group project the same grade or they use peer evaluations to provide individualized grades. Unfortunately, both these methods have shortcomings. This article describes the segment manager method (SMM), a method for assigning individualized grades on the group project that does not rely on peer evaluations. A…

An Approach to Evaluate Blurriness in Retinal Images with Vitreous Opacity for Cataract Diagnosis

PubMed Central

Xu, Liang

2017-01-01

Cataract is one of the leading causes of blindness in the world's population. A method to evaluate blurriness for cataract diagnosis in retinal images with vitreous opacity is proposed in this paper. Three types of features are extracted, which include pixel number of visible structures, mean contrast between vessels and background, and local standard deviation. To avoid the wrong detection of vitreous opacity as retinal structures, a morphological method is proposed to detect and remove such lesions from retinal visible structure segmentation. Based on the extracted features, a decision tree is trained to classify retinal images into five grades of blurriness. The proposed approach was tested using 1355 clinical retinal images, and the accuracies of two-class classification and five-grade grading compared with that of manual grading are 92.8% and 81.1%, respectively. The kappa value between automatic grading and manual grading is 0.74 in five-grade grading, in which both variance and P value are less than 0.001. Experimental results show that the grading difference between automatic grading and manual grading is all within 1 grade, which is much improvement compared with that of other available methods. The proposed grading method provides a universal measure of cataract severity and can facilitate the decision of cataract surgery. PMID:29065620

SU-D-207B-04: Morphological Features of MRI as a Correlate of Capsular Contracture in Breast Cancer Patients with Implant-Based Reconstructions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tyagi, N; Sutton, E; Hunt, M

Purpose: Capsular contracture (CC) is a serious complication in patients receiving implant-based reconstruction for breast cancer. The goal of this study was to identify image-based correlates of CC using MRI imaging in breast cancer patients who received both MRI and clinical evaluation following reconstructive surgery. Methods: We analyzed a retrospective dataset of 50 patients who had both a diagnostic MR and a plastic surgeon’s evaluations of CC score (Baker’s score) within a six month period following mastectomy and reconstructive surgery. T2w sagittal MRIs (TR/TE = 3500/102 ms, slice thickness = 4 mm) were used for morphological shape features (roundness, eccentricity,more » solidity, extent and ratio-length) and histogram features (median, skewness and kurtosis) of the implant and the pectoralis muscle overlying the implant. Implant and pectoralis muscles were segmented in 3D using Computation Environment for Radiological Research (CERR) and shape and histogram features were calculated as a function of Baker’s score. Results: Shape features such as roundness and eccentricity were statistically significant in differentiating grade 1 and grade 2 (p = 0.009; p = 0.06) as well as grade 1 and grade 3 CC (p = 0.001; p = 0.006). Solidity and extent were statistically significant in differentiating grade 1 and grade 3 CC (p = 0.04; p = 0.04). Ratio-length was statistically significant in differentiating all grades of CC except grade 2 and grade 3 that showed borderline significance (p = 0.06). The muscle thickness, median intensity and kurtosis were significant in differentiating between grade 1 and grade 3 (p = 0.02), grade 1 and grade 2 (p = 0.03) and grade 1 and grade 3 (p = 0.01) respectively. Conclusion: Morphological shape features described on MR images were associated with the severity of CC. MRI may be important in objectively evaluating outcomes in breast cancer patients who undergo implant reconstruction.« less

A framework for assessing the adequacy and effectiveness of software development methodologies

NASA Technical Reports Server (NTRS)

Arthur, James D.; Nance, Richard E.

1990-01-01

Tools, techniques, environments, and methodologies dominate the software engineering literature, but relatively little research in the evaluation of methodologies is evident. This work reports an initial attempt to develop a procedural approach to evaluating software development methodologies. Prominent in this approach are: (1) an explication of the role of a methodology in the software development process; (2) the development of a procedure based on linkages among objectives, principles, and attributes; and (3) the establishment of a basis for reduction of the subjective nature of the evaluation through the introduction of properties. An application of the evaluation procedure to two Navy methodologies has provided consistent results that demonstrate the utility and versatility of the evaluation procedure. Current research efforts focus on the continued refinement of the evaluation procedure through the identification and integration of product quality indicators reflective of attribute presence, and the validation of metrics supporting the measure of those indicators. The consequent refinement of the evaluation procedure offers promise of a flexible approach that admits to change as the field of knowledge matures. In conclusion, the procedural approach presented in this paper represents a promising path toward the end goal of objectively evaluating software engineering methodologies.

Effects of Repeated Intraperitoneal Injection of Pharmaceutical-grade and Nonpharmaceutical-grade Corn Oil in Female C57BL/6J Mice

PubMed Central

Hubbard, Jennifer S; Chen, Patty H; Boyd, Kelli L

2017-01-01

Due to potential adverse effects on animal wellbeing, the use of nonpharmaceutical-grade substances in animal research must be scientifically justified in cases where a pharmaceutical-grade version of the substance exists. This requirement applies to all substances, including vehicles used to solubilize experimental drugs. To date, no studies have evaluated the direct effect of the pharmaceutical classification of a compound on animal wellbeing. In this study, we evaluated intraperitoneal administration of pharmaceutical-grade corn oil, nonpharmaceutical-grade corn oil, and saline in female C57BL/6J mice. Compounds were administered every 48 h for a total of 4 injections. Mice were evaluated clinically by using body weight, body condition score, visual assessment score, CBC, and serum chemistries. Animals were euthanized at 24 h and 14 d after the final injection. Inflammation of the peritoneal wall and mesenteric fat was assessed microscopically by using a semiquantitative scoring system. Saline-dosed groups had lower pathology scores at both time points. At day 21, pharmaceutical-grade corn oil had a significantly higher pathology score compared with nonpharmaceutical-grade corn oil. No other significant differences between the corn oil groups were observed. The use of nonpharmaceutical grade corn oil did not result in adverse clinical consequences and is presumed safe to use for intraperitoneal injection in mice. Differences in inflammation between the 2 groups suggest that the use of either pharmaceutical-grade or nonpharmaceutical-grade corn oil should be consistent within a study. PMID:29256373

Toward a Knowledge Base for School Climate in Cyprus's Schools

ERIC Educational Resources Information Center

Pashiardis, Georgia

2008-01-01

Purpose: The main purpose of this study was to explore and analyze secondary school students' (8th grade) perceptions about school climate in three areas, namely: the physical environment of the school, the social environment and the learning environment Design/methodology/approach: A questionnaire, which was designed and pilot-tested around the…

Detecting Math Anxiety with a Mixture Partial Credit Model

ERIC Educational Resources Information Center

Ölmez, Ibrahim Burak; Cohen, Allan S.

2017-01-01

The purpose of this study was to investigate a new methodology for detection of differences in middle grades students' math anxiety. A mixture partial credit model analysis revealed two distinct latent classes based on homogeneities in response patterns within each latent class. Students in Class 1 had less anxiety about apprehension of math…

Computer Literacy of Turkish Preservice Teachers in Different Teacher Training Programs

ERIC Educational Resources Information Center

Ozsevgec, Tuncay

2011-01-01

This paper reports on an investigation into the sophomore and senior preservice teachers' computer literacy in different teacher training programs and to determine relationship between grades and the teacher training programs in terms of their computer literacy. The study used case study research methodology, and the sample consisted of 276…

Methodological Status and Trends in Expository Text Structure Instruction Efficacy Research

ERIC Educational Resources Information Center

Bohaty, Janet J.; Hebert, Michael A.; Nelson, J. Ron; Brown, Jessica A.

2015-01-01

This systematic descriptive historical review was conducted to examine the status and trends in expository text structure instruction efficacy research for first through twelfth grade students. The analysis included sixty studies, which spanned the years 1978 to 2014. Descriptive dimensions of the research included study type, research design,…

Like a Chameleon: A Beginning Teacher's Journey to Implement Active Learning

ERIC Educational Resources Information Center

Edwards, Susan

2017-01-01

The purpose of this study was to follow the learning trajectory of a beginning teacher attempting to implement active learning instructional methods in a middle grades classroom. The study utilized a qualitative case study methodological approach with the researcher in the role of participant observer. Three research questions were explored: the…

Adolescent Daily and General Maladjustment: Is There Reactivity to Daily Repeated Measures Methodologies?

ERIC Educational Resources Information Center

Nishina, Adrienne

2012-01-01

The present study examined whether repeated exposure to daily surveys about negative social experiences predicts changes in adolescents' daily and general maladjustment, and whether question content moderates these changes. Across a 2-week period, 6th-grade students (N = 215; mode age = 11) completed 5 daily reports tapping experienced or…

Trigonometry from a Different Angle

ERIC Educational Resources Information Center

Cavanagh, Michael

2008-01-01

The mathematics methodology subjects the author undertook in the early 1980s encouraged him to adopt a very expository style of teaching in which each new concept is introduced by its formal definition. The teacher should then explain a few carefully chosen examples for students to copy into their books, and then provide plenty of graded practice…

Relationships between Substance Use and Depressive Symptoms: A Longitudinal Study of Australian Adolescents

ERIC Educational Resources Information Center

Scholes-Balog, Kirsty E.; Hemphill, Sheryl A.; Patton, George C.; Toumbourou, John W.

2015-01-01

This study examined longitudinal relationships between depressive symptoms and use of alcohol, cigarettes, and illicit substances among adolescents, addressing methodological limitations and potential confounding in the extant literature. The sample comprised adolescents who were surveyed in Grades 6 (n = 916), 9 (n = 804), and 11 (n = 791).…

Measuring Discrimination in Education. NBER Working Paper No. 15057

ERIC Educational Resources Information Center

Hanna, Rema; Linden. Leigh

2009-01-01

In this paper, we illustrate a methodology to measure discrimination in educational contexts. In India, we ran an exam competition through which children compete for a large financial prize. We recruited teachers to grade the exams. We then randomly assigned child "characteristics" (age, gender, and caste) to the cover sheets of the…

Refactoring a CS0 Course for Engineering Students to Use Active Learning

ERIC Educational Resources Information Center

Lokkila, Erno; Kaila, Erkki; Lindén, Rolf; Laakso, Mikko-Jussi; Sutinen, Erkki

2017-01-01

Purpose: The purpose of this paper was to determine whether applying e-learning material to a course leads to consistently improved student performance. Design/methodology/approach: This paper analyzes grade data from seven instances of the course. The first three instances were performed traditionally. After an intervention, in the form of…

Students' Communication, Argumentation and Knowledge in a Citizens' Conference on Global Warming

ERIC Educational Resources Information Center

Albe, Virginie; Gombert, Marie-Jose

2012-01-01

An empirical study on 12th-grade students' engagement on a global warming debate as a citizens' conference is reported. Within the design-based research methodology, an interdisciplinary teaching sequence integrating an initiation to non-violent communication was developed. Students' debates were analyzed according to three dimensions:…

Adolescents' School Lunch Practices as an Educational Resource

ERIC Educational Resources Information Center

Janhonen, Kristiina Henrietta; Mäkelä, Johanna; Palojoki, Päivi

2016-01-01

Purpose: The purpose of this paper is to examine Finnish ninth grade pupils' (15-16 years) perspectives on hot school lunches and consider the potential of these perspectives as a resource for food and health education. Design/methodology/approach: Data include observations, essays, and visually elicitated focus group discussions from a larger…

The Development of Positive Literate Identities among Emerging Bilingual and Monolingual First Graders

ERIC Educational Resources Information Center

Moses, Lindsey; Kelly, Laura Beth

2017-01-01

In this study, the researchers examined how first-grade students initially positioned as struggling readers took up literacy practices to reposition themselves as capable competent readers and part of a literate community of practice over an academic year. Using positive discourse analysis and case study methodology, the researchers documented and…

Meanings at Hand: Coordinating Semiotic Resources in Explaining Mathematical Terms in Classroom Discourse

ERIC Educational Resources Information Center

Heller, Vivien

2016-01-01

The article examines how diverse semiotic resources are made available for explaining mathematical terms in a fifth-grade classroom. Situated within the methodological framework developed by conversation analysis and the analysis of embodiment-in-interaction, the study deals with two instances of a classroom episode in each of which participants…

Exploring Factors Facilitating and Hindering College-University Pathway Program Completion

ERIC Educational Resources Information Center

Percival, Jennifer; DiGiuseppe, Maurice; Goodman, Bill; LeSage, Ann; Longo, Fabiola; De La Rocha, Arlene; Hinch, Ron; Samis, John; Sanchez, Otto; Augusto Rodrigues, Anna; Raby, Phil

2016-01-01

Purpose: The purpose of this paper is to explore not only the academic measures such as grade point average of success of college-to-university transfer programs (Pathway Programs), but also the social-cultural facilitators and barriers throughout the students' Pathway experience. Design/methodology/approach: The experience of students and…

A Didactic Proposal for EFL in a Public School in Cali

ERIC Educational Resources Information Center

Chaves, Orlando; Fernandez, Alejandro

2016-01-01

This article reports an action-research project aimed at designing, applying, and assessing a didactic sequence for teaching English as a foreign language in the first grade of a public school in Cali. The article comprises the context, reasons that justified the research, theoretical support, methodology, and results, analyzed through descriptive…

Family and School Influences on Adolescent Smoking Behaviour

ERIC Educational Resources Information Center

Wiium, Nora; Wold, Bente

2006-01-01

Purpose: This paper aims to examine how influences at home and school interact to predict smoking among adolescents. Design/methodology/approach: Data were collected from 15-year-old pupils from Norway (n=1,404 in 73 Grade 10 school classes). Multilevel logistic regression analysis was used to determine how family and school influences interact to…

Teacher Perceptions of Global Citizenship Education in a Southern Elementary Public School: Implications for Curriculum and Pedagogy

ERIC Educational Resources Information Center

Jett, Tamela Drennan

2013-01-01

Curriculum for global citizenship education is gaining momentum as countries have experienced an increase in interdependence and interconnectedness through technology over the last century. Through qualitative research, this study employed a phenomenological methodology to understand how ten female elementary teachers in grades third- through…

Family and School Spillover in Adolescents' Daily Lives

ERIC Educational Resources Information Center

Flook, Lisa; Fuligni, Andrew J.

