Community Integration and Quality of Life in Aphasia after Stroke.

PubMed

Lee, Hyejin; Lee, Yuna; Choi, Hyunsoo; Pyun, Sung-Bom

2015-11-01

To examine community integration and contributing factors in people with aphasia (PWA) following stroke and to investigate the relationship between community integration and quality of life (QOL). Thirty PWA and 42 age-and education-matched control subjects were involved. Main variables were as follows: socioeconomic status, mobility, and activity of daily living (ADL) (Modified Barthel Index), language function [Frenchay Aphasia Screening Test (FAST)], depression [Geriatric Depression Scale (GDS)], Community Integration Questionnaire (CIQ) and Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39). Differences between aphasia and control groups and factors affecting community integration and QOL were analyzed. Home and social integration and productive activity were significantly decreased in the aphasia group compared to the control group; 8.5 and 18.3 points in total CIQ score, respectively. Amount of time spent outside the home and frequency of social contact were also significantly reduced in the aphasia group. Total mean score on the SAQOL-39 was 2.75±0.80 points and was significantly correlated with economic status, gait performance, ADL, depressive mood, and social domain score on the CIQ. Depression score measured by GDS was the single most important factor for the prediction of QOL, but the FAST score was significantly correlated only with the communication domain of the SAQOL-39. Community activities of PWA were very limited, and depression was highly associated with decreased community integration and QOL. Enhancing social participation and reducing emotional distress should be emphasized for rehabilitation of PWA.

MSblender: A probabilistic approach for integrating peptide identifications from multiple database search engines.

PubMed

Kwon, Taejoon; Choi, Hyungwon; Vogel, Christine; Nesvizhskii, Alexey I; Marcotte, Edward M

2011-07-01

Shotgun proteomics using mass spectrometry is a powerful method for protein identification but suffers limited sensitivity in complex samples. Integrating peptide identifications from multiple database search engines is a promising strategy to increase the number of peptide identifications and reduce the volume of unassigned tandem mass spectra. Existing methods pool statistical significance scores such as p-values or posterior probabilities of peptide-spectrum matches (PSMs) from multiple search engines after high scoring peptides have been assigned to spectra, but these methods lack reliable control of identification error rates as data are integrated from different search engines. We developed a statistically coherent method for integrative analysis, termed MSblender. MSblender converts raw search scores from search engines into a probability score for every possible PSM and properly accounts for the correlation between search scores. The method reliably estimates false discovery rates and identifies more PSMs than any single search engine at the same false discovery rate. Increased identifications increment spectral counts for most proteins and allow quantification of proteins that would not have been quantified by individual search engines. We also demonstrate that enhanced quantification contributes to improve sensitivity in differential expression analyses.

MSblender: a probabilistic approach for integrating peptide identifications from multiple database search engines

PubMed Central

Kwon, Taejoon; Choi, Hyungwon; Vogel, Christine; Nesvizhskii, Alexey I.; Marcotte, Edward M.

2011-01-01

Shotgun proteomics using mass spectrometry is a powerful method for protein identification but suffers limited sensitivity in complex samples. Integrating peptide identifications from multiple database search engines is a promising strategy to increase the number of peptide identifications and reduce the volume of unassigned tandem mass spectra. Existing methods pool statistical significance scores such as p-values or posterior probabilities of peptide-spectrum matches (PSMs) from multiple search engines after high scoring peptides have been assigned to spectra, but these methods lack reliable control of identification error rates as data are integrated from different search engines. We developed a statistically coherent method for integrative analysis, termed MSblender. MSblender converts raw search scores from search engines into a probability score for all possible PSMs and properly accounts for the correlation between search scores. The method reliably estimates false discovery rates and identifies more PSMs than any single search engine at the same false discovery rate. Increased identifications increment spectral counts for all detected proteins and allow quantification of proteins that would not have been quantified by individual search engines. We also demonstrate that enhanced quantification contributes to improve sensitivity in differential expression analyses. PMID:21488652

Integrating family planning and HIV services in western Kenya: the impact on HIV-infected patients' knowledge of family planning and male attitudes toward family planning.

PubMed

Onono, Maricianah; Guzé, Mary A; Grossman, Daniel; Steinfeld, Rachel; Bukusi, Elizabeth A; Shade, Starley; Cohen, Craig R; Newmann, Sara J

2015-01-01

Little information exists on the impact of integrating family planning (FP) services into HIV care and treatment on patients' familiarity with and attitudes toward FP. We conducted a cluster-randomized trial in 18 public HIV clinics with 12 randomized to integrated FP and HIV services and 6 to the standard referral-based system where patients are referred to an FP clinic. Serial cross-sectional surveys were done before (n = 488 women, 486 men) and after (n = 479 women, 481 men) the intervention to compare changes in familiarity with FP methods and attitudes toward FP between integrated and nonintegrated (NI) sites. We created an FP familiarity score based on the number of more effective FP methods patients could identify (score range: 0-6). Generalized estimating equations were used to control for clustering within sites. An increase in mean familiarity score between baseline (mean = 5.16) and post-intervention (mean = 5.46) occurred with an overall mean change of 0.26 (95% confidence intervals [CI] = 0.09, 0.45; p = 0.003) across all sites. At end line, there was no difference in increase of mean FP familiarity scores at intervention versus control sites (mean = 5.41 vs. 5.49, p = 0.94). We observed a relative decrease in the proportion of males agreeing that FP was "women's business" at integrated sites (baseline 42% to end line 30%; reduction of 12%) compared to males at NI sites (baseline 35% to end line 42%; increase of 7%; adjusted odds ration [aOR] = 0.43; 95% CI = 0.22, 0.85). Following FP-HIV integration, familiarity with FP methods increased but did not differ by study arm. Integration was associated with a decrease in negative attitudes toward FP among men.

Four pathways in the analysis of adult development and aging: comparing analyses of reasoning about personal-life dilemmas.

PubMed

Pratt, M W; Diessner, R; Hunsberger, B; Pancer, S M; Savoy, K

1991-12-01

Four systems for analyzing thinking about 2 personal-life dilemmas, as discussed by 29 men and 35 women (ages 35-85), were compared. Kohlberg's (1976) moral judgment stages, Kegan's (1982) ego-development stages, Gilligan's (1982) moral orientation system, and Suedfeld and Tetlock's (1977) integrative complexity scoring were used. Subjects completed Kohlberg's (Colby & Kohlberg, 1987) standard moral judgment measure, a self-concept description, and several questionnaires. The Kohlberg, Kegan, and integrative complexity codings of the dilemmas were positively related to each other and to the standard Kohlberg moral stage scores. There were no age-group differences and few gender differences on the measures. However, education, role-taking skills, and greater sensitivity to age changes in the self positively predicted higher stage scores across maturity.

Integrated Behavioral Z-Scoring Increases the Sensitivity and Reliability of Behavioral Phenotyping in mice: Relevance to Emotionality and Sex

PubMed Central

Guilloux, Jean-Philippe; Seney, Marianne; Edgar, Nicole; Sibille, Etienne

2011-01-01

Defining anxiety- and depressive-like states in mice (“emotionality”) is best characterized by the use of complementary tests, leading sometimes to puzzling discrepancies and lack of correlation between similar paradigms. To address this issue, we hypothesized that integrating measures along the same behavioral dimensions in different tests would reduce the intrinsic variability of single tests and provide a robust characterization of the underlying “emotionality” of individual mouse, similarly as mood and related syndromes are defined in humans through various related symptoms over time. We describe the use of simple mathematical and integrative tools to help phenotype animals across related behavioral tests (syndrome diagnosis) and experiments (meta-analysis). We applied z-normalization across complementary measures of emotionality in different behavioral tests after unpredictable chronic mild stress (UCMS) or prolonged corticosterone exposure - two approaches to induce anxious-/depressive-like states in mice. Combining z-normalized test values, lowered the variance of emotionality measurement, enhanced the reliability of behavioral phenotyping, and increased analytical opportunities. Comparing integrated emotionality scores across studies revealed a robust sexual dimorphism in the vulnerability to develop high emotionality, manifested as higher UCMS-induced emotionality z-scores, but lower corticosterone-induced scores in females compared to males. Interestingly, the distribution of individual z-scores revealed a pattern of increased baseline emotionality in female mice, reminiscent of what is observed in humans. Together, we show that the z-scoring method yields robust measures of emotionality across complementary tests for individual mice and experimental groups, hence facilitating the comparison across studies and refining the translational applicability of these models. PMID:21277897

Integrated behavioral z-scoring increases the sensitivity and reliability of behavioral phenotyping in mice: relevance to emotionality and sex.

PubMed

Guilloux, Jean-Philippe; Seney, Marianne; Edgar, Nicole; Sibille, Etienne

2011-04-15

Defining anxiety- and depressive-like states in mice (emotionality) is best characterized by the use of complementary tests, leading sometimes to puzzling discrepancies and lack of correlation between similar paradigms. To address this issue, we hypothesized that integrating measures along the same behavioral dimensions in different tests would reduce the intrinsic variability of single tests and provide a robust characterization of the underlying "emotionality" of individual mouse, similarly as mood and related syndromes are defined in humans through various related symptoms over time. We describe the use of simple mathematical and integrative tools to help phenotype animals across related behavioral tests (syndrome diagnosis) and experiments (meta-analysis). We applied z-normalization across complementary measures of emotionality in different behavioral tests after unpredictable chronic mild stress (UCMS) or prolonged corticosterone exposure - two approaches to induce anxious-/depressive-like states in mice. Combining z-normalized test values, lowered the variance of emotionality measurement, enhanced the reliability of behavioral phenotyping, and increased analytical opportunities. Comparing integrated emotionality scores across studies revealed a robust sexual dimorphism in the vulnerability to develop high emotionality, manifested as higher UCMS-induced emotionality z-scores, but lower corticosterone-induced scores in females compared to males. Interestingly, the distribution of individual z-scores revealed a pattern of increased baseline emotionality in female mice, reminiscent of what is observed in humans. Together, we show that the z-scoring method yields robust measures of emotionality across complementary tests for individual mice and experimental groups, hence facilitating the comparison across studies and refining the translational applicability of these models. Copyright © 2011 Elsevier B.V. All rights reserved.

Influence of national culture on the adoption of integrated medical curricula.

PubMed

Jippes, Mariëlle; Majoor, Gerard D

2011-03-01

Integrated curricula have been implemented in medical schools all over the world. However, among countries different relative numbers of schools with integrated curricula are found. This study aims to explore the possible correlation between the percentage of medical schools with integrated curricula in a country and that country's cultural characteristics. Curricula were defined as not integrated if in the first 2 years of the program at least two out of the three monodisciplinary courses Anatomy, Physiology and Biochemistry were identified. Culture was defined using Hofstede's dimensions Power distance, Uncertainty avoidance, Masculinity/Femininity, and Individualism/Collectivism. Consequently, this study had to be restricted to the 63 countries included in Hofstede's studies which harbored 1,195 medical schools. From each country we randomly sampled a maximum of 15 schools yielding 484 schools to be investigated. In total 91% (446) of the curricula were found. Correlation of percent integrated curricula and each dimension of culture was determined by calculating Spearman's Rho. A high score on the Power distance index and a high score on the Uncertainty avoidance index correlated with a low percent integrated curricula; a high score on the Individualism index correlated with a high percent integrated curricula. The percentage integrated curricula in a country did not correlate with its score on the Masculinity index. National culture is associated with the propensity of medical schools to adopt integrated medical curricula. Consequently, medical schools considering introduction of integrated and problem-based medical curricula should take into account dimensions of national culture which may hinder the innovation process.

Community integration after burn injuries.

PubMed

Esselman, P C; Ptacek, J T; Kowalske, K; Cromes, G F; deLateur, B J; Engrav, L H

2001-01-01

Evaluation of community integration is a meaningful outcome criterion after major burn injury. The Community Integration Questionnaire (CIQ) was administered to 463 individuals with major burn injuries. The CIQ results in Total, Home Integration, Social Integration, and Productivity scores. The purposes of this study were to determine change in CIQ scores over time and what burn injury and demographic factors predict CIQ scores. The CIQ scores did not change significantly from 6 to 12 to 24 months postburn injury. Home integration scores were best predicted by sex and living situation; Social Integration scores by marital status; and Productivity scores by functional outcome, burn severity, age, and preburn work factors. The data demonstrate that individuals with burn injuries have significant difficulties with community integration due to burn and nonburn related factors. CIQ scores did not improve over time but improvement may have occurred before the initial 6-month postburn injury follow-up in this study.

Fusion of Scores in a Detection Context Based on Alpha Integration.

PubMed

Soriano, Antonio; Vergara, Luis; Ahmed, Bouziane; Salazar, Addisson

2015-09-01

We present a new method for fusing scores corresponding to different detectors (two-hypotheses case). It is based on alpha integration, which we have adapted to the detection context. Three optimization methods are presented: least mean square error, maximization of the area under the ROC curve, and minimization of the probability of error. Gradient algorithms are proposed for the three methods. Different experiments with simulated and real data are included. Simulated data consider the two-detector case to illustrate the factors influencing alpha integration and demonstrate the improvements obtained by score fusion with respect to individual detector performance. Two real data cases have been considered. In the first, multimodal biometric data have been processed. This case is representative of scenarios in which the probability of detection is to be maximized for a given probability of false alarm. The second case is the automatic analysis of electroencephalogram and electrocardiogram records with the aim of reproducing the medical expert detections of arousal during sleeping. This case is representative of scenarios in which probability of error is to be minimized. The general superior performance of alpha integration verifies the interest of optimizing the fusing parameters.

Assessing Freshman Engineering Students' Understanding of Ethical Behavior.

PubMed

Henslee, Amber M; Murray, Susan L; Olbricht, Gayla R; Ludlow, Douglas K; Hays, Malcolm E; Nelson, Hannah M

2017-02-01

Academic dishonesty, including cheating and plagiarism, is on the rise in colleges, particularly among engineering students. While students decide to engage in these behaviors for many different reasons, academic integrity training can help improve their understanding of ethical decision making. The two studies outlined in this paper assess the effectiveness of an online module in increasing academic integrity among first semester engineering students. Study 1 tested the effectiveness of an academic honesty tutorial by using a between groups design with a Time 1- and Time 2-test. An academic honesty quiz assessed participants' knowledge at both time points. Study 2, which incorporated an improved version of the module and quiz, utilized a between groups design with three assessment time points. The additional Time 3-test allowed researchers to test for retention of information. Results were analyzed using ANCOVA and t tests. In Study 1, the experimental group exhibited significant improvement on the plagiarism items, but not the total score. However, at Time 2 there was no significant difference between groups after controlling for Time 1 scores. In Study 2, between- and within-group analyses suggest there was a significant improvement in total scores, but not plagiarism scores, after exposure to the tutorial. Overall, the academic integrity module impacted participants as evidenced by changes in total score and on specific plagiarism items. Although future implementation of the tutorial and quiz would benefit from modifications to reduce ceiling effects and improve assessment of knowledge, the results suggest such tutorial may be one valuable element in a systems approach to improving the academic integrity of engineering students.

[Effects of auditory integrative training on autistic children].

PubMed

Zhang, Gai-qiao; Gong, Qun; Zhang, Feng-ling; Chen, Sun-min; Hu, Li-qun; Liu, Feng; Cui, Rui-hua; He, Lin

2009-08-18

To explore the short-term treatment effect of the auditory integrative training on autistic children and provide them with clinical support for rehabilitative treatment. A total of 81 cases of autistic children were selected through the standard of DSM-4 and clinical case study was used. They were divided randomly into experimental group and control one, and respectively received auditory integrative training and no training based on the multiple therapies. The patients were investigated using clinical manifestation and Autism Behavior Checklist (ABC) and intelligence quotient (IQ) before and after six months of treatment. The effect was evaluated through the changes of clinical manifestations and scores of ABC and IQ. The changes of scores of IQ were determined with Gesell and WPPSI or WISC-R. Compared with 40 patients of the control group after the six months of the auditory integrative training, 41 of the experimental group had greatly improved in many aspects, such as the disorders of their language, social interactions and typical behavior symptoms while they had not changed in their abnormal behaviors. The scores of IQ or DQ had increased and scores of ABC had dropped. The differences between the two groups were greatly significant in statistics (P < 0.01). The decreasing level of both ABC scores and the increasing level of the IQ scores were negatively correlated with age, and the decreasing level of ABC scores was in line regression(positive correlation) with base IQ. The treatment of auditory integrative training (AIT) could greatly improve on language disorders, the difficulties of social interactions, typical behavior symptoms and developmental levels,therefore it is positive to the autistic children in its short-term treatment effect.

No difference in outcome for open versus arthroscopic rotator cuff repair: a prospective comparative trial.

PubMed

Bayle, Xavier; Pham, Thuy-Trang; Faruch, Marie; Gobet, Aurelie; Mansat, Pierre; Bonnevialle, Nicolas

2017-12-01

Arthroscopic techniques tend to become the gold standard in rotator cuff repair. However, little data are reported in the literature regarding the improvement of postoperative outcomes and re-tear rate relative to conventional open surgery. The aim of this study was to compare clinical outcomes and cuff integrity after arthroscopic versus open cuff repair. We prospectively assessed clinical outcomes and cuff integrity after an arthroscopic or open rotator cuff repair with a minimum follow-up of 12 months. Clinical evaluation was based on Constant score, Simple Shoulder Value (SSV) and American Shoulder and Elbow Score (ASES). Rotator cuff healing was explored with ultrasound. 44 patients in arthroscopic group A (mean age 56-year-old) and 43 in open group O (mean age 61-year-old) fulfilled the inclusion criteria. Tendons were repaired with a single row technique associated with biceps tenodesis and subacromial decompression. All objective clinical scores significantly improved postoperatively in both groups. No statistical difference was identified between group A and O regarding, respectively, Constant score (72 vs 75 points; p = 0.3), ASES score (88 vs 91 points; p = 0.3), and SSV (81 vs 85%). The overall rate of re-tear (Sugaya type IV or V) reached 7 and 9%, respectively, in group A and O (p = 0.8). This study did not prove any difference of arthroscopic over open surgery in case of rotator cuff repair regarding clinical outcome and cuff integrity at 1-year follow-up. Prospective comparative study.

Growth and market integration in Amazonia: a comparison of growth indicators between Shuar, Shiwiar, and nonindigenous school children.

PubMed

Blackwell, Aaron D; Pryor, George; Pozo, José; Tiwia, Washington; Sugiyama, Lawrence S

2009-01-01

We describe and compare the growth of three groups of juveniles, aged 0-18, who experience different degrees of market integration and acculturation in the Ecuadorian Amazon. These include 1,384 indigenous Shuar from the Upano Valley of Ecuador and surrounding areas, 570 nonindigenous colono (or colonist) children from the same area, and 42 Shiwiar from the interior of Ecuador. We use differences between these populations in National Health and Nutrition Examination Survey (NHANES) z-scores to assess the effects of changing subsistence patterns on Shuar growth and nutrition. Although, for all three groups, mean height-for-age z-scores were negative, Shuar z-scores were significantly lower than either colono or Shiwiar z-scores. Mean weight-for-age z-scores were also negative for Shuar and colono juveniles, while mean BMI-for-age and weight-for-height z-scores were greater than zero for all three groups. Using NHANES standards, 41% of male and 38% of female Shuar were classified as stunted, versus 16% of male and 20% of female colonos. Compared to Shuar, colonos were three times less likely to be stunted (OR = 0.33, P < 0.01) and Shiwiar were eight times less likely to be stunted (OR = 0.13, P = 0.01). These differences suggest that changes in diet have negatively affected Shuar growth and nutrition.

An Alternative Approach for Supportive Supervision and Skill Measurements of Health Workers for Integrated Management of Neonatal and Childhood Illnesses Program in 10 Districts of Haryana.

PubMed

Aggarwal, Arun K; Gupta, Rakesh; Das, Dhritiman; Dhakar, Anar S; Sharma, Gourav; Anand, Himani; Kaur, Kamalpreet; Sheoran, Kiran; Dalpath, Suresh; Khatri, Jaidev; Gupta, Madhu

2018-01-01

"Integrated Management of Neonatal and Childhood Illnesses" (IMNCI) needs regular supportive supervision (SS). The aim of this study was to find suitable SS model for implementing IMNCI. This was a prospective interventional study in 10 high-focus districts of Haryana. Two methods of SS were used: (a) visit to subcenters and home visits (model 1) and (b) organization of IMNCI clinics/camps at primary health center (PHC) and community health center (CHC) (model 2). Skill scores were measured at different time points. Routine IMNCI data from study block and randomly selected control block of each district were retrieved for 4 months before and after the training and supervision. Change in percentage mean skill score difference and percentage difference in median number of children were assessed in two areas. Mean skill scores increased significantly from 2.1 (pretest) to 7.0 (posttest 1). Supportive supervisory visits sustained and improved skill scores. While model 2 of SS could positively involve health system officials, model 1 was not well received. Outcome indicator in terms of number of children assessed showed a significant improvement in intervention areas. SS in IMNCI clinics/camps at PHC/CHC level and innovative skill scoring method is a promising approach.

Objective, Structured Proforma to Score the Merit of Scientific Presentations.

PubMed

Agarwal, Nayan; Thawani, Rajat; Gupta, Setu; Sharma, Arun; Dhaliwal, Upreet

2015-12-01

Around 100,000 medical conferences are organized all over the world and hence, they form an integral part of a medical professional's life. Oral presentations, especially award sessions, are judged by a panel of faculty judges who score individual presentations on various aspects including content, delivery and submission. Our objective was to compare the scores given by student-judges and faculty-judges for scientific presentations using the standardized score sheet. An objective, structured score-sheet was designed using existing literature. Five presentations, all made using PowerPoint, were judged using the structured score-sheet by seven student-judges and two-faculty judges. The mean score of all the score-sheets (n = 45) was 38.5 + 5.4 (out of a maximum score of 50). There was no statistical difference between mean scores assigned by students or faculty (p = 0.2). Thus, an objective, structured score sheet like ours, when used to judge scientific presentations, gave uniform results even when judges hailed from different levels of the medical hierarchy.

Integrating knowledge based functionality in commercial hospital information systems.

PubMed

Müller, M L; Ganslandt, T; Eich, H P; Lang, K; Ohmann, C; Prokosch, H U

2000-01-01

Successful integration of knowledge-based functions in the electronic patient record depends on direct and context-sensitive accessibility and availability to clinicians and must suit their workflow. In this paper we describe an exemplary integration of an existing standalone scoring system for acute abdominal pain into two different commercial hospital information systems using Java/Corba technolgy.

Vertically integrated medical education and the readiness for practice of graduates.

PubMed

Wijnen-Meijer, Marjo; Ten Cate, Olle; van der Schaaf, Marieke; Burgers, Chantalle; Borleffs, Jan; Harendza, Sigrid

2015-12-21

Medical curricula become more and more vertically integrated (VI) to prepare graduates better for clinical practice. VI curricula show early clinical education, integration of biomedical sciences and focus on increasing clinical responsibility levels for trainees. Results of earlier questionnaire-based studies indicate that the type of the curriculum can affect the perceived preparedness for work as perceived by students or supervisors. The aim of the present study is to determine difference in actual performance of graduates from VI and non-VI curricula. We developed and implemented an authentic performance assessment based on different facets of competence for medical near-graduates in the role of beginning residents on a very busy day. Fifty nine candidates participated: 30 VI (Utrecht, The Netherlands) and 29 non-VI (Hamburg, Germany). Two physicians, one nurse and five standardized patients independently assessed each candidate on different facets of competence. Afterwards, the physicians indicated how much supervision they estimated each candidate would require on nine so called "Entrustable Professional Activities (EPAs)" unrelated to the observed scenarios. Graduates from a VI curriculum received significantly higher scores by the physicians for the facet of competence "active professional development", with features like 'reflection' and 'asking for feedback'. In addition, VI graduates scored better on the EPA "solving a management problem", while the non-VI graduates got higher scores for the EPA "breaking bad news". This study gives an impression of the actual performance of medical graduates from VI and non-VI curricula. Even though not many differences were found, VI graduates got higher scores for features of professional development, which is important for postgraduate training and continuing education.

Race Differences on the Developmental Test of Visual Motor Integration, the Slosson Intelligence Test, and the ABC Inventory.

ERIC Educational Resources Information Center

Schooler, Douglas L.; Anderson, Robert L.

1979-01-01

Analyzes preschoolers' scores on the Developmental Test of Visual Motor Integration (VMI), the Slosson Intelligence Test (SIT), and the ABC Inventory (ABCI). Separate ANOVAs reveal no race effect on the VMI. Race differences favoring Whites are found for SIT and ABCI. There were no effects for sex on any measure. (Author)

A comparison of intellectual assessments over video conferencing and in-person for individuals with ID: preliminary data.

PubMed

Temple, V; Drummond, C; Valiquette, S; Jozsvai, E

2010-06-01

Video conferencing (VC) technology has great potential to increase accessibility to healthcare services for those living in rural or underserved communities. Previous studies have had some success in validating a small number of psychological tests for VC administration; however, VC has not been investigated for use with persons with intellectual disabilities (ID). A comparison of test results for two well known and widely used assessment instruments was undertaken to establish if scores for VC administration would differ significantly from in-person assessments. Nineteen individuals with ID aged 23-63 were assessed once in-person and once over VC using the Wechsler Abbreviated Scale of Intelligence (WASI) and the Beery-Buktenica Test of Visual-Motor Integration (VMI). Highly similar results were found for test scores. Full-scale IQ on the WASI and standard scores for the VMI were found to be very stable across the two administration conditions, with a mean difference of less than one IQ point/standard score. Video conferencing administration does not appear to alter test results significantly for overall score on a brief intelligence test or a test of visual-motor integration.

[Impact of passing items above the ceiling on the assessment results of Peabody developmental motor scales].

PubMed

Zhao, Gai; Bian, Yang; Li, Ming

2013-12-18

To analyze the impact of passing items above the roof level in the gross motor subtest of Peabody development motor scales (PDMS-2) on its assessment results. In the subtests of PDMS-2, 124 children from 1.2 to 71 months were administered. Except for the original scoring method, a new scoring method which includes passing items above the ceiling were developed. The standard scores and quotients of the two scoring methods were compared using the independent-samples t test. Only one child could pass the items above the ceiling in the stationary subtest, 19 children in the locomotion subtest, and 17 children in the visual-motor integration subtest. When the scores of these passing items were included in the raw scores, the total raw scores got the added points of 1-12, the standard scores added 0-1 points and the motor quotients added 0-3 points. The diagnostic classification was changed only in two children. There was no significant difference between those two methods about motor quotients or standard scores in the specific subtest (P>0.05). The passing items above a ceiling of PDMS-2 isn't a rare situation. It usually takes place in the locomotion subtest and visual-motor integration subtest. Including these passing items into the scoring system will not make significant difference in the standard scores of the subtests or the developmental motor quotients (DMQ), which supports the original setting of a ceiling established by upassing 3 items in a row. However, putting the passing items above the ceiling into the raw score will improve tracking of children's developmental trajectory and intervention effects.

Personality Patterns of Physicians in Person-Oriented and Technique-Oriented Specialties

ERIC Educational Resources Information Center

Borges, Nicole J.; Gibson, Denise D.

2005-01-01

This study investigated differences in personality patterns between person-oriented and technique-oriented physicians. It tested an integrative framework by converting the scores on the Personality Research Form (PRF) to the Big-Five factors and built a predictive model of group membership in clinical specialty area. PRF scores from 238 physicians…

Integrating high dimensional bi-directional parsing models for gene mention tagging.

PubMed

Hsu, Chun-Nan; Chang, Yu-Ming; Kuo, Cheng-Ju; Lin, Yu-Shi; Huang, Han-Shen; Chung, I-Fang

2008-07-01

Tagging gene and gene product mentions in scientific text is an important initial step of literature mining. In this article, we describe in detail our gene mention tagger participated in BioCreative 2 challenge and analyze what contributes to its good performance. Our tagger is based on the conditional random fields model (CRF), the most prevailing method for the gene mention tagging task in BioCreative 2. Our tagger is interesting because it accomplished the highest F-scores among CRF-based methods and second over all. Moreover, we obtained our results by mostly applying open source packages, making it easy to duplicate our results. We first describe in detail how we developed our CRF-based tagger. We designed a very high dimensional feature set that includes most of information that may be relevant. We trained bi-directional CRF models with the same set of features, one applies forward parsing and the other backward, and integrated two models based on the output scores and dictionary filtering. One of the most prominent factors that contributes to the good performance of our tagger is the integration of an additional backward parsing model. However, from the definition of CRF, it appears that a CRF model is symmetric and bi-directional parsing models will produce the same results. We show that due to different feature settings, a CRF model can be asymmetric and the feature setting for our tagger in BioCreative 2 not only produces different results but also gives backward parsing models slight but constant advantage over forward parsing model. To fully explore the potential of integrating bi-directional parsing models, we applied different asymmetric feature settings to generate many bi-directional parsing models and integrate them based on the output scores. Experimental results show that this integrated model can achieve even higher F-score solely based on the training corpus for gene mention tagging. Data sets, programs and an on-line service of our gene mention tagger can be accessed at http://aiia.iis.sinica.edu.tw/biocreative2.htm.

A comparison of survey methods to evaluate macrophyte index of biotic integrity performance in Minnesota lakes

USGS Publications Warehouse

Vondracek, Bruce C.; Koch, Justine D.; Beck, Marcus W.

2014-01-01

Aquatic macrophytes shape trophic web dynamics, provide food and refuge for macroinvertebrates and fish, and increase nutrient retention, sediment stabilization, and water clarity. Macrophytes are well-suited as indicators of ecological health because they are immobile, relatively easy to sample and identify, and respond to anthropogenic disturbance on an ecological time scale. Aquatic plant monitoring programs can provide valuable information to water resource managers, especially in conjunction with macrophyte-based indices of biotic integrity (IBI). However, there are several current sampling designs and the precision of IBI scores has not been evaluated across different surveys. We evaluated the performance of the Minnesota macrophyte-based IBI for two survey designs; a point intercept (PI) survey and a belt transect (BT) survey. PI surveys are time intensive, especially on large lakes, whereas BT are less time intensive and have been used historically in Minnesota. Our objectives were to compare the PI surveys with BT surveys on the same lakes, and to modify the BT survey (MT survey) to improve information obtained from BT surveys. BT surveys consistently overestimated IBI scores compared to the PI method (t = 6.268, df = 60, p < 0.001). Overall IBI scores calculated from MT surveys differed significantly from PI scores, but on average, MT surveys predicted scores only 3% lower than PI scores. Implementation of the Minnesota macrophyte-based IBI through the adoption of the MT survey approach would improve sampling efficiency and enable widespread documentation of the effects of landscape change, shifts in hydrologic regimes, and other anthropogenic activities on the integrity of lacustrine systems.

Differential Weighting for Subcomponent Measures of Integrated Clinical Encounter Scores Based on the USMLE Step 2 CS Examination: Effects on Composite Score Reliability and Pass-Fail Decisions.

PubMed

Park, Yoon Soo; Lineberry, Matthew; Hyderi, Abbas; Bordage, Georges; Xing, Kuan; Yudkowsky, Rachel

2016-11-01

Medical schools administer locally developed graduation competency examinations (GCEs) following the structure of the United States Medical Licensing Examination Step 2 Clinical Skills that combine standardized patient (SP)-based physical examination and the patient note (PN) to create integrated clinical encounter (ICE) scores. This study examines how different subcomponent scoring weights in a locally developed GCE affect composite score reliability and pass-fail decisions for ICE scores, contributing to internal structure and consequential validity evidence. Data from two M4 cohorts (2014: n = 177; 2015: n = 182) were used. The reliability of SP encounter (history taking and physical examination), PN, and communication and interpersonal skills scores were estimated with generalizability studies. Composite score reliability was estimated for varying weight combinations. Faculty were surveyed for preferred weights on the SP encounter and PN scores. Composite scores based on Kane's method were compared with weighted mean scores. Faculty suggested weighting PNs higher (60%-70%) than the SP encounter scores (30%-40%). Statistically, composite score reliability was maximized when PN scores were weighted at 40% to 50%. Composite score reliability of ICE scores increased by up to 0.20 points when SP-history taking (SP-Hx) scores were included; excluding SP-Hx only increased composite score reliability by 0.09 points. Classification accuracy for pass-fail decisions between composite and weighted mean scores was 0.77; misclassification was < 5%. Medical schools and certification agencies should consider implications of assigning weights with respect to composite score reliability and consequences on pass-fail decisions.

Development of a Comprehensive Osteochondral Allograft MRI Scoring System (OCAMRISS) With Histopathologic, Micro–Computed Tomography, and Biomechanical Validation

PubMed Central

Pallante-Kichura, Andrea L.; Bae, Won C.; Du, Jiang; Statum, Sheronda; Wolfson, Tanya; Gamst, Anthony C.; Cory, Esther; Amiel, David; Bugbee, William D.; Sah, Robert L.; Chung, Christine B.

2014-01-01

Objective: To describe and apply a semiquantitative MRI scoring system for multifeature analysis of cartilage defect repair in the knee by osteochondral allografts and to correlate this scoring system with histopathologic, micro–computed tomography (µCT), and biomechanical reference standards using a goat repair model. Design: Fourteen adult goats had 2 osteochondral allografts implanted into each knee: one in the medial femoral condyle and one in the lateral trochlea. At 12 months, goats were euthanized and MRI was performed. Two blinded radiologists independently rated 9 primary features for each graft, including cartilage signal, fill, edge integration, surface congruity, calcified cartilage integrity, subchondral bone plate congruity, subchondral bone marrow signal, osseous integration, and presence of cystic changes. Four ancillary features of the joint were also evaluated, including opposing cartilage, meniscal tears, synovitis, and fat-pad scarring. Comparison was made with histologic and µCT reference standards as well as biomechanical measures. Interobserver agreement and agreement with reference standards was assessed. Cohen’s κ, Spearman’s correlation, and Kruskal-Wallis tests were used as appropriate. Results: There was substantial agreement (κ > 0.6, P < 0.001) for each MRI feature and with comparison against reference standards, except for cartilage edge integration (κ = 0.6). There was a strong positive correlation between MRI and reference standard scores (ρ = 0.86, P < 0.01). Osteochondral allograft MRI scoring system was sensitive to differences in outcomes between the types of allografts. Conclusions: We have described a comprehensive MRI scoring system for osteochondral allografts and have validated this scoring system with histopathologic and µCT reference standards as well as biomechanical indentation testing. PMID:24489999

An Analysis of Medical Laboratory Technology Journals' Instructions for Authors.

PubMed

Horvat, Martina; Mlinaric, Ana; Omazic, Jelena; Supak-Smolcic, Vesna

2016-08-01

Instructions for authors (IFA) need to be informative and regularly updated. We hypothesized that journals with a higher impact factor (IF) have more comprehensive IFA. The aim of the study was to examine whether IFA of journals indexed in the Journal Citation Reports 2013, "Medical Laboratory Technology" category, are written in accordance with the latest recommendations and whether the quality of instructions correlates with the journals' IF. 6 out of 31 journals indexed in "Medical Laboratory Technology" category were excluded (unsuitable or unavailable instructions). The remaining 25 journals were scored based on a set of 41 yes/no questions (score 1/0) and divided into four groups (editorial policy, research ethics, research integrity, manuscript preparation) by three authors independently (max score = 41). We tested the correlation between IF and total score and the difference between scores in separate question groups. The median total score was 26 (21-30) [portion of positive answers 0.63 (0.51-0.73)]. There was no statistically significant correlation between a journal's IF and the total score (rho = 0.291, P = 0.159). IFA included recommendations concerning research ethics and manuscript preparation more extensively than recommendations concerning editorial policy and research integrity (Ht = 15.91, P = 0.003). Some policies were poorly described (portion of positive answers), for example: procedure for author's appeal (0.04), editorial submissions (0.08), appointed body for research integrity issues (0.08). The IF of the "Medical Laboratory Technology" journals does not reflect a journals' compliance to uniform standards. There is a need for improving editorial policies and the policies on research integrity.

Community based rehabilitation: Does it really improve the level of productivity among persons with physical disabilities?

PubMed

Moniruzzaman; Saha, Palash Chandra; Habib, Md Monjurul

2015-01-01

The Community Based Rehabilitation (CBR) is a common approach to work with disable people to improve their quality of life by improving the level of productivity and integrating them into society. But the effectiveness of CBR varies by country to country. The aim of the study was to find out whether CBR programs really improved the level of productivity among persons with physical disabilities. A cross-sectional study was conducted among equal number of respondents (n=51) from each CBR coverage and non-coverage areas from two different upazilla (sub-districts) located 40 km away from the capital city of Bangladesh. Respondents were selected purposively and data were collected by face to face interviews. Willer's (1994) version of the Community Integration Questionnaire (CIQ) was used to measure the level of productivity among adult with physical disabilities. The mean score of total productivity integration in CBR coverage and non-coverage areas were 4.3 ± 2.4 and 4.5 ± 2.2 respectively. This difference was statistically non-significant (p=0.602).The levels of productivity integration between CBR coverage and non-coverage areas varied only 2-4% (p=0.793). The mean score of productivity integration and levels of productivity were not different significantly in CBR coverage and non-coverage areas.

Attitudes among students and teachers on vertical integration between clinical medicine and basic science within a problem-based undergraduate medical curriculum.

PubMed

Brynhildsen, J; Dahle, L O; Behrbohm Fallsberg, M; Rundquist, I; Hammar, M

2002-05-01

Important elements in the curriculum at the Faculty of Health Sciences in Linköping are vertical integration, i.e. integration between the clinical and basic science sections of the curriculum, and horizontal integration between different subject areas. Integration throughout the whole curriculum is time-consuming for both teachers and students and hard work is required for planning, organization and execution. The aim was to assess the importance of vertical and horizontal integration in an undergraduate medical curriculum, according to opinions among students and teachers. In a questionnaire 102 faculty teachers and 106 students were asked about the importance of 14 different components of the undergraduate medical curriculum including vertical and horizontal integration. They were asked to assign between one and six points to each component (6 points = extremely important for the quality of the curriculum; 1 point = unimportant). Students as well as teachers appreciated highly both forms of integration. Students scored horizontal integration slightly but significantly higher than the teachers (median 6 vs 5 points; p=0.009, Mann-Whitney U-test), whereas teachers scored vertical integration higher than students (6 vs 5; p=0.019, Mann-Whitney U-test). Both students and teachers considered horizontal and vertical integration to be highly important components of the undergraduate medical programme. We believe both kinds of integration support problem-based learning and stimulate deep and lifelong learning and suggest that integration should always be considered deeply when a new curriculum is planned for undergraduate medical education.

Individual Differences in Base Rate Neglect: A Fuzzy Processing Preference Index

PubMed Central

Wolfe, Christopher R.; Fisher, Christopher R.

2013-01-01

Little is known about individual differences in integrating numeric base-rates and qualitative text in making probability judgments. Fuzzy-Trace Theory predicts a preference for fuzzy processing. We conducted six studies to develop the FPPI, a reliable and valid instrument assessing individual differences in this fuzzy processing preference. It consists of 19 probability estimation items plus 4 "M-Scale" items that distinguish simple pattern matching from “base rate respect.” Cronbach's Alpha was consistently above 0.90. Validity is suggested by significant correlations between FPPI scores and three other measurers: "Rule Based" Process Dissociation Procedure scores; the number of conjunction fallacies in joint probability estimation; and logic index scores on syllogistic reasoning. Replicating norms collected in a university study with a web-based study produced negligible differences in FPPI scores, indicating robustness. The predicted relationships between individual differences in base rate respect and both conjunction fallacies and syllogistic reasoning were partially replicated in two web-based studies. PMID:23935255

School Policies and the Black-White Test Score Gap. Working Paper Series. SAN08-03

ERIC Educational Resources Information Center

Ladd, Helen F.

2008-01-01

This paper examines school-related policies and strategies that have been proposed or justified, at least in part, on the basis of their potential for reducing black-white test score gaps. These include strategies, one of which is greater integration, to reduce differences in the quality of teachers faced by black and white students; school and…

An integrated data analysis approach to investigating measurement equivalence of DSM nicotine dependence symptoms.

PubMed

Rose, Jennifer S; Dierker, Lisa C; Hedeker, Donald; Mermelstein, Robin

2013-04-01

Research identifying nicotine dependence (ND) symptoms most appropriate for measurement of adolescent ND and invariant across the range of smoking exposure is hampered by limited sample size and variability of smoking behavior within independent studies. Integrative data analysis, the process of pooling and analyzing data from multiple studies, produces larger and more heterogeneous samples with which to evaluate measurement equivalence across the full continuum of smoking quantity and frequency. Data from two studies were pooled to obtain a large sample of adolescent and young adult smokers with considerable variability in smoking. We used moderated nonlinear factor analysis, which produces study equivalent ND scores, to simultaneously evaluate whether 14 DSM ND symptoms had equivalent psychometric properties (1) at different levels of smoking frequency and (2) across a continuous range of smoking quantity, after accounting for study differences. Nine of 14 symptoms were equivalent across levels of smoking frequency and quantity in probability of endorsement at different levels of ND and in ability to discriminate between levels of ND severity. A more precise ND factor score accounted for study and smoking related differences in symptom psychometric properties. DSM-IV symptoms may be used to reliably assess ND in young populations across a wide range of smoking quantity and frequency and within both nationally representative and geographically restricted samples with different study designs. Symptoms shared across studies produced an equivalently scaled ND factor score, demonstrating that integrating data for the purpose of studying ND in young smokers is viable. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Clinical skills training in a skills lab compared with skills training in internships: comparison of skills development curricula.

PubMed

Peeraer, G; Scherpbier, A J J A; Remmen, R; De winter, B Y; Hendrickx, K; van Petegem, P; Weyler, J; Bossaert, L

2007-11-01

The necessity of learning skills through "integrated skills training" at an undergraduate level has been supported by several studies. The University of Antwerp implemented undergraduate skills training in its renewed curriculum in 1998, after it was demonstrated that Flemish students did not master their medical skills as well as Dutch students who received "integrated skills training" as part of their undergraduate medical course. The aim of this study was to compare the skill outcome levels of two different student populations: students who had been trained in basic clinical skills mainly through clinical internships in year 7 with students who had learned these skills through an integrated longitudinal programme in a special learning environment in years 1-5 prior to their internship experience. Students of the traditional curriculum learned skills through a 75 hour programme in years 4 and 5, through plenary sessions followed by a 12 month period of internships during which skills could be further practiced. We tested this group right after completion of their internships. Students from the renewed curriculum followed a 200 hour intensive small group skills training programme offered in years 1-5. This group was tested before starting their internships. On global OSCE-scores, renewed curriculum students had significantly higher overall scores (p<0.001) and they scored significantly higher at 6 of 15 stations. There was no significant difference at 8 stations, while traditional curriculum students scored better at station 1. 5 years and 200 hours of integrated undergraduate skills training is more effective as a method of learning basic clinical skills, compared to learning these skills through 75 hours of traditional skill training and reinforcement of these skills in 12 month clinical internships, when measured by means of an OSCE.

[Upper gastrointestinal bleeding: usefulness of prognostic scores].

PubMed

Badel, S; Dorta, G; Carron, P-N

2011-08-24

Upper gastrointestinal bleeding is a potentially serious event, usually requiring urgent endoscopic treatment. Better stratification of the risk of complication or death could optimize management and improve patient outcomes, while ensuring adequate resource allocation. Several prognostic scores have been developed, in order to identify high risk patients, who require immediate treatment, and patients at low risk for whom endoscopy may be delayed. An ideal prognostic score should be accurate, simple, reproducible, and prospectively validated in different populations. Published scores meet these requirements only partially, and thus can only be used as part of an integrative diagnostic and therapeutic process.

Study of the Continuous Improvement Trend for Health, Safety and Environmental Indicators, after Establishment of Integrated Management System (IMS) in a Pharmaceutical Industry in Iran.

PubMed

Mariouryad, Pegah; Golbabaei, Farideh; Nasiri, Parvin; Mohammadfam, Iraj; Marioryad, Hossein

2015-10-01

Nowadays, organizations try to improve their services and consequently adopt management systems and standards which have become key parts in various industries. One of these management systems which have been noticed in the recent years is Integrated Management System that is the combination of quality, health, safety and environment management systems. This study was conducted with the aim of evaluating the improvement trend after establishment of integrated management system for health, safety and environment indicators, in a pharmaceutical industry in Iran. First, during several inspections in different parts of the industry, indicators that should have been noted were listed and then these indicators were organized in 3 domains of health, safety and environment in the form of a questionnaire that followed Likert method of scaling. Also, the weight of each index was resulted from averaging out of 30 managers and the viewpoints of the related experts in the field. Moreover, by checking the documents and evidence of different years (5 contemplation years of this study), the score of each indicator was determined by multiplying the weight and score of the indices and were finally analysed. Over 5 years, scores of health scope indicators, increased from 161.99 to 202.23. Score in the first year after applying the integrated management system establishment was 172.37 in safety part and in the final year increased to 197.57. The changes of environmental scope rates, from the beginning of the program up to the last year increased from 49.24 to 64.27. Integrated management systems help organizations to improve programs to achieve their objectives. Although in this study all trends of health, safety and environmental indicator changes were positive, but at the same time showed to be slow. So, one can suggest that the result of an annual evaluation should be applied in planning future activities for the years ahead.

Study of the Continuous Improvement Trend for Health, Safety and Environmental Indicators, after Establishment of Integrated Management System (IMS) in a Pharmaceutical Industry in Iran

PubMed Central

Mariouryad, Pegah; Golbabaei, Farideh; Nasiri, Parvin; Mohammadfam, Iraj

2015-01-01

Background Nowadays, organizations try to improve their services and consequently adopt management systems and standards which have become key parts in various industries. One of these management systems which have been noticed in the recent years is Integrated Management System that is the combination of quality, health, safety and environment management systems. Aim This study was conducted with the aim of evaluating the improvement trend after establishment of integrated management system for health, safety and environment indicators, in a pharmaceutical industry in Iran. Materials and Methods First, during several inspections in different parts of the industry, indicators that should have been noted were listed and then these indicators were organized in 3 domains of health, safety and environment in the form of a questionnaire that followed Likert method of scaling. Also, the weight of each index was resulted from averaging out of 30 managers and the viewpoints of the related experts in the field. Moreover, by checking the documents and evidence of different years (5 contemplation years of this study), the score of each indicator was determined by multiplying the weight and score of the indices and were finally analysed. Results Over 5 years, scores of health scope indicators, increased from 161.99 to 202.23. Score in the first year after applying the integrated management system establishment was 172.37 in safety part and in the final year increased to 197.57. The changes of environmental scope rates, from the beginning of the program up to the last year increased from 49.24 to 64.27. Conclusion Integrated management systems help organizations to improve programs to achieve their objectives. Although in this study all trends of health, safety and environmental indicator changes were positive, but at the same time showed to be slow. So, one can suggest that the result of an annual evaluation should be applied in planning future activities for the years ahead. PMID:26557547

Impact of Integrated Teaching Sessions for Comprehensive Learning and Rational Pharmacotherapeutics for Medical Undergraduates

PubMed Central

Ambwani, Sneha; Vegada, Bhavisha; Sidhu, Rimple; Charan, Jaykaran

2017-01-01

Background: It is postulated that integrated teaching method may enhance retention of the knowledge and clinical applicability of the basic sciences as compared to the didactic method. Aim: The present study was undertaken to compare the integrated teaching method with the didactic method for the learning ability and clinical applicability of the basic sciences. Materials and Methods: The 2nd year MBBS students were divided into two groups randomly. The study was conducted into two stages. In the first stage, conventional didactic lectures on hypertension (HT) were delivered to one group and multidisciplinary integrated teaching to another group. For the second stage, diabetes mellitus groups were swapped. Retention of the knowledge between the groups were assessed through a multiple choice questions (MCQ) test. Feedback of the students and faculty was obtained on a 5 point Likert scale. For the comparison, student's data were regrouped into four groups, i.e., integrated HT, didactic HT, integrated diabetes and didactic diabetes. Results: There was no significant difference of MCQ score between integrated HT, didactic HT, and integrated diabetes group. However, the score obtained in didactic diabetes was significantly more (P = 0.00) than other groups. Majority of the students favored integrated teaching for clinical application of basic science and learning of the skill for the future clinical practice. Faculties considered integrated method as a useful method and suggested frequent use of this method. Conclusion: There was no clear difference in knowledge acquisition; however, the students and faculties favored integrated teaching method in the feedback questionnaire. PMID:29344460

Effectiveness of Integrative Restoration (iRest) Yoga Nidra on Mindfulness, Sleep, and Pain in Health Care Workers.

PubMed

Livingston, Eva; Collette-Merrill, Katreena

This article examines the effectiveness of Integrative Restoration (iRest) Yoga Nidra meditation on mindfulness, sleep, and pain in health care workers. As health care workers provide emotional support to patients, it is not uncommon for workers to experience both physical and mental exhaustion. One holistic approach to support employees is mindfulness training. iRest Yoga Nidra is a complementary and integrative health therapy that increases mindfulness. A pre-/postinterveniton descriptive survey design was used. Before and after experiencing iRest meditation, participants completed a 51-item questionnaire consisting of demographics plus 3 validated instruments: the Five-Facet Mindfulness Questionnaire (FFMQ), the Epworth Sleepiness Scale (ESS), and Department of Defense/Veterans Administration (DoD/VA) Pain Supplemental Questions (PSQ). A total of 15 participants completed both questionnaires. Postintervention FFMQ scores were significantly higher than preintervention (z = -3.294, P = .001). The highest subscale scores were "acting with awareness" and "nonjudging of inner experience." There was a not a significant difference in the mean ESS scores at baseline and follow-up. However, there was a strong negative correlation between the mean ESS improvement score and the number of weeks attended (rs = -0.705, P = .003). There was a not a significant difference in the mean pain baseline and follow-up scores. This study showed significant improvement in mindfulness of health care workers following a guided 8-week iRest Yoga Nidra program. The results of this study may provide some insight into helping health care workers deal with the demands of their profession in a positive manner, thus leading to an improved workplace environment.

Comparison of two barium suspensions for dedicated small-bowel series.

PubMed

Davidson, J C; Einstein, D M; Herts, B R; Balfe, D M; Koehler, R E; Morgan, D E; Lieber, M; Baker, M E

1999-02-01

The in vivo radiographic features of two commercially available formulations of barium used as contrast media in dedicated small-bowel series were compared. Fifty-six consecutive outpatients referred for a dedicated small-bowel series were randomly administered either E-Z-Paque or Entrobar. Representative survey radiographs from each examination were randomized and reviewed by six gastrointestinal radiologists from three institutions. Each observer assigned a numeric score (1 = poor, 2 = fair, 3 = good, and 4 = excellent) that rated the quality of the radiograph with respect to these characteristics: definition of fold pattern, translucency, distention, and integrity of the barium column. Statistical analysis was performed for each characteristic using Wilcoxon's two-sample rank sum test. All six observers found a statistically significant difference between the two barium formulations for mean scores for definition of fold pattern and translucency. Mean scores for fold pattern were 3.3, 3.0, 3.2, 3.6, 3.3, and 3.4 for Entrobar and 2.1, 2.3, 2.4, 3.2, 2.6, and 2.7 for E-Z-Paque. Mean scores for translucency were 2.5, 2.7, 2.8, 3.1, 2.7, and 3.3 for Entrobar and 1.6, 1.7, 2.1, 2.3, 1.9, and 2.7 for E-Z-Paque. No statistically significant difference was found for mean score for distention or integrity of the barium column. On radiographs, Entrobar was found to have superior characteristics for visualization of fold pattern and translucency but offered no advantages for distention or integrity of the barium column. Improved translucency and definition of fold pattern may translate into improved sensitivity and confidence in diagnosing small-bowel abnormality.

Methodological considerations when translating “burnout”☆

PubMed Central

Squires, Allison; Finlayson, Catherine; Gerchow, Lauren; Cimiotti, Jeannie P.; Matthews, Anne; Schwendimann, Rene; Griffiths, Peter; Busse, Reinhard; Heinen, Maude; Brzostek, Tomasz; Moreno-Casbas, Maria Teresa; Aiken, Linda H.; Sermeus, Walter

2014-01-01

No study has systematically examined how researchers address cross-cultural adaptation of burnout. We conducted an integrative review to examine how researchers had adapted the instruments to the different contexts. We reviewed the Content Validity Indexing scores for the Maslach Burnout Inventory-Human Services Survey from the 12-country comparative nursing workforce study, RN4CAST. In the integrative review, multiple issues related to translation were found in existing studies. In the cross-cultural instrument analysis, 7 out of 22 items on the instrument received an extremely low kappa score. Investigators may need to employ more rigorous cross-cultural adaptation methods when attempting to measure burnout. PMID:25343131

Transforming Biology Assessment with Machine Learning: Automated Scoring of Written Evolutionary Explanations

NASA Astrophysics Data System (ADS)

Nehm, Ross H.; Ha, Minsu; Mayfield, Elijah

2012-02-01

This study explored the use of machine learning to automatically evaluate the accuracy of students' written explanations of evolutionary change. Performance of the Summarization Integrated Development Environment (SIDE) program was compared to human expert scoring using a corpus of 2,260 evolutionary explanations written by 565 undergraduate students in response to two different evolution instruments (the EGALT-F and EGALT-P) that contained prompts that differed in various surface features (such as species and traits). We tested human-SIDE scoring correspondence under a series of different training and testing conditions, using Kappa inter-rater agreement values of greater than 0.80 as a performance benchmark. In addition, we examined the effects of response length on scoring success; that is, whether SIDE scoring models functioned with comparable success on short and long responses. We found that SIDE performance was most effective when scoring models were built and tested at the individual item level and that performance degraded when suites of items or entire instruments were used to build and test scoring models. Overall, SIDE was found to be a powerful and cost-effective tool for assessing student knowledge and performance in a complex science domain.

Recruitment recommendation system based on fuzzy measure and indeterminate integral

NASA Astrophysics Data System (ADS)

Yin, Xin; Song, Jinjie

2017-08-01

In this study, we propose a comprehensive evaluation approach based on indeterminate integral. By introducing the related concepts of indeterminate integral and their formulas into the recruitment recommendation system, we can calculate the suitability of each job for different applicants with the defined importance for each criterion listed in the job advertisements, the association between different criteria and subjective assessment as the prerequisite. Thus we can make recommendations to the applicants based on the score of the suitability of each job from high to low. In the end, we will exemplify the usefulness and practicality of this system with samples.

Individual class evaluation and effective teaching characteristics in integrated curricula.

PubMed

Hwang, Jung Eun; Kim, Na Jin; Song, Meiying; Cui, Yinji; Kim, Eun Ju; Park, In Ae; Lee, Hye In; Gong, Hye Jin; Kim, Su Young

2017-12-12

In an integrated curriculum, multiple instructors take part in a course in the form of team teaching. Accordingly, medical schools strive to manage each course run by numerous instructors. As part of the curriculum management, course evaluation is conducted, but a single, retrospective course evaluation does not comprehensively capture student perception of classes by different instructors. This study aimed to demonstrate the need for individual class evaluation, and further to identify teaching characteristics that instructors need to keep in mind when preparing classes. From 2014 to 2015, students at one medical school left comments on evaluation forms after each class. Courses were also assessed after each course. Their comments were categorized by connotation (positive or negative) and by subject. Within each subject category, test scores were compared between positively and negatively mentioned classes. The Mann-Whitney U test was performed to test group differences in scores. The same method was applied to the course evaluation data. Test results for course evaluation showed group difference only in the practice/participation category. However, test results for individual class evaluation showed group differences in six categories: difficulty, main points, attitude, media/contents, interest, and materials. That is, the test scores of classes positively mentioned in six domains were significantly higher than those of negatively mentioned classes. It was proved that individual class evaluation is needed to manage multi-instructor courses in integrated curricula of medical schools. Based on the students' extensive feedback, we identified teaching characteristics statistically related to academic achievement. School authorities can utilize these findings to encourage instructors to develop effective teaching characteristics in class preparation.

Utility of the Croatian translation of the community integration questionnaire-revised in a sample of adults with moderate to severe traumatic brain injury.

PubMed

Tršinski, Dubravko; Tadinac, Meri; Bakran, Žarko; Klepo, Ivana

2018-02-23

To examine the utility of the Community Integration Questionnaire-Revised, translated into Croatian, in a sample of adults with moderate to severe traumatic brain injury. The Community Integration Questionnaire-Revised was administered to a sample of 88 adults with traumatic brain injury and to a control sample matched by gender, age and education. Participants with traumatic brain injury were divided into four subgroups according to injury severity. The internal consistency of the Community Integration Questionnaire-Revised was satisfactory. The differences between the group with traumatic brain injury and the control group were statistically significant for the overall Community Integration Questionnaire-Revised score, as well as for all the subscales apart from the Home Integration subscale. The community Integration Questionnaire-Revised score varied significantly for subgroups with different severity of traumatic brain injury. The results show that the Croatian translation of the Community Integration Questionnaire-Revised is useful in assessing participation in adults with traumatic brain injury and confirm previous findings that severity of injury predicts community integration. Results of the new Electronic Social Networking scale indicate that persons who are more active on electronic social networks report better results for other domains of community integration, especially social activities. Implications for rehabilitation The Croatian translation of the Community Integration Questionnaire-Revised is a valid tool for long-term assessment of participation in various domains in persons with moderate to severe traumatic brain injury Persons with traumatic brain injury who are more active in the use of electronic social networking are also more integrated into social and productivity domains. Targeted training in the use of new technologies could enhance participation after traumatic brain injury.

Proposal of a service delivery integration index of home care for older persons: application in several European cities

PubMed Central

Henrard, Jean-Claude; Ankri, Joël; Frijters, Dinnus; Carpenter, Iain; Topinkova, Eva; Garms-Homolova, Vjenka; Finne-Soveri, Harriett; Sørbye, Liv Wergeland; Jónsson, Palmi V.; Ljunggren, Gunnar; Schroll, Marianne; Wagner, Cordula; Bernabei, Roberto

2006-01-01

Abstract Purpose To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. Theory Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure approach. Method Items considered as part of both dimensions according to an expert consensus (face validity) were extracted from a standardised questionnaire used in “Aged in Home care” (AdHoc) study to capture basic characteristics of home care services. Their summation leads to a services' delivery integration index. This index was applied to AdHoc services. A factor analysis was computed in order to empirically test the validity of the theoretical constructs. The plot of the settings was performed. Results Application of the index ranks home care services in four groups according to their score. Factor analysis identifies a first factor which opposes working arrangement within service to organisational structure bringing together provisions for social care. A second factor corresponds to basic nursing care and therapies. Internal consistency for those three domains ranges from 0.78 to 0.93. When plotting the different settings different models of service delivery appear. Conclusion The proposed index shows that behind a total score several models of care delivery are hidden. Comparison of service delivery integration should take into account this heterogeneity. PMID:17006549

Implementing and measuring the level of laboratory service integration in a program setting in Nigeria.

PubMed

Mbah, Henry; Negedu-Momoh, Olubunmi Ruth; Adedokun, Oluwasanmi; Ikani, Patrick Anibbe; Balogun, Oluseyi; Sanwo, Olusola; Ochei, Kingsley; Ekanem, Maurice; Torpey, Kwasi

2014-01-01

The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory services and highlight some key intervention steps taken, to enhance service integration. A quantitative before-and-after study conducted in 122 Family Health International (FHI360) supported health facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no integration, 1 = partial integration, 2 = full integration) for each service package. A composite score grading expressed as a percentage of total obtainable score of 14 was defined and used to classify facilities (≤ 80% FULL, 25% to 79% PARTIAL and <25% NO integration). Weaknesses were noted and addressed. We analyzed 9 (7.4%) primary, 104 (85.2%) secondary and 9 (7.4%) tertiary level facilities. There were statistically significant differences in integration levels between baseline and 3 months follow-up period (p<0.01). Baseline median total integration score was 4 (IQR 3 to 5) compared to 7 (IQR 4 to 9) at 3 months follow-up (p = 0.000). Partial and fully integrated laboratory systems were 64 (52.5%) and 0 (0.0%) at baseline, compared to 100 (82.0%) and 3 (2.4%) respectively at 3 months follow-up (p = 0.000). This project showcases our novel approach to measure the status of each laboratory on the integration continuum.

Meeting the Demands of Professional Education: A Study of Mind Mapping in a Professional Doctoral Physical Therapy Education Program

ERIC Educational Resources Information Center

Pollard, Elicia L.

2010-01-01

The purposes of this study are to investigate whether the quiz scores of physical therapy students who integrated mind mapping in their learning strategies are significantly different than the quiz scores of students who did not use mind mapping to learn in a lecture-based research course and examine the students' perceptions of mind mapping as a…

Characteristics of cancer patients presenting to an integrative medicine practice-based research network.

PubMed

Edman, Joel S; Roberts, Rhonda S; Dusek, Jeffery A; Dolor, Rowena; Wolever, Ruth Q; Abrams, Donald I

2014-09-01

To assess psychosocial characteristics, symptoms and reasons for seeking integrative medicine (IM) care in cancer patients presenting to IM clinical practices. A survey of 3940 patients was conducted at 8 IM sites. Patient reported outcome measures were collected and clinicians provided health status data. This analysis compares 353 participants self-identified as cancer patients with the larger noncancer cohort. Mean age of the cancer cohort was 55.0 years. Participants were predominantly white (85.9%), female (76.4%), and well educated (80.5% completed college). For 15.2% of cancer patients, depression scores were consistent with depressive symptoms, and average scores for perceived stress were higher than normal, but neither were significantly different from noncancer patients. The most prevalent comorbid symptoms were chronic pain (39.8%), fatigue (33.5%), and insomnia (23.3%). In the cancer cohort, perceived stress was significantly associated with depression, fatigue, insomnia, pain, and QOL. Cancer patients who chose an IM clinical practice "seeking healthcare settings that address spirituality as an aspect of care" had significantly higher levels of perceived stress, depression, and pain than those not selecting this reason. Demographic characteristics, depression scores, perceived stress scores, and reasons for seeking integrative cancer care were not significantly different between cancer patients and noncancer patients. Perceived stress may be an important indicator of QOL. The association of perceived stress, depression and pain with seeking spirituality suggests that providing IM interventions, such as effective stress management techniques and pastoral or spiritual counseling, may be helpful to patients living with cancer. © The Author(s) 2014.

Integrating data from randomized controlled trials and observational studies to predict the response to pregabalin in patients with painful diabetic peripheral neuropathy.

PubMed

Alexander, Joe; Edwards, Roger A; Savoldelli, Alberto; Manca, Luigi; Grugni, Roberto; Emir, Birol; Whalen, Ed; Watt, Stephen; Brodsky, Marina; Parsons, Bruce

2017-07-20

More patient-specific medical care is expected as more is learned about variations in patient responses to medical treatments. Analytical tools enable insights by linking treatment responses from different types of studies, such as randomized controlled trials (RCTs) and observational studies. Given the importance of evidence from both types of studies, our goal was to integrate these types of data into a single predictive platform to help predict response to pregabalin in individual patients with painful diabetic peripheral neuropathy (pDPN). We utilized three pivotal RCTs of pregabalin (398 North American patients) and the largest observational study of pregabalin (3159 German patients). We implemented a hierarchical cluster analysis to identify patient clusters in the Observational Study to which RCT patients could be matched using the coarsened exact matching (CEM) technique, thereby creating a matched dataset. We then developed autoregressive moving average models (ARMAXs) to estimate weekly pain scores for pregabalin-treated patients in each cluster in the matched dataset using the maximum likelihood method. Finally, we validated ARMAX models using Observational Study patients who had not matched with RCT patients, using t tests between observed and predicted pain scores. Cluster analysis yielded six clusters (287-777 patients each) with the following clustering variables: gender, age, pDPN duration, body mass index, depression history, pregabalin monotherapy, prior gabapentin use, baseline pain score, and baseline sleep interference. CEM yielded 1528 unique patients in the matched dataset. The reduction in global imbalance scores for the clusters after adding the RCT patients (ranging from 6 to 63% depending on the cluster) demonstrated that the process reduced the bias of covariates in five of the six clusters. ARMAX models of pain score performed well (R 2 : 0.85-0.91; root mean square errors: 0.53-0.57). t tests did not show differences between observed and predicted pain scores in the 1955 patients who had not matched with RCT patients. The combination of cluster analyses, CEM, and ARMAX modeling enabled strong predictive capabilities with respect to pain scores. Integrating RCT and Observational Study data using CEM enabled effective use of Observational Study data to predict patient responses.

Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery-VMI): lessons from exploration of cultural variations in visual-motor integration performance of preschoolers.

PubMed

Lim, C Y; Tan, P C; Koh, C; Koh, E; Guo, H; Yusoff, N D; See, C Q; Tan, T

2015-03-01

Visual-motor integration (VMI) is important in children's development because it is associated with the performance of many functional skills. Deficits in VMI have been linked to difficulties in academic performance and functional tasks. Clinical assessment experience of occupational therapists in Singapore suggested that there is a potential difference between the VMI performance of Singaporean and American children. Cross-cultural studies also implied that culture has an influence on a child's VMI performance, as it shapes the activities that a child participates in. The purpose of this study was to (1) explore if there was a difference between the VMI performance of Singaporean and American preschoolers, and (2) determine if there were ethnic differences in the VMI performance of Singaporean preschoolers. The Beery-VMI, which was standardized in America, is commonly used by occupational therapists in Singapore to assess the VMI ability of children. We administered the Beery-VMI (fifth edition) full form test (excluding the supplemental tests) to 385 preschoolers (mean age = 63.3 months) from randomly selected schools in Singapore. We compared the scores of Singaporean preschoolers with those of the American standardization norms using the one-sample t-test. Scores of different ethnic groups among the Singapore population were also compared using a one-way anova, followed by the Bonferroni post-hoc test. Singaporean preschoolers and the standardization sample of American children performed significantly differently in all age groups (P < 0.05). Among the Singapore population, the scores were also significantly different (P < 0.05) between the (i) Chinese and Malay and (ii) Chinese and Indians ethnic groups. Preschoolers from different cultural and ethnic groups had different VMI performance. Certain cultural beliefs and practices may affect VMI performance. Clinicians should exercise caution when using an assessment in communities and cultures outside the ones on which it was standardized. © 2014 John Wiley & Sons Ltd.

Relationship between the quality of children's handwriting and the Beery Buktenica developmental test of visuomotor integration after one year of writing tuition.

PubMed

Duiser, Ivonne H F; van der Kamp, John; Ledebt, Annick; Savelsbergh, Geert J P

2014-04-01

We examined whether the three subtests of the Beery Buktenica developmental test of visuomotor integration predicted quality of handwriting across and within groups of boys and girls classified as proficient, at risk or non-proficient writers according to the Concise Assessment Scale for Children's Handwriting. The Beery Buktenica developmental test of visuomotor integration and the Concise Assessment Scale for Children's Handwriting tests were administered to 240 grade 2 children. Proficient writers scored better on the visuomotor integration subtest than non-proficient writers, while proficient and at risk writers scored better than non-proficient writers on the motor coordination subtest. No differences were found on the visual perception subtest. Girls were more often classified as proficient writers than boys, and they scored better on the motor coordination subtest. Across groups, regression indicated that gender and both the visuomotor integration subtest and the motor coordination subtest were significant predictors for the quality of handwriting (i.e., accounted for 17% of the variance). After one year of writing tuition, the visuomotor integration subtest (and to a lesser extent the motor coordination subtest) but not the visual perception subtest significant relates to quality of children's handwriting as measured with the Concise Assessment Scale for Children's Handwriting. However, the relatively little variance explained also points to other abilities and/or task constraints that underlie quality of handwriting. © 2013 Occupational Therapy Australia.

[Application of Chinese Medical Syndrome Scores in Effectiveness Evaluation: a Critical Appraisal of 240 Randomized Controlled Trials].

PubMed

Luo, Hui; Liao, Xing; Wang, Qian

2015-10-01

To explore the role of traditional Chinese medicine (TCM) syndrome scores in effectiveness evaluation of clinical studies. Randomized controlled trials (RCTs) of TCM published in five journals in 2013 were retrieved, including Journal of Traditional Chinese Medicine (JTCM), Chinese Journal of Integrated Traditional and Western Medicine (CJITWM), Chinese Journal of Integrative Medicine (CJIM), Evidence-Based Complementary and Alternative Medicine (ECAM), and American Journal of Chinese Medicine (AJCM). The details of TCM syndrome scores and other relevant factors reported in articles were extracted and analyzed. Descriptive statistics and Chi-square test were used to describe general features of inclusive studies, ratios of reports on CM syndrome scores in each journal, formulated evidence, adopted evaluation rules, important degrees. The difference in the application rate of CM syndrome scores were compared in various diseases, diseases with or without CM syndrome typing, places where clinical studies were implemented, and different journals. A total of 240 RCTs were included, involving 178 published in Chinese version and 62 in English version. CM syndrome scores were used for effectiveness evaluation in 27.1% (65/240) of RCTs, of which, the highest application percentage was 35.3% (18/51) in RCTs published in CJITWM, and the lowest was 0 (0/7) in RCTs published in AJCM. There were 17 methods for grading TCM syndrome scores, of which Guideline for Clinical Research of New Chinese Herbal Medicine was most commonly used. Detailed grading standards for CM syndrome scores were reported in 46 RCTs, and CM syndrome scores were taken as primary or secondary outcomes in 6 RCTs. When describing the percentages of RCTs adopting TCM syndrome score by diseases classification, the lowest was 9.5% (2/21) in mental and behavioral disorders, and the highest was 39.1% (9/23) in endocrine, nutritional, and metabolic diseases. RCTs with TCM syndrome differentiation had a higher percentage of adopting TCM syndrome score than those without TCM syndrome differentiation (P < 0.01). Statistical differences were also found among RCTs published in Chinese core journals (32.0%), domestic science citation index (SCI) journals (28.6%), and overseas SCI journals (4.9%) (χ2 = 12.4593, P < 0.01). For RCTs conducted by Chinese scholars, the percentage of using TCM syndrome score was 32.0% in three journals from China, while 7.1% in two foreign language journals, showing significant difference (χ2 =7.3615, P < 0.01); none of RCTs conducted by foreign scholars used TCM syndrome scores for effectiveness assessment. There was a lack of agreeable and universal standards for TCM syndrome scores using in effectiveness evaluation. Therefore, it was not commonly used in domestic CM clinical studies. It was not so favorably agreed in overseas academic circles.

Academic integrity in the online learning environment for health sciences students.

PubMed

Azulay Chertok, Ilana R; Barnes, Emily R; Gilleland, Diana

2014-10-01

The online learning environment not only affords accessibility to education for health sciences students, but also poses challenges to academic integrity. Technological advances contribute to new modes of academic dishonesty, although there may be a lack of clarity regarding behaviors that constitute academic dishonesty in the online learning environment. To evaluate an educational intervention aimed at increasing knowledge and improving attitudes about academic integrity in the online learning environment among health sciences students. A quasi-experimental study was conducted using a survey of online learning knowledge and attitudes with strong reliability that was developed based on a modified version of a previously developed information technology attitudes rating tool with an added knowledge section based on the academic integrity statement. Blended-learning courses in a university health sciences center. 355 health sciences students from various disciplines, including nursing, pre-medical, and exercise physiology students, 161 in the control group and 194 in the intervention group. The survey of online learning knowledge and attitudes (SOLKA) was used in a pre-post test study to evaluate the differences in scores between the control group who received the standard course introduction and the intervention group who received an enhanced educational intervention about academic integrity during the course introduction. Post-intervention attitude scores were significantly improved compared to baseline scores for the control and intervention groups, indicating a positive relationship with exposure to the information, with a greater improvement among intervention group participants (p<0.001). There was a significant improvement in the mean post-intervention knowledge score of the intervention group compared to the control group (p=0.001). Recommendations are provided for instructors in promoting academic integrity in the online environment. Emphasis should be made about the importance of academic integrity in the online learning environment in preparation for professional behavior in the technologically advancing health sciences arena. Copyright © 2013 Elsevier Ltd. All rights reserved.

Relationships between academic performance, SES school type and perceptual-motor skills in first grade South African learners: NW-CHILD study.

PubMed

Pienaar, A E; Barhorst, R; Twisk, J W R

2014-05-01

Perceptual-motor skills contribute to a variety of basic learning skills associated with normal academic success. This study aimed to determine the relationship between academic performance and perceptual-motor skills in first grade South African learners and whether low SES (socio-economic status) school type plays a role in such a relationship. This cross-sectional study of the baseline measurements of the NW-CHILD longitudinal study included a stratified random sample of first grade learners (n = 812; 418 boys and 394 boys), with a mean age of 6.78 years ± 0.49 living in the North West Province (NW) of South Africa. The Beery-Buktenica Developmental Test of Visual-Motor Integration-4 (VMI) was used to assess visual-motor integration, visual perception and hand control while the Bruininks Oseretsky Test of Motor Proficiency, short form (BOT2-SF) assessed overall motor proficiency. Academic performance in math, reading and writing was assessed with the Mastery of Basic Learning Areas Questionnaire. Linear mixed models analysis was performed with spss to determine possible differences between the different VMI and BOT2-SF standard scores in different math, reading and writing mastery categories ranging from no mastery to outstanding mastery. A multinomial multilevel logistic regression analysis was performed to assess the relationship between a clustered score of academic performance and the different determinants. A strong relationship was established between academic performance and VMI, visual perception, hand control and motor proficiency with a significant relationship between a clustered academic performance score, visual-motor integration and visual perception. A negative association was established between low SES school types on academic performance, with a common perceptual motor foundation shared by all basic learning areas. Visual-motor integration, visual perception, hand control and motor proficiency are closely related to basic academic skills required in the first formal school year, especially among learners in low SES type schools. © 2013 John Wiley & Sons Ltd.

Effect of a Lower Extremity Preventive Training Program on Physical Performance Scores in Military Recruits.

PubMed

Peck, Karen Y; DiStefano, Lindsay J; Marshall, Stephen W; Padua, Darin A; Beutler, Anthony I; de la Motte, Sarah J; Frank, Barnett S; Martinez, Jessica C; Cameron, Kenneth L

2017-11-01

Peck, KY, DiStefano, LJ, Marshall, SW, Padua, DA, Beutler, AI, de la Motte, SJ, Frank, BS, Martinez, JC, and Cameron, KL. Effect of a lower extremity preventive training program on physical performance scores in military recruits. J Strength Cond Res 31(11): 3146-3157, 2017-Exercise-based preventive training programs are designed to improve movement patterns associated with lower extremity injury risk; however, the impact of these programs on general physical fitness has not been evaluated. The purpose of this study was to compare fitness scores between participants in a preventive training program and a control group. One thousand sixty-eight freshmen from a U.S. Service Academy were cluster-randomized into either the intervention or control group during 6 weeks of summer training. The intervention group performed a preventive training program, specifically the Dynamic Integrated Movement Enhancement (DIME), which is designed to improve lower extremity movement patterns. The control group performed the Army Preparation Drill (PD), a warm-up designed to prepare soldiers for training. Main outcome measures were the Army Physical Fitness Test (APFT) raw and scaled (for age and sex) scores. Independent t tests were used to assess between-group differences. Multivariable logistic regression models were used to control for the influence of confounding variables. Dynamic Integrated Movement Enhancement group participants completed the APFT 2-mile run 20 seconds faster compared with the PD group (p < 0.001), which corresponded with significantly higher scaled scores (p < 0.001). Army Physical Fitness Test push-up scores were significantly higher in the DIME group (p = 0.041), but there were no significant differences in APFT sit-up scores. The DIME group had significantly higher total APFT scores compared with the PD group (p < 0.001). Similar results were observed in multivariable models after controlling for sex and body mass index (BMI). Committing time to the implementation of a preventive training program does not appear to negatively affect fitness test scores.

Comparisons of Physicians' and Nurses' Attitudes towards Computers.

PubMed

Brumini, Gordana; Ković, Ivor; Zombori, Dejvid; Lulić, Ileana; Bilic-Zulle, Lidija; Petrovecki, Mladen

2005-01-01

Before starting the implementation of integrated hospital information systems, the physicians' and nurses' attitudes towards computers were measured by means of a questionnaire. The study was conducted in Dubrava University Hospital, Zagreb in Croatia. Out of 194 respondents, 141 were nurses and 53 physicians, randomly selected. They surveyed by an anonymous questionnaire consisting of 8 closed questions about demographic data, computer science education and computer usage, and 30 statements on attitudes towards computers. The statements were adapted to a Likert type scale. Differences in attitudes towards computers between groups were compared using Kruskal-Wallis and Mann Whitney test for post-hoc analysis. The total score presented attitudes toward computers. Physicians' total score was 130 (97-144), while nurses' total score was 123 (88-141). It points that the average answer to all statements was between "agree" and "strongly agree", and these high total scores indicated their positive attitudes. Age, computer science education and computer usage were important factors witch enhances the total score. Younger physicians and nurses with computer science education and with previous computer experience had more positive attitudes towards computers than others. Our results are important for planning and implementation of integrated hospital information systems in Croatia.