2008-01-01

This study examined spillover between daily family stressors and school problems among 589 ninth-grade students (mean age = 14.9 years) from Mexican, Chinese, and European backgrounds. Spillover was examined using a daily diary methodology in which adolescents reported on their school and family experiences each day for 2 weeks. Analyses using…

The Impact of the Academic Library on Student Success: Connecting the Dots

ERIC Educational Resources Information Center

Thorpe, Angie; Lukes, Ria; Bever, Diane J.; He, Yan

2016-01-01

In an age of assessment and accountability, academic libraries feel much pressure to prove their value according to new university measurements of student success. This study describes a methodology for how libraries may examine student interactions with services to assess whether library usage impacts student grade point averages (GPAs) and…

The Effect of Multimedia Writing Support Software on Written Productivity

ERIC Educational Resources Information Center

Racicot, Rose

2016-01-01

The purpose of this study was to explore the effects of multimedia writing support software on the quality and quantity of writing productivity and self-perception for students who have mild to moderate developmental delays. Participants in this study included 22 special education students in grades kindergarten through 6. Methodology included a…

Eliciting Systematic Rule Use in Covariation Judgment [the Early Years].

ERIC Educational Resources Information Center

Shaklee, Harriet; Paszek, Donald

Related research suggests that children may show some simple understanding of event covariations by the early elementary school years. The present experiments use a rule analysis methodology to investigate covariation judgments of children in this age range. In Experiment 1, children in second, third and fourth grade judged covariations on 12…

Approaches to Internet Searching: An Analysis of Student in Grades 2 to 12.

ERIC Educational Resources Information Center

Lien, Cynthia

2000-01-01

Examines Internet search approaches by 123 students, and analyzes search methodologies relative to search successes. Presents three findings: (1) student experience with the Internet is closely correlated with ability to explore alternative search methods; (2) student level; and (3) a collaborative work among students in a classroom setting may…

Equal Knowledge Is the Strong Root of Democratic Egalitarianism

ERIC Educational Resources Information Center

Palumbo, Anthony; Levitt, Roberta

2011-01-01

This article considers how to bridge the achievement gap by showing that reading methodology influenced American educational philosophy, primary-grade curricula, and American schools. It considers the impact of the romantic movement on progressive education and notes that the current academic achievement gap has two roots. The first can be traced,…

Of Tilting Earths, Ruler Swans, and Fighting Mosquitoes: First Graders Writing Nonfiction

ERIC Educational Resources Information Center

Wilson, Melissa I.

2012-01-01

Using discourse analysis methodology, this dissertation describes the literacy practices of first grade students as they engaged in researching, writing and illustrating nonfiction. The research focused on two instructional units on writing nonfiction that included a poster unit and a research report unit. The data consisted of 27 days of video…

Error Patterns in Portuguese Students' Addition and Subtraction Calculation Tasks: Implications for Teaching

ERIC Educational Resources Information Center

Watson, Silvana Maria R.; Lopes, João; Oliveira, Célia; Judge, Sharon

2018-01-01

Purpose: The purpose of this descriptive study is to investigate why some elementary children have difficulties mastering addition and subtraction calculation tasks. Design/methodology/approach: The researchers have examined error types in addition and subtraction calculation made by 697 Portuguese students in elementary grades. Each student…

A Meta-Analysis of Reading Recovery in United States Schools

ERIC Educational Resources Information Center

D'Agostino, Jerome V.; Murphy, Judith A.

2004-01-01

We conducted a meta-analysis of 36 studies of Reading Recovery (RR), an intensive tutorial intervention designed to develop the literacy skills of low-performing first-grade students. Few individual studies of the program have yielded conclusive evidence regarding the program's effectiveness due to various methodological limitations. We relied on…

Synthesizing Middle Grades Research on Cultural Responsiveness: The Importance of a Shared Conceptual Framework

ERIC Educational Resources Information Center

Kennedy, Brianna L.; Brinegar, Kathleen; Hurd, Ellis; Harrison, Lisa

2016-01-01

In conducting a literature review of 133 articles on cultural responsiveness in middle level education, we identified a lack of shared definitions, theoretical frameworks, methodological approaches, and foci, which made it difficult to synthesize across articles. Using a conceptual framework that required: a) clear definitions of terms; b) a…

An Efficient Computational Framework for the Analysis of Whole Slide Images: Application to Follicular Lymphoma Immunohistochemistry

PubMed Central

Samsi, Siddharth; Krishnamurthy, Ashok K.; Gurcan, Metin N.

2012-01-01

Follicular Lymphoma (FL) is one of the most common non-Hodgkin Lymphoma in the United States. Diagnosis and grading of FL is based on the review of histopathological tissue sections under a microscope and is influenced by human factors such as fatigue and reader bias. Computer-aided image analysis tools can help improve the accuracy of diagnosis and grading and act as another tool at the pathologist’s disposal. Our group has been developing algorithms for identifying follicles in immunohistochemical images. These algorithms have been tested and validated on small images extracted from whole slide images. However, the use of these algorithms for analyzing the entire whole slide image requires significant changes to the processing methodology since the images are relatively large (on the order of 100k × 100k pixels). In this paper we discuss the challenges involved in analyzing whole slide images and propose potential computational methodologies for addressing these challenges. We discuss the use of parallel computing tools on commodity clusters and compare performance of the serial and parallel implementations of our approach. PMID:22962572

Automatic Gleason grading of prostate cancer using quantitative phase imaging and machine learning

NASA Astrophysics Data System (ADS)

Nguyen, Tan H.; Sridharan, Shamira; Macias, Virgilia; Kajdacsy-Balla, Andre; Melamed, Jonathan; Do, Minh N.; Popescu, Gabriel

2017-03-01

We present an approach for automatic diagnosis of tissue biopsies. Our methodology consists of a quantitative phase imaging tissue scanner and machine learning algorithms to process these data. We illustrate the performance by automatic Gleason grading of prostate specimens. The imaging system operates on the principle of interferometry and, as a result, reports on the nanoscale architecture of the unlabeled specimen. We use these data to train a random forest classifier to learn textural behaviors of prostate samples and classify each pixel in the image into different classes. Automatic diagnosis results were computed from the segmented regions. By combining morphological features with quantitative information from the glands and stroma, logistic regression was used to discriminate regions with Gleason grade 3 versus grade 4 cancer in prostatectomy tissue. The overall accuracy of this classification derived from a receiver operating curve was 82%, which is in the range of human error when interobserver variability is considered. We anticipate that our approach will provide a clinically objective and quantitative metric for Gleason grading, allowing us to corroborate results across instruments and laboratories and feed the computer algorithms for improved accuracy.

Brain tumor classification using AFM in combination with data mining techniques.

PubMed

Huml, Marlene; Silye, René; Zauner, Gerald; Hutterer, Stephan; Schilcher, Kurt

2013-01-01

Although classification of astrocytic tumors is standardized by the WHO grading system, which is mainly based on microscopy-derived, histomorphological features, there is great interobserver variability. The main causes are thought to be the complexity of morphological details varying from tumor to tumor and from patient to patient, variations in the technical histopathological procedures like staining protocols, and finally the individual experience of the diagnosing pathologist. Thus, to raise astrocytoma grading to a more objective standard, this paper proposes a methodology based on atomic force microscopy (AFM) derived images made from histopathological samples in combination with data mining techniques. By comparing AFM images with corresponding light microscopy images of the same area, the progressive formation of cavities due to cell necrosis was identified as a typical morphological marker for a computer-assisted analysis. Using genetic programming as a tool for feature analysis, a best model was created that achieved 94.74% classification accuracy in distinguishing grade II tumors from grade IV ones. While utilizing modern image analysis techniques, AFM may become an important tool in astrocytic tumor diagnosis. By this way patients suffering from grade II tumors are identified unambiguously, having a less risk for malignant transformation. They would benefit from early adjuvant therapies.

An integrated modelling and multicriteria analysis approach to managing nitrate diffuse pollution: 2. A case study for a chalk catchment in England.

PubMed

Koo, B K; O'Connell, P E

2006-04-01

The site-specific land use optimisation methodology, suggested by the authors in the first part of this two-part paper, has been applied to the River Kennet catchment at Marlborough, Wiltshire, UK, for a case study. The Marlborough catchment (143 km(2)) is an agriculture-dominated rural area over a deep chalk aquifer that is vulnerable to nitrate pollution from agricultural diffuse sources. For evaluation purposes, the catchment was discretised into a network of 1 kmx1 km grid cells. For each of the arable-land grid cells, seven land use alternatives (four arable-land alternatives and three grassland alternatives) were evaluated for their environmental and economic potential. For environmental evaluation, nitrate leaching rates of land use alternatives were estimated using SHETRAN simulations and groundwater pollution potential was evaluated using the DRASTIC index. For economic evaluation, economic gross margins were estimated using a simple agronomic model based on nitrogen response functions and agricultural land classification grades. In order to see whether the site-specific optimisation is efficient at the catchment scale, land use optimisation was carried out for four optimisation schemes (i.e. using four sets of criterion weights). Consequently, four land use scenarios were generated and the site-specifically optimised land use scenario was evaluated as the best compromise solution between long term nitrate pollution and agronomy at the catchment scale.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a Summary of Qualitative Findings table.

PubMed

Lewin, Simon; Bohren, Meghan; Rashidian, Arash; Munthe-Kaas, Heather; Glenton, Claire; Colvin, Christopher J; Garside, Ruth; Noyes, Jane; Booth, Andrew; Tunçalp, Özge; Wainwright, Megan; Flottorp, Signe; Tucker, Joseph D; Carlsen, Benedicte

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on making an overall assessment of confidence in a review finding and creating a CERQual Evidence Profile and a CERQual Summary of Qualitative Findings table. We developed this guidance by examining the methods used by other GRADE approaches, gathering feedback from relevant research communities and developing consensus through project group meetings. We then piloted the guidance on several qualitative evidence syntheses before agreeing on the approach. Confidence in the evidence is an assessment of the extent to which a review finding is a reasonable representation of the phenomenon of interest. Creating a summary of each review finding and deciding whether or not CERQual should be used are important steps prior to assessing confidence. Confidence should be assessed for each review finding individually, based on the judgements made for each of the four CERQual components. Four levels are used to describe the overall assessment of confidence: high, moderate, low or very low. The overall CERQual assessment for each review finding should be explained in a CERQual Evidence Profile and Summary of Qualitative Findings table. Structuring and summarising review findings, assessing confidence in those findings using CERQual and creating a CERQual Evidence Profile and Summary of Qualitative Findings table should be essential components of undertaking qualitative evidence syntheses. This paper describes the end point of a CERQual assessment and should be read in conjunction with the other papers in the series that provide information on assessing individual CERQual components.

Measures of low back function: a review of reproducibility studies.

PubMed

Essendrop, Morten; Maul, Irina; Läubli, Thomas; Riihimäki, Hilkka; Schibye, Bente

2002-05-01

The objective of the present study was to make a systematic literature review with preset quality criteria concerning reproducibility of the tests of the low back regarding strength, endurance and range of motion. Literature in Medline and local databases was reviewed for articles concerning the reproducibility of strength, endurance, and range of motion measurements. Measures of low back function are widely used, and are important for both clinical and research purposes in relation to low back problems. A review of the reproducibility of these tests has not previously been made. After extensive discussion among all the authors, general evaluation parameters were defined for the quality assessment. Every study was graded from 0 to 2 for each parameter. Parameters evaluated were: number of subjects, subject description, method description, test/retest interval, description of results, and statistics. The literature search revealed a total of 79 studies. Most studies suffered from methodological weaknesses and only eleven studies received ten or more quality points (maximum 14). The results from the highest graded studies are highlighted. It may be concluded that there is a considerable lack of information about the reproducibility of functional measures for the low back, and therefore a recommendation for consensus is difficult. However, most tests performed in the sagittal plane are reliable for use on groups. Measures of low back function are thought to be of great importance for clinicians, and low back researchers in general. A review of reproducibility will be helpful both as a survey of tests, and to provide information on the usefulness in relation to the level of reproducibility.

Cartography teaching and the development of spatial thinking in Brazilian geography textbooks

NASA Astrophysics Data System (ADS)

Duarte, Ronaldo G.

2018-05-01

Spatial thinking has been recognized as closely related to tools of representation (NRC, 2006) and the maps have been widely pointed out as crucial for the development of that kind of reasoning. Furthermore, the scientific com-munity dedicated to the field of the spatial thinking has been asserting that the abilities encompassed in such a complex cognition can and must be fostered in school. Considering these groundwork, our research focused on the decision to assess the effectiveness of the contribution for the development of student's spatial thinking, provided by the questions found in Brazilian middle school geography textbooks. The main concern was the proficiency regarding cartographic language. To assure the possibility of comparing our results with some other investigations we decided to use a methodology that was strongly based on the Taxonomy of Spatial Thinking, designed by Injeong Jo and Sarah Bednarz (2009). Counting on those powerful tools we analyzed 6.884 questions in the three most adopted geography textbooks sets in Brazilian middle schools (6th, 7th, 8th and 9th grades). For the purpose of enlarging the number of books and countries to be compared, we have also evaluated 2.073 questions that are present in a French geography textbook set edited for the same grades. Using the taxonomy enabled us not only to evaluate if the questions demanded or not the use of the spatial thinking by the students. It also showed us the three general levels of reasoning involved, allowing to discern between low, intermediate and high levels of spatial thinking.

ACR Appropriateness Criteria® First Trimester Vaginal Bleeding.