[Visual and motor functions in schizophrenic patients].

PubMed

Del Vecchio, S; Gargiulo, P A

1992-12-01

In the present work, visual and motor functions have been explored in 26 chronic schizophrenic patients, and 7 acute schizophrenic patients, compared with 26 normal controls, by means of the Bender-Gestalt Test. Parameters under consideration were: Form distortion, rotation, integration, perseveration, use of space, subtle motricity, score (global parameter), and time employed. As regards distortion and rotation there have been highly significant differences between chronic patients and control group. Among acute patients, it was observed that perseveration was also highly significant. Conversely, integration and use of space did not differ significantly among the three groups involved. The global score, resulting from all the above mentioned parameters showed important differences between both patient groups on the one hand, and control group on the other hand. Taking into account that patients were being administered neuroleptic drugs, it can safely be said, however, that the Bender-Gestalt Test allows to recognize alteration in perceptual closure consistent with a loss of the objective structure of perceived phenomena, in both chronic and acute patients.

Using Neuropsychological Process Scores to Identify Subtle Cognitive Decline and Predict Progression to Mild Cognitive Impairment.

PubMed

Thomas, Kelsey R; Edmonds, Emily C; Eppig, Joel; Salmon, David P; Bondi, Mark W

2018-05-26

We previously operationally-defined subtle cognitive decline (SCD) in preclinical Alzheimer's disease (AD) using total scores on neuropsychological (NP) tests. NP process scores (i.e., provide information about how a total NP score was achieved) may be a useful tool for identifying early cognitive inefficiencies prior to objective impairment seen in mild cognitive impairment (MCI) and dementia. We aimed to integrate process scores into the SCD definition to identify stages of SCD and improve early detection of those at risk for decline. Cognitively "normal" participants from the Alzheimer's Disease Neuroimaging Initiative were classified as "early" SCD (E-SCD; >1 SD below mean on 2 process scores or on 1 process score plus 1 NP total score), "late" SCD (L-SCD; existing SCD criteria of >1 SD below norm-adjusted mean on 2 NP total scores in different domains), or "no SCD" (NC). Process scores considered in the SCD criteria were word-list intrusion errors, retroactive interference, and learning slope. Cerebrospinal fluid AD biomarkers were used to examine pathologic burden across groups. E-SCD and L-SCD progressed to MCI 2.5-3.4 times faster than the NC group. Survival curves for E-SCD and L-SCD converged at 7-8 years after baseline. The combined (E-SCD+L-SCD) group had improved sensitivity to detect progression to MCI relative to L-SCD only. AD biomarker positivity increased across NC, SCD, and MCI groups. Process scores can be integrated into the SCD criteria to allow for increased sensitivity and earlier identification of cognitively normal older adults at risk for decline prior to frank impairment on NP total scores.

A randomized controlled study of manikin simulator fidelity on neonatal resuscitation program learning outcomes.

PubMed

Curran, Vernon; Fleet, Lisa; White, Susan; Bessell, Clare; Deshpandey, Akhil; Drover, Anne; Hayward, Mark; Valcour, James

2015-03-01

The neonatal resuscitation program (NRP) has been developed to educate physicians and other health care providers about newborn resuscitation and has been shown to improve neonatal resuscitation skills. Simulation-based training is recommended as an effective modality for instructing neonatal resuscitation and both low and high-fidelity manikin simulators are used. There is limited research that has compared the effect of low and high-fidelity manikin simulators for NRP learning outcomes, and more specifically on teamwork performance and confidence. The purpose of this study was to examine the effect of using low versus high-fidelity manikin simulators in NRP instruction. A randomized posttest-only control group study design was conducted. Third year undergraduate medical students participated in NRP instruction and were assigned to an experimental group (high-fidelity manikin simulator) or control group (low-fidelity manikin simulator). Integrated skills station (megacode) performance, participant satisfaction, confidence and teamwork behaviour scores were compared between the study groups. Participants in the high-fidelity manikin simulator instructional group reported significantly higher total scores in overall satisfaction (p = 0.001) and confidence (p = 0.001). There were no significant differences in teamwork behaviour scores, as observed by two independent raters, nor differences on mandatory integrated skills station performance items at the p < 0.05 level. Medical students' reported greater satisfaction and confidence with high-fidelity manikin simulators, but did not demonstrate overall significantly improved teamwork or integrated skills station performance. Low and high-fidelity manikin simulators facilitate similar levels of objectively measured NRP outcomes for integrated skills station and teamwork performance.

Applied immuno-epidemiological research: an approach for integrating existing knowledge into the statistical analysis of multiple immune markers.

PubMed

Genser, Bernd; Fischer, Joachim E; Figueiredo, Camila A; Alcântara-Neves, Neuza; Barreto, Mauricio L; Cooper, Philip J; Amorim, Leila D; Saemann, Marcus D; Weichhart, Thomas; Rodrigues, Laura C

2016-05-20

Immunologists often measure several correlated immunological markers, such as concentrations of different cytokines produced by different immune cells and/or measured under different conditions, to draw insights from complex immunological mechanisms. Although there have been recent methodological efforts to improve the statistical analysis of immunological data, a framework is still needed for the simultaneous analysis of multiple, often correlated, immune markers. This framework would allow the immunologists' hypotheses about the underlying biological mechanisms to be integrated. We present an analytical approach for statistical analysis of correlated immune markers, such as those commonly collected in modern immuno-epidemiological studies. We demonstrate i) how to deal with interdependencies among multiple measurements of the same immune marker, ii) how to analyse association patterns among different markers, iii) how to aggregate different measures and/or markers to immunological summary scores, iv) how to model the inter-relationships among these scores, and v) how to use these scores in epidemiological association analyses. We illustrate the application of our approach to multiple cytokine measurements from 818 children enrolled in a large immuno-epidemiological study (SCAALA Salvador), which aimed to quantify the major immunological mechanisms underlying atopic diseases or asthma. We demonstrate how to aggregate systematically the information captured in multiple cytokine measurements to immunological summary scores aimed at reflecting the presumed underlying immunological mechanisms (Th1/Th2 balance and immune regulatory network). We show how these aggregated immune scores can be used as predictors in regression models with outcomes of immunological studies (e.g. specific IgE) and compare the results to those obtained by a traditional multivariate regression approach. The proposed analytical approach may be especially useful to quantify complex immune responses in immuno-epidemiological studies, where investigators examine the relationship among epidemiological patterns, immune response, and disease outcomes.

Face recognition system using multiple face model of hybrid Fourier feature under uncontrolled illumination variation.

PubMed

Hwang, Wonjun; Wang, Haitao; Kim, Hyunwoo; Kee, Seok-Cheol; Kim, Junmo

2011-04-01

The authors present a robust face recognition system for large-scale data sets taken under uncontrolled illumination variations. The proposed face recognition system consists of a novel illumination-insensitive preprocessing method, a hybrid Fourier-based facial feature extraction, and a score fusion scheme. First, in the preprocessing stage, a face image is transformed into an illumination-insensitive image, called an "integral normalized gradient image," by normalizing and integrating the smoothed gradients of a facial image. Then, for feature extraction of complementary classifiers, multiple face models based upon hybrid Fourier features are applied. The hybrid Fourier features are extracted from different Fourier domains in different frequency bandwidths, and then each feature is individually classified by linear discriminant analysis. In addition, multiple face models are generated by plural normalized face images that have different eye distances. Finally, to combine scores from multiple complementary classifiers, a log likelihood ratio-based score fusion scheme is applied. The proposed system using the face recognition grand challenge (FRGC) experimental protocols is evaluated; FRGC is a large available data set. Experimental results on the FRGC version 2.0 data sets have shown that the proposed method shows an average of 81.49% verification rate on 2-D face images under various environmental variations such as illumination changes, expression changes, and time elapses.

The Veterans Affairs Cardiac Risk Score: Recalibrating the Atherosclerotic Cardiovascular Disease Score for Applied Use.

PubMed

Sussman, Jeremy B; Wiitala, Wyndy L; Zawistowski, Matthew; Hofer, Timothy P; Bentley, Douglas; Hayward, Rodney A

2017-09-01

Accurately estimating cardiovascular risk is fundamental to good decision-making in cardiovascular disease (CVD) prevention, but risk scores developed in one population often perform poorly in dissimilar populations. We sought to examine whether a large integrated health system can use their electronic health data to better predict individual patients' risk of developing CVD. We created a cohort using all patients ages 45-80 who used Department of Veterans Affairs (VA) ambulatory care services in 2006 with no history of CVD, heart failure, or loop diuretics. Our outcome variable was new-onset CVD in 2007-2011. We then developed a series of recalibrated scores, including a fully refit "VA Risk Score-CVD (VARS-CVD)." We tested the different scores using standard measures of prediction quality. For the 1,512,092 patients in the study, the Atherosclerotic cardiovascular disease risk score had similar discrimination as the VARS-CVD (c-statistic of 0.66 in men and 0.73 in women), but the Atherosclerotic cardiovascular disease model had poor calibration, predicting 63% more events than observed. Calibration was excellent in the fully recalibrated VARS-CVD tool, but simpler techniques tested proved less reliable. We found that local electronic health record data can be used to estimate CVD better than an established risk score based on research populations. Recalibration improved estimates dramatically, and the type of recalibration was important. Such tools can also easily be integrated into health system's electronic health record and can be more readily updated.

Platelet-rich fibrin matrix in the management of arthroscopic repair of the rotator cuff: a prospective, randomized, double-blinded study.

PubMed

Weber, Stephen C; Kauffman, Jeffrey I; Parise, Carol; Weber, Sophia J; Katz, Stephen D

2013-02-01

Arthroscopic rotator cuff repair has a high rate of patient satisfaction. However, multiple studies have shown significant rates of anatomic failure. Biological augmentation would seem to be a reasonable technique to improve clinical outcomes and healing rates. To represent a prospective, double-blinded, randomized study to assess the use of platelet-rich fibrin matrix (PRFM) in rotator cuff surgery. Randomized controlled trial; level of evidence, 1. Prestudy power analysis demonstrated that a sample size of 30 patients in each group (PRFM vs control) would allow recognition of a 20% difference in perioperative pain scores. Sixty consecutive patients were randomized to either receive a commercially available PRFM product or not. Preoperative and postoperative range of motion (ROM), University of California-Los Angeles (UCLA), and simple shoulder test (SST) scores were recorded. Surgery was performed using an arthroscopic single-row technique. Visual analog scale (VAS) pain scores were obtained upon arrival to the recovery room and 1 hour postoperatively, and narcotic consumption was recorded and converted to standard narcotic equivalents. The SST and ROM measurements were taken at 3, 6, 9, and 12 weeks postoperatively, and final (1 year) American shoulder and elbow surgeons (ASES) shoulder and UCLA shoulder scores were assessed. There were no complications. Randomization created comparable groups except that the PRFM group was younger than the control group (mean ± SD, 59.67 ± 8.16 y vs 64.50 ± 8.59 y, respectively; P < .05). Mean surgery time was longer for the PRFM group than for the control group (83.28 ± 17.13 min vs 73.28 ± 17.18 min, respectively; P < .02). There was no significant difference in VAS scores or narcotic use between groups and no statistically significant differences in recovery of motion, SST, or ASES scores. Mean ASES scores were 82.48 ± 8.77 (PRFM group) and 82.52 ± 12.45 (controls) (F(1,56) = 0.00, P > .98). Mean UCLA shoulder scores were 27.94 ± 4.98 for the PRFM group versus 29.59 ± 1.68 for the controls (P < .046). Structural results correlated with age and size of the tear and did not differ between the groups. Platelet-rich fibrin matrix was not shown to significantly improve perioperative morbidity, clinical outcomes, or structural integrity. While longer term follow-up or different platelet-rich plasma formulations may show differences, early follow-up does not show significant improvement in perioperative morbidity, structural integrity, or clinical outcome.

Determining a regional framework for assessing biotic integrity of virginia streams

USGS Publications Warehouse

Smogor, Roy A.; Angermeier, P.L.

2001-01-01

The utility of an index of biotic integrity (IBI) depends on its ability to distinguish anthropogenic effects on biota amid natural biological variability. To enhance this ability, we examined fish assemblage data from least-disturbed stream sites in Virginia to determine the best way to regionally stratify natural variation in candidate IBI metrics and their scoring criteria. Specifically, we examined metric variation among physiographic regions, U.S. Environmental Protection Agency ecoregions, and drainage basins to judge their utility as regions in which to develop and use distinct versions of the IBI for Virginia warmwater streams. Statewide, metrics differed most among physiographic regions; thus, we recommend their use as IBI regions. Largest differences were found for taxonomic metrics between coastal plain and mountain sites, particularly in numbers of native minnow (Cyprinidae), sunfish (Centrarchidae), and darter (Percidae) species. Trophic and reproductive metrics also differed between coastal plain and more-upland streams, presumably reflecting differences in functional adaptations of fishes to upland versus lowland stream habitats. We suggest three preliminary regional IBis for Virginia, each having a distinctive set of taxonomic, trophic, and reproductive metrics and corresponding scoring criteria.

Filling the concept with data: integrating data from different in vitro and in silico assays on skin sensitizers to explore the battery approach for animal-free skin sensitization testing.

PubMed

Natsch, Andreas; Emter, Roger; Ellis, Graham

2009-01-01

Tests for skin sensitization are required prior to the market launch of new cosmetic ingredients. Significant efforts are made to replace the current animal tests. It is widely recognized that this cannot be accomplished with a single in vitro test, but that rather the integration of results from different in vitro and in silico assays will be needed for the prediction of the skin sensitization potential of chemicals. This has been proposed as a theoretical scheme so far, but no attempts have been made to use experimental data to prove the validity of this concept. Here we thus try for the first time to fill this widely cited concept with data. To this aim, we integrate and report both novel and literature data on 116 chemicals of known skin sensitization potential on the following parameters: (1) peptide reactivity as a surrogate for protein binding, (2) induction of antioxidant/electrophile responsive element dependent luciferase activity as a cell-based assay; (3) Tissue Metabolism Simulator skin sensitization model in silico prediction; and (4) calculated octanol-water partition coefficient. The results of the in vitro assays were scaled into five classes from 0 to 4 to give an in vitro score and compared to the local lymph node assay (LLNA) data, which were also scaled from 0 to 4 (nonsensitizer/weak/moderate/strong/extreme). Different ways of evaluating these data have been assessed to rate the hazard of chemicals (Cooper statistics) and to also scale their potency. With the optimized model an overall accuracy for predicting sensitizers of 87.9% was obtained. There is a linear correlation between the LLNA score and the in vitro score. However, the correlation needs further improvement as there is still a relatively high variation in the in vitro score between chemicals belonging to the same sensitization potency class.

Molecular Classification Substitutes for the Prognostic Variables Stage, Age, and MYCN Status in Neuroblastoma Risk Assessment.

PubMed

Rosswog, Carolina; Schmidt, Rene; Oberthuer, André; Juraeva, Dilafruz; Brors, Benedikt; Engesser, Anne; Kahlert, Yvonne; Volland, Ruth; Bartenhagen, Christoph; Simon, Thorsten; Berthold, Frank; Hero, Barbara; Faldum, Andreas; Fischer, Matthias

2017-12-01

Current risk stratification systems for neuroblastoma patients consider clinical, histopathological, and genetic variables, and additional prognostic markers have been proposed in recent years. We here sought to select highly informative covariates in a multistep strategy based on consecutive Cox regression models, resulting in a risk score that integrates hazard ratios of prognostic variables. A cohort of 695 neuroblastoma patients was divided into a discovery set (n=75) for multigene predictor generation, a training set (n=411) for risk score development, and a validation set (n=209). Relevant prognostic variables were identified by stepwise multivariable L1-penalized least absolute shrinkage and selection operator (LASSO) Cox regression, followed by backward selection in multivariable Cox regression, and then integrated into a novel risk score. The variables stage, age, MYCN status, and two multigene predictors, NB-th24 and NB-th44, were selected as independent prognostic markers by LASSO Cox regression analysis. Following backward selection, only the multigene predictors were retained in the final model. Integration of these classifiers in a risk scoring system distinguished three patient subgroups that differed substantially in their outcome. The scoring system discriminated patients with diverging outcome in the validation cohort (5-year event-free survival, 84.9±3.4 vs 63.6±14.5 vs 31.0±5.4; P<.001), and its prognostic value was validated by multivariable analysis. We here propose a translational strategy for developing risk assessment systems based on hazard ratios of relevant prognostic variables. Our final neuroblastoma risk score comprised two multigene predictors only, supporting the notion that molecular properties of the tumor cells strongly impact clinical courses of neuroblastoma patients. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Observation chart design features affect the detection of patient deterioration: a systematic experimental evaluation.

PubMed

Christofidis, Melany J; Hill, Andrew; Horswill, Mark S; Watson, Marcus O

2016-01-01

To systematically evaluate the impact of several design features on chart-users' detection of patient deterioration on observation charts with early-warning scoring-systems. Research has shown that observation chart design affects the speed and accuracy with which abnormal observations are detected. However, little is known about the contribution of individual design features to these effects. A 2 × 2 × 2 × 2 mixed factorial design, with data-recording format (drawn dots vs. written numbers), scoring-system integration (integrated colour-based system vs. non-integrated tabular system) and scoring-row placement (grouped vs. separate) varied within-participants and scores (present vs. absent) varied between-participants by random assignment. 205 novice chart-users, tested between March 2011-March 2014, completed 64 trials where they saw real patient data presented on an observation chart. Each participant saw eight cases (four containing abnormal observations) on each of eight designs (which represented a factorial combination of the within-participants variables). On each trial, they assessed whether any of the observations were physiologically abnormal, or whether all observations were normal. Response times and error rates were recorded for each design. Participants responded faster (scores present and absent) and made fewer errors (scores absent) using drawn-dot (vs. written-number) observations and an integrated colour-based (vs. non-integrated tabular) scoring-system. Participants responded faster using grouped (vs. separate) scoring-rows when scores were absent, but separate scoring-rows when scores were present. Our findings suggest that several individual design features can affect novice chart-users' ability to detect patient deterioration. More broadly, the study further demonstrates the need to evaluate chart designs empirically. © 2015 John Wiley & Sons Ltd.

Assessment of higher level cognitive-communication functions in adolescents with ABI: Standardization of the student version of the functional assessment of verbal reasoning and executive strategies (S-FAVRES).

PubMed

MacDonald, Sheila

2016-01-01

Childhood acquired brain injuries can disrupt communication functions needed for success in school, work and social interaction. Cognitive-communication difficulties may not be apparent until adolescence, when academic, environmental and social-emotional demands increase. The Functional Assessment of Verbal Reasoning and Executive Strategies for Students (S-FAVRES) is a new activity-level measure of cognitive-communication skills in complex, contextual and integrative tasks that simulate real world communication challenges. It is hypothesized that S-FAVRES performance would differentiate adolescents with and without acquired brain injury (ABI) on scores for Accuracy, Rationale, Reasoning Subskills and Time. S-FAVRES was administered to 182 typically-developing (TD) and 57 adolescents with mild-to-severe ABI aged 12-19. Group differences, internal consistency, sensitivity, specificity, reliability and contributing factors to performance (age, gender, brain injury) were examined statistically. Those with ABI attained statistically lower Accuracy, Rationale and Reasoning sub-skills scores than their TD peers. Time scores were not significantly different. Performance trends were consistent across tasks, administrations, gender and age groups. Inter-rater reliability for scoring was acceptable. The S-FAVRES provides a reliable, functional and quantifiable measure of subtle cognitive-communication difficulties in adolescents that can assist speech-language pathologists in planning treatment and integration to school and real world communication.

Applications of "Integrated Data Viewer'' (IDV) in the classroom

NASA Astrophysics Data System (ADS)

Nogueira, R.; Cutrim, E. M.

2006-06-01

Conventionally, weather products utilized in synoptic meteorology reduce phenomena occurring in four dimensions to a 2-dimensional form. This constitutes a road-block for non-atmospheric-science majors who need to take meteorology as a non-mathematical and complementary course to their major programs. This research examines the use of Integrated Data Viewer-IDV as a teaching tool, as it allows a 4-dimensional representation of weather products. IDV was tested in the teaching of synoptic meteorology, weather analysis, and weather map interpretation to non-science students in the laboratory sessions of an introductory meteorology class at Western Michigan University. Comparison of student exam scores according to the laboratory teaching techniques, i.e., traditional lab manual and IDV was performed for short- and long-term learning. Results of the statistical analysis show that the Fall 2004 students in the IDV-based lab session retained learning. However, in the Spring 2005 the exam scores did not reflect retention in learning when compared with IDV-based and MANUAL-based lab scores (short term learning, i.e., exam taken one week after the lab exercise). Testing the long-term learning, seven weeks between the two exams in the Spring 2005, show no statistically significant difference between IDV-based group scores and MANUAL-based group scores. However, the IDV group obtained exam score average slightly higher than the MANUAL group. Statistical testing of the principal hypothesis in this study, leads to the conclusion that the IDV-based method did not prove to be a better teaching tool than the traditional paper-based method. Future studies could potentially find significant differences in the effectiveness of both manual and IDV methods if the conditions had been more controlled. That is, students in the control group should not be exposed to the weather analysis using IDV during lecture.

Measuring Client Experiences in Maternity Care under Change: Development of a Questionnaire Based on the WHO Responsiveness Model

PubMed Central

Scheerhagen, Marisja; van Stel, Henk F.; Birnie, Erwin; Franx, Arie; Bonsel, Gouke J.

2015-01-01

Background Maternity care is an integrated care process, which consists of different services, involves different professionals and covers different time windows. To measure performance of maternity care based on clients' experiences, we developed and validated a questionnaire. Methods and Findings We used the 8-domain WHO Responsiveness model, and previous materials to develop a self-report questionnaire. A dual study design was used for development and validation. Content validity of the ReproQ-version-0 was determined through structured interviews with 11 pregnant women (≥28 weeks), 10 women who recently had given birth (≤12 weeks), and 19 maternity care professionals. Structured interviews established the domain relevance to the women; all items were separately commented on. All Responsiveness domains were judged relevant, with Dignity and Communication ranking highest. Main missing topic was the assigned expertise of the health professional. After first adaptation, construct validity of the ReproQ-version-1 was determined through a web-based survey. Respondents were approached by maternity care organizations with different levels of integration of services of midwives and obstetricians. We sent questionnaires to 605 third trimester pregnant women (response 65%), and 810 women 6 weeks after delivery (response 55%). Construct validity was based on: response patterns; exploratory factor analysis; association of the overall score with a Visual Analogue Scale (VAS), known group comparisons. Median overall ReproQ score was 3.70 (range 1–4) showing good responsiveness. The exploratory factor analysis supported the assumed domain structure and suggested several adaptations. Correlation of the VAS rating and overall ReproQ score (antepartum, postpartum) supported validity (r = 0.56; 0.59, p<0.001 Spearman's correlation coefficient). Pre-stated group comparisons confirmed the expected difference following a good vs. adverse birth outcome. Fully integrated organizations performed slightly better (median = 3.78) than less integrated organizations (median = 3.63; p<0.001). Participation rate of women with a low educational level and/or a non-western origin was low. Conclusions The ReproQ appears suitable for assessing quality of maternity care from the clients' perspective. Recruitment of disadvantaged groups requires additional non-digital approaches. PMID:25671310

Investigation of self-compassion, self-confidence and submissive behaviors of nursing students studying in different curriculums.

PubMed

Eraydın, Şahizer; Karagözoğlu, Şerife

2017-07-01

Today, nursing education which educates the future members of the nursing profession aims to gain them high self-esteem, selfconfidence and self-compassion, independence, assertiveness and ability to establish good human relations. This aim can only be achieved through a contemporary curriculum supporting students in the educational process and enabling those in charge to make arrangements by taking the characters and needs of each individual into account. The study aims to investigate self-compassion, self-confidence and submissive behaviours of undergraduate nursing students studying in different curriculums. This descriptive, cross-sectional, comparative study was carried out with the 1st- and 4th-year students of the three schools, each of which has a different curriculum: conventional, integrated and Problem Based Learning (PBL). The study data were collected with the Self-Compassion Scale (SCS), Self-Confidence Scale (CS) and Submissive Acts Scale (SAS): The data were analyzed through frequency distribution, means, analysis of variance and the significance test for the difference between the two means. The mean scores the participating students obtained from the Self-Compassion, Self-confidence and Submissive Acts Scales were 3.31±0.56, 131.98±20.85 and 36.48±11.43 respectively. The integrated program students' mean self-compassion and self-confidence scores were statistically significantly higher and their mean submissive behaviour scores were lower than were those of the students studying in the other two programs (p<0.05). The analysis of the correlation between the mean scores obtained from the scales revealed that there was a statistically significant relationships between the SCS and CS values (r=0.388, p<0.001), between the SCS and SAS values (r=-0307, p<0.001) and between the CS and SAS values (r=-0325, p<0.001). In line with the study results, it can be said that the participating nursing students tended to display moderate levels of selfcompassion, self-confidence and submissive behaviours, and that the selfcompassion and self-confidence scores of the 4th-year students in the integrated program were higher than were those of the students in the other two programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vertical integration of basic science in final year of medical education.

PubMed

Rajan, Sudha Jasmine; Jacob, Tripti Meriel; Sathyendra, Sowmya

2016-01-01

Development of health professionals with ability to integrate, synthesize, and apply knowledge gained through medical college is greatly hampered by the system of delivery that is compartmentalized and piecemeal. There is a need to integrate basic sciences with clinical teaching to enable application in clinical care. To study the benefit and acceptance of vertical integration of basic science in final year MBBS undergraduate curriculum. After Institutional Ethics Clearance, neuroanatomy refresher classes with clinical application to neurological diseases were held as part of the final year posting in two medical units. Feedback was collected. Pre- and post-tests which tested application and synthesis were conducted. Summative assessment was compared with the control group of students who had standard teaching in other two medical units. In-depth interview was conducted on 2 willing participants and 2 teachers who did neurology bedside teaching. Majority (>80%) found the classes useful and interesting. There was statistically significant improvement in the post-test scores. There was a statistically significant difference between the intervention and control groups' scores during summative assessment (76.2 vs. 61.8 P < 0.01). Students felt that it reinforced, motivated self-directed learning, enabled correlations, improved understanding, put things in perspective, gave confidence, aided application, and enabled them to follow discussions during clinical teaching. Vertical integration of basic science in final year was beneficial and resulted in knowledge gain and improved summative scores. The classes were found to be useful, interesting and thought to help in clinical care and application by majority of students.

Enhancing positive attitudes towards disability: evaluation of an integrated physiotherapy program.

PubMed

Morgan, Prue Elizabeth; Lo, Kristin

2013-02-01

This study explored whether attitudes towards disability in second year undergraduate physiotherapy students could be enhanced by an on-campus integrated curriculum program. A pre-post design was used. Year 2 (pre-clinical) students participated in a 12-week program focused on optimising attitudes towards people with acquired or developmental neurological disability. The Discomfort subscale of the Interaction with Disabled Persons scale, rated on a six-point Likert scale, was applied prior to and at completion of the 12-week program, and compared to year 4 students, just prior to graduation. Qualitative data from year 2 reflective narratives was also gathered. Forty-seven second year and 45 fourth year physiotherapy students participated. The difference in Discomfort subscale scores between weeks 1 and 12 of year 2 was statistically significant (p = 0.0016). The difference in Discomfort subscale scores between year 2 week 1 and year 4 students was also statistically significant (p = 0.040). There was no significant difference in attitudes between students at the end of year 2 and the end of year 4 (p = 0.703). Qualitative data supported the development of more positive attitudes towards neurological disability across the 12 week year 2 pre-clinical program. Student attitudes towards people with acquired and/or developmental neurological disabilities can be enhanced through an on campus integrated curriculum program.

A Candidate Vegetation Index of Biological Integrity Based on Species Dominance and Habitat Fidelity

USGS Publications Warehouse

Gara, Brian D; Stapanian, Martin A.

2015-01-01

Indices of biological integrity of wetlands based on vascular plants (VIBIs) have been developed in many areas of the USA and are used in some states to make critical management decisions. An underlying concept of all VIBIs is that they respond negatively to disturbance. The Ohio VIBI (OVIBI) is calculated from 10 metrics, which are different for each wetland vegetation class. We present a candidate vegetation index of biotic integrity based on floristic quality (VIBI-FQ) that requires only two metrics to calculate an overall score regardless of vegetation class. These metrics focus equally on the critical ecosystem elements of diversity and dominance as related to a species’ degree of fidelity to habitat requirements. The indices were highly correlated but varied among vegetation classes. Both indices responded negatively with a published index of wetland disturbance in 261 Ohio wetlands. Unlike VIBI-FQ, however, errors in classifying wetland vegetation may lead to errors in calculating OVIBI scores. This is especially critical when assessing the ecological condition of rapidly developing ecosystems typically associated with wetland restoration and creation projects. Compared to OVIBI, the VIBI-FQ requires less field work, is much simpler to calculate and interpret, and can potentially be applied to all habitat types. This candidate index, which has been “standardized” across habitats, would make it easier to prioritize funding because it would score the “best” and “worst” of all habitats appropriately and allow for objective comparison across different vegetation classes.

Performance of third-year primary-care-track students in an integrated curriculum at Case Western Reserve University.

PubMed

Lewin, L O; Papp, K K; Hodder, S L; Workings, M G; Wolfe, L; Glover, P; Headrick, L A

1999-01-01

In 1994, Case Western Reserve University School of Medicine established a Primary Care Track (PCT) with an integrated curriculum as part of The Robert Wood Johnson Foundation's Generalist Physician Initiative. This study compared the performance of the first cohort of students to participate in the PCT third year with that of their classmates and determined student attitudes toward their experiences. The performances of 24 PCT and 81 traditional students on the Medical School Admissions Test (MCAT) and the United States Medical Licensure Examination (USMLE) Step 1 and 2 were compared using analysis of variance. Grades on the six core clerkships were compared using chi-square analysis. Performances of the PCT students and a subset of traditional students on the generalist school's objective structured clinical exam (OSCE) were compared using multivariate analysis. The students reported their perceptions on a questionnaire. The traditional students had significantly higher scores on the physical science section of the MCAT and on the USMLE Step 1, but at the end of year three, their USMLE Step 2 scores did not differ. Grade distributions in the core clerkships did not differ, except in psychiatry, where the PCT students received honors significantly more often. The PCT students had a lower mean score on the internal medicine National Board of Medicine Examiners shelf exam but performed better on the generalist OSCE exam. A majority of PCT students reported that they would choose the integrated third year again and recommend it to others.

Predictors of School Garden Integration: Factors Critical to Gardening Success in New York City.

PubMed

Burt, Kate Gardner; Burgermaster, Marissa; Jacquez, Raquel

2018-03-01

The purpose of this study was to determine the level of integration of school gardens and identify factors that predict integration. 211 New York City schools completed a survey that collected demographic information and utilized the School Garden Integration Scale. A mean garden integration score was calculated, and multiple regression analysis was conducted to determine independent predictors of integration and assess relationships between individual integration characteristics and budget. The average integration score was 34.1 (of 57 points) and ranged from 8 to 53. Operating budget had significant influence on integration score, controlling for all other factors ( p < .0001). Partner organizations, evaluation/feedback, planning the physical space, and characteristics of the physical space were positively and significantly related to budget. The results of this study indicate that any garden can become well integrated, as budget is a modifiable factor. When adequate funding is secured, a well-integrated garden may be established with proper planning and sound implementation.

Comparative Self-Esteem of Blacks and Whites in Segregated and Integrated Dyads.

DTIC Science & Technology

The purpose of the study is to provide information concerning the self esteem of blacks and whites under conditions of integrative and segregative...simulated work groups. Subjects were 96 undergraduate students, half black and half white, who performed three laboratory tasks. Ziller’s self esteem ...scales were used to measure the self esteem of subjects. Results indicate a significant difference between the self esteem scores of blacks and whites

An Approach to measuring Integrated Care within a Maternity Care System: Experiences from the Maternity Care Network Study and the Dutch Birth Centre Study.

PubMed

Boesveld, Inge C; Valentijn, Pim P; Hitzert, Marit; Hermus, Marieke A A; Franx, Arie; de Vries, Raymond G; Wiegers, Therese A; Bruijnzeels, Marc A

2017-06-20

Integrated care is considered to be a means to reduce costs, improve the quality of care and generate better patient outcomes. At present, little is known about integrated care in maternity care systems. We developed questionnaires to examine integrated care in two different settings, using the taxonomy of the Rainbow Model of Integrated Care. The aim of this study was to explore the validity of these questionnaires. We used data collected between 2013 and 2015 from two studies: the Maternity Care Network Study (634 respondents) and the Dutch Birth Centre Study (56 respondents). We assessed the feasibility, discriminative validity, and reliability of the questionnaires. Both questionnaires showed good feasibility (overall missing rate < 20%) and reliability (Cronbach's Alpha coefficient > 0.70). Between-subgroups post-hoc comparisons showed statistically significant differences on integration profiles between regional networks (on all items, dimensions of integration and total integration score) and birth centres (on 50% of the items and dimensions of integration). Both questionnaires are feasible and can discriminate between sites with different integration profiles in The Netherlands. They offer an opportunity to better understand integrated care as one step in understanding the complexity of the concept.

An Approach to measuring Integrated Care within a Maternity Care System: Experiences from the Maternity Care Network Study and the Dutch Birth Centre Study

PubMed Central

Valentijn, Pim P.; Hitzert, Marit; Hermus, Marieke A.A.; Franx, Arie; de Vries, Raymond G.; Wiegers, Therese A.; Bruijnzeels, Marc A.

2017-01-01

Introduction: Integrated care is considered to be a means to reduce costs, improve the quality of care and generate better patient outcomes. At present, little is known about integrated care in maternity care systems. We developed questionnaires to examine integrated care in two different settings, using the taxonomy of the Rainbow Model of Integrated Care. The aim of this study was to explore the validity of these questionnaires. Methods: We used data collected between 2013 and 2015 from two studies: the Maternity Care Network Study (634 respondents) and the Dutch Birth Centre Study (56 respondents). We assessed the feasibility, discriminative validity, and reliability of the questionnaires. Results: Both questionnaires showed good feasibility (overall missing rate < 20%) and reliability (Cronbach’s Alpha coefficient > 0.70). Between-subgroups post-hoc comparisons showed statistically significant differences on integration profiles between regional networks (on all items, dimensions of integration and total integration score) and birth centres (on 50% of the items and dimensions of integration). Discussion: Both questionnaires are feasible and can discriminate between sites with different integration profiles in The Netherlands. They offer an opportunity to better understand integrated care as one step in understanding the complexity of the concept. PMID:28970747

A study of the effects of gender and different instructional media (computer-assisted instruction tutorials vs. textbook) on student attitudes and achievement in a team-taught integrated science class

NASA Astrophysics Data System (ADS)

Eardley, Julie Anne

The purpose of this study was to determine the effect of different instructional media (computer assisted instruction (CAI) tutorial vs. traditional textbook) on student attitudes toward science and computers and achievement scores in a team-taught integrated science course, ENS 1001, "The Whole Earth Course," which was offered at Florida Institute of Technology during the Fall 2000 term. The effect of gender on student attitudes toward science and computers and achievement scores was also investigated. This study employed a randomized pretest-posttest control group experimental research design with a sample of 30 students (12 males and 18 females). Students had registered for weekly lab sessions that accompanied the course and had been randomly assigned to the treatment or control group. The treatment group used a CAI tutorial for completing homework assignments and the control group used the required textbook for completing homework assignments. The Attitude toward Science and Computers Questionnaire and Achievement Test were the two instruments administered during this study to measure students' attitudes and achievement score changes. A multivariate analysis of covariance (MANCOVA), using hierarchical multiple regression/correlation (MRC), was employed to determine: (1) treatment versus control group attitude and achievement differences; and (2) male versus female attitude and achievement differences. The differences between the treatment group's and control group's homework averages were determined by t test analyses. The overall MANCOVA model was found to be significant at p < .05. Examining research factor set independent variables separately resulted in gender being the only variable that significantly contributed in explaining the variability in a dependent variable, attitudes toward science and computers. T test analyses of the homework averages showed no significant differences. Contradictory to the findings of this study, anecdotal information from personal communication, course evaluations, and homework assignments indicated favorable attitudes and higher achievement scores for a majority of the students in the treatment group.

Pleiotropic and Epistatic Network-Based Discovery: Integrated Networks for Target Gene Discovery

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

Weighill, Deborah; Jones, Piet; Shah, Manesh

Biological organisms are complex systems that are composed of functional networks of interacting molecules and macro-molecules. Complex phenotypes are the result of orchestrated, hierarchical, heterogeneous collections of expressed genomic variants. However, the effects of these variants are the result of historic selective pressure and current environmental and epigenetic signals, and, as such, their co-occurrence can be seen as genome-wide correlations in a number of different manners. Biomass recalcitrance (i.e., the resistance of plants to degradation or deconstruction, which ultimately enables access to a plant's sugars) is a complex polygenic phenotype of high importance to biofuels initiatives. This study makes usemore » of data derived from the re-sequenced genomes from over 800 different Populus trichocarpa genotypes in combination with metabolomic and pyMBMS data across this population, as well as co-expression and co-methylation networks in order to better understand the molecular interactions involved in recalcitrance, and identify target genes involved in lignin biosynthesis/degradation. A Lines Of Evidence (LOE) scoring system is developed to integrate the information in the different layers and quantify the number of lines of evidence linking genes to target functions. This new scoring system was applied to quantify the lines of evidence linking genes to lignin-related genes and phenotypes across the network layers, and allowed for the generation of new hypotheses surrounding potential new candidate genes involved in lignin biosynthesis in P. trichocarpa, including various AGAMOUS-LIKE genes. Lastly, the resulting Genome Wide Association Study networks, integrated with Single Nucleotide Polymorphism (SNP) correlation, co-methylation, and co-expression networks through the LOE scores are proving to be a powerful approach to determine the pleiotropic and epistatic relationships underlying cellular functions and, as such, the molecular basis for complex phenotypes, such as recalcitrance.« less

Pleiotropic and Epistatic Network-Based Discovery: Integrated Networks for Target Gene Discovery

DOE PAGES

Weighill, Deborah; Jones, Piet; Shah, Manesh; ...

2018-05-11

Biological organisms are complex systems that are composed of functional networks of interacting molecules and macro-molecules. Complex phenotypes are the result of orchestrated, hierarchical, heterogeneous collections of expressed genomic variants. However, the effects of these variants are the result of historic selective pressure and current environmental and epigenetic signals, and, as such, their co-occurrence can be seen as genome-wide correlations in a number of different manners. Biomass recalcitrance (i.e., the resistance of plants to degradation or deconstruction, which ultimately enables access to a plant's sugars) is a complex polygenic phenotype of high importance to biofuels initiatives. This study makes usemore » of data derived from the re-sequenced genomes from over 800 different Populus trichocarpa genotypes in combination with metabolomic and pyMBMS data across this population, as well as co-expression and co-methylation networks in order to better understand the molecular interactions involved in recalcitrance, and identify target genes involved in lignin biosynthesis/degradation. A Lines Of Evidence (LOE) scoring system is developed to integrate the information in the different layers and quantify the number of lines of evidence linking genes to target functions. This new scoring system was applied to quantify the lines of evidence linking genes to lignin-related genes and phenotypes across the network layers, and allowed for the generation of new hypotheses surrounding potential new candidate genes involved in lignin biosynthesis in P. trichocarpa, including various AGAMOUS-LIKE genes. Lastly, the resulting Genome Wide Association Study networks, integrated with Single Nucleotide Polymorphism (SNP) correlation, co-methylation, and co-expression networks through the LOE scores are proving to be a powerful approach to determine the pleiotropic and epistatic relationships underlying cellular functions and, as such, the molecular basis for complex phenotypes, such as recalcitrance.« less

Integrated analysis of miRNA and mRNA expression data identifies multiple miRNAs regulatory networks for the tumorigenesis of colorectal cancer.

PubMed

Xu, Peng; Wang, Junhua; Sun, Bo; Xiao, Zhongdang

2018-06-15

Investigating the potential biological function of differential changed genes through integrating multiple omics data including miRNA and mRNA expression profiles, is always hot topic. However, how to evaluate the repression effect on target genes integrating miRNA and mRNA expression profiles are not fully solved. In this study, we provide an analyzing method by integrating both miRNAs and mRNAs expression data simultaneously. Difference analysis was adopted based on the repression score, then significantly repressed mRNAs were screened out by DEGseq. Pathway analysis for the significantly repressed mRNAs shows that multiple pathways such as MAPK signaling pathway, TGF-beta signaling pathway and so on, may correlated to the colorectal cancer(CRC). Focusing on the MAPK signaling pathway, a miRNA-mRNA network that centering the cell fate genes was constructed. Finally, the miRNA-mRNAs that potentially important in the CRC carcinogenesis were screened out and scored by impact index. Copyright © 2018 Elsevier B.V. All rights reserved.

Visual-Motor Integration in Children With Mild Intellectual Disability: A Meta-Analysis.

PubMed

Memisevic, Haris; Djordjevic, Mirjana

2018-01-01

Visual-motor integration (VMI) skills, defined as the coordination of fine motor and visual perceptual abilities, are a very good indicator of a child's overall level of functioning. Research has clearly established that children with intellectual disability (ID) have deficits in VMI skills. This article presents a meta-analytic review of 10 research studies involving 652 children with mild ID for which a VMI skills assessment was also available. We measured the standardized mean difference (Hedges' g) between scores on VMI tests of these children with mild ID and either typically developing children's VMI test scores in these studies or normative mean values on VMI tests used by the studies. While mild ID is defined in part by intelligence scores that are two to three standard deviations below those of typically developing children, the standardized mean difference of VMI differences between typically developing children and children with mild ID in this meta-analysis was 1.75 (95% CI [1.11, 2.38]). Thus, the intellectual and adaptive skill deficits of children with mild ID may be greater (perhaps especially due to their abstract and conceptual reasoning deficits) than their relative VMI deficits. We discuss the possible meaning of this relative VMI strength among children with mild ID and suggest that their stronger VMI skills may be a target for intensive academic interventions as a means of attenuating problems in adaptive functioning.

Integration of somatic mutation, expression and functional data reveals potential driver genes predictive of breast cancer survival.

PubMed

Suo, Chen; Hrydziuszko, Olga; Lee, Donghwan; Pramana, Setia; Saputra, Dhany; Joshi, Himanshu; Calza, Stefano; Pawitan, Yudi

2015-08-15

Genome and transcriptome analyses can be used to explore cancers comprehensively, and it is increasingly common to have multiple omics data measured from each individual. Furthermore, there are rich functional data such as predicted impact of mutations on protein coding and gene/protein networks. However, integration of the complex information across the different omics and functional data is still challenging. Clinical validation, particularly based on patient outcomes such as survival, is important for assessing the relevance of the integrated information and for comparing different procedures. An analysis pipeline is built for integrating genomic and transcriptomic alterations from whole-exome and RNA sequence data and functional data from protein function prediction and gene interaction networks. The method accumulates evidence for the functional implications of mutated potential driver genes found within and across patients. A driver-gene score (DGscore) is developed to capture the cumulative effect of such genes. To contribute to the score, a gene has to be frequently mutated, with high or moderate mutational impact at protein level, exhibiting an extreme expression and functionally linked to many differentially expressed neighbors in the functional gene network. The pipeline is applied to 60 matched tumor and normal samples of the same patient from The Cancer Genome Atlas breast-cancer project. In clinical validation, patients with high DGscores have worse survival than those with low scores (P = 0.001). Furthermore, the DGscore outperforms the established expression-based signatures MammaPrint and PAM50 in predicting patient survival. In conclusion, integration of mutation, expression and functional data allows identification of clinically relevant potential driver genes in cancer. The documented pipeline including annotated sample scripts can be found in http://fafner.meb.ki.se/biostatwiki/driver-genes/. yudi.pawitan@ki.se Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

How well do second-year students learn physical diagnosis? Observational study of an Objective Structured Clinical Examination (OSCE).

PubMed

Hamann, Claus; Volkan, Kevin; Fishman, Mary B; Silvestri, Ronald C; Simon, Steven R; Fletcher, Suzanne W

2002-01-01

Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Cross-sectional study at Harvard Medical School, 1997-1999, for 489 second-year students. Average total OSCE score was 57% (range 39-75%). Among clinical skills, students scored highest on patient interaction (72%), followed by examination technique (65%), abnormality identification (62%), history-taking (60%), patient presentation (60%), physical examination knowledge (47%), and differential diagnosis (40%) (p <.0001). Among 16 OSCE stations, scores ranged from 70% for arthritis to 29% for calf pain (p <.0001). Teaching sites accounted for larger adjusted differences in station scores, up to 28%, than in skill scores (9%) (p <.0001). Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.

How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE)

PubMed Central

Hamann, Claus; Volkan, Kevin; Fishman, Mary B; Silvestri, Ronald C; Simon, Steven R; Fletcher, Suzanne W

2002-01-01

Background Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods Cross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students. Results Average total OSCE score was 57% (range 39–75%). Among clinical skills, students scored highest on patient interaction (72%), followed by examination technique (65%), abnormality identification (62%), history-taking (60%), patient presentation (60%), physical examination knowledge (47%), and differential diagnosis (40%) (p < .0001). Among 16 OSCE stations, scores ranged from 70% for arthritis to 29% for calf pain (p < .0001). Teaching sites accounted for larger adjusted differences in station scores, up to 28%, than in skill scores (9%) (p < .0001). Conclusions Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching. PMID:11888484

Developmental Test of Visual–Motor Integration (VMI): An Effective Outcome Measure for Handwriting Interventions for Kindergarten, First-Grade, and Second-Grade Students?

PubMed Central

Moskowitz, Beverly; Paoletti, Andrew; Brusilovskiy, Eugene; Zylstra, Sheryl Eckberg; Murray, Tammy

2015-01-01

We determined whether a widely used assessment of visual–motor skills, the Beery–Buktenica Developmental Test of Visual–Motor Integration (VMI), is appropriate for use as an outcome measure for handwriting interventions. A two-group pretest–posttest design was used with 207 kindergarten, first-grade, and second-grade students. Two well-established handwriting measures and the VMI were administered pre- and postintervention. The intervention group participated in the Size Matters Handwriting Program for 40 sessions, and the control group received standard instruction. Paired and independent-samples t tests were used to analyze group differences. The intervention group demonstrated significant improvements on the handwriting measures, with change scores having mostly large effect sizes. We found no significant difference in change scores on the VMI, t(202) = 1.19, p = .23. Results of this study suggest that the VMI may not detect changes in handwriting related to occupational therapy intervention. PMID:26114468

Developmental Test of Visual-Motor Integration (VMI): An Effective Outcome Measure for Handwriting Interventions for Kindergarten, First-Grade, and Second-Grade Students?

PubMed

Pfeiffer, Beth; Moskowitz, Beverly; Paoletti, Andrew; Brusilovskiy, Eugene; Zylstra, Sheryl Eckberg; Murray, Tammy

2015-01-01

We determined whether a widely used assessment of visual-motor skills, the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), is appropriate for use as an outcome measure for handwriting interventions. A two-group pretest-posttest design was used with 207 kindergarten, first-grade, and second-grade students. Two well-established handwriting measures and the VMI were administered pre- and postintervention. The intervention group participated in the Size Matters Handwriting Program for 40 sessions, and the control group received standard instruction. Paired and independent-samples t tests were used to analyze group differences. The intervention group demonstrated significant improvements on the handwriting measures, with change scores having mostly large effect sizes. We found no significant difference in change scores on the VMI, t(202)=1.19, p=.23. Results of this study suggest that the VMI may not detect changes in handwriting related to occupational therapy intervention. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Statistical Test of Expression Pattern (STEPath): a new strategy to integrate gene expression data with genomic information in individual and meta-analysis studies.

PubMed

Martini, Paolo; Risso, Davide; Sales, Gabriele; Romualdi, Chiara; Lanfranchi, Gerolamo; Cagnin, Stefano

2011-04-11

In the last decades, microarray technology has spread, leading to a dramatic increase of publicly available datasets. The first statistical tools developed were focused on the identification of significant differentially expressed genes. Later, researchers moved toward the systematic integration of gene expression profiles with additional biological information, such as chromosomal location, ontological annotations or sequence features. The analysis of gene expression linked to physical location of genes on chromosomes allows the identification of transcriptionally imbalanced regions, while, Gene Set Analysis focuses on the detection of coordinated changes in transcriptional levels among sets of biologically related genes. In this field, meta-analysis offers the possibility to compare different studies, addressing the same biological question to fully exploit public gene expression datasets. We describe STEPath, a method that starts from gene expression profiles and integrates the analysis of imbalanced region as an a priori step before performing gene set analysis. The application of STEPath in individual studies produced gene set scores weighted by chromosomal activation. As a final step, we propose a way to compare these scores across different studies (meta-analysis) on related biological issues. One complication with meta-analysis is batch effects, which occur because molecular measurements are affected by laboratory conditions, reagent lots and personnel differences. Major problems occur when batch effects are correlated with an outcome of interest and lead to incorrect conclusions. We evaluated the power of combining chromosome mapping and gene set enrichment analysis, performing the analysis on a dataset of leukaemia (example of individual study) and on a dataset of skeletal muscle diseases (meta-analysis approach). In leukaemia, we identified the Hox gene set, a gene set closely related to the pathology that other algorithms of gene set analysis do not identify, while the meta-analysis approach on muscular disease discriminates between related pathologies and correlates similar ones from different studies. STEPath is a new method that integrates gene expression profiles, genomic co-expressed regions and the information about the biological function of genes. The usage of the STEPath-computed gene set scores overcomes batch effects in the meta-analysis approaches allowing the direct comparison of different pathologies and different studies on a gene set activation level.

Are the Differences between CLIL and Non-CLIL Groups in Andalusia Due to CLIL? A Reply to Lorenzo, Casal and Moore (2010)

ERIC Educational Resources Information Center

Bruton, Anthony

2011-01-01

Lorenzo "et al". (2010) attribute some quite astounding average FL language score differences between Content and Language Integrated Learning (CLIL) and non-CLIL groups in Andalusia, Spain, precisely favoring the CLIL initiative. However, there are a number of methodological research questions that jeopardize any verifiable conclusions…

Auditory integration training for children with autism: no behavioral benefits detected.

PubMed

Mudford, O C; Cross, B A; Breen, S; Cullen, C; Reeves, D; Gould, J; Douglas, J

2000-03-01

Auditory integration training and a control treatment were provided for 16 children with autism in a crossover experimental design. Measures, blind to treatment order, included parent and teacher ratings of behavior, direct observational recordings, IQ, language, and social/adaptive tests. Significant differences tended to show that the control condition was superior on parent-rated measures of hyperactivity and on direct observational measures of ear-occlusion. No differences were detected on teacher-rated measures. Children's IQs and language comprehension did not increase, but adaptive/social behavior scores and expressive language quotients decreased. The majority of parents (56%) were unable to report in retrospect when their child had received auditory integration training. No individual child was identified as benefiting clinically or educationally from the treatment.

Reinforce: An Ensemble Approach for Inferring PPI Network from AP-MS Data.

PubMed

Tian, Bo; Duan, Qiong; Zhao, Can; Teng, Ben; He, Zengyou

2017-05-17

Affinity Purification-Mass Spectrometry (AP-MS) is one of the most important technologies for constructing protein-protein interaction (PPI) networks. In this paper, we propose an ensemble method, Reinforce, for inferring PPI network from AP-MS data set. The new algorithm named Reinforce is based on rank aggregation and false discovery rate control. Under the null hypothesis that the interaction scores from different scoring methods are randomly generated, Reinforce follows three steps to integrate multiple ranking results from different algorithms or different data sets. The experimental results show that Reinforce can get more stable and accurate inference results than existing algorithms. The source codes of Reinforce and data sets used in the experiments are available at: https://sourceforge.net/projects/reinforce/.

Vertical integration of basic science in final year of medical education

PubMed Central

Rajan, Sudha Jasmine; Jacob, Tripti Meriel; Sathyendra, Sowmya

2016-01-01

Background: Development of health professionals with ability to integrate, synthesize, and apply knowledge gained through medical college is greatly hampered by the system of delivery that is compartmentalized and piecemeal. There is a need to integrate basic sciences with clinical teaching to enable application in clinical care. Aim: To study the benefit and acceptance of vertical integration of basic science in final year MBBS undergraduate curriculum. Materials and Methods: After Institutional Ethics Clearance, neuroanatomy refresher classes with clinical application to neurological diseases were held as part of the final year posting in two medical units. Feedback was collected. Pre- and post-tests which tested application and synthesis were conducted. Summative assessment was compared with the control group of students who had standard teaching in other two medical units. In-depth interview was conducted on 2 willing participants and 2 teachers who did neurology bedside teaching. Results: Majority (>80%) found the classes useful and interesting. There was statistically significant improvement in the post-test scores. There was a statistically significant difference between the intervention and control groups' scores during summative assessment (76.2 vs. 61.8 P < 0.01). Students felt that it reinforced, motivated self-directed learning, enabled correlations, improved understanding, put things in perspective, gave confidence, aided application, and enabled them to follow discussions during clinical teaching. Conclusion: Vertical integration of basic science in final year was beneficial and resulted in knowledge gain and improved summative scores. The classes were found to be useful, interesting and thought to help in clinical care and application by majority of students. PMID:27563584

Developing Analytic Rating Guides for "TOEFL iBT"® Integrated Speaking Tasks. "TOEFL iBT"® Research Report, TOEFL iBT-20. ETS Research Report. RR-13-13

ERIC Educational Resources Information Center

Jamieson, Joan; Poonpon, Kornwipa

2013-01-01

Research and development of a new type of scoring rubric for the integrated speaking tasks of "TOEFL iBT"® are described. These "analytic rating guides" could be helpful if tasks modeled after those in TOEFL iBT were used for formative assessment, a purpose which is different from TOEFL iBT's primary use for admission…

Data quality scoring system for microcosm and mesocosm studies used to derive a level of concern for atrazine.

PubMed

Giddings, Jeffrey M; Campana, David; Nair, Shyam; Brain, Richard

2018-04-16

The US Environmental Protection Agency (USEPA) has historically used different methods to derive an aquatic level of concern (LoC) for atrazine, though all have generally relied on an expanding set of mesocosm and microcosm ("cosm") studies for calibration. The database of results from ecological effects studies with atrazine in cosms now includes 108 data points from 39 studies and forms the basis for assessing atrazine's potential to impact aquatic plant communities. Inclusion of the appropriate cosm studies and accurate interpretation of each data point-delineated as binary scores of "effect" (effect score 1) or "no effect" (effect score 0) of a specific atrazine exposure profile on plant communities in a single study-is critical to USEPA's approach to determining the LoC. We reviewed the atrazine cosm studies in detail and carefully interpreted their results in terms of the binary effect scores. The cosm database includes a wide range of experimental systems and study designs, some of which are more relevant to natural plant communities than others. Moreover, the studies vary in the clarity and consistency of their results. We therefore evaluated each study against objective criteria for relevance and reliability to produce a weighting score that can be applied to the effect scores when calculating the LoC. This approach is useful because studies that are more relevant and reliable have greater influence on the LoC than studies with lower weighting scores. When the current iteration of USEPA's LoC approach, referred to as the plant assemblage toxicity index (PATI), was calibrated with the weighted cosm data set, the result was a 60-day LoC of 21.2 μg/L. Integr Environ Assess Manag 2018;00:000-000. © 2018 The Authors. Integrated Environmental Assessment and Management Published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2018 The Authors. Integrated Environmental Assessment and Management Published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

The reliability and validity of a portfolio designed as a programmatic assessment of performance in an integrated clinical placement.

PubMed

Roberts, Chris; Shadbolt, Narelle; Clark, Tyler; Simpson, Phillip

2014-09-20

Little is known about the technical adequacy of portfolios in reporting multiple complex academic and performance-based assessments. We explored, first, the influencing factors on the precision of scoring within a programmatic assessment of student learning outcomes within an integrated clinical placement. Second, the degree to which validity evidence supported interpretation of student scores. Within generalisability theory, we estimated the contribution that each wanted factor (i.e. student capability) and unwanted factors (e.g. the impact of assessors) made to the variation in portfolio task scores. Relative and absolute standard errors of measurement provided a confidence interval around a pre-determined pass/fail standard for all six tasks. Validity evidence was sought through demonstrating the internal consistency of the portfolio and exploring the relationship of student scores with clinical experience. The mean portfolio mark for 257 students, across 372 raters, based on six tasks, was 75.56 (SD, 6.68). For a single student on one assessment task, 11% of the variance in scores was due to true differences in student capability. The most significant interaction was context specificity (49%), the tendency for one student to engage with one task and not engage with another task. Rater subjectivity was 29%. An absolute standard error of measurement of 4.74%, gave a 95% CI of +/- 9.30%, and a 68% CI of +/- 4.74% around a pass/fail score of 57%. Construct validity was supported by demonstration of an assessment framework, the internal consistency of the portfolio tasks, and higher scores for students who did the clinical placement later in the academic year. A portfolio designed as a programmatic assessment of an integrated clinical placement has sufficient evidence of validity to support a specific interpretation of student scores around passing a clinical placement. It has modest precision in assessing students' achievement of a competency standard. There were identifiable areas for reducing measurement error and providing more certainty around decision-making. Reducing the measurement error would require engaging with the student body on the value of the tasks, more focussed academic and clinical supervisor training, and revisiting the rubric of the assessment in the light of feedback.

International epidemiology of child and adolescent psychopathology ii: integration and applications of dimensional findings from 44 societies.

PubMed

Rescorla, Leslie; Ivanova, Masha Y; Achenbach, Thomas M; Begovac, Ivan; Chahed, Myriam; Drugli, May Britt; Emerich, Deisy Ribas; Fung, Daniel S S; Haider, Mariam; Hansson, Kjell; Hewitt, Nohelia; Jaimes, Stefanny; Larsson, Bo; Maggiolini, Alfio; Marković, Jasminka; Mitrović, Dragan; Moreira, Paulo; Oliveira, João Tiago; Olsson, Martin; Ooi, Yoon Phaik; Petot, Djaouida; Pisa, Cecilia; Pomalima, Rolando; da Rocha, Marina Monzani; Rudan, Vlasta; Sekulić, Slobodan; Shahini, Mimoza; de Mattos Silvares, Edwiges Ferreira; Szirovicza, Lajos; Valverde, José; Vera, Luis Anderssen; Villa, Maria Clara; Viola, Laura; Woo, Bernardine S C; Zhang, Eugene Yuqing

2012-12-01

To build on Achenbach, Rescorla, and Ivanova (2012) by (a) reporting new international findings for parent, teacher, and self-ratings on the Child Behavior Checklist, Youth Self-Report, and Teacher's Report Form; (b) testing the fit of syndrome models to new data from 17 societies, including previously underrepresented regions; (c) testing effects of society, gender, and age in 44 societies by integrating new and previous data; (d) testing cross-society correlations between mean item ratings; (e) describing the construction of multisociety norms; (f) illustrating clinical applications. Confirmatory factor analyses (CFAs) of parent, teacher, and self-ratings, performed separately for each society; tests of societal, gender, and age effects on dimensional syndrome scales, DSM-oriented scales, Internalizing, Externalizing, and Total Problems scales; tests of agreement between low, medium, and high ratings of problem items across societies. CFAs supported the tested syndrome models in all societies according to the primary fit index (Root Mean Square Error of Approximation [RMSEA]), but less consistently according to other indices; effect sizes were small-to-medium for societal differences in scale scores, but very small for gender, age, and interactions with society; items received similarly low, medium, or high ratings in different societies; problem scores from 44 societies fit three sets of multisociety norms. Statistically derived syndrome models fit parent, teacher, and self-ratings when tested individually in all 44 societies according to RMSEAs (but less consistently according to other indices). Small to medium differences in scale scores among societies supported the use of low-, medium-, and high-scoring norms in clinical assessment of individual children. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

General practice: the DREEM attachment? Comparing the educational environment of hospital and general practice placements.

PubMed

Kelly, Martina; Bennett, Deirdre; O'Flynn, Siun

2012-01-01

The clinical learning environment is changing. General practice placements are now a fundamental part of undergraduate medical education. There is growing recognition that changes in hospital work practices are altering the breadth of exposure available to students. Surprisingly little work has been done comparing the quality of clinical placements between the hospital and community using validated tools. Such comparisons inform curriculum planning and resource allocation. The aim of this study was to compare the quality of the educational environment experienced by junior medical students during hospital and general practice placements using a widely used tool. Following the introduction of a new integrated curriculum, all Year 3 students (n=108) completed a standardised evaluation instrument, the Dundee Ready Education Environment Measure (DREEM) at the end of each of their clinical attachments (two different hospital sites and one in general practice), giving a total of 324 questionnaires. All forms were analysed and input into Graphpad INSTAT version 3. Total DREEM scores as well as subscale scores were calculated for each site. These were compared across sites using a Mann-Whitney U non-parametric test. By comparison with international standards, clinical attachments in our new integrated curriculum were rated highly. In particular, attachments in general practice scored highly with a mean score of 156.6 and perform significantly better (P < 0.01) when compared with the mean score for hospital rotations of 149.0. Significant differences between general practice and hospital rotations exist in the domains of students' perceptions of atmosphere and students' social self-perceptions. Finally, significant differences also emerged in students' perceptions of teachers in general practice when compared to those in the hospital setting. These findings provide evidence of the high-quality educational environment afforded students in primary care. They challenge the traditional emphasis on hospital-based teaching and preempt the question - Is the community a better place for junior students to learn?

An improved procedure for integrated behavioral z-scoring illustrated with modified Hole Board behavior of male inbred laboratory mice.

PubMed

Labots, M Maaike; Laarakker, M C Marijke; Schetters, D Dustin; Arndt, S S Saskia; van Lith, H A Hein

2018-01-01

Guilloux et al. introduced: integrated behavioral z-scoring, a method for behavioral phenotyping of mice. Using this method multiple ethological variables can be combined to show an overall description of a certain behavioral dimension or motivational system. However, a problem may occur when the control group used for the calculation has a standard deviation of zero or when no control group is present to act as a reference group. In order to solve these problems, an improved procedure is suggested: taking the pooled data as reference. For this purpose a behavioral study with male mice from three inbred strains was carried out. The integrated behavioral z-scoring methodology was applied, thereby taking five different reference group options. The outcome regarding statistical significance and practical importance was compared. Significant effects and effect sizes were influenced by the choice of the reference group. In some cases it was impossible to use a certain population and condition, because one or more behavioral variables in question had a standard deviation of zero. Based on the improved method, male mice from the three inbred strains differed regarding activity and anxiety. Taking the method described by Guilloux et al. as basis, the present procedure improved the generalizability to all types of experimental designs in animal behavioral research. To solve the aforementioned problems and to avoid getting the diagnosis of data manipulation, the pooled data (combining the data from all experimental groups in a study) as reference option is recommended. Copyright © 2017 Elsevier B.V. All rights reserved.

Monthly streamflow forecasting based on hidden Markov model and Gaussian Mixture Regression

NASA Astrophysics Data System (ADS)

Liu, Yongqi; Ye, Lei; Qin, Hui; Hong, Xiaofeng; Ye, Jiajun; Yin, Xingli

2018-06-01

Reliable streamflow forecasts can be highly valuable for water resources planning and management. In this study, we combined a hidden Markov model (HMM) and Gaussian Mixture Regression (GMR) for probabilistic monthly streamflow forecasting. The HMM is initialized using a kernelized K-medoids clustering method, and the Baum-Welch algorithm is then executed to learn the model parameters. GMR derives a conditional probability distribution for the predictand given covariate information, including the antecedent flow at a local station and two surrounding stations. The performance of HMM-GMR was verified based on the mean square error and continuous ranked probability score skill scores. The reliability of the forecasts was assessed by examining the uniformity of the probability integral transform values. The results show that HMM-GMR obtained reasonably high skill scores and the uncertainty spread was appropriate. Different HMM states were assumed to be different climate conditions, which would lead to different types of observed values. We demonstrated that the HMM-GMR approach can handle multimodal and heteroscedastic data.

Test anxiety and performance-avoidance goals explain gender differences in SAT-V, SAT-M, and overall SAT scores.

PubMed

Hannon, Brenda

2012-11-01

This study uses analysis of co-variance in order to determine which cognitive/learning (working memory, knowledge integration, epistemic belief of learning) or social/personality factors (test anxiety, performance-avoidance goals) might account for gender differences in SAT-V, SAT-M, and overall SAT scores. The results revealed that none of the cognitive/learning factors accounted for gender differences in SAT performance. However, the social/personality factors of test anxiety and performance-avoidance goals each separately accounted for all of the significant gender differences in SAT-V, SAT-M, and overall SAT performance. Furthermore, when the influences of both of these factors were statistically removed simultaneously, all non-significant gender differences reduced further to become trivial by Cohen's (1988) standards. Taken as a whole, these results suggest that gender differences in SAT-V, SAT-M, and overall SAT performance are a consequence of social/learning factors.

The Impact of an Academic Integrity Module and Turnitin® on Similarity Index Scores of Undergraduate Student Papers

ERIC Educational Resources Information Center

Ballard, Iva B.

2013-01-01

In this quasi-experimental 2 x 2 factorial design study, the impact of an academic integrity module and Turnitin® on undergraduate student similarity index scores was investigated. Similarity index scores were used to measure suggested plagiarism rates of student papers. A purposive sample consisting of 96 undergraduate education students enrolled…

Estimating chemical ecotoxicity in EU ecolabel and in EU product environmental footprint.

PubMed

Saouter, Erwan; De Schryver, An; Pant, Rana; Sala, Serenella

2018-05-21

The EU Commission Ecolabel and the Product and Environmental Footprint (PEF) aim at promoting the development and consumption of greener products. The product aquatic toxicity score from these 2 methods may lead in some circumstances to opposite conclusions. Although this could be interpreted as an inconsistency, the score should not be compared to each other but used in a complementary way. In short, CDV provided a "full" product formula aquatic toxicity score, even if some chemicals may never reach or persist in freshwater ecosystems. The USEtox® score, by integrating fate and exposure, focuses on the potential toxicity of persistent-water-soluble chemicals at steady state. Since no risk or safety assessment can be conducted with USEtox® nor with the CDV, both are a hazard-based scoring system. This short communication clarifies the difference between approaches underpinning the toxicity scores used in Ecolabel and PEF, providing guidance on how to interpret the results. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Correlation between safety climate and contractor safety assessment programs in construction

PubMed Central

Sparer, EH1; Murphy, LA; Taylor, KM; Dennerlein, Jt

2015-01-01

Background Contractor safety assessment programs (CSAPs) measure safety performance by integrating multiple data sources together; however, the relationship between these measures of safety performance and safety climate within the construction industry is unknown. Methods 401 construction workers employed by 68 companies on 26 sites and 11 safety managers employed by 11 companies completed brief surveys containing a nine-item safety climate scale developed for the construction industry. CSAP scores from ConstructSecure, Inc., an online CSAP database, classified these 68 companies as high or low scorers, with the median score of the sample population as the threshold. Spearman rank correlations evaluated the association between the CSAP score and the safety climate score at the individual level, as well as with various grouping methodologies. In addition, Spearman correlations evaluated the comparison between manager-assessed safety climate and worker-assessed safety climate. Results There were no statistically significant differences between safety climate scores reported by workers in the high and low CSAP groups. There were, at best, weak correlations between workers’ safety climate scores and the company CSAP scores, with marginal statistical significance with two groupings of the data. There were also no significant differences between the manager-assessed safety climate and the worker-assessed safety climate scores. Conclusions A CSAP safety performance score does not appear to capture safety climate, as measured in this study. The nature of safety climate in construction is complex, which may be reflective of the challenges in measuring safety climate within this industry. PMID:24038403

Evaluation of Linking Methods for Placing Three-Parameter Logistic Item Parameter Estimates onto a One-Parameter Scale

ERIC Educational Resources Information Center

Karkee, Thakur B.; Wright, Karen R.

2004-01-01

Different item response theory (IRT) models may be employed for item calibration. Change of testing vendors, for example, may result in the adoption of a different model than that previously used with a testing program. To provide scale continuity and preserve cut score integrity, item parameter estimates from the new model must be linked to the…

Using InTeGrate materials to develop interdisciplinary thinking for a sustainable future

NASA Astrophysics Data System (ADS)

Awad, A. A.; Gilbert, L.; Iverson, E. A. R.; Manduca, C. A.; Steer, D. N.

2017-12-01

InTeGrate materials focus on societal grand challenges, sustainability, and interdisciplinary problems through developing geoscientific habits of mind, the use of credible data, and systems thinking. The materials are freely available 2-3 week modules and courses that allow instructors to focus on a wide variety of topics from regulating carbon emissions, changing biosphere, and storms and community resilience to environmental justice, ocean sustainability, and humans' dependence on mineral resources, integrating a variety of relevant interdisciplinary activities throughout. Presented with interdisciplinary approaches, students learn with tools to integrate engineering, policy, economics, and social aspects with the science to address the challenges. Students' ability to apply interdisciplinary approaches to address sustainability problems is made visible through the essays they write as a part of the materials assessment. InTeGrate modules have been adopted and implemented by faculty members interested in sustainability themes and innovative pedagogy, and have reached more than 50,000 students in all 50 states, Puerto Rico, India, and Micronesia. Student data were collected from 533 assessment essays in 57 undergraduate classes. The essays required students to describe a global challenge in an interdisciplinary manner through identifying scientific implications, and connecting it to economic, social and policy decisions. Students also completed a second essay assessing their systems thinking ability, a geoscience literacy exam (GLE), and demographic and attitudinal surveys. Scores for students enrolled in classes using InTeGrate materials were compared to scores from students in similar classes that did not use InteGrate materials. The InTeGrate and control groups had equivalent GLE scores and demographic characteristics. Essay scores for students in InTeGrate introductory or majors courses outperformed students in comparable level control courses as measured by the average interdisciplinary essay scores.

Impact of a comprehensive population health management program on health care costs.

PubMed

Grossmeier, Jessica; Seaverson, Erin L D; Mangen, David J; Wright, Steven; Dalal, Karl; Phalen, Chris; Gold, Daniel B

2013-06-01

Assess the influence of participation in a population health management (PHM) program on health care costs. A quasi-experimental study relied on logistic and ordinary least squares regression models to compare the costs of program participants with those of nonparticipants, while controlling for differences in health care costs and utilization, demographics, and health status. Propensity score models were developed and analyses were weighted by inverse propensity scores to control for selection bias. Study models yielded an estimated savings of $60.65 per wellness participant per month and $214.66 per disease management participant per month. Program savings were combined to yield an integrated return-on-investment of $3 in savings for every dollar invested. A PHM program yielded a positive return on investment after 2 years of wellness program and 1 year of integrated disease management program launch.

On the comparison of the strength of morphological integration across morphometric datasets.

PubMed

Adams, Dean C; Collyer, Michael L

2016-11-01

Evolutionary morphologists frequently wish to understand the extent to which organisms are integrated, and whether the strength of morphological integration among subsets of phenotypic variables differ among taxa or other groups. However, comparisons of the strength of integration across datasets are difficult, in part because the summary measures that characterize these patterns (RV coefficient and r PLS ) are dependent both on sample size and on the number of variables. As a solution to this issue, we propose a standardized test statistic (a z-score) for measuring the degree of morphological integration between sets of variables. The approach is based on a partial least squares analysis of trait covariation, and its permutation-based sampling distribution. Under the null hypothesis of a random association of variables, the method displays a constant expected value and confidence intervals for datasets of differing sample sizes and variable number, thereby providing a consistent measure of integration suitable for comparisons across datasets. A two-sample test is also proposed to statistically determine whether levels of integration differ between datasets, and an empirical example examining cranial shape integration in Mediterranean wall lizards illustrates its use. Some extensions of the procedure are also discussed. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

Visuospatial Aptitude Testing Differentially Predicts Simulated Surgical Skill.

PubMed

Hinchcliff, Emily; Green, Isabel; Destephano, Christopher; Cox, Mary; Smink, Douglas; Kumar, Amanika; Hokenstad, Erik; Bengtson, Joan; Cohen, Sarah

2018-02-05

To determine if visuospatial perception (VSP) testing is correlated to simulated or intraoperative surgical performance as rated by the American College of Graduate Medical Education (ACGME) milestones. Classification II-2 SETTING: Two academic training institutions PARTICIPANTS: 41 residents, including 19 Brigham and Women's Hospital and 22 Mayo Clinic residents from three different specialties (OBGYN, general surgery, urology). Participants underwent three different tests: visuospatial perception testing (VSP), Fundamentals of Laparoscopic Surgery (FLS®) peg transfer, and DaVinci robotic simulation peg transfer. Surgical grading from the ACGME milestones tool was obtained for each participant. Demographic and subject background information was also collected including specialty, year of training, prior experience with simulated skills, and surgical interest. Standard statistical analysis using Student's t test were performed, and correlations were determined using adjusted linear regression models. In univariate analysis, BWH and Mayo training programs differed in both times and overall scores for both FLS® peg transfer and DaVinci robotic simulation peg transfer (p<0.05 for all). Additionally, type of residency training impacted time and overall score on robotic peg transfer. Familiarity with tasks correlated with higher score and faster task completion (p= 0.05 for all except VSP score). There was no difference in VSP scores by program, specialty, or year of training. In adjusted linear regression modeling, VSP testing was correlated only to robotic peg transfer skills (average time p=0.006, overall score p=0.001). Milestones did not correlate to either VSP or surgical simulation testing. VSP score was correlated with robotic simulation skills but not with FLS skills or ACGME milestones. This suggests that the ability of VSP score to predict competence differs between tasks. Therefore, further investigation is required into aptitude testing, especially prior to its integration as an entry examination into a surgical subspecialty. Copyright © 2018. Published by Elsevier Inc.

Medical ethical standards in dermatology: an analytical study of knowledge, attitudes and practices.

PubMed

Mostafa, W Z; Abdel Hay, R M; El Lawindi, M I

2015-01-01

Dermatology practice has not been ethically justified at all times. The objective of the study was to find out dermatologists' knowledge about medical ethics, their attitudes towards regulatory measures and their practices, and to study the different factors influencing the knowledge, the attitude and the practices of dermatologists. This is a cross-sectional comparative study conducted among 214 dermatologists, from five Academic Universities and from participants in two conferences. A 54 items structured anonymous questionnaire was designed to describe the demographical characteristics of the study group as well as their knowledge, attitude and practices regarding the medical ethics standards in clinical and research settings. Five scoring indices were estimated regarding knowledge, attitude and practice. Inferential statistics were used to test differences between groups as indicated. The Student's t-test and analysis of variance were carried out for quantitative variables. The chi-squared test was conducted for qualitative variables. The results were considered statistically significant at a P > 0.05. Analysis of the possible factors having impact on the overall scores revealed that the highest knowledge scores were among dermatologists who practice in an academic setting plus an additional place; however, this difference was statistically non-significant (P = 0.060). Female dermatologists showed a higher attitude score compared to males (P = 0.028). The highest significant attitude score (P = 0.019) regarding clinical practice was recorded among those practicing cosmetic dermatology. The different studied groups of dermatologists revealed a significant impact on the attitude score (P = 0.049), and the evidence-practice score (P < 0.001). Ethical practices will improve the quality and integrity of dermatology research. © 2014 European Academy of Dermatology and Venereology.

Impact of care management processes and integration of care on blood pressure control in diabetes.

PubMed

Wong, Ken; Boulanger, Luke; Smalarz, Amy; Wu, Ning; Fraser, Kimberly; Wogen, Jenifer

2013-02-27

Fragmentation within health care systems may negatively impact the quality of chronic disease patient care. We sought to evaluate the relationship between care management processes (CMP), integration of services, and blood pressure (BP) control among diabetic patients. Retrospective chart reviews were performed for a random sample of adult diabetic hypertensive patients (n = 2,162) from 28 physician organizations in the United States (US). A modified version of the Physician Practice Connection Readiness Survey (PPC-RS) was completed by the chief medical officer at each site. The PPC-RS measured health system organization, delivery system redesign, decision support, clinical information systems, and self-management support, and an integration scale measured structure, functions, and financial risk. Correlations between PPC and integration scores and BP outcomes were assessed using Spearman correlation coefficients. Approximately 39.9% of diabetic patients had controlled BP. Mean total PPC score across sites was 55, with highest mean scores for health system organization (81), followed by design support (60), clinical information systems (57), self-management support (39), and delivery system redesign (39). Mean integration score was 46 (SD 27, range 4-93), and means of subscores were 64 for structure, 33 for financial risk, and 42 for function. Clinical information systems subscore was correlated with uncontrolled BP (r = -0.38, p < 0.05), while association with total PPC score was strong but not significant at p < 0.05 (r = -0.32). Total integration score and the structure subscore were significantly correlated with BP control (r = 0.38, p < 0.05, and r = 0.49, p < 0.01). This study suggests that CMP and service integration may be associated with better outcomes in diabetes, though results were mixed and limited by a small number of participating sites. Primary care implementation of integrated electronic medical records may have a beneficial effect on patient outcomes for diabetes and other chronic diseases.

[Effects of a group counseling integration program on self-determination and Internet addiction in high school students with tendency to Internet addiction].

PubMed

Park, Gyeong Ran; Kim, Hee Sook

2011-10-01

In this study the effects of a Group Counseling Integration Program for students with a tendency to Internet addiction were examined. Thirty-seven students who were in a vocational high school in G city participated in a survey, which was carried out from October 12 to November 12, 2009. To test the effects of the Group Counseling Integration Program, the participants were divided into two groups, an experimental group (18) and a control group (19). The research design used in this study was a nonequivalent control group non-synchronized pre-posttest quasi-experimental research design. The research tools included a self-determination scale and an internet addiction scale. Data were analyzed using Chi-square test, t-test, and ANCOVA with the SPSS/WIN 14.0 program. Significant differences were found in self-determination scores and internet addiction scores between the experimental group and the control group (F=5.99, p=.020) (t=-2.53, p=.016). The results indicate that Group Counseling Integration Programs are an effective nursing intervention for improving self-determination and decreasing Internet addiction in students with a tendency to Internet addiction.

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…

Comparing Standardized Test Scores among Arts-Integrated and Non-Arts Integrated Schools in Central Mississippi

ERIC Educational Resources Information Center

Dean, Darlene

2014-01-01

The topic of arts integration creates continuing dialog among educators and arts advocates. This study examined the degree to which student achievement was affected when arts education is limited or eliminated from schools to meet the mandates of NCLB (2001) legislation. Standardized test scores from 12 schools in Central Mississippi were used to…

Initial development of a treatment adherence measure for cognitive-behavioral therapy for child anxiety.

PubMed

Southam-Gerow, Michael A; McLeod, Bryce D; Arnold, Cassidy C; Rodríguez, Adriana; Cox, Julia R; Reise, Steven P; Bonifay, Wesley E; Weisz, John R; Kendall, Philip C

2016-01-01

The measurement of treatment adherence (a component of treatment integrity defined as the extent to which a treatment is delivered as intended) is a critical element in treatment evaluation research. This article presents initial psychometric data for scores on the Cognitive-Behavioral Therapy Adherence Scale for Youth Anxiety (CBAY-A), an observational measure designed to be sensitive to common practice elements found in individual cognitive-behavioral therapy (ICBT) for youth anxiety. Therapy sessions (N = 954) from 1 efficacy and 1 effectiveness study of ICBT for youth anxiety were independently rated by 2 coders. Interrater reliability (as gauged by intraclass correlation coefficients) for the item scores averaged 0.77 (SD = 0.15; range .48 to .80). The CBAY-A item and scale (skills, model, total) scores demonstrated evidence of convergent and discriminant validity with an observational measure of therapeutic interventions and an observational measure of the alliance. The CBAY-A item and scale scores also discriminated between therapists delivering ICBT in research and practice settings and therapists delivering nonmanualized usual clinical care. We discuss the importance of replicating these psychometric findings in different samples and highlight possible application of an adherence measure in testing integrity-outcome relations. (c) 2016 APA, all rights reserved).

Integrating nutrition education into the cardiovascular curriculum changes eating habits of second-year medical students.

PubMed

Vargas, Eric J; Zelis, Robert

2014-01-01

Survey of medical curricula continues to show that nutrition education is not universally adequate. One measure of nutritional educational competence is a positive change in student eating habits. The objective of this study was to evaluate whether integrating nutrition education within the second-year cardiovascular course for medical students, using the "Rate Your Plate" (RYP) questionnaire, coupled with knowledge of student personal 30-year risk of a cardiovascular event was useful in changing students' eating behaviors. Thirty-two students completed an unpublished 24-item questionnaire (modified-RYP) about their eating habits in the spring of their first year. The same students then completed the questionnaire in the spring of their second year. Paired t test was used to analyze the difference in RYP scores. Pearson correlation coefficients were calculated for the Framingham 30-year cardiovascular event risk and change in RYP score to examine whether risk knowledge may have changed eating habits. Mean scores at baseline and 1 year later were 57.19 and 58.97, respectively (paired t test, P < .01). Correlation coefficient between 30-year relative risk, adjusted for family history, and change in RYP score was -0.322. Although medical students were eating healthy at baseline, integration of nutrition education within the second-year cardiovascular medical curriculum was associated with improved heart healthy eating habits. Because student attitudes about prevention counseling are influenced by personal eating habits, this suggests that students with a more healthy diet will be more likely to recommend the same for their patients. Copyright © 2014 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Influence of national culture on the adoption of integrated and problem-based curricula in Europe.

PubMed

Jippes, Mariëlle; Majoor, Gerard D

2008-03-01

There is an evident misbalance in the frequency of medical schools with problem-based learning (PBL) curricula in northern versus southern Europe. This study explores the hypothesis that national culture influences the flexibility of (medical) schools in terms of their propensity to adopt integrated and PBL curricula. National culture was defined by a country's scores on indexes for 4 dimensions of culture as described by Hofstede, defined as: power distance; individualism/collectivism; masculinity/femininity, and uncertainty avoidance. Non-integrated medical curricula were defined as those that included courses in 2 of the 3 basic sciences (anatomy, biochemistry and physiology) in the first 2 years; otherwise, by exclusion, curricula were assumed to be integrated. The medical curricula of 134 of the 263 schools in the 17 European countries included in Hofstede's study were examined. Correlations were calculated between the percentage of integrated medical curricula in a country and that country's scores on indexes for each of the 4 dimensions of culture. Significant negative correlations were found between the percentage of integrated curricula and scores on the power distance index (correlation coefficient [CC]: - 0.692; P = 0.002) and the uncertainty avoidance index (CC: - 0.704; P = 0.002). No significant correlations were found between the percentage of integrated curricula and scores on the indexes for individualism/collectivism and masculinity/femininity. A (medical) school which is considering adopting an integrated or PBL curriculum and which is based in a country with a high score on Hofstede's power distance index and/or uncertainty avoidance index must a priori design strategies to reduce or overcome the obstructive effects of these dimensions of culture on the school's organisation.

Validation of a stream and riparian habitat assessment protocol using stream salamanders in the southwest Virginia coalfields

USGS Publications Warehouse

Sweeten, Sara E.; Ford, W. Mark

2016-01-01

Within the central Appalachia Coalfields, the aquatic impacts of large-scale land uses, such as surface mining, are of particular ecological concern. Identification and quantification of land use impacts to aquatic ecosystems are a necessary first step to aid in mitigation of negative consequences to biota. However, quantifying physical environmental quality such as stream and riparian habitat often can be quite difficult, particularly when there is time or fiscal limitations. As such, standard protocols such as the U.S. EPA’s Stream Habitat Rapid Bioassessment Protocol have been established to be cost- and time-effective. This protocol estimates ten different stream and riparian conditions on a scale of 0 to 20. Unfortunately, using estimations can be problematic because of large potential variation in the scoring depending on differences in training, experience, and opinion of the personnel doing the estimations. In order to help negate these biases and provide a simplified process, the U.S. Army Corps of Engineers (USACE) developed a functional assessment for streams that measures 11 stream and riparian variables along with watershed land use to calculate three different scores, a hydrology score, biogeochemical score, and habitat score. In our study, we examined the correlation of stream salamander presence and abundance to the three USACE scores. In the summer of 2013, we visited 70 sites in the southwest Virginia Coalfields multiple times to collect salamanders and quantify stream and riparian microhabitat parameters. Using occupancy and abundance analyses, we found strong relationships among three Desmognathus spp. and the USACE Habitat FCI score. Accordingly, the Habitat FCI score provides a reasonable assessment of physical instream and riparian conditions that may serve as a surrogate for understanding the community composition and integrity of aquatic salamander in the region.

A metadata-aware application for remote scoring and exchange of tissue microarray images

PubMed Central

2013-01-01

Background The use of tissue microarrays (TMA) and advances in digital scanning microscopy has enabled the collection of thousands of tissue images. There is a need for software tools to annotate, query and share this data amongst researchers in different physical locations. Results We have developed an open source web-based application for remote scoring of TMA images, which exploits the value of Microsoft Silverlight Deep Zoom to provide a intuitive interface for zooming and panning around digital images. We use and extend existing XML-based standards to ensure that the data collected can be archived and that our system is interoperable with other standards-compliant systems. Conclusion The application has been used for multi-centre scoring of TMA slides composed of tissues from several Phase III breast cancer trials and ten different studies participating in the International Breast Cancer Association Consortium (BCAC). The system has enabled researchers to simultaneously score large collections of TMA and export the standardised data to integrate with pathological and clinical outcome data, thereby facilitating biomarker discovery. PMID:23635078

Auditory integration training and other sound therapies for autism spectrum disorders (ASD).

PubMed

Sinha, Yashwant; Silove, Natalie; Hayen, Andrew; Williams, Katrina

2011-12-07

Auditory integration therapy was developed as a technique for improving abnormal sound sensitivity in individuals with behavioural disorders including autism spectrum disorders. Other sound therapies bearing similarities to auditory integration therapy include the Tomatis Method and Samonas Sound Therapy. To determine the effectiveness of auditory integration therapy or other methods of sound therapy in individuals with autism spectrum disorders. For this update, we searched the following databases in September 2010: CENTRAL (2010, Issue 2), MEDLINE (1950 to September week 2, 2010), EMBASE (1980 to Week 38, 2010), CINAHL (1937 to current), PsycINFO (1887 to current), ERIC (1966 to current), LILACS (September 2010) and the reference lists of published papers. One new study was found for inclusion. Randomised controlled trials involving adults or children with autism spectrum disorders. Treatment was auditory integration therapy or other sound therapies involving listening to music modified by filtering and modulation. Control groups could involve no treatment, a waiting list, usual therapy or a placebo equivalent. The outcomes were changes in core and associated features of autism spectrum disorders, auditory processing, quality of life and adverse events. Two independent review authors performed data extraction. All outcome data in the included papers were continuous. We calculated point estimates and standard errors from t-test scores and post-intervention means. Meta-analysis was inappropriate for the available data. We identified six randomised comtrolled trials of auditory integration therapy and one of Tomatis therapy, involving a total of 182 individuals aged three to 39 years. Two were cross-over trials. Five trials had fewer than 20 participants. Allocation concealment was inadequate for all studies. Twenty different outcome measures were used and only two outcomes were used by three or more studies. Meta-analysis was not possible due to very high heterogeneity or the presentation of data in unusable forms. Three studies (Bettison 1996; Zollweg 1997; Mudford 2000) did not demonstrate any benefit of auditory integration therapy over control conditions. Three studies (Veale 1993; Rimland 1995; Edelson 1999) reported improvements at three months for the auditory integration therapy group based on the Aberrant Behaviour Checklist, but they used a total score rather than subgroup scores, which is of questionable validity, and Veale's results did not reach statistical significance. Rimland 1995 also reported improvements at three months in the auditory integration therapy group for the Aberrant Behaviour Checklist subgroup scores. The study addressing Tomatis therapy (Corbett 2008) described an improvement in language with no difference between treatment and control conditions and did not report on the behavioural outcomes that were used in the auditory integration therapy trials. There is no evidence that auditory integration therapy or other sound therapies are effective as treatments for autism spectrum disorders. As synthesis of existing data has been limited by the disparate outcome measures used between studies, there is not sufficient evidence to prove that this treatment is not effective. However, of the seven studies including 182 participants that have been reported to date, only two (with an author in common), involving a total of 35 participants, report statistically significant improvements in the auditory intergration therapy group and for only two outcome measures (Aberrant Behaviour Checklist and Fisher's Auditory Problems Checklist). As such, there is no evidence to support the use of auditory integration therapy at this time.

Standardization and application of an index of community integrity for waterbirds in the Chesapeake Bay, USA

USGS Publications Warehouse

Prosser, Diann J.; Nagel, Jessica L.; Marban, Paul; Ze, Luo; Day, Daniel D.; Erwin, R. Michael

2017-01-01

In recent decades, there has been increasing interest in the application of ecological indices to assess ecosystem condition in response to anthropogenic activities. An Index of Waterbird Community Integrity was previously developed for the Chesapeake Bay, USA. However, the scoring criteria were not defined well enough to generate scores for new species that were not observed in the original study. The goal of this study was to explicitly define the scoring criteria for the existing index and to develop index scores for all waterbirds of the Chesapeake Bay. The standardized index then was applied to a case study investigating the relationship between waterbird community integrity and shoreline development during late summer and late fall (2012–2014) using an alternative approach to survey methodology, which allowed for greater area coverage compared to the approach used in the original study. Index scores for both seasons were negatively related to percentage of developed shorelines. Providing these updated tools using the detailed scoring system will facilitate future application to new species or development of the index in other estuaries worldwide. This methodology allows for consistent cross-study comparisons and can be combined with other community integrity indices, allowing for more effective estuarine management.

Slow Temporal Summation of Pain for Assessment of Central Pain Sensitivity and Clinical Pain of Fibromyalgia Patients

PubMed Central

Staud, Roland; Weyl, Elizabeth E.; Riley, Joseph L.; Fillingim, Roger B.

2014-01-01

Background In healthy individuals slow temporal summation of pain or wind-up (WU) can be evoked by repetitive heat-pulses at frequencies of ≥.33 Hz. Previous WU studies have used various stimulus frequencies and intensities to characterize central sensitization of human subjects including fibromyalgia (FM) patients. However, many trials demonstrated considerable WU-variability including zero WU or even wind-down (WD) at stimulus intensities sufficient for activating C-nociceptors. Additionally, few WU-protocols have controlled for contributions of individual pain sensitivity to WU-magnitude, which is critical for WU-comparisons. We hypothesized that integration of 3 different WU-trains into a single WU-response function (WU-RF) would not only control for individuals’ pain sensitivity but also better characterize their central pain responding including WU and WD. Methods 33 normal controls (NC) and 38 FM patients participated in a study of heat-WU. We systematically varied stimulus intensities of.4 Hz heat-pulse trains applied to the hands. Pain summation was calculated as difference scores of 1st and 5th heat-pulse ratings. WU-difference (WU-Δ) scores related to 3 heat-pulse trains (44°C, 46°C, 48°C) were integrated into WU-response functions whose slopes were used to assess group differences in central pain sensitivity. WU-aftersensations (WU-AS) at 15 s and 30 s were used to predict clinical FM pain intensity. Results WU-Δ scores linearly accelerated with increasing stimulus intensity (p<.001) in both groups of subjects (FM>NC) from WD to WU. Slope of WU-RF, which is representative of central pain sensitivity, was significantly steeper in FM patients than NC (p<.003). WU-AS predicted clinical FM pain intensity (Pearson’s r = .4; p<.04). Conclusions Compared to single WU series, WU-RFs integrate individuals’ pain sensitivity as well as WU and WD. Slope of WU-RFs was significantly different between FM patients and NC. Therefore WU-RF may be useful for assessing central sensitization of chronic pain patients in research and clinical practice. PMID:24558475

More Symmetrical Children Have Faster and More Consistent Choice Reaction Times

ERIC Educational Resources Information Center

Hope, David; Bates, Timothy C.; Dykiert, Dominika; Der, Geoff; Deary, Ian J.

2015-01-01

Greater cognitive ability in childhood is associated with increased longevity, and speedier reaction time (RT) might account for much of this linkage. Greater bodily symmetry is linked to both higher cognitive test scores and faster RTs. It is possible, then, that differences in bodily system integrity indexed by symmetry may underlie the…

Gender Differences in Perceptions of Sexual Intent: A Qualitative Review and Integration

ERIC Educational Resources Information Center

Lindgren, Kristen P.; Parkhill, Michele R.; George, William H.; Hendershot, Christian S.

2008-01-01

Men appear to interpret people's behaviors more sexually than do women. This finding, which has been replicated in scores of studies using a variety of methodological approaches, has been linked to important social concerns, including sexual assault and sexual harassment. This article provides a critical review of the published literature on…

How to confidently teach EBM on foot: development and evaluation of a web-based e-learning course.

PubMed

Weberschock, Tobias; Sorinola, Olanrewaju; Thangaratinam, Shakila; Oude Rengerink, Katrien; Arvanitis, Theodoros N; Khan, Khalid S

2013-10-01

Scarcity of well-trained clinical tutors is a key constraint in integrating teaching of evidence-based medicine (EBM) into clinical activities. We developed a web-based educational course for clinical trainers to confidently teach EBM principles in everyday practice. Its e-learning modules defined the learning objectives and incorporated video clips of practical and effective EBM teaching methods for exploiting educational opportunities in six different clinical settings. We evaluated the course with clinical tutors in different specialties across six European countries using a questionnaire to capture learning achievement against preset objectives. Among 56 tutors, 47 participants (84%) improved their scores from baseline. The mean pre-course score was 69.2 (SD=10.4), which increased to 77.3 (SD=11.7) postcourse (p<0.0001). The effect size was moderate with a Cohen's d of 0.73. An e-learning approach incorporating videos of applied EBM teaching and learning based on real clinical scenarios in the workplace can be useful in facilitating EBM teaching on foot. It can be integrated in the continuing professional development programmes for clinical trainers.

Examining the integrity of measurement of cognitive abilities in the prediction of achievement: Comparisons and contrasts across variables from higher-order and bifactor models.

PubMed

Benson, Nicholas F; Kranzler, John H; Floyd, Randy G

2016-10-01

Prior research examining cognitive ability and academic achievement relations have been based on different theoretical models, have employed both latent variables as well as observed variables, and have used a variety of analytic methods. Not surprisingly, results have been inconsistent across studies. The aims of this study were to (a) examine how relations between psychometric g, Cattell-Horn-Carroll (CHC) broad abilities, and academic achievement differ across higher-order and bifactor models; (b) examine how well various types of observed scores corresponded with latent variables; and (c) compare two types of observed scores (i.e., refined and non-refined factor scores) as predictors of academic achievement. Results suggest that cognitive-achievement relations vary across theoretical models and that both types of factor scores tend to correspond well with the models on which they are based. However, orthogonal refined factor scores (derived from a bifactor model) have the advantage of controlling for multicollinearity arising from the measurement of psychometric g across all measures of cognitive abilities. Results indicate that the refined factor scores provide more precise representations of their targeted constructs than non-refined factor scores and maintain close correspondence with the cognitive-achievement relations observed for latent variables. Thus, we argue that orthogonal refined factor scores provide more accurate representations of the relations between CHC broad abilities and achievement outcomes than non-refined scores do. Further, the use of refined factor scores addresses calls for the application of scores based on latent variable models. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Tailored balance exercises on people with multiple sclerosis: A pilot randomized, controlled study.

PubMed

Brichetto, Giampaolo; Piccardo, Elisa; Pedullà, Ludovico; Battaglia, Mario Alberto; Tacchino, Andrea

2015-07-01

Altered integration of signals from visual (VIS), somatosensory (PROP) and vestibular system (VEST) lead to balance control impairments affecting the daily living activities of patients with multiple sclerosis (PwMS). As a consequence, tailored interventions could be crucial in improving efficacy of balance rehabilitation treatments. The objective of this paper is to assess the efficacy of tailored rehabilitation treatments for balance disorders based on visual, somatosensory and vestibular deficits versus traditional rehabilitation exercises. Thirty-two PwMS were assessed with the Berg Balance Scale (BBS), the composite score (CS) obtained by computerized dynamic posturography (CDP) test and the Modified Fatigue Impact Scale (MFIS). Based on CDP analysis, prevalent VIS, PROP or VEST deficits were identified and patients randomly allocated to a personalized (PRG) or traditional (TRG) rehabilitation group. BBS score showed a significant difference between pre- and post-treatment scores of 6.3 and 2.0 points respectively for PRG and TRG. CS showed a significant difference between pre- and post-treatment scores of 16.6 and 7.6 points respectively for PRG and TRG. No interaction effect was found for MFIS score. BBS and CS showed changes in the PRG group that met clinical relevant difference, underlining that tailored rehabilitation interventions based on patient-specific sensory system impairment could improve balance and postural control in PwMS. © The Author(s), 2015.

The relationships between integration strategies and student achievement scores in science among the non-college bound in Pennsylvania

NASA Astrophysics Data System (ADS)

Foster, John Curtis

1997-09-01

To assume that students, or anyone for that matter, can recall bits of information when they have never been shown any practical application for that information is ludicrous. This study focuses on a variety of integration strategies that exist between vocational and academic subjects in Pennsylvania through an initiative called High Schools That Work. The data utilized was collected by the Educational Testing Service in 1994 and included information from 385 graduating seniors. The purpose of this study was to explore the relationship between the perceived level of integration between science and vocational subject areas and scores on the National Assessment of Educational Progress (NAEP). The study utilized frequency distributions, descriptive statistics, correlation techniques, and regression analysis. Differences in the type of vocational program that students were enrolled in were examined as well as their gender. It is evident from this study that the use of vocational methodologies, particularly those involving student assignments on workplace problems in their classrooms, helps students consistently score higher on the NAEP. Findings also indicated that females performed better in areas which required higher level thinking skills when these methods were utilized. The usefulness of this study is broad and it has implications for those teaching, those designing curricula, those determining policy, as well as those in higher education.

Comparative study of subtalar arthrodesis after calcaneal frature malunion with autologous bone graft or freeze-dried xenograft.

PubMed

Henning, Carlo; Poglia, Gabriel; Leie, Murilo Anderson; Galia, Carlos Roberto

2015-12-01

Calcaneal fracture malunion may evolve into arthrosis and severe foot deformities. The aim of this study was to identify differences in bony union following corrective subtalar arthrodesis with interposition of autologous tricortical bone graft or freeze-dried bovine xenograft. We prospectively evaluated 12 patients who underwent subtalar arthrodesis, six patients received autografts and 6 received freeze-dried bovine xenografts. After a mean followup of 58 weeks, the patients were clinical assessed using AOFAS scale and the visual analog scale (VAS) for pain and for final radiographic parameters measurement. Two blind raters evaluated the length of time required for solid union of the arthrodesis and graft integration by retrospective radiographic examination. In the autograft group, AOFAS score improved from a preoperative average of 37 to 64 points postoperatively (p = 0.02) and mean VAS score improved from 4.7 to 1.9 (p = 0.028). In the xenograft group, AOFAS score improved from 38 to 74 points (p = 0.02) and VAS from 5.5 to 2.7 (p = 0.046). Solid union was achieved in all cases in the autograft group at an average of 5.3 weeks and in five cases in the xenograft group at 8.8 weeks (p = 0.077). Graft integration occurred after an average of 10.7 weeks in the autograft group and 28.8 weeks in the xenograft group (p = 0.016). With the numbers available, no significant difference could be detected in the length of time required for solid union of subtalar arthrodesis between groups, although time to integration of freeze-dried bovine xenografts was statistically higher. Clinical and functional improvement was observed in both groups.

Changes in language development among autistic and peer children in segregated and integrated preschool settings.

PubMed

Harris, S L; Handleman, J S; Kristoff, B; Bass, L; Gordon, R

1990-03-01

Five young children with autism enrolled in a segregated class, five other children with autism in an integrated class, and four normally developing peer children in the integrated class were compared for developmental changes in language ability as measured by the Preschool Language Scale before and after training. The results, based on Mann-Whitney U tests, showed that (a) all of the children as a group made better than normative progress in rate of language development, (b) the scores of the autistic children were significantly lower than the peers before and after treatment, and (c) there were no significant differences in changes in language ability between the autistic children in the segregated and integrated classes.

A Qualitative Readiness-Requirements Assessment Model for Enterprise Big-Data Infrastructure Investment

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

Olama, Mohammed M; McNair, Wade; Sukumar, Sreenivas R

2014-01-01

In the last three decades, there has been an exponential growth in the area of information technology providing the information processing needs of data-driven businesses in government, science, and private industry in the form of capturing, staging, integrating, conveying, analyzing, and transferring data that will help knowledge workers and decision makers make sound business decisions. Data integration across enterprise warehouses is one of the most challenging steps in the big data analytics strategy. Several levels of data integration have been identified across enterprise warehouses: data accessibility, common data platform, and consolidated data model. Each level of integration has its ownmore » set of complexities that requires a certain amount of time, budget, and resources to implement. Such levels of integration are designed to address the technical challenges inherent in consolidating the disparate data sources. In this paper, we present a methodology based on industry best practices to measure the readiness of an organization and its data sets against the different levels of data integration. We introduce a new Integration Level Model (ILM) tool, which is used for quantifying an organization and data system s readiness to share data at a certain level of data integration. It is based largely on the established and accepted framework provided in the Data Management Association (DAMA-DMBOK). It comprises several key data management functions and supporting activities, together with several environmental elements that describe and apply to each function. The proposed model scores the maturity of a system s data governance processes and provides a pragmatic methodology for evaluating integration risks. The higher the computed scores, the better managed the source data system and the greater the likelihood that the data system can be brought in at a higher level of integration.« less

A qualitative readiness-requirements assessment model for enterprise big-data infrastructure investment

NASA Astrophysics Data System (ADS)

Olama, Mohammed M.; McNair, Allen W.; Sukumar, Sreenivas R.; Nutaro, James J.

2014-05-01

In the last three decades, there has been an exponential growth in the area of information technology providing the information processing needs of data-driven businesses in government, science, and private industry in the form of capturing, staging, integrating, conveying, analyzing, and transferring data that will help knowledge workers and decision makers make sound business decisions. Data integration across enterprise warehouses is one of the most challenging steps in the big data analytics strategy. Several levels of data integration have been identified across enterprise warehouses: data accessibility, common data platform, and consolidated data model. Each level of integration has its own set of complexities that requires a certain amount of time, budget, and resources to implement. Such levels of integration are designed to address the technical challenges inherent in consolidating the disparate data sources. In this paper, we present a methodology based on industry best practices to measure the readiness of an organization and its data sets against the different levels of data integration. We introduce a new Integration Level Model (ILM) tool, which is used for quantifying an organization and data system's readiness to share data at a certain level of data integration. It is based largely on the established and accepted framework provided in the Data Management Association (DAMADMBOK). It comprises several key data management functions and supporting activities, together with several environmental elements that describe and apply to each function. The proposed model scores the maturity of a system's data governance processes and provides a pragmatic methodology for evaluating integration risks. The higher the computed scores, the better managed the source data system and the greater the likelihood that the data system can be brought in at a higher level of integration.

Appraising the quality of medical education research methods: the Medical Education Research Study Quality Instrument and the Newcastle-Ottawa Scale-Education.

PubMed

Cook, David A; Reed, Darcy A

2015-08-01

The Medical Education Research Study Quality Instrument (MERSQI) and the Newcastle-Ottawa Scale-Education (NOS-E) were developed to appraise methodological quality in medical education research. The study objective was to evaluate the interrater reliability, normative scores, and between-instrument correlation for these two instruments. In 2014, the authors searched PubMed and Google for articles using the MERSQI or NOS-E. They obtained or extracted data for interrater reliability-using the intraclass correlation coefficient (ICC)-and normative scores. They calculated between-scale correlation using Spearman rho. Each instrument contains items concerning sampling, controlling for confounders, and integrity of outcomes. Interrater reliability for overall scores ranged from 0.68 to 0.95. Interrater reliability was "substantial" or better (ICC > 0.60) for nearly all domain-specific items on both instruments. Most instances of low interrater reliability were associated with restriction of range, and raw agreement was usually good. Across 26 studies evaluating published research, the median overall MERSQI score was 11.3 (range 8.9-15.1, of possible 18). Across six studies, the median overall NOS-E score was 3.22 (range 2.08-3.82, of possible 6). Overall MERSQI and NOS-E scores correlated reasonably well (rho 0.49-0.72). The MERSQI and NOS-E are useful, reliable, complementary tools for appraising methodological quality of medical education research. Interpretation and use of their scores should focus on item-specific codes rather than overall scores. Normative scores should be used for relative rather than absolute judgments because different research questions require different study designs.

Correlation between safety climate and contractor safety assessment programs in construction.

PubMed

Sparer, Emily H; Murphy, Lauren A; Taylor, Kathryn M; Dennerlein, Jack T

2013-12-01

Contractor safety assessment programs (CSAPs) measure safety performance by integrating multiple data sources together; however, the relationship between these measures of safety performance and safety climate within the construction industry is unknown. Four hundred and one construction workers employed by 68 companies on 26 sites and 11 safety managers employed by 11 companies completed brief surveys containing a nine-item safety climate scale developed for the construction industry. CSAP scores from ConstructSecure, Inc., an online CSAP database, classified these 68 companies as high or low scorers, with the median score of the sample population as the threshold. Spearman rank correlations evaluated the association between the CSAP score and the safety climate score at the individual level, as well as with various grouping methodologies. In addition, Spearman correlations evaluated the comparison between manager-assessed safety climate and worker-assessed safety climate. There were no statistically significant differences between safety climate scores reported by workers in the high and low CSAP groups. There were, at best, weak correlations between workers' safety climate scores and the company CSAP scores, with marginal statistical significance with two groupings of the data. There were also no significant differences between the manager-assessed safety climate and the worker-assessed safety climate scores. A CSAP safety performance score does not appear to capture safety climate, as measured in this study. The nature of safety climate in construction is complex, which may be reflective of the challenges in measuring safety climate within this industry. Am. J. Ind. Med. 56:1463-1472, 2013. © 2013 Wiley Periodicals, Inc. © 2013 Wiley Periodicals, Inc.

Integrated system links cost data, patient satisfaction scores for the first time.

PubMed

1999-10-01

Linking cost data, patient satisfaction scores. HBS International and The Picker Institute have joined forces to make integrated data available that directly links operational efficiency and patient satisfaction. Find out how the systems lets providers know when reducing expenses compromises care.

Effect of Health Education Based on Integrative Therapy of Chinese and Western Medicine for Adult Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study.

PubMed

Shi, Mai; Liu, Zhao-Lan; Zhu, Yan-Bo; Xu, Mei-Yan; Duan, Xue-Ying; Shi, Hui-Mei; Jiang, Bo; Zhang, Xiao-Mei; Yu, Xiao-Han

2018-02-01

To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus (T2DM) from the aspects of knowledge, attitude and practice (KAP), health-related quality of life (HRQoL), body mass index (BMI) and glucose control. Patients were individually randomized into intervention group (receiving integrative education, n=120) and control group (receiving usual education, n=120). The primary outcome was the changes in glycosylated hemoglobin A1c (HbA1c) levels after 3, 6, 9 and 12 months from baseline. Hierarchical linear models (HLMs) were used to assess within-group changes in outcomes over time and between-group differences in patterns of change. Secondary outcomes were KAP scores, HRQoL scores and BMI after 6 and 12 months, paired-sample t test was used to assess within-group changes in outcomes in 6 and 12 months, independent-sample t test was used to assess between-group differences in patterns of change. HbA1c decreased statistically from baseline to 3 months, from 3 to 6 months, from 6 to 9 months and from 9 to 12 months in the intervention group (all P<0.01); and decreased significantly from baseline to 3 months, and from 3 to 6 months in the control group P<0.01). There was a significant between-group difference from baseline to 3 months (P=0.044), from 6 to 9 months (P<0.01) and from 9 to 12 months (P<0.01). Significant improvements in the intervention group along with significant between-group differences were found in KAP and HRQoL scores respectively (all P<0.05). The number in the intervention group of normal weight increased from 56 at baseline to 81 (6 months), 94 (12 months), the number in the control group were 63 (baseline), 69 (6 months), 70 (12 months), the χ 2 of hierarchical analysis of BMI were 6.93 (P=0.075), 10.31 (P=0.016), 15.53 (P<0.01), respectively. Health education based on integrative therapy of Chinese and Western medicine is beneficial to the control of T2DM and should be recommended for T2DM.

Genetic effect of interleukin-1 beta (C-511T) polymorphism on the structural covariance network and white matter integrity in Alzheimer's disease.

PubMed

Huang, Chi-Wei; Hsu, Shih-Wei; Tsai, Shih-Jen; Chen, Nai-Ching; Liu, Mu-En; Lee, Chen-Chang; Huang, Shu-Hua; Chang, Weng-Neng; Chang, Ya-Ting; Tsai, Wan-Chen; Chang, Chiung-Chih

2017-01-18

Inflammatory processes play a pivotal role in the degenerative process of Alzheimer's disease. In humans, a biallelic (C/T) polymorphism in the promoter region (position-511) (rs16944) of the interleukin-1 beta gene has been significantly associated with differences in the secretory capacity of interleukin-1 beta. In this study, we investigated whether this functional polymorphism mediates the brain networks in patients with Alzheimer's disease. We enrolled a total of 135 patients with Alzheimer's disease (65 males, 70 females), and investigated their gray matter structural covariance networks using 3D T1 magnetic resonance imaging and their white matter macro-structural integrities using fractional anisotropy. The patients were classified into two genotype groups: C-carriers (n = 108) and TT-carriers (n = 27), and the structural covariance networks were constructed using seed-based analysis focusing on the default mode network medial temporal or dorsal medial subsystem, salience network and executive control network. Neurobehavioral scores were used as the major outcome factors for clinical correlations. There were no differences between the two genotype groups in the cognitive test scores, seed, or peak cluster volumes and white matter fractional anisotropy. The covariance strength showing C-carriers > TT-carriers was the entorhinal-cingulum axis. There were two peak clusters (Brodmann 6 and 10) in the salience network and four peak clusters (superior prefrontal, precentral, fusiform, and temporal) in the executive control network that showed C-carriers < TT-carriers in covariance strength. The salience network and executive control network peak clusters in the TT group and the default mode network peak clusters in the C-carriers strongly predicted the cognitive test scores. Interleukin-1 beta C-511 T polymorphism modulates the structural covariance strength on the anterior brain network and entorhinal-interconnected network which were independent of the white matter tract integrity. Depending on the specific C-511 T genotype, different network clusters could predict the cognitive tests.

The Big-Five factor structure as an integrative framework: an analysis of Clarke's AVA model.

PubMed

Goldberg, L R; Sweeney, D; Merenda, P F; Hughes, J E

1996-06-01

Using a large (N = 3,629) sample of participants selected to be representative of U.S. working adults in the year 2,000, we provide links between the constructs in 2 personality models that have been derived from quite different rationales. We demonstrate the use of a novel procedure for providing orthogonal Big-Five factor scores and use those scores to analyze the scales of the Activity Vector Analysis (AVA). We discuss the implications of our many findings both for the science of personality assessment and for future research using the AVA model.

A probabilistic verification score for contours demonstrated with idealized ice-edge forecasts

NASA Astrophysics Data System (ADS)

Goessling, Helge; Jung, Thomas

2017-04-01

We introduce a probabilistic verification score for ensemble-based forecasts of contours: the Spatial Probability Score (SPS). Defined as the spatial integral of local (Half) Brier Scores, the SPS can be considered the spatial analog of the Continuous Ranked Probability Score (CRPS). Applying the SPS to idealized seasonal ensemble forecasts of the Arctic sea-ice edge in a global coupled climate model, we demonstrate that the SPS responds properly to ensemble size, bias, and spread. When applied to individual forecasts or ensemble means (or quantiles), the SPS is reduced to the 'volume' of mismatch, in case of the ice edge corresponding to the Integrated Ice Edge Error (IIEE).

A Prorating Method for Estimating MMPI-2-RF Scores From MMPI Responses: Examination of Score Fidelity and Illustration of Empirical Utility in the PERSEREC Police Integrity Study Sample.

PubMed

Tarescavage, Anthony M; Corey, David M; Ben-Porath, Yossef S

2016-04-01

The purpose of the current study was to identify Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) correlates of police officer integrity violations and other problem behaviors in an archival database with original MMPI item responses and collateral information regarding integrity violations obtained for 417 male officers. In Study 1, we estimated MMPI-2-RF scores from the MMPI item pool (which includes approximately 80% of the MMPI-2-RF items) in a normative sample, a psychiatric inpatient sample, and a police officer sample, and conducted analyses that demonstrated the comparability of estimated and full scale scores for 41 of the 51 MMPI-2-RF scales. In Study 2, we correlated estimated MMPI-2-RF scores with information about subsequent integrity violations and problem behaviors from the integrity violation data set. Several meaningful associations were obtained, predominately with scales from the emotional, thought, and behavioral dysfunction domains of the MMPI-2-RF. Application of a correction for range restriction yielded substantially improved validity estimates. Finally, we calculated relative risk ratios for the statistically significant findings using cutoffs lower than 65T, which is traditionally used to identify clinically significant elevations, and found several meaningful relative risk ratios. © The Author(s) 2015.

Validating the TeleStroke Mimic Score: A Prediction Rule for Identifying Stroke Mimics Evaluated Over Telestroke Networks.

PubMed

Ali, Syed F; Hubert, Gordian J; Switzer, Jeffrey A; Majersik, Jennifer J; Backhaus, Roland; Shepard, L Wylie; Vedala, Kishore; Schwamm, Lee H

2018-03-01

Up to 30% of acute stroke evaluations are deemed stroke mimics, and these are common in telestroke as well. We recently published a risk prediction score for use during telestroke encounters to differentiate stroke mimics from ischemic cerebrovascular disease derived and validated in the Partners TeleStroke Network. Using data from 3 distinct US and European telestroke networks, we sought to externally validate the TeleStroke Mimic (TM) score in a broader population. We evaluated the TM score in 1930 telestroke consults from the University of Utah, Georgia Regents University, and the German TeleMedical Project for Integrative Stroke Care Network. We report the area under the curve in receiver-operating characteristic curve analysis with 95% confidence interval for our previously derived TM score in which lower TM scores correspond with a higher likelihood of being a stroke mimic. Based on final diagnosis at the end of the telestroke consultation, there were 630 of 1930 (32.6%) stroke mimics in the external validation cohort. All 6 variables included in the score were significantly different between patients with ischemic cerebrovascular disease versus stroke mimics. The TM score performed well (area under curve, 0.72; 95% confidence interval, 0.70-0.73; P <0.001), similar to our prior external validation in the Partners National Telestroke Network. The TM score's ability to predict the presence of a stroke mimic during telestroke consultation in these diverse cohorts was similar to its performance in our original cohort. Predictive decision-support tools like the TM score may help highlight key clinical differences between mimics and patients with stroke during complex, time-critical telestroke evaluations. © 2018 American Heart Association, Inc.

Independent or Integrated? The Impact on Subject Examination Scores of Changing a Neuropsychiatry Clerkship to Independent Clerkships in Psychiatry and Neurology.

PubMed

Anderson, Heather S; Gabrielli, William F; Paolo, Anthony; Walling, Anne

2017-08-01

This study was undertaken to assess any impact on National Board of Medical Examiners (NBME) neurology and psychiatry subject examination scores of changing from an integrated neuropsychiatry clerkship to independent neurology and psychiatry clerkships. NBME psychiatry and neurology subject examinations scores were compared for all 625 students completing the required neuropsychiatry clerkship in academic years 2005-2006 through 2008-2009 with all 650 students completing the independent neurology and psychiatry clerkships in academic years 2009-2010 through 2012-2013. Statistical adjustments were made to ensure comparability across groups and over time. A significant improvement in subject examination scores was associated with the independent clerkships. The independent clerkship model was associated with a modest improvement in NBME subject examination scores. This finding may be attributable to many causes or combination of causes other than curricular design. Curricular planners need to pay attention to the potential impact of course integration on specialty-specific NBME subject examination performance.

Condoning Aggressive Behaviour in Sport: A Cross-Sectional Research in a Few Consecutive Age Categories

ERIC Educational Resources Information Center

Fruchart, Eric; Rulence-Pâques, Patricia

2016-01-01

The aim of this study was to compare the way in which 216 young handball players ("Mage" = 12.79, SD = 2.20) of different ages (nine- to 10-years-old, 11- to 12-years-old, 13- to 14-years-old, and 15- to 16-years-old) combined and integrated five different information cues (the consequences of the aggression, the current score, the time…

IMHOTEP—a composite score integrating popular tools for predicting the functional consequences of non-synonymous sequence variants

PubMed Central

Knecht, Carolin; Mort, Matthew; Junge, Olaf; Cooper, David N.; Krawczak, Michael

2017-01-01

Abstract The in silico prediction of the functional consequences of mutations is an important goal of human pathogenetics. However, bioinformatic tools that classify mutations according to their functionality employ different algorithms so that predictions may vary markedly between tools. We therefore integrated nine popular prediction tools (PolyPhen-2, SNPs&GO, MutPred, SIFT, MutationTaster2, Mutation Assessor and FATHMM as well as conservation-based Grantham Score and PhyloP) into a single predictor. The optimal combination of these tools was selected by means of a wide range of statistical modeling techniques, drawing upon 10 029 disease-causing single nucleotide variants (SNVs) from Human Gene Mutation Database and 10 002 putatively ‘benign’ non-synonymous SNVs from UCSC. Predictive performance was found to be markedly improved by model-based integration, whilst maximum predictive capability was obtained with either random forest, decision tree or logistic regression analysis. A combination of PolyPhen-2, SNPs&GO, MutPred, MutationTaster2 and FATHMM was found to perform as well as all tools combined. Comparison of our approach with other integrative approaches such as Condel, CoVEC, CAROL, CADD, MetaSVM and MetaLR using an independent validation dataset, revealed the superiority of our newly proposed integrative approach. An online implementation of this approach, IMHOTEP (‘Integrating Molecular Heuristics and Other Tools for Effect Prediction’), is provided at http://www.uni-kiel.de/medinfo/cgi-bin/predictor/. PMID:28180317

Seeing the same thing differently: mechanisms that contribute to assessor differences in directly-observed performance assessments.

PubMed

Yeates, Peter; O'Neill, Paul; Mann, Karen; Eva, Kevin

2013-08-01

Assessors' scores in performance assessments are known to be highly variable. Attempted improvements through training or rating format have achieved minimal gains. The mechanisms that contribute to variability in assessors' scoring remain unclear. This study investigated these mechanisms. We used a qualitative approach to study assessors' judgements whilst they observed common simulated videoed performances of junior doctors obtaining clinical histories. Assessors commented concurrently and retrospectively on performances, provided scores and follow-up interviews. Data were analysed using principles of grounded theory. We developed three themes that help to explain how variability arises: Differential Salience-assessors paid attention to (or valued) different aspects of the performances to different degrees; Criterion Uncertainty-assessors' criteria were differently constructed, uncertain, and were influenced by recent exemplars; Information Integration-assessors described the valence of their comments in their own unique narrative terms, usually forming global impressions. Our results (whilst not precluding the operation of established biases) describe mechanisms by which assessors' judgements become meaningfully-different or unique. Our results have theoretical relevance to understanding the formative educational messages that performance assessments provide. They give insight relevant to assessor training, assessors' ability to be observationally "objective" and to the educational value of narrative comments (in contrast to numerical ratings).

Patterns of Expectations about Counseling: Relations to the Five-Factor Model of Personality.

ERIC Educational Resources Information Center

Schaub, Michael; Tokar, David M.

1999-01-01

Study seeks to identify groups of students who differed in their patterns of expectations about counseling and then to relate those groups to personality, as organized by the Five Factor Model (FFM). A brief interpretation is offered of each cluster that integrates information based on expectation scores and the significant personality functions.…

A Cross-Sectional Descriptive Study of Occupational Therapy Students' Perceptions and Attitudes Towards Spirituality and Spiritual Care in Occupational Therapy Education.

PubMed

Mthembu, Thuli Godfrey; Roman, Nicolette Vanessa; Wegner, Lisa

2016-10-01

Spirituality and spiritual care both have received increased attention over the course of this past decade from different disciplines. However, for many years, in the occupational therapy profession, the importance of spirituality and spiritual care seems to be controversial because it is unclear how these concepts are integrated in occupational therapy education. Although occupational therapy students are being educated to consider a holistic and client-centred approach, spirituality is not regarded within this framework which diminishes the integrity of holistic approach. In South African occupational therapy education, it is unclear whether any single course on teaching and learning of spirituality and spiritual care exists. Thus, the aim of this study was to describe occupational therapy students' perceptions and attitudes regarding spirituality and spiritual care in occupational therapy education. A cross-sectional descriptive study design of undergraduate occupational therapy students from one educational institution was used. Data included demographic characteristics, responses on Spiritual Care-Giving Scale (SCGS), Spiritual and Spiritual Care Rating Scale (SSCRS) and Spirituality in Occupational Therapy Scale (SOTS). A response rate of 50.5 % (n = 100 out of 198) was achieved. In the SCGS, among the factors only factor 1 had the highest mean value score showing consistent agreement about spirituality, whereas in the SSCRS only three factors were found to have highest mean score and one with lowest mean score. In SOTS, participants had a highest score mean in relation to formal education and training about spirituality. Thus, in the integration of spirituality and spiritual care a holistic approach needs to be considered in education to enhance students' knowledge of how to address mind, body and spirit needs.

Sonographic assessment of the subscapularis after reverse shoulder arthroplasty: impact of tendon integrity on shoulder function.

PubMed

Dedy, Nicolas J; Gouk, Conor J; Taylor, Fraser J; Thomas, Michael; Tan, S L Ezekiel

2018-06-01

The deltopectoral approach for reverse shoulder arthroplasty (RSA) requires subscapularis tenotomy or lesser tuberosity osteotomy. Whether the subscapularis should be repaired at the conclusion of the procedure remains controversial. The present study sonographically assessed the subscapularis after RSA and evaluated the effect of tendon integrity on functional outcome. All patients who had undergone RSA in the Gold Coast University Hospital between 2005 and 2016 were included. Sonography was performed by a blinded examiner. Function was assessed using the Disabilities of the Arm, Shoulder and Hand, the Constant-Murley, and Oxford Shoulder scores. Internal rotation ability was recorded on a 6-point scale. The study included 43 patients (48 shoulders). Median length of follow-up was 19 months (range, 4-132 months). On sonography, the subscapularis was graded intact in 6 shoulders (13%), intact with mild attenuation in 16 (33%), severely attenuated in 15 (31%), and not intact or absent in 11 (23%). Differences in Disabilities of the Arm, Shoulder and Hand, Constant-Murley, or Oxford Shoulder scores between intact and attenuated or absent subscapularis shoulders were not significant. Internal rotation scores were significantly higher in the intact and mildly attenuated tendon group than in the absent tendon group (U = 1.0, P = .001 and U = 28.5, P = .007, respectively). The present work is the first long-term outcome study of RSA using sonography to assess the subscapularis. Subscapularis integrity did not appear to have a measurable effect on patient outcome as measured by standard scores but was important for internal rotation ability after RSA. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

New graduate students' baseline knowledge of the responsible conduct of research.

PubMed

Heitman, Elizabeth; Olsen, Cara H; Anestidou, Lida; Bulger, Ruth Ellen

2007-09-01

To assess (1) new biomedical science graduate students' baseline knowledge of core concepts and standards in responsible conduct of research (RCR), (2) differences in graduate students' baseline knowledge overall and across the Office of Research Integrity's nine core areas, and (3) demographic and educational factors in these differences. A 30-question, computer-scored multiple-choice test on core concepts and standards of RCR was developed following content analysis of 20 United States-published RCR texts, and combined with demographic questions on undergraduate experience with RCR developed from graduate student focus groups. Four hundred two new graduate students at three health science universities were recruited for Scantron and online testing before beginning RCR instruction. Two hundred fifty-one of 402 eligible trainees (62%) at three universities completed the test; scores ranged from 26.7% to 83.3%, with a mean of 59.5%. Only seven (3%) participants scored 80% or above. Students who received their undergraduate education outside the United States scored significantly lower (mean 52.0%) than those with U.S. bachelor's degrees (mean 60.5%, P < .001). Participants with prior graduate biomedical or health professions education scored marginally higher than new students, but both groups' mean scores were well below 80%. The mean score of 16 participants who reported previous graduate-level RCR instruction was 67.7%. Participants' specific knowledge varied, but overall scores were universally low. New graduate biomedical sciences students have inadequate and inconsistent knowledge of RCR, irrespective of their prior education or experience. Incoming trainees with previous graduate RCR education may also have gaps in core knowledge.

Genetic effect of MTHFR C677T polymorphism on the structural covariance network and white-matter integrity in Alzheimer's disease.

PubMed

Chang, Yu-Tzu; Hsu, Shih-Wei; Tsai, Shih-Jen; Chang, Ya-Ting; Huang, Chi-Wei; Liu, Mu-En; Chen, Nai-Ching; Chang, Wen-Neng; Hsu, Jung-Lung; Lee, Chen-Chang; Chang, Chiung-Chih

2017-06-01

The 677 C to T transition in the MTHFR gene is a genetic determinant for hyperhomocysteinemia. We investigated whether this polymorphism modulates gray matter (GM) structural covariance networks independently of white-matter integrity in patients with Alzheimer's disease (AD). GM structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed-based analysis. The patients were divided into two genotype groups: C homozygotes (n = 73) and T carriers (n = 62). Using diffusion tensor imaging and white-matter parcellation, 11 fiber bundle integrities were compared between the two genotype groups. Cognitive test scores were the major outcome factors. The T carriers had higher homocysteine levels, lower posterior cingulate cortex GM volume, and more clusters in the dorsal medial lobe subsystem showing stronger covariance strength. Both posterior cingulate cortex seed and interconnected peak cluster volumes predicted cognitive test scores, especially in the T carriers. There were no between-group differences in fiber tract diffusion parameters. The MTHFR 677T polymorphism modulates posterior cingulate cortex-anchored structural covariance strength independently of white matter integrities. Hum Brain Mapp 38:3039-3051, 2017. © 2017 The Authors Human Brain Mapping Published Wiley by Periodicals, Inc. © 2017 The Authors Human Brain Mapping Published Wiley by Periodicals, Inc.

Force-Sensing Enhanced Simulation Environment (ForSense) for laparoscopic surgery training and assessment.

PubMed

Cundy, Thomas P; Thangaraj, Evelyn; Rafii-Tari, Hedyeh; Payne, Christopher J; Azzie, Georges; Sodergren, Mikael H; Yang, Guang-Zhong; Darzi, Ara

2015-04-01

Excessive or inappropriate tissue interaction force during laparoscopic surgery is a recognized contributor to surgical error, especially for robotic surgery. Measurement of force at the tool-tissue interface is, therefore, a clinically relevant skill assessment variable that may improve effectiveness of surgical simulation. Popular box trainer simulators lack the necessary technology to measure force. The aim of this study was to develop a force sensing unit that may be integrated easily with existing box trainer simulators and to (1) validate multiple force variables as objective measurements of laparoscopic skill, and (2) determine concurrent validity of a revised scoring metric. A base plate unit sensitized to a force transducer was retrofitted to a box trainer. Participants of 3 different levels of operative experience performed 5 repetitions of a peg transfer and suture task. Multiple outcome variables of force were assessed as well as a revised scoring metric that incorporated a penalty for force error. Mean, maximum, and overall magnitudes of force were significantly different among the 3 levels of experience, as well as force error. Experts were found to exert the least force and fastest task completion times, and vice versa for novices. Overall magnitude of force was the variable most correlated with experience level and task completion time. The revised scoring metric had similar predictive strength for experience level compared with the standard scoring metric. Current box trainer simulators can be adapted for enhanced objective measurements of skill involving force sensing. These outcomes are significantly influenced by level of expertise and are relevant to operative safety in laparoscopic surgery. Conventional proficiency standards that focus predominantly on task completion time may be integrated with force-based outcomes to be more accurately reflective of skill quality. Copyright © 2015 Elsevier Inc. All rights reserved.

TISSUES 2.0: an integrative web resource on mammalian tissue expression

PubMed Central

Palasca, Oana; Santos, Alberto; Stolte, Christian; Gorodkin, Jan; Jensen, Lars Juhl

2018-01-01

Abstract Physiological and molecular similarities between organisms make it possible to translate findings from simpler experimental systems—model organisms—into more complex ones, such as human. This translation facilitates the understanding of biological processes under normal or disease conditions. Researchers aiming to identify the similarities and differences between organisms at the molecular level need resources collecting multi-organism tissue expression data. We have developed a database of gene–tissue associations in human, mouse, rat and pig by integrating multiple sources of evidence: transcriptomics covering all four species and proteomics (human only), manually curated and mined from the scientific literature. Through a scoring scheme, these associations are made comparable across all sources of evidence and across organisms. Furthermore, the scoring produces a confidence score assigned to each of the associations. The TISSUES database (version 2.0) is publicly accessible through a user-friendly web interface and as part of the STRING app for Cytoscape. In addition, we analyzed the agreement between datasets, across and within organisms, and identified that the agreement is mainly affected by the quality of the datasets rather than by the technologies used or organisms compared. Database URL: http://tissues.jensenlab.org/ PMID:29617745

BUSCA: an integrative web server to predict subcellular localization of proteins.

PubMed

Savojardo, Castrense; Martelli, Pier Luigi; Fariselli, Piero; Profiti, Giuseppe; Casadio, Rita

2018-04-30

Here, we present BUSCA (http://busca.biocomp.unibo.it), a novel web server that integrates different computational tools for predicting protein subcellular localization. BUSCA combines methods for identifying signal and transit peptides (DeepSig and TPpred3), GPI-anchors (PredGPI) and transmembrane domains (ENSEMBLE3.0 and BetAware) with tools for discriminating subcellular localization of both globular and membrane proteins (BaCelLo, MemLoci and SChloro). Outcomes from the different tools are processed and integrated for annotating subcellular localization of both eukaryotic and bacterial protein sequences. We benchmark BUSCA against protein targets derived from recent CAFA experiments and other specific data sets, reporting performance at the state-of-the-art. BUSCA scores better than all other evaluated methods on 2732 targets from CAFA2, with a F1 value equal to 0.49 and among the best methods when predicting targets from CAFA3. We propose BUSCA as an integrated and accurate resource for the annotation of protein subcellular localization.

Psychometric Properties of Scores from the Web-based LibQUAL+ Study of Perceptions of Library Service Quality.

ERIC Educational Resources Information Center

Cook, Colleen; Thompson, Bruce

2001-01-01

Investigated the psychometric integrity of scores from the LibQUAL+ evaluation of perceived library service quality conducted by ARL (Association of Research Libraries). Examines score structure, score reliability, score correlation and concurrent validity coefficients, scale means, and scale standardized norms, and considers the potential of the…

Timing, duration, and severity of iron deficiency in early development and motor outcomes at 9 months

PubMed Central

Santos, Denise CC; Angulo-Barroso, Rosa M; Li, Ming; Bian, Yang; Sturza, Julie; Richards, Blair; Lozoff, Betsy

2017-01-01

BACKGROUND/OBJECTIVES Poorer motor development is reported in infants with iron deficiency (ID). The role of timing, duration and severity is unclear. We assessed relations between ID timing, duration, and severity and gross motor scores, neurological integrity, and motor behavior quality at 9 months. METHODS Iron status was determined at birth and 9 months in otherwise healthy term Chinese infants. The 9-month motor evaluation included the Peabody Developmental Motor Scale (PDMS-2), Infant Neurological International Battery (INFANIB), and motor quality factor. Motor outcomes were analyzed by ID timing (fetal-neonatal, infancy), duration, and severity. For severity, we also considered maternal iron status. RESULTS Data were available for 1194 infants. Iron status was classified as fetal-neonatal and infancy ID (n=253), fetal-neonatal ID (n=256), infancy ID (n=288), and not ID (n=397). Compared with not ID, infants with fetal-neonatal or infancy ID had lower locomotion scores (effect size ds=0.19, 0.18) and those with ID in both periods (longer duration) had lower locomotion and overall PDMS-2 gross motor scores (ds=0.20, 0.18); ID groups did not differ. More severe ID in late pregnancy was associated with lower INFANIB Vestibular function (p=0.01), and total score (p=0.03). More severe ID in infancy was associated with lower scores for locomotion (p=0.03), overall gross motor (p=0.05). CONCLUSIONS Fetal-neonatal and/or infancy ID was associated with lower overall gross motor development and locomotion test scores at 9 months. Associations with ID severity varied by ID timing: more severe ID in late pregnancy, poorer neurological integrity; more severe ID in infancy, poorer gross motor development. PMID:29235557

A Midterm Evaluation of Postoperative Platelet-Rich Plasma Injections on Arthroscopic Supraspinatus Repair: A Randomized Controlled Trial.

PubMed

Ebert, Jay R; Wang, Allan; Smith, Anne; Nairn, Robert; Breidahl, William; Zheng, Ming Hao; Ackland, Timothy

2017-11-01

Platelet-rich plasma (PRP) has been applied as an adjunct to rotator cuff repair to improve tendon-bone healing and potentially reduce the incidence of subsequent tendon retears. To investigate whether the midterm clinical and radiographic outcomes of arthroscopic supraspinatus repair are enhanced after repeated postoperative applications of PRP. Randomized controlled trial; Level of evidence, 1. A total of 60 patients (30 control; 30 PRP) were initially randomized to receive 2 ultrasound-guided injections of PRP to the tendon repair site at 7 and 14 days after double-row arthroscopic supraspinatus repair or not. A total of 55 patients (91.7%) underwent a clinical review and magnetic resonance imaging (MRI) at a mean of 3.5 years after surgery (range, 36-51 months). Patient-reported outcome measures (PROMs) included the Constant score, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, Oxford Shoulder Score (OSS), and visual analog scale (VAS) for pain. Global rating of change (GRC) scale and patient satisfaction scores were evaluated. Structural integrity of the surgical repair was assessed via MRI using the Sugaya classification system. At the midterm review, there was no difference between the groups for any of the PROMs. No differences between the groups were demonstrated for the subjective and range of motion subscales of the Constant score, although a significantly higher Constant strength subscale score was observed in the PRP group (3.3 points; 95% CI, 1.0-5.7; P = .006). There was no evidence for any group differences in MRI scores or retear rates, with 66.7% of PRP patients and 64.3% of control patients rated as Sugaya grade 1. Two control patients had symptomatic retears (both full thickness) within the first 16 weeks after surgery compared with 2 PRP patients, who suffered symptomatic retears (both partial thickness) between 16 weeks and a mean 3.5-year follow-up. Significant postoperative clinical improvements and high levels of patient satisfaction were observed in patients at the midterm review after supraspinatus repair. While pain-free, maximal abduction strength was greater in the midterm after PRP treatment, repeated applications of PRP delivered at 7 and 14 days after surgery provided no additional benefit to tendon integrity.

Generalising better: Applying deep learning to integrate deleteriousness prediction scores for whole-exome SNV studies.

PubMed

Korvigo, Ilia; Afanasyev, Andrey; Romashchenko, Nikolay; Skoblov, Mikhail

2018-01-01

Many automatic classifiers were introduced to aid inference of phenotypical effects of uncategorised nsSNVs (nonsynonymous Single Nucleotide Variations) in theoretical and medical applications. Lately, several meta-estimators have been proposed that combine different predictors, such as PolyPhen and SIFT, to integrate more information in a single score. Although many advances have been made in feature design and machine learning algorithms used, the shortage of high-quality reference data along with the bias towards intensively studied in vitro models call for improved generalisation ability in order to further increase classification accuracy and handle records with insufficient data. Since a meta-estimator basically combines different scoring systems with highly complicated nonlinear relationships, we investigated how deep learning (supervised and unsupervised), which is particularly efficient at discovering hierarchies of features, can improve classification performance. While it is believed that one should only use deep learning for high-dimensional input spaces and other models (logistic regression, support vector machines, Bayesian classifiers, etc) for simpler inputs, we still believe that the ability of neural networks to discover intricate structure in highly heterogenous datasets can aid a meta-estimator. We compare the performance with various popular predictors, many of which are recommended by the American College of Medical Genetics and Genomics (ACMG), as well as available deep learning-based predictors. Thanks to hardware acceleration we were able to use a computationally expensive genetic algorithm to stochastically optimise hyper-parameters over many generations. Overfitting was hindered by noise injection and dropout, limiting coadaptation of hidden units. Although we stress that this work was not conceived as a tool comparison, but rather an exploration of the possibilities of deep learning application in ensemble scores, our results show that even relatively simple modern neural networks can significantly improve both prediction accuracy and coverage. We provide open-access to our finest model via the web-site: http://score.generesearch.ru/services/badmut/.

Has the inclusion of a longitudinally integrated communication skills program improved consultation skills in medical students? A pilot study.

PubMed

Shah, Sameena; Andrades, Marie; Basir, Fasia; Jaleel, Anila; Azam, Iqbal; Islam, Muhammad; Ahmed, Rashida

2016-01-01

Evidence highlights a lack of communication skills in doctors leading to dysfunctional consultations. To address this deficit, a private medical college instituted curricular reforms with inclusion of a longitudinal communication skills program. A pilot study was undertaken to evaluate the effectiveness of this program by comparing the consultation skills of medical students of this college with a medical college without a communication skills program. A 4-station Objective Structured Clinical Examination (OSCE) was conducted in the third and final year. Mann-Whitney U-test was used to compare the difference in the distribution between OSCE stations total and construct scores. At the end of the third year, 21 (31.34%), students of the study site (medical college 1 [college with integrated longitudinal communication skills program]) and 31 (46.26%) students from the comparison site (medical college 2 [comparable college without communication skills program]) consented. Medical college 1 achieved a significantly higher overall mean total station score of 68.0% (standard deviation [SD] =13.5) versus 57.2% (SD = 15.4) (P < 0.001). Significantly higher mean scores were achieved on three stations. At the end of the final year, 19 students (29.3%) from medical college 1 and 22 (34%) students from medical college 2 consented. The difference in overall mean total station score reduced from 9.2% to 7.1% (70.2) (SD = 13.7) versus 63.1 (SD = 15.2) (P = 0.004). The mean scores of both colleges decreased in "Patient presenting with Hepatitis C Report" station (P values 0.004 and 0.775) and in "Patient Request for Faith Healing Therapy in Diabetes Mellitus" station (P values 0.0046 and 0.036), respectively. Longitudinal communication skills in an undergraduate curriculum positively impacted consultation skills. Community-based training and faculty development are required to develop effective patient-centered consultation skills.

Automated Trait Scores for "TOEFL"® Writing Tasks. Research Report. ETS RR-15-14

ERIC Educational Resources Information Center

Attali, Yigal; Sinharay, Sandip

2015-01-01

The "e-rater"® automated essay scoring system is used operationally in the scoring of "TOEFL iBT"® independent and integrated tasks. In this study we explored the psychometric added value of reporting four trait scores for each of these two tasks, beyond the total e-rater score.The four trait scores are word choice, grammatical…

Reconstructing genome-wide regulatory network of E. coli using transcriptome data and predicted transcription factor activities

PubMed Central

2011-01-01

Background Gene regulatory networks play essential roles in living organisms to control growth, keep internal metabolism running and respond to external environmental changes. Understanding the connections and the activity levels of regulators is important for the research of gene regulatory networks. While relevance score based algorithms that reconstruct gene regulatory networks from transcriptome data can infer genome-wide gene regulatory networks, they are unfortunately prone to false positive results. Transcription factor activities (TFAs) quantitatively reflect the ability of the transcription factor to regulate target genes. However, classic relevance score based gene regulatory network reconstruction algorithms use models do not include the TFA layer, thus missing a key regulatory element. Results This work integrates TFA prediction algorithms with relevance score based network reconstruction algorithms to reconstruct gene regulatory networks with improved accuracy over classic relevance score based algorithms. This method is called Gene expression and Transcription factor activity based Relevance Network (GTRNetwork). Different combinations of TFA prediction algorithms and relevance score functions have been applied to find the most efficient combination. When the integrated GTRNetwork method was applied to E. coli data, the reconstructed genome-wide gene regulatory network predicted 381 new regulatory links. This reconstructed gene regulatory network including the predicted new regulatory links show promising biological significances. Many of the new links are verified by known TF binding site information, and many other links can be verified from the literature and databases such as EcoCyc. The reconstructed gene regulatory network is applied to a recent transcriptome analysis of E. coli during isobutanol stress. In addition to the 16 significantly changed TFAs detected in the original paper, another 7 significantly changed TFAs have been detected by using our reconstructed network. Conclusions The GTRNetwork algorithm introduces the hidden layer TFA into classic relevance score-based gene regulatory network reconstruction processes. Integrating the TFA biological information with regulatory network reconstruction algorithms significantly improves both detection of new links and reduces that rate of false positives. The application of GTRNetwork on E. coli gene transcriptome data gives a set of potential regulatory links with promising biological significance for isobutanol stress and other conditions. PMID:21668997

Identity development in adolescents with mental problems.

PubMed

Jung, Emanuel; Pick, Oliver; Schlüter-Müller, Susanne; Schmeck, Klaus; Goth, Kirstin

2013-07-31

In the revision of the Diagnostic and Statistical Manual (DSM-5), "Identity" is an essential diagnostic criterion for personality disorders (self-related personality functioning) in the alternative approach to the diagnosis of personality disorders in Section III of DSM-5. Integrating a broad range of established identity concepts, AIDA (Assessment of Identity Development in Adolescence) is a new questionnaire to assess pathology-related identity development in healthy and disturbed adolescents aged 12 to 18 years. Aim of the present study is to investigate differences in identity development between adolescents with different psychiatric diagnoses. Participants were 86 adolescent psychiatric in- and outpatients aged 12 to 18 years. The test set includes the questionnaire AIDA and two semi-structured psychiatric interviews (SCID-II, K-DIPS). The patients were assigned to three diagnostic groups (personality disorders, internalizing disorders, externalizing disorders). Differences were analyzed by multivariate analysis of variance MANOVA. In line with our hypotheses, patients with personality disorders showed the highest scores in all AIDA scales with T>70. Patients with externalizing disorders showed scores in an average range compared to population norms, while patients with internalizing disorders lay in between with scores around T=60. The AIDA total score was highly significant between the groups with a remarkable effect size of f= 0.44. Impairment of identity development differs between adolescent patients with different forms of mental disorders. The AIDA questionnaire is able to discriminate between these groups. This may help to improve assessment and treatment of adolescents with severe psychiatric problems.

Cyber Contingency Analysis version 1.x

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

Contingency analysis based approach for quantifying and examining the resiliency of a cyber system in respect to confidentiality, integrity and availability. A graph representing an organization's cyber system and related resources is used for the availability contingency analysis. The mission critical paths associated with an organization are used to determine the consequences of a potential contingency. A node (or combination of nodes) are removed from the graph to analyze a particular contingency. The value of all mission critical paths that are disrupted by that contingency are used to quantify its severity. A total severity score can be calculated based onmore » the complete list of all these contingencies. A simple n1 analysis can be done in which only one node is removed at a time for the analysis. We can also compute nk analysis, where k is the number of nodes to simultaneously remove for analysis. A contingency risk score can also be computed, which takes the probability of the contingencies into account. In addition to availability, we can also quantify confidentiality and integrity scores for the system. These treat user accounts as potential contingencies. The amount (and type) of files that an account can read to is used to compute the confidentiality score. The amount (and type) of files that an account can write to is used to compute the integrity score. As with availability analysis, we can use this information to compute total severity scores in regards to confidentiality and integrity. We can also take probability into account to compute associated risk scores.« less

A Fish-Based Index of Biotic Integrity for the Assessment of Streams Located in a Sugarcane-Dominated Landscape in Southeastern Brazil.

PubMed

dos Santos, Fernanda Bastos; Esteves, Katharina Eichbaum

2015-08-01

A multimetric, fish-based Index of Biotic Integrity (IBI) was developed and tested to assess the ecological status of streams with different riparian conditions in the Piracicaba River Basin. Nine streams with three categories of riparian zone preservation were selected: native forest (NF) with preserved forest, secondary forest (SF) with forest in an advanced state of regeneration and surrounded by sugarcane plantations, and sugarcane (SC) without riparian vegetation and surrounded by SC crops. A continuous scoring system was employed, and candidate metrics were tested for range, responsiveness, and redundancy, resulting in the selection of eight metrics to compose the index. The final IBI score was positively correlated with an Environmental Index both in the dry (Spearman's rho = 0.76; P = 0.01) and rainy seasons (Spearman's rho = 0.66; P = 0.04), suggesting that this IBI is a suitable tool for the assessment of the biological conditions of these streams. The highest IBI values were observed in the rainy season at the NF and SF sites, with significant differences between the NF and SC sites (Kruskal-Wallis test: P = 0.03). The results indicated some variability in the biological integrity at SF and SC sites, suggesting a relationship with the intensity of the management of this crop. Patterns were consistent with other studies that have shown the effects of agriculture on the environmental quality of streams, which indicate the importance of the riparian zone to the maintenance of ecosystem integrity and supports the use of the IBI for biological monitoring in similar regions.

A Fish-Based Index of Biotic Integrity for the Assessment of Streams Located in a Sugarcane-Dominated Landscape in Southeastern Brazil

NASA Astrophysics Data System (ADS)

dos Santos, Fernanda Bastos; Esteves, Katharina Eichbaum

2015-08-01

A multimetric, fish-based Index of Biotic Integrity (IBI) was developed and tested to assess the ecological status of streams with different riparian conditions in the Piracicaba River Basin. Nine streams with three categories of riparian zone preservation were selected: native forest (NF) with preserved forest, secondary forest (SF) with forest in an advanced state of regeneration and surrounded by sugarcane plantations, and sugarcane (SC) without riparian vegetation and surrounded by SC crops. A continuous scoring system was employed, and candidate metrics were tested for range, responsiveness, and redundancy, resulting in the selection of eight metrics to compose the index. The final IBI score was positively correlated with an Environmental Index both in the dry (Spearman's rho = 0.76; P = 0.01) and rainy seasons (Spearman's rho = 0.66; P = 0.04), suggesting that this IBI is a suitable tool for the assessment of the biological conditions of these streams. The highest IBI values were observed in the rainy season at the NF and SF sites, with significant differences between the NF and SC sites (Kruskal-Wallis test: P = 0.03). The results indicated some variability in the biological integrity at SF and SC sites, suggesting a relationship with the intensity of the management of this crop. Patterns were consistent with other studies that have shown the effects of agriculture on the environmental quality of streams, which indicate the importance of the riparian zone to the maintenance of ecosystem integrity and supports the use of the IBI for biological monitoring in similar regions.

Community integration outcomes of people with spinal cord injury and multiple matched controls: A pilot study.

PubMed

Callaway, Libby; Enticott, Joanne; Farnworth, Louise; McDonald, Rachael; Migliorini, Christine; Willer, Barry

2017-06-01

Australia's National Disability Insurance Scheme (NDIS) is designed to influence home, social and economic participation for Scheme participants. Given the major disability reform underway, this pilot study aimed to: (i) examine community integration outcomes of people with spinal cord injury (SCI); (ii) compare findings with multiple matched controls and (iii) consider findings within the context of Australia's NDIS. Setting: Victoria, Australia. Matched analysis (people with and without SCI). Community Integration Questionnaire (CIQ). n = 40 adults with SCI (M age = 52.8 years; 61% male; 77% traumatic SCI). Matched analyses from each SCI subject aged <70 years (n = 31) with four CIQ normative data subjects (from n = 1927) was undertaken, with key demographic variables matched (age range, gender, living location and living situation). Risk of low CIQ score as a function of SCI was also examined using conditional Poisson regression. With key demographic variables held constant, small to medium effect sizes were found in favour of the normative sample, with statistically significant differences in home (ρ = 0.003) and productivity integration (ρ = 0.02). Relative risk of low home integration was significant in the SCI cohort (conditional RR (95% CI) = 3.1 (1.5-6.3), ρ = 0.001). Relative risk of low CIQ total, social integration and productivity scores did not reach significance. This cohort of SCI participants was less integrated into home and productive occupations than matched norms, holding implications for planning and allocation of supports to influence outcomes within an NDIS. Further research is necessary to understand community integration outcomes in larger matched samples. © 2016 Occupational Therapy Australia.

Culinary preparation of beetroot (Beta vulgaris L.): the impact on sensory quality and appropriateness.

PubMed

Bach, Vibe; Mikkelsen, Laerke; Kidmose, Ulla; Edelenbos, Merete

2015-07-01

Beetroot is a diverse vegetable available in different shapes and colours. The objectives of this study were to evaluate sensory qualities, and sugar and dry matter content of five beetroot varieties in relationship to the appropriateness for raw, boiled and pan-fried preparation. Sensory evaluation by descriptive sensory analysis and consumer tests showed clear distinctions between red varieties Taunus, Rocket and Pablo, and the pink-white striped Chioggia and yellow Burpee's Golden in raw preparations. However, variety delimination was more difficult after boiling and pan-frying. Different sensory qualities were important for beetroot appropriateness in raw, boiled and pan-fried preparations. Appropriateness of raw beetroots was associated with high sensory scores in beetroot flavour, crispness and juiciness, and low scores in bitterness. Appropriateness of boiled beetroots was related to high scores in beetroot and earthy flavours. Pan-fried beetroot appropriateness was associated with high scores in beetroot flavour, colour intensity and crispness. This study showed that the quality of raw materials is integral in culinary preparations. These results can be used to guide consumers in the use of beetroot in culinary preparations and subsequently increase consumption. © 2014 Society of Chemical Industry.

Value of adding the renal pathological score to the kidney failure risk equation in advanced diabetic nephropathy.

PubMed

Yamanouchi, Masayuki; Hoshino, Junichi; Ubara, Yoshifumi; Takaichi, Kenmei; Kinowaki, Keiichi; Fujii, Takeshi; Ohashi, Kenichi; Mise, Koki; Toyama, Tadashi; Hara, Akinori; Kitagawa, Kiyoki; Shimizu, Miho; Furuichi, Kengo; Wada, Takashi

2018-01-01

There have been a limited number of biopsy-based studies on diabetic nephropathy, and therefore the clinical importance of renal biopsy in patients with diabetes in late-stage chronic kidney disease (CKD) is still debated. We aimed to clarify the renal prognostic value of pathological information to clinical information in patients with diabetes and advanced CKD. We retrospectively assessed 493 type 2 diabetics with biopsy-proven diabetic nephropathy in four centers in Japan. 296 patients with stage 3-5 CKD at the time of biopsy were identified and assigned two risk prediction scores for end-stage renal disease (ESRD): the Kidney Failure Risk Equation (KFRE, a score composed of clinical parameters) and the Diabetic Nephropathy Score (D-score, a score integrated pathological parameters of the Diabetic Nephropathy Classification by the Renal Pathology Society (RPS DN Classification)). They were randomized 2:1 to development and validation cohort. Hazard Ratios (HR) of incident ESRD were reported with 95% confidence interval (CI) of the KFRE, D-score and KFRE+D-score in Cox regression model. Improvement of risk prediction with the addition of D-score to the KFRE was assessed using c-statistics, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). During median follow-up of 1.9 years, 194 patients developed ESRD. The cox regression analysis showed that the KFRE,D-score and KFRE+D-score were significant predictors of ESRD both in the development cohort and in the validation cohort. The c-statistics of the D-score was 0.67. The c-statistics of the KFRE was good, but its predictive value was weaker than that in the miscellaneous CKD cohort originally reported (c-statistics, 0.78 vs. 0.90) and was not significantly improved by adding the D-score (0.78 vs. 0.79, p = 0.83). Only continuous NRI was positive after adding the D-score to the KFRE (0.4%; CI: 0.0-0.8%). We found that the predict values of the KFRE and the D-score were not as good as reported, and combining the D-score with the KFRE did not significantly improve prediction of the risk of ESRD in advanced diabetic nephropathy. To improve prediction of renal prognosis for advanced diabetic nephropathy may require different approaches with combining clinical and pathological parameters that were not measured in the KFRE and the RPS DN Classification.

The use of automated Ki67 analysis to predict Oncotype DX risk-of-recurrence categories in early-stage breast cancer.