PubMed

Brown, Douglas L; Packard, Ann; Maturen, Katherine E; Deshmukh, Sandeep Prakash; Dudiak, Kika M; Henrichsen, Tara L; Meyer, Benjamin J; Poder, Liina; Sadowski, Elizabeth A; Shipp, Thomas D; Simpson, Lynn; Weber, Therese M; Zelop, Carolyn M; Glanc, Phyllis

2018-05-01

Vaginal bleeding is not uncommon in the first trimester of pregnancy. The majority of such patients will have a normal intrauterine pregnancy (IUP), a nonviable IUP, or an ectopic pregnancy. Ultrasound (US) is the primary imaging modality in evaluation of these patients. US, along with clinical observations and serum human chorionic gonadotropin levels, can usually distinguish these causes. Although it is important to diagnose ectopic pregnancies and nonviable IUPs, one should also guard against injury to normal pregnancies due to inappropriate treatment with methotrexate or surgical intervention. Less common causes of first trimester vaginal bleeding include gestational trophoblastic disease and arteriovenous malformations. Pulsed methods of Doppler US should generally be avoided in the first trimester when there is a normal, or a potentially normal, IUP. Once a normal IUP has been excluded, Doppler US may be useful when other diagnoses such as retained products of conception or arteriovenous malformations are suspected. MRI may occasionally be helpful as a problem-solving tool. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

An illustrative overview of semi-quantitative MRI scoring of knee osteoarthritis: lessons learned from longitudinal observational studies.

PubMed

Roemer, F W; Hunter, D J; Crema, M D; Kwoh, C K; Ochoa-Albiztegui, E; Guermazi, A

2016-02-01

To introduce the most popular magnetic resonance imaging (MRI) osteoarthritis (OA) semi-quantitative (SQ) scoring systems to a broader audience with a focus on the most commonly applied scores, i.e., the MOAKS and WORMS system and illustrate similarities and differences. While the main structure and methodology of each scoring system are publicly available, the core of this overview will be an illustrative imaging atlas section including image examples from multiple OA studies applying MRI in regard to different features assessed, show specific examples of different grades and point out pitfalls and specifics of SQ assessment including artifacts, blinding to time point of acquisition and within-grade evaluation. Similarities and differences between different scoring systems are presented. Technical considerations are followed by a brief description of the most commonly utilized SQ scoring systems including their responsiveness and reliability. The second part is comprised of the atlas section presenting illustrative image examples. Evidence suggests that SQ assessment of OA by expert MRI readers is valid, reliable and responsive, which helps investigators to understand the natural history of this complex disease and to evaluate potential new drugs in OA clinical trials. Researchers have to be aware of the differences and specifics of the different systems to be able to engage in imaging assessment and interpretation of imaging-based data. SQ scoring has enabled us to explain associations of structural tissue damage with clinical manifestations of the disease and with morphological alterations thought to represent disease progression. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

An illustrative overview of semi-quantitative MRI scoring of knee osteoarthritis: Lessons learned from longitudinal observational studies

PubMed Central

Roemer, Frank W.; Hunter, David J.; Crema, Michel D.; Kwoh, C. Kent; Ochoa-Albiztegui, Elena; Guermazi, Ali

2015-01-01

Objective To introduce the most popular magnetic resonance imaging (MRI) osteoarthritis (OA) semi-quantitative (SQ) scoring systems to a broader audience with a focus on the most commonly applied scores, i.e. the MOAKS and WORMS system and illustrate similarities and differences. Design While the main structure and methodology of each scoring system are publicly available, the core of this overview will be an illustrative imaging atlas section including image examples from multiple osteoarthritis studies applying MRI in regard to different features assessed, show specific examples of different grades and point out pitfalls and specifics of SQ assessment including artifacts, blinding to time point of acquisition and within-grade evaluation. Results Similarities and differences between different scoring systems are presented. Technical considerations are followed by a brief description of the most commonly utilized SQ scoring systems including their responsiveness and reliability. The second part is comprised of the atlas section presenting illustrative image examples. Conclusions Evidence suggests that SQ assessment of OA by expert MRI readers is valid, reliable and responsive, which helps investigators to understand the natural history of this complex disease and to evaluate potential new drugs in OA clinical trials. Researchers have to be aware of the differences and specifics of the different systems to be able to engage in imaging assessment and interpretation of imaging-based data. SQ scoring has enabled us to explain associations of structural tissue damage with clinical manifestations of the disease and with morphological alterations thought to represent disease progression. PMID:26318656

Multimodel assessment of the upper troposphere and lower stratosphere: Tropics and global trends

NASA Astrophysics Data System (ADS)

Gettelman, A.; Hegglin, M. I.; Son, S.-W.; Kim, J.; Fujiwara, M.; Birner, T.; Kremser, S.; Rex, M.; AñEl, J. A.; Akiyoshi, H.; Austin, J.; Bekki, S.; Braesike, P.; Brühl, C.; Butchart, N.; Chipperfield, M.; Dameris, M.; Dhomse, S.; Garny, H.; Hardiman, S. C.; JöCkel, P.; Kinnison, D. E.; Lamarque, J. F.; Mancini, E.; Marchand, M.; Michou, M.; Morgenstern, O.; Pawson, S.; Pitari, G.; Plummer, D.; Pyle, J. A.; Rozanov, E.; Scinocca, J.; Shepherd, T. G.; Shibata, K.; Smale, D.; TeyssèDre, H.; Tian, W.

2010-01-01

The performance of 18 coupled Chemistry Climate Models (CCMs) in the Tropical Tropopause Layer (TTL) is evaluated using qualitative and quantitative diagnostics. Trends in tropopause quantities in the tropics and the extratropical Upper Troposphere and Lower Stratosphere (UTLS) are analyzed. A quantitative grading methodology for evaluating CCMs is extended to include variability and used to develop four different grades for tropical tropopause temperature and pressure, water vapor and ozone. Four of the 18 models and the multi-model mean meet quantitative and qualitative standards for reproducing key processes in the TTL. Several diagnostics are performed on a subset of the models analyzing the Tropopause Inversion Layer (TIL), Lagrangian cold point and TTL transit time. Historical decreases in tropical tropopause pressure and decreases in water vapor are simulated, lending confidence to future projections. The models simulate continued decreases in tropopause pressure in the 21st century, along with ˜1K increases per century in cold point tropopause temperature and 0.5-1 ppmv per century increases in water vapor above the tropical tropopause. TTL water vapor increases below the cold point. In two models, these trends are associated with 35% increases in TTL cloud fraction. These changes indicate significant perturbations to TTL processes, specifically to deep convective heating and humidity transport. Ozone in the extratropical lowermost stratosphere has significant and hemispheric asymmetric trends. O3 is projected to increase by nearly 30% due to ozone recovery in the Southern Hemisphere (SH) and due to enhancements in the stratospheric circulation. These UTLS ozone trends may have significant effects in the TTL and the troposphere.

British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus.

PubMed

Fitzgerald, Rebecca C; di Pietro, Massimiliano; Ragunath, Krish; Ang, Yeng; Kang, Jin-Yong; Watson, Peter; Trudgill, Nigel; Patel, Praful; Kaye, Philip V; Sanders, Scott; O'Donovan, Maria; Bird-Lieberman, Elizabeth; Bhandari, Pradeep; Jankowski, Janusz A; Attwood, Stephen; Parsons, Simon L; Loft, Duncan; Lagergren, Jesper; Moayyedi, Paul; Lyratzopoulos, Georgios; de Caestecker, John

2014-01-01

These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was followed to provide a methodological strategy for the guideline development. A systematic review of the literature was performed for English language articles published up until December 2012 in order to address controversial issues in Barrett's oesophagus including definition, screening and diagnosis, surveillance, pathological grading for dysplasia, management of dysplasia, and early cancer including training requirements. The rigour and quality of the studies was evaluated using the SIGN checklist system. Recommendations on each topic were scored by each author using a five-tier system (A+, strong agreement, to D+, strongly disagree). Statements that failed to reach substantial agreement among authors, defined as >80% agreement (A or A+), were revisited and modified until substantial agreement (>80%) was reached. In formulating these guidelines, we took into consideration benefits and risks for the population and national health system, as well as patient perspectives. For the first time, we have suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria. In order to improve communication between clinicians, we recommend the use of minimum datasets for reporting endoscopic and pathological findings. We advocate endoscopic therapy for high-grade dysplasia and early cancer, which should be performed in high-volume centres. We hope that these guidelines will standardise and improve management for patients with Barrett's oesophagus and related neoplasia.

Murray secretion scale and fiberoptic endoscopic evaluation of swallowing in predicting aspiration in dysphagic patients.

PubMed

Kuo, Chia-Wei; Allen, Clint Tanner; Huang, Chu-Chun; Lee, Chia-Jung

2017-06-01

The objective of this retrospective review is to evaluate the ability of the Murray secretion scale to predict aspiration as determined by fiberoptic endoscopic evaluation of swallowing. Patients with dysphagia undergoing a fiberoptic endoscopic evaluation of swallowing study between January 2013 and November 2015 from a single, tertiary care institution were retrospectively reviewed. The Murray secretion scale and penetration aspiration scale on fiberoptic endoscopic evaluation of swallowing examination were determined. Spearman's correlation analysis, sensitivity, specificity, predictive values, and relative risk evaluating the relationship between the Murray secretion scale and aspiration on fiberoptic endoscopic evaluation of swallowing were calculated. Subgroups of head and neck cancer patients, penetration group, and aspiration group were also analyzed. The mean age of the cases (N = 212) was 62.4 years. Eighty percent were male. There was a strong correlation between Murray secretion scale grade and penetration aspiration scale score (r = 0.785, p < 0.001). The sensitivity and specificity of a Murray secretion scale grade 2 or higher in predicting aspiration were 74 and 90%, respectively. Individuals with a Murray secretion scale grade of 2 or higher were 13.6 times more likely to aspirate than patients with a lower Murray secretion scale grade. All subgroups showed similar trend. Determination of a Murray secretion scale grade, determined by flexible nasopharyngoscopy, may predict patients at high risk for aspiration. In clinical scenarios where more complete assessments of aspiration risk are immediately impossible or impractical, the Murray secretion scale grade may add valuable information to assist in clinical decision-making in patients with dysphagia.

Evaluation of the Buckeye Crossbuck at public, passive railroad/highway grade crossings in Ohio.

DOT National Transportation Integrated Search

2000-12-01

Two new crossbuck designs for use at passive Railroad/Highway Grade Crossings (RRX) were evaluated. The Standard Improved and the Buckeye crossbuck were evaluated on a state-wide basis in Ohio with respect to their potential to alter driver risk taki...

[Development of a standardized evaluation system for cataracta complicata in retinitis pigmentosa].

PubMed

Auffarth, G U; Faller, U; Tetz, M R; Krastel, H; Völcker, H E

1997-07-01

Retinitis pigmentosa (RP) is associated with the formation of a posterior subcapsular cataract (PSC). As only a small part of the crystalline lens is usually affected, it is sometimes difficult to determine to what extent the visual loss is caused by the PSC alone. The methodology was developed in analogy to a scoring system for posterior capsule opacification by Tetz et al. Following dilation of the pupil, standardized photographs of the anterior segments were obtained utilizing a Zeiss photoslitlamp model 40 SL/P. The PSC was scored by evaluating retroillumination photographs. The individual PSC index was calculated by multiplying the density of the opacification (graded from 0 to 4) by the area involved in the central 4 mm zone of the pupil (calculated between 0 and 1). For testing the reliability of the evaluation system in part 1 of this study, 11 RP patients with different grades of PSC were examined by three independent observers. In part 2 of this study 37 eyes of 24 RP patients, aged 47.2 +/- 11.8 years, were evaluated and the PSC index was correlated with different parameters (visual acuity, age, visual fields, eletroretinography). RESULTS PART 1: The cataract-density grades were between 1 and 4 in the 11 patients. In relation to the central 4-mm pupillary zone between 13 and 100% of the area were opacified. Cataract indices (density x area) were between 0.13 and 4.0 (Mean values: Examiner 1:1.41 +/- 1.49; Examiner 2:1.28 +/- 1.46; Examiner 3:1.22 +/- 1.44; differences not significant: P = 0.77). PART 2: After an average duration of RP of 23 years, the average cataract index of the 24 patients was 1.72 +/- 1.35. There was no correlation between cataract index and ERG or visual fields (r < 0.2; P > 0.4); however, there was a good correlation to visual acuity (r = -0.72; P = 0.0001). Patients with early onset of RP (before 20th year of life) presented on average with an higher cataract index (2.06 +/- 1.67) compared to patients with late manifestation (0.61 +/- 0.44), but equivalent duration of RP. The evaluation system offers a reliable and reproducible method for measuring PSC density and extension in RP patients. The method can serve as a useful tool for documenting PSC development and help to define the indications for cataract surgery in RP.

Comparison of Different Methods of Grading a Level Turn Task on a Flight Simulator

NASA Technical Reports Server (NTRS)

Heath, Bruce E.; Crier, tomyka

2003-01-01

With the advancements in the computing power of personal computers, pc-based flight simulators and trainers have opened new avenues in the training of airplane pilots. It may be desirable to have the flight simulator make a quantitative evaluation of the progress of a pilot's training thereby reducing the physical requirement of the flight instructor who must, in turn, watch every flight. In an experiment, University students conducted six different flights, each consisting of two level turns. The flights were three minutes in duration. By evaluating videotapes, two certified flight instructors provided separate letter grades for each turn. These level turns were also evaluated using two other computer based grading methods. One method determined automated grades based on prescribed tolerances in bank angle, airspeed and altitude. The other method used was deviations in altitude and bank angle for performance index and performance grades.

Evaluating Sermons: The Function of Grades in Teaching Preaching

ERIC Educational Resources Information Center

Helsel, Carolyn Browning

2017-01-01

What are grades doing in a homiletics classroom? This article traces the function of grades through the broader history of the educational system in the United States and then makes suggestions for how grades can be used more effectively in teaching preaching. Beginning in the nineteenth century, teachers used grades to rank and motivate students,…

The effects of massage therapy in hospitalized preterm neonates: A systematic review.