PubMed

Thakur, Satbir Singh; Li, Haocheng; Chan, Angela M Y; Tudor, Roxana; Bigras, Gilbert; Morris, Don; Enwere, Emeka K; Yang, Hua

2018-01-01

Ki67 is a commonly used marker of cancer cell proliferation, and has significant prognostic value in breast cancer. In spite of its clinical importance, assessment of Ki67 remains a challenge, as current manual scoring methods have high inter- and intra-user variability. A major reason for this variability is selection bias, in that different observers will score different regions of the same tumor. Here, we developed an automated Ki67 scoring method that eliminates selection bias, by using whole-slide analysis to identify and score the tumor regions with the highest proliferative rates. The Ki67 indices calculated using this method were highly concordant with manual scoring by a pathologist (Pearson's r = 0.909) and between users (Pearson's r = 0.984). We assessed the clinical validity of this method by scoring Ki67 from 328 whole-slide sections of resected early-stage, hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer. All patients had Oncotype DX testing performed (Genomic Health) and available Recurrence Scores. High Ki67 indices correlated significantly with several clinico-pathological correlates, including higher tumor grade (1 versus 3, P<0.001), higher mitotic score (1 versus 3, P<0.001), and lower Allred scores for estrogen and progesterone receptors (P = 0.002, 0.008). High Ki67 indices were also significantly correlated with higher Oncotype DX risk-of-recurrence group (low versus high, P<0.001). Ki67 index was the major contributor to a machine learning model which, when trained solely on clinico-pathological data and Ki67 scores, identified Oncotype DX high- and low-risk patients with 97% accuracy, 98% sensitivity and 80% specificity. Automated scoring of Ki67 can thus successfully address issues of consistency, reproducibility and accuracy, in a manner that integrates readily into the workflow of a pathology laboratory. Furthermore, automated Ki67 scores contribute significantly to models that predict risk of recurrence in breast cancer.

The effects of an integrated Algebra 1/physical science curriculum on student achievement in Algebra 1, proportional reasoning and graphing abilities

NASA Astrophysics Data System (ADS)

Lawrence, Lettie Carol

1997-08-01

The purpose of this investigation was to determine if an integrated curriculum in algebra 1/physical science facilitates acquisition of proportional reasoning and graphing abilities better than a non-integrated, traditional, algebra 1 curriculum. Also, this study was to ascertain if the integrated algebra 1/physical science curriculum resulted in greater student achievement in algebra 1. The curriculum used in the experimental class was SAM 9 (Science and Mathematics 9), an investigation-based curriculum that was written to integrate physical science and basic algebra content. The experiment was conducted over one school year. The subjects in the study were 61 ninth grade students. The experimental group consisted of one class taught concurrently by a mathematics teacher and a physical science teacher. The control group consisted of three classes of algebra 1 students taught by one mathematics teacher and taking physical science with other teachers in the school who were not participating in the SAM 9 program. This study utilized a quasi-experimental non-randomized control group pretest-posttest design. The investigator obtained end-of-algebra 1 scores from student records. The written open-ended graphing instruments and the proportional reasoning instrument were administered to both groups as pretests and posttests. The graphing instruments were also administered as a midtest. A two sample t-test for independent means was used to determine significant differences in achievement on the end-of-course algebra 1 test. Quantitative data from the proportional reasoning and graphing instruments were analyzed using a repeated measures analysis of variance to determine differences in scores over time for the experimental and control groups. The findings indicate no significant difference between the experimental and control groups on the end-of-course algebra 1 test. Results also indicate no significant differences in proportional reasoning and graphing abilities between the two groups over time. However, all subjects (experimental and control groups) made significant improvement in graphing abilities over one school year. In this study, students participating in an investigation-based curriculum integrating algebra 1 and physical science performed as well on the instruments as the students in the traditional curriculum. Therefore, an argument can be made that instruction using an integrated curriculum (algebra l/physical science) is a viable alternative to instruction using a more traditional algebra 1 curriculum. Finally, the integrated curriculum adheres to the constructivist theoretical perspective (Krupnik-Gotlieb, 1995) and is more consistent with recommendations in the NCTM Standards (1992) than the traditional curriculum.

Objective community integration of mental health consumers living in supported housing and of others in the community.

PubMed

Yanos, Philip T; Stefancic, Ana; Tsemberis, Sam

2012-01-01

Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration.

Integrating image quality in 2nu-SVM biometric match score fusion.

PubMed

Vatsa, Mayank; Singh, Richa; Noore, Afzel

2007-10-01

This paper proposes an intelligent 2nu-support vector machine based match score fusion algorithm to improve the performance of face and iris recognition by integrating the quality of images. The proposed algorithm applies redundant discrete wavelet transform to evaluate the underlying linear and non-linear features present in the image. A composite quality score is computed to determine the extent of smoothness, sharpness, noise, and other pertinent features present in each subband of the image. The match score and the corresponding quality score of an image are fused using 2nu-support vector machine to improve the verification performance. The proposed algorithm is experimentally validated using the FERET face database and the CASIA iris database. The verification performance and statistical evaluation show that the proposed algorithm outperforms existing fusion algorithms.

Bayesian Ideal Types: Integration of Psychometric Data for Visually Impaired Persons.

ERIC Educational Resources Information Center

Jones, W. P.

1991-01-01

A model is proposed for the clinical synthesis of data from psychological tests of persons with visual impairments. The model integrates the concepts of the ideal type and Bayesian probability and compares actual test scores with ideal scores through use of a pattern similarity coefficient. A pilot study with Business Enterprise Program operators…

The Development of a New Method of Idiographic Measurement for Dynamic Assessment Intervention

ERIC Educational Resources Information Center

Hurley, Emma; Murphy, Raegan

2015-01-01

This paper proposes a new method of idiographic measurement for dynamic assessment (DA) intervention. There are two main methods of measurement for DA intervention; split-half tests and integrated scoring systems. Split-half tests of ability have proved useful from a research perspective. Integrated scoring systems coupled with case studies are…

Outcome Comparison Between in Situ Repair Versus Tear Completion Repair for Partial Thickness Rotator Cuff Tears.

PubMed

Kim, Yang-Soo; Lee, Hyo-Jin; Bae, Sung-Ho; Jin, Hyonki; Song, Hyun Seok

2015-11-01

To compare the clinical outcomes of arthroscopic in situ repair with the tear completion repair technique for partial-thickness rotator cuff tears (PT-RCTs). We prospectively enrolled 100 cases with articular-sided and bursal-sided PT-RCTs exceeding 50% of tendon thickness and allocated them randomly. An in situ repair was performed in group 1 (n = 50). Completion of the remaining cuff tissue and repair were performed in group 2 (n = 50). The medial row was knotted as transosseous repair (suture-bridge technique) in all cases. American Shoulder Elbow Society (ASES) score, Constant shoulder (CS) score, Simple shoulder (SS) score, and Korean shoulder (KS) score, and visual analog scale (VAS) for pain and range of motion were assessed at 3, 6, and 12 months and at the last visit. Repaired tendon integrity was determined at 6 to 12 months by magnetic resonance imaging. Eight cases were lost to follow-up. Ultimately, 92 cases were analyzed. The average follow-up was 19.1 months (range, 12 to 42 months). Significant improvements in the VAS for pain and functional outcomes were observed in both groups postoperatively (P = .001 for VAS; P < .001 for ASES score; P < .001 for CS score; P = .001 for SS score; P<.001 for KS score). No significant difference in the clinical results was observed at any time between the groups. No difference of retear rate on articular-sided PT-RCT was observed between the groups (P = .34). Retears on the bursal-sided PT-RCT were more frequent in group 2 (P = .02). Arthroscopic repair of PT-RCT exceeding 50% of the thickness provided functional improvements and pain relief regardless of the repair technique. The retear rate for bursal-sided PT-RCT was higher in group 2, although the retear rate for the articular-sided PT-RCT was not different. Level II, prospective comparative study. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Community reintegration in rehabilitated South Indian persons with spinal cord injury.

PubMed

Samuelkamaleshkumar, Selvaraj; Radhika, Somasundaram; Cherian, Binu; Elango, Aarumugam; Winrose, Windsor; Suhany, Baby T; Prakash, M Henry

2010-07-01

To explore community reintegration in rehabilitated South Indian persons with spinal cord injury (SCI) and to compare the level of community reintegration based on demographic variables. Survey. Rehabilitation center of a tertiary care university teaching hospital. Community-dwelling persons with SCI (N=104). Not applicable. Craig Handicap Assessment and Reporting Technique (CHART). The mean scores for each CHART domain were physical independence 98+/-5, social Integration 96+/-11, cognitive independence 92+/-17, occupation 70+/-34, mobility 65+/-18, and economic self sufficiency 53+/-40. Demographic variables showed no statistically significant difference with any of the CHART domains except for age and mobility, level of education, and social integration. Persons with SCI in rural South India who have completed comprehensive, mostly self-financed, rehabilitation with an emphasis on achieving functional ambulation, family support, and self-employment and who attend a regular annual follow-up show a high level of community reintegration in physical independence, social integration, and cognitive independence. CHART scores in the domains of occupation, mobility, and economic self-sufficiency showed lower levels of community reintegration. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Socio-demographic and academic correlates of clinical reasoning in a dental school in South Africa.

PubMed

Postma, T C; White, J G

2017-02-01

There are no empirical studies that describe factors that may influence the development of integrated clinical reasoning skills in dental education. Hence, this study examines the association between outcomes of clinical reasoning in relation with differences in instructional design and student factors. Progress test scores, including diagnostic and treatment planning scores, of fourth and fifth year dental students (2009-2011) at the University of Pretoria, South Africa served as the outcome measures in stepwise linear regression analyses. These scores were correlated with the instructional design (lecture-based teaching and learning (LBTL = 0) or case-based teaching and learning (CBTL = 1), students' grades in Oral Biology, indicators of socio-economic status (SES) and gender. CBTL showed an independent association with progress test scores. Oral Biology scores correlated with diagnostic component scores. Diagnostic component scores correlated with treatment planning scores in the fourth year of study but not in the fifth year of study. 'SES' correlated with progress test scores in year five only, while gender showed no correlation. The empirical evidence gathered in this study provides support for scaffolded inductive teaching and learning methods to develop clinical reasoning skills. Knowledge in Oral Biology and reading skills may be important attributes to develop to ensure that students are able to reason accurately in a clinical setting. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Interactive web-based format vs conventional brochure material for information transfer to children and parents: a randomized controlled trial regarding preoperative information.

PubMed

Lööf, Gunilla; Liljeberg, Cecilia; Eksborg, Staffan; Lönnqvist, Per-Arne

2017-06-01

Information transfer to patients is an integral part of modern medicine. Internet-based alternatives represent a new and attractive way for information transfer. The study used a prospective observer-blinded design. Children (3-12 years) and parents were instructed to get further preoperative information either through an interactive web-based platform, the Anaesthesia-Web, or conventional brochure material until day of outpatient surgery. On the day of surgery, children and parents were separately asked six different questions. The primary end-point was to compare the total question score in children between the two information options (maximum score = 36). Secondary aims were the total question score for parents and the influence of age, sex, and time between the preoperative visit and day of surgery. A total of 125 children were recruited, of which 103 were included in the final analysis (the Anaesthesia-Web group, n = 49; the brochure material group, n = 54). At the predetermined interim analysis, the total question score in children was found to be substantially higher in the Anaesthesia-Web group than in the brochure material group (median score: 27; IQR: 16.5-33 and median score: 19.5; IQR: 11.25-27.75, respectively, P = 0.0076). The median difference in score was 6; 95% CI: 0-9. The total question score in parents was also higher in the Anaesthesia-Web group than in the brochure material group. Increasing child age was associated with a higher total question score in both groups. Sex did not influence the total question score in the Anaesthesia-Web group, whereas girls scored better than boys in the brochure material group. Children in the age range 3-12 years of age as well as their parents do better attain preoperative information from an interactive web-based platform compared to conventional brochure material. © 2017 John Wiley & Sons Ltd.

Concurrent Validity of the Psychopathic Personality Inventory with Offender and Community Samples

PubMed Central

Malterer, Melanie B.; Lilienfeld, Scott O.; Neumann, Craig S.; Newman, Joseph P.

2009-01-01

The Psychopathy Checklist - Revised (PCL-R; Hare, 2003) is a frequently used and well-validated measure of psychopathy, but is relatively time-intensive and expensive to administer. The Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) is a self-report measure that provides a less time-intensive and less expensive method for identifying psychopathic individuals. Using three independent samples and two different versions of the PCL (i.e., PCL-R, PCL:SV), we evaluated the extent to which the PPI and PCL overlap in their measurement of the psychopathy construct. Across three studies, PPI total and Factor 2 scores correlated moderately to strongly with PCL total and Factor 2 scores. Results for PPI and PCL Factor 1 scores were less positive. These findings raise important questions concerning the integration of results obtained using alternative psychopathy assessments. PMID:19955107

Effects of Saccular Function on Recovery of Subjective Dizziness After Vestibular Rehabilitation.

PubMed

Jeong, Junhui; Jung, Jinsei; Lee, Jeon Mi; Suh, Michelle J; Kwak, Sang Hyun; Kim, Sung Huhn

2017-08-01

We attempted to investigate whether the integrity of saccular function influences the severity of subjective dizziness after vestibular rehabilitation in vestibular neuritis. Retrospective analysis. Tertiary referral center. Forty-six patients with acute unilateral vestibular neuritis were included. Diagnostic, therapeutic, and rehabilitative. All the patients completed vestibular rehabilitation therapy until their computerized dynamic posturography and rotary chair test results were significantly improved. The rehabilitation patients were classified into the normal to mild subjective dizziness and moderate to severe subjective dizziness groups according to the dizziness handicap inventory score (cutoff of 40). Differences between the two groups were analyzed. After rehabilitation, 32.6% of the patients still complained of moderate to severe dizziness. Age, sex distribution, the presence of comorbidities, caloric weakness, pre- and postrehabilitation gain values in rotary chair test, postrehabilitation composite scores in posturography, and the duration of rehabilitation were not significantly different between the two groups. However, initial dizziness handicap inventory (DHI) score and composite score in dynamic posturography were worse and the proportion of patients with absent cervical vestibular-evoked myogenic potential in the moderate to severe group was much higher (93.3% vs. 35.5%, p < 0.001). After multiple regression analysis of those factors, initial DHI score and absent cervical vestibular-evoked myogenic potential response were identified as being associated with higher postrehabilitation DHI score. Saccular dysfunction in acute vestibular neuritis can contribute to persistent subjective dizziness, even after the objective parameters of vestibular function tests have been improved by vestibular rehabilitation.

Does a socio-ecological school model promote resilience in primary schools?

PubMed

Lee, Patricia C; Stewart, Donald E

2013-11-01

This research investigates the extent to which the holistic, multistrategy "health-promoting school" (HPS) model using a resilience intervention can lead to improved resilience among students. A quasi-experimental design using a study cohort selected from 20 primary schools in Queensland, Australia was employed. Ten intervention schools using HPS protocols, with training support, were compared with 10 control schools in student resilience scores and protective factors. Baseline data explored the interactive effect of protective factors on overall resilience scores. Postintervention analysis compared changes in protective factors and resilience, after implementing the HPS project. Baseline data analysis indicated no significant differences in the mean scores of protective factors and resilience scores between intervention and control groups (except for school connection). After 18 months of implementation, a resurvey showed that the intervention group had significantly higher scores than the control group on students' family connection, community connection, peer support, and their overall resilience. Results showed that students in the HPS group had significantly higher scores on resilience than did students in the control group. A comprehensive, whole-school approach to building resilience that integrates students, staff, and community can strengthen important protective factors and build student resilience. © 2013, American School Health Association.

Comparison of different incremental analysis update schemes in a realistic assimilation system with Ensemble Kalman Filter

NASA Astrophysics Data System (ADS)

Yan, Y.; Barth, A.; Beckers, J. M.; Brankart, J. M.; Brasseur, P.; Candille, G.

2017-07-01

In this paper, three incremental analysis update schemes (IAU 0, IAU 50 and IAU 100) are compared in the same assimilation experiments with a realistic eddy permitting primitive equation model of the North Atlantic Ocean using the Ensemble Kalman Filter. The difference between the three IAU schemes lies on the position of the increment update window. The relevance of each IAU scheme is evaluated through analyses on both thermohaline and dynamical variables. The validation of the assimilation results is performed according to both deterministic and probabilistic metrics against different sources of observations. For deterministic validation, the ensemble mean and the ensemble spread are compared to the observations. For probabilistic validation, the continuous ranked probability score (CRPS) is used to evaluate the ensemble forecast system according to reliability and resolution. The reliability is further decomposed into bias and dispersion by the reduced centred random variable (RCRV) score. The obtained results show that 1) the IAU 50 scheme has the same performance as the IAU 100 scheme 2) the IAU 50/100 schemes outperform the IAU 0 scheme in error covariance propagation for thermohaline variables in relatively stable region, while the IAU 0 scheme outperforms the IAU 50/100 schemes in dynamical variables estimation in dynamically active region 3) in case with sufficient number of observations and good error specification, the impact of IAU schemes is negligible. The differences between the IAU 0 scheme and the IAU 50/100 schemes are mainly due to different model integration time and different instability (density inversion, large vertical velocity, etc.) induced by the increment update. The longer model integration time with the IAU 50/100 schemes, especially the free model integration, on one hand, allows for better re-establishment of the equilibrium model state, on the other hand, smooths the strong gradients in dynamically active region.

Ultrasound-detected subclinical inflammation was better reflected by the disease activity score (DAS-28) in patients with suspicion of inflammatory arthritis compared to established rheumatoid arthritis.

PubMed

Ciurtin, Coziana; Wyszynski, Karol; Clarke, Robert; Mouyis, Maria; Manson, Jessica; Marra, Giampiero

2016-10-01

Limited data are available about the ultrasound (US)-detected inflammatory features in patients with suspicion of inflammatory arthritis (S-IA) vs. established rheumatoid arthritis (RA). Our study aimed to assess if the presence of power Doppler (PD) can be predicted by a combination of clinical, laboratory and US parameters. We conducted a real-life, retrospective cohort study comparing clinical, laboratory and US parameters of 108 patients with established RA and 93 patients with S-IA. We propose a PD signal prediction model based on a beta-binomial distribution for PD variable using a mix of outcome measures. Patients with RA in clinical remission had significantly more active inflammation and erosions on US when compared with patients with S-IA with similar disease scores (p = 0.03 and p = 0.01, respectively); however, RA patients with different disease activity score (DAS-28) scores had similar PD scores (p = 0.058). The PD scores did not correlate with erosions (p = 0.38) or DAS-28 scores (p = 0.28) in RA patients, but they correlated with high disease activity in S-IA patients (p = 0.048). Subclinical inflammation is more common in patients with RA in clinical remission or with low disease activity than in patients with S-IA; therefore, US was more useful in assessing for true remission in RA rather than diagnosing IA in patients with low disease activity scores. This is the first study to propose a PD prediction model integrating several outcome measures in the two different groups of patients. Further research into validating this model can minimise the risk of underdiagnosing subclinical inflammation.

Development of a survey instrument to measure patient experience of integrated care.

PubMed

Walker, Kara Odom; Stewart, Anita L; Grumbach, Kevin

2016-06-01

Healthcare systems are working to move towards more integrated, patient-centered care. This study describes the development and testing of a multidimensional self-report measure of patients' experiences of integrated care. Random-digit-dial telephone survey in 2012 of 317 adults aged 40 years or older in the San Francisco region who had used healthcare at least twice in the past 12 months. One-time cross-sectional survey; psychometric evaluation to confirm dimensions and create multi-item scales. Survey data were analyzed using VARCLUS and confirmatory factor analysis and internal consistency reliability testing. Scales measuring five domains were confirmed: coordination within and between care teams, navigation (arranging appointments and visits), communication between specialist and primary care doctor, and communication between primary care doctor and specialist. Four of these demonstrated excellent internal consistency reliability. Mean scale scores indicated low levels of integration. These scales measuring integrated care capture meaningful domains of patients' experiences of health care. The low levels of care integration reported by patients in the study sample suggest that these types of measures should be considered in ongoing evaluations of health system performance and improvement. Further research should examine whether differences in patient experience of integrated care are associated with differences in the processes and outcomes of care received.

Integration of multiple biological features yields high confidence human protein interactome.

PubMed

Karagoz, Kubra; Sevimoglu, Tuba; Arga, Kazim Yalcin

2016-08-21

The biological function of a protein is usually determined by its physical interaction with other proteins. Protein-protein interactions (PPIs) are identified through various experimental methods and are stored in curated databases. The noisiness of the existing PPI data is evident, and it is essential that a more reliable data is generated. Furthermore, the selection of a set of PPIs at different confidence levels might be necessary for many studies. Although different methodologies were introduced to evaluate the confidence scores for binary interactions, a highly reliable, almost complete PPI network of Homo sapiens is not proposed yet. The quality and coverage of human protein interactome need to be improved to be used in various disciplines, especially in biomedicine. In the present work, we propose an unsupervised statistical approach to assign confidence scores to PPIs of H. sapiens. To achieve this goal PPI data from six different databases were collected and a total of 295,288 non-redundant interactions between 15,950 proteins were acquired. The present scoring system included the context information that was assigned to PPIs derived from eight biological attributes. A high confidence network, which included 147,923 binary interactions between 13,213 proteins, had scores greater than the cutoff value of 0.80, for which sensitivity, specificity, and coverage were 94.5%, 80.9%, and 82.8%, respectively. We compared the present scoring method with others for evaluation. Reducing the noise inherent in experimental PPIs via our scoring scheme increased the accuracy significantly. As it was demonstrated through the assessment of process and cancer subnetworks, this study allows researchers to construct and analyze context-specific networks via valid PPI sets and one can easily achieve subnetworks around proteins of interest at a specified confidence level. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quantitative prediction of drug side effects based on drug-related features.

PubMed

Niu, Yanqing; Zhang, Wen

2017-09-01

Unexpected side effects of drugs are great concern in the drug development, and the identification of side effects is an important task. Recently, machine learning methods are proposed to predict the presence or absence of interested side effects for drugs, but it is difficult to make the accurate prediction for all of them. In this paper, we transform side effect profiles of drugs as their quantitative scores, by summing up their side effects with weights. The quantitative scores may measure the dangers of drugs, and thus help to compare the risk of different drugs. Here, we attempt to predict quantitative scores of drugs, namely the quantitative prediction. Specifically, we explore a variety of drug-related features and evaluate their discriminative powers for the quantitative prediction. Then, we consider several feature combination strategies (direct combination, average scoring ensemble combination) to integrate three informative features: chemical substructures, targets, and treatment indications. Finally, the average scoring ensemble model which produces the better performances is used as the final quantitative prediction model. Since weights for side effects are empirical values, we randomly generate different weights in the simulation experiments. The experimental results show that the quantitative method is robust to different weights, and produces satisfying results. Although other state-of-the-art methods cannot make the quantitative prediction directly, the prediction results can be transformed as the quantitative scores. By indirect comparison, the proposed method produces much better results than benchmark methods in the quantitative prediction. In conclusion, the proposed method is promising for the quantitative prediction of side effects, which may work cooperatively with existing state-of-the-art methods to reveal dangers of drugs.

What it feels like to be me: Linking emotional intelligence, identity, and intimacy.

PubMed

Maher, Hemali; Winston, Christine N; S, Usha Rani

2017-04-01

The search for the self and for an intimate other are the normative tasks of adolescence and early adulthood. The role of emotions in the resolution of these developmental tasks, however, remains largely under-studied, especially in non-western cultures. The objective of the present study, therefore, was to examine the relationships between emotional intelligence, identity, and intimacy, among Indian adolescents. Differences across genders (boys vs. girls) and types of school (gender segregated vs. integrated) were also explored. A sample of 486 adolescents completed measures of emotional intelligence, identity, and intimacy. Girls scored higher than boys on intimacy, and those from segregated schools scored higher, than those from integrated schools, on emotional intelligence. Significant relationships emerged between emotional intelligence, and identity and intimacy, and were invariant across the groups. These findings underscore the pivotal role that emotional intelligence plays in healthy adolescent development, irrespective of personal and environmental variables. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Press-fit versus threaded acetabular cups in total hip arthroplasty: Functional and radiological results after five years.

PubMed

Ellenrieder, Martin; Bader, Rainer; Bergschmidt, Philipp; Mittelmeier, Wolfram

2016-03-01

Prospectively the outcome after total hip replacement with a new threaded acetabular cup design was compared to an established press-fit cup. After 1, 2 and 5 years, the 36-item Short Form Health Survey, Western Ontario and McMaster University Osteoarthritis Index and Harris Hip Score revealed no significant differences between the two groups (each group: n=42 patients), except for a higher Harris Hip Score in the threaded cup group after five years (p=0.02). After five years, one threaded cup had a mild radiolucent line without further signs of loosening. All other cups of both groups (98.6%) showed a full osseous integration. The cup inclination angle ranged from 41-58° (threaded cups) to 39-77° (press-fit cups). The new threaded cup provides equivalent clinical outcomes and osseous integration but more precise implant positioning compared to the press-fit design. No complications typically ascribed to threaded cups (acetabular fractures, bone resorption, nerve impairment) occurred.

The Effect of English Language on Multiple Choice Question Scores of Thai Medical Students.

PubMed

Phisalprapa, Pochamana; Muangkaew, Wayuda; Assanasen, Jintana; Kunavisarut, Tada; Thongngarm, Torpong; Ruchutrakool, Theera; Kobwanthanakun, Surapon; Dejsomritrutai, Wanchai

2016-04-01

Universities in Thailand are preparing for Thailand's integration into the ASEAN Economic Community (AEC) by increasing the number of tests in English language. English language is not the native language of Thailand Differences in English language proficiency may affect scores among test-takers, even when subject knowledge among test-takers is comparable and may falsely represent the knowledge level of the test-taker. To study the impact of English language multiple choice test questions on test scores of medical students. The final examination of fourth-year medical students completing internal medicine rotation contains 120 multiple choice questions (MCQ). The languages used on the test are Thai and English at a ratio of 3:1. Individual scores of tests taken in both languages were collected and the effect of English language on MCQ was analyzed Individual MCQ scores were then compared with individual student English language proficiency and student grade point average (GPA). Two hundred ninety five fourth-year medical students were enrolled. The mean percentage of MCQ scores in Thai and English were significantly different (65.0 ± 8.4 and 56.5 ± 12.4, respectively, p < 0.001). The correlation between MCQ scores in Thai and English was fair (Spearman's correlation coefficient = 0.41, p < 0.001). Of 295 students, only 73 (24.7%) students scored higher when being tested in English than in Thai language. Students were classified into six grade categories (A, B+, B, C+, C, and D+), which cumulatively measured total internal medicine rotation performance score plus final examination score. MCQ scores from Thai language examination were more closely correlated with total course grades than were the scores from English language examination (Spearman's correlation coefficient = 0.73 (p < 0.001) and 0.53 (p < 0.001), respectively). The gap difference between MCQ scores in both languages was higher in borderline students than in the excellent student group (11.2 ± 11.2 and 7.1 ± 8.2, respectively, p < 0.001). Overall, average student English proficiency score was very high, at 3.71 ± 0.35 from a total of 4.00. Mean student GPA was 3.40 ± 0.33 from a possible 4.00. English language MCQ examination scores were more highly associated with GPA than with English language proficiency. The use of English language multiple choice question test may decrease scores of the fourth-year internal medicine post-rotation final examination, especially those of borderline students.

Comparing usability testing outcomes and functions of six electronic nursing record systems.

PubMed

Cho, Insook; Kim, Eunman; Choi, Woan Heui; Staggers, Nancy

2016-04-01

This study examined the usability of six differing electronic nursing record (ENR) systems on the efficiency, proficiency and available functions for documenting nursing care and subsequently compared the results to nurses' perceived satisfaction from a previous study. The six hospitals had different ENR systems, all with narrative nursing notes in use for more than three years. Stratified by type of nursing unit, 54 staff nurses were digitally recorded during on-site usability testing by employing validated patient care scenarios and think-aloud protocols. The time to complete specific tasks was also measured. Qualitative performance data were converted into scores on efficiency (relevancy), proficiency (accuracy), and a competency index using scoring schemes described by McGuire and Babbott. Six nurse managers and the researchers completed assessments of available ENR functions and examined computerized nursing process components including the linkages among them. For the usability test, participants' mean efficiency score was 94.2% (95% CI, 91.4-96.9%). The mean proficiency was 60.6% (95% CI, 54.3-66.8%), and the mean competency index was 59.5% (95% CI, 52.9-66.0). Efficiency scores were significantly different across ENRs as was the time to complete tasks, ranging from 226.3 to 457.2s (χ(2)=12.3, P=0.031; χ(2)=11.2, P=0.048). No significant differences were seen for proficiency scores. The coverage of the various ENRs' nursing process ranged from 67% to 100%, but only two systems had complete integration of nursing components. Two systems with high efficiency and proficiency scores had much lower usability test scores and perceived user satisfaction along with more complex navigation patterns. In terms of system usability and functions, different levels of sophistication of and interaction performance with ENR systems exist in practice. This suggests that ENRs may have variable impacts on clinical outcomes and care quality. Future studies are needed to explore ENR impact on nursing care quality, efficiency, and safety. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Framework for the quantitative weight-of-evidence analysis of 'omics data for regulatory purposes.

PubMed

Bridges, Jim; Sauer, Ursula G; Buesen, Roland; Deferme, Lize; Tollefsen, Knut E; Tralau, Tewes; van Ravenzwaay, Ben; Poole, Alan; Pemberton, Mark

2017-12-01

A framework for the quantitative weight-of-evidence (QWoE) analysis of 'omics data for regulatory purposes is presented. The QWoE framework encompasses seven steps to evaluate 'omics data (also together with non-'omics data): (1) Hypothesis formulation, identification and weighting of lines of evidence (LoEs). LoEs conjoin different (types of) studies that are used to critically test the hypothesis. As an essential component of the QWoE framework, step 1 includes the development of templates for scoring sheets that predefine scoring criteria with scores of 0-4 to enable a quantitative determination of study quality and data relevance; (2) literature searches and categorisation of studies into the pre-defined LoEs; (3) and (4) quantitative assessment of study quality and data relevance using the respective pre-defined scoring sheets for each study; (5) evaluation of LoE-specific strength of evidence based upon the study quality and study relevance scores of the studies conjoined in the respective LoE; (6) integration of the strength of evidence from the individual LoEs to determine the overall strength of evidence; (7) characterisation of uncertainties and conclusion on the QWoE. To put the QWoE framework in practice, case studies are recommended to confirm the relevance of its different steps, or to adapt them as necessary. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

An integrated approach for facilities planning by ELECTRE method

NASA Astrophysics Data System (ADS)

Elbishari, E. M. Y.; Hazza, M. H. F. Al; Adesta, E. Y. T.; Rahman, Nur Salihah Binti Abdul

2018-01-01

Facility planning is concerned with the design, layout, and accommodation of people, machines and activities of a system. Most of the researchers try to investigate the production area layout and the related facilities. However, few of them try to investigate the relationship between the production space and its relationship with service departments. The aim of this research to is to integrate different approaches in order to evaluate, analyse and select the best facilities planning method that able to explain the relationship between the production area and other supporting departments and its effect on human efforts. To achieve the objective of this research two different approaches have been integrated: Apple’s layout procedure as one of the effective tools in planning factories, ELECTRE method as one of the Multi Criteria Decision Making methods (MCDM) to minimize the risk of getting poor facilities planning. Dalia industries have been selected as a case study to implement our integration the factory have been divided two main different area: the whole facility (layout A), and the manufacturing area (layout B). This article will be concerned with the manufacturing area layout (Layout B). After analysing the data gathered, the manufacturing area was divided into 10 activities. There are five factors that the alternative were compared upon which are: Inter department satisfactory level, total distance travelled for workers, total distance travelled for the product, total time travelled for the workers, and total time travelled for the product. Three different layout alternatives have been developed in addition to the original layouts. Apple’s layout procedure was used to study and evaluate the different alternatives layouts, the study and evaluation of the layouts was done by calculating scores for each of the factors. After obtaining the scores from evaluating the layouts, ELECTRE method was used to compare the proposed alternatives with each other and with the existing layout; ELECTRE compares the alternatives based on their concordance and discordance indices. The alternatives were ranked from best to worst where regarding to the layouts concerned with the manufacturing area B.4 is the best alternative.

Identity development in adolescents with mental problems

PubMed Central

2013-01-01

Background In the revision of the Diagnostic and Statistical Manual (DSM-5), “Identity” is an essential diagnostic criterion for personality disorders (self-related personality functioning) in the alternative approach to the diagnosis of personality disorders in Section III of DSM-5. Integrating a broad range of established identity concepts, AIDA (Assessment of Identity Development in Adolescence) is a new questionnaire to assess pathology-related identity development in healthy and disturbed adolescents aged 12 to 18 years. Aim of the present study is to investigate differences in identity development between adolescents with different psychiatric diagnoses. Methods Participants were 86 adolescent psychiatric in- and outpatients aged 12 to 18 years. The test set includes the questionnaire AIDA and two semi-structured psychiatric interviews (SCID-II, K-DIPS). The patients were assigned to three diagnostic groups (personality disorders, internalizing disorders, externalizing disorders). Differences were analyzed by multivariate analysis of variance MANOVA. Results In line with our hypotheses, patients with personality disorders showed the highest scores in all AIDA scales with T>70. Patients with externalizing disorders showed scores in an average range compared to population norms, while patients with internalizing disorders lay in between with scores around T=60. The AIDA total score was highly significant between the groups with a remarkable effect size of f= 0.44. Conclusion Impairment of identity development differs between adolescent patients with different forms of mental disorders. The AIDA questionnaire is able to discriminate between these groups. This may help to improve assessment and treatment of adolescents with severe psychiatric problems. PMID:23899433

MeSHLabeler: improving the accuracy of large-scale MeSH indexing by integrating diverse evidence.

PubMed

Liu, Ke; Peng, Shengwen; Wu, Junqiu; Zhai, Chengxiang; Mamitsuka, Hiroshi; Zhu, Shanfeng

2015-06-15

Medical Subject Headings (MeSHs) are used by National Library of Medicine (NLM) to index almost all citations in MEDLINE, which greatly facilitates the applications of biomedical information retrieval and text mining. To reduce the time and financial cost of manual annotation, NLM has developed a software package, Medical Text Indexer (MTI), for assisting MeSH annotation, which uses k-nearest neighbors (KNN), pattern matching and indexing rules. Other types of information, such as prediction by MeSH classifiers (trained separately), can also be used for automatic MeSH annotation. However, existing methods cannot effectively integrate multiple evidence for MeSH annotation. We propose a novel framework, MeSHLabeler, to integrate multiple evidence for accurate MeSH annotation by using 'learning to rank'. Evidence includes numerous predictions from MeSH classifiers, KNN, pattern matching, MTI and the correlation between different MeSH terms, etc. Each MeSH classifier is trained independently, and thus prediction scores from different classifiers are incomparable. To address this issue, we have developed an effective score normalization procedure to improve the prediction accuracy. MeSHLabeler won the first place in Task 2A of 2014 BioASQ challenge, achieving the Micro F-measure of 0.6248 for 9,040 citations provided by the BioASQ challenge. Note that this accuracy is around 9.15% higher than 0.5724, obtained by MTI. The software is available upon request. © The Author 2015. Published by Oxford University Press.

MeSHLabeler: improving the accuracy of large-scale MeSH indexing by integrating diverse evidence

PubMed Central

Liu, Ke; Peng, Shengwen; Wu, Junqiu; Zhai, Chengxiang; Mamitsuka, Hiroshi; Zhu, Shanfeng

2015-01-01

Motivation: Medical Subject Headings (MeSHs) are used by National Library of Medicine (NLM) to index almost all citations in MEDLINE, which greatly facilitates the applications of biomedical information retrieval and text mining. To reduce the time and financial cost of manual annotation, NLM has developed a software package, Medical Text Indexer (MTI), for assisting MeSH annotation, which uses k-nearest neighbors (KNN), pattern matching and indexing rules. Other types of information, such as prediction by MeSH classifiers (trained separately), can also be used for automatic MeSH annotation. However, existing methods cannot effectively integrate multiple evidence for MeSH annotation. Methods: We propose a novel framework, MeSHLabeler, to integrate multiple evidence for accurate MeSH annotation by using ‘learning to rank’. Evidence includes numerous predictions from MeSH classifiers, KNN, pattern matching, MTI and the correlation between different MeSH terms, etc. Each MeSH classifier is trained independently, and thus prediction scores from different classifiers are incomparable. To address this issue, we have developed an effective score normalization procedure to improve the prediction accuracy. Results: MeSHLabeler won the first place in Task 2A of 2014 BioASQ challenge, achieving the Micro F-measure of 0.6248 for 9,040 citations provided by the BioASQ challenge. Note that this accuracy is around 9.15% higher than 0.5724, obtained by MTI. Availability and implementation: The software is available upon request. Contact: zhusf@fudan.edu.cn PMID:26072501

Reduction Continuous Rank Probability Score for Hydrological Ensemble Prediction System

NASA Astrophysics Data System (ADS)

Trinh, Nguyen Bao; Thielen Del-Pozo, Jutta; Pappenberger, Florian; Cloke, Hannah L.; Bogner, Konrad

2010-05-01

Ensemble Prediction System (EPS), calculated operationally by the weather services for various lead-times, are increasingly used as input to hydrological models to extend warning times from short- to medium and even long-range. Although the general skill of EPS has been demonstrated to increase continuously over the past decades, it remains comparatively low for precipitation, one of the driving forces of hydrological processes. Due to the non-linear integrating nature of river runoff and the complexities of catchment runoff processes, one cannot assume that the skill of the hydrological forecasts is necessarily similar to the skill of the meteorological predictions. Furthermore, due to the integrating nature of discharge, which accumulates effects from upstream catchment and slow-responding groundwater processes, commonly applied skill scores in meteorology may not be fully adapted to describe the skill of probabilistic discharge predictions. For example, while for hydrological applications it may be interesting to compare the forecast skill between upstream and downstream stations, meteorological applications focus more on climatologically relevant regions. In this paper, a range of widely used probabilistic skill scores for assessing reliability, spread-skill, sharpness and bias are calculated for a 12 months case study in the Danube river basin. The Continuous Rank Probability Score (CRPS) is demonstrated to have deficiencies when comparing skill of discharge forecast for different hydrological stations. Therefore, we propose a modified CRPS that allows this comparison and is therefore particularly useful for hydrological applications.

Web-site evaluation tools: a case study in reproductive health information.

PubMed

Aslani, Azam; Pournik, Omid; Abu-Hanna, Ameen; Eslami, Saeid

2014-01-01

Internet forms an opportunity to inform, teach, and connect professionals and patients. However, much information on Internet is incomplete, inaccurate, or misleading, and not only in the medical domain. Because of the potential for damage from misleading and inaccurate health information, many organizations and individuals have published or implemented scoring tools for evaluating the appropriateness or quality of these resources. The objective of this study is to identify and summarize scoring tools that have evaluated web-sites providing reproductive health information in order to compare them and recommend an overarching evaluation tool. We searched Ovid MEDLINE(R) (1946 to July 2013) and OVID Embase (1980 to July 2013); and included English language studies that have evaluated the quality of websites providing reproductive health information. Studies only assessing the content of websites were excluded. We identified 5 scoring tools: 1-The HON (health on the net) Code of Conduct for medical and health Web sites, 2-Silberg scores, 3-Hogne Sandvik scale, 4-Jim Kapoun's Criteria for Evaluating Web Pages, and 5-The Health Information Technology Institute (HITI) criteria. We have compared these scales and identified 14 criteria: authorship, ownership, currency, objectivity/content, transparency/source, interactivity, privacy/ethics, financial disclosure, navigability/links, complementarity, advertising policy, design, quantity, and accessibility. We integrated these criteria and introduced a new tool with 10 criteria. Website evaluation tools differ in their evaluation criteria and there is a lack of consensus about which to use; therefore, an integrated easy to use set of criteria is needed.

Nurses' attitudes towards computers: cross sectional questionnaire study.

PubMed

Brumini, Gordan; Kovic, Ivor; Zombori, Dejvid; Lulic, Ileana; Petrovecki, Mladen

2005-02-01

To estimate the attitudes of hospital nurses towards computers and the influence of gender, age, education, and computer usage on these attitudes. The study was conducted in two Croatian hospitals where integrated hospital information system is being implemented. There were 1,081 nurses surveyed by an anonymous questionnaire consisting of 8 questions about demographic data, education, and computer usage, and 30 statements on attitudes towards computers. The statements were adapted to a Likert type scale. Differences in attitudes towards computers were compared using one-way ANOVA and Tukey-b post-hoc test. The total score was 120+/-15 (mean+/-standard deviation) out of maximal 150. Nurses younger than 30 years had a higher total score than those older than 30 years (124+/-13 vs 119+/-16 for 30-39 age groups and 117+/-15 for>39 age groups, P<0.001). Nurses with a bachelor's degree (119+/-16 vs 122+/-14, P=0.002) and nurses who had attended computer science courses had a higher total score compared to the others (124+/-13 vs 118+/-16, P<0.001). Nurses using computers more than 5 hours per week had higher total score than those who used computers less than 5 hours (127+/-13 vs 124+/-12 for 1-5 h and and 119+/-14 for <1 hour per day, P<0.001, post-hoc test). Nurses in general have positive attitudes towards computers. These results are important for the planning and implementing an integrated hospital information system.

A comparison of piezosurgery with conventional techniques for internal osteotomy.

PubMed

Koçak, I; Doğan, R; Gökler, O

2017-06-01

To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p < 0.05). On postoperative day 2, the pain level was lower in the piezosurgery group than in the conventional osteotomy group (p < 0.05). In an endoscopic examination on postoperative day 4, while 24% of the patients in the conventional osteotomy group had mucosal damage, no such damage was observed in the piezosurgery group. When total operation duration was compared, there was no significant difference between the groups (p > 0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.

Integration of a Community Pharmacy Simulation Program into a Therapeutics Course.

PubMed

Shin, Jaekyu; Tabatabai, Daryush; Boscardin, Christy; Ferrone, Marcus; Brock, Tina

2018-02-01

Objective. To demonstrate the feasibility of integrating the computer simulation, MyDispense, into a therapeutics course and to measure its effects on student perception and learning. Methods. We conducted a prospective study with an experimental phase and an implementation phase. In the first phase, students were randomized to complete a therapeutics case using MyDispense or traditional paper methods in class. In the second phase, all students completed two therapeutic cases using MyDispense in class with the option to complete four additional outside-of-class cases using MyDispense. Students completed pre- and post-tests in class and three surveys. Results. In the experimental phase, mean test scores increased from pre- to post-test for both MyDispense and traditional paper groups, but the difference between the groups was not statistically significant. Students in the traditional paper group reported statistically significant gains in confidence compared to the MyDispense group. In the implementation phase, mean test scores again increased, however, student perception of the use of MyDispense for therapeutics was negative. Completing the optional outside-of-class cases, however, was positively and significantly correlated with the midterm and final examination scores. Conclusion. Implementation of MyDispense in therapeutics may be feasible and has positive effects (eg, correlation with exam scores, capacity for immediate feedback, and potential for effective self-study). With short-term use and in the absence of assessment methods that also require seeking information from patients, students prefer to learn via traditional paper cases.

PAGER 2.0: an update to the pathway, annotated-list and gene-signature electronic repository for Human Network Biology

PubMed Central

Yue, Zongliang; Zheng, Qi; Neylon, Michael T; Yoo, Minjae; Shin, Jimin; Zhao, Zhiying; Tan, Aik Choon

2018-01-01

Abstract Integrative Gene-set, Network and Pathway Analysis (GNPA) is a powerful data analysis approach developed to help interpret high-throughput omics data. In PAGER 1.0, we demonstrated that researchers can gain unbiased and reproducible biological insights with the introduction of PAGs (Pathways, Annotated-lists and Gene-signatures) as the basic data representation elements. In PAGER 2.0, we improve the utility of integrative GNPA by significantly expanding the coverage of PAGs and PAG-to-PAG relationships in the database, defining a new metric to quantify PAG data qualities, and developing new software features to simplify online integrative GNPA. Specifically, we included 84 282 PAGs spanning 24 different data sources that cover human diseases, published gene-expression signatures, drug–gene, miRNA–gene interactions, pathways and tissue-specific gene expressions. We introduced a new normalized Cohesion Coefficient (nCoCo) score to assess the biological relevance of genes inside a PAG, and RP-score to rank genes and assign gene-specific weights inside a PAG. The companion web interface contains numerous features to help users query and navigate the database content. The database content can be freely downloaded and is compatible with third-party Gene Set Enrichment Analysis tools. We expect PAGER 2.0 to become a major resource in integrative GNPA. PAGER 2.0 is available at http://discovery.informatics.uab.edu/PAGER/. PMID:29126216

A Risk Score for Predicting Multiple Sclerosis.

PubMed

Dobson, Ruth; Ramagopalan, Sreeram; Topping, Joanne; Smith, Paul; Solanky, Bhavana; Schmierer, Klaus; Chard, Declan; Giovannoni, Gavin

2016-01-01

Multiple sclerosis (MS) develops as a result of environmental influences on the genetically susceptible. Siblings of people with MS have an increased risk of both MS and demonstrating asymptomatic changes in keeping with MS. We set out to develop an MS risk score integrating both genetic and environmental risk factors. We used this score to identify siblings at extremes of MS risk and attempted to validate the score using brain MRI. 78 probands with MS, 121 of their unaffected siblings and 103 healthy controls were studied. Personal history was taken, and serological and genetic analysis using the illumina immunochip was performed. Odds ratios for MS associated with each risk factor were derived from existing literature, and the log values of the odds ratios from each of the risk factors were combined in an additive model to provide an overall score. Scores were initially calculated using log odds ratio from the HLA-DRB1*1501 allele only, secondly using data from all MS-associated SNPs identified in the 2011 GWAS. Subjects with extreme risk scores underwent validation studies. MRI was performed on selected individuals. There was a significant difference in the both risk scores between people with MS, their unaffected siblings and healthy controls (p<0.0005). Unaffected siblings had a risk score intermediate to people with MS and controls (p<0.0005). The best performing risk score generated an AUC of 0.82 (95%CI 0.75-0.88). The risk score demonstrates an AUC on the threshold for clinical utility. Our score enables the identification of a high-risk sibling group to inform pre-symptomatic longitudinal studies.

Dose-escalation using intensity-modulated radiotherapy for prostate cancer - evaluation of quality of life with and without (18)F-choline PET-CT detected simultaneous integrated boost.

PubMed

Pinkawa, Michael; Piroth, Marc D; Holy, Richard; Klotz, Jens; Djukic, Victoria; Corral, Nuria Escobar; Caffaro, Mariana; Winz, Oliver H; Krohn, Thomas; Mottaghy, Felix M; Eble, Michael J

2012-01-30

In comparison to the conventional whole-prostate dose escalation, an integrated boost to the macroscopic malignant lesion might potentially improve tumor control rates without increasing toxicity. Quality of life after radiotherapy (RT) with vs. without (18)F-choline PET-CT detected simultaneous integrated boost (SIB) was prospectively evaluated in this study. Whole body image acquisition in supine patient position followed 1 h after injection of 178-355MBq (18)F-choline. SIB was defined by a tumor-to-background uptake value ratio > 2 (GTV(PET)). A dose of 76Gy was prescribed to the prostate (PTV(prostate)) in 2Gy fractions, with or without SIB up to 80Gy. Patients treated with (n = 46) vs. without (n = 21) SIB were surveyed prospectively before (A), at the last day of RT (B) and a median time of two (C) and 19 month (D) after RT to compare QoL changes applying a validated questionnaire (EPIC - expanded prostate cancer index composite). With a median cut-off standard uptake value (SUV) of 3, a median GTV(PET) of 4.0 cm(3) and PTV(boost) (GTV(PET) with margins) of 17.3 cm(3) was defined. No significant differences were found for patients treated with vs. without SIB regarding urinary and bowel QoL changes at times B, C and D (mean differences ≤3 points for all comparisons). Significantly decreasing acute urinary and bowel score changes (mean changes > 5 points in comparison to baseline level at time A) were found for patients with and without SIB. However, long-term urinary and bowel QoL (time D) did not differ relative to baseline levels - with mean urinary and bowel function score changes < 3 points in both groups (median changes = 0 points). Only sexual function scores decreased significantly (> 5 points) at time D. Treatment planning with (18)F-choline PET-CT allows a dose escalation to a macroscopic intraprostatic lesion without significantly increasing toxicity.

Capability and opportunity in hot shooting performance: Evidence from top-scoring NBA leaders

PubMed Central

2018-01-01

In basketball games, whenever players successfully shoot in streaks, they are expected to demonstrate heightened performance for a stretch of time. Streak shooting in basketball has been debated for more than three decades, but most studies have provided little significant statistical evidence and have labeled random subjective judgments the “hot hand fallacy.” To obtain a broader perspective of the hot hand phenomenon and its accompanying influences on the court, this study uses field goal records and optical tracking data from the official NBA database for the entire 2015–2016 season to analyze top-scoring leaders’ shooting performances. We first reflect on the meaning of “hot hand” and the “Matthew effect” in actual basketball competition. Second, this study employs statistical models to integrate three different shooting perspectives (field goal percentage, points scored, and attempts). This study’s findings shed new light not only on the existence or nonexistence of streaks, but on the roles of capability and opportunity in NBA hot shooting. Furthermore, we show how hot shooting performances resulting from capability and opportunity lead to actual differences for teams. PMID:29432458

Capability and opportunity in hot shooting performance: Evidence from top-scoring NBA leaders.

PubMed

Chang, Shun-Chuan

2018-01-01

In basketball games, whenever players successfully shoot in streaks, they are expected to demonstrate heightened performance for a stretch of time. Streak shooting in basketball has been debated for more than three decades, but most studies have provided little significant statistical evidence and have labeled random subjective judgments the "hot hand fallacy." To obtain a broader perspective of the hot hand phenomenon and its accompanying influences on the court, this study uses field goal records and optical tracking data from the official NBA database for the entire 2015-2016 season to analyze top-scoring leaders' shooting performances. We first reflect on the meaning of "hot hand" and the "Matthew effect" in actual basketball competition. Second, this study employs statistical models to integrate three different shooting perspectives (field goal percentage, points scored, and attempts). This study's findings shed new light not only on the existence or nonexistence of streaks, but on the roles of capability and opportunity in NBA hot shooting. Furthermore, we show how hot shooting performances resulting from capability and opportunity lead to actual differences for teams.

Effectiveness of Integrating Simulation with Art-Based Teaching Strategies on Oncology Fellows' Performance Regarding Breaking Bad News.

PubMed

Yakhforoshha, Afsaneh; Emami, Seyed Amir Hossein; Shahi, Farhad; Shahsavari, Saeed; Cheraghi, Mohammadali; Mojtahedzadeh, Rita; Mahmoodi-Bakhtiari, Behrooz; Shirazi, Mandana

2018-02-21

The task of breaking bad news (BBN) may be improved by incorporating simulation with art-based teaching methods. The aim of the present study was to assess the effect of an integrating simulation with art-based teaching strategies, on fellows' performance regarding BBN, in Iran. The study was carried out using quasi-experimental methods, interrupted time series. The participants were selected from medical oncology fellows at two teaching hospitals of Tehran University of Medical Sciences (TUMS), Iran. Participants were trained through workshop, followed by engaging participants with different types of art-based teaching methods. In order to assess the effectiveness of the integrating model, fellows' performance was rated by two independent raters (standardized patients (SPs) and faculty members) using the BBN assessment checklist. This assessment tool measured seven different domains of BBN skill. Segmented regression was used to analyze the results of study. Performance of all oncology fellows (n = 19) was assessed for 228 time points during the study, by rating three time points before and three time points after the intervention by two raters. Based on SP ratings, fellows' performance scores in post-training showed significant level changes in three domains of BBN checklist (B = 1.126, F = 3.221, G = 2.241; p < 0.05). Similarly, the significant level change in fellows' score rated by faculty members in post-training was B = 1.091, F = 3.273, G = 1.724; p < 0.05. There was no significant change in trend of fellows' performance after the intervention. Our results showed that using an integrating simulation with art-based teaching strategies may help oncology fellows to improve their communication skills in different facets of BBN performance. Iranian Registry of Clinical Trials ID: IRCT2016011626039N1.

Implementation and evaluation of an integrated computerized asthma management system in a pediatric emergency department: a randomized clinical trial.

PubMed

Dexheimer, Judith W; Abramo, Thomas J; Arnold, Donald H; Johnson, Kevin; Shyr, Yu; Ye, Fei; Fan, Kang-Hsien; Patel, Neal; Aronsky, Dominik

2014-11-01

The use of evidence-based guidelines can improve the care for asthma patients. We implemented a computerized asthma management system in a pediatric emergency department (ED) to integrate national guidelines. Our objective was to determine whether patient eligibility identification by a probabilistic disease detection system (Bayesian network) combined with an asthma management system embedded in the workflow decreases time to disposition decision. We performed a prospective, randomized controlled trial in an urban, tertiary care pediatric ED. All patients 2-18 years of age presenting to the ED between October 2010 and February 2011 were screened for inclusion by the disease detection system. Patients identified to have an asthma exacerbation were randomized to intervention or control. For intervention patients, asthma management was computer-driven and workflow-integrated including computer-based asthma scoring in triage, and time-driven display of asthma-related reminders for re-scoring on the electronic patient status board combined with guideline-compliant order sets. Control patients received standard asthma management. The primary outcome measure was the time from triage to disposition decision. The Bayesian network identified 1339 patients with asthma exacerbations, of which 788 had an asthma diagnosis determined by an ED physician-established reference standard (positive predictive value 69.9%). The median time to disposition decision did not differ among the intervention (228 min; IQR=(141, 326)) and control group (223 min; IQR=(129, 316)); (p=0.362). The hospital admission rate was unchanged between intervention (25%) and control groups (26%); (p=0.867). ED length of stay did not differ among intervention (262 min; IQR=(165, 410)) and control group (247 min; IQR=(163, 379)); (p=0.818). The control and intervention groups were similar in regards to time to disposition; the computerized management system did not add additional wait time. The time to disposition decision did not change; however the management system integrated several different information systems to support clinicians' communication. Copyright © 2014. Published by Elsevier Ireland Ltd.

Integrative approach for inference of gene regulatory networks using lasso-based random featuring and application to psychiatric disorders.

PubMed

Kim, Dongchul; Kang, Mingon; Biswas, Ashis; Liu, Chunyu; Gao, Jean

2016-08-10

Inferring gene regulatory networks is one of the most interesting research areas in the systems biology. Many inference methods have been developed by using a variety of computational models and approaches. However, there are two issues to solve. First, depending on the structural or computational model of inference method, the results tend to be inconsistent due to innately different advantages and limitations of the methods. Therefore the combination of dissimilar approaches is demanded as an alternative way in order to overcome the limitations of standalone methods through complementary integration. Second, sparse linear regression that is penalized by the regularization parameter (lasso) and bootstrapping-based sparse linear regression methods were suggested in state of the art methods for network inference but they are not effective for a small sample size data and also a true regulator could be missed if the target gene is strongly affected by an indirect regulator with high correlation or another true regulator. We present two novel network inference methods based on the integration of three different criteria, (i) z-score to measure the variation of gene expression from knockout data, (ii) mutual information for the dependency between two genes, and (iii) linear regression-based feature selection. Based on these criterion, we propose a lasso-based random feature selection algorithm (LARF) to achieve better performance overcoming the limitations of bootstrapping as mentioned above. In this work, there are three main contributions. First, our z score-based method to measure gene expression variations from knockout data is more effective than similar criteria of related works. Second, we confirmed that the true regulator selection can be effectively improved by LARF. Lastly, we verified that an integrative approach can clearly outperform a single method when two different methods are effectively jointed. In the experiments, our methods were validated by outperforming the state of the art methods on DREAM challenge data, and then LARF was applied to inferences of gene regulatory network associated with psychiatric disorders.

Outcomes of Integrated Behavioral Health with Primary Care.

PubMed

Balasubramanian, Bijal A; Cohen, Deborah J; Jetelina, Katelyn K; Dickinson, L Miriam; Davis, Melinda; Gunn, Rose; Gowen, Kris; deGruy, Frank V; Miller, Benjamin F; Green, Larry A

2017-01-01

Integrating behavioral health and primary care is beneficial to patients and health systems. However, for integration to be widely adopted, studies demonstrating its benefits in community practices are needed. The objective of this study was to evaluate effect of integrated care, adapted to local contexts, on depression severity and patients' experience of care. This study used a convergent mixed-methods design, merging findings from a quasi-experimental study with patient interviews conducted as part of Advancing Care Together, a community demonstration project that created an innovation incubator for practices implementing evidence-based integration strategies. The study included 475 patients with a 9-item Patient Health Questionnaire (PHQ-9) score ≥10 at baseline, from 5 practices. Statistically significant reductions in mean PHQ-9 scores were observed in all practices, ranging from 2.72 to 6.46 points. Clinically, 50% of patients had a ≥5-point reduction in PHQ-9 score and 32% had a ≥50% reduction. This finding was corroborated by patient interviews that demonstrated positive experiences with behavioral health clinicians and acquiring new skills to cope with adverse situations at work and home. Integrating behavioral health and primary care, when adapted to fit into community practices, reduced depression severity and enhanced patients' experience of care. Integration is a worthwhile investment; clinical leaders, policymakers, and payers should support integration in their communities. © Copyright 2017 by the American Board of Family Medicine.

Association of Chronic Pain and Community Integration of Returning Veterans With and Without Traumatic Brain Injury.

PubMed

Wu, Emily; Graham, David P

2016-01-01

To evaluate the association between community integration and pain in veterans with and without mild blast-related traumatic brain injury (TBI). A cross-sectional study of 198 Operation Enduring Freedom/Operation Iraqi Freedom veterans, 135 with mild TBI and 63 without TBI exposure. Community Integration Questionnaire (CIQ), Community Reintegration of Injured Service Members Instrument, Brief Pain Inventory. Pain interference was significantly associated with CIQ social integration (P = .037), and pain severity was significantly associated with CIQ home integration (P = .038) and CIQ social integration (P = .044). Pain interference and pain severity had a significant interaction as related to the CIQ total score (P = .046), CIQ job score (P = .034), and CIQ productivity score (P = .034). Pain interference (P = .042) and pain severity (P = .015) were associated with community participation, but not perceived limitations (P > .05) or satisfaction (P > .05) as measures by the Community Reintegration of Injured Service Members Instrument. There was a significant interaction between TBI status and pain severity (P = .021) with community participation. Chronic pain has a negative association with the community integration of returning veterans. Although TBI status was associated with overall community integration ratings, depression had a stronger association with impairments. These findings suggest, above and beyond the treatment of depression, the importance of effectively managing TBI-related pain to foster improved social functioning and to promote the psychological and social well-being of returning veterans.

Effect of online formative assessment on summative performance in integrated musculoskeletal system module.

PubMed

Mitra, Nilesh Kumar; Barua, Ankur

2015-03-03

The impact of web-based formative assessment practices on performance of undergraduate medical students in summative assessments is not widely studied. This study was conducted among third-year undergraduate medical students of a designated university in Malaysia to compare the effect, on performance in summative assessment, of repeated computer-based formative assessment with automated feedback with that of single paper-based formative assessment with face-to face feedback. This quasi-randomized trial was conducted among two groups of undergraduate medical students who were selected by stratified random technique from a cohort undertaking the Musculoskeletal module. The control group C (n = 102) was subjected to a paper-based formative MCQ test. The experimental group E (n = 65) was provided three online formative MCQ tests with automated feedback. The summative MCQ test scores for both these groups were collected after the completion of the module. In this study, no significant difference was observed between the mean summative scores of the two groups. However, Band 1 students from group E with higher entry qualification showed higher mean score in the summative assessment. A trivial, but significant and positive correlation (r(2) = +0.328) was observed between the online formative test scores and summative assessment scores of group E. The proportionate increase of performance in group E was found to be almost double than group C. The use of computer based formative test with automated feedback improved the performance of the students with better academic background in the summative assessment. Computer-based formative test can be explored as an optional addition to the curriculum of pre-clinical integrated medical program to improve the performance of the students with higher academic ability.

Community integration following multidisciplinary rehabilitation for traumatic brain injury.

PubMed

Goranson, Tamara E; Graves, Roger E; Allison, Deborah; La Freniere, Ron

2003-09-01

To determine the extent to which participation in a multidisciplinary rehabilitation programme and patient characteristics predict improvement in community integration following mild-to-moderate traumatic brain injury (TBI). A non-randomized case-control study was conducted employing a pre-test-post-test multiple regression design. Archival data for 42 patients with mild-to-moderate TBI who completed the Community Integration Questionnaire (CIQ) at intake and again 6-18 months later were analysed. Half the sample participated in an intensive outpatient rehabilitation programme that provided multi-modal interventions, while the other half received no rehabilitation. The two groups were matched on age, education and time since injury. On the CIQ Home Integration scale, participation in rehabilitation and female gender predicted better outcome. On the Productivity scale, patients with a lower age at injury had better outcome. Outcome on both of these scales, as well as on the Social Integration scale, was predicted by the baseline pre-test score (initial severity). Overall, multidisciplinary rehabilitation appeared to increase personal independence. It is also concluded that: (1) multivariate analysis can reveal the relative importance of multiple predictors of outcome; (2) different predictors may predict different aspects of outcome; and (3) more sensitive and specific outcome measures are needed.

Higher levels of trait emotional awareness are associated with more efficient global information integration throughout the brain: A graph-theoretic analysis of resting state functional connectivity.

PubMed

Smith, Ryan; Sanova, Anna; Alkozei, Anna; Lane, Richard D; Killgore, William D S

2018-06-21

Previous studies have suggested that trait differences in emotional awareness (tEA) are clinically relevant, and associated with differences in neural structure/function. While multiple leading theories suggest that conscious awareness requires widespread information integration across the brain, no study has yet tested the hypothesis that higher tEA corresponds to more efficient brain-wide information exchange. Twenty-six healthy volunteers (13 female) underwent a resting state functional magnetic resonance imaging scan, and completed the Levels of Emotional Awareness Scale (LEAS; a measure of tEA) and the Wechsler Abbreviated Scale of Intelligence (WASI-II; a measure of general intelligence [IQ]). Using a whole-brain (functionally defined) region-of-interest (ROI) atlas, we computed several graph theory metrics to assess the efficiency of brain-wide information exchange. After statistically controlling for differences in age, gender, and IQ, we first observed a significant relationship between higher LEAS scores and greater average degree (i.e., overall whole-brain network density). When controlling for average degree, we found that higher LEAS scores were also associated with shorter average path lengths across the collective network of all included ROIs. These results jointly suggest that individuals with higher tEA display more efficient global information exchange throughout the brain. This is consistent with the idea that conscious awareness requires global accessibility of represented information.

Verbal memory outcome in patients with normal preoperative verbal memory and left mesial temporal sclerosis.

PubMed

LoGalbo, Anthony; Sawrie, Stephen; Roth, David L; Kuzniecky, Ruben; Knowlton, Robert; Faught, Edward; Martin, Roy

2005-05-01

Previous studies have shown that structural integrity (i.e., presence/absence of mesial temporal sclerosis (MTS)) of the left mesial temporal lobe is associated with verbal memory outcome following left anterior temporal lobectomy (ATL). However, the functional integrity of the left temporal lobe, as exemplified by preoperative verbal memory performance, has also been associated with verbal memory outcome following surgery. We investigated the risk of verbal memory loss in patients with known structural abnormality (i.e., left mesial temporal sclerosis by MRI) and normal preoperative verbal memory performance who undergo left ATL. Seventeen patients with left temporal lobe epilepsy, MRI-based exclusive left MTS, and normal preoperative verbal memory were identified. Normal verbal memory was defined as performance on both Acquisition (learning across trials 1-5) and Retrieval (long delayed free recall) portions of the California Verbal Learning Test (CVLT) above a T score of 40 (>16%ile). Postoperative verbal memory outcome was established by incorporating standardized regression-based (SRB) change scores. Postoperative declines across both CVLT Retrieval T scores and Acquisition T scores (average 20% and average 15% declines from baseline scores, respectively) were measured for the group. The average CVLT Retrieval SRB change score was -2.5, and the average CVLT Acquisition SRB change score was -1.0. A larger proportion of patients demonstrated postoperative declines on Retrieval scores than Acquisition scores (64.7% vs 17.6%, respectively). Even in the presence of left MTS, patients exhibiting normal presurgical verbal memory are at risk for verbal memory declines following ATL. These results suggest that the functional integrity of the left mesial temporal lobe may play an important role in the verbal memory outcome in this patient group.

Objective Community Integration of Mental Health Consumers Living in Supported Housing and of Others in the Community

PubMed Central

Yanos, Philip T.; Stefancic, Ana; Tsemberis, Sam

2015-01-01

Objective Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Methods Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Results Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Conclusions Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration. PMID:22549530

The influence of culture of honor and emotional intelligence in the acculturation of Moroccan immigrant women.

PubMed

Lopez-Zafra, Esther; El Ghoudani, Karima

2014-01-01

Migration is a normal process of people seeking new opportunities, work, or leisure in societies. The way people adapt to a new country (acculturation) is a complex process in which immigrants' evaluations about the culture of origin and their perceptions of the host country interact. The combination of these two factors produces four types of acculturation: separation, assimilation, integration, and marginalization. Several variables, such as personality, attitudes, and emotional intelligence, have been studied to help explain this process. However, the impact of a culture of honor and its interaction with other variables remains an open question that may help to explain how migrants can better adjust to their host culture. In this study, we examine the influence of the culture of honor (social) and emotional intelligence (individual) on acculturation. In a sample of 129 Moroccan women (mean age = 29, SD = 9.40) immigrants in Spain (mean time in Spain = 6 years, SD = 3.60), we investigated the relations among the variables of interest. Our results show that no significant differences emerged in the scores given for culture of honor (CH) and the acculturation strategies of the Moroccan immigrant women F(3, 99) = .233; p = .87. However women who preferred the integration strategy scored highest on emotional intelligence (EI), whereas the assimilated immigrants showed the lowest scores for EI F(3, 92) = 4.63; p = .005. Additionally, only in the case of integration does EI mediate between CH and the value given to the immigrant's own and host cultures (p <.001).

Altered microstructural connectivity of the superior cerebellar peduncle is related to motor dysfunction in children with autistic spectrum disorders.

PubMed

Hanaie, Ryuzo; Mohri, Ikuko; Kagitani-Shimono, Kuriko; Tachibana, Masaya; Azuma, Junji; Matsuzaki, Junko; Watanabe, Yoshiyuki; Fujita, Norihiko; Taniike, Masako

2013-10-01

Many studies have reported motor impairments in autistic spectrum disorders (ASD). However, the brain mechanism underlying motor impairment in ASD remains unclear. Recent neuroimaging studies have suggested that underconnectivity between the cerebellum and other brain regions contributes to the features of ASD. In this study, we investigated the microstructural integrity of the cerebellar pathways, including the superior, middle, and inferior cerebellar peduncles, of children with and without ASD by using diffusion tensor imaging (DTI) tractography to determine whether the microstructural integrity of the cerebellar pathways is related to motor function in children with ASD. Thirteen children with ASD and 11 age-, gender-, handedness-, and IQ-matched typically developing (TD) controls were enrolled in this study. DTI outcome measurements, such as fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD), for the cerebellar pathways were calculated. The Movement Assessment Battery for Children 2 (M-ABC 2) was used for assessing motor functions. There were no significant differences between the two groups in RD. However, compared to the TD subjects, patients with ASD had a significantly lower FA in the right superior cerebellar peduncle and lower AD in the left superior cerebellar peduncle, in addition to a significantly lower score in ball skills and the total test score of M-ABC 2. There was a significant positive correlation between the total test score of M-ABC 2 and FA in the right superior cerebellar peduncle in the ASD group. These findings suggest that the altered microstructural integrity of the superior cerebellar peduncle may be related to motor impairment in ASD.

The person's conception of the structures of developing intellect: early adolescence to middle age.

PubMed

Demetriou, A; Efklides, A

1989-08-01

According to experiential structuralism, thought abilities have six capacity spheres: experimental, propositional, quantitative, imaginal, qualitative, and metacognitive. The first five are applied to the environment. The metacognitive capacity is applied to the others, serving as the interface between reality and the cognitive system or between any of the other capacities. To test this postulate, 648 subjects aged 12 to 40 years, solved eight tasks that were addressed, in pairs, to the first four capacity spheres. One of the tasks in each pair tapped the first and the other the third formal level of the sphere. Having solved the tasks, the subjects were required to rate each pair of tasks in terms of similarity of operations, difficulty, and success of solution. Factor analysis of difficulty and success evaluation scores revealed the same capacity-specific factors as the analysis of performance scores. Factor analysis of similarity scores differentiated between same- and different-sphere pairs. Analysis of variance showed that difficulty and success evaluation scores preserved performance differences between the first and the third formal tasks. Cognitive level, age, socioeconomic status, and sex were related to the metacognitive measures in ways similar to their relations to performance measures. These findings were integrated into a model aimed at capturing real-time metacognitive functioning.

Do large-scale assessments measure students' ability to integrate scientific knowledge?

NASA Astrophysics Data System (ADS)

Lee, Hee-Sun

2010-03-01

Large-scale assessments are used as means to diagnose the current status of student achievement in science and compare students across schools, states, and countries. For efficiency, multiple-choice items and dichotomously-scored open-ended items are pervasively used in large-scale assessments such as Trends in International Math and Science Study (TIMSS). This study investigated how well these items measure secondary school students' ability to integrate scientific knowledge. This study collected responses of 8400 students to 116 multiple-choice and 84 open-ended items and applied an Item Response Theory analysis based on the Rasch Partial Credit Model. Results indicate that most multiple-choice items and dichotomously-scored open-ended items can be used to determine whether students have normative ideas about science topics, but cannot measure whether students integrate multiple pieces of relevant science ideas. Only when the scoring rubric is redesigned to capture subtle nuances of student open-ended responses, open-ended items become a valid and reliable tool to assess students' knowledge integration ability.

A Pilot Randomized Controlled Trial of a Holistic Needs Assessment Questionnaire in a Supportive and Palliative Care Service.

PubMed

Ahmed, Nisar; Hughes, Philippa; Winslow, Michelle; Bath, Peter A; Collins, Karen; Noble, Bill

2015-11-01

At present, there is no widely used systematic evidence-based holistic approach to assessment of patients' supportive and palliative care needs. To determine whether the use of a holistic needs assessment questionnaire, Sheffield Profile for Assessment and Referral for Care (SPARC), will lead to improved health care outcomes for patients referred to a palliative care service. This was an open, pragmatic, randomized controlled trial. Patients (n = 182) referred to the palliative care service were randomized to receive SPARC at baseline (n = 87) or after a period of two weeks (waiting-list control n = 95). Primary outcome measure is the difference in score between Measure Yourself Concerns and Wellbeing (MYCAW) patient-nominated Concern 1 on the patient self-scoring visual analogue scale at baseline and the two-week follow-up. Secondary outcomes include difference in scores in the MYCAW, EuroQoL (EQ-5D), and Patient Enablement Instrument (PEI) scores at Weeks 2, 4, and 6. There was a significant association between change in MYCAW score and whether the patients were in the intervention or control group (χ(2)trend = 5.51; degrees of freedom = 1; P = 0.019). A higher proportion of patients in the control group had an improvement in MYCAW score from baseline to Week 2: control (34 of 70 [48.6%]) vs. intervention (19 of 66 [28.8%]). There were no significant differences (no detectable effect) between the control and intervention groups in the scores for EQ-5D and Patient Enablement Instrument at 2-, 4-, or 6-week follow-up. This trial result identifies a potential negative effect of SPARC in specialist palliative care services, raising questions that standardized holistic needs assessment questionnaires may be counterproductive if not integrated with a clinical assessment that informs the care plan. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Inter-Rater and Test-Retest Reliability of the Beery VMI in Schoolchildren

PubMed Central

Harvey, Erin M.; Leonard-Green, Tina K.; Mohan, Kathleen M.; Kulp, Marjean Taylor; Davis, Amy L.; Miller, Joseph M.; Twelker, J. Daniel; Campus, Irene; Dennis, Leslie K.

2017-01-01

Purpose To assess inter-rater and test-retest reliability of the 6th Edition Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI) and test-retest reliability of the VMI Visual Perception Supplemental Test (VMIp) in school-age children. Methods Subjects were 163 Native American 3rd – 8th grade students with no significant refractive error (astigmatism < 1.00 D, myopia: < 0.75 D, hyperopia: < 2.50 D, anisometropia < 1.50 D) or ocular abnormalities. The VMI and VMIp were administered twice, on separate days. All VMI tests were scored by two trained scorers and a subset of 50 tests were also scored by an experienced scorer. Scorers strictly applied objective scoring criteria. Analyses included inter-rater and test-retest assessments of bias, 95% limits of agreement, and intraclass correlation analysis. Results Trained scorers had no significant scoring bias compared to the experienced scorer. One of the two trained scorers tended to provide higher scores than the other (mean difference in standardized scores = 1.54). Inter-rater correlations were strong (0.75 to 0.88). VMI and VMIp test-retest comparisons indicated no significant bias (subjects did not tend to score better on retest). Test-retest correlations were moderate (0.54 to 0.58). The 95% LOAs for the VMI were −24.14 to 24.67 (scorer 1) and −26.06 to 26.58 (scorer 2) and the 95% LOAs for the VMIp were −27.11 to 27.34. Conclusions The 95% LOA for test-retest differences will be useful for determining if the VMI and VMIp have sufficient sensitivity for detecting change with treatment in both clinical and research settings. Further research on test-retest reliability reporting 95% LOAs for children across different age ranges are recommended, particularly if the test is to be used to detect changes due to intervention or treatment. PMID:28422801

The effects of police contact on trajectories of violence: a group-based, propensity score matching analysis.

PubMed

Ward, Jeffrey T; Krohn, Marvin D; Gibson, Chris L

2014-02-01

This study uses a life course framework to investigate how police contacts may serve as a potential turning point in a violent crime trajectory. Drawing on the central ideas from deterrence and labeling theories, we determine whether individuals on different violent offending trajectories increase or decrease their offending following a police contact. Analyzing nine waves of data from the Rochester Youth Development Study, an integrated propensity score matching and latent class growth model was used. First, three violent trajectory groups emerged including high offenders, non-offenders, and low offenders. Second, after accounting for selection bias using propensity score matching procedures, experiencing a police contact increased the likelihood of future violent offending for the entire sample and for those who were on a low violent-offending trajectory specifically. These findings are interpreted as partial support for labeling theory. Limitations of the study and directions for future research are discussed.

On-road driving impairments and associated cognitive deficits after stroke.

PubMed

Devos, Hannes; Tant, Mark; Akinwuntan, Abiodun E

2014-01-01

Little is known about the critical on-road driving skills that get affected after a stroke. The purpose of this study was to investigate the key on-road driving impairments and their associated cognitive deficits after a stroke. A second aim was to investigate if lateralization of stroke impacts results of the cognitive and on-road driving tests. In this cross-sectional study, 99 participants with a first-ever stroke who were actively driving prior to stroke underwent a cognitive battery and a standardized road test that evaluated 13 specific on-road driving skills. These on-road driving skills were mapped onto an existing, theoretical framework that categorized the on-road items into hierarchic clusters of operational, tactical, visuo-integrative, and mixed driving skills. The total score on the road test and the on-road decision, made by a certified fitness-to-drive expert, decided the main outcome. The critical on-road driving skills predicting the on-road decision were identified using logistic regression analysis. Linear regression analysis was employed to determine the cognitive impairments leading to poor total on-road scores. Analyses were repeated for right- and left-sided strokes. In all, 37 persons scored poorly on the road test. These participants performed worse in all hierarchic clusters of on-road driving. Performances on the operational cluster and the visuo-integrative cluster best predicted on-road decisions (R(2) = 0.60). 'Lane changing' and 'understanding, insight, and quality of traffic participation' were the critical skill deficits leading to poor performance on the road test (R(2) = 0.65). Divided attention was the main determinant of on-road scores in the total group (R(2) = 0.06). Participants with right-sided stroke performed worse on visual field, visual neglect, visual scanning, visuo-constructive skills, and divided attention compared with those with left-sided stroke. Divided attention was the main determinant of total on-road scores in the right-sided stroke group (R(2) = 0.10). A combination of visual scanning, speed of processing, and executive dysfunction yielded the best model to predict on-road scores in left-sided strokes (R(2) = 0.46). Poor performance in the road test after stroke is determined by critical operational and visuo-integrative driving impairments. Specific and different driving evaluation and training programs are needed for right- and left-sided strokes. © 2014 S. Karger AG, Basel.