PubMed

Álvarez, María José; Fernández, Daniel; Gómez-Salgado, Juan; Rodríguez-González, Dolores; Rosón, María; Lapeña, Santiago

2017-04-01

The aim of this study was to perform a systematic review to identify, evaluate and summarise studies on the administration of therapeutic massage to preterm neonates during their stay in the NICU, and to assess their methodological quality. systematic review following PRISMA statements guidelines. A comprehensive search was performed including relevant articles between January 2004 and December 2013, using the following electronic databases: Medline, PEDro, Web of Science and Scopus. Two reviewers conducted a review of the selected articles: one evaluated the methodological quality of the studies and performed data extraction and the other performed a cross-check. Divergences of opinion were resolved by discussion with a third reviewer. The studies reviewed implemented a wide variety of interventions and evaluation methods, and therefore it was not possible to perform a meta-analysis. The following data were extracted from each article: year of publication, study design, participants and main measurements of outcomes obtained through the intervention. A non-quantitative synthesis of the extracted data was performed. Level of evidence was graded using the Jadad Scale. A total of 23 articles met the inclusion criteria and were thus included in the review; these presented a methodological quality ranging from 1 to 5 points (with a mean of 3 points). Most studies reported that the administration of various forms of therapeutic massage exerted a beneficial effect on factors related to the growth of preterm infants. The causes indicated by the researchers for these anthropometric benefits included increased vagal activity, increased gastric activity and increased serum insulin levels. Other demonstrated benefits of massage therapy when administered to hospitalised preterm infants included better neurodevelopment, a positive effect on brain development, a reduced risk of neonatal sepsis, a reduction in length of hospital stay and reduced neonatal stress. Although based on a qualitative analysis of heterogeneous data, the present review suggests that a clear benefit is obtained from the administration of massage therapy in hospitalised preterm infants, a finding which should encourage the more generalised use of massotherapy in NICU clinical practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

RMP Evaluations, Course Easiness, and Grades: Are They Related?

ERIC Educational Resources Information Center

Rizvi, Syed A.

2015-01-01

This paper investigates the relationship between the student evaluations of the instructors at the RateMyProfessors.com (RMP) website and the average grades awarded by those instructors. As of Spring 2012, the RMP site included evaluations of 538 full-and part-time instructors at the College of Staten Island (CSI). We selected the evaluations of…

Re-evaluation of Second Grade, Revised MANS Tests. Evaluation Report 7-B-4. Extended Pilot Trial of the Comprehensive School Mathematics Program.

ERIC Educational Resources Information Center

Herbert, Martin

The Comprehensive School Mathematics Program (CSMP) is a program of CEMREL, Inc., one of the national educational laboratories, and was funded by the National Institute of Education (NIE). Its primary purpose is the development of curriculum materials for kindergarten through grade 6. This study compared CSMP and non-CSMP second-grade students'…

Cytological grading of canine cutaneous mast cell tumours.

PubMed

Scarpa, Filippo; Sabattini, Silvia; Bettini, Giuliano

2016-09-01

A cytological grading for mast cell tumours (MCTs) would be highly desirable, allowing to select the most appropriate therapeutic intervention prior to surgery. This study evaluates the applicability on fine-needle aspirations (FNAs) of the novel Kiupel grading system, based on number of mitoses, multinucleated cells, bizarre nuclei and presence of karyomegaly. Fifty consecutive cases with pre-operative cytological diagnosis were included. In cytological specimens, approximately 1000 cells were evaluated, and the histological grade was assessed on the corresponding resected specimens. On cytology, the above parameters were significantly different between histologically low-grade and high-grade tumours (P < 0.001). The cytograding correctly predicted the histological grade in 47 cases (accuracy, 94%; sensitivity, 84.6%; specificity, 97.3%). Two high-grade MCTs (4%) were not detected on cytology. The cytograding can provide helpful insights to assist clinical decisions in most cases. However, the risk of underestimation in a minority of patients represents a limit to the overall utility of the technique. © 2014 John Wiley & Sons Ltd.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 6: how to assess relevance of the data.

PubMed

Noyes, Jane; Booth, Andrew; Lewin, Simon; Carlsen, Benedicte; Glenton, Claire; Colvin, Christopher J; Garside, Ruth; Bohren, Meghan A; Rashidian, Arash; Wainwright, Megan; Tunςalp, Özge; Chandler, Jacqueline; Flottorp, Signe; Pantoja, Tomas; Tucker, Joseph D; Munthe-Kaas, Heather

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's relevance component. We developed the relevance component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual relevance component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define relevance as the extent to which the body of data from the primary studies supporting a review finding is applicable to the context (perspective or population, phenomenon of interest, setting) specified in the review question. In this paper, we describe the relevance component and its rationale and offer guidance on how to assess relevance in the context of a review finding. This guidance outlines the information required to assess relevance, the steps that need to be taken to assess relevance and examples of relevance assessments. This paper provides guidance for review authors and others on undertaking an assessment of relevance in the context of the CERQual approach. Assessing the relevance component requires consideration of potentially important contextual factors at an early stage in the review process. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 4: how to assess coherence.

PubMed

Colvin, Christopher J; Garside, Ruth; Wainwright, Megan; Munthe-Kaas, Heather; Glenton, Claire; Bohren, Meghan A; Carlsen, Benedicte; Tunçalp, Özge; Noyes, Jane; Booth, Andrew; Rashidian, Arash; Flottorp, Signe; Lewin, Simon

2018-01-25

The GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE working group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) relevance, (3) coherence and (4) adequacy of data. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's coherence component. We developed the coherence component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual coherence component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define coherence as how clear and cogent the fit is between the data from the primary studies and a review finding that synthesises that data. In this paper, we describe the coherence component and its rationale and offer guidance on how to assess coherence in the context of a review finding as part of the CERQual approach. This guidance outlines the information required to assess coherence, the steps that need to be taken to assess coherence and examples of coherence assessments. This paper provides guidance for review authors and others on undertaking an assessment of coherence in the context of the CERQual approach. We suggest that threats to coherence may arise when the data supporting a review finding are contradictory, ambiguous or incomplete or where competing theories exist that could be used to synthesise the data. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.

The effects of sleep loss on young drivers’ performance: A systematic review

PubMed Central

Smith, Simon S.

2017-01-01

Young drivers (18–24 years) are over-represented in sleep-related crashes (comprising one in five fatal crashes in developed countries) primarily due to decreased sleep opportunity, lower tolerance for sleep loss, and ongoing maturation of brain areas associated with driving-related decision making. Impaired driving performance is the proximal reason for most car crashes. There is still a limited body of evidence examining the effects of sleep loss on young drivers’ performance, with discrepancies in the methodologies used, and in the definition of outcomes. This study aimed to identify the direction and magnitude of the effects of sleep loss on young drivers’ performance, and to appraise the quality of current evidence via a systematic review. Based on the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) approach, 16 eligible studies were selected for review, and their findings summarised. Next, critical elements of these studies were identified, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines augmented to rate those elements. Using those criteria, the quality of individual papers was calculated and the overall body of evidence for each driving outcome were assigned a quality ranking (from ‘very low’ to ‘high-quality’). Two metrics, the standard deviation of lateral position and number of line crossings, were commonly reported outcomes (although in an overall ‘low-quality’ body of evidence), with significant impairments after sleep loss identified in 50% of studies. While speed-related outcomes and crash events (also with very low- quality evidence) both increased under chronic sleep loss, discrepant findings were reported under conditions of acute total sleep deprivation. It is crucial to obtain more reliable data about the effects of sleep loss on young drivers’ performance by using higher quality experimental designs, adopting common protocols, and the use of consistent metrics and reporting of findings based on GRADE criteria and the PRISMA statement. Key words: Young drivers, sleep loss, driving performance, PRISMA, the GRADE, systematic review. PMID:28859144

The effects of sleep loss on young drivers' performance: A systematic review.

PubMed

Shekari Soleimanloo, Shamsi; White, Melanie J; Garcia-Hansen, Veronica; Smith, Simon S

2017-01-01

Young drivers (18-24 years) are over-represented in sleep-related crashes (comprising one in five fatal crashes in developed countries) primarily due to decreased sleep opportunity, lower tolerance for sleep loss, and ongoing maturation of brain areas associated with driving-related decision making. Impaired driving performance is the proximal reason for most car crashes. There is still a limited body of evidence examining the effects of sleep loss on young drivers' performance, with discrepancies in the methodologies used, and in the definition of outcomes. This study aimed to identify the direction and magnitude of the effects of sleep loss on young drivers' performance, and to appraise the quality of current evidence via a systematic review. Based on the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) approach, 16 eligible studies were selected for review, and their findings summarised. Next, critical elements of these studies were identified, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines augmented to rate those elements. Using those criteria, the quality of individual papers was calculated and the overall body of evidence for each driving outcome were assigned a quality ranking (from 'very low' to 'high-quality'). Two metrics, the standard deviation of lateral position and number of line crossings, were commonly reported outcomes (although in an overall 'low-quality' body of evidence), with significant impairments after sleep loss identified in 50% of studies. While speed-related outcomes and crash events (also with very low- quality evidence) both increased under chronic sleep loss, discrepant findings were reported under conditions of acute total sleep deprivation. It is crucial to obtain more reliable data about the effects of sleep loss on young drivers' performance by using higher quality experimental designs, adopting common protocols, and the use of consistent metrics and reporting of findings based on GRADE criteria and the PRISMA statement. Key words: Young drivers, sleep loss, driving performance, PRISMA, the GRADE, systematic review.

C2 nerve root on magnetic resonance imaging of occipital neuralgia.

PubMed

Yi, Minkyung; Lee, Joon Woo; Yeom, Jin S; Joe, Eugene; Hong, Sung Hwan; Lee, Guen Young; Kang, Heung Sik

2014-06-01

Review and grade the morphology of the C1-C2 neural foramina, from the MR images of patients who underwent C1-C2 spinal surgery, and determine the relationship with ON. To evaluate the feasibility of MRI for C1-C2 neural foramen evaluation with a new grading system and to correlate the C1-C2 neural foramen grade with ON. There have been no MRI studies of patients with and without ON in relation to C2 nerve root ganglion findings. Among the registry of 124 patients who underwent C1-C2 spinal surgery between July 2004 and May 2012 in Seoul National University Bundang Hospital, we enrolled 101 patients who had information about ON and a relevant preoperative cervical spine MR image. A total of 202 neural foramina were evaluated with our new C1-C2 neural foramen grading system (grade, 0-3) using consensus reading by 2 experienced radiologists who were blinded to the clinical information. The relationship between the C1-C2 grading system and ON was assessed using a χ test and Fisher exact test. Inter- and intraobserver reliability agreement was assessed using the κ statistic. All C1-C2 neural foramina were delineated on T2 parasagittal images. Among 202 C1-C2 neural foramina, grade zero was found in 49 foramina (24.3%), grade 1 in 95 (47.0%), grade 2 in 30 (14.9%), and grade 3 in 28 (13.9%). Grade 1 stenosis was most frequently noted. The grade 2 group had the most frequent prevalence of ON (43.3%), followed by grade 3 (35.7%), grade zero (30.6%), and grade 1 (29.5%). However, the relationship between the grade and ON was not statistically significant. Inter- and intraobserver agreements were substantially high. C1-C2 neural foramina can be depicted on MR image. However, the relationship between the new grading system for C1-C2 neural foramina and ON was not statistically significant. 4.

Long-Term Performance of Readers Trained in Grading Crohn Disease Activity Using MRI.

PubMed

Puylaert, Carl A J; Tielbeek, Jeroen A W; Bipat, Shandra; Boellaard, Thierry N; Nio, C Yung; Stoker, Jaap

2016-12-01

We aim to evaluate the long-term performance of readers who had participated in previous magnetic resonance imaging (MRI) reader training in grading Crohn disease activity. Fourteen readers (8 women; 12 radiologists, 2 residents; mean age 40; range 31-59), who had participated in a previous MRI reader training, participated in a follow-up evaluation after a mean interval of 29 months (range 25-34 months). Follow-up evaluation comprised 25 MRI cases of suspected or known Crohn disease patients with direct feedback; cases were identical to the evaluation set used in the initial reader training (of which readers were unaware). Grading accuracy, overstaging, and understaging were compared between training and follow-up using a consensus score by two experienced abdominal radiologists as the reference standard. In the follow-up evaluation, overall grading accuracy was 73% (95% confidence interval [CI]: 62%-81%), which was comparable to reader training grading accuracy (72%, 95% CI: 61%-80%) (P = .66). Overstaging decreased significantly from 19% (95% CI: 12%-27%) to 13% (95% CI: 8%-21%) between training and follow-up (P = .03), whereas understaging increased significantly from 9% (95% CI: 4%-21%) to 14% (95% CI: 7%-26%) (P < .01). Readers have consistent long-term accuracy for grading Crohn disease activity after case-based reader training with direct feedback. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Solar energy program evaluation: an introduction

DOE Office of Scientific and Technical Information (OSTI.GOV)

deLeon, P.

The Program Evaluation Methodology provides an overview of the practice and methodology of program evaluation and defines more precisely the evaluation techniques and methodologies that would be most appropriate to government organizations which are actively involved in the research, development, and commercialization of solar energy systems. Formal evaluation cannot be treated as a single methodological approach for assessing a program. There are four basic types of evaluation designs - the pre-experimental design; the quasi-experimental design based on time series; the quasi-experimental design based on comparison groups; and the true experimental design. This report is organized to first introduce the rolemore » and issues of evaluation. This is to provide a set of issues to organize the subsequent sections detailing the national solar energy programs. Then, these two themes are integrated by examining the evaluation strategies and methodologies tailored to fit the particular needs of the various individual solar energy programs. (MCW)« less

Identifying models of delivery, care domains and quality indicators relevant to palliative day services: a scoping review protocol.

PubMed

O'Connor, Seán R; Dempster, Martin; McCorry, Noleen K

2017-05-16

With an ageing population and increasing numbers of people with life-limiting illness, there is a growing demand for palliative day services. There is a need to measure and demonstrate the quality of these services, but there is currently little agreement on which aspects of care should be used to do this. The aim of the scoping review will be to map the extent, range and nature of the evidence around models of delivery, care domains and existing quality indicators used to evaluate palliative day services. Electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials) will be searched for evidence using consensus development methods; randomised or quasi-randomised controlled trials; mixed methods; and prospective, longitudinal or retrospective case-control studies to develop or test quality indicators for evaluating palliative care within non-residential settings, including day hospices and community or primary care settings. At least two researchers will independently conduct all searches, study selection and data abstraction procedures. Meta-analyses and statistical methods of synthesis are not planned as part of the review. Results will be reported using numerical counts, including number of indicators in each care domain and by using qualitative approach to describe important indicator characteristics. A conceptual model will also be developed to summarise the impact of different aspects of quality in a palliative day service context. Methodological quality relating to indicator development will be assessed using the Appraisal of Indicators through Research and Evaluation (AIRE) tool. Overall strength of evidence will be assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Final decisions on quality assessment will be made via consensus between review authors. Identifying, developing and implementing evidence-based quality indicators is critical to the evaluation and continued improvement of palliative care. Review findings will be used to support clinicians and policymakers make decisions on which quality indicators are most appropriate for evaluating day services at the patient and service level, and to identify areas for further research.

[Clinical Practice Guidelines for Management of Schizophrenia: Evaluation Using AGREE II].

PubMed

de la Hoz Bradford, Ana María; Ávila, Mauricio J; Bohórquez Peñaranda, Adriana Patricia; García Valencia, Jenny; Arenas Borrero, Álvaro Enrique; Vélez Traslaviña, Ángela; Jaramillo González, Luis Eduardo; Gómez-Restrepo, Carlos

2014-01-01

Colombia is developing multiple national practice guidelines from a range of diseases. Clinical practice guidelines represent a very useful tool to be able to take decision over a patient care that is widely available for the clinician. In psychiatry there are a good number of international clinical guidelines for the treatment of schizophrenia nevertheless there is no article that evaluate them scientifically In the settings of developing a Colombian schizophrenia practice guideline, a systematic search was performed in multiple databases and the results were then evaluated by two trained persons. We present the results globally and by domains. We found 164 matches for possible guidelines. After screening 7 guidelines were evaluated with the AGREE II instrument. Globally and by the different domains, the National Institute for Health and Care Excellence (NICE) was the guideline that got the best score. From the guidelines that were reviewed, 4 were from Europe and only 2 were from Latin America. None of the guidelines used GRADE methodology for the recommendations. The diversity of the schizophrenia treatment guidelines does not allow an easy adoption of the recommendation by a psychiatrist in Colombia. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Is There a European View on Health Economic Evaluations? Results from a Synopsis of Methodological Guidelines Used in the EUnetHTA Partner Countries.

PubMed

Heintz, Emelie; Gerber-Grote, Andreas; Ghabri, Salah; Hamers, Francoise F; Rupel, Valentina Prevolnik; Slabe-Erker, Renata; Davidson, Thomas

2016-01-01

The objectives of this study were to review current methodological guidelines for economic evaluations of all types of technologies in the 33 countries with organizations involved in the European Network for Health Technology Assessment (EUnetHTA), and to provide a general framework for economic evaluation at a European level. Methodological guidelines for health economic evaluations used by EUnetHTA partners were collected through a survey. Information from each guideline was extracted using a pre-tested extraction template. On the basis of the extracted information, a summary describing the methods used by the EUnetHTA countries was written for each methodological item. General recommendations were formulated for methodological issues where the guidelines of the EUnetHTA partners were in agreement or where the usefulness of economic evaluations may be increased by presenting the results in a specific way. At least one contact person from all 33 EUnetHTA countries (100 %) responded to the survey. In total, the review included 51 guidelines, representing 25 countries (eight countries had no methodological guideline for health economic evaluations). On the basis of the results of the extracted information from all 51 guidelines, EUnetHTA issued ten main recommendations for health economic evaluations. The presented review of methodological guidelines for health economic evaluations and the consequent recommendations will hopefully improve the comparability, transferability and overall usefulness of economic evaluations performed within EUnetHTA. Nevertheless, there are still methodological issues that need to be investigated further.

Evaluation of the Buckeye Crossbuck at public, passive railroad/highway grade crossings in Ohio : executive summary.

DOT National Transportation Integrated Search

2000-12-01

Two new crossbuck designs for use at passive Railroad/Highway Grade Crossings (RRX) were evaluated. : The Standard Improved and the Buckeye crossbuck were evaluated on a state-wide basis in Ohio with : respect to their potential to alter driver risk ...

Materials Selection Criteria for Nuclear Power Applications: A Decision Algorithm

NASA Astrophysics Data System (ADS)

Rodríguez-Prieto, Álvaro; Camacho, Ana María; Sebastián, Miguel Ángel

2016-02-01

An innovative methodology based on stringency levels is proposed in this paper and improves the current selection method for structural materials used in demanding industrial applications. This paper describes a new approach for quantifying the stringency of materials requirements based on a novel deterministic algorithm to prevent potential failures. We have applied the new methodology to different standardized specifications used in pressure vessels design, such as SA-533 Grade B Cl.1, SA-508 Cl.3 (issued by the American Society of Mechanical Engineers), DIN 20MnMoNi55 (issued by the German Institute of Standardization) and 16MND5 (issued by the French Nuclear Commission) specifications and determine the influence of design code selection. This study is based on key scientific publications on the influence of chemical composition on the mechanical behavior of materials, which were not considered when the technological requirements were established in the aforementioned specifications. For this purpose, a new method to quantify the efficacy of each standard has been developed using a deterministic algorithm. The process of assigning relative weights was performed by consulting a panel of experts in materials selection for reactor pressure vessels to provide a more objective methodology; thus, the resulting mathematical calculations for quantitative analysis are greatly simplified. The final results show that steel DIN 20MnMoNi55 is the best material option. Additionally, more recently developed materials such as DIN 20MnMoNi55, 16MND5 and SA-508 Cl.3 exhibit mechanical requirements more stringent than SA-533 Grade B Cl.1. The methodology presented in this paper can be used as a decision tool in selection of materials for a wide range of applications.

Influence of "Halo" and "Demon" Effects in Subjective Grading.

ERIC Educational Resources Information Center

Gibb, Gerald D.

1983-01-01

The phenomenon of "halo" effects in subjective grading was investigated. Two groups of three raters evaluated 20 term papers in introductory psychology. Term paper grades correlated significantly with course grades when information about previous academic performance was made available. When this information was not available, the…

Student Perspectives of Grading in Physical Education

ERIC Educational Resources Information Center

Zhu, Xihe

2015-01-01

Recent state and federal legislations on educational accountability push evaluation and grading to the frontline. This study examined students' perspectives of grading in physical education. The participants included students (N = 39) from two middle schools. Data were collected through observation, student profile grading sheets and interviews.…

Applying DOE's Graded Approach for assessing radiation impacts to non-human biota at the INL.

PubMed

Morris, Randall C

2006-01-01

In July 2002, The US Department of Energy (DOE) released a new technical standard entitled A Graded Approach for Evaluating Radiation Doses to Aquatic and Terrestrial Biota. DOE facilities are annually required to demonstrate that routine radioactive releases from their sites are protective of non-human receptors and sites are encouraged to use the Graded Approach for this purpose. Use of the Graded Approach requires completion of several preliminary steps, to evaluate the degree to which the site environmental monitoring program is appropriate for evaluating impacts to non-human biota. We completed these necessary activities at the Idaho National Laboratory (INL) using the following four tasks: (1) develop conceptual models and evaluate exposure pathways; (2) define INL evaluation areas; (3) evaluate sampling locations and media; (4) evaluate data gaps. All of the information developed in the four steps was incorporated, data sources were identified, departures from the Graded Approach were justified, and a step-by-step procedure for biota dose assessment at the INL was specified. Finally, we completed a site-wide biota dose assessment using the 2002 environmental surveillance data and an offsite assessment using soil and surface water data collected since 1996. These assessments demonstrated the environmental concentrations of radionuclides measured on and near the INL do not present significant risks to populations of non-human biota.

Evaluation du programme d'etudes de francais langue seconde en immersion a la 6e annee. La comprehension orale et la production orale, 1990. Rapport Final. (Evaluation of French as a Second Language Study Program for Grade Six Immersion. Oral Comprehension and Speaking Skills, 1990. Final Report).

ERIC Educational Resources Information Center

Theberge, Raymond

An evaluation of Manitoba's French immersion programs at the levels of grades 3, 6, and 9 focused on program effectiveness in teaching listening comprehension and speech skills. The results for grade 6 are presented here. The first section describes the framework of the immersion curriculum and the listening and oral skills targeted in it. The…

Evidence supporting see-and-treat management of cervical intraepithelial neoplasia: a systematic review and meta-analysis.

PubMed

Ebisch, R M F; Rovers, M M; Bosgraaf, R P; van der Pluijm-Schouten, H W; Melchers, W J G; van den Akker, P A J; Massuger, L F A G; Bekkers, R L M

2016-01-01

Studies of see-and-treat management of cervical intraepithelial neoplasia (CIN) vary in their inclusion criteria, resulting in a broad range of overtreatment rates. To determine overtreatment rates in see-and-treat management of women referred for colposcopy because of suspected CIN, in order to define circumstances supporting see-and-treat management. MEDLINE, EMBASE, and the Cochrane Library were searched from inception up to 12 May 2014. Studies of see-and-treat management in women with a reported cervical smear result, colposcopic impression, and histology result were included. Methodological quality was assessed with the Newcastle-Ottawa scale. We used the inverse variance method for pooling incidences, and a random-effects model was used to account for heterogeneity between studies. Overtreatment was defined as treatment in patients with no CIN or CIN1. Thirteen studies (n = 4611) were included. The overall overtreatment rate in women with a high-grade cervical smear and a high-grade colposcopic impression was 11.6% (95% CI 7.8-15.3%). The overtreatment rate in women with a high-grade cervical smear and low-grade colposcopic impression was 29.3% (95% CI 16.7-41.9%), and in the case of a low-grade smear and high-grade colposcopic impression it was 46.4% (95% CI 15.7-77.1%). In women with a low-grade smear and low-grade colposcopic impression, the overtreatment rate was 72.9% (95% CI 68.1-77.7%). The pooled overtreatment rate in women with a high-grade smear and high-grade colposcopic impression is at least comparable with the two-step procedure, which supports the use of see-and-treat management in this subgroup of women. See-and-treat management is justified in the case of a high-grade smear and a high-grade colposcopic impression. © 2015 Royal College of Obstetricians and Gynaecologists.

The Multimodal Brain Tumor Image Segmentation Benchmark (BRATS).

PubMed

Menze, Bjoern H; Jakab, Andras; Bauer, Stefan; Kalpathy-Cramer, Jayashree; Farahani, Keyvan; Kirby, Justin; Burren, Yuliya; Porz, Nicole; Slotboom, Johannes; Wiest, Roland; Lanczi, Levente; Gerstner, Elizabeth; Weber, Marc-André; Arbel, Tal; Avants, Brian B; Ayache, Nicholas; Buendia, Patricia; Collins, D Louis; Cordier, Nicolas; Corso, Jason J; Criminisi, Antonio; Das, Tilak; Delingette, Hervé; Demiralp, Çağatay; Durst, Christopher R; Dojat, Michel; Doyle, Senan; Festa, Joana; Forbes, Florence; Geremia, Ezequiel; Glocker, Ben; Golland, Polina; Guo, Xiaotao; Hamamci, Andac; Iftekharuddin, Khan M; Jena, Raj; John, Nigel M; Konukoglu, Ender; Lashkari, Danial; Mariz, José Antonió; Meier, Raphael; Pereira, Sérgio; Precup, Doina; Price, Stephen J; Raviv, Tammy Riklin; Reza, Syed M S; Ryan, Michael; Sarikaya, Duygu; Schwartz, Lawrence; Shin, Hoo-Chang; Shotton, Jamie; Silva, Carlos A; Sousa, Nuno; Subbanna, Nagesh K; Szekely, Gabor; Taylor, Thomas J; Thomas, Owen M; Tustison, Nicholas J; Unal, Gozde; Vasseur, Flor; Wintermark, Max; Ye, Dong Hye; Zhao, Liang; Zhao, Binsheng; Zikic, Darko; Prastawa, Marcel; Reyes, Mauricio; Van Leemput, Koen

2015-10-01

In this paper we report the set-up and results of the Multimodal Brain Tumor Image Segmentation Benchmark (BRATS) organized in conjunction with the MICCAI 2012 and 2013 conferences. Twenty state-of-the-art tumor segmentation algorithms were applied to a set of 65 multi-contrast MR scans of low- and high-grade glioma patients-manually annotated by up to four raters-and to 65 comparable scans generated using tumor image simulation software. Quantitative evaluations revealed considerable disagreement between the human raters in segmenting various tumor sub-regions (Dice scores in the range 74%-85%), illustrating the difficulty of this task. We found that different algorithms worked best for different sub-regions (reaching performance comparable to human inter-rater variability), but that no single algorithm ranked in the top for all sub-regions simultaneously. Fusing several good algorithms using a hierarchical majority vote yielded segmentations that consistently ranked above all individual algorithms, indicating remaining opportunities for further methodological improvements. The BRATS image data and manual annotations continue to be publicly available through an online evaluation system as an ongoing benchmarking resource.