Computerization of Mental Health Integration Complexity Scores at Intermountain Healthcare

PubMed Central

Oniki, Thomas A.; Rodrigues, Drayton; Rahman, Noman; Patur, Saritha; Briot, Pascal; Taylor, David P.; Wilcox, Adam B.; Reiss-Brennan, Brenda; Cannon, Wayne H.

2014-01-01

Intermountain Healthcare’s Mental Health Integration (MHI) Care Process Model (CPM) contains formal scoring criteria for assessing a patient’s mental health complexity as “mild,” “medium,” or “high” based on patient data. The complexity score attempts to assist Primary Care Physicians in assessing the mental health needs of their patients and what resources will need to be brought to bear. We describe an effort to computerize the scoring. Informatics and MHI personnel collaboratively and iteratively refined the criteria to make them adequately explicit and reflective of MHI objectives. When tested on retrospective data of 540 patients, the clinician agreed with the computer’s conclusion in 52.8% of the cases (285/540). We considered the analysis sufficiently successful to begin piloting the computerized score in prospective clinical care. So far in the pilot, clinicians have agreed with the computer in 70.6% of the cases (24/34). PMID:25954401

The effect of a senior jazz dance class on static balance in healthy women over 50 years of age: a pilot study.

PubMed

Wallmann, Harvey W; Gillis, Carrie B; Alpert, Patricia T; Miller, Sally K

2009-01-01

The purpose of this pilot study is to assess the impact of a senior jazz dance class on static balance for healthy women over 50 years of age using the NeuroCom Smart Balance Master System (Balance Master). A total of 12 healthy women aged 54-88 years completed a 15-week jazz dance class which they attended 1 time per week for 90 min per class. Balance data were collected using the Sensory Organization Test (SOT) at baseline (pre), at 7 weeks (mid), and after 15 weeks (post). An equilibrium score measuring postural sway was calculated for each of six different conditions. The composite equilibrium score (all six conditions integrated to 1 score) was used as an overall measure of balance. Repeated measures analyses of variance (ANOVAs) were used to compare the means of each participant's SOT composite equilibrium score in addition to the equilibrium score for each individual condition (1-6) across the 3 time points (pre, mid, post). There was a statistically significant difference among the means, p < .0005. Pairwise (Bonferroni) post hoc analyses revealed the following statistically significant findings for SOT composite equilibrium scores for the pre (67.33 + 10.43), mid (75.25 + 6.97), and post (79.00 + 4.97) measurements: premid (p = .008); prepost (p < .0005); midpost (p = .033). In addition, correlational statistics were used to determine any relationship between SOT scores and age. Results indicated that administration of a 15-week jazz dance class 1 time per week was beneficial in improving static balance as measured by the Balance Master SOT.

A Longitudinal Analysis of the Influence of a Peer Run Warm Line Phone Service on Psychiatric Recovery.

PubMed

Dalgin, Rebecca Spirito; Dalgin, M Halim; Metzger, Scott J

2018-05-01

This article focuses on the impact of a peer run warm line as part of the psychiatric recovery process. It utilized data including the Recovery Assessment Scale, community integration measures and crisis service usage. Longitudinal statistical analysis was completed on 48 sets of data from 2011, 2012, and 2013. Although no statistically significant differences were observed for the RAS score, community integration data showed increases in visits to primary care doctors, leisure/recreation activities and socialization with others. This study highlights the complexity of psychiatric recovery and that nonclinical peer services like peer run warm lines may be critical to the process.

Comparative analysis based on factor analysis of integrate production capacity of foodstuff in main foodstuff provinces

NASA Astrophysics Data System (ADS)

Zhang, Dehua; Zhou, Huiqiu

2011-10-01

Under great background of financial crisis, large fluctuation on international foodstuff price and frequent happening of natural disasters, each nation attaches importance to foodstuff safety problem increasingly. As a Great Power of population, China pays more attention to foodstuff safety problem definitely. Large foodstuff provinces play a major role on ensuring it. The paper arrives at the conclusion that each province has advantages and disadvantages in different factors through factor analyses on influencing factors of integrated production capacity of foodstuff in each province. Then we arrange the factor score, analyze the result of each large foodstuff province and ultimately give out feasible suggestions.

Automated essay scoring and the future of educational assessment in medical education.

PubMed

Gierl, Mark J; Latifi, Syed; Lai, Hollis; Boulais, André-Philippe; De Champlain, André

2014-10-01

Constructed-response tasks, which range from short-answer tests to essay questions, are included in assessments of medical knowledge because they allow educators to measure students' ability to think, reason, solve complex problems, communicate and collaborate through their use of writing. However, constructed-response tasks are also costly to administer and challenging to score because they rely on human raters. One alternative to the manual scoring process is to integrate computer technology with writing assessment. The process of scoring written responses using computer programs is known as 'automated essay scoring' (AES). An AES system uses a computer program that builds a scoring model by extracting linguistic features from a constructed-response prompt that has been pre-scored by human raters and then, using machine learning algorithms, maps the linguistic features to the human scores so that the computer can be used to classify (i.e. score or grade) the responses of a new group of students. The accuracy of the score classification can be evaluated using different measures of agreement. Automated essay scoring provides a method for scoring constructed-response tests that complements the current use of selected-response testing in medical education. The method can serve medical educators by providing the summative scores required for high-stakes testing. It can also serve medical students by providing them with detailed feedback as part of a formative assessment process. Automated essay scoring systems yield scores that consistently agree with those of human raters at a level as high, if not higher, as the level of agreement among human raters themselves. The system offers medical educators many benefits for scoring constructed-response tasks, such as improving the consistency of scoring, reducing the time required for scoring and reporting, minimising the costs of scoring, and providing students with immediate feedback on constructed-response tasks. © 2014 John Wiley & Sons Ltd.

Integration of intracardiac echocardiography and computed tomography during atrial fibrillation ablation: Combining ultrasound contours obtained from the right atrium and ventricular outflow tract.

PubMed

Nakamura, Kohki; Naito, Shigeto; Kaseno, Kenichi; Nakatani, Yosuke; Sasaki, Takehito; Anjo, Naofumi; Yamashita, Eiji; Kumagai, Koji; Funabashi, Nobusada; Kobayashi, Yoshio; Oshima, Shigeru

2017-02-01

We aimed to optimize the acquisition of the left atrial (LA) and pulmonary vein (PV) ultrasound contours for more accurate integration of intracardiac echocardiography (ICE) and computed tomography (CT) using the CARTO ® 3 system during atrial fibrillation (AF) ablation. Eighty-five AF patients underwent integration of ICE and CT using (1) the LA roof and posterior wall contours acquired from the right atrium (RA), (2) all LA/PV contours from the RA (Whole-RA-integration), (3) the LA roof/posterior wall contours from the RA and right ventricular outflow tract (RVOT) (Posterior-RA/RV-integration), and (4) all LA/PV contours from the RA and RVOT (Whole-RA/RV-integration). The integration accuracy was compared using the (1) surface registration error, (2) distances between the three-dimensional CT and eight specific sites on the anterior, posterior, superior, and inferior aspects of the right and left circumferential PV isolation lines, and (3) registration score: a score of 0 or 1 was assigned for whether or not each specific site was visually aligned with the CT, and summed for each method (0 best, 8 worst). Posterior-RA/RV-integration revealed a significantly lower surface registration error (1.30±0.15mm) than Whole-RA- and Whole-RA/RV-integration (p<0.001). The mean distances of the eight specific sites and the registration score for Posterior-RA/RV-integration (median 1.26mm and 2, respectively) were significantly smaller than those for the other integration approaches (p<0.001). Image integration with the LA roof and posterior wall contours acquired from the RA and RVOT may provide greater accuracy for catheter navigation with three-dimensional CT during AF ablation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Quality of Methods Reporting in Parasitology Experiments

PubMed Central

Flórez-Vargas, Oscar; Bramhall, Michael; Noyes, Harry; Cruickshank, Sheena; Stevens, Robert; Brass, Andy

2014-01-01

There is a growing concern both inside and outside the scientific community over the lack of reproducibility of experiments. The depth and detail of reported methods are critical to the reproducibility of findings, but also for making it possible to compare and integrate data from different studies. In this study, we evaluated in detail the methods reporting in a comprehensive set of trypanosomiasis experiments that should enable valid reproduction, integration and comparison of research findings. We evaluated a subset of other parasitic (Leishmania, Toxoplasma, Plasmodium, Trichuris and Schistosoma) and non-parasitic (Mycobacterium) experimental infections in order to compare the quality of method reporting more generally. A systematic review using PubMed (2000–2012) of all publications describing gene expression in cells and animals infected with Trypanosoma spp was undertaken based on PRISMA guidelines; 23 papers were identified and included. We defined a checklist of essential parameters that should be reported and have scored the number of those parameters that are reported for each publication. Bibliometric parameters (impact factor, citations and h-index) were used to look for association between Journal and Author status and the quality of method reporting. Trichuriasis experiments achieved the highest scores and included the only paper to score 100% in all criteria. The mean of scores achieved by Trypanosoma articles through the checklist was 65.5% (range 32–90%). Bibliometric parameters were not correlated with the quality of method reporting (Spearman's rank correlation coefficient <−0.5; p>0.05). Our results indicate that the quality of methods reporting in experimental parasitology is a cause for concern and it has not improved over time, despite there being evidence that most of the assessed parameters do influence the results. We propose that our set of parameters be used as guidelines to improve the quality of the reporting of experimental infection models as a pre-requisite for integrating and comparing sets of data. PMID:25076044

The quality of methods reporting in parasitology experiments.

PubMed

Flórez-Vargas, Oscar; Bramhall, Michael; Noyes, Harry; Cruickshank, Sheena; Stevens, Robert; Brass, Andy

2014-01-01

There is a growing concern both inside and outside the scientific community over the lack of reproducibility of experiments. The depth and detail of reported methods are critical to the reproducibility of findings, but also for making it possible to compare and integrate data from different studies. In this study, we evaluated in detail the methods reporting in a comprehensive set of trypanosomiasis experiments that should enable valid reproduction, integration and comparison of research findings. We evaluated a subset of other parasitic (Leishmania, Toxoplasma, Plasmodium, Trichuris and Schistosoma) and non-parasitic (Mycobacterium) experimental infections in order to compare the quality of method reporting more generally. A systematic review using PubMed (2000-2012) of all publications describing gene expression in cells and animals infected with Trypanosoma spp was undertaken based on PRISMA guidelines; 23 papers were identified and included. We defined a checklist of essential parameters that should be reported and have scored the number of those parameters that are reported for each publication. Bibliometric parameters (impact factor, citations and h-index) were used to look for association between Journal and Author status and the quality of method reporting. Trichuriasis experiments achieved the highest scores and included the only paper to score 100% in all criteria. The mean of scores achieved by Trypanosoma articles through the checklist was 65.5% (range 32-90%). Bibliometric parameters were not correlated with the quality of method reporting (Spearman's rank correlation coefficient <-0.5; p>0.05). Our results indicate that the quality of methods reporting in experimental parasitology is a cause for concern and it has not improved over time, despite there being evidence that most of the assessed parameters do influence the results. We propose that our set of parameters be used as guidelines to improve the quality of the reporting of experimental infection models as a pre-requisite for integrating and comparing sets of data.

Comparison of integrated testlet and constructed-response question formats

NASA Astrophysics Data System (ADS)

Slepkov, Aaron D.; Shiell, Ralph C.

2014-12-01

Constructed-response (CR) questions are a mainstay of introductory physics textbooks and exams. However, because of the time, cost, and scoring reliability constraints associated with this format, CR questions are being increasingly replaced by multiple-choice (MC) questions in formal exams. The integrated testlet (IT) is a recently developed question structure designed to provide a proxy of the pedagogical advantages of CR questions while procedurally functioning as set of MC questions. ITs utilize an answer-until-correct response format that provides immediate confirmatory or corrective feedback, and they thus allow not only for the granting of partial credit in cases of initially incorrect reasoning, but, furthermore, the ability to build cumulative question structures. Here, we report on a study that directly compares the functionality of ITs and CR questions in introductory physics exams. To do this, CR questions were converted to concept-equivalent ITs, and both sets of questions were deployed in midterm and final exams. We find that both question types provide adequate discrimination between stronger and weaker students, with CR questions discriminating slightly better than the ITs. There is some indication that any difference in discriminatory power may result from the baseline score for guessing that is inherent in MC testing. Meanwhile, an analysis of interrater scoring of the CR questions raises serious concerns about the reliability of the granting of partial credit when this traditional assessment technique is used in a realistic (but nonoptimized) setting. Furthermore, we show evidence that partial credit is granted in a valid manner in the ITs. Thus, together with consideration of the vastly reduced costs of administering IT-based examinations compared to CR-based examinations, our findings indicate that ITs are viable replacements for CR questions in formal examinations where it is desirable both to assess concept integration and to reward partial knowledge, while efficiently scoring examinations.

A comparative evaluation of five hazard screening tools.

PubMed

Panko, J M; Hitchcock, K; Fung, M; Spencer, P J; Kingsbury, T; Mason, A M

2017-01-01

An increasing number of hazard assessment tools and approaches are being used in the marketplace as a means to differentiate products and ingredients with lower versus higher hazards or to certify what some call greener chemical ingredients in consumer products. Some leading retailers have established policies for product manufacturers and their suppliers to disclose chemical ingredients and their related hazard characteristics often specifying what tools to use. To date, no data exists that show a tool's reliability to provide consistent, credible screening-level hazard scores that can inform greener product selection. We conducted a small pilot study to understand and compare the hazard scoring of several hazard screening tools to determine if hazard and toxicity profiles for chemicals differ. Seven chemicals were selected that represent both natural and man-made chemistries as well as a range of toxicological activity. We conducted the assessments according to each tool provider's guidelines, which included factors such as endpoints, weighting preferences, sources of information, and treatment of data gaps. The results indicate the tools varied in the level of discrimination seen in the scores for these 7 chemicals and that tool classifications of the same chemical varied widely between the tools, ranging from little or no hazard or toxicity to very high hazard or toxicity. The results also highlight the need for transparency in describing the basis for the tool's hazard scores and suggest possible enhancements. Based on this pilot study, tools should not be generalized to fit all situations because their evaluations are context-specific. Before choosing a tool or approach, it is critical that the assessment rationale be clearly defined and matches the selected tool or approach. Integr Environ Assess Manag 2017;13:139-154. © 2016 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of SETAC. © 2016 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of SETAC.

The Somatic Marker Hypothesis and Sexual Decision Making: Understanding the Role of Iowa Gambling Task Performance and Daily Sexual Arousal on the Sexual Behavior of Gay and Bisexual Men.

PubMed

Rendina, H Jonathon; Millar, Brett M; Dash, Genevieve; Feldstein Ewing, Sarah W; Parsons, Jeffrey T

2018-04-19

The sexual decision-making literature suggests that sexual arousal and behavior are associated. The somatic marker hypothesis suggests that individual neuropsychological differences in decision making, as measured by the Iowa Gambling Task (IGT), may moderate these associations; however, this hypothesis has yet to be tested with event-level sexual behavior data. We hypothesized that (a) daily sexual arousal would be positively associated with likelihood of engaging in sex and condomless anal sex (CAS) and (b) IGT scores would moderate these associations such that the associations would be stronger among those with higher IGT scores. We used daily diary data from 334 highly sexually active gay and bisexual men to examine the main and interaction effects of sexual arousal and IGT scores on sexual engagement and CAS. As hypothesized, daily sexual arousal was positively associated with greater odds of both sexual engagement and CAS with casual male partners. Individual-level IGT performance significantly moderated the day-level association between arousal and sexual engagement, which was stronger for men with higher IGT scores. There was no main effect of IGT scores on either sexual behavior outcome, nor did it moderate the association between arousal and CAS. These findings highlight the influence of sexual arousal on sexual engagement, which differed by IGT scores; the effect of arousal on CAS was much less variable and may not be moderated by neurocognitive factors. This study supports the importance of exploring integrated behavioral/biomedical interventions to improve individual decision making to prevent HIV infection.

Comparison and integration of deleteriousness prediction methods for nonsynonymous SNVs in whole exome sequencing studies

PubMed Central

Dong, Chengliang; Wei, Peng; Jian, Xueqiu; Gibbs, Richard; Boerwinkle, Eric; Wang, Kai; Liu, Xiaoming

2015-01-01

Accurate deleteriousness prediction for nonsynonymous variants is crucial for distinguishing pathogenic mutations from background polymorphisms in whole exome sequencing (WES) studies. Although many deleteriousness prediction methods have been developed, their prediction results are sometimes inconsistent with each other and their relative merits are still unclear in practical applications. To address these issues, we comprehensively evaluated the predictive performance of 18 current deleteriousness-scoring methods, including 11 function prediction scores (PolyPhen-2, SIFT, MutationTaster, Mutation Assessor, FATHMM, LRT, PANTHER, PhD-SNP, SNAP, SNPs&GO and MutPred), 3 conservation scores (GERP++, SiPhy and PhyloP) and 4 ensemble scores (CADD, PON-P, KGGSeq and CONDEL). We found that FATHMM and KGGSeq had the highest discriminative power among independent scores and ensemble scores, respectively. Moreover, to ensure unbiased performance evaluation of these prediction scores, we manually collected three distinct testing datasets, on which no current prediction scores were tuned. In addition, we developed two new ensemble scores that integrate nine independent scores and allele frequency. Our scores achieved the highest discriminative power compared with all the deleteriousness prediction scores tested and showed low false-positive prediction rate for benign yet rare nonsynonymous variants, which demonstrated the value of combining information from multiple orthologous approaches. Finally, to facilitate variant prioritization in WES studies, we have pre-computed our ensemble scores for 87 347 044 possible variants in the whole-exome and made them publicly available through the ANNOVAR software and the dbNSFP database. PMID:25552646

Incontinence after primary repair of obstetric anal sphincter tears is related to relative length of reconstructed external sphincter: a case-control study.

PubMed

Norderval, S; Røssaak, K; Markskog, A; Vonen, B

2012-08-01

To determine if anatomic primary repair with end-to-end reconstruction of the external anal sphincter (EAS) in its full length combined with separate repair of coexisting internal anal sphincter (IAS) tear, when present, results in less incontinence and better anal sphincter integrity compared with conventional primary end-to-end repair in which the IAS is not actively reconstructed. Women who sustained third- or fourth-degree obstetric tears were included prospectively in the study following anatomic primary repair. Women treated with conventional primary repair prior to the study period comprised the control group. Three-dimensional endoanal ultrasonography (3D-EAUS) images were classified according to the EAUS defect score, and incontinence according to St Mark's score. Sixty-three women were included in the study group and 61 in the control group, with mean follow-up times of 11 and 21 months, respectively. Among women who had not delivered vaginally prior to the tear, St Mark's score ≥ 3 was reported by 9.6% (5/52) in the study group and 37.5% (15/40) in the control group at follow-up (P = 0.002). The corresponding numbers among women who had previously delivered vaginally were 36.4% (4/11) and 42.9% (9/21), respectively (non-significant). St Mark's score correlated with the EAUS defect score (P = 0.017). An EAS defect exceeding 50% of the sphincter length was significantly less common in the study group, and in a multivariable logistic regression model, mode of repair (anatomic vs conventional) was the only factor explaining the difference in EAS sphincter length between the two groups (P = 0.007). Improved continence status after anatomic primary repair was associated with a better longitudinal reconstruction of the EAS, while the integrity of the IAS did not differ between the groups. Women with a history of vaginal delivery prior to the sphincter tear had an inferior outcome regardless of mode of repair. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Genetic Study of White Matter Integrity in UK Biobank (N=8448) and the Overlap With Stroke, Depression, and Dementia.

PubMed

Rutten-Jacobs, Loes C A; Tozer, Daniel J; Duering, Marco; Malik, Rainer; Dichgans, Martin; Markus, Hugh S; Traylor, Matthew

2018-06-01

Structural integrity of the white matter is a marker of cerebral small vessel disease, which is the major cause of vascular dementia and a quarter of all strokes. Genetic studies provide a way to obtain novel insights in the disease mechanism underlying cerebral small vessel disease. The aim was to identify common variants associated with microstructural integrity of the white matter and to elucidate the relationships of white matter structural integrity with stroke, major depressive disorder, and Alzheimer disease. This genome-wide association analysis included 8448 individuals from UK Biobank-a population-based cohort study that recruited individuals from across the United Kingdom between 2006 and 2010, aged 40 to 69 years. Microstructural integrity was measured as fractional anisotropy- (FA) and mean diffusivity (MD)-derived parameters on diffusion tensor images. White matter hyperintensity volumes (WMHV) were assessed on T2-weighted fluid-attenuated inversion recovery images. We identified 1 novel locus at genome-wide significance ( VCAN [versican]: rs13164785; P =3.7×10 -18 for MD and rs67827860; P =1.3×10 -14 for FA). LD score regression showed a significant genome-wide correlation between FA, MD, and WMHV (FA-WMHV rG 0.39 [SE, 0.15]; MD-WMHV rG 0.56 [SE, 0.19]). In polygenic risk score analysis, FA, MD, and WMHV were significantly associated with lacunar stroke, MD with major depressive disorder, and WMHV with Alzheimer disease. Genetic variants within the VCAN gene may play a role in the mechanisms underlying microstructural integrity of the white matter in the brain measured as FA and MD. Mechanisms underlying white matter alterations are shared with cerebrovascular disease, and inherited differences in white matter microstructure impact on Alzheimer disease and major depressive disorder. © 2018 The Authors.

The effect of an integrated high school science curriculum on student achievement, knowledge retention, and science attitudes

NASA Astrophysics Data System (ADS)

Smith, Kimberly A.

The research study investigates the effectiveness of an integrated high school science curriculum on student achievement, knowledge retention and science attitudes using quantitative and qualitative research. Data was collected from tenth grade students, in a small urban high school in Kansas City, Missouri, who were enrolled in a traditional Biology course or an integrated Environmental Science course. Quantitative data was collected in Phase 1 of the study. Data collected for academic achievement included pretest and posttest scores on the CTBS MATN exam. Data collected for knowledge retention included post-posttest scores on the CTBS MATN exam. Data collected for science attitudes were scores on a pretest and posttest using the TOSRA. SPSS was used to analyze the data using independent samples t-tests, one-way ANCOVA's and paired samples statistics. Qualitative data was collected in Phase 2 of the study. Data included responses to open-ended interview questions using three focus groups. Data was analyzed for common themes. Data analysis revealed the integrated Environmental Science course had a statistically significant impact on academic achievement, knowledge retention and positive science attitudes. Gender and socioeconomic status did not influence results. The study also determined that the CTBS MATN exam was not an accurate predictor of scores on state testing as was previously thought.

Functional Improvement in Geriatric Hip Fractures: Does Vitamin D Deficiency Affect the Functional Outcome of Patients With Surgically Treated Intertrochanteric Hip Fractures.

PubMed

Seng, W R D; Belani, M H; Ramason, R; Naidu, G; Doshi, H K

2015-09-01

The "Integrated Care Pathway" for geriatric intertrochanteric (IT) fractures in Singapore's Tan Tock Seng Hospital has shown significant functional recovery in patients' activities of daily living. However, the influence of preoperative vitamin D on functional recovery remains equivocal. This retrospective study therefore aims to determine whether patients with preoperative vitamin D deficiency have poorer functional outcomes. A total of 171 patients who had surgical treatment for IT fractures were recruited in the study. They were categorized into group A (vitamin D deficient) and group B (normal vitamin D). Charlson Comorbidity Index (CCI) score and nutritional parameters including hemoglobin, albumin, and adjusted calcium levels on admission were recorded. The Modified Barthel Index (MBI) score was used to measure functional recovery at the following time intervals: at pre-fall, at discharge after surgery, at 6 months, and at 1-year follow-up. The mean age of both the groups (A: 79.7 years, n = 45; B: 83.0 years, n = 126) was statistically different (P < .05). However, the mean CCI (A: 9.42 and B: 10.13), hemoglobin (A: 12.4 and B 11.1), adjusted calcium (A: 2.39 and B: 2.38), and mean albumin (A: 33.6 and B: 33.0) of the groups were not significantly different. Furthermore, the MBI scores were not significantly different for both groups at preinjury (A: 91.5 and B: 89.4), at discharge (A: 55.2 and B: 58.9), at 6 months (A: 70.9 and B: 75.1), and at 1 year (A: 75.8 and B: 79.4). In our cohort, patients with vitamin D deficiency were younger. However, vitamin D deficiency at time of injury had no significant influence on functional recovery in patients with surgically treated hip fracture in our Integrated Care Pathway. In addition, patients who had a normal vitamin D levels had similar functional scores and improvement postoperatively and at 1 year (A: 82.8% and B: 88.9%).

Arthroscopic repair of massive contracted rotator cuff tears: aggressive release with anterior and posterior interval slides do not improve cuff healing and integrity.

PubMed

Kim, Sung-Jae; Kim, Sung-Hwan; Lee, Su-Keon; Seo, Jae-Wan; Chun, Yong-Min

2013-08-21

Few studies of large-to-massive contracted rotator cuff tears have examined the arthroscopic complete repair obtained by a posterior interval slide and whether the clinical outcomes or structural integrity achieved are better than those after partial repair without the posterior interval slide. The study included forty-one patients with large-to-massive contracted rotator cuff tears, not amenable to complete repair with margin convergence alone. The patients underwent either arthroscopic complete repair with a posterior interval slide and side-to-side repair of the interval slide edge (twenty-two patients; Group P) or partial repair with margin convergence (nineteen patients; Group M). The patient assignment was not randomized. The Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder score, and range of motion were used to compare the functional outcomes. Preoperative and six-month postoperative magnetic resonance arthrography (MRA) images were compared within or between groups. At the two-year follow-up evaluation, the SST, ASES score, UCLA score, and range of motion had significantly improved (p < 0.001 for all) in both groups. However, no significant differences were detected between groups. Even though the difference in preoperative tear size on MRA images was not significant, follow-up MRA images identified a retear in twenty patients (91%) in Group P and a significant difference in tear size between groups (p = 0.007). The complete repair group with an aggressive release had no better clinical or structural outcomes compared with the partial repair group with margin convergence alone for large-to-massive contracted rotator cuff tears. In addition, the complete repair group had a 91% retear rate and a greater defect on follow-up MRA images. Even though this study had a relatively short-term follow-up, a complete repair of large-to-massive contracted rotator cuff tears, with an aggressive release such as posterior interval slide, may not have an increased benefit compared with partial repair without posterior interval slide.

[Argentine norms for the 16 PF test taken by subjects 17 to 20 years old].

PubMed

Rodríquez Feijoo, N

1981-07-01

This test was administered to a sample of 314 17 years old Argentine subjects (157 boy and 157 girls), and to another sample of 240 Argentine subjects, consisting of 127 boys and 113 girls of 20 years of age. Means, standard deviations and percentile ranks for both samples were obtained. To compare groups of different sex and age test of significance for mean differences of independent samples were applied. Boys obtained scores significantly higher than girls, without taking into consideration the age, in Factors C (lower ego strength-higher ego strength), E (submissiveness-dominance), H (threctia-parmia), Q1 (conservativism of temperament-radicalism) and Q3 (low self-sentiment integration - high strength of self sentiment). Contrarywise, girl showed scores significantly higher than boys of the same age in factors I (harria-premsia), N (artlessness-shrewdness), O (untroubled adequacy-guilt proneness) and Q4 (low ergic tension-high ergic tension).

BIOREL: the benchmark resource to estimate the relevance of the gene networks.

PubMed

Antonov, Alexey V; Mewes, Hans W

2006-02-06

The progress of high-throughput methodologies in functional genomics has lead to the development of statistical procedures to infer gene networks from various types of high-throughput data. However, due to the lack of common standards, the biological significance of the results of the different studies is hard to compare. To overcome this problem we propose a benchmark procedure and have developed a web resource (BIOREL), which is useful for estimating the biological relevance of any genetic network by integrating different sources of biological information. The associations of each gene from the network are classified as biologically relevant or not. The proportion of genes in the network classified as "relevant" is used as the overall network relevance score. Employing synthetic data we demonstrated that such a score ranks the networks fairly in respect to the relevance level. Using BIOREL as the benchmark resource we compared the quality of experimental and theoretically predicted protein interaction data.

Trauma Exposure, PTSD, and HIV Sexual Risk Behaviors among Labor Migrants from Tajikistan

PubMed Central

Weine, Stevan; Bahromov, Mahbat; Loue, Sana; Owens, Linda

2012-01-01

Little is known about the role of trauma and PTSD symptoms in the context of migration-associated HIV risk behaviors. A survey of Tajik married male seasonal labor migrants in Moscow was completed by 200 workers from 4 bazaars and 200 workers from 18 construction sites as part of a mixed method (quantitative and qualitative) study. The mean PC-PTSD score was 1.2 with one-quarter of migrants scoring at or above the cutoff of 3 indicating likely PTSD diagnosis. PC-PTSD score was directly correlated with both direct and indirect trauma exposure, but PC-PTSD score did not predict either HIV sexual risk behaviors or HIV protective behaviors. HIV sexual risk behavior was associated with higher indirect trauma exposure. PC-PTSD score was associated with some indicators of increased caution (e.g. more talking with partners about HIV and condoms; more use of condom when drinking). Qualitative findings were used to illustrate the differences between direct and indirect traumas in terms of HIV sexual risk. The study findings call for future efforts to address labor migrant's mental health needs and to integrate trauma dimensions into HIV prevention. PMID:22261829

Trauma exposure, PTSD, and HIV sexual risk behaviors among labor migrants from Tajikistan.

PubMed

Weine, Stevan; Bahromov, Mahbat; Loue, Sana; Owens, Linda

2012-08-01

Little is known about the role of trauma and PTSD symptoms in the context of migration-associated HIV risk behaviors. A survey of Tajik married male seasonal labor migrants in Moscow was completed by 200 workers from 4 bazaars and 200 workers from 18 construction sites as part of a mixed method (quantitative and qualitative) study. The mean PC-PTSD score was 1.2 with one-quarter of migrants scoring at or above the cutoff of 3 indicating likely PTSD diagnosis. PC-PTSD score was directly correlated with both direct and indirect trauma exposure, but PC-PTSD score did not predict either HIV sexual risk behaviors or HIV protective behaviors. HIV sexual risk behavior was associated with higher indirect trauma exposure. PC-PTSD score was associated with some indicators of increased caution (e.g., more talking with partners about HIV and condoms; more use of condom when drinking). Qualitative findings were used to illustrate the differences between direct and indirect traumas in terms of HIV sexual risk. The study findings call for future efforts to address labor migrant's mental health needs and to integrate trauma dimensions into HIV prevention.

An index of ecological integrity for the Mississippi alluvial plain ecoregion: index development and relations to selected landscape variables

USGS Publications Warehouse

Justus, B.G.

2003-01-01

Macroinvertebrate community, fish community, water-quality, and habitat data collected from 36 sites in the Mississippi Alluvial Plain Ecoregion during 1996-98 by the U.S. Geological Survey were considered for a multimetric test of ecological integrity. Test metrics were correlated to site scores of a Detrended Correspondence Analysis of the fish community (the biological community that was the most statistically significant for indicating ecological conditions in the ecoregion) and six metrics--four fish metrics, one chemical metric (total ammonia plus organic nitrogen) and one physical metric (turbidity)--having the highest correlations were selected for the index. Index results indicate that sites in the northern half of the study unit (in Arkansas and Missouri) were less degraded than sites in the southern half of the study unit (in Louisiana and Mississippi). Of 148 landscape variables evaluated, the percentage of Holocene deposits and cotton insecticide rates had the highest correlations to index of ecological integrity results. sites having the highest (best) index scores had the lowest percentages of Holocene deposits and the lowest cotton insecticide use rates, indicating that factors relating to the amount of Holocene deposits and cotton insecticide use rates partially explain differences in ecological conditions throughout the Mississippi Alluvial Plain Ecoregion.

Clinical, Echocardiographic, and Electrocardiographic Predictors of Persistent Atrial Fibrillation after Dual-Chamber Pacemaker Implantation: An Integrated Scoring Model Approach.

PubMed

Cho, Min Soo; Kim, Jun; Kim, Ju Hyeon; Kim, Minsu; Lee, Ji Hyun; Hwang, You Mi; Jo, Uk; Nam, Gi-Byoung; Choi, Kee-Joon; Kim, You-Ho

2016-01-01

Persistent atrial fibrillation (PeAF) predictors after dual-chamber pacemaker (PM) implantation remain unclear. We sought to determine these predictors and establish an integrated scoring model. Data were retrospectively reviewed for 649 patients (63.8 ± 12.3 years, 48.6% male, mean CHA2DS2-VASC score 2.7 ± 2.0) undergoing dual-chamber PM implantation. PeAF was defined as documented AF on two consecutive electrocardiograms acquired ≥7 days apart. During a 7.1-year median follow-up (interquartile range 4.5-10.1 years), 67 (10.3%) patients had PeAF. Multivariable analysis showed the following independent predictors of future PeAF: ischemic stroke or transient ischemic accident history (hazard ratio [HR] 2.03, 95% confidence interval [CI] 1.03-3.50, p = 0.040), atrial fibrillation/flutter history (HR 1.80, 95% CI 1.01-3.20, p = 0.046), sinus node disease (HR 2.24, 95% CI 1.16-4.35, p = 0.016), left atrial enlargement (>45 mm, HR 2.14, 95% CI 1.26-3.63, p = 0.005), and time in automatic mode switching >1% at first follow-up interrogation (HR 2.58, 95% CI 1.51-4.42, p < 0.001). An integrated scoring model combining these predictors showed good discrimination performance at the seven-year follow-up. (C-statistic 0.716, 95% CI 0.629-0.802, p < 0.001). Significantly greater seven-year PeAF incidences were seen in patients with higher scores (2-5) than in those with lower scores (0-1) (22.8% ± 3.8% vs. 5.3% ± 1.7%, p < 0.001). In conclusion, an integrated scoring model combining clinical, echocardiographic, and electrocardiographic characteristics is useful for predicting future PeAF in patients with a dual-chamber PM.

Clinical, Echocardiographic, and Electrocardiographic Predictors of Persistent Atrial Fibrillation after Dual-Chamber Pacemaker Implantation: An Integrated Scoring Model Approach

PubMed Central

Cho, Min Soo; Kim, Ju Hyeon; Kim, Minsu; Lee, Ji Hyun; Hwang, You Mi; Jo, Uk; Nam, Gi-Byoung; Choi, Kee-Joon; Kim, You-Ho

2016-01-01

Persistent atrial fibrillation (PeAF) predictors after dual-chamber pacemaker (PM) implantation remain unclear. We sought to determine these predictors and establish an integrated scoring model. Data were retrospectively reviewed for 649 patients (63.8 ± 12.3 years, 48.6% male, mean CHA2DS2–VASC score 2.7 ± 2.0) undergoing dual-chamber PM implantation. PeAF was defined as documented AF on two consecutive electrocardiograms acquired ≥7 days apart. During a 7.1-year median follow-up (interquartile range 4.5–10.1 years), 67 (10.3%) patients had PeAF. Multivariable analysis showed the following independent predictors of future PeAF: ischemic stroke or transient ischemic accident history (hazard ratio [HR] 2.03, 95% confidence interval [CI] 1.03–3.50, p = 0.040), atrial fibrillation/flutter history (HR 1.80, 95% CI 1.01–3.20, p = 0.046), sinus node disease (HR 2.24, 95% CI 1.16–4.35, p = 0.016), left atrial enlargement (>45 mm, HR 2.14, 95% CI 1.26–3.63, p = 0.005), and time in automatic mode switching >1% at first follow-up interrogation (HR 2.58, 95% CI 1.51–4.42, p < 0.001). An integrated scoring model combining these predictors showed good discrimination performance at the seven-year follow-up. (C-statistic 0.716, 95% CI 0.629–0.802, p < 0.001). Significantly greater seven-year PeAF incidences were seen in patients with higher scores (2–5) than in those with lower scores (0–1) (22.8% ± 3.8% vs. 5.3% ± 1.7%, p < 0.001). In conclusion, an integrated scoring model combining clinical, echocardiographic, and electrocardiographic characteristics is useful for predicting future PeAF in patients with a dual-chamber PM. PMID:27479069

The Integrating and Segregating Effects of School Choice

ERIC Educational Resources Information Center

Koedel, Cory; Betts, Julian R.; Rice, Lorien A.; Zau, Andrew C.

2009-01-01

We evaluate the integrating and segregating effects of three distinct school choice programs in San Diego. We go beyond the traditional question of racial integration and examine the integration of students by test scores, parental education levels, and language status. In addition to measuring the net integrative effects of school choice, we also…

A structural equation model of the relationship between muscle strength, balance performance, walking endurance and community integration in stroke survivors

PubMed Central

2017-01-01

Purpose To use structural equation modelling (SEM) to determine (1) the direct and indirect associations of strength of paretic lower limb muscles with the level of community integration, and (2) the direct association of walking endurance and balance performance with the level of community integration in community-dwelling stroke survivors. Materials and methods In this cross-sectional study of 105 stroke survivors, the Subjective Index of Physical and Social Outcome (SIPSO) was used to measure the level of community integration. Lower-limb strength measures included isometric paretic ankle strength and isokinetic paretic knee peak torque. The Berg Balance Scale (BBS) and the 6-minute walk test (6MWT) were used to evaluate balance performance and walking endurance, respectively. Results SEM revealed that the distance walked on the 6MWT had the strongest direct association with the SIPSO score (β = 0.41, p <0.001). An increase of one standard deviation in the 6MWT distance resulted in an increase of 0.41 standard deviations in the SIPSO score. Moreover, dorsiflexion strength (β = 0.18, p = 0.044) and the BBS score (β = 0.21, p = 0.021) had direct associations with the SIPSO score. Conclusions The results of the proposed model suggest that rehabilitation training of community-dwelling stroke survivors could focus on walking endurance, balance performance and dorsiflexor muscle strengthening if the aim is to augment the level of community integration. PMID:29049293

CK-MM Polymorphism is Associated With Physical Fitness Test Scores in Military Recruits.

PubMed

Sprouse, Courtney; Tosi, Laura L; Gordish-Dressman, Heather; Abdel-Ghani, Mai S; Panchapakesan, Karuna; Niederberger, Brenda; Devaney, Joseph M; Kelly, Karen R

2015-09-01

Muscle-specific creatine kinase is thought to play an integral role in maintaining energy homeostasis by providing a supply of creatine phosphate. The genetic variant, rs8111989, contributes to individual differences in physical performance, and thus the purpose of this study was to determine if rs8111989 variant is predictive of Physical Fitness Test (PFT) scores in male, military infantry recruits. DNA was extracted from whole blood, and genotyping was performed in 176 Marines. Relationships between PFT measures (run, sit-ups, and pull-ups) and genotype were determined. Participants with 2 copies of the T allele for rs8111989 variant had higher PFT scores for run time, pull-ups, and total PFT score. Specifically, participants with 2 copies of the TT allele (variant) (n = 97) demonstrated an overall higher total PFT score as compared with those with one copy of the C allele (n = 79) (TT: 250 ± 31 vs. 238 ± 31; p = 0.02), run score (TT: 82 ± 10 vs. 78 ± 11; p = 0.04) and pull-up score (TT: 78 ± 11 vs. 65 ± 21; p = 0.04) or those with the CC/CT genotype. These results demonstrate an association between physical performance measures and genetic variation in the muscle-specific creatine kinase gene (rs8111989). Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Interrater reliability for sleep scoring according to the Rechtschaffen & Kales and the new AASM standard.

PubMed

Danker-Hopfe, Heidi; Anderer, Peter; Zeitlhofer, Josef; Boeck, Marion; Dorn, Hans; Gruber, Georg; Heller, Esther; Loretz, Erna; Moser, Doris; Parapatics, Silvia; Saletu, Bernd; Schmidt, Andrea; Dorffner, Georg

2009-03-01

Interrater variability of sleep stage scorings has an essential impact not only on the reading of polysomnographic sleep studies (PSGs) for clinical trials but also on the evaluation of patients' sleep. With the introduction of a new standard for sleep stage scorings (AASM standard) there is a need for studies on interrater reliability (IRR). The SIESTA database resulting from an EU-funded project provides a large number of studies (n = 72; 56 healthy controls and 16 subjects with different sleep disorders, mean age +/- SD: 57.7 +/- 18.7, 34 females) for which scorings according to both standards (AASM and R&K) were done. Differences in IRR were analysed at two levels: (1) based on quantitative sleep parameter by means of intraclass correlations; and (2) based on an epoch-by-epoch comparison by means of Cohen's kappa and Fleiss' kappa. The overall agreement was for the AASM standard 82.0% (Cohen's kappa = 0.76) and for the R&K standard 80.6% (Cohen's kappa = 0.68). Agreements increased from R&K to AASM for all sleep stages, except N2. The results of this study underline that the modification of the scoring rules improve IRR as a result of the integration of occipital, central and frontal leads on the one hand, but decline IRR on the other hand specifically for N2, due to the new rule that cortical arousals with or without concurrent increase in submental electromyogram are critical events for the end of N2.

The effect of social integration on outcomes after major lower extremity amputation.

PubMed

Hawkins, Alexander T; Pallangyo, Anthony J; Herman, Ayesiga M; Schaumeier, Maria J; Smith, Ann D; Hevelone, Nathanael D; Crandell, David M; Nguyen, Louis L

2016-01-01

Major lower extremity (MLE) amputation is a common procedure that results in a profound change in a patient's life. We sought to determine the association between social support and outcomes after amputation. We hypothesized that patients with greater social support will have better post amputation outcomes. From November 2011 to May 2013, we conducted a cross-sectional, observational, multicenter study. Social integration was measured by the social integration subset of the Short Form Craig Handicap Assessment and Reporting Technique. Systemic social support was assessed by comparing a United States and Tanzanian population. Walking function was measured using the 6-minute walk test and quality of life (QoL) was measured using the EuroQol-5D. We recruited 102 MLE amputees. Sixty-three patients were enrolled in the United States with a mean age of 58.0. Forty-two (67%) were male. Patients with low social integration were more likely to be unable to ambulate (no walk 39% vs slow walk 23% vs fast walk 10%; P = .01) and those with high social integration were more likely to be fast walkers (no walk 10% vs slow walk 59% vs fast walk 74%; P = .01). This relationship persisted in a multivariable analysis. Increasing social integration scores were also positively associated with increasing QoL scores in a multivariable analysis (β, .002; standard error, 0.0008; P = .02). In comparing the United States population with the Tanzanian cohort (39 subjects), there were no differences between functional or QoL outcomes in the systemic social support analysis. In the United States population, increased social integration is associated with both improved function and QoL outcomes among MLE amputees. Systemic social support, as measured by comparing the United States population with a Tanzanian population, was not associated with improved function or QoL outcomes. In the United States, steps should be taken to identify and aid amputees with poor social integration. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

The Effect of Social Integration on Outcomes after Major Lower Extremity Amputation

PubMed Central

Hawkins, Alexander T.; Pallangyo, Anthony J.; Herman, Ayesiga M.; Schaumeier, Maria J.; Smith, Ann D.; Hevelone, Nathanael D.; Crandell, David M.; Nguyen, Louis

2016-01-01

Objective Major lower extremity amputation is a common procedure that results in a profound change in a patient's life. We sought to determine the association between social support and outcomes after amputation. We hypothesized that patients with greater social support will have better post amputation outcomes. Methods From November 2011 to May 2013, we conducted a cross-sectional, observational, multicenter study. Social integration was measured by the social integration subset of the Short Form (Craig Handicap Assessment and Reporting Technique (CHART). Systemic social support was assessed by comparing a US and Tanzanian population. Walking function was measured using the 6MWT and quality of life (QoL) was measured using the EQ-5D. Results 102 major lower extremity amputees were recruited. 63 patients were enrolled in the US with a mean age of 58.0. Forty-two (67%) were male. Patients with low social integration were more likely to be unable to ambulate (no walk 39% vs. slow walk 23% vs. fast walk 10%; P=.01) and those with high social integration were more likely to be fast walkers (no walk 10% vs. slow walk 59% vs. fast walk 74%; P=.01). This relationship persisted in a multivariable analysis. Increasing social integration scores were also positively associated with increasing quality of life scores in a multivariable analysis (β .002; SE .0008; P = .02). In comparing the US population with the Tanzanian cohort (39 subjects), there were no significant differences between functional or quality of life outcomes in the systemic social support analysis. Conclusions In the US population, increased social integration is associated with both improved function and quality of life outcomes among major lower extremity amputees. Systemic social support, as measured by comparing the US population with a Tanzanian population, was not associated with improved function or quality of life outcomes. In the US, steps should be taken to identify and aid amputees with poor social integration. PMID:26474508

Community integration and life satisfaction among individuals with spinal cord injury living in the community after receiving institutional care in Bangladesh.

PubMed

Ahmed, Nayeema; Quadir, Mohammad Morshedul; Rahman, Mohammad Akhlasur; Alamgir, Hasanat

2018-05-01

This study reports level of community integration and life satisfaction among individuals who sustained traumatic spinal cord injuries, received institutional rehabilitation care services, and went back to live in the community in Bangladesh. It examines the impact of type of injury, demographic characteristics, socio-economic profile, and secondary health conditions on community integration and life satisfaction and explores the association between these two measures. Individuals with spinal cord injury were telephone interviewed by the Centre for the Rehabilitation of the Paralysed, Bangladesh from February to June of 2014. Data were collected from the subjects on type of injury, demographic and socio-economic profile, and secondary health conditions. The outcome measures were determined by using two validated tools - Community Integration Questionnaire and Life Satisfaction 9 Questionnaire. Total community integration and life satisfaction scores were 15.09 and 3.69, respectively. A significant positive relationship between community integration and life satisfaction was revealed. Type of injury, gender, and age were found to be significant predictors of both community integration and life satisfaction scores. Higher education was significantly related to community integration and life satisfaction scores. Participants scored low in total community integration and life satisfaction, suggesting there is a great need to develop interventions by governmental and non-governmental organizations to better integrate individuals with spinal cord injury in the community. Implications for Rehabilitation Government and non-government organizations should offer disability friendly public transportation facilities for individuals with spinal cord injury so that they can return to education, resume employment, and involve in social activities. Entrepreneurs and businesses should develop assistive devices featuring low technology, considering the rural structure and housing conditions in Bangladesh. Innovations being made in assistive technology should be supported by subsidies and grants. They should also plan to offer injury appropriate employment opportunities for individuals who suffer major injuries like spinal cord injury in Bangladesh. Housing facilities with accessible bathrooms, kitchens and stairs should be designed and offered for this population to improve their ability to self-care and decrease the dependence on caregivers for household tasks such as - cooking meals and taking care of children.

Design of the Growth hormone deficiency and Efficacy of Treatment (GET) score and non-interventional proof of concept study.

PubMed

Kann, Peter H; Bergmann, Simona; Bidlingmaier, Martin; Dimopoulou, Christina; Pedersen, Birgitte T; Stalla, Günter K; Weber, Matthias M; Meckes-Ferber, Stefanie

2018-02-13

The adverse effects of growth hormone (GH) deficiency (GHD) in adults (AGHD) on metabolism and health-related quality of life (HRQoL) can be improved with GH substitution. This investigation aimed to design a score summarising the features of GHD and evaluate its ability to measure the effect of GH substitution in AGHD. The Growth hormone deficiency and Efficacy of Treatment (GET) score (0-100 points) assessed (weighting): HRQoL (40%), disease-related days off work (10%), bone mineral density (20%), waist circumference (10%), low-density lipoprotein cholesterol (10%) and body fat mass (10%). A prospective, non-interventional, multicentre proof-of-concept study investigated whether the score could distinguish between untreated and GH-treated patients with AGHD. A 10-point difference in GET score during a 2-year study period was expected based on pre-existing knowledge of the effect of GH substitution in AGHD. Of 106 patients eligible for analysis, 22 were untreated GHD controls (9 females, mean ± SD age 52 ± 17 years; 13 males, 57 ± 13 years) and 84 were GH-treated (31 females, age 45 ± 13 years, GH dose 0.30 ± 0.16 mg/day; 53 males, age 49 ± 15 years, GH dose 0.25 ± 0.10 mg/day). Follow-up was 706 ± 258 days in females and 653 ± 242 days in males. The GET score differed between the untreated control and treated groups with a least squares mean difference of + 10.01 ± 4.01 (p = 0.0145). The GET score appeared to be a suitable integrative instrument to summarise the clinical features of GHD and measure the effects of GH substitution in adults. Exercise capacity and muscle strength/body muscle mass could be included in the GET score. NCT number: NCT00934063 . Date of registration: 02 July 2009.

Excellent healing rates and patient satisfaction after arthroscopic repair of medium to large rotator cuff tears with a single-row technique augmented with bone marrow vents.

PubMed

Dierckman, Brian D; Ni, Jake J; Karzel, Ronald P; Getelman, Mark H

2018-01-01

This study evaluated the repair integrity and patient clinical outcomes following arthroscopic rotator cuff repair of medium to large rotator cuff tears using a single-row technique consisting of medially based, triple-loaded anchors augmented with bone marrow vents in the rotator cuff footprint lateral to the repair. This is a retrospective study of 52 patients (53 shoulders) comprising 36 males and 16 females with a median age of 62 (range 44-82) with more than 24-month follow-up, tears between 2 and 4 cm in the anterior-posterior dimension and utilizing triple-loaded anchors. Mann-Whitney test compared Western Ontario Rotator Cuff (WORC) outcome scores between patients with healed and re-torn cuff repairs. Multivariate logistic regression analysed association of variables with healing status and WORC score. Cuff integrity was assessed on MRI, read by a musculoskeletal fellowship-trained radiologist. Magnetic resonance imaging (MRI) demonstrated an intact repair in 48 of 53 shoulders (91%). The overall median WORC score was 95.7 (range 27.6-100.0). A significant difference in WORC scores were seen between patients with healed repairs 96.7 (range 56.7-100.0) compared with a re-tear 64.6 (27.6-73.8), p < 0.00056. Arthroscopic repair of medium to large rotator cuff tears using a triple-loaded single-row repair augmented with bone marrow vents resulted in a 91% healing rate by MRI and excellent patient reported clinical outcomes comparable to similar reported results in the literature. IV.

A systematic review of patient inflammatory bowel disease information resources on the World Wide Web.

PubMed

Bernard, André; Langille, Morgan; Hughes, Stephanie; Rose, Caren; Leddin, Desmond; Veldhuyzen van Zanten, Sander

2007-09-01

The Internet is a widely used information resource for patients with inflammatory bowel disease, but there is variation in the quality of Web sites that have patient information regarding Crohn's disease and ulcerative colitis. The purpose of the current study is to systematically evaluate the quality of these Web sites. The top 50 Web sites appearing in Google using the terms "Crohn's disease" or "ulcerative colitis" were included in the study. Web sites were evaluated using a (a) Quality Evaluation Instrument (QEI) that awarded Web sites points (0-107) for specific information on various aspects of inflammatory bowel disease, (b) a five-point Global Quality Score (GQS), (c) two reading grade level scores, and (d) a six-point integrity score. Thirty-four Web sites met the inclusion criteria, 16 Web sites were excluded because they were portals or non-IBD oriented. The median QEI score was 57 with five Web sites scoring higher than 75 points. The median Global Quality Score was 2.0 with five Web sites achieving scores of 4 or 5. The average reading grade level score was 11.2. The median integrity score was 3.0. There is marked variation in the quality of the Web sites containing information on Crohn's disease and ulcerative colitis. Many Web sites suffered from poor quality but there were five high-scoring Web sites.

"Some like it hot": spectators who score high on the personality trait openness enjoy the excitement of hearing dancers breathing without music.

PubMed

Jola, Corinne; Pollick, Frank E; Calvo-Merino, Beatriz

2014-01-01

Music is an integral part of dance. Over the last 10 years, however, dance stimuli (without music) have been repeatedly used to study action observation processes, increasing our understanding of the influence of observer's physical abilities on action perception. Moreover, beyond trained skills and empathy traits, very little has been investigated on how other observer or spectators' properties modulate action observation and action preference. Since strong correlations have been shown between music and personality traits, here we aim to investigate how personality traits shape the appreciation of dance when this is presented with three different music/sounds. Therefore, we investigated the relationship between personality traits and the subjective esthetic experience of 52 spectators watching a 24 min lasting contemporary dance performance projected on a big screen containing three movement phrases performed to three different sound scores: classical music (i.e., Bach), an electronic sound-score, and a section without music but where the breathing of the performers was audible. We found that first, spectators rated the experience of watching dance without music significantly different from with music. Second, we found that the higher spectators scored on the Big Five personality factor openness, the more they liked the no-music section. Third, spectators' physical experience with dance was not linked to their appreciation but was significantly related to high average extravert scores. For the first time, we showed that spectators' reported entrainment to watching dance movements without music is strongly related to their personality and thus may need to be considered when using dance as a means to investigate action observation processes and esthetic preferences.

“Some like it hot”: spectators who score high on the personality trait openness enjoy the excitement of hearing dancers breathing without music

PubMed Central

Jola, Corinne; Pollick, Frank E.; Calvo-Merino, Beatriz

2014-01-01

Music is an integral part of dance. Over the last 10 years, however, dance stimuli (without music) have been repeatedly used to study action observation processes, increasing our understanding of the influence of observer’s physical abilities on action perception. Moreover, beyond trained skills and empathy traits, very little has been investigated on how other observer or spectators’ properties modulate action observation and action preference. Since strong correlations have been shown between music and personality traits, here we aim to investigate how personality traits shape the appreciation of dance when this is presented with three different music/sounds. Therefore, we investigated the relationship between personality traits and the subjective esthetic experience of 52 spectators watching a 24 min lasting contemporary dance performance projected on a big screen containing three movement phrases performed to three different sound scores: classical music (i.e., Bach), an electronic sound-score, and a section without music but where the breathing of the performers was audible. We found that first, spectators rated the experience of watching dance without music significantly different from with music. Second, we found that the higher spectators scored on the Big Five personality factor openness, the more they liked the no-music section. Third, spectators’ physical experience with dance was not linked to their appreciation but was significantly related to high average extravert scores. For the first time, we showed that spectators’ reported entrainment to watching dance movements without music is strongly related to their personality and thus may need to be considered when using dance as a means to investigate action observation processes and esthetic preferences. PMID:25309393

Semantic similarity measure in biomedical domain leverage web search engine.

PubMed

Chen, Chi-Huang; Hsieh, Sheau-Ling; Weng, Yung-Ching; Chang, Wen-Yung; Lai, Feipei

2010-01-01

Semantic similarity measure plays an essential role in Information Retrieval and Natural Language Processing. In this paper we propose a page-count-based semantic similarity measure and apply it in biomedical domains. Previous researches in semantic web related applications have deployed various semantic similarity measures. Despite the usefulness of the measurements in those applications, measuring semantic similarity between two terms remains a challenge task. The proposed method exploits page counts returned by the Web Search Engine. We define various similarity scores for two given terms P and Q, using the page counts for querying P, Q and P AND Q. Moreover, we propose a novel approach to compute semantic similarity using lexico-syntactic patterns with page counts. These different similarity scores are integrated adapting support vector machines, to leverage the robustness of semantic similarity measures. Experimental results on two datasets achieve correlation coefficients of 0.798 on the dataset provided by A. Hliaoutakis, 0.705 on the dataset provide by T. Pedersen with physician scores and 0.496 on the dataset provided by T. Pedersen et al. with expert scores.

Lupus anticoagulant: a multicenter study for a standardized and harmonized reporting.

PubMed

Poz, Alessandra; Pradella, Paola; Azzarini, Gabriella; Santarossa, Liliana; Bardin, Cristina; Zardo, Lorena; Giacomello, Roberta

2016-03-01

Laboratory assessment of Lupus anticoagulant (LAC) is very challenging because of inter and intralaboratory variability, which makes it difficult to standardize and harmonize results expression. Five hospital laboratories in North-eastern Italy shared their efforts and their experience in a cross-laboratory study, conducting the diagnostic process as homogeneously as possible and providing a better interpretation for LAC positivity. Hundred normal samples from healthy subjects (20 from each center) were processed to confirm negative upper limits and calculate positivity cutoffs of LAC integrated assays, that is dilute Russell's viper venom time (dRVVT) and silica clotting time (SCT). Moreover, 311 samples previously diagnosed by the laboratories as positive for LAC were analyzed to characterize different positivity levels for each assay. As far as the analysis of healthy subjects is concerned, negative upper limits are set at 1.17 and 1.19 for dRVVT and SCT screen ratio, respectively. Positivity cutoffs are set at 1.20 for dRVVT and 1.23 for SCT, expressed as Test Ratio calculated on screen and confirm integrated tests. Positive results for each integrated assay are subsequently divided into three subgroups: weak, moderate and strong; the results obtained are presented as a score proposal that can provide LAC interpretation. The combined use of both dRVVT and SCT assays and the definition of different positivity levels may lead to clearer, more objective LAC reporting. An interpretative table for LAC-proposed score provides LAC-positive results and it is now adopted by all centers involved in the study.

An integrated approach to evaluate food antioxidant capacity.

PubMed

Sun, T; Tanumihardjo, S A

2007-11-01

Many methods are available for determining food antioxidant capacity, which is an important topic in food and nutrition research and marketing. However, the results and inferences from different methods may vary substantially because each complex chemical reaction generates unique values. To get a complete and dynamic picture of the ranking of food antioxidant capacity, relative antioxidant capacity index (RACI), a hypothetical concept, is created from the perspective of statistics by integrating the antioxidant capacity values generated from different in vitro methods. RACI is the mean value of standard scores transformed from the initial data generated with different methods for each food item. By comparing the antioxidant capacity of 20 commonly consumed vegetables in the U.S. market that were measured with 7 chemical methods, we demonstrated that the RACI correlated strongly with each method. The significant correlation of RACI with an independent data set further confirmed that RACI is a valid tool to assess food antioxidant capacity. The key advantage of this integrated approach is that RACI is in a numerical scale with no units and has consistent agreement with chemical methods. Although it is a relative index and may not represent a specific antioxidant property of different food items, RACI provides a reasonably accurate rank of antioxidant capacity among foods. Therefore, it can be used as an integrated approach to evaluate food antioxidant capacity.

Dor Vs Toupet Fundoplication After Laparoscopic Heller Myotomy: Long-Term Randomized Controlled Trial Evaluated by High-Resolution Manometry.

PubMed

Torres-Villalobos, Gonzalo; Coss-Adame, Enrique; Furuzawa-Carballeda, Janette; Romero-Hernández, Fernanda; Blancas-Breña, Blanca; Torres-Landa, Samuel; Palacios-Ramírez, Axel; Alejandro-Medrano, Edgar; Hernández-Ávila, Axel; Flores-Najera, Athenea; Ávila Escobedo, Lourdes Margarita; Ramírez Angulo, Cecilia; Rodríguez-Garcés, Angélica; Valdovinos, Miguel Ángel

2018-01-01

Laparoscopic Heller myotomy (LHM) with partial fundoplication is an effective treatment for achalasia. However, the type of fundoplication is still a subject of debate. The aim of the study is to identify which partial fundoplication leads to better control of acid exposure, manometric parameters, and symptoms scores. A randomized controlled trial was performed to compare Dor vs Toupet fundoplication after LHM. The preoperative diagnosis was made by high-resolution manometry (HRM), upper endoscopy, and barium esophagogram. Preoperative and postoperative symptoms were evaluated with Eckardt, GERD-HRQL, and EAT-10 questionnaires. Seventy-three patients were randomized, 38 underwent Dor and 35 Toupet. Baseline characteristics were similar between groups. Postoperative HRM showed that the integrated relaxation pressure (IRP) and basal lower esophageal sphincter (LES) pressure were similar at 6 and 24 months. The number of patients with abnormal acid exposure was significantly lower for Dor (6.9%) than that of Toupet (34.0%) at 6 months, but it was not different at 12 or 24 months. No differences were found in postoperative symptom scores at 1, 6, or 24 months. There were no differences in symptom scores or HRM between fundoplications in the long term. A higher percentage of abnormal 24-h pH test were found for the Toupet group, with no difference in the long term.

Implementation of an Integrated Longitudinal Curricular Activity for Graduating Pharmacy Students

PubMed Central

Meyer, Doug; Fujisaki, Brad; Stein, Susan

2014-01-01

Objectives. To evaluate whether a novel integrated longitudinal curricular activity to prepare graduating doctor of pharmacy (PharmD) students for 2 comprehensive examinations was successful, and to assess whether it engaged other pharmacy students in curricular discussion and learning. Design. Thirty-eight of 91graduating third-year (P3) students in a PharmD program formed 11 teams to create and present pharmacotherapeutic posters to their peers. The impact of the novel activity on graduating students’ performance on the North American Pharmacist Licensure Examination (NAPLEX) and a comprehensive commercial examination was assessed. All first-year (P1), second-year (P2), and P3 students reviewed and discussed the content of each poster. Assessment. Participants in the integrated longitudinal curricular activity performed better than nonparticipants on the commercial examination (p=0.023) and NAPLEX (p=0.033). However, regardless of participation, commercial examination scores predicted a significant amount of variance (ie, 34%) in NAPLEX scores. The P3 participants (83%) believed the curricular activity assisted them in their NAPLEX preparation, while 75% of P1 students, 79% of P2 students, and 80% of P3 students agreed that poster review provided an effective summary of different disease states. Ninety percent of faculty poster evaluators reported that the posters were professional, and all evaluators agreed that participants effectively conveyed their message to the intended audience. Conclusion. The integrated longitudinal curricular activity provided a positive learning environment for all pharmacy students and may have better prepared graduating students’ for the NAPLEX. PMID:25147396

The effectiveness of a clinically integrated e-learning course in evidence-based medicine: a cluster randomised controlled trial.

PubMed

Kulier, Regina; Coppus, Sjors F P J; Zamora, Javier; Hadley, Julie; Malick, Sadia; Das, Kausik; Weinbrenner, Susanne; Meyerrose, Berrit; Decsi, Tamas; Horvath, Andrea R; Nagy, Eva; Emparanza, Jose I; Arvanitis, Theodoros N; Burls, Amanda; Cabello, Juan B; Kaczor, Marcin; Zanrei, Gianni; Pierer, Karen; Stawiarz, Katarzyna; Kunz, Regina; Mol, Ben W J; Khan, Khalid S

2009-05-12

To evaluate the educational effects of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM) among postgraduates compared to a traditional lecture-based course of equivalent content. We conducted a cluster randomised controlled trial in the Netherlands and the UK involving postgraduate trainees in six obstetrics and gynaecology departments. Outcomes (knowledge gain and change in attitude towards EBM) were compared between the clinically integrated e-learning course (intervention) and the traditional lecture based course (control). We measured change from pre- to post-intervention scores using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). There were six clusters involving teaching of 61 postgraduate trainees (28 in the intervention and 33 in the control group). The intervention group achieved slightly higher scores for knowledge gain compared to the control, but these results were not statistically significant (difference in knowledge gain: 3.5 points, 95% CI -2.7 to 9.8, p = 0.27). The attitudinal changes were similar for both groups. A clinically integrated e-learning course was at least as effective as a traditional lecture based course and was well accepted. Being less costly than traditional teaching and allowing for more independent learning through materials that can be easily updated, there is a place for incorporating e-learning into postgraduate EBM curricula that offer on-the-job training for just-in-time learning. ACTRN12609000022268.

Mapping White Matter Integrity in Elderly People with HIV

PubMed Central

Nir, Talia M.; Jahanshad, Neda; Busovaca, Edgar; Wendelken, Lauren; Nicolas, Krista; Thompson, Paul M.; Valcour, Victor G.

2013-01-01

People with HIV are living longer as combination antiretroviral therapy (cART) becomes more widely available. However, even when plasma viral load is reduced to untraceable levels, chronic HIV infection is associated with neurological deficits and brain atrophy beyond that of normal aging. HIV is often marked by cortical and subcortical atrophy, but the integrity of the brain’s white matter (WM) pathways also progressively declines. Few studies focus on older cohorts where normal aging may be compounded with HIV infection to influence deficit patterns. In this relatively large diffusion tensor imaging (DTI) study, we investigated abnormalities in WM fiber integrity in 56 HIV+ adults with access to cART (mean age: 63.9 ± 3.7 years), compared to 31 matched healthy controls (65.4 ± 2.2 years). Statistical 3D maps revealed the independent effects of HIV diagnosis and age on fractional anisotropy (FA) and diffusivity, but we did not find any evidence for an age by diagnosis interaction in our current sample. Compared to healthy controls, HIV patients showed pervasive FA decreases and diffusivity increases throughout WM. We also assessed neuropsychological (NP) summary z-score associations. In both patients and controls, fiber integrity measures were associated with NP summary scores. The greatest differences were detected in the corpus callosum and in the projection fibers of the corona radiata. These deficits are consistent with published NP deficits and cortical atrophy patterns in elderly people with HIV. PMID:23362139

Are there gender differences in cognitive function, chronic stress, and neurobehavioral symptoms after mild-to-moderate traumatic brain injury?

PubMed

Covassin, Tracey; Bay, Esther

2012-06-01

Research is inconclusive on whether gender differences exist in cognitive function in persons who sustain a mild-to-moderate traumatic brain injury (TBI). Furthermore, it is also unclear whether there is a relationship between chronic stress and cognitive function in these persons. The purpose of this integrative review is to determine whether gender differences exist in cognitive function, neurobehavioral symptoms, and chronic stress levels after a mild-to-moderate TBI. Participants (n = 72) were recruited from eight outpatient rehabilitation centers. Participants completed the demographic questions, the Immediate Postconcussion Assessment Cognitive Testing neurocognitive test battery, the Perceived Stress Scale-14, and the Neurobehavioral Functioning Inventory (NFI). Gender differences were present on verbal memory composite scores (p = .033), with women performing worse than men. There were no other between-gender differences on cognitive tasks, neurobehavioral symptoms, or chronic stress. Higher chronic stress levels result in a decrease in verbal memory (p = .015) and motor processing speed (p = .006) and slower reaction time (p = .007) for women. As male NFI cognition scores increased, motor processing speed scores decreased (p = .012) and reaction time got slower (p = .019), whereas women exhibited decreased verbal memory (p = .017) and slower reaction time (p = .034). As NFI motor symptoms increased, men exhibited decreased verbal memory (p = .005), visual memory (p = .002), and motor processing speed (p = .002) and slower reaction time (p = .002). Overall, this study only found gender differences on verbal memory composite scores, whereas the remaining cognitive tasks, neurobehavioral symptoms, and chronic stress did not indicate gender differences. Correlations between chronic stress, neurobehavioral symptoms, and cognitive function differed in both men and women with TBI. Persons in the chronic phase of recovery from a TBI may benefit from training in compensatory strategies for verbal memory deficits and stress management.

Auditory integration training and other sound therapies for autism spectrum disorders: a systematic review

PubMed Central

Sinha, Y; Silove, N; Wheeler, D; Williams, K

2006-01-01

Objectives To determine the effectiveness of auditory integration training (AIT) or other methods of sound therapy in people with autism spectrum disorders (ASD). Study design A systematic review was carried out of randomised controlled trials (RCTs) of adults or children with ASD. Meta‐analysis was attempted. Results Six RCTs of AIT, including one crossover trial, were identified, with a total of 171 participants aged 3–39 years. 17 different outcome measures were used, with only two outcome measures used by three or more studies. Meta‐analysis was not possible owing to very high heterogeneity or presentation of data in unusable forms. Three studies did not show any benefit of AIT over control conditions. Three studies reported improvements at 3 months in the AIT group for total mean scores of the Aberrant Behaviour Checklist (ABC), which is of questionable validity. Of these, one study also reported improvements at 3 months in the AIT group for ABC subgroup scores. No significant adverse effects of AIT were reported. Conclusion At present there is not sufficient evidence to support its use. PMID:16887860

Improving the residency admissions process by integrating a professionalism assessment: a validity and feasibility study.

PubMed

Bajwa, Nadia M; Yudkowsky, Rachel; Belli, Dominique; Vu, Nu Viet; Park, Yoon Soo

2017-03-01

The purpose of this study was to provide validity and feasibility evidence in measuring professionalism using the Professionalism Mini-Evaluation Exercise (P-MEX) scores as part of a residency admissions process. In 2012 and 2013, three standardized-patient-based P-MEX encounters were administered to applicants invited for an interview at the University of Geneva Pediatrics Residency Program. Validity evidence was gathered for P-MEX content (item analysis); response process (qualitative feedback); internal structure (inter-rater reliability with intraclass correlation and Generalizability); relations to other variables (correlations); and consequences (logistic regression to predict admission). To improve reliability, Kane's formula was used to create an applicant composite score using P-MEX, structured letter of recommendation (SLR), and structured interview (SI) scores. Applicant rank lists using composite scores versus faculty global ratings were compared using the Wilcoxon signed-rank test. Seventy applicants were assessed. Moderate associations were found between pairwise correlations of P-MEX scores and SLR (r = 0.25, P = .036), SI (r = 0.34, P = .004), and global ratings (r = 0.48, P < .001). Generalizability of the P-MEX using three cases was moderate (G-coefficient = 0.45). P-MEX scores had the greatest correlation with acceptance (r = 0.56, P < .001), were the strongest predictor of acceptance (OR 4.37, P < .001), and increased pseudo R-squared by 0.20 points. Including P-MEX scores increased composite score reliability from 0.51 to 0.74. Rank lists of applicants using composite score versus global rating differed significantly (z = 5.41, P < .001). Validity evidence supports the use of P-MEX scores to improve the reliability of the residency admissions process by improving applicant composite score reliability.

A comparison of educational strategies for the acquisition of nursing student's performance and critical thinking: simulation-based training vs. integrated training (simulation and critical thinking strategies).

PubMed

Zarifsanaiey, Nahid; Amini, Mitra; Saadat, Farideh

2016-11-16

There is a need to change the focus of nursing education from traditional teacher-centered training programs to student-centered active methods. The integration of the two active learning techniques will improve the effectiveness of training programs. The objective of this study is to compare the effects of the integrated training (simulation and critical thinking strategies) and simulation-based training on the performance level and critical thinking ability of nursing students. The present quasi-experimental study was performed in 2014 on 40 students who were studying practical nursing principles and skills course in the first half of the academic year in Shiraz University of Medical Sciences. Students were randomly divided into control (n = 20) and experimental (n = 20) groups. After training students through simulation and integrated education (simulation and critical thinking strategies), the students' critical thinking ability and performance were evaluated via the use of California Critical Thinking Ability Questionnaire B (CCTST) and Objective Structured Clinical Examination (OSCE) comprising 10 stations, respectively. The external reliability of the California Critical Thinking questionnaire was reported by Case B.to be between 0.78 and 0.80 and the validity of OSCE was approved by 5 members of the faculty. Furthermore, by using Split Half method (the correlation between odd and even stations), the reliability of the test was approved with correlation coefficient of 0.66. Data were analyzed using t-test and Mann-Whitney test. A significance level of 0.05 was considered to be statistically significant. The mean scores of the experimental group performance level were higher than the mean score of the control group performance level. This difference was statistically significant and students in the experimental group in OSCE stations had significantly higher performance than the control group (P <0.001). However, the mean scores obtained for the critical thinking did not increase before and after the intervention. The results showed that, the students' performance level was increased by the application of integrated training (simulation and critical thinking strategies).

Mother-infant interaction during the first 3 months: the emergence of culture-specific contingency patterns.

PubMed

Kärtner, Joscha; Keller, Heidi; Yovsi, Relindis D

2010-01-01

This study analyzed German and Nso mothers' auditory, proximal, and visual contingent responses to their infants' nondistress vocalizations in postnatal Weeks 4, 6, 8, 10, and 12. Visual contingency scores increased whereas proximal contingency scores decreased over time for the independent (German urban middle-class, N = 20) but not the interdependent sociocultural context (rural Nso farmers, N = 24). It seems, therefore, that culture-specific differences in the modal patterns of contingent responsiveness emerge during the 2nd and 3rd months of life. This differential development was interpreted as the result of the interplay between maturational processes associated with the 2-month shift that are selectively integrated and reinforced in culture-specific mother-infant interaction.

A General Approach for Estimating Scale Score Reliability for Panel Survey Data

ERIC Educational Resources Information Center

Biemer, Paul P.; Christ, Sharon L.; Wiesen, Christopher A.

2009-01-01

Scale score measures are ubiquitous in the psychological literature and can be used as both dependent and independent variables in data analysis. Poor reliability of scale score measures leads to inflated standard errors and/or biased estimates, particularly in multivariate analysis. Reliability estimation is usually an integral step to assess…

Clickers to the Rescue: Technology Integration Helps Boost Literacy Scores

ERIC Educational Resources Information Center

Moratelli, Katelyn; DeJarnette, Nancy K.

2014-01-01

Literacy assessment scores in an urban 5th grade classroom left much to be desired. In this diverse classroom population, typical urban distractions such as poverty, crime, English as a second language, and lack of parental support contribute to extremely low literacy scores. This classroom study examined the effects of implementing clickers, a…

RCT of an integrated CBT-HIV intervention on depressive symptoms and HIV risk.

PubMed

Tobin, Karin; Davey-Rothwell, Melissa A; Nonyane, Bareng A S; Knowlton, Amy; Wissow, Lawrence; Latkin, Carl A

2017-01-01

Depression and depressive symptoms mediate the association between drug use and HIV risk. Yet, there are few interventions that target depressive symptoms and HIV risk for people who use drugs (PWUD). This study was a randomized controlled trial of an integrated cognitive behavioral therapy and HIV prevention intervention to reduce depressive symptoms, injection risk behaviors and increase condom use in a sample of urban people who used heroin or cocaine in the prior 6 months. A total of 315 individuals aged 18-55, who self-reported at least one HIV drug and sex risk behavior and scored ≥16 and <40 on the Centers for Epidemiologic Studies-Depression (CES-D) scale were randomized using a two-block design, stratified by sex to ensure equivalent numbers, to a 10 session intervention arm (n = 162) or a single session control arm (n = 153). The outcomes of interest were decreases in CES-D score and injection risk behaviors and increases in condom use. The sample was majority African American (85%) and unemployed (94%). Nearly half (47%) reported injection in the prior 6 months and only 19% were taking medication for depression. Follow-up assessments were conducted at 6 and 12 months. Retention at 12 months was 94%. Intervention arm was associated with statistically significantly lower CES-D score at 12 month compared to control. No differences were observed between arms in injection risk. At 6 month, intervention was associated with greater odds of condom use with non-main partner. These findings suggest the potential role of the integrated intervention in reducing depressive symptoms, but weak impact on HIV risk. This trial is registered with ClinicalTrials.gov under the title "Neighborhoods, Networks, Depression, and HIV Risk" number NCT01380613.

Systematic identification of an integrative network module during senescence from time-series gene expression.

PubMed

Park, Chihyun; Yun, So Jeong; Ryu, Sung Jin; Lee, Soyoung; Lee, Young-Sam; Yoon, Youngmi; Park, Sang Chul

2017-03-15

Cellular senescence irreversibly arrests growth of human diploid cells. In addition, recent studies have indicated that senescence is a multi-step evolving process related to important complex biological processes. Most studies analyzed only the genes and their functions representing each senescence phase without considering gene-level interactions and continuously perturbed genes. It is necessary to reveal the genotypic mechanism inferred by affected genes and their interaction underlying the senescence process. We suggested a novel computational approach to identify an integrative network which profiles an underlying genotypic signature from time-series gene expression data. The relatively perturbed genes were selected for each time point based on the proposed scoring measure denominated as perturbation scores. Then, the selected genes were integrated with protein-protein interactions to construct time point specific network. From these constructed networks, the conserved edges across time point were extracted for the common network and statistical test was performed to demonstrate that the network could explain the phenotypic alteration. As a result, it was confirmed that the difference of average perturbation scores of common networks at both two time points could explain the phenotypic alteration. We also performed functional enrichment on the common network and identified high association with phenotypic alteration. Remarkably, we observed that the identified cell cycle specific common network played an important role in replicative senescence as a key regulator. Heretofore, the network analysis from time series gene expression data has been focused on what topological structure was changed over time point. Conversely, we focused on the conserved structure but its context was changed in course of time and showed it was available to explain the phenotypic changes. We expect that the proposed method will help to elucidate the biological mechanism unrevealed by the existing approaches.