The Multimodal Brain Tumor Image Segmentation Benchmark (BRATS)

PubMed Central

Jakab, Andras; Bauer, Stefan; Kalpathy-Cramer, Jayashree; Farahani, Keyvan; Kirby, Justin; Burren, Yuliya; Porz, Nicole; Slotboom, Johannes; Wiest, Roland; Lanczi, Levente; Gerstner, Elizabeth; Weber, Marc-André; Arbel, Tal; Avants, Brian B.; Ayache, Nicholas; Buendia, Patricia; Collins, D. Louis; Cordier, Nicolas; Corso, Jason J.; Criminisi, Antonio; Das, Tilak; Delingette, Hervé; Demiralp, Çağatay; Durst, Christopher R.; Dojat, Michel; Doyle, Senan; Festa, Joana; Forbes, Florence; Geremia, Ezequiel; Glocker, Ben; Golland, Polina; Guo, Xiaotao; Hamamci, Andac; Iftekharuddin, Khan M.; Jena, Raj; John, Nigel M.; Konukoglu, Ender; Lashkari, Danial; Mariz, José António; Meier, Raphael; Pereira, Sérgio; Precup, Doina; Price, Stephen J.; Raviv, Tammy Riklin; Reza, Syed M. S.; Ryan, Michael; Sarikaya, Duygu; Schwartz, Lawrence; Shin, Hoo-Chang; Shotton, Jamie; Silva, Carlos A.; Sousa, Nuno; Subbanna, Nagesh K.; Szekely, Gabor; Taylor, Thomas J.; Thomas, Owen M.; Tustison, Nicholas J.; Unal, Gozde; Vasseur, Flor; Wintermark, Max; Ye, Dong Hye; Zhao, Liang; Zhao, Binsheng; Zikic, Darko; Prastawa, Marcel; Reyes, Mauricio; Van Leemput, Koen

2016-01-01

In this paper we report the set-up and results of the Multimodal Brain Tumor Image Segmentation Benchmark (BRATS) organized in conjunction with the MICCAI 2012 and 2013 conferences. Twenty state-of-the-art tumor segmentation algorithms were applied to a set of 65 multi-contrast MR scans of low- and high-grade glioma patients—manually annotated by up to four raters—and to 65 comparable scans generated using tumor image simulation software. Quantitative evaluations revealed considerable disagreement between the human raters in segmenting various tumor sub-regions (Dice scores in the range 74%–85%), illustrating the difficulty of this task. We found that different algorithms worked best for different sub-regions (reaching performance comparable to human inter-rater variability), but that no single algorithm ranked in the top for all sub-regions simultaneously. Fusing several good algorithms using a hierarchical majority vote yielded segmentations that consistently ranked above all individual algorithms, indicating remaining opportunities for further methodological improvements. The BRATS image data and manual annotations continue to be publicly available through an online evaluation system as an ongoing benchmarking resource. PMID:25494501

Satisfactory arterial repair 1 year after ultrathin strut biodegradable polymer sirolimus-eluting stent implantation: an angioscopic observation.

PubMed

Ishihara, Takayuki; Awata, Masaki; Iida, Osamu; Fujita, Masashi; Masuda, Masaharu; Okamoto, Shin; Nanto, Kiyonori; Kanda, Takashi; Tsujimura, Takuya; Uematsu, Masaaki; Mano, Toshiaki

2018-01-15

The ultrathin strut biodegradable polymer sirolimus-eluting stent (Orsiro, O-SES) exhibits satisfactory clinical outcomes. However, no report to date has documented the intravascular status of artery repair after O-SES implantation. We examined 5 O-SES placed in 4 patients (age 65 ± 12 years, male 75%) presenting with stable angina pectoris due to de novo lesions in native coronary arteries. Coronary angioscopy was performed immediately after percutaneous coronary intervention and 1 year later. Angioscopic images were analyzed to determine the following: (1) dominant grade of neointimal coverage (NIC) over the stent; (2) maximum yellow plaque grade; and (3) existence of thrombus. Yellow plaque grade was evaluated both immediately after stent implantation and at the time of follow-up observation. The other parameters were evaluated at the time of follow-up examination. NIC was graded as: grade 0, stent struts exposed; grade 1, struts bulging into the lumen, although covered; grade 2, struts embedded in the neointima, but translucent; grade 3, struts fully embedded and invisible. Yellow plaque severity was graded as: grade 0, white; grade 1, light yellow; grade 2, yellow; and grade 3, intensive yellow. Angioscopic findings at 1 year demonstrated the following: dominant NIC grade 1, grade 2, and grade 3 in 1, 2, and 2 stents, respectively; all stents were covered to some extent; focal thrombus adhesion was observed in only 1 stent. Yellow plaque grade did not change from immediately after stent implantation to follow-up. O-SES demonstrated satisfactory arterial repair 1 year after implantation.

Student Behavior during a School Closure Caused by Pandemic Influenza A/H1N1

PubMed Central

Miller, Joel C.; Danon, Leon; O'Hagan, Justin J.; Goldstein, Edward; Lajous, Martin; Lipsitch, Marc

2010-01-01

Background Many schools were temporarily closed in response to outbreaks of the recently emerged pandemic influenza A/H1N1 virus. The effectiveness of closing schools to reduce transmission depends largely on student/family behavior during the closure. We sought to improve our understanding of these behaviors. Methodology/Principal Findings To characterize this behavior, we surveyed students in grades 9–12 and parents of students in grades 5–8 about student activities during a weeklong closure of a school during the first months after the disease emerged. We found significant interaction with the community and other students–though less interaction with other students than during school–with the level of interaction increasing with grade. Conclusions Our results are useful for the future design of social distancing policies and to improving the ability of modeling studies to accurately predict their impact. PMID:20463960

Results From Portugal's 2016 Report Card on Physical Activity for Children and Youth.

PubMed

Mota, Jorge; E Silva, Manuel Joâo Coelho; Raimundo, Armando M; Sardinha, Luís B

2016-11-01

This article describes the procedures and development of the first Portuguese Report Card on Physical Activity in Children and Adolescents. Comprehensive searches for data related to indicators of physical activity (PA) were completed by a committee of physical activity and sports specialists. Grades were assigned to each indicator consistent with the process and methodology outlined by the Active Healthy Kids Canada Report Card model. Nine indicators of PA were graded. The following grades were assigned: Overall Physical Activity Levels, D; Organized Sport Participation, B; Active Play, D; Active Transportation, C; Sedentary Behaviors, D; Family and Peers, C; Schools, B; Community and the Built Environment, D; and Government, C. Portuguese children and adolescents do not reach sufficient physical activity levels and spend larger amounts of time spent in sedentary behaviors compared with recommendations. Effective policies of PA promotion and implementation are needed in different domains of young people's daily lives.

A Phenomenology Study of First-Year Teachers Looking at the Shared Lived Experience of Learning to Grade

ERIC Educational Resources Information Center

Yost, Brandon Lee

2015-01-01

This study describes the phenomenon of how first-year teachers learn to evaluate students learning by (letter) grades. Grades seem simple enough; but in reality, each grade carries serious consequences with it--for either good or bad. For example, grades affect benefits/consequences at home; they affect placement in remedial or advanced courses;…

Characterizing the adoption of low-grade hardwood lumber by the secondary wood processing industry

Treesearch

Robert L. Smith; Wibke Pohle; Philip Araman; Dan Cumbo

2004-01-01

This study investigated the adoption of low-grade lumber in the secondary hardwood industry. Factors influencing decisions regarding the utilization of low-grade lumber were identified and value-added opportunities to increase the use of low-grade lumber among manufacturers currently using higher grades were evaluated. Data were collected via a nationwide mail survey...

Report on METHODS OF Evaluating Students at the University of California, Berkeley.

ERIC Educational Resources Information Center

Miller, Stuart

Several arguments are made for changing the present system of grading in college. The arguments deal with: (1) the negative effect of grading on the teaching situation--the system is capricious and variable and encourages "grade grubbing"; (2) the lack of accuracy and uniformity of grades; (3) the effect of grading, as an enforcer of the…

Fecal Microbiota Therapy for Clostridium difficile Infection: A Health Technology Assessment.

PubMed

2016-01-01

Fecal microbiota therapy is increasingly being used to treat patients with Clostridium difficile infection. This health technology assessment primarily evaluated the effectiveness and cost-effectiveness of fecal microbiota therapy compared with the usual treatment (antibiotic therapy). We performed a literature search using Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, CRD Health Technology Assessment Database, Cochrane Central Register of Controlled Trials, and NHS Economic Evaluation Database. For the economic review, we applied economic filters to these search results. We also searched the websites of agencies for other health technology assessments. We conducted a meta-analysis to analyze effectiveness. The quality of the body of evidence for each outcome was examined according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. Using a step-wise, structural methodology, we determined the overall quality to be high, moderate, low, or very low. We used a survey to examine physicians' perception of patients' lived experience, and a modified grounded theory method to analyze information from the survey. For the review of clinical effectiveness, 16 of 1,173 citations met the inclusion criteria. A meta-analysis of two randomized controlled trials found that fecal microbiota therapy significantly improved diarrhea associated with recurrent C. difficile infection versus treatment with vancomycin (relative risk 3.24, 95% confidence interval [CI] 1.85-5.68) (GRADE: moderate). While fecal microbiota therapy is not associated with a significant decrease in mortality compared with antibiotic therapy (relative risk 0.69, 95% CI 0.14-3.39) (GRADE: low), it is associated with a significant increase in adverse events (e.g., short-term diarrhea, relative risk 30.76, 95% CI 4.46-212.44; abdominal cramping, relative risk 14.81, 95% CI 2.07-105.97) (GRADE: low). For the value-for-money component, two of 151 economic evaluations met the inclusion criteria. One reported that fecal microbiota therapy was dominant (more effective and less expensive) compared with vancomycin; the other reported an incremental cost-effectiveness ratio of $17,016 USD per quality-adjusted life-year for fecal microbiota therapy compared with vancomycin. This ratio for the second study indicated that there would be additional cost associated with each recurrent C. difficile infection resolved. In Ontario, if fecal microbiota therapy were adopted to treat recurrent C. difficile infection, considering it from the perspective of the Ministry of Health and Long-Term Care as the payer, an estimated $1.5 million would be saved after the first year of adoption and $2.9 million after 3 years. The contradiction between the second economic evaluation and the savings we estimated may be a result of the lower cost of fecal microbiota therapy and hospitalization in Ontario compared with the cost of therapy used in the US model. Physicians reported that C. difficile infection significantly reduced patients' quality of life. Physicians saw fecal microbiota therapy as improving patients' quality of life because patients could resume daily activities. Physicians reported that their patients were happy with the procedures required to receive fecal microbiota therapy. In patients with recurrent C. difficile infection, fecal microbiota therapy improves outcomes that are important to patients and provides good value for money.

Fecal Microbiota Therapy for Clostridium difficile Infection: A Health Technology Assessment

PubMed Central

2016-01-01

Background Fecal microbiota therapy is increasingly being used to treat patients with Clostridium difficile infection. This health technology assessment primarily evaluated the effectiveness and cost-effectiveness of fecal microbiota therapy compared with the usual treatment (antibiotic therapy). Methods We performed a literature search using Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, CRD Health Technology Assessment Database, Cochrane Central Register of Controlled Trials, and NHS Economic Evaluation Database. For the economic review, we applied economic filters to these search results. We also searched the websites of agencies for other health technology assessments. We conducted a meta-analysis to analyze effectiveness. The quality of the body of evidence for each outcome was examined according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. Using a step-wise, structural methodology, we determined the overall quality to be high, moderate, low, or very low. We used a survey to examine physicians’ perception of patients’ lived experience, and a modified grounded theory method to analyze information from the survey. Results For the review of clinical effectiveness, 16 of 1,173 citations met the inclusion criteria. A meta-analysis of two randomized controlled trials found that fecal microbiota therapy significantly improved diarrhea associated with recurrent C. difficile infection versus treatment with vancomycin (relative risk 3.24, 95% confidence interval [CI] 1.85–5.68) (GRADE: moderate). While fecal microbiota therapy is not associated with a significant decrease in mortality compared with antibiotic therapy (relative risk 0.69, 95% CI 0.14–3.39) (GRADE: low), it is associated with a significant increase in adverse events (e.g., short-term diarrhea, relative risk 30.76, 95% CI 4.46–212.44; abdominal cramping, relative risk 14.81, 95% CI 2.07–105.97) (GRADE: low). For the value-for-money component, two of 151 economic evaluations met the inclusion criteria. One reported that fecal microbiota therapy was dominant (more effective and less expensive) compared with vancomycin; the other reported an incremental cost-effectiveness ratio of $17,016 USD per quality-adjusted life-year for fecal microbiota therapy compared with vancomycin. This ratio for the second study indicated that there would be additional cost associated with each recurrent C. difficile infection resolved. In Ontario, if fecal microbiota therapy were adopted to treat recurrent C. difficile infection, considering it from the perspective of the Ministry of Health and Long-Term Care as the payer, an estimated $1.5 million would be saved after the first year of adoption and $2.9 million after 3 years. The contradiction between the second economic evaluation and the savings we estimated may be a result of the lower cost of fecal microbiota therapy and hospitalization in Ontario compared with the cost of therapy used in the US model. Physicians reported that C. difficile infection significantly reduced patients’ quality of life. Physicians saw fecal microbiota therapy as improving patients’ quality of life because patients could resume daily activities. Physicians reported that their patients were happy with the procedures required to receive fecal microbiota therapy. Conclusions In patients with recurrent C. difficile infection, fecal microbiota therapy improves outcomes that are important to patients and provides good value for money. PMID:27516814

Methodology for AACT evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning.

PubMed

Gosselin, Sophie; Morris, Martin; Miller-Nesbitt, Andrea; Hoffman, Robert S; Hayes, Bryan D; Turgeon, Alexis F; Gilfix, Brian M; Grunbaum, Ami M; Bania, Theodore C; Thomas, Simon H L; Morais, José A; Graudins, Andis; Bailey, Benoit; Mégarbane, Bruno; Calello, Diane P; Levine, Michael; Stellpflug, Samuel J; Hoegberg, Lotte C G; Chuang, Ryan; Stork, Christine; Bhalla, Ashish; Rollins, Carol J; Lavergne, Valéry

2015-07-01

Intravenous lipid emulsion (ILE) therapy is a novel treatment that was discovered in the last decade. Despite unclear understanding of its mechanisms of action, numerous and diverse publications attested to its clinical use. However, current evidence supporting its use is unclear and recommendations are inconsistent. To assist clinicians in decision-making, the American Academy of Clinical Toxicology created a workgroup composed of international experts from various clinical specialties, which includes representatives of major clinical toxicology associations. Rigorous methodology using the Appraisal of Guidelines for Research and Evaluation or AGREE II instrument was developed to provide a framework for the systematic reviews for this project and to formulate evidence-based recommendations on the use of ILE in poisoning. Systematic reviews on the efficacy of ILE in local anesthetic toxicity and non-local anesthetic poisonings as well as adverse effects of ILE are planned. A comprehensive review of lipid analytical interferences and a survey of ILE costs will be developed. The evidence will be appraised using the GRADE system. A thorough and transparent process for consensus statements will be performed to provide recommendations, using a modified Delphi method with two rounds of voting. This process will allow for the production of useful practice recommendations for this therapy.