75 FR 42431 - Notice of Intent To Grant Partially Exclusive License; METOCEAN Data System

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... exclusive license, with exclusive fields of use in portable acoustic scoring, acoustic sounding and..., issued February 7, 2006, entitled ``Integrated Maritime Portable Acoustic Scoring and Simulator Control...

Performance on Tests of Central Auditory Processing by Individuals Exposed to High-Intensity Blasts

DTIC Science & Technology

2012-07-01

percent (gap detected on at least four of the six presentations), with all longer durations receiving a score greater than 50 percent. Binaural ...Processing and Sound Localization Temporal precision of neural firing is also involved in binaural processing and localization of sound in space. The...Masking Level Difference (MLD) test evaluates the integrity of the earliest sites of binaural comparison and sensitivity to interaural phase in the

MCNP-based computational model for the Leksell gamma knife.

PubMed

Trnka, Jiri; Novotny, Josef; Kluson, Jaroslav

2007-01-01

We have focused on the usage of MCNP code for calculation of Gamma Knife radiation field parameters with a homogenous polystyrene phantom. We have investigated several parameters of the Leksell Gamma Knife radiation field and compared the results with other studies based on EGS4 and PENELOPE code as well as the Leksell Gamma Knife treatment planning system Leksell GammaPlan (LGP). The current model describes all 201 radiation beams together and simulates all the sources in the same time. Within each beam, it considers the technical construction of the source, the source holder, collimator system, the spherical phantom, and surrounding material. We have calculated output factors for various sizes of scoring volumes, relative dose distributions along basic planes including linear dose profiles, integral doses in various volumes, and differential dose volume histograms. All the parameters have been calculated for each collimator size and for the isocentric configuration of the phantom. We have found the calculated output factors to be in agreement with other authors' works except the case of 4 mm collimator size, where averaging over the scoring volume and statistical uncertainties strongly influences the calculated results. In general, all the results are dependent on the choice of the scoring volume. The calculated linear dose profiles and relative dose distributions also match independent studies and the Leksell GammaPlan, but care must be taken about the fluctuations within the plateau, which can influence the normalization, and accuracy in determining the isocenter position, which is important for comparing different dose profiles. The calculated differential dose volume histograms and integral doses have been compared with data provided by the Leksell GammaPlan. The dose volume histograms are in good agreement as well as integral doses calculated in small calculation matrix volumes. However, deviations in integral doses up to 50% can be observed for large volumes such as for the total skull volume. The differences observed in treatment of scattered radiation between the MC method and the LGP may be important in this case. We have also studied the influence of differential direction sampling of primary photons and have found that, due to the anisotropic sampling, doses around the isocenter deviate from each other by up to 6%. With caution about the details of the calculation settings, it is possible to employ the MCNP Monte Carlo code for independent verification of the Leksell Gamma Knife radiation field properties.

Does Integrating Family Planning into HIV Services Improve Gender Equitable Attitudes? Results from a Cluster Randomized Trial in Nyanza, Kenya.

PubMed

Newmann, Sara J; Rocca, Corinne H; Zakaras, Jennifer M; Onono, Maricianah; Bukusi, Elizabeth A; Grossman, Daniel; Cohen, Craig R

2016-09-01

This study investigated whether integrating family planning (FP) services into HIV care was associated with gender equitable attitudes among HIV-positive adults in western Kenya. Surveys were conducted with 480 women and 480 men obtaining HIV services from 18 clinics 1 year after the sites were randomized to integrated FP/HIV services (N = 12) or standard referral for FP (N = 6). We used multivariable regression, with generalized estimating equations to account for clustering, to assess whether gender attitudes (range 0-12) were associated with integrated care and with contraceptive use. Men at intervention sites had stronger gender equitable attitudes than those at control sites (adjusted mean difference in scores = 0.89, 95 % CI 0.03-1.74). Among women, attitudes did not differ by study arm. Gender equitable attitudes were not associated with contraceptive use among men (AOR = 1.06, 95 % CI 0.93-1.21) or women (AOR = 1.03, 95 % CI 0.94-1.13). Further work is needed to understand how integrating FP into HIV care affects gender relations, and how improved gender equity among men might be leveraged to improve contraceptive use and other reproductive health outcomes.

Towards integration of clinical decision support in commercial hospital information systems using distributed, reusable software and knowledge components.

PubMed

Müller, M L; Ganslandt, T; Eich, H P; Lang, K; Ohmann, C; Prokosch, H U

2001-12-01

Clinicians' acceptance of clinical decision support depends on its workflow-oriented, context-sensitive accessibility and availability at the point of care, integrated into the Electronic Patient Record (EPR). Commercially available Hospital Information Systems (HIS) often focus on administrative tasks and mostly do not provide additional knowledge based functionality. Their traditionally monolithic and closed software architecture encumbers integration of and interaction with external software modules. Our aim was to develop methods and interfaces to integrate knowledge sources into two different commercial hospital information systems to provide the best decision support possible within the context of available patient data. An existing, proven standalone scoring system for acute abdominal pain was supplemented by a communication interface. In both HIS we defined data entry forms and developed individual and reusable mechanisms for data exchange with external software modules. We designed an additional knowledge support frontend which controls data exchange between HIS and the knowledge modules. Finally, we added guidelines and algorithms to the knowledge library. Despite some major drawbacks which resulted mainly from the HIS' closed software architectures we showed exemplary, how external knowledge support can be integrated almost seamlessly into different commercial HIS. This paper describes the prototypical design and current implementation and discusses our experiences.

Superficial and deep learning approaches among medical students in an interdisciplinary integrated curriculum.

PubMed

Mirghani, Hisham M; Ezimokhai, Mutairu; Shaban, Sami; van Berkel, Henk J M

2014-01-01

Students' learning approaches have a significant impact on the success of the educational experience, and a mismatch between instructional methods and the learning approach is very likely to create an obstacle to learning. Educational institutes' understanding of students' learning approaches allows those institutes to introduce changes in their curriculum content, instructional format, and assessment methods that will allow students to adopt deep learning techniques and critical thinking. The objective of this study was to determine and compare learning approaches among medical students following an interdisciplinary integrated curriculum. This was a cross-sectional study in which an electronic questionnaire using the Biggs two-factor Study Process Questionnaire (SPQ) with 20 questions was administered. Of a total of 402 students at the medical school, 214 (53.2%) completed the questionnaire. There was a significant difference in the mean score of superficial approach, motive and strategy between students in the six medical school years. However, no significant difference was observed in the mean score of deep approach, motive and strategy. The mean score for years 1 and 2 showed a significantly higher surface approach, surface motive and surface strategy when compared with students in years 4-6 in medical school. The superficial approach to learning was mostly preferred among first and second year medical students, and the least preferred among students in the final clinical years. These results may be useful in creating future teaching, learning and assessment strategies aiming to enhance a deep learning approach among medical students. Future studies are needed to investigate the reason for the preferred superficial approach among medical students in their early years of study.

An Integrated Interactive-Spaced Education Radiology Curriculum for Preclinical Students.

PubMed

Tshibwabwa, Eli; Mallin, Robert; Fraser, Madeleine; Tshibwabwa, Martin; Sanii, Reza; Rice, James; Cannon, Jenifer

2017-01-01

The objective of this study is to determine whether a radiology module, together with online spaced education, helps students of an integrated problem-based learning (PBL) curriculum increase their radiology knowledge and long-term retention. Second-year students at the American University of Antigua College of Medicine participated in small groups of ten students each into two 2 h of radiology laboratories. The study comprised two cohorts: winter and fall 2013 students (control group) and 2014 students (experimental group). Both groups used face-to-face PBL. The students of the experimental group received additional online-spaced education. The skills were assessed for both groups before the beginning of laboratories and 4 weeks and 7 months after laboratories. There was no significant difference on pretest between the control and experimental groups. On completion of the radiology laboratories, comparison of test results before and after training showed net improvement for both groups. The corresponding difference for the experimental group was higher compared to the one for the control group (7.83 vs. 6.21, P < 0.001). The difference between the scores on delayed test and pretest showed that the students of both groups demonstrated average knowledge improvement even though their level of performance was slightly below the posttest. The corresponding difference for the experimental group did not differ much from the posttest ( P > 0.05), and no significant difference of scores was observed 7 months later for either group. Further, a higher percentage of the students in the experimental group strongly agreed that their learning objectives were met (92% vs. 71%, P > 0.001), and this trend persisted throughout the study. Online spaced education combined to a face-to-face PBL enhances not only the student's knowledge of basic radiology along with his/her self-assessment skills but also the long-term retention of radiology material and satisfaction with the integrated interactive system-based module. Future research is needed to see if medical students in need of additional education support may benefit from spaced education in the field of remediation.

Interlaboratory assessment of mitotic index by flow cytometry confirms superior reproducibility relative to microscopic scoring.

PubMed

Roberts, D J; Spellman, R A; Sanok, K; Chen, H; Chan, M; Yurt, P; Thakur, A K; DeVito, G L; Murli, H; Stankowski, L F

2012-05-01

A flow cytometric procedure for determining mitotic index (MI) as part of the metaphase chromosome aberrations assay, developed and utilized routinely at Pfizer as part of their standard assay design, has been adopted successfully by Covance laboratories. This method, using antibodies against phosphorylated histone tails (H3PS10) and nucleic acid stain, has been evaluated by the two independent test sites and compared to manual scoring. Primary human lymphocytes were treated with cyclophosphamide, mitomycin C, benzo(a)pyrene, and etoposide at concentrations inducing dose-dependent cytotoxicity. Deming regression analysis indicates that the results generated via flow cytometry (FCM) were more consistent between sites than those generated via microscopy. Further analysis using the Bland-Altman modification of the Tukey mean difference method supports this finding, as the standard deviations (SDs) of differences in MI generated by FCM were less than half of those generated manually. Decreases in scoring variability owing to the objective nature of FCM, and the greater number of cells analyzed, make FCM a superior method for MI determination. In addition, the FCM method has proven to be transferable and easily integrated into standard genetic toxicology laboratory operations. Copyright © 2012 Wiley Periodicals, Inc.

Biological Diversity, Ecological Health and Condition of Aquatic Assemblages at National Wildlife Refuges in Southern Indiana, USA

PubMed Central

Morris, Charles C.; Robb, Joseph R.; McCoy, William

2015-01-01

Abstract The National Wildlife Refuge system is a vital resource for the protection and conservation of biodiversity and biological integrity in the United States. Surveys were conducted to determine the spatial and temporal patterns of fish, macroinvertebrate, and crayfish populations in two watersheds that encompass three refuges in southern Indiana. The Patoka River National Wildlife Refuge had the highest number of aquatic species with 355 macroinvertebrate taxa, six crayfish species, and 82 fish species, while the Big Oaks National Wildlife Refuge had 163 macroinvertebrate taxa, seven crayfish species, and 37 fish species. The Muscatatuck National Wildlife Refuge had the lowest diversity of macroinvertebrates with 96 taxa and six crayfish species, while possessing the second highest fish species richness with 51 species. Habitat quality was highest in the Muscatatuck River drainage with increased amounts of forested habitats compared to the Patoka River drainage. Biological integrity of the three refuges ranked the Patoka NWR as the lowest biological integrity (mean IBI reach scores = 35 IBI points), while Big Oaks had the highest biological integrity (mean IBI reach score = 41 IBI points). The Muscatatuck NWR had a mean IBI reach score of 31 during June, which seasonally increased to a mean of 40 IBI points during summer. Watershed IBI scores and habitat condition were highest in the Big Oaks NWR. PMID:25632261

Application of basic science to clinical problems: traditional vs. hybrid problem-based learning.

PubMed

Callis, Amber N; McCann, Ann L; Schneiderman, Emet D; Babler, William J; Lacy, Ernestine S; Hale, David Sidney

2010-10-01

It is widely acknowledged that clinical problem-solving is a key skill for dental practitioners. The aim of this study was to determine if students in a hybrid problem-based learning curriculum (h-PBL) were better at integrating basic science knowledge with clinical cases than students in a traditional, lecture-based curriculum (TC). The performance of TC students (n=40) was compared to that of h-PBL students (n=31). Participants read two clinical scenarios and answered a series of questions regarding each. To control for differences in ability, Dental Admission Test (DAT) Academic Average scores and predental grade point averages (GPAs) were compared, and an ANCOVA was used to adjust for the significant differences in DAT (t-test, p=0.002). Results showed that h-PBL students were better at applying basic science knowledge to a clinical case (ANCOVA, p=0.022) based on overall scores on one case. TC students' overall scores were better than h-PBL students on a separate case; however, it was not statistically significant (p=0.107). The h-PBL students also demonstrated greater skills in the areas of hypothesis generation (Mann-Whitney U, p=0.016) and communication (p=0.006). Basic science comprehension (p=0.01) and neurology (p<0.001) were two areas in which the TC students did score significantly higher than h-PBL students.

The desirable qualities of future doctors--a study of medical student perceptions.

PubMed

Hurwitz, Steven; Kelly, Brian; Powis, David; Smyth, Robyn; Lewin, Terry

2013-07-01

There is a lack of consensus regarding the qualities possessed by the ideal doctor, and very limited research regarding the views of medical students on these qualities. To investigate the views of commencing medical students regarding the desirable qualities of doctors. A survey containing a set of proposed desirable qualities of doctors identified from the existing literature was completed by 158 first-year medical students. The survey had a 75% response rate. Students rated the individual qualities of empathy, motivation to be a doctor, good verbal communication, ethically sound, integrity and honesty as the most important. A factor analysis identified six categories of qualities: methodical processing, cognitive capacity, people skills, generic work ethic, role certainty and warmth. Significant differences in factor scores were found across subgroups of students (international and domestic students, with and without prior tertiary studies) on the following factors: methodical processing, which was scored highest by domestic students with prior tertiary studies, cognitive capacity, which was scored highest by domestic students without prior tertiary studies and generic work ethic, which was scored highest by international students. Medical students identified a range of desirable personal qualities of a doctor which varied according to student characteristics, including their prior educational experience. Future research aiming to define such desirable qualities should include a broader range of stakeholders, including students at different training levels and institutions.

Comparison of self, physician, and simulated patient ratings of pharmacist performance in a family practice simulator.

PubMed

Lau, Elaine; Dolovich, Lisa; Austin, Zubin

2007-03-01

The Family Practice Simulator (FPS) was piloted as a teaching, learning, and assessment opportunity for pharmacists making the transition into primary care practice. During this one-day simulation of a typical day in a family physician's office, nine pharmacists rotated through a series of 13 OSCE stations where they interacted with physicians, patients, nurses and office staff while completing primary care activities and receiving performance evaluations. Pharmacists' performance ratings from self, physician, and standardized patient evaluations were compared using Global Rating Scales (GRS) scores and station-specific key points checklists. The mean (SD) overall GRS scores obtained by pharmacists across all stations in the FPS were 4.56 (SD = 0.60) from standardized patients, 3.95 (SD = 0.63) from physicians, and 3.60 (SD = 0.63) from self-assessment (out of a maximum score of 5). Agreement between pharmacists' and patients' GRS ratings ranged from moderate to good (generalizability coefficient (G) = 0.45 to 0.72) for all except one station. Agreement in GRS scores between pharmacists and physicians was at most fair for every station (G = 0.02 - 0.26). There was fair agreement on key points scores between pharmacists and patients (weighted kappa = 27%; 95% CI 7%, 47%) and moderate agreement between pharmacists and physicians (weighted kappa = 45%; 95% CI 21%, 70%). Although there was at best moderate agreement in rating scores between pharmacists, standardized patients, and physicians, the FPS provided an important opportunity to measure expectations regarding the professional role, responsibilities, and performance of pharmacists from a multi-professional perspective, thus better preparing pharmacists for integration into primary care practice. Differences in agreement may have been due to different preconceptions and expectations among raters.

White Matter Correlates of Neuropsychological Dysfunction in Systemic Lupus Erythematosus

PubMed Central

Jung, Rex E.; Chavez, Robert S.; Flores, Ranee A.; Qualls, Clifford; Sibbitt, Wilmer L.; Roldan, Carlos A.

2012-01-01

Patients diagnosed with Systemic Lupus Erythematosus have similar levels of neuropsychological dysfunction (i.e., 20–50%) as those with Neuropsychiatric Systemic Lupus Erythematosus (NPSLE). We hypothesized a gradient between cognition and white matter integrity, such that strongest brain-behavior relationships would emerge in NPSLE, intermediate in non-NPSLE, and minimal in controls. We studied thirty-one patients (16 non-NPSLE; 15 NPSLE), ranging in age from 18 to 59 years old (100% female), and eighteen age and gender matched healthy controls. DTI examinations were performed on a 1.5T scanner. A broad neuropsychological battery was administered, tapping attention, memory, processing speed, and executive functioning. The Total z-score consisted of the combined sum of all neuropsychological measures. In control subjects, we found no significant FA-Total z-score correlations. NPSLE, non-NPSLE, and control subjects differed significantly in terms of Total z-score (NPSLE = −2.25+/−1.77, non-NPSLE = −1.22+/−1.03, Controls = −0.10+/−.57; F = 13.2, p<.001). In non-NPSLE subjects, FA within the right external capsule was significantly correlated with Total z-score. In NPSLE subjects, the largest FA-Total z-score clusters were observed within the left anterior thalamic radiation and right superior longitudinal fasciculus. In subsequent analyses the largest number of significant voxels linked FA with the Processing Speed z-score in NPSLE. The current results reflect objective white matter correlates of neuropsychological dysfunction in both NPSLE and (to a lesser degree) in non-NPSLE. non-NPSLE and NPSLE subjects did not differ significantly in terms of depression, as measured by the GDI; thus, previous hypotheses suggesting moderating effects of depression upon neuropsychological performance do not impact the current FA results. PMID:22291880

GENDER DIFFERENCES IN PERCEPTIONS OF SEXUAL INTENT: A QUALITATIVE REVIEW AND INTEGRATION

PubMed Central

Lindgren, Kristen P.; Parkhill, Michele R.; George, William H.; Hendershot, Christian S.

2009-01-01

Men appear to interpret people’s behaviors more sexually than do women. This finding, which has been replicated in scores of studies using a variety of methodological approaches, has been linked to important social concerns, including sexual assault and sexual harassment. This article provides a critical review of the published literature on gender differences in sexual intent perception, using selective examples to illustrate and summarize the field’s major constructs, methodologies, and empirical findings. Theoretical explanations for gender differences in sexual intent perceptions are reviewed. Finally, we highlight the field’s remaining issues and make several recommendations for future research directions. PMID:19763282

Sustainability and public health nutrition at school: assessing the integration of healthy and environmentally sustainable food initiatives in Vancouver schools.

PubMed

Black, Jennifer L; Velazquez, Cayley E; Ahmadi, Naseam; Chapman, Gwen E; Carten, Sarah; Edward, Joshua; Shulhan, Stephanie; Stephens, Teya; Rojas, Alejandro

2015-09-01

To describe the development and application of the School Food Environment Assessment Tools and a novel scoring system to assess the integration of healthy and environmentally sustainable food initiatives in elementary and secondary schools. The cross-sectional study included direct observations of physical food environments and interviews with key school personnel regarding food-related programmes and policies. A five-point scoring system was then developed to assess actions across six domains: (i) food gardens; (ii) composting systems; (iii) food preparation activities; (iv) food-related teaching and learning activities; and availability of (v) healthy food; and (vi) environmentally sustainable food. Vancouver, Canada. A purposive sample of public schools (n 33) from all six sectors of the Vancouver Board of Education. Schools scored highest in the areas of food garden and compost system development and use. Regular integration of food-related teaching and learning activities and hands-on food preparation experiences were also commonly reported. Most schools demonstrated rudimentary efforts to make healthy and environmentally sustainable food choices available, but in general scored lowest on these two domains. Moreover, no schools reported widespread initiatives fully supporting availability or integration of healthy or environmentally sustainable foods across campus. More work is needed in all areas to fully integrate programmes and policies that support healthy, environmentally sustainable food systems in Vancouver schools. The assessment tools and proposed indicators offer a practical approach for researchers, policy makers and school stakeholders to assess school food system environments, identify priority areas for intervention and track relevant changes over time.

Inferring dynamic gene regulatory networks in cardiac differentiation through the integration of multi-dimensional data.

PubMed

Gong, Wuming; Koyano-Nakagawa, Naoko; Li, Tongbin; Garry, Daniel J

2015-03-07

Decoding the temporal control of gene expression patterns is key to the understanding of the complex mechanisms that govern developmental decisions during heart development. High-throughput methods have been employed to systematically study the dynamic and coordinated nature of cardiac differentiation at the global level with multiple dimensions. Therefore, there is a pressing need to develop a systems approach to integrate these data from individual studies and infer the dynamic regulatory networks in an unbiased fashion. We developed a two-step strategy to integrate data from (1) temporal RNA-seq, (2) temporal histone modification ChIP-seq, (3) transcription factor (TF) ChIP-seq and (4) gene perturbation experiments to reconstruct the dynamic network during heart development. First, we trained a logistic regression model to predict the probability (LR score) of any base being bound by 543 TFs with known positional weight matrices. Second, four dimensions of data were combined using a time-varying dynamic Bayesian network model to infer the dynamic networks at four developmental stages in the mouse [mouse embryonic stem cells (ESCs), mesoderm (MES), cardiac progenitors (CP) and cardiomyocytes (CM)]. Our method not only infers the time-varying networks between different stages of heart development, but it also identifies the TF binding sites associated with promoter or enhancers of downstream genes. The LR scores of experimentally verified ESCs and heart enhancers were significantly higher than random regions (p <10(-100)), suggesting that a high LR score is a reliable indicator for functional TF binding sites. Our network inference model identified a region with an elevated LR score approximately -9400 bp upstream of the transcriptional start site of Nkx2-5, which overlapped with a previously reported enhancer region (-9435 to -8922 bp). TFs such as Tead1, Gata4, Msx2, and Tgif1 were predicted to bind to this region and participate in the regulation of Nkx2-5 gene expression. Our model also predicted the key regulatory networks for the ESC-MES, MES-CP and CP-CM transitions. We report a novel method to systematically integrate multi-dimensional -omics data and reconstruct the gene regulatory networks. This method will allow one to rapidly determine the cis-modules that regulate key genes during cardiac differentiation.

Accelerometry-enabled measurement of walking performance with a robotic exoskeleton: a pilot study.

PubMed

Lonini, Luca; Shawen, Nicholas; Scanlan, Kathleen; Rymer, William Z; Kording, Konrad P; Jayaraman, Arun

2016-03-31

Clinical scores for evaluating walking skills with lower limb exoskeletons are often based on a single variable, such as distance walked or speed, even in cases where a host of features are measured. We investigated how to combine multiple features such that the resulting score has high discriminatory power, in particular with few patients. A new score is introduced that allows quantifying the walking ability of patients with spinal cord injury when using a powered exoskeleton. Four spinal cord injury patients were trained to walk over ground with the ReWalk™ exoskeleton. Body accelerations during use of the device were recorded by a wearable accelerometer and 4 features to evaluate walking skills were computed. The new score is the Gaussian naïve Bayes surprise, which evaluates patients relative to the features' distribution measured in 7 expert users of the ReWalk™. We compared our score based on all the features with a standard outcome measure, which is based on number of steps only. All 4 patients improved over the course of training, as their scores trended towards the expert users' scores. The combined score (Gaussian naïve surprise) was considerably more discriminative than the one using only walked distance (steps). At the end of training, 3 out of 4 patients were significantly different from the experts, according to the combined score (p < .001, Wilcoxon Signed-Rank Test). In contrast, all but one patient were scored as experts when number of steps was the only feature. Integrating multiple features could provide a more robust metric to measure patients' skills while they learn to walk with a robotic exoskeleton. Testing this approach with other features and more subjects remains as future work.

Comparison of alternative MS/MS and bioinformatics approaches for confident phosphorylation site localization.

PubMed

Wiese, Heike; Kuhlmann, Katja; Wiese, Sebastian; Stoepel, Nadine S; Pawlas, Magdalena; Meyer, Helmut E; Stephan, Christian; Eisenacher, Martin; Drepper, Friedel; Warscheid, Bettina

2014-02-07

Over the past years, phosphoproteomics has advanced to a prime tool in signaling research. Since then, an enormous amount of information about in vivo protein phosphorylation events has been collected providing a treasure trove for gaining a better understanding of the molecular processes involved in cell signaling. Yet, we still face the problem of how to achieve correct modification site localization. Here we use alternative fragmentation and different bioinformatics approaches for the identification and confident localization of phosphorylation sites. Phosphopeptide-enriched fractions were analyzed by multistage activation, collision-induced dissociation and electron transfer dissociation (ETD), yielding complementary phosphopeptide identifications. We further found that MASCOT, OMSSA and Andromeda each identified a distinct set of phosphopeptides allowing the number of site assignments to be increased. The postsearch engine SLoMo provided confident phosphorylation site localization, whereas different versions of PTM-Score integrated in MaxQuant differed in performance. Based on high-resolution ETD and higher collisional dissociation (HCD) data sets from a large synthetic peptide and phosphopeptide reference library reported by Marx et al. [Nat. Biotechnol. 2013, 31 (6), 557-564], we show that an Andromeda/PTM-Score probability of 1 is required to provide an false localization rate (FLR) of 1% for HCD data, while 0.55 is sufficient for high-resolution ETD spectra. Additional analyses of HCD data demonstrated that for phosphotyrosine peptides and phosphopeptides containing two potential phosphorylation sites, PTM-Score probability cutoff values of <1 can be applied to ensure an FLR of 1%. Proper adjustment of localization probability cutoffs allowed us to significantly increase the number of confident sites with an FLR of <1%.Our findings underscore the need for the systematic assessment of FLRs for different score values to report confident modification site localization.

Video game-based exercise, Latino children's physical health, and academic achievement.

PubMed

Gao, Zan; Hannan, Peter; Xiang, Ping; Stodden, David F; Valdez, Verónica E

2013-03-01

There is a paucity of research investigating the effects of innovative physical activity programs on physical health and academic performance in the Latino population. To examine the impact of Dance Dance Revolution [DDR]-based exercise on Latino children's physical fitness and academic achievement. A repeated-measures crossover design was used. In Year 1, Grade-4 students were assigned to the intervention group and offered 30 minutes of exercise (DDR, aerobic dance) three times per week. Grade-3 and Grade-5 students made up the comparison group and were offered no structured exercise at school. In Year 2, the Grade-4 students were again assigned to the intervention, whereas Grade-5 and Grade-6 students were in the comparison group. Assessments were conducted with 208 Latino school children. The baseline measures included time to complete a 1-mile run, BMI, and reading and math scores. Data were collected again 9 months later. Overall, data were collected in 2009-2011 and analyzed in 2012. Data yielded significant differences between the intervention and comparison groups in differences in 1-mile run and math scores in Year 1 and Year 2. The results also revealed net differences in the intervention versus comparison group scores on the 1-mile run for Grade 3 (p<0.01). Additionally, children's yearly pre-test and post-test BMI group changes differed (χ(2)((2)) = 6.6, p<0.05) only for the first year of intervention. The DDR-based exercise intervention improved children's cardiorespiratory endurance and math scores over time. Professionals should consider integrating exergaming at schools to achieve the goals of promoting a physically active lifestyle and enhancing academic success among Latino children. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

A Genetic Response Score for Hydrochlorothiazide Use: Insights From Genomics and Metabolomics Integration.

PubMed

Shahin, Mohamed H; Gong, Yan; McDonough, Caitrin W; Rotroff, Daniel M; Beitelshees, Amber L; Garrett, Timothy J; Gums, John G; Motsinger-Reif, Alison; Chapman, Arlene B; Turner, Stephen T; Boerwinkle, Eric; Frye, Reginald F; Fiehn, Oliver; Cooper-DeHoff, Rhonda M; Kaddurah-Daouk, Rima; Johnson, Julie A

2016-09-01

Hydrochlorothiazide is among the most commonly prescribed antihypertensives; yet, <50% of hydrochlorothiazide-treated patients achieve blood pressure (BP) control. Herein, we integrated metabolomic and genomic profiles of hydrochlorothiazide-treated patients to identify novel genetic markers associated with hydrochlorothiazide BP response. The primary analysis included 228 white hypertensives treated with hydrochlorothiazide from the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) study. Genome-wide analysis was conducted using Illumina Omni 1 mol/L-Quad Chip, and untargeted metabolomics was performed on baseline fasting plasma samples using a gas chromatography-time-of-flight mass spectrometry platform. We found 13 metabolites significantly associated with hydrochlorothiazide systolic BP (SBP) and diastolic BP (DBP) responses (false discovery rate, <0.05). In addition, integrating genomic and metabolomic data revealed 3 polymorphisms (rs2727563 PRKAG2, rs12604940 DCC, and rs13262930 EPHX2) along with arachidonic acid, converging in the netrin signaling pathway (P=1×10(-5)), as potential markers, significantly influencing hydrochlorothiazide BP response. We successfully replicated the 3 genetic signals in 212 white hypertensives treated with hydrochlorothiazide and created a response score by summing their BP-lowering alleles. We found patients carrying 1 response allele had a significantly lower response than carriers of 6 alleles (∆SBP/∆DBP: -1.5/1.2 versus -16.3/-10.4 mm Hg, respectively, SBP score, P=1×10(-8) and DBP score, P=3×10(-9)). This score explained 11.3% and 11.9% of the variability in hydrochlorothiazide SBP and DBP responses, respectively, and was further validated in another independent study of 196 whites treated with hydrochlorothiazide (DBP score, P=0.03; SBP score, P=0.07). This study suggests that PRKAG2, DCC, and EPHX2 might be important determinants of hydrochlorothiazide BP response. © 2016 American Heart Association, Inc.

The Essay Scoring and Scorer Reliability in TOEFL CBT.

ERIC Educational Resources Information Center

Lee, Yong-Won

An essay test is now an integral part of the computer based Test of English as a Foreign Language (TOEFL-CBT). This paper provides a brief overview of the current TOEFL-CBT essay test, describes the operational procedures for essay scoring, including the Online Scoring Network (OSN) of the Educational Testing Service (ETS), and discusses major…

Validation of a New Metric for Assessing the Integration of Health Protection and Health Promotion in a Sample of Small- and Medium-Sized Employer Groups.

PubMed

Williams, Jessica A R; Nelson, Candace C; Cabán-Martinez, Alberto J; Katz, Jeffrey N; Wagner, Gregory R; Pronk, Nicolaas P; Sorensen, Glorian; McLellan, Deborah L

2015-09-01

To conduct validation analyses for a new measure of the integration of worksite health protection and health promotion approaches developed in earlier research. A survey of small- to medium-sized employers located in the United States was conducted between October 2013 and March 2014 (n = 111). Cronbach α coefficient was used to assess reliability, and Pearson correlation coefficients were used to assess convergent validity. The integration score was positively associated with the measures of occupational safety and health and health promotion activities/policies-supporting its convergent validity (Pearson correlation coefficients of 0.32 to 0.47). Cronbach α coefficient was 0.94, indicating excellent reliability. The integration score seems to be a promising tool for assessing integration of health promotion and health protection. Further work is needed to test its dimensionality and validate its use in other samples.

Investigating the Use of Integrated Instructions to Reduce the Cognitive Load Associated with Doing Practical Work in Secondary School Science

NASA Astrophysics Data System (ADS)

Haslam, Carolyn Yvonne; Hamilton, Richard Joseph

2010-09-01

This study investigated the effects of integrated illustrations on understanding instructions for practical work in science. Ninety-six secondary school students who were unfamiliar with the target content knowledge and practical equipment took part. The students were divided into two conditions: (1) modified instructions containing integrated text and illustrations, and (2) conventional instructions containing text only. Modified instructions produced significantly higher levels of performance on task, lower time to completion and perceived cognitive load and task difficulty, higher relative efficiency score, and higher post-test scores than the conventional instructions. When learners are inexperienced and the information is complex, the results suggest that physically integrating mutually referring sources of information reduces cognitive load, and therefore makes practical work instructions easier to understand.

[Validation of two indices of biological integrity (IBI) for the Angulo River subbasin in Central Mexico].

PubMed

Ramírez-Herrejón, Juan Pablo; Mercado-Silva, Norman; Medina-Nava, Martina; Domínguez-Domínguez, Omar

2012-12-01

Efforts to halt freshwater ecosystem degradation in central Mexico can benefit from using bio-monitoring tools that reflect the condition of their biotic integrity. We analyzed the applicability of two fish-based indices of biotic integrity using data from lotic and lentic systems in the Angulo River subbasin (Lerma-Chapala basin). Both independent data from our own collections during two consecutive years, and existing information detailing the ecological attributes of each species, were used to calculate indices of biological integrity for 16 sites in lotic and lentic habitats. We assessed environmental quality by combining independent evaluations water and habitat quality for each site. We found sites with poor, regular and good biotic integrity. Our study did not find sites with good environmental quality. Fish-based IBI scores were strongly and significantly correlated with scores from independent environmental assessment techniques. IBI scores were adequate at representing environmental conditions in most study sites. These results expand the area where a lotic system fish-based IBI can be used, and constitute an initial validation of a lentic system fish-based IBI. Our results suggest that these bio-monitoring tools can be used in future conservation efforts in freshwater ecosystems in the Middle Lerma Basin.

Autologous Bone Plug Supplemented With Autologous Chondrocyte Implantation in Osteochondral Defects of the Knee.

PubMed

Bhattacharjee, Atanu; McCarthy, Helen S; Tins, Bernhard; Roberts, Sally; Kuiper, J H; Harrison, Paul E; Richardson, James B

2016-05-01

Structural and functional outcome of bone graft with first- or second-generation autologous chondrocyte implantation (ACI) in treating cartilage and subchondral bone defect has not been reported previously. To evaluate the outcome of simultaneous transplantation of an autologous bone plug with first- or second-generation ACI for restoration of concomitant subchondral bone and full-thickness cartilage defect in the femoral condyle of the knee. Case series; Level of evidence, 4. Seventeen patients (mean ± SD age, 27 ± 7 years; range, 17-40 years)-12 with osteochondritis dissecans (International Cartilage Repair Society [ICRS] grades 3 and 4) and 5 with an isolated osteochondral defect (ICRS grade 4)-had the defect reconstructed with implantation of a unicortical autologous bone graft combined with ACI (the OsPlug technique). Functional outcome was assessed with Lysholm scores obtained preoperatively and at 1 and 5 years postoperatively. The repair site was evaluated with the Oswestry Arthroscopy Score (OAS), MOCART score (magnetic resonance observation of cartilage repair tissue), and ICRS II histology score. Formation of a subchondral lamina and lateral integration of the bone grafts were evaluated from magnetic resonance imaging scans. The mean defect size was 4.5 ± 2.6 cm(2) (range, 1-9 cm(2)), and the mean depth was 11.3 ± 5 mm (range, 5-18 mm). The preoperative Lysholm score improved from 45 (interquartile range [IQR], 24; range, 16-79) to 77 (IQR, 28; range, 41-100) at 1 year (P = .001) and 70 (IQR, 35; range, 33-91) at 5 years (P = .009). The mean OAS of the repair site was 6.2 (range, 0-9) at a mean of 1.3 years. The mean MOCART score was 61 ± 22 (range, 20-85) at 2.6 ± 1.8 years. Histology demonstrated generally good integration of the repair cartilage with the underlying bone. Poor lateral integration of the bone graft, as assessed on magnetic resonance imaging scan, and a low OAS were significantly associated with a poor Lysholm score and failure. A total of 3 patients had treatment failure, with 1 requiring total knee replacement at 5 years (Lysholm score of 33 at failure) and the other 2 requiring further surgical intervention because of persistent symptoms at 2 and 4 years, respectively (both had Lysholm score of 45 at failure). The Lysholm score in these patients before failure were still noted to be higher than at the preoperative level. The OsPlug technique shows significant improvement of functional outcome for up to 5 years in patients with high-grade osteochondritis dissecans or osteochondral defect. This is the first report describing association of bone graft integration with functional outcome after such a procedure. It also demonstrates histologic evidence of integration of the repair cartilage with the underlying bone graft. © 2016 The Author(s).

The effect of handling method on the mouse grimace scale in two strains of laboratory mice

PubMed Central

Leach, Matthew C

2015-01-01

Pain assessment in laboratory animals is an ethical and legal requirement. The mouse grimace scale (MGS) is a new method of pain assessment deemed to be both accurate and reliable, and observers can be rapidly trained to use it. In order for a new pain assessment technique to be effective, we must ensure that the score awarded by the technique is only influenced by pain and not by other husbandry or non-painful but integral aspects of research protocols. Here, we studied 16 male mice, housed under standard laboratory conditions. Eight mice were randomly assigned to tail handling and eight to tube handling on arrival at the unit. On each occasion the mice were removed from their cage for routine husbandry, they were picked up using their assigned handling method. Photographs of the mouse faces were then scored by treatment-blind observers as per the MGS manual (see Nature Methods 2010, Vol. 7, pp 447–449), and scores from the two groups were compared. There was no significant difference in MGS scores between the mice that had been handled using a tube compared with the tail. Consequently, these methods of handling did not influence the baseline grimace score given, suggesting that these handling techniques are not confounding factors when establishing baseline MGS scores, further validating this technique. PMID:26657061

The effect of handling method on the mouse grimace scale in two strains of laboratory mice.

PubMed

Miller, Amy L; Leach, Matthew C

2016-08-01

Pain assessment in laboratory animals is an ethical and legal requirement. The mouse grimace scale (MGS) is a new method of pain assessment deemed to be both accurate and reliable, and observers can be rapidly trained to use it. In order for a new pain assessment technique to be effective, we must ensure that the score awarded by the technique is only influenced by pain and not by other husbandry or non-painful but integral aspects of research protocols. Here, we studied 16 male mice, housed under standard laboratory conditions. Eight mice were randomly assigned to tail handling and eight to tube handling on arrival at the unit. On each occasion the mice were removed from their cage for routine husbandry, they were picked up using their assigned handling method. Photographs of the mouse faces were then scored by treatment-blind observers as per the MGS manual (see Nature Methods 2010, Vol. 7, pp 447-449), and scores from the two groups were compared. There was no significant difference in MGS scores between the mice that had been handled using a tube compared with the tail. Consequently, these methods of handling did not influence the baseline grimace score given, suggesting that these handling techniques are not confounding factors when establishing baseline MGS scores, further validating this technique. © The Author(s) 2015.

Technological pedagogical content knowledge and teaching practice of mathematics trainee teachers

NASA Astrophysics Data System (ADS)

Tajudin, Nor'ain Mohd.; Kadir, Noor Zarinawaty Abd.

2014-07-01

This study aims to identify the level of technological pedagogical content knowledge (TPCK) of mathematics trainee teachers at Universiti Pendidikan Sultan Idris (UPSI) and explore their teaching practices during practical training at school. The study was conducted in two phases using a mix-method research. In the first phase, a survey method using a questionnaire was carried out on 156 trainee teachers of Bachelor of Mathematics Education (AT14) and Bachelor of Science (Mathematics) with Education (AT48). The instrument used was a questionnaire that measures the level of content knowledge, pedagogy, technology and TPCK of mathematics. Data were analyzed using descriptive statistics, namely the mean. While in the second phase, the interview method involved four trainee teachers were performed. The instrument used was the semi-structured interview protocol to assess the trainee teacher's TPCK integration in their teaching practice. Data were analyzed using the content analysis. The findings showed that the level of knowledge of TPCK among trainee teachers was moderate with overall mean score of 3.60. This level did not show significant differences between the two programs with mean scores of 3.601 for the AT14 group and 3.603 for the AT48 group. However, there was a difference for gender classification such that the female trainees had mean score of 3.58 and male trainees with mean score of 3.72. Although students' TPCK level was moderate, the level of content knowledge (CK), technological knowledge (TK) and pedagogical knowledge (PK), showed a higher level with overall mean scores of 3.75, 3.87 and 3.84 respectively. The findings also showed that in terms of content knowledge, trainee teacher's learning mathematics background was good, but the knowledge of mathematics was limited in the curriculum, philosophy and application aspect. In terms of pedagogical content knowledge, all respondents tend to use lecture and discussion methods in teaching Trigonometry topic in almost the entire teaching and learning sessions. In terms of using technology in teaching and learning process, all respondents were more likely to use PowerPoint presentation as well as assisted by the use of a scientific calculator. The use of PowerPoint was limited in explaining the title and its content and the calculators were used during practice sessions. The four trainee teachers were still at the recognizing and acceptance levels of TPCK integration during their teaching practice. This study indicates that UPSI trainee teachers should be given exposure in the use of information and communication technology and trained to provide alternative teaching strategies in more creative ways if there are obstacles when integrating technology in teaching and learning process.

Role of binding entropy in the refinement of protein-ligand docking predictions: analysis based on the use of 11 scoring functions.

PubMed

Ruvinsky, Anatoly M

2007-06-01

We present results of testing the ability of eleven popular scoring functions to predict native docked positions using a recently developed method (Ruvinsky and Kozintsev, J Comput Chem 2005, 26, 1089) for estimation the entropy contributions of relative motions to protein-ligand binding affinity. The method is based on the integration of the configurational integral over clusters obtained from multiple docked positions. We use a test set of 100 PDB protein-ligand complexes and ensembles of 101 docked positions generated by (Wang et al. J Med Chem 2003, 46, 2287) for each ligand in the test set. To test the suggested method we compared the averaged root-mean square deviations (RMSD) of the top-scored ligand docked positions, accounting and not accounting for entropy contributions, relative to the experimentally determined positions. We demonstrate that the method increases docking accuracy by 10-21% when used in conjunction with the AutoDock scoring function, by 2-25% with G-Score, by 7-41% with D-Score, by 0-8% with LigScore, by 1-6% with PLP, by 0-12% with LUDI, by 2-8% with F-Score, by 7-29% with ChemScore, by 0-9% with X-Score, by 2-19% with PMF, and by 1-7% with DrugScore. We also compared the performance of the suggested method with the method based on ranking by cluster occupancy only. We analyze how the choice of a clustering-RMSD and a low bound of dense clusters impacts on docking accuracy of the scoring methods. We derive optimal intervals of the clustering-RMSD for 11 scoring functions.

The potential of the inventory of learning styles to study students' learning patterns in three types of medical curricula.

PubMed

Van der Veken, J; Valcke, M; Muijtjens, A; De Maeseneer, J; Derese, A

2008-01-01

Introducing innovative curricular designs can be evaluating by scrutinizing the learning patterns students use. Studying the potential of Vermunt's Inventory of Learning Styles (ILS) in detecting differences in student learning patterns in different medical curricula. Cross-sectional between-subjects comparison of ILS-scores in third-year medical students in a conventional, an integrated contextual and a PBL-curriculum using one-way post hoc ANOVA. Response rate was 85%: 197 conventional, 130 integrated contextual and 301 PBL students. The results show a differential impact from the three curricula. In relation to processing strategies, the students in the problem-based curriculum showed less rote learning and rehearsing, greater variety in sources of knowledge used and less ability to express study content in a personal manner than did the students in the conventional curriculum. The students of the integrated contextual curriculum showed more structuring of subject matter by integrating different aspects into a whole. In relation to regulation strategies, the students in the problem-based curriculum showed significantly more self-regulation of learning content and the students in the integrated contextual curriculum showed lower levels of regulation. As to learning orientations, the students in the problem-based curriculum showed less ambivalence and the students of the conventional curriculum were less vocationally oriented. The study provides empirical support for expected effects of traditional and innovative curricula which thus far were not well supported by empirical studies.

The Art in Visualizing Natural Landscapes from Space

NASA Astrophysics Data System (ADS)

Webley, P. W.; Shipman, J. S.; Adams, T.

2017-12-01

Satellite remote sensing data can capture the changing Earth at cm resolution, across hundreds of spectral channels, and multiple times per hour. There is an art in combining these datasets together to fully capture the beauty of our planet. The resulting artistic piece can be further transformed by building in an accompanying musical score, allowing for a deeper emotional connection with the public. We make use of visible, near, middle and long wave infrared and radar data as well as different remote sensing techniques to uniquely capture our changing landscape in the spaceborne data. We will generate visually compelling imagery and videos that represent hazardous events from dust storms to landslides and from volcanic eruptions to forest fires. We will demonstrate how specific features of the Earth's landscape can be emphasized through the use of different datasets and color combinations and how, by adding a musical score, we can directly connect with the viewer and heighten their experience. We will also discuss our process to integrate the different aspects of our project together and how it could be developed to capture the beauty of other planets across the solar system using spaceborne imagery and data. Bringing together experts in art installations, composing musical scores, and remote sensing image visualization can lead to new and exciting artistic representations of geoscience data. The resulting product demonstrates there is an art to visualizing remote sensing data to capture the beauty of our planet and that incorporating a musical score can take us all to new places and emotions to enhance our experience.

Development of a seaweed species-selection index for successful culture in a seaweed-based integrated aquaculture system

NASA Astrophysics Data System (ADS)

Kang, Yun Hee; Hwang, Jae Ran; Chung, Ik Kyo; Park, Sang Rul

2013-03-01

Integrated multi-trophic aquaculture (IMTA) has been proposed as a concept that combines the cultivation of fed aquaculture species ( e.g., finfish/shrimp) with extractive aquaculture species ( e.g., shellfish/seaweed). In seaweed-based integrated aquaculture, seaweeds have the capacity to reduce the environmental impact of nitrogen-rich effluents on coastal ecosystems. Thus, selection of optimal species for such aquaculture is of great importance. The present study aimed to develop a seaweed species-selection index for selecting suitable species in seaweed-based integrated aquaculture system. The index was synthesized using available literature-based information, reference data, and physiological seaweed experiments to identify and prioritize the desired species. Undaria pinnatifida, Porphyra yezoensis and Ulva compressa scored the highest according to a seaweed-based integrated aquaculture suitability index (SASI). Seaweed species with the highest scores were adjudged to fit the integrated aquaculture systems. Despite the application of this model limited by local aquaculture environment, it is considered to be a useful tool for selecting seaweed species in IMTA.

Extraversion and behavioral activation: integrating the components of approach.

PubMed

Quilty, Lena C; DeYoung, Colin G; Oakman, Jonathan M; Bagby, R Michael

2014-01-01

This investigation evaluates the structure and correlates of lower order traits related to approach, specifically, facets of extraversion and behavioral activation system (BAS) sensitivity. A 3-factor structure of approach was derived in community and clinical samples: assertiveness, enthusiasm, and sensation seeking. All factors were positively associated with Openness/Intellect scores. Enthusiasm and assertiveness were both negatively associated with Neuroticism scores, but were distinguished by associations with Agreeableness and Conscientiousness. Sensation seeking was negatively associated with Conscientiousness scores. The 3 factors demonstrated a unique profile of association with components of impulsivity. Enthusiasm and assertiveness were negatively related to psychopathological symptoms, whereas sensation seeking was largely independent of psychopathology. Results suggest that approach is associated with 3 subfactors, which differ in their pattern or magnitude of associations with other variables, thus underscoring the importance of distinguishing among them. Further, results support the construct validity of the Assertiveness and Enthusiasm aspect scales of the Big Five Aspect Scales to assess traits at this level of the personality hierarchy.

Creativity and positive symptoms in schizophrenia revisited: Structural connectivity analysis with diffusion tensor imaging.

PubMed

Son, Shuraku; Kubota, Manabu; Miyata, Jun; Fukuyama, Hidenao; Aso, Toshihiko; Urayama, Shin-ichi; Murai, Toshiya; Takahashi, Hidehiko

2015-05-01

Both creativity and schizotypy are suggested to be manifestations of the hyperactivation of unusual or remote concepts/words. However, the results of studies on creativity in schizophrenia are diverse, possibly due to the multifaceted aspects of creativity and difficulties of differentiating adaptive creativity from pathological schizotypy/positive symptoms. To date, there have been no detailed studies comprehensively investigating creativity, positive symptoms including delusions, and their neural bases in schizophrenia. In this study, we investigated 43 schizophrenia and 36 healthy participants using diffusion tensor imaging. We used idea, design, and verbal (semantic and phonological) fluency tests as creativity scores and Peters Delusions Inventory as delusion scores. Subsequently, we investigated group differences in every psychological score, correlations between fluency and delusions, and relationships between these scores and white matter integrity using tract-based spatial statistics (TBSS). In schizophrenia, idea and verbal fluency were significantly lower in general, and delusion score was higher than in healthy controls, whereas there were no group differences in design fluency. We also found positive correlation between phonological fluency and delusions in schizophrenia. By correlation analyses using TBSS, we found that the anterior part of corpus callosum was the substantially overlapped area, negatively correlated with both phonological fluency and delusion severity. Our results suggest that the anterior interhemispheric dysconnectivity might be associated with executive dysfunction, and disinhibited automatic spreading activation in the semantic network was manifested as uncontrollable phonological fluency or delusions. This dysconnectivity could be one possible neural basis that differentiates pathological positive symptoms from adaptive creativity. Copyright © 2015 Elsevier B.V. All rights reserved.

Prioritizing research for integrated implementation of early childhood development and maternal, newborn, child and adolescent health and nutrition platforms.

PubMed

Sharma, Renee; Gaffey, Michelle F; Alderman, Harold; Bassani, Diego G; Bogard, Kimber; Darmstadt, Gary L; Das, Jai K; de Graft-Johnson, Joseph E; Hamadani, Jena D; Horton, Susan; Huicho, Luis; Hussein, Julia; Lye, Stephen; Pérez-Escamilla, Rafael; Proulx, Kerrie; Marfo, Kofi; Mathews-Hanna, Vanessa; Mclean, Mireille S; Rahman, Atif; Silver, Karlee L; Singla, Daisy R; Webb, Patrick; Bhutta, Zulfiqar A

2017-06-01

Existing health and nutrition services present potential platforms for scaling up delivery of early childhood development (ECD) interventions within sensitive windows across the life course, especially in the first 1000 days from conception to age 2 years. However, there is insufficient knowledge on how to optimize implementation for such strategies in an integrated manner. In light of this knowledge gap, we aimed to systematically identify a set of integrated implementation research priorities for health, nutrition and early child development within the 2015 to 2030 timeframe of the Sustainable Development Goals (SDGs). We applied the Child Health and Nutrition Research Initiative method, and consulted a diverse group of global health experts to develop and score 57 research questions against five criteria: answerability, effectiveness, deliverability, impact, and effect on equity. These questions were ranked using a research priority score, and the average expert agreement score was calculated for each question. The research priority scores ranged from 61.01 to 93.52, with a median of 82.87. The average expert agreement scores ranged from 0.50 to 0.90, with a median of 0.75. The top-ranked research question were: i) "How can interventions and packages to reduce neonatal mortality be expanded to include ECD and stimulation interventions?"; ii) "How does the integration of ECD and MNCAH&N interventions affect human resource requirements and capacity development in resource-poor settings?"; and iii) "How can integrated interventions be tailored to vulnerable refugee and migrant populations to protect against poor ECD and MNCAH&N outcomes?". Most highly-ranked research priorities varied across the life course and highlighted key aspects of scaling up coverage of integrated interventions in resource-limited settings, including: workforce and capacity development, cost-effectiveness and strategies to reduce financial barriers, and quality assessment of programs. Investing in ECD is critical to achieving several of the SDGs, including SDG 2 on ending all forms of malnutrition, SDG 3 on ensuring health and well-being for all, and SDG 4 on ensuring inclusive and equitable quality education and promotion of life-long learning opportunities for all. The generated research agenda is expected to drive action and investment on priority approaches to integrating ECD interventions within existing health and nutrition services.

Prioritizing research for integrated implementation of early childhood development and maternal, newborn, child and adolescent health and nutrition platforms

PubMed Central

Sharma, Renee; Gaffey, Michelle F; Alderman, Harold; Bassani, Diego G; Bogard, Kimber; Darmstadt, Gary L; Das, Jai K; de Graft–Johnson, Joseph E; Hamadani, Jena D; Horton, Susan; Huicho, Luis; Hussein, Julia; Lye, Stephen; Pérez–Escamilla, Rafael; Proulx, Kerrie; Marfo, Kofi; Mathews–Hanna, Vanessa; Mclean, Mireille S; Rahman, Atif; Silver, Karlee L; Singla, Daisy R; Webb, Patrick; Bhutta, Zulfiqar A

2017-01-01

Background Existing health and nutrition services present potential platforms for scaling up delivery of early childhood development (ECD) interventions within sensitive windows across the life course, especially in the first 1000 days from conception to age 2 years. However, there is insufficient knowledge on how to optimize implementation for such strategies in an integrated manner. In light of this knowledge gap, we aimed to systematically identify a set of integrated implementation research priorities for health, nutrition and early child development within the 2015 to 2030 timeframe of the Sustainable Development Goals (SDGs). Methods We applied the Child Health and Nutrition Research Initiative method, and consulted a diverse group of global health experts to develop and score 57 research questions against five criteria: answerability, effectiveness, deliverability, impact, and effect on equity. These questions were ranked using a research priority score, and the average expert agreement score was calculated for each question. Findings The research priority scores ranged from 61.01 to 93.52, with a median of 82.87. The average expert agreement scores ranged from 0.50 to 0.90, with a median of 0.75. The top–ranked research question were: i) “How can interventions and packages to reduce neonatal mortality be expanded to include ECD and stimulation interventions?”; ii) “How does the integration of ECD and MNCAH&N interventions affect human resource requirements and capacity development in resource–poor settings?”; and iii) “How can integrated interventions be tailored to vulnerable refugee and migrant populations to protect against poor ECD and MNCAH&N outcomes?”. Most highly–ranked research priorities varied across the life course and highlighted key aspects of scaling up coverage of integrated interventions in resource–limited settings, including: workforce and capacity development, cost–effectiveness and strategies to reduce financial barriers, and quality assessment of programs. Conclusions Investing in ECD is critical to achieving several of the SDGs, including SDG 2 on ending all forms of malnutrition, SDG 3 on ensuring health and well–being for all, and SDG 4 on ensuring inclusive and equitable quality education and promotion of life–long learning opportunities for all. The generated research agenda is expected to drive action and investment on priority approaches to integrating ECD interventions within existing health and nutrition services. PMID:28685048

Lung cancer in patients with chronic obstructive pulmonary disease. Development and validation of the COPD Lung Cancer Screening Score.

PubMed

de-Torres, Juan P; Wilson, David O; Sanchez-Salcedo, Pablo; Weissfeld, Joel L; Berto, Juan; Campo, Arantzazu; Alcaide, Ana B; García-Granero, Marta; Celli, Bartolome R; Zulueta, Javier J

2015-02-01

Patients with chronic obstructive pulmonary disease (COPD) are at high risk for lung cancer (LC) and represent a potential target to improve the diagnostic yield of screening programs. To develop a predictive score for LC risk for patients with COPD. The Pamplona International Early Lung Cancer Detection Program (P-IELCAP) and the Pittsburgh Lung Screening Study (PLuSS) databases were analyzed. Only patients with COPD on spirometry were included. By logistic regression we determined which factors were independently associated with LC in PLuSS and developed a COPD LC screening score (COPD-LUCSS) to be validated in P-IELCAP. By regression analysis, age greater than 60, body mass index less than 25 kg/m(2), pack-years history greater than 60, and emphysema presence were independently associated with LC diagnosis and integrated into the COPD-LUCSS, which ranges from 0 to 10 points. Two COPD-LUCSS risk categories were proposed: low risk (scores 0-6) and high risk (scores 7-10). In comparison with low-risk patients, in both cohorts LC risk increased 3.5-fold in the high-risk category. The COPD-LUCSS is a good predictor of LC risk in patients with COPD participating in LC screening programs. Validation in two different populations adds strength to the findings.

Insight in psychotic disorder: relation with psychopathology and frontal lobe function.

PubMed

Kumar, Atmesh; Sharma, Pranjal; Das, Shyamanta; Nath, Kamal; Talukdar, Uddip; Bhagabati, Dipesh

2014-01-01

Through conceptualising poor insight in psychotic disorders as a form of anosognosia, frontal lobe dysfunction is often ascribed a vital role in its pathogenesis. The objective of this study was to compare the relation of insight in patients with psychotic illness to that of psychopathology and frontal lobe function. Forty patients with psychotic disorder were selected from those attending the Department of Psychiatry in a tertiary care teaching hospital. The evaluation of insight was carried out using the Schedule for Assessment of Insight (SAI), that of frontal lobe function by the Frontal Assessment Battery (FAB) and psychopathology by the Brief Psychiatric Rating Scale (BPRS). The correlation coefficients were determined. A negative correlation between SAI and BPRS scores means that the BPRS score is opposite to SAI scores. When the SAI total score was compared with the FAB total score, the correlation coefficient demonstrated a positive correlation. Better insight predicted lesser psychopathology and also that poor insight would exist with greater psychopathology. Better insight predicted a higher functional status of frontal lobes and prefrontal cortex in particular. Insight deficits in schizophrenia and other psychotic illnesses are multidimensional. Integration of different aetiological factors like biological, psychopathological, environmental ones and others are necessary for a better understanding of insight in psychosis. Copyright © 2013 S. Karger AG, Basel.

Deficits in vision and visual attention associated with motor performance of very preterm/very low birth weight children.

PubMed

Geldof, Christiaan J A; van Hus, Janeline W P; Jeukens-Visser, Martine; Nollet, Frans; Kok, Joke H; Oosterlaan, Jaap; van Wassenaer-Leemhuis, Aleid G

2016-01-01

To extend understanding of impaired motor functioning of very preterm (VP)/very low birth weight (VLBW) children by investigating its relationship with visual attention, visual and visual-motor functioning. Motor functioning (Movement Assessment Battery for Children, MABC-2; Manual Dexterity, Aiming & Catching, and Balance component), as well as visual attention (attention network and visual search tests), vision (oculomotor, visual sensory and perceptive functioning), visual-motor integration (Beery Visual Motor Integration), and neurological status (Touwen examination) were comprehensively assessed in a sample of 106 5.5-year-old VP/VLBW children. Stepwise linear regression analyses were conducted to investigate multivariate associations between deficits in visual attention, oculomotor, visual sensory, perceptive and visual-motor integration functioning, abnormal neurological status, neonatal risk factors, and MABC-2 scores. Abnormal MABC-2 Total or component scores occurred in 23-36% of VP/VLBW children. Visual and visual-motor functioning accounted for 9-11% of variance in MABC-2 Total, Manual Dexterity and Balance scores. Visual perceptive deficits only were associated with Aiming & Catching. Abnormal neurological status accounted for an additional 19-30% of variance in MABC-2 Total, Manual Dexterity and Balance scores, and 5% of variance in Aiming & Catching, and neonatal risk factors for 3-6% of variance in MABC-2 Total, Manual Dexterity and Balance scores. Motor functioning is weakly associated with visual and visual-motor integration deficits and moderately associated with abnormal neurological status, indicating that motor performance reflects long term vulnerability following very preterm birth, and that visual deficits are of minor importance in understanding motor functioning of VP/VLBW children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integrating health profile with survival for quality of life assessment.

PubMed

Hwang, Jing-Shiang; Wang, Jung-Der

2004-02-01

In cohort studies or clinical trials, measurements of quality of life (QoL) were averaged across available individuals for each group at given points in time to produce single measures for comparisons. However, estimates of these single measures may be severely biased if substantial mortality occurs over time. The objective of this study is to develop a method that integrates QoL measurement and survival for long-term evaluation of health services. We defined a mean QoL score function over time for an index population as the average QoL score of all individuals both alive and dead at each time point in the population. While a living subject's QoL can be assessed by asking one's subjective preference, the score of a decedent can be assigned a fixed value depending on the specific facet on health profile. The mean QoL score function over time is reduced to a single measure of expected cumulative QoL score, which is the area under the curve of mean QoL score function over a given time interval and can be estimated by taking a random sample from a cross-sectional survey. For the QoL score function to be extrapolated to life-long, it requires the assumption that the disease causes premature death or a long-term moderate impairment of QoL. We provided methods and computer programs for estimating mean QoL score functions and the reduced single measures for use in comparisons. A cohort of 779 breast cancer patients from Chiangmai, Thailand were followed for 12 years to demonstrate the proposed methods. The data included the 12-year complete survival records and QoL scores on 233 patients collected from a cross-sectional survey using WHOQOL questionnaire and standard gamble method. The expected cumulative QoL scores using utility and psychometric scales were compared among patients in four groups of clinical stages in this cohort for time from onset up to 12 years and life-long. We conclude that such an integration of QoL measurement with survival can be useful for the evaluation of health service and clinical decision.

msCompare: A Framework for Quantitative Analysis of Label-free LC-MS Data for Comparative Candidate Biomarker Studies*

PubMed Central

Hoekman, Berend; Breitling, Rainer; Suits, Frank; Bischoff, Rainer; Horvatovich, Peter

2012-01-01

Data processing forms an integral part of biomarker discovery and contributes significantly to the ultimate result. To compare and evaluate various publicly available open source label-free data processing workflows, we developed msCompare, a modular framework that allows the arbitrary combination of different feature detection/quantification and alignment/matching algorithms in conjunction with a novel scoring method to evaluate their overall performance. We used msCompare to assess the performance of workflows built from modules of publicly available data processing packages such as SuperHirn, OpenMS, and MZmine and our in-house developed modules on peptide-spiked urine and trypsin-digested cerebrospinal fluid (CSF) samples. We found that the quality of results varied greatly among workflows, and interestingly, heterogeneous combinations of algorithms often performed better than the homogenous workflows. Our scoring method showed that the union of feature matrices of different workflows outperformed the original homogenous workflows in some cases. msCompare is open source software (https://trac.nbic.nl/mscompare), and we provide a web-based data processing service for our framework by integration into the Galaxy server of the Netherlands Bioinformatics Center (http://galaxy.nbic.nl/galaxy) to allow scientists to determine which combination of modules provides the most accurate processing for their particular LC-MS data sets. PMID:22318370

Loss of corticospinal tract integrity in early MS disease stages

PubMed Central

Neumann, Jens; Kaufmann, Jörn; Heidel, Jan; Stadler, Erhard; Sweeney-Reed, Catherine; Sailer, Michael; Schreiber, Stefanie

2017-01-01

Objective: We investigated corticospinal tract (CST) integrity in the absence of white matter (WM) lesions using diffusion tensor imaging (DTI) in early MS disease stages. Methods: Our study comprised 19 patients with clinically isolated syndrome (CIS), 11 patients with relapsing-remitting MS (RRMS), and 32 age- and sex-matched healthy controls, for whom MRI measures of CST integrity (fractional anisotropy [FA], mean diffusivity [MD]), T1- and T2-based lesion load, and brain volumes were available. The mean (SD) disease duration was 3.5 (2.1) months, and disability score was low (median Expanded Disability Status Scale 1.5) at the time of the study. Results: Patients with CIS and RRMS had significantly lower CST FA and higher CST MD values compared with controls. These findings were present, irrespective of whether WM lesions affected the CST. However, no group differences in the overall gray or WM volume were identified. Conclusions: In early MS disease stages, CST integrity is already affected in the absence of WM lesions or brain atrophy. PMID:28959706

Illusions of integration are subjectively impenetrable: Phenomenological experience of Lag 1 percepts during dual-target RSVP.

PubMed

Simione, Luca; Akyürek, Elkan G; Vastola, Valentina; Raffone, Antonino; Bowman, Howard

2017-05-01

We investigated the relationship between different kinds of target reports in a rapid serial visual presentation task, and their associated perceptual experience. Participants reported the identity of two targets embedded in a stream of stimuli and their associated subjective visibility. In our task, target stimuli could be combined together to form more complex ones, thus allowing participants to report temporally integrated percepts. We found that integrated percepts were associated with high subjective visibility scores, whereas reports in which the order of targets was reversed led to a poorer perceptual experience. We also found a reciprocal relationship between the chance of the second target not being reported correctly and the perceptual experience associated with the first one. Principally, our results indicate that integrated percepts are experienced as a unique, clear perceptual event, whereas order reversals are experienced as confused, similar to cases in which an entirely wrong response was given. Copyright © 2017 Elsevier Inc. All rights reserved.

Historeceptomic Fingerprints for Drug-Like Compounds.

PubMed

Shmelkov, Evgeny; Grigoryan, Arsen; Swetnam, James; Xin, Junyang; Tivon, Doreen; Shmelkov, Sergey V; Cardozo, Timothy

2015-01-01

Most drugs exert their beneficial and adverse effects through their combined action on several different molecular targets (polypharmacology). The true molecular fingerprint of the direct action of a drug has two components: the ensemble of all the receptors upon which a drug acts and their level of expression in organs/tissues. Conversely, the fingerprint of the adverse effects of a drug may derive from its action in bystander tissues. The ensemble of targets is almost always only partially known. Here we describe an approach improving upon and integrating both components: in silico identification of a more comprehensive ensemble of targets for any drug weighted by the expression of those receptors in relevant tissues. Our system combines more than 300,000 experimentally determined bioactivity values from the ChEMBL database and 4.2 billion molecular docking scores. We integrated these scores with gene expression data for human receptors across a panel of human tissues to produce drug-specific tissue-receptor (historeceptomics) scores. A statistical model was designed to identify significant scores, which define an improved fingerprint representing the unique activity of any drug. These multi-dimensional historeceptomic fingerprints describe, in a novel, intuitive, and easy to interpret style, the holistic, in vivo picture of the mechanism of any drug's action. Valuable applications in drug discovery and personalized medicine, including the identification of molecular signatures for drugs with polypharmacologic modes of action, detection of tissue-specific adverse effects of drugs, matching molecular signatures of a disease to drugs, target identification for bioactive compounds with unknown receptors, and hypothesis generation for drug/compound phenotypes may be enabled by this approach. The system has been deployed at drugable.org for access through a user-friendly web site.

Threatened species and the potential loss of phylogenetic diversity: conservation scenarios based on estimated extinction probabilities and phylogenetic risk analysis.

PubMed

Faith, Daniel P

2008-12-01

New species conservation strategies, including the EDGE of Existence (EDGE) program, have expanded threatened species assessments by integrating information about species' phylogenetic distinctiveness. Distinctiveness has been measured through simple scores that assign shared credit among species for evolutionary heritage represented by the deeper phylogenetic branches. A species with a high score combined with a high extinction probability receives high priority for conservation efforts. Simple hypothetical scenarios for phylogenetic trees and extinction probabilities demonstrate how such scoring approaches can provide inefficient priorities for conservation. An existing probabilistic framework derived from the phylogenetic diversity measure (PD) properly captures the idea of shared responsibility for the persistence of evolutionary history. It avoids static scores, takes into account the status of close relatives through their extinction probabilities, and allows for the necessary updating of priorities in light of changes in species threat status. A hypothetical phylogenetic tree illustrates how changes in extinction probabilities of one or more species translate into changes in expected PD. The probabilistic PD framework provided a range of strategies that moved beyond expected PD to better consider worst-case PD losses. In another example, risk aversion gave higher priority to a conservation program that provided a smaller, but less risky, gain in expected PD. The EDGE program could continue to promote a list of top species conservation priorities through application of probabilistic PD and simple estimates of current extinction probability. The list might be a dynamic one, with all the priority scores updated as extinction probabilities change. Results of recent studies suggest that estimation of extinction probabilities derived from the red list criteria linked to changes in species range sizes may provide estimated probabilities for many different species. Probabilistic PD provides a framework for single-species assessment that is well-integrated with a broader measurement of impacts on PD owing to climate change and other factors.

Different coding strategies for the perception of stable and changeable facial attributes.

PubMed

Taubert, Jessica; Alais, David; Burr, David

2016-09-01

Perceptual systems face competing requirements: improving signal-to-noise ratios of noisy images, by integration; and maximising sensitivity to change, by differentiation. Both processes occur in human vision, under different circumstances: they have been termed priming, or serial dependencies, leading to positive sequential effects; and adaptation or habituation, which leads to negative sequential effects. We reasoned that for stable attributes, such as the identity and gender of faces, the system should integrate: while for changeable attributes like facial expression, it should also engage contrast mechanisms to maximise sensitivity to change. Subjects viewed a sequence of images varying simultaneously in gender and expression, and scored each as male or female, and happy or sad. We found strong and consistent positive serial dependencies for gender, and negative dependency for expression, showing that both processes can operate at the same time, on the same stimuli, depending on the attribute being judged. The results point to highly sophisticated mechanisms for optimizing use of past information, either by integration or differentiation, depending on the permanence of that attribute.

Integrating patient reported outcome measures and computerized adaptive test estimates on the same common metrics: an example from the assessment of activities in rheumatoid arthritis.

PubMed

Doğanay Erdoğan, Beyza; Elhan, Atilla Halİl; Kaskatı, Osman Tolga; Öztuna, Derya; Küçükdeveci, Ayşe Adile; Kutlay, Şehim; Tennant, Alan

2017-10-01

This study aimed to explore the potential of an inclusive and fully integrated measurement system for the Activities component of the International Classification of Functioning, Disability and Health (ICF), incorporating four classical scales, including the Health Assessment Questionnaire (HAQ), and a Computerized Adaptive Testing (CAT). Three hundred patients with rheumatoid arthritis (RA) answered relevant questions from four questionnaires. Rasch analysis was performed to create an item bank using this item pool. A further 100 RA patients were recruited for a CAT application. Both real and simulated CATs were applied and the agreement between these CAT-based scores and 'paper-pencil' scores was evaluated with intraclass correlation coefficient (ICC). Anchoring strategies were used to obtain a direct translation from the item bank common metric to the HAQ score. Mean age of 300 patients was 52.3 ± 11.7 years; disease duration was 11.3 ± 8.0 years; 74.7% were women. After testing for the assumptions of Rasch analysis, a 28-item Activities item bank was created. The agreement between CAT-based scores and paper-pencil scores were high (ICC = 0.993). Using those HAQ items in the item bank as anchoring items, another Rasch analysis was performed with HAQ-8 scores as separate items together with anchoring items. Finally a conversion table of the item bank common metric to the HAQ scores was created. A fully integrated and inclusive health assessment system, illustrating the Activities component of the ICF, was built to assess RA patients. Raw score to metric conversions and vice versa were available, giving access to the metric by a simple look-up table. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Integrating physical examination and trunk anatomy; a new course for second year medical students.

PubMed

Adibi, Iman; Hasani, Nasibeh; Ashoorioun, Vahid; Sadrearhami, Shohreh; Monajemi, Ali Reza

2007-11-01

The aim of this study was to determine the effect of an integrated course of physical examination and trunk anatomy on second year medical students' attitude and knowledge of anatomy. Thirty nine second year medical students attended a physical examination course (5 small group sessions) related to topics in trunk anatomy (2004/05). Students in control group attended routine anatomy lectures and problem based learning discussions relevant to their physiology course. Routine final anatomy exam (65 multiple choices questions) was performed. Attitude toward course impacts in intervention group were assessed by a likert questionnaire (18 items). A T-test was performed to compare anatomy scores. The Intervention group had higher score exam anatomy (46.6 +/- 6.3) than others (41.4 +/- 6.0, p = 0.04). The mean score of attitude questionnaire was 3.48 (SD = 0.8). In conclusion teaching physical examinations integrated with trunk anatomy improves students' knowledge and motivated them in learning anatomy.

A Comparison of Methods to Screen Middle School Students for Reading and Math Difficulties

ERIC Educational Resources Information Center

Nelson, Peter M.; Van Norman, Ethan R.; Lackner, Stacey K.

2016-01-01

The current study explored multiple ways in which middle schools can use and integrate data sources to predict proficiency on future high-stakes state achievement tests. The diagnostic accuracy of (a) prior achievement data, (b) teacher rating scale scores, (c) a composite score combining state test scores and rating scale responses, and (d) two…

Patients' Preference for Integrating Homoeopathy Services within the Secondary Health Care Settings in India: The Part 3 (PPIH-3) Study.

PubMed

Manchanda, Rajkumar; Koley, Munmun; Saha, Subhranil; Sarkar, Debabrata; Mondal, Ramkumar; Thakur, Prosenjit; Biswas, Debjyoti; Rawat, Birendra Singh; Rajachandrasekar, Bhuvaneswari; Mittal, Renu

2016-05-23

Indian patients' preference for integrated homoeopathy services remains underresearched. Two earlier surveys revealed favorable attitude toward and satisfaction from integrated services. The objectives of this study were to examine knowledge, attitudes, and practice of homoeopathy and to evaluate preference toward its integration into secondary-level health care. A cross-sectional survey was conducted during May to October 2015 among 659 adult patients visiting randomly selected secondary-level conventional health care setups in Kolkata, Mumbai, Kottayam, and New Delhi (India) using a self-administered 24-item questionnaire in 4 local vernaculars (Bengali, Marathi, Malayalam, and Hindi). Knowledge and practice scores were compromised; attitude scores toward integration and legal regulation were high. Respondents were uncertain regarding side effects of homoeopathy and concurrent use and interactions with conventional medicines. A total of 82.40% (95% confidence interval = 79.23, 85.19) of the participants were in favor of integrating homoeopathy services. Preference was significantly higher in Delhi and lower in Kottayam. Probable strategic measures for further development of integrated models are discussed. © The Author(s) 2016.

Patients’ Preference for Integrating Homoeopathy Services within the Secondary Health Care Settings in India

PubMed Central

Manchanda, Rajkumar; Koley, Munmun; Saha, Subhranil; Sarkar, Debabrata; Mondal, Ramkumar; Thakur, Prosenjit; Biswas, Debjyoti; Rawat, Birendra Singh; Rajachandrasekar, Bhuvaneswari; Mittal, Renu

2016-01-01

Indian patients’ preference for integrated homoeopathy services remains underresearched. Two earlier surveys revealed favorable attitude toward and satisfaction from integrated services. The objectives of this study were to examine knowledge, attitudes, and practice of homoeopathy and to evaluate preference toward its integration into secondary-level health care. A cross-sectional survey was conducted during May to October 2015 among 659 adult patients visiting randomly selected secondary-level conventional health care setups in Kolkata, Mumbai, Kottayam, and New Delhi (India) using a self-administered 24-item questionnaire in 4 local vernaculars (Bengali, Marathi, Malayalam, and Hindi). Knowledge and practice scores were compromised; attitude scores toward integration and legal regulation were high. Respondents were uncertain regarding side effects of homoeopathy and concurrent use and interactions with conventional medicines. A total of 82.40% (95% confidence interval = 79.23, 85.19) of the participants were in favor of integrating homoeopathy services. Preference was significantly higher in Delhi and lower in Kottayam. Probable strategic measures for further development of integrated models are discussed. PMID:27215693

Measuring variations in bicultural identity across U.S. ethnic and generational groups: Development and validation of the Bicultural Identity Integration Scale-Version 2 (BIIS-2).

PubMed

Huynh, Que-Lam; Benet-Martínez, Verònica; Nguyen, Angela-MinhTu D

2018-06-14

Bicultural Identity Integration (BII) is an individual difference construct that captures variations in the experience of biculturalism. Using multiple samples in a series of steps, we refined BII measurement and then tested the construct in a diverse sample of bicultural individuals. Specifically, we wrote new BII items based on qualitative data ( n = 108), examined the quality of the new measure using subject-matter experts ( n = 23) and bicultural individuals ( n = 5), and then collected validation data from bicultural college students ( n = 1049). We used exploratory factor analyses to select items and explore BIIS-2 structure with a random subset of the larger sample ( n = 600), confirmatory factor analyses to show that the factor structure fit the data well ( n = 449), and multigroup confirmatory factor analyses to demonstrate measurement invariance in two ethnic and two generational groups. Results showed that the Bicultural Identity Integration Scale-Version 2 (BIIS-2) yielded reliable and stable scores. The data also revealed interesting and important patterns of associations with theoretically relevant constructs: personality, acculturation, and psychological well-being. Additionally, structural equation models confirmed that in general, personality and acculturation variables influence individuals' experiences with their dual cultural identities, which in turn influence adjustment, but there were interesting and important generational differences in how these variables were related. These findings lend support for the validity of BIIS-2 score interpretations; add to our understanding of the sociocultural, personality, and adjustment correlates of the bicultural experience; and have important implications for understanding the well-being of bicultural individuals. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Epistemological and methodological significance of quantitative studies of psychomotor activity for the explanation of clinical depression.