Canadian Cardiovascular Society position statement on the management of thoracic aortic disease.

PubMed

Boodhwani, Munir; Andelfinger, Gregor; Leipsic, Jonathon; Lindsay, Thomas; McMurtry, M Sean; Therrien, Judith; Siu, Samuel C

2014-06-01

This Canadian Cardiovascular Society position statement aims to provide succinct perspectives on key issues in the management of thoracic aortic disease (TAD). This document is not a comprehensive overview of TAD and important elements of the epidemiology, presentation, diagnosis, and management of acute aortic syndromes are deliberately not discussed; readers are referred to the 2010 guidelines published by the American Heart Association, American College of Cardiology, American Association for Thoracic Surgery, and other stakeholders. Rather, this document is a practical guide for clinicians managing adult patients with TAD. Topics covered include size thresholds for surgical intervention, emerging therapies, imaging modalities, medical and lifestyle management, and genetics of TAD. The primary panel consisted of experts from a variety of disciplines that are essential for comprehensive management of TAD patients. The methodology involved a focused literature review with an emphasis on updates since 2010 and the use of Grading of Recommendations Assessment, Development, and Evaluation methodology to arrive at specific recommendations. The final document then underwent review by a secondary panel. This document aims to provide recommendations for most patients and situations. However, the ultimate judgement regarding the management of any individual patients should be made by their health care team. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Locating, characterizing and minimizing sources of error for a paper case-based structured oral examination in a multi-campus clerkship.

PubMed

Kumar, A; Bridgham, R; Potts, M; Gushurst, C; Hamp, M; Passal, D

2001-01-01

To determine consistency of assessment in a new paper case-based structured oral examination in a multi-community pediatrics clerkship, and to identify correctable problems in the administration of examination and assessment process. Nine paper case-based oral examinations were audio-taped. From audio-tapes five community coordinators scored examiner behaviors and graded student performance. Correlations among examiner behaviors scores were examined. Graphs identified grading patterns of evaluators. The effect of exam-giving on evaluators was assessed by t-test. Reliability of grades was calculated and the effect of reducing assessment problems was modeled. Exam-givers differed most in their "teaching-guiding" behavior, and this negatively correlated with student grades. Exam reliability was lowered mainly by evaluator differences in leniency and grading pattern; less important was absence of standardization in cases. While grade reliability was low in early use of the paper case-based oral examination, modeling of plausible effects of training and monitoring for greater uniformity in administration of the examination and assigning scores suggests that more adequate reliabilities can be attained.

Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review.

PubMed

Pastora-Bernal, Jose Manuel; Martín-Valero, Rocio; Barón-López, Francisco Javier; Estebanez-Pérez, María José

2017-04-28

In addition to traditional physiotherapy, studies based on telerehabilitation programs have published the results of effectiveness, validity, noninferiority, and important advantages in some neurological, cognitive, and musculoskeletal disorders, providing an opportunity to define new social policies and interventions. The aim of this systematic review is to investigate the effects of telerehabilitation after surgical procedures on orthopedic conditions as well as to describe how interventions are designed and to determine whether telerehabilitation is comparable with conventional methods of delivery. This systematic review summarizes the levels of evidence and grades of recommendation regarding telerehabilitation intervention (synchronous or asynchronous provided via the telerehabilitation medium, either in conjunction with, or in isolation of, other treatment interventions) after surgical procedures on orthopedic conditions. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scores and grade of recommendation following the recommendation of the Oxford Centre for Evidence-Based Medicine. We found 3 studies with PEDro scores between 6 and 8, which is considered as level 1 evidence (good; 20% [3/15]), 4 studies with a score of 5, which is considered as level 2 evidence (acceptable; 27% [4/15]), and the remaining 8 studies had scores of 4 or less, which is considered (poor; 53% [8/15]). A total of 1316 participants received telerehabilitation intervention in the selected studies, where knee and hip replacement were 75% of all the studies. Strong and moderate grades of evidence (grade of recommendation A-B) were found in knee and hip replacement interventions. Studies on the upper limb were 25% of the studies, but only 1 study presented a moderate grade of evidence (grade of recommendation B) and the rest were of poor methodological quality with weak evidence (grade of recommendation C). Conclusive evidence on the efficacy of telerehabilitation for treatment after an orthopedic surgery, regardless of pathology, was not obtained. We found strong evidence in favor of telerehabilitation in patients following total knee and hip arthroplasty and limited evidence in the upper limb interventions (moderate and weak evidence). Future research needs to be more extensive and conclusive. To the best of the authors' knowledge, this is the first attempt at evaluating the quality of telerehabilitation intervention research after surgical procedures on orthopedic conditions in a systematic review. Clinical messages and future research recommendations are included in the review. ©Jose Manuel Pastora-Bernal, Rocio Martín-Valero, Francisco Javier Barón-López, María José Estebanez-Pérez. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.04.2017.

Management of acute exacerbations of chronic obstructive pulmonary disease (COPD). Guidelines from the Société de pneumologie de langue française (summary).

PubMed

Jouneau, S; Dres, M; Guerder, A; Bele, N; Bellocq, A; Bernady, A; Berne, G; Bourdin, A; Brinchault, G; Burgel, P R; Carlier, N; Chabot, F; Chavaillon, J M; Cittee, J; Claessens, Y E; Delclaux, B; Deslée, G; Ferré, A; Gacouin, A; Girault, C; Ghasarossian, C; Gouilly, P; Gut-Gobert, C; Gonzalez-Bermejo, J; Jebrak, G; Le Guillou, F; Léveiller, G; Lorenzo, A; Mal, H; Molinari, N; Morel, H; Morel, V; Noel, F; Pégliasco, H; Perotin, J M; Piquet, J; Pontier, S; Rabbat, A; Revest, M; Reychler, G; Stelianides, S; Surpas, P; Tattevin, P; Roche, N

2017-04-01

Chronic obstructive pulmonary disease (COPD) is the chronic respiratory disease with the most important burden on public health in terms of morbidity, mortality and health costs. For patients, COPD is a major source of disability because of dyspnea, restriction in daily activities, exacerbation, risk of chronic respiratory failure and extra-respiratory systemic organ disorders. The previous French Language Respiratory Society (SPLF) guidelines on COPD exacerbations were published in 2003. Using the GRADE methodology, the present document reviews the current knowledge on COPD exacerbation through 4 specific outlines: (1) epidemiology, (2) clinical evaluation, (3) therapeutic management and (4) prevention. Specific aspects of outpatients and inpatients care are discussed, especially regarding assessment of exacerbation severity and pharmacological approach. Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Assessing Potential Energy Cost Savings from Increased Energy Code Compliance in Commercial Buildings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rosenberg, Michael I.; Hart, Philip R.; Athalye, Rahul A.

The US Department of Energy’s most recent commercial energy code compliance evaluation efforts focused on determining a percent compliance rating for states to help them meet requirements under the American Recovery and Reinvestment Act (ARRA) of 2009. That approach included a checklist of code requirements, each of which was graded pass or fail. Percent compliance for any given building was simply the percent of individual requirements that passed. With its binary approach to compliance determination, the previous methodology failed to answer some important questions. In particular, how much energy cost could be saved by better compliance with the commercial energymore » code and what are the relative priorities of code requirements from an energy cost savings perspective? This paper explores an analytical approach and pilot study using a single building type and climate zone to answer those questions.« less

Executive Summary of the Guidelines for the Use of interferon-gamma Release Assays in the Diagnosis of Tuberculosis Infection.

PubMed

Santin, Miguel; García-García, José-María; Rigau, David; Altet, Neus; Anibarro, Luis; Casas, Irma; Díez, Nuria; García-Gasalla, Mercedes; Martínez-Lacasa, Xavier; Penas, Antón; Pérez-Escolano, Elvira; Sánchez, Francisca; Domínguez, José

2016-09-01

Interferon-gamma release assays are widely used for the diagnosis of tuberculosis infection in Spain. However, there is no consensus on their application in specific clinical scenarios. To develop a guide-line for their use, a panel of experts comprising specialists in infectious diseases, respiratory diseases, microbiology, pediatrics and preventive medicine, together with a methodologist, conducted a systematic literature search, summarized the findings, rated the quality of the evidence, and formulated recommendations following the Grading of Recommendations of Assessment Development and Evaluations methodology. This document provides evidence-based guidance on the use of interferon-gamma release assays for the diagnosis of tuberculosis infection in patients at risk of tuberculosis or suspected of having active disease. The guidelines will be applicable to specialist and primary care, and public health. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Multiaxial Creep-Fatigue and Creep-Ratcheting Failures of Grade 91 and Haynes 230 Alloys Toward Addressing Design Issues of Gen IV Nuclear Power Plants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hassan, Tasnim; Lissenden, Cliff; Carroll, Laura

The proposed research will develop systematic sets of uniaxial and multiaxial experimental data at a very high temperature (850-950°C) for Alloy 617. The loading histories to be prescribed in the experiments will induce creep-fatigue and creep-ratcheting failure mechanisms. These experimental responses will be scrutinized in order to quantify the influences of temperature and creep on fatigue and ratcheting failures. A unified constitutive model (UCM) will be developed and validated against these experimental responses. The improved UCM will be incorporated into the widely used finite element commercial software packages ANSYS. The modified ANSYS will be validated so that it can bemore » used for evaluating the very high temperature ASME-NH design-by-analysis methodology for Alloy 617 and thereby addressing the ASME-NH design code issues.« less

Physical Properties of Normal Grade Biodiesel and Winter Grade Biodiesel

PubMed Central

Sadrolhosseini, Amir Reza; Moksin, Mohd Maarof; Nang, Harrison Lau Lik; Norozi, Monir; Yunus, W. Mahmood Mat; Zakaria, Azmi

2011-01-01

In this study, optical and thermal properties of normal grade and winter grade palm oil biodiesel were investigated. Surface Plasmon Resonance and Photopyroelectric technique were used to evaluate the samples. The dispersion curve and thermal diffusivity were obtained. Consequently, the variation of refractive index, as a function of wavelength in normal grade biodiesel is faster than winter grade palm oil biodiesel, and the thermal diffusivity of winter grade biodiesel is higher than the thermal diffusivity of normal grade biodiesel. This is attributed to the higher palmitic acid C16:0 content in normal grade than in winter grade palm oil biodiesel. PMID:21731429

Supporting Mediated Peer-Evaluation to Grade Answers to Open-Ended Questions

ERIC Educational Resources Information Center

De Marsico, Maria; Sciarrone, Filippo; Sterbini, Andrea; Temperini, Marco

2017-01-01

We show an approach to semi-automatic grading of answers given by students to open ended questions (open answers). We use both peer-evaluation and teacher evaluation. A learner is modeled by her Knowledge and her assessments quality (Judgment). The data generated by the peer- and teacher-evaluations, and by the learner models is represented by a…

Extra virgin (EV) and ordinary (ON) olive oils: distinction and detection of adulteration (EV with ON) as determined by direct infusion electrospray ionization mass spectrometry and chemometric approaches.

PubMed

Alves, Júnia de O; Neto, Waldomiro B; Mitsutake, Hery; Alves, Paulo S P; Augusti, Rodinei

2010-07-15

Extra virgin (EV), the finest and most expensive among all the olive oil grades, is often adulterated by the cheapest and lowest quality ordinary (ON) olive oil. A new methodology is described herein that provides a simple, rapid, and accurate way not only to detect such type of adulteration, but also to distinguish between these olive oil grades (EV and ON). This approach is based on the application of direct infusion electrospray ionization mass spectrometry in the positive ion mode, ESI(+)-MS, followed by the treatment of the MS data via exploratory statistical approaches, PCA (principal component analysis) and HCA (hierarchical clustering analysis). Ten distinct brands of each EV and ON olive oil, acquired at local stores, were analyzed by ESI(+)-MS and the results from HCA and PCA clearly indicated the formation of two distinct groups related to these two categories. For the adulteration study, one brand of each olive oil grade (EV and ON) was selected. The counterfeit samples (a total of 20) were then prepared by adding assorted proportions, from 1 to 20% w/w, with increments of 1% w/w, of the ON to the EV olive oil. The PCA and HCA methodologies, applied to the ESI(+)-MS data from the counterfeit (20) and authentic (10) EV samples, were able to readily detect adulteration, even at levels as low as 1% w/w. Copyright 2010 John Wiley & Sons, Ltd.