PubMed

Terziivanova, Petya; Haralanov, Svetlozar

2012-12-01

Psychomotor disturbances have been regarded as cardinal symptoms of depression for centuries and their objective assessment may have predictive value with respect to the severity of clinical depression, treatment outcome and prognosis of the affective disorder. Montgomery-Åsberg Depression Rating Scale (MADRS) and Hamilton Rating Scale for Anxiety (HAM-A). Psychomotor indicators of activity and reactivity were objectively recorded and measured by means of computerized ultrasonographic craniocorpography. We found a statistically significant correlation between disturbances in psychomotor indicators and MADRS total score (r = 0.4; P < 0.0001). The severity of HAM-A total score had no statistically significant correlation with psychomotor indicators (P > 0.05). We found that different items of MADRS and HAM-A correlated with psychomotor disturbances of different strength and significance. Objectively, measured psychomotor retardation was associated with greater severity of depressive symptoms assessed at the clinical level. Integration between different methods is needed in order to improve understanding of the psychopathology and the neurobiology of a disputable diagnosis such as clinical depression. © 2012 Blackwell Publishing Ltd.

Quantitative maps of genetic interactions in yeast - comparative evaluation and integrative analysis.

PubMed

Lindén, Rolf O; Eronen, Ville-Pekka; Aittokallio, Tero

2011-03-24

High-throughput genetic screening approaches have enabled systematic means to study how interactions among gene mutations contribute to quantitative fitness phenotypes, with the aim of providing insights into the functional wiring diagrams of genetic interaction networks on a global scale. However, it is poorly known how well these quantitative interaction measurements agree across the screening approaches, which hinders their integrated use toward improving the coverage and quality of the genetic interaction maps in yeast and other organisms. Using large-scale data matrices from epistatic miniarray profiling (E-MAP), genetic interaction mapping (GIM), and synthetic genetic array (SGA) approaches, we carried out here a systematic comparative evaluation among these quantitative maps of genetic interactions in yeast. The relatively low association between the original interaction measurements or their customized scores could be improved using a matrix-based modelling framework, which enables the use of single- and double-mutant fitness estimates and measurements, respectively, when scoring genetic interactions. Toward an integrative analysis, we show how the detections from the different screening approaches can be combined to suggest novel positive and negative interactions which are complementary to those obtained using any single screening approach alone. The matrix approximation procedure has been made available to support the design and analysis of the future screening studies. We have shown here that even if the correlation between the currently available quantitative genetic interaction maps in yeast is relatively low, their comparability can be improved by means of our computational matrix approximation procedure, which will enable integrative analysis and detection of a wider spectrum of genetic interactions using data from the complementary screening approaches.

Integration of Distributed Services and Hybrid Models Based on Process Choreography to Predict and Detect Type 2 Diabetes

PubMed Central

Bayo-Monton, Jose-Luis; Argente-Pla, María; Fernandez-Llatas, Carlos; Merino-Torres, Juan Francisco

2017-01-01

Life expectancy is increasing and, so, the years that patients have to live with chronic diseases and co-morbidities. Type 2 diabetes is one of the most prevalent chronic diseases, specifically linked to being overweight and ages over sixty. Recent studies have demonstrated the effectiveness of new strategies to delay and even prevent the onset of type 2 diabetes by a combination of active and healthy lifestyle on cohorts of mid to high risk subjects. Prospective research has been driven on large groups of the population to build risk scores that aim to obtain a rule for the classification of patients according to the odds for developing the disease. Currently, there are more than two hundred models and risk scores for doing this, but a few have been properly evaluated in external groups and integrated into a clinical application for decision support. In this paper, we present a novel system architecture based on service choreography and hybrid modeling, which enables a distributed integration of clinical databases, statistical and mathematical engines and web interfaces to be deployed in a clinical setting. The system was assessed during an eight-week continuous period with eight endocrinologists of a hospital who evaluated up to 8080 patients with seven different type 2 diabetes risk models implemented in two mathematical engines. Throughput was assessed as a matter of technical key performance indicators, confirming the reliability and efficiency of the proposed architecture to integrate hybrid artificial intelligence tools into daily clinical routine to identify high risk subjects. PMID:29286314

Mental health treatment outcomes in a humanitarian emergency: a pilot model for the integration of mental health into primary care in Habilla, Darfur.

PubMed

Souza, Renato; Yasuda, Silvia; Cristofani, Susanna

2009-07-21

There is no description of outcomes for patients receiving treatment for mental illnesses in humanitarian emergencies. MSF has developed a model for integration of mental health into primary care in a humanitarian emergency setting based on the capacity of community health workers, clinical officers and health counsellors under the supervision of a psychiatrist trainer. Our study aims to describe the characteristics of patients first attending mental health services and their outcomes on functionality after treatment. A total of 114 patients received mental health care and 81 adult patients were evaluated with a simplified functionality assessment instrument at baseline, one month and 3 months after initiation of treatment. Most patients were diagnosed with epilepsy (47%) and psychosis (31%) and had never received treatment. In terms of follow up, 58% came for consultations at 1 month and 48% at 3 months. When comparing disability levels at baseline versus 1 month, mean disability score decreased from 9.1 (95%CI 8.1-10.2) to 7.1 (95%CI 5.9-8.2) p = 0.0001. At 1 month versus 3 months, mean score further decreased to 5.8 (95%CI 4.6-7.0) p < 0.0001. The findings suggest that there is potential to integrate mental health into primary care in humanitarian emergency contexts. Patients with severe mental illness and epilepsy are in particular need of mental health care. Different strategies for integration of mental health into primary care in humanitarian emergency settings need to be compared in terms of simplicity and feasibility.

Integration of Distributed Services and Hybrid Models Based on Process Choreography to Predict and Detect Type 2 Diabetes.

PubMed

Martinez-Millana, Antonio; Bayo-Monton, Jose-Luis; Argente-Pla, María; Fernandez-Llatas, Carlos; Merino-Torres, Juan Francisco; Traver-Salcedo, Vicente

2017-12-29

Life expectancy is increasing and, so, the years that patients have to live with chronic diseases and co-morbidities. Type 2 diabetes is one of the most prevalent chronic diseases, specifically linked to being overweight and ages over sixty. Recent studies have demonstrated the effectiveness of new strategies to delay and even prevent the onset of type 2 diabetes by a combination of active and healthy lifestyle on cohorts of mid to high risk subjects. Prospective research has been driven on large groups of the population to build risk scores that aim to obtain a rule for the classification of patients according to the odds for developing the disease. Currently, there are more than two hundred models and risk scores for doing this, but a few have been properly evaluated in external groups and integrated into a clinical application for decision support. In this paper, we present a novel system architecture based on service choreography and hybrid modeling, which enables a distributed integration of clinical databases, statistical and mathematical engines and web interfaces to be deployed in a clinical setting. The system was assessed during an eight-week continuous period with eight endocrinologists of a hospital who evaluated up to 8080 patients with seven different type 2 diabetes risk models implemented in two mathematical engines. Throughput was assessed as a matter of technical key performance indicators, confirming the reliability and efficiency of the proposed architecture to integrate hybrid artificial intelligence tools into daily clinical routine to identify high risk subjects.

An analysis of the economic and patient outcome impact of an integrated COPD service in east London.

PubMed

Garner, Anna; Hodson, Matthew; Ketsetzis, Georgios; Pulle, Laurence; Yorke, Janelle; Bhowmik, Angshu

2017-01-01

Exacerbations of COPD carry a huge burden of morbidity and a significant economic impact. It has been shown that home care may be useful for exacerbations of COPD. This article presents a review of an integrated COPD service in east London. Hospital Episode Statistics, Public Health Mortality Files and clinical data were used to analyze differences in health care usage and COPD patient outcomes, including COPD assessment test (CAT) scores for a subsample, before and after the introduction of the integrated service. There was a significant (30%) reduction in the number of hospital bed days for COPD patients ( P <0.05), alongside a significant increase in patients with only a short stay (0-1 days) in hospital ( P <0.0001). There was a significant increase in the number of patients dying outside of hospital (a proxy for quality of end-of-life care) following introduction of the service ( P =0.00015). Patients also reported a clinically significant improvement in CAT scores. A locally developed economic model shows that the economic benefits of the service (via impact on place of death and reduction in length of hospital stay) were almost equal to the cost of the service. The increase in proportion of short-stay admissions and the reduction in bed days suggest an impact of the service on early supported discharge and that this along with an improvement in patient clinical outcomes and in quality of end-of-life care shows that an exemplar integrated COPD service can provide benefits that equate to a nearly cost-neutral service.

Educational outcomes of the Harvard Medical School-Cambridge integrated clerkship: a way forward for medical education.

PubMed

Hirsh, David; Gaufberg, Elizabeth; Ogur, Barbara; Cohen, Pieter; Krupat, Edward; Cox, Malcolm; Pelletier, Stephen; Bor, David

2012-05-01

The authors report data from the Harvard Medical School-Cambridge Integrated Clerkship (CIC), a model of medical education in which students' entire third year consists of a longitudinal, integrated curriculum. The authors compare the knowledge, skills, and attitudes of students completing the CIC with those of students completing traditional third-year clerkships. The authors compared 27 students completing the first three years of the CIC (2004-2007) with 45 students completing clerkships at other Harvard teaching hospitals during the same period. At baseline, no significant between-group differences existed (Medical College Admission Test and Step 1 scores, second-year objective structured clinical examination [OSCE] performance, attitudes toward patient-centered care, and plans for future practice) in any year. The authors compared students' National Board of Medical Examiners Subject and Step 2 Clinical Knowledge scores, OSCE performance, perceptions of the learning environment, and attitudes toward patient-centeredness. CIC students performed as well as or better than their traditionally trained peers on measures of content knowledge and clinical skills. CIC students expressed higher satisfaction with the learning environment, more confidence in dealing with numerous domains of patient care, and a stronger sense of patient-centeredness. CIC students are at least as well as and in several ways better prepared than their peers. CIC students also demonstrate richer perspectives on the course of illness, more insight into social determinants of illness and recovery, and increased commitment to patients. These data suggest that longitudinal integrated clerkships offer students important intellectual, professional, and personal benefits.

Simulation-Based Educational Module Improves Intern and Medical Student Performance of Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures.

PubMed

Butler, Bennet A; Lawton, Cort D; Burgess, Jamie; Balderama, Earvin S; Barsness, Katherine A; Sarwark, John F

2017-12-06

Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution. Subjects all completed a combined didactic and simulation-based course on pediatric supracondylar humeral fractures. The first part of this course was an electronic (e)-learning module that the subjects could complete at home in approximately 40 minutes. The second part of the course was a 20-minute simulation-based skills learning session completed in the simulation center. Subject knowledge of closed reduction and percutaneous pinning of supracondylar humeral fractures was tested using a 30-question, multiple-choice, written test. Surgical skills were tested in the operating room or in a simulated operating room. Subject pre-intervention and post-intervention scores were compared to determine if and how much they had improved. A total of 21 subjects were tested. These subjects significantly improved their scores on both the written, multiple-choice test and skills test after completing the combined didactic and simulation module. Prior to the module, intern and subintern multiple-choice test scores were significantly worse than postgraduate year (PGY)-2 to PGY-5 resident scores (p < 0.01); after completion of the module, there was no significant difference in the multiple-choice test scores. After completing the module, there was no significant difference in skills test scores between interns and PGY-2 to PGY-5 residents. Both tests were validated using the scores obtained from PGY-2 to PGY-5 residents. Our combined didactic and simulation course significantly improved intern and subintern understanding of supracondylar humeral fractures and their ability to perform a closed reduction and percutaneous pinning of these fractures.

Patient Responses on Quality of Care and Satisfaction with Staff After Integrated HIV Care in South African Primary Health Care Clinics.

PubMed

Rawat, Angeli; Uebel, Kerry; Moore, David; Cingl, Lubomir; Yassi, Annalee

2018-05-16

HIV care integrated into primary health care (PHC) encourages reorganized service delivery but could increase workload. In 2012-2013, we surveyed 910 patients and caregivers at two time points after integration in four clinics in Free State, South Africa. Likert surveys measured quality of care (QoC) and satisfaction with staff (SwS). QoC scores were lower for females, those older than 56 years, those visiting clinics every 3 months, and child health participants. Regression estimates showed QoC scores higher for ages 36-45 versus 18-25 years, and lower for those attending clinics for more than 10 years versus 6-12 months. Overall, SwS scores were lower for child health attendees and higher for tuberculosis attendees compared to chronic disease care attendees. Research is needed to understand determinants of disparities in QoC and SwS, especially for child health, diabetes, and hypertension attendees, to ensure high-quality care experiences for all patients attending PHC clinics with integrated HIV care. Copyright © 2018 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

High truncated-O-glycan score predicts adverse clinical outcome in patients with localized clear-cell renal cell carcinoma after surgery.

PubMed

NguyenHoang, SonTung; Liu, Yidong; Xu, Le; Zhou, Lin; Chang, Yuan; Fu, Qiang; Liu, Zheng; Lin, Zongming; Xu, Jiejie

2017-10-03

Truncated O-glycans, including Tn-antigen, sTn-antigen, T-antigen, sT-antigen, are incomplete glycosylated structures and their expression occur frequently in tumor tissue. The study aims to evaluate the abundance of each truncated O-glycans and its clinical significance in postoperative patients with localized clear-cell renal cell carcinoma (ccRCC). We used immunohistochemical testing to analyze the expression of truncated O-glycans in tumor specimens from 401 patients with localized ccRCC. Truncated-O-glycan score was built by integrating the expression level of Tn-, sTn- and sT-antigen. Kaplan-Meier survival and Cox regression analysis were done to compare clinical outcomes in subgroups. Receiver operating characteristic (ROC) was applied to assess the impact of prognostic factors on overall survival (OS) and recurrence-free survival (RFS). The results identified Tn-, sTn-, sT-antigen as independent prognosticators. The OS and RFS were shortened among the 198 (49.4%) patients with high Truncated-O-glycan score than among the 203 (50.6%) patients with low score (hazard ratio for OS, 7.060; 95% confidence interval [CI]: 2.765 to 18.027; p <0.001; for RFS, 4.612; 95% CI: 2.141 to 9.931; p <0.001). There is no difference between low-risk patients and high-risk patients in low score group ( p = 0.987). High-risk patients with low score showed a better prognosis than low-risk patient with high score ( p = 0.029). The Truncated-O-glycan score showed better prognostic value for OS (AUC: 0.739, p = 0.003) and RFS (AUC: 0.719, p = 0.003) than TNM stage. In summary, the high Truncated-O-glycan score could predict adverse clinical outcome in localized ccRCC patients after surgery.

Effects of an Integrated Science and Societal Implication Intervention on Promoting Adolescents' Positive Thinking and Emotional Perceptions in Learning Science

NASA Astrophysics Data System (ADS)

Hong, Zuway R.; Lin, Huann-Shyang; Lawrenz, Frances P.

2012-02-01

The goal of this study was to test the effectiveness of integrating science and societal implication on adolescents' positive thinking and emotional perceptions about learning science. Twenty-five eighth-grade Taiwanese adolescents (9 boys and 16 girls) volunteered to participate in a 12-week intervention and formed the experimental group. Fifty-seven eighth-grade Taiwanese adolescents (30 boys and 27 girls) volunteered to participate in the assessments and were used as the comparison group. Additionally, 15 experimental students were recruited to be observed and interviewed. Paired t-tests, correlations, and analyses of covariance assessed the similarity and differences between groups. The findings were that the experimental group significantly outperformed its counterpart on positive thinking and emotional perceptions, and all participants' positive thinking scores were significantly related to their emotional perceptions about learning science. Recommendations for integrating science and societal implication for adolescents are provided.

Improving Allergen Prediction in Main Crops Using a Weighted Integrative Method.

PubMed

Li, Jing; Wang, Jing; Li, Jing

2017-12-01

As a public health problem, food allergy is frequently caused by food allergy proteins, which trigger a type-I hypersensitivity reaction in the immune system of atopic individuals. The food allergens in our daily lives are mainly from crops including rice, wheat, soybean and maize. However, allergens in these main crops are far from fully uncovered. Although some bioinformatics tools or methods predicting the potential allergenicity of proteins have been proposed, each method has their limitation. In this paper, we built a novel algorithm PREAL W , which integrated PREAL, FAO/WHO criteria and motif-based method by a weighted average score, to benefit the advantages of different methods. Our results illustrated PREAL W has better performance significantly in the crops' allergen prediction. This integrative allergen prediction algorithm could be useful for critical food safety matters. The PREAL W could be accessed at http://lilab.life.sjtu.edu.cn:8080/prealw .

Does child and adolescent mental health in-service training result in equivalent knowledge gain among cadres of non-specialist health workers in Uganda? A pre-test post-test study.

PubMed

Akol, Angela; Nalugya, Joyce; Nshemereirwe, Sylvia; Babirye, Juliet N; Engebretsen, Ingunn Marie Stadskleiv

2017-01-01

Early identification and management of child and adolescent mental health (CAMH) disorders helps to avert mental illness in adulthood but a CAMH treatment gap exists in Uganda. CAMH integration into primary health care (PHC) through in-service training of non-specialist health workers (NSHW) using the World Health Organisation (WHO) Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) is a strategy to address this gap. However, results of such training are not supported by information on training development or delivery; and are undifferentiated by NSHW cadre. We aim to describe an in-service CAMH training for NSHW in Uganda and assess cadre-differentiated learning outcomes. Thirty-six clinical officers, nurses and midwives from 18 randomly selected PHC clinics in eastern Uganda were trained for 5 days on CAMH screening and referral using a curriculum based on the mhGAP-IG version 1.0 and PowerPoint slides from the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP). The residential training was evaluated through pre- and post- training tests of CAMH knowledge and attitudes using the participants' post-test scores; and the difference between pre-test and post-test scores. Two-tailed t-tests assessed differences in mean pre-test and post-test scores between the cadres; hierarchical linear regression tested the association between cadre and post test scores; and logistic regression evaluated the relationship between cadre and knowledge gain at three pre-determined cut off points. Thirty-three participants completed both pre-and post-tests. Improved mean scores from pre- to post-test were observed for both clinical officers (20% change) and nurse/midwives (18% change). Clinical officers had significantly higher mean test scores than nurses and midwives (p < 0.05) but cadre was not significantly associated with improvement in CAMH knowledge at the 10% (AOR 0.08; 95 CI [0.01, 1.19]; p = 0.066), 15% (AOR 0.16; 95% CI [0.01, 2.21]; p = 0.170), or 25% (AOR 0.13; 95% CI [0.01, 1.74]; p = 0.122) levels. We aimed to examine CAMH learning outcomes by NSHW cadre. NSHW cadre does not influence knowledge gain from in-service CAMH training. Thus, an option for integrating CAMH into PHC in Uganda using the mhGAP-IG and IACAPAP PowerPoint slides is to proceed without cadre differentiation.

[Therapy of adult-onset laryngeal papilloma: integrallty submucosal dissection of the tumor by CO2 laser].

PubMed

Lei, W B; Liu, Q H; Chai, L P; Zhu, X L; Wang, Z F; Li, Q M; Tang, H C; Jiang, A Y; Wen, Y H; Wen, W P

2016-10-07

Objective: To evaluate the feasibility and efficacy of the integrallty submucosal resection of adult-onset laryngeal papilloma by CO 2 laser. Methods: A group of 64 cases (36 males and 28 females, multipe lesions 54 cases and single lesion 10 cases, aged 18-75 years, mean age 43.13 years) with adult-onset laryngeal papilloma encountered in the first affliated hospital of Sun Yatsen university from 2009 to 2015 was retrospectively analyzed. All cases were treated with integrallty submucosal dissection of the tumor by CO 2 laser, and observed the changes of tumor integral scope, inter-operative, operative processes, postoperative voice quality, postoperative scarring, and the tracheotomy conditions, which were analysed and evaluated. Results: A total of 64 patients were followed up from 1 year to 5 years. Preoperative tumor integral scope of these patients averaged of 7.00. A total of 62 cases kept 0 score of the tumor integral scope for at least one year, which lead to a clinical cure rate of 96.9%. The inter-operative averaged of 25.7 months. The total operative processes of these patients were 87 times (mean time 1.36). Four cases resulted in postoperative scarring. However these was a good result in postoperative voice quality with a mean score 4.25. As to the changes of tumor integral scope, all cases got a declining score (mean score 6.72), which resulted in a remission rate of 100%. Conclusion: The integrallty submucosal dissection of adult-onset 1aryngeal papilloma by CO 2 laser was an effective way to reduce the tumor integral scope; lengthen their inter-operative; decrease the operative processes, avoid the occurrence of tracheotomy; and improve the postoperative voice quality. Most of the patients could even be cured ultimately.

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).

Depressive symptomatology in persons with spinal cord injury who reside in the community.

PubMed

Fuhrer, M J; Rintala, D H; Hart, K A; Clearman, R; Young, M E

1993-03-01

Depressive symptomatology was studied in a community-based sample of 100 men and 40 women with spinal cord injury. The mean for the Center for Epidemiologic Studies Depression Scale was higher than that reported previously for the general population, and the mean for women was higher than that for men. Findings from the Mobility dimension of the Craig Handicap Assessment and Reporting Technique (CHART) suggested that differences between men and women in degree of mobility within home and community partly mediate the gender difference in depressive symptomatology. Other CHART dimensions, Social Integration and Occupation, were inversely related with depression scores, although these dimensions did not differentiate men and women. A statistically significant relationship was not obtained between depression and disability, assessed by a self-report version of the Functional Independence Measure, or between depression and impairment, reflected by the ASIA Total Motor Index Score. Depression was not related with the presence of either pressure ulcers or presumptive evidence of urinary tract infection.

Incorporating big data into treatment plan evaluation: Development of statistical DVH metrics and visualization dashboards.

PubMed

Mayo, Charles S; Yao, John; Eisbruch, Avraham; Balter, James M; Litzenberg, Dale W; Matuszak, Martha M; Kessler, Marc L; Weyburn, Grant; Anderson, Carlos J; Owen, Dawn; Jackson, William C; Haken, Randall Ten

2017-01-01

To develop statistical dose-volume histogram (DVH)-based metrics and a visualization method to quantify the comparison of treatment plans with historical experience and among different institutions. The descriptive statistical summary (ie, median, first and third quartiles, and 95% confidence intervals) of volume-normalized DVH curve sets of past experiences was visualized through the creation of statistical DVH plots. Detailed distribution parameters were calculated and stored in JavaScript Object Notation files to facilitate management, including transfer and potential multi-institutional comparisons. In the treatment plan evaluation, structure DVH curves were scored against computed statistical DVHs and weighted experience scores (WESs). Individual, clinically used, DVH-based metrics were integrated into a generalized evaluation metric (GEM) as a priority-weighted sum of normalized incomplete gamma functions. Historical treatment plans for 351 patients with head and neck cancer, 104 with prostate cancer who were treated with conventional fractionation, and 94 with liver cancer who were treated with stereotactic body radiation therapy were analyzed to demonstrate the usage of statistical DVH, WES, and GEM in a plan evaluation. A shareable dashboard plugin was created to display statistical DVHs and integrate GEM and WES scores into a clinical plan evaluation within the treatment planning system. Benchmarking with normal tissue complication probability scores was carried out to compare the behavior of GEM and WES scores. DVH curves from historical treatment plans were characterized and presented, with difficult-to-spare structures (ie, frequently compromised organs at risk) identified. Quantitative evaluations by GEM and/or WES compared favorably with the normal tissue complication probability Lyman-Kutcher-Burman model, transforming a set of discrete threshold-priority limits into a continuous model reflecting physician objectives and historical experience. Statistical DVH offers an easy-to-read, detailed, and comprehensive way to visualize the quantitative comparison with historical experiences and among institutions. WES and GEM metrics offer a flexible means of incorporating discrete threshold-prioritizations and historic context into a set of standardized scoring metrics. Together, they provide a practical approach for incorporating big data into clinical practice for treatment plan evaluations.

Visuomotor Performance in KCNJ11-Related Neonatal Diabetes Is Impaired in Children With DEND-Associated Mutations and May Be Improved by Early Treatment With Sulfonylureas

PubMed Central

Shah, Reshma P.; Spruyt, Karen; Kragie, Brigette C.; Greeley, Siri Atma W.; Msall, Michael E.

2012-01-01

OBJECTIVE To assess performance on an age-standardized neuromotor coordination task among sulfonylurea-treated KCNJ11-related neonatal diabetic patients. RESEARCH DESIGN AND METHODS Nineteen children carrying KCNJ11 mutations associated with isolated diabetes (R201H; n = 8), diabetes with neurodevelopmental impairment (V59M or V59A [V59M/A]; n = 8), or diabetes not consistently associated with neurodevelopmental disability (Y330C, E322K, or R201C; n = 3) were studied using the age-standardized Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI). RESULTS Although R201H subjects tested in the normal range (median standard score = 107), children with V59M/A mutations had significantly lower than expected VMI standard scores (median = 49). The scores for all three groups were significantly different from each other (P = 0.0017). The age of sulfonylurea initiation was inversely correlated with VMI scores in the V59M/A group (P < 0.05). CONCLUSIONS Neurodevelopmental disability in KCNJ11-related diabetes includes visuomotor problems that may be ameliorated by early sulfonylurea treatment. Comprehensive longitudinal assessment on larger samples will be imperative. PMID:22855734

Measuring occupational balance and its relationship to perceived stress and health: Mesurer l'équilibre occupationnel et sa relation avec le stress perçus et la santé.

PubMed

Yu, Yu; Manku, Mandeep; Backman, Catherine L

2018-04-01

There is an assumption that occupational balance is integrally related to health and well-being. This study aimed to investigate test-retest reliability of the English-translated Occupational Balance Questionnaire (OBQ), its relationship to measures of health (Short Form Health Survey-36 Version 2.0 [SF-36v2]) and stress (Perceived Stress Scale-10; PSS-10), and demographic differences in OBQ scores in Canadian adults. Test-retest reliability (2 weeks) was assessed using intraclass correlation (ICC) coefficients. Online surveys from 86 adults were analyzed using descriptive, correlational, and t test statistics. OBQ test-retest reliability was ICC = 0.74 (95% CI [0.34, 0.90]; p = .003) when excluding an influential case ( n = 20). OBQ correlations with PSS-10 were r = -.72; with SF-36v2 Mental Component Score, r = .65; and with Physical Component Score, r = .31; all p < .001. Age and gender had no impact on OBQ scores. Findings help elucidate relationships among health, stress, and occupational balance; however, further psychometric testing is warranted before using OBQ for clinical purposes.

Compliance with the Australian 24-hour movement guidelines for the early years: associations with weight status.

PubMed

Santos, Rute; Zhang, Zhiguang; Pereira, João R; Sousa-Sá, Eduarda; Cliff, Dylan P; Okely, Anthony D

2017-11-20

For effective public health and surveillance it is important to document the proportion of young children who meet the new Australian Integrated 24 h Movement Guidelines for the Early Years and how these associate with health outcomes. We aimed to (i) assess compliance with the new Integrated 24 h Movement Guidelines for the Early Years in a sample of Australian toddlers; and (ii) ascertain whether compliance with the guidelines associates with weight status. The sample comprised 202 toddlers (104 girls) aged 19.74 ± 4.07 months from the GET UP! Participants wore accelerometers (Actigraph GT3X+) for 24 h over 7 consecutive days to assess physical activity, sedentary time and sleep. Parents reported participants' screen time. Weight and height were measured and body mass index (BMI) z-scores by age and sex were calculated. Analysis of Covariance (ANCOVA) was performed to test differences in BMI z-scores between participants complying with (i) none or any individual guideline, (ii) any combination of meeting two guidelines, and (iii) those who met all three guidelines, adjusting for child age, gender and socioeconomic status. Only 8.9% of the sample met the overall 24 h movement guidelines. Most of the sample met the physical activity (96.5%) and sleep (79.7%) guidelines but only 11.4% met the sedentary behavior guideline. Average BMI Z-scores did not significantly differ between children who complied with none or any individual guideline, any combination of meeting two guidelines, and those who met all three guidelines (p > 0.05). Although the lack of significant differences, participants who accomplished any combination of two guidelines or all three guidelines appear to have had a lower BMI Z-score than those complying with one of the guidelines or none. Just under 9% of our sample met the overall Australian 24 h Movement Guidelines for the Early Years. BMI was not associated with the accomplishment of any of the 24-h Movement Guidelines. Strategies to promote adherence to the 24-h movement guidelines in toddlers, particularly for screen time, are necessary, as promoting health-related behaviors in early childhood has the potential to provide children a strong foundation for lifelong physical and mental health.

Effects of Autogenous Bone Marrow Aspirate Concentrate on Radiographic Integration of Femoral Condylar Osteochondral Allografts.

PubMed

Oladeji, Lasun O; Stannard, James P; Cook, Cristi R; Kfuri, Mauricio; Crist, Brett D; Smith, Matthew J; Cook, James L

2017-10-01

Transplantation of fresh osteochondral allografts (OCAs) is an attractive treatment option for symptomatic articular cartilage lesions in young, healthy patients. Because the lack of OCA bone integration can be a cause of treatment failure, methods for speeding and enhancing OCA bone integration to mitigate this potential complication are highly desirable. To determine if autogenous bone marrow aspirate concentrate (BMC) treatment of large femoral condylar OCAs would be associated with superior radiographic OCA bone integration compared with nontreated allografts during the critical first 6 months after surgery. Cohort study; Level of evidence, 3. A review of patients enrolled in a prospective registry who were treated with transplantation of large OCAs to one or both femoral condyles at our institution from March 12, 2013 to March 14, 2016 was performed. Patients were stratified into 2 groups based on BMC treatment versus no BMC treatment; the treatment was nonrandomized and was rooted in a shift in practice and a continuing effort to optimize OCA transplantation at our institution. Patients were excluded if they did not have orthogonal view radiographs performed at 6 weeks, 3 months, and 6 months postoperatively. Each condyle undergoing OCA transplantation was assessed individually by an independent musculoskeletal radiologist, who was blinded to the treatment group and time point. OCAs were assessed with respect to graft integration (0%-100%; 0 = no integration, 100 = complete integration) and degree of sclerosis (0-3; 0 = normal, 1 = mild sclerosis, 2 = moderate sclerosis, and 3 = severe sclerosis) of the graft at each time point. This study identified 17 condyles in 15 patients who underwent OCA transplantation without BMC and 29 condyles in 22 patients who underwent OCA transplantation with BMC. The BMC group had significantly ( P = .033) higher graft integration scores at 6 weeks, 3 months, and 6 months after surgery. Graft sclerosis was significantly ( P = .017) less in the BMC group at 6 weeks and 3 months, with no significant difference at 6 months after surgery. When combining the groups to examine the influence of smoking on graft integration, nonsmokers had significantly ( P = .007) higher graft integration scores at 6 months. Large femoral condylar OCAs treated with autogenous BMC before implantation showed superior radiographic integration to bone and less sclerosis during the initial 6-month postoperative period. BMC treatment of OCAs may mitigate the failure of OCA bone healing.

Modified suture-bridge technique to prevent a marginal dog-ear deformity improves structural integrity after rotator cuff repair.

PubMed

Ryu, Keun Jung; Kim, Bang Hyun; Lee, Yohan; Lee, Yoon Seok; Kim, Jae Hwa

2015-03-01

The arthroscopic suture-bridge technique has proved to provide biomechanically firm fixation of the torn rotator cuff to the tuberosity by increasing the footprint contact area and pressure. However, a marginal dog-ear deformity is encountered not infrequently when this technique is used, impeding full restoration of the torn cuff. To evaluate the structural and functional outcomes of the use of a modified suture-bridge technique to prevent a marginal dog-ear deformity compared with a conventional suture-bridge method in rotator cuff repair. Cohort study; Level of evidence 2. A consecutive series of 71 patients aged 50 to 65 years who underwent arthroscopic rotator cuff repair for full-thickness medium-sized to massive tears was evaluated. Patients were divided into 2 groups according to repair technique: a conventional suture-bridge technique (34 patients; group A) versus a modified suture-bridge technique to prevent a marginal dog-ear deformity (37 patients; group B). Radiographic evaluations included postoperative cuff integrity using MRI. Functional evaluations included pre- and postoperative range of motion (ROM), pain visual analog scale (VAS), the University of California, Los Angeles (UCLA) shoulder rating scale, the Constant score, and the American Shoulder and Elbow Surgeons (ASES) score. All patients were followed up clinically at a minimum of 1 year. When the 2 surgical techniques were compared, postoperative structural integrity by Sugaya classification showed the distribution of types I:II:III:IV:V to be 4:20:2:4:4 in group A and 20:12:4:0:1 in group B. More subjects in group B had a favorable Sugaya type compared with group A (P < .001). The postoperative healed:retear rate was 26:8 in group A and 36:1 in group B, with a significantly lower retear rate in group B (P = .011). However, there were no significant differences in ROM and all functional outcome scores between the 2 groups postoperatively. When surgical techniques were compared across healed (n = 62) and retear (n = 9) groups, significantly fewer modified suture-bridge technique repairs were found in the retear group (P = .03). There were significant differences between healed and retear groups in functional outcome scores, with worse results in the retear group. A modified suture-bridge technique to prevent a marginal dog-ear deformity provided better structural outcomes than a conventional suture-bridge technique for medium-sized to massive rotator cuff tears. This technique may ultimately provide better functional outcomes by decreasing the retear rate. © 2014 The Author(s).

Prenatal High Risk Scoring: How Family Doctors Do It

PubMed Central

Shea, Philip

1978-01-01

Assessment of risk factors is an integral part of family medicine and of prenatal care. A strong positive relationship has been demonstrated between a high risk score and higher incidence of maternal or perinatal morbidity and mortality. The family physician, because of his previous knowledge of the patient, and his familiarity with a broad range of normals, is in a good position to use his clinical judgement in high risk scoring in pregnancy. We must also be cautious that high risk scoring does not become a self fulfilling prophecy. Risk scoring is simply risk scoring, not a plan of management and intervention. PMID:21301562

[Effects of virtual reality training on limb movement in children with spastic diplegia cerebral palsy].

PubMed

Ren, Kai; Gong, Xiao-Ming; Zhang, Rong; Chen, Xiu-Hui

2016-10-01

To study the effects of virtual reality (VR) training on the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy. Thirty-five children with spastic diplegia cerebral palsy were randomly assigned to VR training group (n=19) and conventional training group (n=16). The conventional training group received conventional physical therapy and occupational therapy for three months. The VR training group received VR training and occupational therapy for three months. Grip and visual-motor integration subtests in Peabody Developmental Motor Scales-2 were used to evaluate the fine movement in patients before and after treatment. The D and E domains of the 88-item version of the Gross Motor Function Measure (GMFM-88), Modified Ashworth Scale (MAS), and Berg Balance Scale (BBS) were used to evaluate the gross movement in patients before and after treatment. Before treatment, there were no significant differences in grip, visual-motor integration, fine motor development quotient, scores of D and E domains of GMFM-88, MAS score, or BBS score between the two groups (P>0.05). After treatment, all the indices were significantly improved in the VR training group compared with the conventional training group (P<0.05). VR training can effectively improve the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy.

Stress predictors in two Asian dental schools with an integrated curriculum and traditional curriculum.

PubMed

Nguyen, T T T; Seki, N; Morio, I

2018-05-01

This study explored stress predictors and the role of instructional methods and institutional differences in perceived stress levels amongst students at two Asian dental schools. An anonymous questionnaire was distributed to undergraduate dental students at Tokyo Medical and Dental University (TMDU), Japan and the University of Medicine and Pharmacy (UMP), Hochiminh City, Vietnam in 2016. Data concerning the students' demographic information and grades, and responses to the Perceived Stress Scale (PSS) and Dental Environment Stress questionnaire (DES) were collected. The questionnaires were prepared in English and translated into Japanese and Vietnamese following a forward-backward translation process. Altogether 684 students answered the questionnaire with a response rate of 97% for TMDU and 89% for UMP. The mean DES score of UMP students was significantly higher than TMDU (P < .001). TMDU students with dentistry as their first programme choice had significantly lower PSS and DES scores in several categories than other TMDU students, whilst UMP clinical students reported higher stress scores in several areas than UMP preclinical students. Having dentistry as their first choice of educational programme was a significant stress predictor for Japanese students whilst the clinical practicum was a significant stress predictor for Vietnamese students. Previous academic performance was not a significant stress predictor for students at either dental school. Dental students of an integrated, active-learning curriculum reported lower stress levels than students of a traditional, discipline-based curriculum. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluating the validity of an integrity-based situational judgement test for medical school admissions.

PubMed

Husbands, Adrian; Rodgerson, Mark J; Dowell, Jon; Patterson, Fiona

2015-09-02

While the construct of integrity has emerged as a front-runner amongst the desirable attributes to select for in medical school admissions, it is less clear how best to assess this characteristic. A potential solution lies in the use of Situational Judgement Tests (SJTs) which have gained popularity due to robust psychometric evidence and potential for large-scale administration. This study aims to explore the psychometric properties of an SJT designed to measure the construct of integrity. Ten SJT scenarios, each with five response stems were developed from critical incident interviews with academic and clinical staff. 200 of 520 (38.5 %) Multiple Mini Interview candidates at Dundee Medical School participated in the study during the 2012-2013 admissions cycle. Participants were asked to rate the appropriateness of each SJT response on a 4-point likert scale as well as complete the HEXACO personality inventory and a face validity questionnaire. Pearson's correlations and descriptive statistics were used to examine the associations between SJT score, HEXACO personality traits, pre-admissions measures namely academic and United Kingdom Clinical Aptitude Test (UKCAT) scores, as well as acceptability. Cronbach's alpha reliability for the SJT was .64. Statistically significant correlations ranging from .16 to .36 (.22 to .53 disattenuated) were observed between SJT score and the honesty-humility (integrity), conscientiousness, extraversion and agreeableness dimensions of the HEXACO inventory. A significant correlation of .32 (.47 disattenuated) was observed between SJT and MMI scores and no significant relationship with the UKCAT. Participant reactions to the SJTs were generally positive. Initial findings are encouraging regarding the psychometric robustness of an integrity-based SJT for medical student selection, with significant associations found between the SJTs, integrity, other desirable personality traits and the MMI. The SJTs showed little or no redundancy with cognitive ability. Results suggest that carefully-designed SJTs may augment more costly MMIs.

Brain Imaging and Neurodevelopment in HIV-uninfected Thai Children Born to HIV-infected Mothers.

PubMed

Jahanshad, Neda; Couture, Marie-Claude; Prasitsuebsai, Wasana; Nir, Talia M; Aurpibul, Linda; Thompson, Paul M; Pruksakaew, Kanchana; Lerdlum, Sukalaya; Visrutaratna, Pannee; Catella, Stephanie; Desai, Akash; Kerr, Stephen J; Puthanakit, Thanyawee; Paul, Robert; Ananworanich, Jintanat; Valcour, Victor G

2015-09-01

Perinatal use of combination antiretroviral therapy dramatically reduces vertical (mother-to-child) transmission of HIV but has led to a growing population of children with perinatal HIV-exposure but uninfected (HEU). HIV can cause neurological injury among children born with infection, but the neuroanatomical and developmental effects in HEU children are poorly understood. We used structural magnetic resonance imaging with diffusion tensor imaging to compare brain anatomy between 30 HEU and 33 age-matched HIV-unexposed and uninfected (HUU) children from Thailand. Maps of brain volume and microstructural anatomy were compared across groups; associations were tested between neuroimaging measures and concurrent neuropsychological test performance. Mean (standard deviation) age of children was 10.3 (2.8) years, and 58% were male. All were enrolled in school and lived with family members. Intelligence quotient (IQ) did not differ between groups. Caretaker education levels did not differ, but income was higher for HUU (P < 0.001). We did not detect group differences in brain volume or diffusion tensor imaging metrics, after controlling for sociodemographic factors. The mean (95% confidence interval) fractional anisotropy in the corpus callosum was 0.375 (0.368-0.381) in HEU compared with 0.370 (0.364-0.375) in HUU. Higher fractional anisotropy and lower mean diffusivity were each associated with higher IQ scores in analyses with both groups combined. No differences in neuroanatomical or brain integrity measures were detectable in HEU children compared with age-matched and sex-matched controls (HUU children). Expected associations between brain integrity measures and IQ scores were identified suggesting sufficient power to detect subtle associations that were present.

Patient reported outcomes in head and neck cancer: selecting instruments for quality of life integration in clinical protocols.

PubMed

Silveira, Augusta P; Gonçalves, Joaquim; Sequeira, Teresa; Ribeiro, Cláudia; Lopes, Carlos; Monteiro, Eurico; Pimentel, Francisco L

2010-10-31

Health Related Quality of Life has been used in medical research for more than twenty years, being progressively accepted during the last decade as an important patient reported outcome. Considering the multidimensional approach involved in Health Related Quality of Life assessment, instrument applicability and cultural adaptation must be tested for each population. In order to select the most appropriate instrument for Head and Neck cancer patients, two major Health Related Quality of Life specific questionnaires for Head and Neck cancer patients were compared. Conceptual differences, psychometric characteristics, scores, reliability, construct validity and sensitivity to symptomatology, tumour location, tumour size were analyzed. 102 consecutive Head and Neck cancer patients completed two different Health Related Quality of Life questionnaires: EORTC QLQ-C30 and its specific head and neck module QLQ-H&N35 and the Functional Assessment of Cancer Therapy Scales (FACT-H&N). Patients completed the questionnaires, immediately before consultation as a part of the routine evaluation. A greater variability was always found in the EORTC QLC-C30 questionnaire's scores for all comparable domains. Both instruments revealed a good internal consistency and demonstrated to be good tools to distinguish symptomatic patients. The EORTC questionnaires still demonstrated sensitivity to distinguish T3 and T4 staging. Conceptual differences and the psychometric characteristics are discussed. Our results suggest that these two instruments assess different aspects of Health Related Quality of Life - the questionnaires should be used separately and chosen according to the study objectives and methodology. This study emphases the importance in selecting the appropriate tool as a critical success factor in implementing routine Health Related Quality of Life assessment in clinical practice. This decision assumes particularly importance when utilization of results in real time and integration into clinical protocols are considered.

Gendering Genetics: Biological Contingencies in the Protective Effects of Social Integration for Men and Women.

PubMed

Perry, Brea L

2016-05-01

Evidence that social and biological processes are intertwined in producing health and human behavior is rapidly accumulating. Using a feminist approach, this research explores how gender moderates the interaction between biological processes and men's and women's behavioral and emotional responses to similar social environments. Using data from the Collaborative Study on the Genetics of Alcoholism, the influence of gender, social integration, and genetic risk on nicotine and alcohol dependence is examined. Three-way interaction models reveal gender-specific moderation of interactions between genetic risk score and social integration. Namely, being currently married and reporting positive social psychological integration are predictive of reduced risk of nicotine dependence among men with genetic susceptibility to strong nicotine cravings in the presence of social cues like stress. In contrast, the protective effects of marital status and social integration are substantially attenuated and absent, respectively, among women with high-risk genotypes. This pattern reflects the dualism (i.e., simultaneous costs and benefits) inherent in social integration for women, which may disproportionately affect those with a genetic sensitivity to stress. These findings contest the notion of genotype as static biological hardwiring that is independent from social and cultural systems of gender difference.

The cryoprotective effect of trehalose supplementation on boar spermatozoa quality.

PubMed

Hu, Jian-Hong; Li, Qing-Wang; Li, Gang; Jiang, Zhong-Liang; Bu, Shu-hai; Yang, Hai; Wang, Li-Qiang

2009-05-01

In order to improve boar sperm quality during frozen-thawed process, the influence of the presence of trehalose on success of cryopreservation of boar sperm were investigated. We evaluated freeze-thawing tolerance of boar spermatozoa in a base cooling extender with the addition of different trehalose concentrations (0, 25, 50, 100 and 200mmol/l), and tried to determine the optimum concentration of trehalose. We chose sperm motility, acrosome integrity, membrane integrity and cryocapacitation as parameters to evaluate cryopreservation capacity of boar spermatozoa. We obtained the best results for 100mmol/l trehalose-supplemented extenders, with values of 49.89% for motility, 66.52% for acrosome integrity and 44.61% for membrane integrity, while freeze-thawing tolerance was diminished significantly for 200mmol/l of trehalose. Before and after capacitation, the CTC score for semen diluted by extender containing 100mmol/l trehalose was 3.68% and 43.82%, respectively. In conclusion, trehalose could confer a greater cryoprotective capacity to boar spermatozoa. Trehalose-supplementation with 100mmol/l concentration in basic extender could significantly improve sperm motility, membrane integrity and acrosome integrity parameters, and reduce boar spermatozoa cryocapacitation during the cryopreservation process.

The potential of standards-based agriculture biology as an alternative to traditional biology in California

NASA Astrophysics Data System (ADS)

Sellu, George Sahr

Over the past five decades, several waves of educational reform have influenced K-12 science course offerings and classroom instruction in public education. The effectiveness of educational policies has been increasingly measured by standardized tests. The focus on test scores, content standards, and performance standards (which is a product of recent educational policies) has influenced course offerings and the depth and breadth of curriculum coverage (Linn, 2000). For the better part of the last hundred years, vocational education and traditional education have followed two separate tracks in terms of objectives, policies, and values (Hillison, 1996). Educational reform policies have had varying influences on school programs. For example, elective courses such as Career Technical Education (CTE) courses---which are not considered core academic courses---have been negatively influenced by current educational reform. In the past three decades, there has been gradual movement toward merging vocational and traditional education. It has been difficult for policies from both sides to merge because of differences in objectives for both tracks. Traditional courses have been guided by federal policies, such as No Child Left Behind (NCLB) and Common Core State Standards (CCSS) while the Carl D. Perkins Act (Perkins Act) has shaped CTE courses. It appears that several of the requirements of the Perkins Act meet expectations of traditional education policies. However, there is no direct metric for measuring the contribution of CTE courses toward increased achievement in science as measured by standardized tests. As such, CTE courses will continue to lose resources in order to support courses that prepare students for standardized tests. In order to address some of these challenges over the last three decades, agriculture educators have developed integrated science courses as a means for increasing science achievement scores for agriculture education students in K-12 public schools. Thoron & Meyer (2011) suggested that research into the contribution of integrated science courses toward higher test scores yielded mixed results. This finding may have been due in part to the fact that integrated science courses only incorporate select topics into agriculture education courses. In California, however, agriculture educators have developed standards-based courses such as Agriculture Biology (AgBio) that cover the same content standards as core traditional courses such as traditional biology. Students in both AgBio and traditional biology take the same standardized biology test. This is the first time there has been an opportunity for a fair comparison and a uniform metric for an agriscience course such as AgBio to be directly compared to traditional biology. This study will examine whether there are differences between AgBio and traditional biology with regard to standardized test scores in biology. Furthermore, the study examines differences in perception between teachers and students regarding teaching and learning activities associated with higher achievement in science. The findings of the study could provide a basis for presenting AgBio as a potential alternative to traditional biology. The findings of this study suggest that there are no differences between AgBio and traditional biology students with regard to standardized biology test scores. Additionally, the findings indicate that co-curricular activities in AgBio could contribute higher student achievement in biology. However, further research is required to identify specific activities in AgBio that contribute to higher achievement in science.

An independent confirmatory factor analysis of the Wechsler Intelligence Scale for Children-fourth Edition (WISC-IV) integrated: what do the process approach subtests measure?

PubMed

Benson, Nicholas; Hulac, David M; Bernstein, Joshua D

2013-09-01

The Wechsler intelligence scale for children--fourth edition (WISC-IV) Integrated contains the WISC-IV core and supplemental subtests along with process approach subtests designed to facilitate a process-oriented approach to score interpretation. The purpose of this study was to examine the extent to which WISC-IV Integrated subtests measure the constructs they are purported to measure. In addition to examining the measurement and scoring model provided in the manual, this study also tested hypotheses regarding Cattell-Horn-Carroll abilities that might be measured along with other substantive questions regarding the factor structure of the WISC-IV Integrated and the nature of abilities measured by process approach subtests. Results provide insight regarding the constructs measured by these subtests. Many subtests appear to be good to excellent measures of psychometric g (i.e., the general factor presumed to cause the positive correlation of mental tasks). Other abilities measured by subtests are described. For some subtests, the majority of variance is not accounted for by theoretical constructs included in the scoring model. Modifications made to remove demands such as memory recall and verbal expression were found to reduce construct-irrelevant variance. The WISC-IV Integrated subtests appear to measure similar constructs across ages 6-16, although strict factorial invariance was not supported.

Influence of sport participation on community integration and quality of life: a comparison between sport participants and non-sport participants with spinal cord injury.

PubMed

McVeigh, Sonja A; Hitzig, Sander L; Craven, B Cathy

2009-01-01

To determine whether community integration and/or quality of life (QoL) among people living with chronic spinal cord injury (SCI) are superior among sport participants vs non-sport participants. Cross-sectional study. Persons (n=90) living in the community with SCI (ASIA Impairment Scale A-D), level C5 or below, > 15 years of age, >12 months postinjury, and requiring a wheelchair for >1 hours/day were divided into 2 groups based on their self-reported sport participation at interview: sport participants (n=45) and non-sport participants (n 5). Independent-sample t tests revealed that both Community Integration Questionnaire (CIQ) and Reintegration to Normal Living Index (RNL) total mean scores were higher among sport participants vs nonsport participants (P < 0.05). Significant correlation between CIQ and RNL total scores was found for all participants (Pearson correlation coefficients, P < 0.01). Logistic regression analysis revealed that the unadjusted odds ratio of a high CIQ mean score was 4.75 (95% CI 1.7, 13.5) among current sport participants. Similarly, the unadjusted odds ratio of a high RNL score was 7.00 (95% CI 2.3, 21.0) among current sport participants. Regression-adjusted odds ratios of high CIQ and high RNL scores were 1.36 (95% CI 0.09, 1.45) and 0.15 (95% CI 0.04, 0.55), respectively. The odds ratio for pre-SCI sport participation predicting post-SCI sport participation was 3.06 (95% CI 1.23, 7.65). CIQ and QoL scores were higher among sport participants compared to non-sport participants. There was an association between mean CIQ and RNL scores for both groups. Sport participants were 4.75 and 7.00 times as likely to have high CIQ and QoL scores. Both groups had a similar likelihood of high CIQ and RNL scores after adjusting for important confounders. Individuals who participated in sports prior to SCI were more likely to participate in sports post-SCI.

Exposure and attitudes toward interprofessional teams: a three-year prospective study of longitudinal integrated clerkship versus rotation-based clerkship students.

PubMed

Myhre, Douglas L; Woloschuk, Wayne; Pedersen, Jeanette Somlak

2014-05-01

This study explored exposure to, and attitudes toward, interprofessional (IP) teams between third-year longitudinal integrated clerkship (LIC) and traditional rotation-based clerkship (RBC) students at the University of Calgary medical school. Students completed a survey pre-post 32-week LIC or 6-week rural, regional or urban RBC family medicine rotations. Pre and post rotation surveys were completed by 213 (48%) students (LIC = 33/34; rural = 76/152; regional = 24/46; urban = 80/208). More LIC students (76%) reported participating on six or more IP teams than RBC students (rural = 38%; regional = 25%; urban = 21%). At pre rotation, the mean attitude to IP teams score of LIC and rural RBC students was high and did not differ. At post rotation, the mean attitude score of LIC students was significantly greater than the mean reported by rural RBC students. Only LIC students reported a significant pre-post rotation increase in attitude. Exposure to IP teams, possibly facilitated by a longer duration of rotation, appears to be an important factor in affecting attitude to IP teams.

Correlation of High-Resolution Manometric Findings with Symptoms of Dysphagia and Endoscopic Features in Adults with Eosinophilic Esophagitis.

PubMed

von Arnim, Ulrike; Kandulski, Arne; Weigt, Jochen; Malfertheiner, Peter

2017-01-01

Eosinophilic esophagitis (EoE) presents with dysphagia, but data about motility patterns using high-resolution manometry (HRM) are rare. We aimed at evaluating esophageal motility patterns in EoE and their correlation to endoscopic and dysphagia scores. Twenty-six EoE patients and 23 controls were included after 4 weeks of treatment with proton pump inhibitors. Dysphagia and endoscopic scores were evaluated before performing HRM. EoE patients were classified to have fibrostenotic (FS) or inflammatory (IF) type. HRM analysis was performed according to the Chicago classification (CC) system. According to the CC, the HRM findings in EoE and controls were normal in 11 (42%) and 20 (88.5%), p < 0.0001. Weak and failed peristaltic integrity was only seen in EoE patients (failed 1/2.7%, weak 7/26.9%, p = 0.004). Of the EoE patients, 17 had IF and 9 presented with FS type. HRM parameters showed no differences according to the EoE subtype. The endoscopic score in the FS subtype was significantly higher than in EoE with IF subtype (5.33 vs. 3.58, p = 0.001). No significant difference was seen in dysphagia scores in EoE subtypes. HRM findings in EoE are often diagnostic, but they are non-specific and do not correlate with the severity of dysphagia or endoscopic appearance. The clinical impact of HRM in EoE needs further evaluation. © 2017 S. Karger AG, Basel.

Cardiovascular risk

PubMed Central

Payne, Rupert A

2012-01-01

Cardiovascular disease is a major, growing, worldwide problem. It is important that individuals at risk of developing cardiovascular disease can be effectively identified and appropriately stratified according to risk. This review examines what we understand by the term risk, traditional and novel risk factors, clinical scoring systems, and the use of risk for informing prescribing decisions. Many different cardiovascular risk factors have been identified. Established, traditional factors such as ageing are powerful predictors of adverse outcome, and in the case of hypertension and dyslipidaemia are the major targets for therapeutic intervention. Numerous novel biomarkers have also been described, such as inflammatory and genetic markers. These have yet to be shown to be of value in improving risk prediction, but may represent potential therapeutic targets and facilitate more targeted use of existing therapies. Risk factors have been incorporated into several cardiovascular disease prediction algorithms, such as the Framingham equation, SCORE and QRISK. These have relatively poor predictive power, and uncertainties remain with regards to aspects such as choice of equation, different risk thresholds and the roles of relative risk, lifetime risk and reversible factors in identifying and treating at-risk individuals. Nonetheless, such scores provide objective and transparent means of quantifying risk and their integration into therapeutic guidelines enables equitable and cost-effective distribution of health service resources and improves the consistency and quality of clinical decision making. PMID:22348281

People detection in crowded scenes using active contour models

NASA Astrophysics Data System (ADS)

Sidla, Oliver

2009-01-01

The detection of pedestrians in real-world scenes is a daunting task, especially in crowded situations. Our experience over the last years has shown that active shape models (ASM) can contribute significantly to a robust pedestrian detection system. The paper starts with an overview of shape model approaches, it then explains our approach which builds on top of Eigenshape models which have been trained using real-world data. These models are placed over candidate regions and matched to image gradients using a scoring function which integrates i) point distribution, ii) local gradient orientations iii) local image gradient strengths. A matching and shape model update process is iteratively applied in order to fit the flexible models to the local image content. The weights of the scoring function have a significant impact on the ASM performance. We analyze different settings of scoring weights for gradient magnitude, relative orientation differences, distance between model and gradient in an experiment which uses real-world data. Although for only one pedestrian model in an image computation time is low, the number of necessary processing cycles which is needed to track many people in crowded scenes can become the bottleneck in a real-time application. We describe the measures which have been taken in order to improve the speed of the ASM implementation and make it real-time capable.

A new pathological scoring system by the Japanese classification to predict renal outcome in diabetic nephropathy.

PubMed

Hoshino, Junichi; Furuichi, Kengo; Yamanouchi, Masayuki; Mise, Koki; Sekine, Akinari; Kawada, Masahiro; Sumida, Keiichi; Hiramatsu, Rikako; Hasegawa, Eiko; Hayami, Noriko; Suwabe, Tatsuya; Sawa, Naoki; Hara, Shigeko; Fujii, Takeshi; Ohashi, Kenichi; Kitagawa, Kiyoki; Toyama, Tadashi; Shimizu, Miho; Takaichi, Kenmei; Ubara, Yoshifumi; Wada, Takashi

2018-01-01

The impact of the newly proposed pathological classification by the Japan Renal Pathology Society (JRPS) on renal outcome is unclear. So we evaluated that impact and created a new pathological scoring to predict outcome using this classification. A multicenter cohort of 493 biopsy-proven Japanese patients with diabetic nephropathy (DN) were analyzed. The association between each pathological factor-Tervaert' and JRPS classifications-and renal outcome (dialysis initiation or 50% eGFR decline) was estimated by adjusted Cox regression. The overall pathological risk score (J-score) was calculated, whereupon its predictive ability for 10-year risk of renal outcome was evaluated. The J-scores of diffuse lesion classes 2 or 3, GBM doubling class 3, presence of mesangiolysis, polar vasculosis, and arteriolar hyalinosis were, respectively, 1, 2, 4, 1, and 2. The scores of IFTA classes 1, 2, and 3 were, respectively, 3, 4, and 4, and those of interstitial inflammation classes 1, 2, and 3 were 5, 5, and 4 (J-score range, 0-19). Renal survival curves, when dividing into four J-score grades (0-5, 6-10, 11-15, and 16-19), were significantly different from each other (p<0.01, log-rank test). After adjusting clinical factors, the J-score was a significant predictor of renal outcome. Ability to predict 10-year renal outcome was improved when the J-score was added to the basic model: c-statistics from 0.661 to 0.685; category-free net reclassification improvement, 0.154 (-0.040, 0.349, p = 0.12); and integrated discrimination improvement, 0.015 (0.003, 0.028, p = 0.02). Mesangiolysis, polar vasculosis, and doubling of GBM-features of the JRPS system-were significantly associated with renal outcome. Prediction of DN patients' renal outcome was better with the J-score than without it.

Proposal and validation of a new model to estimate survival for hepatocellular carcinoma patients.

PubMed

Liu, Po-Hong; Hsu, Chia-Yang; Hsia, Cheng-Yuan; Lee, Yun-Hsuan; Huang, Yi-Hsiang; Su, Chien-Wei; Lee, Fa-Yauh; Lin, Han-Chieh; Huo, Teh-Ia

2016-08-01

The survival of hepatocellular carcinoma (HCC) patients is heterogeneous. We aim to develop and validate a simple prognostic model to estimate survival for HCC patients (MESH score). A total of 3182 patients were randomised into derivation and validation cohort. Multivariate analysis was used to identify independent predictors of survival in the derivation cohort. The validation cohort was employed to examine the prognostic capabilities. The MESH score allocated 1 point for each of the following parameters: large tumour (beyond Milan criteria), presence of vascular invasion or metastasis, Child-Turcotte-Pugh score ≥6, performance status ≥2, serum alpha-fetoprotein level ≥20 ng/ml, and serum alkaline phosphatase ≥200 IU/L, with a maximal of 6 points. In the validation cohort, significant survival differences were found across all MESH scores from 0 to 6 (all p < 0.01). The MESH system was associated with the highest homogeneity and lowest corrected Akaike information criterion compared with Barcelona Clínic Liver Cancer, Hong Kong Liver Cancer (HKLC), Cancer of the Liver Italian Program, Taipei Integrated Scoring and model to estimate survival in ambulatory HCC Patients systems. The prognostic accuracy of the MESH scores remained constant in patients with hepatitis B- or hepatitis C-related HCC. The MESH score can also discriminate survival for patients from early to advanced stages of HCC. This newly proposed simple and accurate survival model provides enhanced prognostic accuracy for HCC. The MESH system is a useful supplement to the BCLC and HKLC classification schemes in refining treatment strategies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationship between alexithymia and coping strategies in patients with somatoform disorder

PubMed Central

Tominaga, Toshiyuki; Choi, Hyungin; Nagoshi, Yasuhide; Wada, Yoshihisa; Fukui, Kenji

2014-01-01

Purpose A multidimensional intervention integrating alexithymia, negative affect, and type of coping strategy is needed for the effective treatment of somatoform disorder; however, few studies have applied this approach to the three different dimensions of alexithymia in patients with somatoform disorder. The purpose of this study was to determine the relationship between type of coping strategy and three different dimensions of alexithymia expressed in patients. Patients and methods A total of 196 patients with somatoform disorder completed the 20-item Toronto Alexithymia Scale, the Zung Self-Rating Depression Scale, the Spielberger State–Trait Anxiety Inventory, the Somatosensory Amplification Scale, and the Lazarus Stress Coping Inventory. The relationships between alexithymia (Toronto Alexithymia Scale – 20 score and subscales), demographic variables, and psychological inventory scores were analyzed using Pearson’s correlation coefficients and stepwise multiple regression analysis. Results The mean Toronto Alexithymia Scale – 20 total score (56.1±10.57) was positively correlated with the number of physical symptoms as well as with psychopathology scores (Self-Rating Depression Scale, State–Trait Anxiety Inventory trait, state, and Somatosensory Amplification Scale), but negatively correlated with planful problem solving, confrontive coping, seeking social support, and positive reappraisal coping scores. With respect to coping strategy, multiple regression analyses revealed that “difficulty in identifying feelings” was positively associated with an escape–avoidance strategy, “difficulty in describing feelings” was negatively associated with a seeking social support strategy, and “externally oriented thinking” was negatively associated with a confrontive coping strategy. Conclusion Alexithymia was strongly associated with the number of somatic symptoms and negative affect. Patients with high “difficulty in describing feelings” tend to rely less on seeking social support, and patients with high “externally oriented thinking” tend to rely less on confrontive coping strategies. The coping skills intervention implemented should differ across individuals and should be based on the alexithymia dimension of each patient. PMID:24403835

Are two systemic fish assemblage sampling programmes on the upper Mississippi River telling us the same thing?

USGS Publications Warehouse

Dukerschein, J.T.; Bartels, A.D.; Ickes, B.S.; Pearson, M.S.

2013-01-01

We applied an Index of Biotic Integrity (IBI) used on Wisconsin/Minnesota waters of the upper Mississippi River (UMR) to compare data from two systemic sampling programmes. Ability to use data from multiple sampling programmes could extend spatial and temporal coverage of river assessment and monitoring efforts. We normalized for effort and tested fish community data collected by the Environmental Monitoring and Assessment Program-Great Rivers Ecosystems (EMAP-GRE) 2004–2006 and the Long Term Resource Monitoring Program (LTRMP) 1993–2006. Each programme used daytime electrofishing along main channel borders but with some methodological and design differences. EMAP-GRE, designed for baseline and, eventually, compliance monitoring, used a probabilistic, continuous design. LTRMP, designed primarily for baseline and trend monitoring, used a stratified random design in five discrete study reaches. Analysis of similarity indicated no significant difference between EMAP-GRE and LTRMP IBI scores (n=238; Global R= 0.052; significance level=0.972). Both datasets distinguished clear differences only between 'Fair' and 'Poor' condition categories, potentially supporting a 'pass–fail' assessment strategy. Thirteen years of LTRMP data demonstrated stable IBI scores through time in four of five reaches sampled. LTRMP and EMAPGRE IBI scores correlated along the UMR's upstream to downstream gradient (df [3, 25]; F=1.61; p=0.22). A decline in IBI scores from upstream to downstream was consistent with UMR fish community studies and a previous, empirically modelled human disturbance gradient. Comparability between EMAP-GRE (best upstream to downstream coverage) and LTRMP data (best coverage over time and across the floodplain) supports a next step of developing and testing a systemic, multi-metric fish index on the UMR that both approaches could inform.

A Randomized Clinical Trial of a Telephone Depression Intervention to Reduce Employee Presenteeism and Absenteeism

PubMed Central

Lerner, Debra; Adler, David A.; Rogers, William H.; Chang, Hong; Greenhill, Annabel; Cymerman, Elina; Azocar, Francisca

2015-01-01

Objectives The study tested an intervention aimed at improving work functioning among middle-aged and older adults with depression and work limitations. Methods A randomized clinical trial allocated an initial sample of 431 eligible employed adults (age ≥45) to a work-focused intervention (WFI) or usual care. Inclusion criteria were depression as measured by the Patient Health Questionnaire–9 (PHQ-9) and at-work limitations indicated by a productivity loss score ≥5% on the Work Limitations Questionnaire (WLQ). Study sites included 19 employers and five related organizations. Telephone-based counseling provided three integrated modalities: care coordination, cognitive-behavioral therapy strategy development, and work coaching and modification. Effectiveness (change in productivity loss scores from preintervention to four months postintervention) was tested with mixed models adjusted for confounders. Secondary outcomes included change in WLQ work performance scales, self-reported absences, and depression. Results Of 1,227 eligible employees (7% of screened), 431 (35%) enrolled and 380 completed the study (12% attrition). At-work productivity loss improved 44% in the WFI group versus 13% in usual care (difference in change, p<.001). WFI group scores on the four WLQ scales improved 44% to 47%, significantly better than in usual care (p<.001 for each scale). Absence days declined by 53% in the WFI group versus 13% in usual care (difference in change, p<.001). Mean PHQ-9 depression symptom severity scores declined 51% for WFI versus 26% for usual care (difference in change, p<.001). Conclusions The WFI was more effective than usual care at four-month follow-up. Given increasing efforts to provide more patient-centered, value-based care, the WFI could be an important resource. PMID:25726984

A randomized clinical trial of a telephone depression intervention to reduce employee presenteeism and absenteeism.

PubMed

Lerner, Debra; Adler, David A; Rogers, William H; Chang, Hong; Greenhill, Annabel; Cymerman, Elina; Azocar, Francisca

2015-06-01

The study tested an intervention aimed at improving work functioning among middle-aged and older adults with depression and work limitations. A randomized clinical trial allocated an initial sample of 431 eligible employed adults (age ≥45) to a work-focused intervention (WFI) or usual care. Inclusion criteria were depression as measured by the Patient Health Questionnaire-9 (PHQ-9) and at-work limitations indicated by a productivity loss score ≥5% on the Work Limitations Questionnaire (WLQ). Study sites included 19 employers and five related organizations. Telephone-based counseling provided three integrated modalities: care coordination, cognitive-behavioral therapy strategy development, and work coaching and modification. Effectiveness (change in productivity loss scores from preintervention to four months postintervention) was tested with mixed models adjusted for confounders. Secondary outcomes included change in WLQ work performance scales, self-reported absences, and depression. Of 1,227 eligible employees (7% of screened), 431 (35%) enrolled and 380 completed the study (12% attrition). At-work productivity loss improved 44% in the WFI group versus 13% in usual care (difference in change, p<.001). WFI group scores on the four WLQ scales improved 44% to 47%, significantly better than in usual care (p<.001 for each scale). Absence days declined by 53% in the WFI group versus 13% in usual care (difference in change, p<.001). Mean PHQ-9 depression symptom severity scores declined 51% for WFI versus 26% for usual care (difference in change, p<.001). The WFI was more effective than usual care at four-month follow-up. Given increasing efforts to provide more patient-centered, value-based care, the WFI could be an important resource.

Chronic cigarette smoking and the microstructural integrity of white matter in healthy adults

PubMed Central

Paul, Robert H.; Grieve, Stuart M.; Niaura, Raymond; David, Sean P.; Laidlaw, David H.; Cohen, Ronald; Sweet, Lawrence; Taylor, George; Clark, C. Richard; Pogun, Sakire; Gordon, Evian

2008-01-01

Results from recent studies suggest that chronic cigarette smoking is associated with increased white matter volume in the brain as determined by in vivo neuroimaging. We used diffusion tensor imaging to examine the microstructural integrity of the white matter in 10 chronic smokers and 10 nonsmokers. All individuals were healthy, without histories of medical or psychiatric illness. Fractional anisotropy (FA) and trace were measured in the genu, body, and splenium of the corpus callosum. FA provides a measure of directional versus nondirectional water diffusion, whereas trace provides a measure of nondirectional water diffusion. Lower FA and higher trace values are considered to reflect less brain integrity. Voxel-based morphometry was used to define volumes in each of these regions of the corpus callosum. Chronic smokers exhibited significantly higher FA in the body and whole corpus callosum and a strong trend for higher FA in the splenium compared with nonsmokers. FA did not differ between groups in the genu, and neither trace nor white matter volumes differed between groups in any of the regions of interest. When subdivided by Fagerström score (low vs. high), the low Fagerström group exhibited significantly higher FA in the body of the corpus callosum compared with the high Fagerström group and the nonsmokers. These results suggest that, among healthy adults, lower exposure to cigarette smoking is associated with increased microstructural integrity of the white matter compared with either no exposure or higher exposure. Additional studies are needed to further explore differences in white matter integrity between smokers and nonsmokers. PMID:18188754

Correlation between asthenopic symptoms and different measurements of convergence and reading comprehension and saccadic fixation eye movements.

PubMed

Cohen, Yuval; Segal, Ori; Barkana, Yaniv; Lederman, Robert; Zadok, David; Pras, Eran; Morad, Yair

2010-01-01

The aim of this study was to evaluate the relationship between asthenopic symptoms, convergence amplitude, reading comprehension, and saccadic eye movements in children 8 to 10 years of age. Sixty-six children age 8 to 10 years were examined. Convergence was evaluated using (1) nonaccommodative target at near and distance, (2) a near computerized stereogram, and (3) measurement of the near point of convergence (NPC). Reading ability was examined by (1) a reading comprehension test in which children had to answer questions regarding a paragraph they read and (2) the Developmental Eye Movement Test (DEM), which evaluates saccadic speed and accuracy. Asthenopic symptoms were scored by an Asthenopic Symptoms Questionnaire. Asthenopic symptoms score was correlated with the near point of convergence (r = -0.4; P = 0.003), convergence on a near stereogram (r = 0.38; P = 0.01) and distant light (r = 0.27; P = 0.04), but not with convergence on a near nonaccommodative target (r = 0.07; P = 0.6). The DEM ratio score was correlated with the asthenopic symptoms score (r = -0.32; P = 0.01), but the reading comprehension test score was not (r = 0.12; P = 0.4). There was correlation, however, between the time for completion of the reading comprehension test and the asthenopic symptoms score (r = 0.39; P = 0.006). Asthenopic symptoms score was correlated with convergence amplitude as measured, whereas accommodation is controlled and the ratio score calculated based upon DEM results. Further study is needed to evaluate the usefulness of the integration between symptom survey and objective reading examinations as screening tool for the diagnosis of convergence insufficiency.

Physical, chemical, and biological characteristics of selected headwater streams along the Allegheny Front, Blair County, Pennsylvania, July 2011–September 2013

USGS Publications Warehouse

Low, Dennis J.; Brightbill, Robin A.; Eggleston, Heather L.; Chaplin, Jeffrey J.

2016-02-29

Biotic health was characterized at 10 of 12 stream sites; the two sites excluded were established late in the study period (May 2013) for refinement of water quality in the headwaters of Poplar Run and the location of Marcellus Formation gas wells. On the basis of the Maryland Index of Biotic Integrity (MdIBI) for fish assemblages, 8 of 10 streams can be considered in fair health. Tipton Run had the highest MdIBI score (3.75) and the greatest number of native species. South Poplar Run had the lowest MdIBI score (1.75); pollution tolerant blacknose dace was dominant. On the basis of the Pennsylvania Department of Environmental Protection macroinvertebrate index of biotic integrity, 9 of 10 streams were characterized as attaining, with scores as high as 88.9 at Tipton Run. Only Sugar Run was characterized as impaired, with a score of 40.4.

Predicting College Success: The Relative Contributions of Five Social/Personality Factors, Five Cognitive/Learning Factors, and SAT Scores

PubMed Central

Hannon, Brenda

2014-01-01

To-date, studies have examined simultaneously the relative predictive powers of two or three factors on GPA. The present study examines the relative powers of five social/personality factors, five cognitive/learning factors, and SAT scores to predict freshmen and non-freshmen (sophomores, juniors, seniors) academic success (i.e., GPA). The results revealed many significant predictors of GPA for both freshmen and non-freshmen. However, subsequent regressions showed that only academic self-efficacy, epistemic belief of learning, and high-knowledge integration explained unique variance in GPA (19%-freshmen, 23.2%-non-freshmen). Further for freshmen, SAT scores explained an additional unique 10.6% variance after the influences attributed to these three predictors was removed whereas for non-freshmen, SAT scores failed to explain any additional variance. These results highlight the unique and important contributions of academic self-efficacy, epistemic belief of learning and high-knowledge integration to GPA beyond other previously-identified predictors. PMID:25568884

Establishment and Validation of GV-SAPS II Scoring System for Non-Diabetic Critically Ill Patients.

PubMed

Liu, Wen-Yue; Lin, Shi-Gang; Zhu, Gui-Qi; Poucke, Sven Van; Braddock, Martin; Zhang, Zhongheng; Mao, Zhi; Shen, Fei-Xia; Zheng, Ming-Hua

2016-01-01

Recently, glucose variability (GV) has been reported as an independent risk factor for mortality in non-diabetic critically ill patients. However, GV is not incorporated in any severity scoring system for critically ill patients currently. The aim of this study was to establish and validate a modified Simplified Acute Physiology Score II scoring system (SAPS II), integrated with GV parameters and named GV-SAPS II, specifically for non-diabetic critically ill patients to predict short-term and long-term mortality. Training and validation cohorts were exacted from the Multiparameter Intelligent Monitoring in Intensive Care database III version 1.3 (MIMIC-III v1.3). The GV-SAPS II score was constructed by Cox proportional hazard regression analysis and compared with the original SAPS II, Sepsis-related Organ Failure Assessment Score (SOFA) and Elixhauser scoring systems using area under the curve of the receiver operator characteristic (auROC) curve. 4,895 and 5,048 eligible individuals were included in the training and validation cohorts, respectively. The GV-SAPS II score was established with four independent risk factors, including hyperglycemia, hypoglycemia, standard deviation of blood glucose levels (GluSD), and SAPS II score. In the validation cohort, the auROC values of the new scoring system were 0.824 (95% CI: 0.813-0.834, P< 0.001) and 0.738 (95% CI: 0.725-0.750, P< 0.001), respectively for 30 days and 9 months, which were significantly higher than other models used in our study (all P < 0.001). Moreover, Kaplan-Meier plots demonstrated significantly worse outcomes in higher GV-SAPS II score groups both for 30-day and 9-month mortality endpoints (all P< 0.001). We established and validated a modified prognostic scoring system that integrated glucose variability for non-diabetic critically ill patients, named GV-SAPS II. It demonstrated a superior prognostic capability and may be an optimal scoring system for prognostic evaluation in this patient group.

Historical and current perspectives on fish assemblages of the Snake River, Idaho and Wyoming

USGS Publications Warehouse

Maret, T.R.; Mebane, C.A.

2005-01-01

The Snake River is the tenth longest river in the United States, extending 1,667 km from its origin in Yellowstone National Park in western Wyoming to its union with the Columbia River at Pasco, Washington. Historically, the main-stem Snake River upstream from the Hells Canyon Complex supported at least 26 native fish species, including anadromous stocks of Chinook salmon Oncorhynchus tshawytscha, steelhead O. mykiss, Pacific lamprey Lampetra tridentata, and white sturgeon Acipenser transmontanus. Of these anadromous species, only the white sturgeon remains in the Snake River between the Hells Canyon Complex and Shoshone Falls. Today, much of the Snake River has been transformed into a river with numerous impoundments and flow diversions, increased pollutant loads, and elevated water temperatures. Current (1993-2002) fish assemblage collections from 15 sites along the Snake River and Henrys Fork contained 35 fish species, including 16 alien species. Many of these alien species such as catfish (Ictaluridae), carp (Cyprinidae), and sunfish (Centrarchidae) are adapted for warmwater impounded habitats. Currently, the Snake River supports 19 native species. An index of biotic integrity (IBI), developed to evaluate large rivers in the Northwest, was used to evaluate recent (1993-2002) fish collections from the Snake River and Henrys Fork in southern Idaho and western Wyoming. Index of biotic integrity site scores and component metrics revealed a decline in biotic integrity from upstream to downstream in both the Snake River and Henrys Fork. Two distinct groups of sites were evident that correspond to a range of IBI scores-an upper Snake River and Henrys Fork group with relatively high biotic integrity (mean IBI scores of 46-84) and a lower Snake River group with low biotic integrity (mean IBI scores of 10-29). Sites located in the lower Snake River exhibited fish assemblages that reflect poor-quality habitat where coldwater and sensitive species are rare or absent, and where tolerant, less desirable species predominate. Increases in percentages of agricultural land, total number of diversions, and number of constructed channels were strongly associated with these decreasing IBI scores.

Maximization of the usage of coronary CTA derived plaque information using a machine learning based algorithm to improve risk stratification; insights from the CONFIRM registry.