Application of Response Surface Methodology for Modeling of Postweld Heat Treatment Process in a Pressure Vessel Steel ASTM A516 Grade 70

PubMed Central

Peasura, Prachya

2015-01-01

This research studied the application of the response surface methodology (RSM) and central composite design (CCD) experiment in mathematical model and optimizes postweld heat treatment (PWHT). The material of study is a pressure vessel steel ASTM A516 grade 70 that is used for gas metal arc welding. PWHT parameters examined in this study included PWHT temperatures and time. The resulting materials were examined using CCD experiment and the RSM to determine the resulting material tensile strength test, observed with optical microscopy and scanning electron microscopy. The experimental results show that using a full quadratic model with the proposed mathematical model is Y TS = −285.521 + 15.706X 1 + 2.514X 2 − 0.004X 1 2 − 0.001X 2 2 − 0.029X 1 X 2. Tensile strength parameters of PWHT were optimized PWHT time of 5.00 hr and PWHT temperature of 645.75°C. The results show that the PWHT time is the dominant mechanism used to modify the tensile strength compared to the PWHT temperatures. This phenomenon could be explained by the fact that pearlite can contribute to higher tensile strength. Pearlite has an intensity, which results in increased material tensile strength. The research described here can be used as material data on PWHT parameters for an ASTM A516 grade 70 weld. PMID:26550602

Using GRADE methodology for the development of public health guidelines for the prevention and treatment of HIV and other STIs among men who have sex with men and transgender people

PubMed Central

2012-01-01

Background The World Health Organization (WHO) Department of HIV/AIDS led the development of public health guidelines for delivering an evidence-based, essential package of interventions for the prevention and treatment of HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender people in the health sector in low- and middle-income countries. The objective of this paper is to review the methodological challenges faced and solutions applied during the development of the guidelines. Methods The development of the guidelines followed the WHO guideline development process, which utilizes the GRADE approach. We identified, categorized and labeled the challenges identified in the guidelines development process and described the solutions through an interactive process of in-person and electronic communication. Results We describe how we dealt with the following challenges: (1) heterogeneous and complex interventions; (2) paucity of trial data; (3) selecting outcomes of interest; (4) using indirect evidence; (5) integrating values and preferences; (6) considering resource use; (7) addressing social and legal barriers; (8) wording of recommendations; and (9) developing global guidelines. Conclusion We were able to successfully apply the GRADE approach for developing recommendations for public health interventions. Applying the general principles of the approach while carefully considering specific challenges can enhance both the process and the outcome of guideline development. PMID:22640260

The Effect of the DISTAR Instructional System on First and Second Grade Achievement: An Evaluation of the 1971-1972 Title I Program of Winthrop, Massachusetts.

ERIC Educational Resources Information Center

Kaufman, Maurice

The Distar I Reading, Language and Arithmetic programs were used with two first grade classes. The Distar II programs were used with two second grade classes. One first grade Distar class appeared to make some progress in oral language. Comparison of the first grade Distar classes with a first grade control class that used a Scott-Foresman basal…

Bim Orientation: Grades of Generation and Information for Different Type of Analysis and Management Process

NASA Astrophysics Data System (ADS)

Banfi, F.

2017-08-01

Architecture, Engineering and Construction (AEC) industry is facing a great process re-engineering of the management procedures for new constructions, and recent studies show a significant increase of the benefits obtained through the use of Building Information Modelling (BIM) methodologies. This innovative approach needs new developments for information and communication technologies (ICT) in order to improve cooperation and interoperability among different actors and scientific disciplines. Accordingly, BIM could be described as a new tool capable of collect/analyse a great quantity of information (Big data) and improve the management of building during its life of cycle (LC). The main aim of this research is, in addition to a reduction in production times, reduce physical and financial resources (economic impact), to demonstrate how technology development can support a complex generative process with new digital tools (modelling impact). This paper reviews recent BIMs of different historical Italian buildings such as Basilica of Collemaggio in L'Aquila, Masegra Castle in Sondrio, Basilica of Saint Ambrose in Milan and Visconti Bridge in Lecco and carries out a methodological analysis to optimize output information and results combining different data and modelling techniques into a single hub (cloud service) through the use of new Grade of Generation (GoG) and Information (GoI) (management impact). Finally, this study shows the need to orient GoG and GoI for a different type of analysis, which requires a high Grade of Accuracy (GoA) and an Automatic Verification System (AVS ) at the same time.

Evaluation of the Cobas TaqMan MTB Test for the Detection of Mycobacterium tuberculosis Complex According to Acid-Fast-Bacillus Smear Grades in Respiratory Specimens

PubMed Central

Huh, Hee Jae; Koh, Won-Jung; Song, Dong Joon

2014-01-01

We evaluated the performance of the Cobas TaqMan MTB test (Roche Diagnostics, Basel, Switzerland), stratified by acid-fast bacilli (AFB) smear grades. The sensitivity of this test in smear-positive specimens was >95% in all grades, while that in trace and negative specimens was 85.3% and 34.4%, respectively. PMID:25428157

Sample of Second Grade Classroom Protocols from Special Study A of the Beginning Teacher Evaluation Study for the California Commission for Teacher Preparation and Licensing.

ERIC Educational Resources Information Center

Tikunoff, William J.; And Others

Second grade classroom protocols collected within this volume are examples of the protocols developed by the ethnographers associated with Special Study A: "An Ethnographic Study of the Forty Classrooms of the Beginning Teacher Evaluation Study." Twenty teachers at both the second and fifth grades were observed for one week by an…

Sample of Fifth Grade Classroom Protocols from Special Study A of the Beginning Teacher Evaluation Study for the California Commission for Teacher Preparation and Licensing.

ERIC Educational Resources Information Center

Tikunoff, William J.; And Others

Classroom protocols collected within this volume are examples of the protocols from grade 5 developed by the ethnographers associated with Special Study A: "An Ethnographic Study of the Forty Classrooms of the Beginning Teacher Evaluation Study." Twenty teachers at both the second and fifth grades were observed for one week by an…

Positive and Negative Aspects of the IWB and Tablet Computers in the First Grade of Primary School: A Multiple-Perspective Approach

ERIC Educational Resources Information Center

Fekonja-Peklaj, Urška; Marjanovic-Umek, Ljubica

2015-01-01

The aim of this qualitative study was to evaluate the positive and negative aspects of the interactive whiteboard (IWB) and tablet computers use in the first grade of primary school from the perspectives of three groups of evaluators, namely the teachers, the pupils and an independent observer. The sample included three first grade classes with…

Achievement Test Provincial Report, June 1987 Administration.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Student Evaluation and Records Branch.

This document summarizes results of province-wide achievement tests given in Alberta, Canada in June 1987. These tests evaluated student achievement in third grade science, sixth grade mathematics, and ninth grade social studies. The test questions for each subject area reflected Alberta's curriculum specifications for that subject. The grade 3…

Grade Inflation: An Issue for Higher Education?

ERIC Educational Resources Information Center

Caruth, Donald L.; Caruth, Gail D.

2013-01-01

Grade inflation impacts university credibility, student courses of study, choices of institution, and other areas. There has been an upward shift in grades without a corresponding upward shift in knowledge gained. Some of the most frequently mentioned causes of grade inflation are: (1) student evaluations of professors; (2) student teacher…

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

Methodologies for evaluating performance and assessing uncertainty of atmospheric dispersion models

NASA Astrophysics Data System (ADS)

Chang, Joseph C.

This thesis describes methodologies to evaluate the performance and to assess the uncertainty of atmospheric dispersion models, tools that predict the fate of gases and aerosols upon their release into the atmosphere. Because of the large economic and public-health impacts often associated with the use of the dispersion model results, these models should be properly evaluated, and their uncertainty should be properly accounted for and understood. The CALPUFF, HPAC, and VLSTRACK dispersion modeling systems were applied to the Dipole Pride (DP26) field data (˜20 km in scale), in order to demonstrate the evaluation and uncertainty assessment methodologies. Dispersion model performance was found to be strongly dependent on the wind models used to generate gridded wind fields from observed station data. This is because, despite the fact that the test site was a flat area, the observed surface wind fields still showed considerable spatial variability, partly because of the surrounding mountains. It was found that the two components were comparable for the DP26 field data, with variability more important than uncertainty closer to the source, and less important farther away from the source. Therefore, reducing data errors for input meteorology may not necessarily increase model accuracy due to random turbulence. DP26 was a research-grade field experiment, where the source, meteorological, and concentration data were all well-measured. Another typical application of dispersion modeling is a forensic study where the data are usually quite scarce. An example would be the modeling of the alleged releases of chemical warfare agents during the 1991 Persian Gulf War, where the source data had to rely on intelligence reports, and where Iraq had stopped reporting weather data to the World Meteorological Organization since the 1981 Iran-Iraq-war. Therefore the meteorological fields inside Iraq must be estimated by models such as prognostic mesoscale meteorological models, based on observational data from areas outside of Iraq, and using the global fields simulated by the global meteorological models as the initial and boundary conditions for the mesoscale models. It was found that while comparing model predictions to observations in areas outside of Iraq, the predicted surface wind directions had errors between 30 to 90 deg, but the inter-model differences (or uncertainties) in the predicted surface wind directions inside Iraq, where there were no onsite data, were fairly constant at about 70 deg. (Abstract shortened by UMI.)

Are we a gift shop? A perspective on grade inflation.

PubMed

Shoemaker, J K; DeVos, M

1999-12-01

Grade inflation is a phenomenon that has been written about extensively since the mid 1970s. It is theorized that it made its initial appearance as an adjustment to the rigorous educational standards that were imposed in the post-Sputnik era. Some authors speculate that grade inflation as we know it is an outcome of student demands for high grades combined with faculty willingness to capitulate to them. Others believe the problem is related to lack of faculty knowledge about evaluation methods, or the quest for positive student evaluations in support of promotion, tenure, and merit decisions. Of particular concern is the lack of published studies of grade inflation in nursing education. The purpose of this article is to describe what we know about grade inflation-its history, causative factors, and implications for nursing.

Good practice or positive action? Using Q methodology to identify competing views on improving gender equality in academic medicine

PubMed Central

Burkinshaw, Paula; West, Robert M; Ward, Vicky

2017-01-01

Objectives The number of women entering medicine has increased significantly, yet women are still under-represented at senior levels in academic medicine. To support the gender equality action plan at one School of Medicine, this study sought to (1) identify the range of viewpoints held by staff on how to address gender inequality and (2) identify attitudinal barriers to change. Design Q methodology. 50 potential interventions representing good practice or positive action, and addressing cultural, organisational and individual barriers to gender equality, were ranked by participants according to their perception of priority. Setting The School of Medicine at the University of Leeds, UK. Participants Fifty-five staff members were purposively sampled to represent gender and academic pay grade. Results Principal components analysis identified six competing viewpoints on how to address gender inequality. Four viewpoints favoured positive action interventions: (1) support careers of women with childcare commitments, (2) support progression of women into leadership roles rather than focus on women with children, (3) support careers of all women rather than just those aiming for leadership, and (4) drive change via high-level financial and strategic initiatives. Two viewpoints favoured good practice with no specific focus on women by (5) recognising merit irrespective of gender and (6) improving existing career development practice. No viewpoint was strongly associated with gender, pay grade or role; however, latent class analysis identified that female staff were more likely than male to prioritise the setting of equality targets. Attitudinal barriers to the setting of targets and other positive action initiatives were identified, and it was clear that not all staff supported positive action approaches. Conclusions The findings and the approach have utility for those involved in gender equality work in other medical and academic institutions. However, the impact of such initiatives needs to be evaluated in the longer term. PMID:28830870

An integrated model of academic self-concept development: Academic self-concept, grades, test scores, and tracking over 6 years.

PubMed

Marsh, Herbert W; Pekrun, Reinhard; Murayama, Kou; Arens, A Katrin; Parker, Philip D; Guo, Jiesi; Dicke, Theresa

2018-02-01

Our newly proposed integrated academic self-concept model integrates 3 major theories of academic self-concept formation and developmental perspectives into a unified conceptual and methodological framework. Relations among math self-concept (MSC), school grades, test scores, and school-level contextual effects over 6 years, from the end of primary school through the first 5 years of secondary school (a representative sample of 3,370 German students, 42 secondary schools, 50% male, M age at grade 5 = 11.75) support the (1) internal/external frame of reference model: Math school grades had positive effects on MSC, but the effects of German grades were negative; (2) reciprocal effects (longitudinal panel) model: MSC was predictive of and predicted by math test scores and school grades; (3) big-fish-little-pond effect: The effects on MSC were negative for school-average achievement based on 4 indicators (primary school grades in math and German, school-track prior to the start of secondary school, math test scores in the first year of secondary school). Results for all 3 theoretical models were consistent across the 5 secondary school years: This supports the prediction of developmental equilibrium. This integration highlights the robustness of support over the potentially volatile early to middle adolescent period; the interconnectedness and complementarity of 3 ASC models; their counterbalancing strengths and weaknesses; and new theoretical, developmental, and substantive implications at their intersections. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Assessment of Diastolic Function in Single Ventricle Patients Following the Fontan Procedure

PubMed Central

Margossian, Renee; Sleeper, Lynn A.; Pearson, Gail D.; Barker, Piers C.; Mertens, Luc; Quartermain, Michael D.; Su, Jason T.; Shirali, Girish; Chen, Shan; Colan, Steven D.

2016-01-01

Objectives Patients with functional single ventricles (FSV) following the Fontan procedure have abnormal cardiac mechanics. We sought to determine factors that influence diastolic function and to describe associations of diastolic function with current clinical status. Methods Echocardiograms were obtained as part of the Pediatric Heart Network Fontan Cross-Sectional Study. Diastolic function grade (DFG) was assessed as normal (grade 0), impaired relaxation (grade 1), pseudonormalization (grade 2), restrictive (grade 3). Studies were also classified dichotomously (restrictive pattern present or absent). Relationships between DFG and pre-Fontan variables (e.g., ventricular morphology, age at Fontan, history of volume-unloading surgery), and current status (e.g., systolic function, valvar regurgitation, exercise performance) were explored. Results DFG was calculable in 326/546 subjects (60%); mean age = 11.7±3.3 years. Overall, 32% of patients had grade 0, 9% grade 1, 37% grade 2, and 22% grade 3. Although there was no association between ventricular morphology and DFG, there was an association between ventricular morphology and E’, which was lowest in those with right ventricular morphology (p<.001); this association remained significant when using z-scores adjusted for age (p=<.001). DFG was associated with achieving maximal effort on exercise testing (p=.004); the majority (64%) of those not achieving maximal effort had DFG 2 or 3.No additional significant associations of DFG with laboratory or clinical measures were identified. Conclusion Assessment of diastolic function by current algorithms results in a high percentage of patients with abnormal DFG, but we found few clinically or statistically significant associations. This may imply a lack of impact of abnormal diastolic function upon clinical outcome in this cohort, or may indicate that the methodology may not be applicable to pediatric FSV patients. PMID:27624592