PubMed

van Rosendael, Alexander R; Maliakal, Gabriel; Kolli, Kranthi K; Beecy, Ashley; Al'Aref, Subhi J; Dwivedi, Aeshita; Singh, Gurpreet; Panday, Mohit; Kumar, Amit; Ma, Xiaoyue; Achenbach, Stephan; Al-Mallah, Mouaz H; Andreini, Daniele; Bax, Jeroen J; Berman, Daniel S; Budoff, Matthew J; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J W; Cury, Ricardo C; DeLago, Augustin; Feuchtner, Gudrun; Hadamitzky, Martin; Hausleiter, Joerg; Kaufmann, Philipp A; Kim, Yong-Jin; Leipsic, Jonathon A; Maffei, Erica; Marques, Hugo; Pontone, Gianluca; Raff, Gilbert L; Rubinshtein, Ronen; Shaw, Leslee J; Villines, Todd C; Gransar, Heidi; Lu, Yao; Jones, Erica C; Peña, Jessica M; Lin, Fay Y; Min, James K

Machine learning (ML) is a field in computer science that demonstrated to effectively integrate clinical and imaging data for the creation of prognostic scores. The current study investigated whether a ML score, incorporating only the 16 segment coronary tree information derived from coronary computed tomography angiography (CCTA), provides enhanced risk stratification compared with current CCTA based risk scores. From the multi-center CONFIRM registry, patients were included with complete CCTA risk score information and ≥3 year follow-up for myocardial infarction and death (primary endpoint). Patients with prior coronary artery disease were excluded. Conventional CCTA risk scores (conventional CCTA approach, segment involvement score, duke prognostic index, segment stenosis score, and the Leaman risk score) and a score created using ML were compared for the area under the receiver operating characteristic curve (AUC). Only 16 segment based coronary stenosis (0%, 1-24%, 25-49%, 50-69%, 70-99% and 100%) and composition (calcified, mixed and non-calcified plaque) were provided to the ML model. A boosted ensemble algorithm (extreme gradient boosting; XGBoost) was used and the entire data was randomly split into a training set (80%) and testing set (20%). First, tuned hyperparameters were used to generate a trained model from the training data set (80% of data). Second, the performance of this trained model was independently tested on the unseen test set (20% of data). In total, 8844 patients (mean age 58.0 ± 11.5 years, 57.7% male) were included. During a mean follow-up time of 4.6 ± 1.5 years, 609 events occurred (6.9%). No CAD was observed in 48.7% (3.5% event), non-obstructive CAD in 31.8% (6.8% event), and obstructive CAD in 19.5% (15.6% event). Discrimination of events as expressed by AUC was significantly better for the ML based approach (0.771) vs the other scores (ranging from 0.685 to 0.701), P < 0.001. Net reclassification improvement analysis showed that the improved risk stratification was the result of down-classification of risk among patients that did not experience events (non-events). A risk score created by a ML based algorithm, that utilizes standard 16 coronary segment stenosis and composition information derived from detailed CCTA reading, has greater prognostic accuracy than current CCTA integrated risk scores. These findings indicate that a ML based algorithm can improve the integration of CCTA derived plaque information to improve risk stratification. Published by Elsevier Inc.

Health-related quality-of-life assessment and surgical outcomes for auricular reconstruction using autologous costal cartilage.

PubMed

Soukup, Benjamin; Mashhadi, Syed A; Bulstrode, Neil W

2012-03-01

This study aims to assess the health-related quality-of-life benefit following auricular reconstruction using autologous costal cartilage in children. In addition, key aspects of the surgical reconstruction are assessed. After auricular reconstruction, patients completed two questionnaires. The first was a postinterventional health-related quality-of-life assessment tool, the Glasgow Benefit Inventory. A score of 0 signifies no change in health-related quality-of-life, +100 indicates maximal improvement, and -100 indicates maximal negative impact. The second questionnaire assessed surgical outcomes in auricular reconstruction across three areas: facial integration, aesthetic auricular units, and costal reconstruction. These were recorded on a five-point ordinal scale and are presented as mean scores of a total of 5. The mean total Glasgow Benefit Inventory score was 48.1; significant improvements were seen in all three Glasgow Benefit Inventory subscales (p < 0.0001). A mean integration score of 3.8 and a mean aesthetic auricular unit reconstruction score of 3.4 were recorded. Skin color matching (4.3) of the ear was most successfully reconstructed and auricular cartilage reconstruction scored lowest (3.5). Of the aesthetic units, the helix scored highest (3.6) and the tragus/antitragus scored lowest (3.3). Donor-site reconstruction scored 3.9. Correlation analysis revealed that higher reconstruction scores are associated with a greater health-related quality-of-life gain (r = 0.5). Ninety-six percent of patients would recommend the procedure to a friend. Auricular reconstruction with autologous cartilage results in significant improvements in health-related quality-of-life. In addition, better surgical outcomes lead to a greater improvement in health-related quality-of-life. Comparatively poorer reconstructed areas of the ear were identified so that surgical techniques may be improved. Therapeutic, IV.

Performance results for a workstation-integrated radiology peer review quality assurance program.

PubMed

O'Keeffe, Margaret M; Davis, Todd M; Siminoski, Kerry

2016-06-01

To assess review completion rates, RADPEER score distribution, and sources of disagreement when using a workstation-integrated radiology peer review program, and to evaluate radiologist perceptions of the program. Retrospective review of prospectively collected data. Large private outpatient radiology practice. Radiologists (n = 66) with a mean of 16.0 (standard deviation, 9.2) years of experience. Prior studies and reports of cases being actively reported were randomly selected for peer review using the RADPEER scoring system (a 4-point scale, with a score of 1 indicating agreement and scores of 2-4 indicating increasing levels of disagreement). Assigned peer review completion rates, review scores, sources of disagreement and radiologist survey responses. Of 31 293 assigned cases, 29 044 (92.8%; 95% CI 92.5-93.1%) were reviewed. Discrepant scores (score = 2, 3 or 4) were given in 0.69% (95% CI 0.60-0.79%) of cases and clinically significant discrepancy (score = 3 or 4) was assigned in 0.42% (95% CI 0.35-0.50%). The most common cause of disagreement was missed diagnosis (75.2%; 95% CI 66.8-82.1%). By anonymous survey, 94% of radiologists felt that peer review was worthwhile, 90% reported that the scores they received were appropriate and 78% felt that the received feedback was valuable. Workstation-based peer review can increase completion rates and levels of radiologist acceptance while producing RADPEER scores similar to those previously reported. This approach may be one way to increase radiologist engagement in peer review quality assurance. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Audio Taping Simulated Patient Encounters in Community Pharmacy to Enhance the Reliability of Assessments

PubMed Central

Werner, Joel Benjamin

2008-01-01

Objectives To assess whether audio taping simulated patient interactions can improve the reliability of manually documented data and result in more accurate assessments. Methods Over a 3-month period, 1340 simulated patient visits were made to community pharmacies. Following the encounters, data gathered by the simulated patient were relayed to a coordinator who completed a rating form. Data recorded on the forms were later compared to an audiotape of the interaction. Corrections were tallied and reasons for making them were coded. Results Approximately 10% of cases required corrections, resulting in a 10%-20% modification in the pharmacy's total score. The difference between postcorrection and precorrection scores was significant. Conclusions Audio taping simulated patient visits enhances data integrity. Most corrections were required because of the simulated patients' poor recall abilities. PMID:19325956

Integrated segmentation and recognition of connected Ottoman script

NASA Astrophysics Data System (ADS)

Yalniz, Ismet Zeki; Altingovde, Ismail Sengor; Güdükbay, Uğur; Ulusoy, Özgür

2009-11-01

We propose a novel context-sensitive segmentation and recognition method for connected letters in Ottoman script. This method first extracts a set of segments from a connected script and determines the candidate letters to which extracted segments are most similar. Next, a function is defined for scoring each different syntactically correct sequence of these candidate letters. To find the candidate letter sequence that maximizes the score function, a directed acyclic graph is constructed. The letters are finally recognized by computing the longest path in this graph. Experiments using a collection of printed Ottoman documents reveal that the proposed method provides >90% precision and recall figures in terms of character recognition. In a further set of experiments, we also demonstrate that the framework can be used as a building block for an information retrieval system for digital Ottoman archives.

Managing family centered palliative care in aged and acute settings.

PubMed

Street, Annette Fay; Love, Anthony; Blackford, Jeanine

2005-03-01

This paper reports on the management of family centered palliative care in different aged care and acute Australian inpatient settings, following the integration of palliative care with mainstream services. Eighty-eight semistructured interviews were conducted and 425 questionnaires (Palliative Care Practices Questionnaire--PCPQ) were returned, completed from 12 regional and metropolitan locations. Transcribed interviews were analyzed using QSR NVivo and mean PCPQ scores from the four settings were compared. Scores on items from the PCPQ related to family centered care confirmed the analyses. Interviews revealed that factors contributing to the level of support for families offered in the various settings included the core business of the unit; the length of stay of the patients or residents; the acuity or symptom burden; and the coordinated involvement of the multidisciplinary team. Strategies for improving supportive family care are proposed.

Using Educational Prescriptions to Teach Medical Students Evidence-based Medicine

PubMed Central

Umscheid, Craig A.; Maenner, Matthew J.; Mull, Nikhil; Veesenmeyer, Angela F.; Farrar, John T.; Goldfarb, Stanley; Morrison, Gail; Albanese, Mark A.; Frohna, John G.; Feldstein, David A.

2018-01-01

Purpose To evaluate feasibility and impact of evidence-based medicine (EBM) educational prescriptions (EPs) in medical student clerkships. Methods Students answered clinical questions during clerkships using EPs, which guide learners through the “four As” of EBM. Epidemiology fellows graded EPs using a rubric. Feasibility was assessed using descriptive statistics and student and fellow end-of-study questionnaires, which also measured impact. In addition, for each EP, students reported patient impact. Impact on EBM skills was assessed by change in EP scores over time and scores on an EBM objective structured clinical exam (OSCE) that were compared to controls from the prior year. Results 117 students completed 402 EPs evaluated by 24 fellows. Average score was 7.34/9.00 (SD 1.58). 69 students (59%) and 21 fellows (88%) completed questionnaires. Most students thought EPs improved “Acquiring” and “Appraising.” Almost half thought EPs improved “Asking” and “Applying.” Fellows did not value grading EPs. For 18%of EPs, students reported a “change” or “potential change” in treatment. 56% “confirmed” treatment. EP scores increased by 1.27 (95% CI: 0.81–1.72). There were no differences in OSCE scores between cohorts. Conclusions Integrating EPs into clerkships is feasible and has impact, yet OSCEs were unchanged, and research fellows had limitations as evaluators. PMID:27075864

The impact of community pharmacy-led medicines management support for people with COPD.

PubMed

Alton, Sarah; Farndon, Lisa

2018-06-02

Chronic obstructive pulmonary disease (COPD) is a common long-term condition involving restricted airflow, which reduces quality of life. Treatments include lifestyle changes (smoking cessation), pulmonary rehabilitation and medication with inhaled therapies. However, medication adherence is often suboptimal, resulting in poor health outcomes. A pilot project assessed the impact of medicines management support from a community pharmacy team for people with COPD, delivered in their own homes. Individuals were given a medication review and an assessment of their inhaler technique and were followed up at 3 and 6 months. The COPD Assessment Test (CAT) score was administered before and after the intervention. A change in score of 2 or more suggests a significant difference; the average score was 19.2 at the first assessment and 16.7 at the six month follow-up. Seventeen patients had improved CAT scores, 10 patients had a reduced score and three remained unchanged. Most patients evaluated the project positively as it helped them to improve their inhaler technique. Medicines optimisation was also achieved as a person-centred approach was taken; suboptimal practice had not been picked up by health professionals previously. Community pharmacists working in integrated care teams provide invaluable support to patients with COPD. This project will be rolled out across the community team, and training on medicines management and inhaler technique provided to other health professionals involved in the care of these patients.

Integrated CLL Scoring System, a New and Simple Index to Predict Time to Treatment and Overall Survival in Patients With Chronic Lymphocytic Leukemia.

PubMed

Visentin, Andrea; Facco, Monica; Frezzato, Federica; Castelli, Monica; Trimarco, Valentina; Martini, Veronica; Gattazzo, Cristina; Severin, Filippo; Chiodin, Giorgia; Martines, Annalisa; Bonaldi, Laura; Gianesello, Ilaria; Pagnin, Elisa; Boscaro, Elisa; Piazza, Francesco; Zambello, Renato; Semenzato, Gianpietro; Trentin, Livio

2015-10-01

Several prognostic factors have been identified to predict the outcome of patients with chronic lymphocytic leukemia (CLL), but only a few studies analyzed more markers together. Taking advantage of a population of 608 patients, we identified the strongest prognostic markers of survival and, subsequently, in a cohort of 212 patients we integrated data of cytogenetic lesions, IGHV mutational status, and CD38 expression in a new and easy scoring system we called the integrated CLL scoring system (ICSS). ICSS defines 3 groups of risk: (1) low risk (patients with 13q(-) or normal fluorescence in-situ hybridization analysis results, mutated IGHV, and CD38) (2) high risk (all 11q(-) or 17p(-) patients and/or all unmutated IGHV and CD38(+) patients); and (3) intermediate risk (all remaining patients). Using only these 3 already available prognostic factors, we were able to properly redefine patients and better predict the clinical course of the disease. ICSS could become a useful tool for CLL patients' management. Copyright © 2015 Elsevier Inc. All rights reserved.

Modification site localization scoring integrated into a search engine.

PubMed

Baker, Peter R; Trinidad, Jonathan C; Chalkley, Robert J

2011-07-01

Large proteomic data sets identifying hundreds or thousands of modified peptides are becoming increasingly common in the literature. Several methods for assessing the reliability of peptide identifications both at the individual peptide or data set level have become established. However, tools for measuring the confidence of modification site assignments are sparse and are not often employed. A few tools for estimating phosphorylation site assignment reliabilities have been developed, but these are not integral to a search engine, so require a particular search engine output for a second step of processing. They may also require use of a particular fragmentation method and are mostly only applicable for phosphorylation analysis, rather than post-translational modifications analysis in general. In this study, we present the performance of site assignment scoring that is directly integrated into the search engine Protein Prospector, which allows site assignment reliability to be automatically reported for all modifications present in an identified peptide. It clearly indicates when a site assignment is ambiguous (and if so, between which residues), and reports an assignment score that can be translated into a reliability measure for individual site assignments.

Stability and Change of Behavioral and Emotional Screening Scores

ERIC Educational Resources Information Center

Dever, Bridget V.; Dowdy, Erin; Raines, Tara C.; Carnazzo, Katherine

2015-01-01

Universal screening for behavioral and emotional difficulties is integral to the identification of students needing early intervention and prevention efforts. However, unanswered questions regarding the stability of screening scores impede the ability to determine optimal strategies for subsequent screening. This study examined the 2-year…

Large Critical Shoulder Angle Has Higher Risk of Tendon Retear After Arthroscopic Rotator Cuff Repair.

PubMed

Li, Hong; Chen, Yuzhou; Chen, Jiwu; Hua, Yinghui; Chen, Shiyi

2018-05-01

The critical shoulder angle (CSA) is the angle created between the superior and inferior bone margins of the glenoid and the most lateral border of the acromion. A few studies recently investigated the relation between CSA and functional outcomes after rotator cuff repair. However, there is a lack of research investigating the effect of CSA on postoperative tendon integrity after rotator cuff repair. To assess the effects of the CSA on postoperative tendon integrity after rotator cuff repair. Cohort study; Level of evidence, 3. All patients who underwent rotator cuff repair for full-thickness supraspinatus tears by 1 senior surgeon between January 2010 and January 2014 were included in this study. All patients had standardized anteroposterior shoulder radiographs the day before surgery. CSA and acromial index (AI) were measured. AI was derived by measuring the distance from the glenoid plane to the lateral border of the acromion and dividing it by the distance from the glenoid plane to the lateral aspect of the humeral head. Functional scores-including American Shoulder and Elbow Surgeons shoulder evaluation form, modified University of California at Los Angeles score, Constant-Murley score, and visual analog scale for pain-were used to evaluate shoulder function at a minimum follow-up of 2 years. Meanwhile, magnetic resonance imaging examinations were performed to evaluate rotator cuff integrity according to the Sugaya method and the signal/noise quotient (SNQ) of the rotator cuff tendon. A total of 90 patients were included in this study: 42 patients with a single-row repair and 48 with a double-row repair. There was a significant positive correlation between CSA or AI and tendon SNQ. On the basis of CSA, the patients were divided into 2 groups: large CSA (>38°) and control (CSA ≤38°). At final follow-up, the large CSA group and the control CSA group demonstrated no significant differences in American Shoulder and Elbow Surgeons, University of California at Los Angeles, Constant, and visual analog scale scores. Postoperative magnetic resonance imaging revealed that the large CSA group had 9 cases of retear, with a significantly higher retear rate than the control group (15% vs 0%, P = .03). Furthermore, the tendon SNQ of the large CSA group was significantly greater than that of the control group. CSA did not appear to influence postoperative functional outcomes, while those in the large CSA group had poor tendon integrity after rotator cuff repair. These findings indicate that a large CSA is associated with an increased risk of rotator cuff tendon retear after repair.

STEAM: A National Study of the Integration of the Arts Into STEM Instruction and its Impact on Student Achievement

NASA Astrophysics Data System (ADS)

Rabalais, Mark E.

The purpose of this study is to examine the relationship between exposure to the arts and performance in Science, Technology, Engineering, and Math (STEM) subjects. STEAM, an integration of arts-based instruction into science and math related fields, is viewed as an alternative to traditional STEM academies. The literature briefly examines the current state of STEM programs and the deficiencies in graduate quality and quantity and the call from employers for a more innovative workforce. Advocates for STEAM argue for arts as a means to improve creativity, collaboration, risk-taking and exploration. Arguments against arts in STEM are grounded in political opinions concerning arts funding and logistical complications of implementing STEAM. However, some schools and STEM programs have embraced the STEAM premise and have begun to integrate arts into the traditional curriculum. The 2009 National Assessment of Educational Progress (NAEP) dataset was utilized to determine a correlation between the number of arts credits earned and mathematics/science achievement. Results from the NAEP dataset indicated a correlation between the amount of arts credits and increased achievement scores in science and math. The same correlation was found when controlling for demographic factors such as gender, race, and socio-economic status (SES). Overall, the arts' greatest impact was on students identified as "at-risk" or underrepresented in STEM fields. Controlling for these variable groups, one can note the quantifiable differences in scores. Overall, findings of the study provide empirical support for the addition of arts in STEM.

Biological assessment of streams in the Indianapolis Metropolitan Area, Indiana, 1999-2001

USGS Publications Warehouse

Voelker, David C.

2004-01-01

During 1999?2001, benthic invertebrates and fish were sampled to describe biological communities in the White River and selected tributaries in the Indianapolis Metropolitan Area in Indiana. Twelve sites (six on the White River and six on tributaries) were sampled biannually for benthic invertebrates and annually for fish. The information complements water-chemistry data collected by the Indianapolis Department of Public Works in the study area. Evaluation of the habitat for sites in the study area was done, using a Qualitative Habitat Evaluation Index (QHEI) developed by the Ohio Environmental Protection Agency. The QHEI scores basin and habitat characteristics for each site, with a maximum possible score of 100. Higher scores indicate better habitat conditions for biotic communities. The QHEI scores for sites on the White River ranged from 55 at the Harding site to 71 at the Waverly site; scores on the tributaries ranged from 45 on Pogues Run to 82 on Williams Creek. A total of 151 taxa were identified from the benthic-invertebrate samples. The Ephemeroptera, Plecoptera, and Trichoptera (EPT) Index scores for sites on the White River ranged from 0 at the Harding site to 15 at the Nora site. The Nora site, which is upstream from Indianapolis, generally scored the highest of all White River sites. Sites in the immediate vicinity of Indianapolis scored the lowest and indicate a negative effect on benthic-invertebrate communities in that reach. EPT Index scores increased in the farthest downstream reaches, which indicate that water-quality conditions had improved in comparison to sites in Indianapolis. For the tributary sites, EPT Index values ranged from 0 at Pogues Run to 16 at Buck Creek. Tributary sites on Fall Creek, Pleasant Run, and Pogues Run consistently scored 7 or lower; sites on Buck Creek, Eagle Creek, and Williams Creek scored 7 or higher. Hilsenhoff Biotic Index (HBI) scores ranged from 4.9 (good) to 9.6 (very poor) for the White River sites and from 5.2 (good) to 8.0 (poor) for the tributary sites. The lowest scores among the White River sites were at the Nora site, indicating the best water-quality conditions were where the White River enters Marion County. The highest HBI scores were at the Morris and Harding sites, indicating the least-favorable water-quality conditions of all the White River sites. Of the tributary sites, HBI scores for Buck, Eagle, and Williams Creeks indicate fair water-quality conditions; HBI scores for Pleasant Run and Pogues Run were the highest, indicating relatively poor water-quality conditions. On the White River, the highest Invertebrate Community Index (ICI) scores, which indicate the best benthic-invertebrate conditions, were at the Nora site. Conditions were fair to poor in the downtown Indianapolis area; ICI scores indicate slight improvement in the downstream reaches of the study area. Of the tributary sites, Buck Creek was the only site with ICI scores indicating exceptional water quality. Williams Creek ICI scores indicate good water quality; the remaining tributary-site scores reflect fair conditions. A total of 74 species and 3 hybrids of fish were identified during the study period. The Cyprinidae (carps and minnows) was the largest group of fish identified and consisted of more than half of all fish collected. The most numerous species was the central stoneroller (Campostoma anomalum), which accounted for almost 25 percent of the fish identified. Two nonnative species, the koi carp (Cyprinus carpio) and the western mosquitofish (Gambusia affinis), and one species classified as an Indiana species of special concern, the northern studfish (Fundulus catenatus), also were collected during the study. Indiana Index of Biotic Integrity (IBI) and Ohio Index of Biotic Integrity scores were calculated to show the condition of the fish communities at each site. Results of the Indiana IBI calculations showed no apparent differences in scores among the Wh

Methodology for energy strategy to prescreen the feasibility of Ground Source Heat Pump systems in residential and commercial buildings in the United States

DOE PAGES

Cho, Soolyeon; Ray, Saurabh; Im, Piljae; ...

2017-09-21

Geothermal resources have potential to reduce dependence on fossil fuels. The viability of geothermal heat pumps or ground source heat pumps (GSHPs) is significant as a potential alternative energy source with substantial savings potential. While the prospect of these systems is promising for energy efficiency, careful feasibility analysis is required before implementation. Here, this paper presents the results of evaluation of the application feasibility for GSHPs in buildings across seven climate zones in three United States regions. A comprehensive methodology is developed to measure the integrated feasibility of GSHPs using compiled data for energy use intensity, energy cost and designmore » parameters. Four different feasibility metrics are utilized: ground temperature, outdoor weather condition, energy savings potential, and cost benefits. For each metric, a corresponding feasibility score system is developed. The defined integrated feasibility score classifies the locations into five different feasibility levels ranging from Fair (0–20), Moderate (21–40), Good (41–60), High (61–80), and Very High (81–100). Conclusions show the GSHP feasibility level is High for 3 sites, Good for 8 sites and Moderate for 4 sites. Through the methodology, it is possible to develop a practical energy strategy for more economic and sustainable GSHP systems at an early design stage in the various viewpoints of geometries, climate conditions, operational factors, and energy costs.« less

Methodology for energy strategy to prescreen the feasibility of Ground Source Heat Pump systems in residential and commercial buildings in the United States

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

Cho, Soolyeon; Ray, Saurabh; Im, Piljae

Geothermal resources have potential to reduce dependence on fossil fuels. The viability of geothermal heat pumps or ground source heat pumps (GSHPs) is significant as a potential alternative energy source with substantial savings potential. While the prospect of these systems is promising for energy efficiency, careful feasibility analysis is required before implementation. Here, this paper presents the results of evaluation of the application feasibility for GSHPs in buildings across seven climate zones in three United States regions. A comprehensive methodology is developed to measure the integrated feasibility of GSHPs using compiled data for energy use intensity, energy cost and designmore » parameters. Four different feasibility metrics are utilized: ground temperature, outdoor weather condition, energy savings potential, and cost benefits. For each metric, a corresponding feasibility score system is developed. The defined integrated feasibility score classifies the locations into five different feasibility levels ranging from Fair (0–20), Moderate (21–40), Good (41–60), High (61–80), and Very High (81–100). Conclusions show the GSHP feasibility level is High for 3 sites, Good for 8 sites and Moderate for 4 sites. Through the methodology, it is possible to develop a practical energy strategy for more economic and sustainable GSHP systems at an early design stage in the various viewpoints of geometries, climate conditions, operational factors, and energy costs.« less

Patterns of adaptation to children's food allergies.

PubMed

Fedele, D A; McQuaid, E L; Faino, A; Strand, M; Cohen, S; Robinson, J; Atkins, D; Hourihane, J O'B; Klinnert, M D

2016-04-01

Families with food allergy (FA) are at risk of reduced quality of life and elevated anxiety. A moderate level of anxiety may be beneficial to sustain vigilance for food avoidance; however, excessive anxiety may increase risk for burden and maladjustment. The current study presents a framework for understanding the patterns of adaptation to FA across families and to identify typologies of families that would benefit from intervention. Participants included 57 children, 6-12 years old with documented FA, and their mothers. Families were assessed using the Food Allergy Management and Adaptation Scale. Families also completed measures of quality of life, anxiety, FA management, and psychosocial impairment. A hierarchical cluster analysis revealed that 56 of the 57 families of food-allergic children were categorized into four groups that differed on their adequacy of family FA management, levels of anxiety, and balanced psychosocial functioning: balanced responders (n = 23; 41%), high responders (n = 25; 45%), and low responders (n = 3; 5%). The fourth group, anxious high responders (n = 5; 9%), was characterized by extremely high maternal FA anxiety scores and low scores for balanced integration of FA management and psychosocial functioning. Families in clusters differed across illness and psychosocial outcome variables. Families with FA were characterized by patterns of FA management, anxiety, and ability to integrate FA demands into daily life. Identified adaptation patterns correspond with clinical impressions and provide a framework for identifying families in need of intervention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effectiveness of evidence-based medicine training for undergraduate students at a Chinese Military Medical University: a self-controlled trial.

PubMed

Ma, Xiangyu; Xu, Bin; Liu, Qingyun; Zhang, Yao; Xiong, Hongyan; Li, Yafei

2014-07-04

To evaluate the effect of the integration of evidence-based medicine (EBM) into medical curriculum by measuring undergraduate medical students' EBM knowledge, attitudes, personal application, and anticipated future use. A self-controlled trial was conducted with 251 undergraduate students at a Chinese Military Medical University, using a validated questionnaire regarding the students' evidence-based practice (EBP) about knowledge (EBP-K), attitude (EBP-A), personal application (EBP-P), and future anticipated use (EBP-F). The educational intervention was a 20-hour EBM course formally included in the university's medical curriculum, combining lectures with small group discussion and student-teacher exchange sessions. Data were analyzed using paired t-tests to test the significance of the difference between a before and after comparison. The difference between the pre- and post-training scores were statistically significant for EBP-K, EBP-A, EBP-P, and EBP-F. The scores for EBP-P showed the most pronounced percentage change after EBM training (48.97 ± 8.6%), followed by EBP-A (20.83 ± 2.1%), EBP-K (19.21 ± 3.2%), and EBP-F (17.82 ± 5.7%). Stratified analyses by gender, and program subtypes did not result in any significant changes to the results. The integration of EBM into the medical curriculum improved undergraduate medical students' EBM knowledge, attitudes, personal application, and anticipated future use. A well-designed EBM training course and objective outcome measurements are necessary to ensure the optimum learning opportunity for students.

The Effect Of Different Corrective Feedback Methods on the Outcome and Self Confidence of Young Athletes

PubMed Central

Tzetzis, George; Votsis, Evandros; Kourtessis, Thomas

2008-01-01

This experiment investigated the effects of three corrective feedback methods, using different combinations of correction, or error cues and positive feedback for learning two badminton skills with different difficulty (forehand clear - low difficulty, backhand clear - high difficulty). Outcome and self-confidence scores were used as dependent variables. The 48 participants were randomly assigned into four groups. Group A received correction cues and positive feedback. Group B received cues on errors of execution. Group C received positive feedback, correction cues and error cues. Group D was the control group. A pre, post and a retention test was conducted. A three way analysis of variance ANOVA (4 groups X 2 task difficulty X 3 measures) with repeated measures on the last factor revealed significant interactions for each depended variable. All the corrective feedback methods groups, increased their outcome scores over time for the easy skill, but only groups A and C for the difficult skill. Groups A and B had significantly better outcome scores than group C and the control group for the easy skill on the retention test. However, for the difficult skill, group C was better than groups A, B and D. The self confidence scores of groups A and C improved over time for the easy skill but not for group B and D. Again, for the difficult skill, only group C improved over time. Finally a regression analysis depicted that the improvement in performance predicted a proportion of the improvement in self confidence for both the easy and the difficult skill. It was concluded that when young athletes are taught skills of different difficulty, different type of instruction, might be more appropriate in order to improve outcome and self confidence. A more integrated approach on teaching will assist coaches or physical education teachers to be more efficient and effective. Key pointsThe type of the skill is a critical factor in determining the effectiveness of the feedback types.Different instructional methods of corrective feedback could have beneficial effects in the outcome and self-confidence of young athletesInstructions focusing on the correct cues or errors increase performance of easy skills.Positive feedback or correction cues increase self-confidence of easy skills but only the combination of error and correction cues increase self confidence and outcome scores of difficult skills. PMID:24149905

Mental health treatment outcomes in a humanitarian emergency: a pilot model for the integration of mental health into primary care in Habilla, Darfur

PubMed Central

Souza, Renato; Yasuda, Silvia; Cristofani, Susanna

2009-01-01

Background There is no description of outcomes for patients receiving treatment for mental illnesses in humanitarian emergencies. MSF has developed a model for integration of mental health into primary care in a humanitarian emergency setting based on the capacity of community health workers, clinical officers and health counsellors under the supervision of a psychiatrist trainer. Our study aims to describe the characteristics of patients first attending mental health services and their outcomes on functionality after treatment. Methods A total of 114 patients received mental health care and 81 adult patients were evaluated with a simplified functionality assessment instrument at baseline, one month and 3 months after initiation of treatment. Results Most patients were diagnosed with epilepsy (47%) and psychosis (31%) and had never received treatment. In terms of follow up, 58% came for consultations at 1 month and 48% at 3 months. When comparing disability levels at baseline versus 1 month, mean disability score decreased from 9.1 (95%CI 8.1–10.2) to 7.1 (95%CI 5.9–8.2) p = 0.0001. At 1 month versus 3 months, mean score further decreased to 5.8 (95%CI 4.6–7.0) p < 0.0001. Conclusion The findings suggest that there is potential to integrate mental health into primary care in humanitarian emergency contexts. Patients with severe mental illness and epilepsy are in particular need of mental health care. Different strategies for integration of mental health into primary care in humanitarian emergency settings need to be compared in terms of simplicity and feasibility. PMID:19622151

Quality of integrated chronic care measured by patient survey: identification, selection and application of most appropriate instruments

PubMed Central

Vrijhoef, Hubertus J. M.; Berbee, Rieneke; Wagner, Edward H.; Steuten, Lotte M. G.

2009-01-01

Abstract Objective  To identify the most appropriate generic instrument to measure experience and/or satisfaction of people receiving integrated chronic care. Background  Health care is becoming more user‐centred and, as a result, the experience of users of care and evaluation of their experience and/or satisfaction is taken more seriously. It is unclear to what extent existing instruments are appropriate in measuring the experience and/or satisfaction of people using integrated chronic care. Methods  Instruments were identified by means of a systematic literature review. Appropriateness of instruments was analysed on seven criteria. The two most promising instruments were translated into Dutch, if necessary, and administered to a convenience sample of 109 people with a chronic illness. Data derived from respondents were analysed statistically. Focus‐group interviews were conducted to assess the semantic and technical equivalence as well as opinions of people about the applicability and relevance of the translated instruments. Results  From 37 instruments identified, the Patients’ Assessment of Care for chronIc Conditions (PACIC) and the short form of the Patient Satisfaction Questionnaire III (PSQ‐18) were selected as most promising instruments. Both instruments produced similar median scores across people with different chronic conditions. The overall PACIC and its subscales and the overall PSQ‐18 were highly internally consistent, but not the PSQ‐18 subscales. Overall, the PACIC demonstrated better psychometric characteristics. PACIC and PSQ‐18 scores were found to be moderately correlated. Whereas more respondents preferred the PSQ‐18, focus‐group participants regarded the PACIC to be more applicable and relevant. The technical and semantic equivalence of both instruments were sufficient. Conclusions  Because of its psychometric characteristics, perceived applicability and relevance, the PACIC is the most appropriate instrument to measure the experience of people receiving integrated chronic care. PMID:19709315

A Probabilistic Model of Local Sequence Alignment That Simplifies Statistical Significance Estimation

PubMed Central

Eddy, Sean R.

2008-01-01

Sequence database searches require accurate estimation of the statistical significance of scores. Optimal local sequence alignment scores follow Gumbel distributions, but determining an important parameter of the distribution (λ) requires time-consuming computational simulation. Moreover, optimal alignment scores are less powerful than probabilistic scores that integrate over alignment uncertainty (“Forward” scores), but the expected distribution of Forward scores remains unknown. Here, I conjecture that both expected score distributions have simple, predictable forms when full probabilistic modeling methods are used. For a probabilistic model of local sequence alignment, optimal alignment bit scores (“Viterbi” scores) are Gumbel-distributed with constant λ = log 2, and the high scoring tail of Forward scores is exponential with the same constant λ. Simulation studies support these conjectures over a wide range of profile/sequence comparisons, using 9,318 profile-hidden Markov models from the Pfam database. This enables efficient and accurate determination of expectation values (E-values) for both Viterbi and Forward scores for probabilistic local alignments. PMID:18516236

Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder.

PubMed

Doney, Robyn; Lucas, Barbara R; Watkins, Rochelle E; Tsang, Tracey W; Sauer, Kay; Howat, Peter; Latimer, Jane; Fitzpatrick, James P; Oscar, June; Carter, Maureen; Elliott, Elizabeth J

2016-08-01

Visual-motor integration (VMI) skills are essential for successful academic performance, but to date no studies have assessed these skills in a population-based cohort of Australian Aboriginal children who, like many children in other remote, disadvantaged communities, consistently underperform academically. Furthermore, many children in remote areas of Australia have prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD), which are often associated with VMI deficits. VMI, visual perception, and fine motor coordination were assessed using The Beery-Buktenica Developmental Test of Visual-Motor Integration, including its associated subtests of Visual Perception and Fine Motor Coordination, in a cohort of predominantly Australian Aboriginal children (7.5-9.6 years, n=108) in remote Western Australia to explore whether PAE adversely affected test performance. Cohort results were reported, and comparisons made between children i) without PAE; ii) with PAE (no FASD); and iii) FASD. The prevalence of moderate (≤16th percentile) and severe (≤2nd percentile) impairment was established. Mean VMI scores were 'below average' (M=87.8±9.6), and visual perception scores were 'average' (M=97.6±12.5), with no differences between groups. Few children had severe VMI impairment (1.9%), but moderate impairment rates were high (47.2%). Children with FASD had significantly lower fine motor coordination scores and higher moderate impairment rates (M=87.9±12.5; 66.7%) than children without PAE (M=95.1±10.7; 23.3%) and PAE (no FASD) (M=96.1±10.9; 15.4%). Aboriginal children living in remote Western Australia have poor VMI skills regardless of PAE or FASD. Children with FASD additionally had fine motor coordination problems. VMI and fine motor coordination should be assessed in children with PAE, and included in FASD diagnostic assessments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of urbanization on the geomorphology, habitat, hydrology, and fish index of biotic integrity of streams in the Chicago area, Illinois and Wisconsin

USGS Publications Warehouse

Fitzpatrick, F.A.; Diebel, M.W.; Harris, M.A.; Arnold, T.L.; Lutz, M.A.; Richards, K.D.

2005-01-01

Effects of urbanization on geomorphic, habitat, and hydrologic characteristics and fish biotic integrity of 45 streams in the Chicago area were examined by the U.S. Geological Survey from 2000 to 2001. An agricultural to urban land-cover gradient approach was used. Landscape characteristics such as texture of surficial deposits, slope, riparian land cover, and stream network position also were examined to determine if these factors influenced the effects of urbanization. Among geomorphic characteristics, channel enlargement occurred in urban streams with a high percent of watershed clayey surficial deposits. Other geomorphic and habitat characteristics such as stream power, fine substrate, and amount of riffles did not correlate with percent watershed urban land but instead correlated with reach slope. Bank erosion, habitat variability, and two habitat indexes did not correlate with watershed urban land. Below 30% watershed urban land, the unit area discharge for a 2-year flood increased with increasing urban land; however, above 30% urban land, unit area discharges for a 2-year flood were variable, most likely due to variations in stormwater management practices, point-source contributions, and the transport index. Streams with greater than 33% watershed urban land had low base flow, but the effects of urbanization on base flow were offset by point-source contributions. Fish index of biotic integrity (IBI) scores were low in streams with greater than 25% watershed urban land. Fish IBI scores also were low in streams with high percentages of watershed clayey surficial deposits and enlarged channels. The amount of riparian forest/wetland buffer had no moderating effect on geomorphic/habitat/hydrologic characteristics and fish IBI scores. Variations in the texture and topography of glacial landforms affected reach slope and some habitat characteristics. Longitudinal profiles were useful for distinguishing differences in local geologic settings among sampled sites.

Using comics to increase literacy and assess student learning

NASA Astrophysics Data System (ADS)

Schwaller, Terry

2013-02-01

Formative assessment strategies and the integration of literacy pose two of the many hurdles teachers face. With the pressure of standardized test scores hanging over everyone's heads, finding class time to integrate these essential strategies is at a premium. By integrating comics with quick, formative written assessment, you can kill the proverbial two birds with one stone.

An Evaluation of the Effectiveness of Integrated Learning Systems on Urban Middle School Student Achievement

ERIC Educational Resources Information Center

Williams, Yamilette

2012-01-01

Many school districts have chosen to invest their federal funds in computer-based integrated learning systems that focus on literacy to increase high-stakes test scores and academic gains (Becker, 1994). Buly and Velencia (2002) supported the belief that a student's reading ability can improve substantially when instruction is integrated with…

Understanding Learner Strengths and Weaknesses: Assessing Performance on an Integrated Writing Task

ERIC Educational Resources Information Center

Sawaki, Yasuyo; Quinlan, Thomas; Lee, Yong-Won

2013-01-01

The present study examined the factor structures across features of 446 examinees' responses to a writing task that integrates reading and listening modalities as well as reading and listening comprehension items of the TOEFL iBT[R] (Internet-based test). Both human and automated scores obtained for the integrated essays were utilized. Based on a…

Ten Years in the Academic Integrity Trenches: Experiences and Issues

ERIC Educational Resources Information Center

Atkinson, Doug; Nau, S. Zaung; Symons, Christine

2016-01-01

In 2016, our university launched its Academic Integrity Program (AIP) in order to promote and protect academic integrity. All commencing students must complete this online AIP within 14 days of starting their course. Satisfactory completion of this module with a test score of 80% is required before students can access their course materials.…

Multisite Studies Demonstrate Positive Relationship Between Practice Environments and Smoking Cessation Counseling Evidence-Based Practices.

PubMed

Newhouse, Robin; Byon, Ha Do; Storkman Wolf, Emily; Johantgen, Meg

2018-06-01

High-quality smoking cessation counseling guidelines for people who use tobacco are not fully integrated in acute-care services presenting missed opportunities to improve health outcomes. The role of the practice environment on enhancing or inhibiting guideline use is unknown. To examine the relationship between the nurse practice environment and nurses' use of smoking cessation counseling practices, and to evaluate the effect of the individual nurse and organization characteristics on nurse smoking cessation counseling practices. Cross-sectional secondary analysis of survey data from two multisite studies. The sample included responses from registered nurses (N = 844) in 45 hospitals (22 rural hospitals from the Eastern United States and 23 Magnet hospitals across the United States). Linear mixed model was used to adjust intradependency among the responses of individual nurses nested within hospitals. Data were abstracted from survey responses including nurse characteristics, the Smoking Cessation Counseling Scale (SCCS), and the Practice Environment Scale-Nursing Work Index (PES). Increasing positive relationships exist between PES and SCCS total and subscales scores. Also, SCCS total scores were significantly related with favorable PES total scores (SCCS score difference of 0.26 between favorable and unfavorable PES scores, SE = .08, p = .002) controlling for other covariates. Non-White respondents (vs. White) demonstrated a positive association with SCCS total scores (difference of .18, SE = .07, p = .010), but not in advanced counseling. Nurse practice environments are positively associated with the use of evidence-based smoking cessation practices by nurses. As practice environments become more favorable, higher level counseling practices occur more often. Healthcare leaders should focus on enhancing the practice environment using a quality improvement approach and framework for evidence translation. Quality improvement initiatives should be prioritized in which high-quality evidence is available to support nursing processes. © 2018 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

Satisfaction in Older Persons and General Practitioners during the Implementation of Integrated Care

PubMed Central

Caljouw, Monique A. A.; de Waard, Claudia S.; Wind, Annet W.; Gussekloo, Jacobijn

2016-01-01

Background Integrated care for older persons with complex care needs is widely advocated. Particularly professionals and policy makers have positive expectations. Care outcome results are ambiguous. Receiver and provider satisfaction is relevant but still poorly understood. Methods During implementation of integrated care in residential homes (The MOVIT project), we compared general satisfaction and satisfaction with specific aspects of General Practitioner (GP) care in older persons and GPs before (cohort I) and after at least 12 months of implementation (cohort II). Results The general satisfaction score for GP care given by older persons does not change (Cohort I (n = 762) mean score 8.0 (IQR:7.0–9.0) vs. Cohort II (n = 505) mean score 8.0 (IQR:7.0–8.0);P = 0.01). Expressions of general satisfaction in GPs do not show consistent change (Cohort I (n = 87) vs Cohort II (n = 66), percentage satisfied about; role as GP, 56% vs 67%;P = 0.194, ability to provide personal care, 60% vs 67%;P = 0.038, quality of care, 54% vs 62%;P = 0.316). Satisfaction in older persons about some specific aspects of care do show change; GP-patient relationship, points 61.6 vs 63.3;P = 0.001, willingness to talk about mistakes, score 3.47 vs 3.73;P = 0.001, information received about drugs, score 2.79 vs 2.46;P = 0.002. GPs also report changes in specific aspects: percentage satisfied about multidisciplinary meetings; occurrence, 21% vs 53%;P = <0.001, GP presence, 12% vs 41%;P = <0.001, and participation, 29% vs.51%;P = 0.046. Conclusion General satisfaction about care received and provided shows no consistent change in older persons and GPs during the implementation of integrated care. Specific changes in satisfaction are found. These show an emphasis on inter-personal aspects in older persons and organizational aspects in GPs. PMID:27737012

On combining multi-normalization and ancillary measures for the optimal score level fusion of fingerprint and voice biometrics

NASA Astrophysics Data System (ADS)

Mohammed Anzar, Sharafudeen Thaha; Sathidevi, Puthumangalathu Savithri

2014-12-01

In this paper, we have considered the utility of multi-normalization and ancillary measures, for the optimal score level fusion of fingerprint and voice biometrics. An efficient matching score preprocessing technique based on multi-normalization is employed for improving the performance of the multimodal system, under various noise conditions. Ancillary measures derived from the feature space and the score space are used in addition to the matching score vectors, for weighing the modalities, based on their relative degradation. Reliability (dispersion) and the separability (inter-/intra-class distance and d-prime statistics) measures under various noise conditions are estimated from the individual modalities, during the training/validation stage. The `best integration weights' are then computed by algebraically combining these measures using the weighted sum rule. The computed integration weights are then optimized against the recognition accuracy using techniques such as grid search, genetic algorithm and particle swarm optimization. The experimental results show that, the proposed biometric solution leads to considerable improvement in the recognition performance even under low signal-to-noise ratio (SNR) conditions and reduces the false acceptance rate (FAR) and false rejection rate (FRR), making the system useful for security as well as forensic applications.

Using Neuropsychometric Measurements in the Differential Diagnosis of Specific Learning Disability

PubMed Central

TURGUT TURAN, Sevil; ERDOĞAN BAKAR, Emel; ERDEN, Gülsen; KARAKAŞ, Sirel

2016-01-01

Introduction The aim of this study was to develop a neuropsychometric battery for the differential diagnosis of specific learning disability (SLD), with specific respect to attention deficit hyperactivity disorder (ADHD), and to help resolve the conflicting results in the literature by an integrative utilization of scores on both the Bannatyne categories and neuropsychological tests. Methods The sample included 168 primary school boys who were assigned to SLD (n=21), ADHD (n=45), SLD and ADHD (n=57), and control groups (n=45). The exclusion criteria were a neurological or psychiatric comorbidity other than ADHD, a level of anxiety and/or depression above the cutoff score, medication affecting cognitive processes, visual and/or auditory disorders, and an intelligence level outside the IQ range of 85–129. Psychometric scores were obtained from the SLD Battery and Wechsler Intelligence Scale for Children-Revised in the form of Bannatyne category scores. Neuropsychological scores were from the Visual–Aural Digit Span Test-Form B, Serial Digit Learning Test, Judgment of Line Orientation, and Mangina Test. The battery was called the Integrative Battery of SLD. Results The correctness of estimation for classifying cases into the diagnostic dyads (SLD/ADHD, SLD/SLD+ADHD, and SLD+ADHD/ADHD) by an integrative utilization of both the Bannatyne category scores (n=4) and scores from the four neuropsychological tests (n=10) was 92.4%, 81.4%, and 71.8%, respectively. These proportions were generally higher than those obtained using the Bannatyne category scores alone (86.4%, 75.5%, and 73.1%, respectively). The same trend was seen in the classification of children into diagnostic and control groups. However, the proportion of the correctness of estimation was higher than that obtained for the diagnostic dyads. Conclusion When conducted using appropriately chosen research designs and statistical techniques and if confounding variables are sufficiently controlled, a neuropsychometric battery that includes capacities that relate to intelligence (Bannatyne categories) and those that relate to neurocognitive processes (neuropsychological tests) can be useful in the differential diagnosis of SLD. PMID:28360787

Web-based versus traditional lecture: are they equally effective as a flexible bronchoscopy teaching method?

PubMed

Mata, Caio Augusto Sterse; Ota, Luiz Hirotoshi; Suzuki, Iunis; Telles, Adriana; Miotto, Andre; Leão, Luiz Eduardo Vilaça

2012-01-01

This study compares the traditional live lecture to a web-based approach in the teaching of bronchoscopy and evaluates the positive and negative aspects of both methods. We developed a web-based bronchoscopy curriculum, which integrates texts, images and animations. It was applied to first-year interns, who were later administered a multiple-choice test. Another group of eight first-year interns received the traditional teaching method and the same test. The two groups were compared using the Student's t-test. The mean scores (± SD) of students who used the website were 14.63 ± 1.41 (range 13-17). The test scores of the other group had the same range, with a mean score of 14.75 ± 1. The Student's t-test showed no difference between the test results. The common positive point noted was the presence of multimedia content. The web group cited as positive the ability to review the pages, and the other one the role of the teacher. Web-based bronchoscopy education showed results similar to the traditional live lecture in effectiveness.

Assessing the Utility of Compound Trait Estimates of Narrow Personality Traits.

PubMed

Credé, Marcus; Harms, Peter D; Blacksmith, Nikki; Wood, Dustin

2016-01-01

It has been argued that approximations of narrow traits can be made through linear combinations of broad traits such as the Big Five personality traits. Indeed, Hough and Ones ( 2001 ) used a qualitative analysis of scale content to arrive at a taxonomy of how Big Five traits might be combined to approximate various narrow traits. However, the utility of such compound trait approximations has yet to be established beyond specific cases such as integrity and customer service orientation. Using data from the Eugene-Springfield Community Sample (Goldberg, 2008 ), we explore the ability of linear composites of scores on Big Five traits to approximate scores on 127 narrow trait measures from 5 well-known non-Big-Five omnibus measures of personality. Our findings indicate that individuals' standing on more than 30 narrow traits can be well estimated from 3 different types of linear composites of scores on Big Five traits without a substantial sacrifice in criterion validity. We discuss theoretical accounts for why such relationships exist as well as the theoretical and practical implications of these findings for researchers and practitioners.

Integrating the ACR Appropriateness Criteria Into the Radiology Clerkship: Comparison of Didactic Format and Group-Based Learning.

PubMed

Stein, Marjorie W; Frank, Susan J; Roberts, Jeffrey H; Finkelstein, Malka; Heo, Moonseong

2016-05-01

The aim of this study was to determine whether group-based or didactic teaching is more effective to teach ACR Appropriateness Criteria to medical students. An identical pretest, posttest, and delayed multiple-choice test was used to evaluate the efficacy of the two teaching methods. Descriptive statistics comparing test scores were obtained. On the posttest, the didactic group gained 12.5 points (P < .0001), and the group-based learning students gained 16.3 points (P < .0001). On the delayed test, the didactic group gained 14.4 points (P < .0001), and the group-based learning students gained 11.8 points (P < .001). The gains in scores on both tests were statistically significant for both groups. However, the differences in scores were not statistically significant comparing the two educational methods. Compared with didactic lectures, group-based learning is more enjoyable, time efficient, and equally efficacious. The choice of educational method can be individualized for each institution on the basis of group size, time constraints, and faculty availability. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Assessment of current undergraduate anesthesia course in a Saudi University

PubMed Central

Shams, Tarek; El-Masry, Ragaa; al Wadani, Hamed; Amr, Mostafa

2013-01-01

Background: The assessment of the anesthesia course in our university comprises Objective Structured Clinical Examinations (OSCEs), in conjunction with portfolio and multiple-choice questions (MCQ). The objective of this study was to evaluate the outcome of different forms of anesthesia course assessment among 5th year medical students in our university, as well as study the influence of gender on student performance in anesthesia. Methods: We examined the performance of 154, 5th year medical students through OSCE, portfolios, and MCQ. Results: The score ranges in the portfolio, OSCE, and MCQs were 16-24, 4.2-28.9, and 15.5-44.5, respectively. There was highly significant difference in scores in relation to gender in all assessments other than the written one (P=0.000 for Portfolio, OSCE, and Total exam, whereas P=0.164 for written exam). In the generated linear regression model, OSCE alone could predict 86.4% of the total mark if used alone. In addition, if the score of the written examination is added, OSCE will drop to 57.2% and the written exam will be 56.8% of the total mark. Conclusions: This study demonstrates that different clinical methods used to assess medical students during their anesthesia course were consistent and integrated. The performance of female was superior to male in OSCE and portfolio. This information is the basis for improving educational and assessment standards in anesthesiology and for introducing a platform for developing modern learning media in countries with dearth of anesthesia personnel. PMID:23956708

Assessment of current undergraduate anesthesia course in a Saudi University.

PubMed

Shams, Tarek; El-Masry, Ragaa; Al Wadani, Hamed; Amr, Mostafa

2013-04-01

The assessment of the anesthesia course in our university comprises Objective Structured Clinical Examinations (OSCEs), in conjunction with portfolio and multiple-choice questions (MCQ). The objective of this study was to evaluate the outcome of different forms of anesthesia course assessment among 5(th) year medical students in our university, as well as study the influence of gender on student performance in anesthesia. We examined the performance of 154, 5(th) year medical students through OSCE, portfolios, and MCQ. The score ranges in the portfolio, OSCE, and MCQs were 16-24, 4.2-28.9, and 15.5-44.5, respectively. There was highly significant difference in scores in relation to gender in all assessments other than the written one (P=0.000 for Portfolio, OSCE, and Total exam, whereas P=0.164 for written exam). In the generated linear regression model, OSCE alone could predict 86.4% of the total mark if used alone. In addition, if the score of the written examination is added, OSCE will drop to 57.2% and the written exam will be 56.8% of the total mark. This study demonstrates that different clinical methods used to assess medical students during their anesthesia course were consistent and integrated. The performance of female was superior to male in OSCE and portfolio. This information is the basis for improving educational and assessment standards in anesthesiology and for introducing a platform for developing modern learning media in countries with dearth of anesthesia personnel.

Web-Enabled Mechanistic Case Diagramming: A Novel Tool for Assessing Students' Ability to Integrate Foundational and Clinical Sciences.

PubMed

Ferguson, Kristi J; Kreiter, Clarence D; Haugen, Thomas H; Dee, Fred R

2018-02-20

As medical schools move from discipline-based courses to more integrated approaches, identifying assessment tools that parallel this change is an important goal. The authors describe the use of test item statistics to assess the reliability and validity of web-enabled mechanistic case diagrams (MCDs) as a potential tool to assess students' ability to integrate basic science and clinical information. Students review a narrative clinical case and construct an MCD using items provided by the case author. Students identify the relationships among underlying risk factors, etiology, pathogenesis and pathophysiology, and the patients' signs and symptoms. They receive one point for each correctly-identified link. In 2014-15 and 2015-16, case diagrams were implemented in consecutive classes of 150 medical students. The alpha reliability coefficient for the overall score, constructed using each student's mean proportion correct across all cases, was 0.82. Discrimination indices for each of the case scores with the overall score ranged from 0.23 to 0.51. In a G study using those students with complete data (n = 251) on all 16 cases, 10% of the variance was true score variance, and systematic case variance was large. Using 16 cases generated a G coefficient (relative score reliability) equal to .72 and a Phi equal to .65. The next phase of the project will involve deploying MCDs in higher-stakes settings to determine whether similar results can be achieved. Further analyses will determine whether these assessments correlate with other measures of higher-order thinking skills.

Primary Care-Mental Health Integration in the Veterans Affairs Health System: Program Characteristics and Performance.

PubMed

Cornwell, Brittany L; Brockmann, Laurie M; Lasky, Elaine C; Mach, Jennifer; McCarthy, John F

2018-06-01

The Veterans Health Administration (VHA) has achieved substantial national implementation of primary care-mental health integration (PC-MHI) services. However, little is known regarding program characteristics, variation in characteristics across settings, or associations between program fidelity and performance. This study identified core elements of PC-MHI services and evaluated their associations with program characteristics and performance. A principal-components analysis (PCA) of reports from 349 sites identified factors associated with PC-MHI fidelity. Analyses assessed the correlation among factors and between each factor and facility type (medical center or community-based outpatient clinic), primary care population size, and performance indicators (receipt of PC-MHI services, same-day access to mental health and primary care services, and extended duration of services). PCA identified seven factors: core implementation, care management (CM) assessments and supervision, CM supervision receipt, colocated collaborative care (CCC) by prescribing providers, CCC by behavioral health providers, participation in patient aligned care teams (PACTs) for special populations, and treatment of complex mental health conditions. Sites serving larger populations had greater core implementation scores. Medical centers and sites serving larger populations had greater scores for CCC by prescribing providers, CM assessments and supervision, and participation in PACTs. Greater core implementation scores were associated with greater same-day access. Sites with greater scores for CM assessments and supervision had lower scores for treatment of complex conditions. Outpatient clinics and sites serving smaller populations experienced challenges in integrated care implementation. To enhance same-day access, VHA should continue to prioritize PC-MHI implementation. Providing brief, problem-focused care may enhance CM implementation.

Plaque reduction over time of an integrated oral hygiene system.

PubMed

Nunn, Martha E; Ruhlman, C Douglas; Mallatt, Philip R; Rodriguez, Sally M; Ortblad, Katherine M

2004-10-01

This article compares the efficacy of a prototype integrated system (the IntelliClean System from Sonicare and Crest) in the reduction of supragingival plaque to that of a manual toothbrush and conventional toothpaste. The integrated system was compared to a manual toothbrush with conventional toothpaste in a randomized, single-blinded, parallel, 4-week, controlled clinical trial with 100 subjects randomized to each treatment group. There was a low dropout rate, with 89 subjects in the manual toothbrush group (11% loss to follow-up) and 93 subjects in the integrated system group (7% loss to follow-up) completing the study. The Turesky modification of the Quigley and Hein Plaque Index was used to assess full-mouth plaque scores for each subject. Prebrushing plaque scores were obtained at baseline and at 4 weeks after 14 to 20 hours of plaque accumulation. A survey also was conducted at the conclusion of the study to determine the attitude toward the two oral hygiene systems. The integrated system was found to significantly reduce overall and interproximal prebrushing plaque scores over 4 weeks, both by 8.6%, demonstrating statistically significant superiority in overall plaque reduction (P = .002) and interproximal plaque reduction (P < .001) compared to the manual toothbrush with conventional toothpaste, which showed no significant reduction in either overall plaque or interproximal plaque. This study demonstrates that the IntelliClean System from Sonicare and Crest is superior to a manual toothbrush with conventional toothpaste in reducing overall plaque and interproximal plaque over time.

Rapid integrated water quality evaluation of Mahisagar river using benthic macroinvertebrates.

PubMed

Bhadrecha, M H; Khatri, Nitasha; Tyagi, Sanjiv

2016-04-01

The water quality of Mahisagar river, near Galteshwar in Kheda district of Gujarat, India, was assessed through a rapid integrated technique by physicochemical parameters as well as benthic macroinvertebrates. Physicochemical parameters retrieved were pH, color, conductivity, total solids, total suspended solids, total dissolved solids, chlorides, total hardness, calcium hardness, magnesium hardness, alkalinity, turbidity, ammoniacal nitrogen, chemical oxygen demand, biochemical oxygen demand, dissolved oxygen, sulfates, and nitrates. The biological indices calculated were BMWP (Bio Monitoring Working Party) score or saprobic score and sequential comparison index or diversity score. In total, 37 families were encountered along the studied river stretch. The findings indicate that the water quality of Mahisagar river at sampled locations is “slightly polluted.” Moreover, the results of physicochemical analysis are also in consonance with the biological water quality criteria developed by Central Pollution Control Board.

Cross-Cultural Validation of the Patient Perception of Integrated Care Survey.

PubMed

Tietschert, Maike V; Angeli, Federica; van Raak, Arno J A; Ruwaard, Dirk; Singer, Sara J

2017-07-20

To test the cross-cultural validity of the U.S. Patient Perception of Integrated Care (PPIC) Survey in a Dutch sample using a standardized procedure. Primary data collected from patients of five primary care centers in the south of the Netherlands, through survey research from 2014 to 2015. Cross-sectional data collected from patients who saw multiple health care providers during 6 months preceding data collection. The PPIC survey includes 59 questions that measure patient perceived care integration across providers, settings, and time. Data analysis followed a standardized procedure guiding data preparation, psychometric analysis, and included invariance testing with the U.S. dataset. Latent scale structures of the Dutch and U.S. survey were highly comparable. Factor "Integration with specialist" had lower reliability scores and noninvariance. For the remaining factors, internal consistency and invariance estimates were strong. The standardized cross-cultural validation procedure produced strong support for comparable psychometric characteristics of the Dutch and U.S. surveys. Future research should examine the usability of the proposed procedure for contexts with greater cultural differences. © Health Research and Educational Trust.

a New Multi-Criteria Evaluation Model Based on the Combination of Non-Additive Fuzzy Ahp, Choquet Integral and Sugeno λ-MEASURE

NASA Astrophysics Data System (ADS)

Nadi, S.; Samiei, M.; Salari, H. R.; Karami, N.

2017-09-01

This paper proposes a new model for multi-criteria evaluation under uncertain condition. In this model we consider the interaction between criteria as one of the most challenging issues especially in the presence of uncertainty. In this case usual pairwise comparisons and weighted sum cannot be used to calculate the importance of criteria and to aggregate them. Our model is based on the combination of non-additive fuzzy linguistic preference relation AHP (FLPRAHP), Choquet integral and Sugeno λ-measure. The proposed model capture fuzzy preferences of users and fuzzy values of criteria and uses Sugeno λ -measure to determine the importance of criteria and their interaction. Then, integrating Choquet integral and FLPRAHP, all the interaction between criteria are taken in to account with least number of comparison and the final score for each alternative is determined. So we would model a comprehensive set of interactions between criteria that can lead us to more reliable result. An illustrative example presents the effectiveness and capability of the proposed model to evaluate different alternatives in a multi-criteria decision problem.

Investigating the Impact of Automated Feedback on Students' Scientific Argumentation

ERIC Educational Resources Information Center

Zhu, Mengxiao; Lee, Hee-Sun; Wang, Ting; Liu, Ou Lydia; Belur, Vinetha; Pallant, Amy

2017-01-01

This study investigates the role of automated scoring and feedback in supporting students' construction of written scientific arguments while learning about factors that affect climate change in the classroom. The automated scoring and feedback technology was integrated into an online module. Students' written scientific argumentation occurred…

Local Observed-Score Kernel Equating

ERIC Educational Resources Information Center

Wiberg, Marie; van der Linden, Wim J.; von Davier, Alina A.

2014-01-01

Three local observed-score kernel equating methods that integrate methods from the local equating and kernel equating frameworks are proposed. The new methods were compared with their earlier counterparts with respect to such measures as bias--as defined by Lord's criterion of equity--and percent relative error. The local kernel item response…

The Effect of Training on Multicultural Counseling Competencies: An Exploratory Study over a Ten-Year Period.

ERIC Educational Resources Information Center

Manese, Jeanne E.; Wu, John T.; Nepomuceno, Cecilia A.

2001-01-01

Evaluates the impact of integrated multicultural internship training on multicultural counseling competencies. Multicultural Counseling Awareness Scale scores were obtained at the beginning and end of the internship. Knowledge/Skills scores significantly increased at the end of training. Discusses implications for training, measurement, and…

Test Takers and the Validity of Score Interpretations

ERIC Educational Resources Information Center

Kopriva, Rebecca J.; Thurlow, Martha L.; Perie, Marianne; Lazarus, Sheryl S.; Clark, Amy

2016-01-01

This article argues that test takers are as integral to determining validity of test scores as defining target content and conditioning inferences on test use. A principled sustained attention to how students interact with assessment opportunities is essential, as is a principled sustained evaluation of evidence confirming the validity or calling…

Transforming Biology Assessment with Machine Learning: Automated Scoring of Written Evolutionary Explanations

ERIC Educational Resources Information Center

Nehm, Ross H.; Ha, Minsu; Mayfield, Elijah

2012-01-01

This study explored the use of machine learning to automatically evaluate the accuracy of students' written explanations of evolutionary change. Performance of the Summarization Integrated Development Environment (SIDE) program was compared to human expert scoring using a corpus of 2,260 evolutionary explanations written by 565 undergraduate…

Lifelong Bilingualism Contributes to Cognitive Reserve against White Matter Integrity Declines in Aging

PubMed Central

Gold, Brian T.; Johnson, Nathan F.; Powell, David K.

2013-01-01

Recent evidence suggests that lifelong bilingualism may contribute to cognitive reserve (CR) in normal aging. However, there is currently no neuroimaging evidence to suggest that lifelong bilinguals can retain normal cognitive functioning in the face of age-related neurodegeneration. Here we explored this issue by comparing white matter (WM) integrity and gray matter (GM) volumetric patterns of older adult lifelong bilinguals (N = 20) and monolinguals (N = 20). The groups were matched on a range of relevant cognitive test scores and on the established CR variables of education, socioeconomic status and intelligence. Participants underwent high-resolution structural imaging for assessment of GM volume and diffusion tensor imaging (DTI) for assessment of WM integrity. Results indicated significantly lower microstructural integrity in the bilingual group in several WM tracts. In particular, compared to their monolingual peers, the bilingual group showed lower fractional anisotropy and/or higher radial diffusivity in the inferior longitudinal fasciculus/inferior fronto-occipital fasciculus bilaterally, the fornix, and multiple portions of the corpus callosum. There were no group differences in GM volume. Our results suggest that lifelong bilingualism contributes to CR against WM integrity declines in aging. PMID:24103400

Assessing environmental quality status by integrating chemical and biological effect data: The Cartagena coastal zone as a case.

PubMed

Martínez-Gómez, Concepción; Fernández, Beatriz; Robinson, Craig D; Campillo, J Antonio; León, Víctor M; Benedicto, José; Hylland, Ketil; Vethaak, A Dick

2017-03-01

Cartagena coastal zone (W Mediterranean) was chosen for a practical case study to investigate the suitability of an integrated indicator framework for marine monitoring and assessment of chemicals and their effects, which was developed by ICES and OSPAR. Red mullet (Mullus barbatus) and the Mediterranean mussel (Mytilus galloprovincialis) were selected as target species. Concentrations of contaminants in sediment and biota, and contaminant-related biomarkers were analysed. To assess environmental quality in the Cartagena coastal zone with respect to chemical pollution, data were assessed using available assessment criteria, and then integrated for different environmental matrices. A qualitative scoring method was used to rank the overall assessments into selected categories and to evaluate the confidence level of the final integrated assessment. The ICES/OSPAR integrated assessment framework, originally designed for the North Atlantic, was found to be applicable for Mediterranean species and environmental matrices. Further development of assessment criteria of chemical and biological parameters in sediments and target species from the Mediterranean will, however, be required before this framework can be fully applied for determining Good Environmental Status (GES) of the Marine Strategy Framework Directive in these regions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reduced integration and improved segregation of functional brain networks in Alzheimer’s disease

NASA Astrophysics Data System (ADS)

Kabbara, A.; Eid, H.; El Falou, W.; Khalil, M.; Wendling, F.; Hassan, M.

2018-04-01

Objective. Emerging evidence shows that cognitive deficits in Alzheimer’s disease (AD) are associated with disruptions in brain functional connectivity. Thus, the identification of alterations in AD functional networks has become a topic of increasing interest. However, to what extent AD induces disruption of the balance of local and global information processing in the human brain remains elusive. The main objective of this study is to explore the dynamic topological changes of AD networks in terms of brain network segregation and integration. Approach. We used electroencephalography (EEG) data recorded from 20 participants (10 AD patients and 10 healthy controls) during resting state. Functional brain networks were reconstructed using EEG source connectivity computed in different frequency bands. Graph theoretical analyses were performed assess differences between both groups. Main results. Results revealed that AD networks, compared to networks of age-matched healthy controls, are characterized by lower global information processing (integration) and higher local information processing (segregation). Results showed also significant correlation between the alterations in the AD patients’ functional brain networks and their cognitive scores. Significance. These findings may contribute to the development of EEG network-based test that could strengthen results obtained from currently-used neurophysiological tests in neurodegenerative diseases.

Reduced integration and improved segregation of functional brain networks in Alzheimer's disease.

PubMed

Kabbara, A; Eid, H; El Falou, W; Khalil, M; Wendling, F; Hassan, M

2018-04-01

Emerging evidence shows that cognitive deficits in Alzheimer's disease (AD) are associated with disruptions in brain functional connectivity. Thus, the identification of alterations in AD functional networks has become a topic of increasing interest. However, to what extent AD induces disruption of the balance of local and global information processing in the human brain remains elusive. The main objective of this study is to explore the dynamic topological changes of AD networks in terms of brain network segregation and integration. We used electroencephalography (EEG) data recorded from 20 participants (10 AD patients and 10 healthy controls) during resting state. Functional brain networks were reconstructed using EEG source connectivity computed in different frequency bands. Graph theoretical analyses were performed assess differences between both groups. Results revealed that AD networks, compared to networks of age-matched healthy controls, are characterized by lower global information processing (integration) and higher local information processing (segregation). Results showed also significant correlation between the alterations in the AD patients' functional brain networks and their cognitive scores. These findings may contribute to the development of EEG network-based test that could strengthen results obtained from currently-used neurophysiological tests in neurodegenerative diseases.

Safety and usefulness of Laghu shankha prakshalana in patients with essential hypertension: A self controlled clinical study

PubMed Central

Mashyal, Prakash; Bhargav, Hemant; Raghuram, Nagarathna

2014-01-01

Background: Yoga and Ayurveda texts emphasize the role of cleansing the bowel as an important component of management of hypertension (HTN). Observations during our clinical experience and pilot studies on Laghu shankha prakshalana kriya (LSP), a yogic bowel cleansing technique, appeared to be safe and complimentary. Objective: To test the safety and effectiveness of LSP in patients with essential hypertension. Materials and Methods: This self control study recruited 32 patients with mild to moderate essential HTN admitted for a week long residential integrated yoga therapy program at the integrative health home in Bengaluru. Patients had a daily routine of 6 hours of integrated approach of yoga therapy (IAYT) module for HTN that included physical postures, relaxation sessions, pranayama and meditations. LSP, an additional practice, that involved drinking of luke-warm water (with or without a herbal combination, triphala) followed by a set of specific yoga postures that activates defecation reflex, was administered on 2nd (LSP without triphala) and 5th day (LSP with triphala). Assessments (sitting blood pressure and pulse rate) were done just before and after both the sessions of LSP. Secondary outcome measures such as body mass index (BMI), symptom scores, medication scores, fatigue, state and trait anxiety, general health and quality of life were assessed on 1st and 6th day of IAYT intervention. Results: There was significant (P < 0.001, paired t test) reduction in blood pressure (systolic and diastolic) and pulse rate immediately after both the sessions (LSP with and without triphala). There were no adverse effects reported during or after LSP. There was no significant difference between the two techniques (P < 0.505, independent samples t test), although the percentage change appeared to be higher after triphala LSP session. The number of visits to clear the bowel during the procedure was significantly (P < 0.001, independent samples t test) higher after LSP with triphala than LSP without triphalā. After weeklong IAYT, there were significant reductions in blood pressure (P < 0.001), BMI (P < 0.004), medication score (P < 0.001), symptoms score (P < 0.001), fatigue (P < 0.001), state and trait anxiety (STAI, P < 0.001), scores of general ill health (GHQ, P < 0.001), and increase in comfort level (P < 0.001) and quality of sleep (P < 0.001). Conclusion: LSP (a part of IAYT) is a safe and useful procedure for patients with essential hypertension. LSP with triphala is more useful. PMID:25624697

Rectus Muscle Reapproximation at Cesarean Delivery and Postoperative Pain: A Randomized Controlled Trial

PubMed Central

Lyell, Deirdre J.; Naqvi, Mariam; Wong, Amy; Urban, Renata; Carvalho, Brendan

2017-01-01

Objective  Rectus muscle reapproximation at cesarean delivery (CD) is performed frequently by some obstetricians; however, the effect on postoperative pain is unclear. To this end, we investigated whether rectus muscle reapproximation increases postoperative pain. Materials and Methods  This is a prospective, double-blind, randomized controlled trial of women undergoing primary CD with singleton or twin pregnancy at >35 weeks' gestation. Women were randomized to rectus muscle reapproximation with three interrupted sutures or no reapproximation. Exclusion criteria were prior cesarean, prior laparotomy, vertical skin incision, active labor, chronic analgesia use, allergy to opioid or nonsteroidal anti-inflammatory drugs, and body mass index ≥ 40. Intra- and postoperative pain management was standardized within the study protocol. The primary outcome was a combined movement pain and opioid use score averaged over the 72-hour study period, called the Silverman integrated assessment. Movement pain scores were assessed at 24, 48, and 72 postoperative hours. Results  In total, 63 women were randomized, of whom 35 underwent rectus muscle reapproximation and 28 did not. Demographic and obstetric variables were similar between groups. Silverman integrated assessment scores during the 72-hour postoperative period were higher in the rectus muscle reapproximation group (15 ± 100% vs. –31 ± 78% difference from the mean; p  = 0.04). Operative times were similar between groups (63 ± 15 vs. 65 ± 15 minutes; p  = 0.61), and there were no surgical complications in either group. Maternal satisfaction with analgesia at 72 hours was high in both groups (85% [73–90] rectus muscle reapproximation vs. 90% [75–100]; p  = 0.16). Conclusion  Rectus muscle reapproximation increased immediate postoperative pain without differences in operative time, surgical complications, or maternal satisfaction. Benefits of rectus muscle reapproximation should be weighed against increased postoperative pain, and analgesia should be planned accordingly. PMID:28840194

Effects of mirror therapy integrated with task-oriented exercise on the balance function of patients with poststroke hemiparesis: a randomized-controlled pilot trial.

PubMed

Cha, Hyun-Gyu; Oh, Duck-Won

2016-03-01

This study aimed to explore the effects of mirror therapy integrated with task-oriented exercise on balance function in poststroke hemiparesis. Twenty patients with poststroke hemiparesis were assigned randomly to an experimental group (EG) and a control group (CG), with 10 individuals each. Participants of the EG and CG received a task-oriented exercise program with a focus on the strengthening of the lower limb and the practice of balance-related functional tasks. An additional option for the EG was front and side wall mirrors to provide visual feedback for their own movements while performing the exercise. The program was performed for 30 min, twice a day, five times per week for 4 weeks. Outcome measures included the Berg balance scale, the timed up-and-go test, and quantitative data (balance index and dynamic limits of stability). In the EG and CG, all variables showed significant differences between pretest and post-test (P<0.05), and post-test values of all variables appeared to be significantly different between two groups (P<0.05). Furthermore, in the EG, the change values between pretest and post-test values of Berg balance scale (13.00±3.20 vs. 6.60±4.55 scores), and timed up-and-go test (6.45±3.00 vs. 3.61±1.84 s), balance index (2.29±0.51 vs. 0.96±0.65 scores), dynamic limits of stability (7.70±3.83 vs. 3.70±4.60 scores) were significantly higher than those of the CG (P<0.05). The findings suggest that a mirror therapy may be used as a beneficial therapeutic option to facilitate the effects of a task-oriented exercise on balance function of patients with poststroke hemiparesis.

Optimizing Clinical Drug Product Performance: Applying Biopharmaceutics Risk Assessment Roadmap (BioRAM) and the BioRAM Scoring Grid.

PubMed

Dickinson, Paul A; Kesisoglou, Filippos; Flanagan, Talia; Martinez, Marilyn N; Mistry, Hitesh B; Crison, John R; Polli, James E; Cruañes, Maria T; Serajuddin, Abu T M; Müllertz, Anette; Cook, Jack A; Selen, Arzu

2016-11-01

The aim of Biopharmaceutics Risk Assessment Roadmap (BioRAM) and the BioRAM Scoring Grid is to facilitate optimization of clinical performance of drug products. BioRAM strategy relies on therapy-driven drug delivery and follows an integrated systems approach for formulating and addressing critical questions and decision-making (J Pharm Sci. 2014,103(11): 3777-97). In BioRAM, risk is defined as not achieving the intended in vivo drug product performance, and success is assessed by time to decision-making and action. Emphasis on time to decision-making and time to action highlights the value of well-formulated critical questions and well-designed and conducted integrated studies. This commentary describes and illustrates application of the BioRAM Scoring Grid, a companion to the BioRAM strategy, which guides implementation of such an integrated strategy encompassing 12 critical areas and 6 assessment stages. Application of the BioRAM Scoring Grid is illustrated using published literature. Organizational considerations for implementing BioRAM strategy, including the interactions, function, and skillsets of the BioRAM group members, are also reviewed. As a creative and innovative systems approach, we believe that BioRAM is going to have a broad-reaching impact, influencing drug development and leading to unique collaborations influencing how we learn, and leverage and share knowledge. Published by Elsevier Inc.

Developing HEAT Scores with H-Res Thermal Imagery to Support Urban Energy Efficiency

NASA Astrophysics Data System (ADS)

Hemachandran, Bharanidharan

As part of The Calgary Community GHG Reduction Plan (2009) The City is seeking an implementation strategy to reduce GHGs and promote low-carbon living, with a focus on improving urban energy efficiency. The most cited obstacle to energy efficiency improvements is the lack of interest from consumers (CUI, 2008). However, Darby (2006) has shown that effective feedback significantly reduces energy consumption. To exploit these findings, the HEAT (Heat Energy Assessment Technologies) Geoweb project integrates high-resolution (H-Res) airborne thermal imagery (TABI 1800) to provide unique energy efficiency feedback to Calgary homeowners in the form of interactive HEAT Maps and Hot Spots (Hay et al., 2011). As a part of the HEAT Phase II program, the goal of this research is to provide enhanced feedback support for urban energy efficiency by meeting two key objectives: (i) develop an appropriate method to define HEAT Scores using TABI 1800 imagery that allows for the comparison of waste heat of one or more houses with all other mapped houses in the community and city, and (ii) develop a multi-scale interactive Geoweb interface that displays the HEAT Scores at City, Community and Residential scales. To achieve these goals, we describe the evolution of three novel HEAT Score techniques based on: (i) a Standardized Score, (ii) the WUFIRTM model and Logistic Regression and (iii ) a novel criteria weighted method that considers: (a) heat transfer through different roofing materials, (b) local climatic conditions and (c) house age and living area attributes. Furthermore, (d) removing or adding houses to analysis based on this 3rd technique, does not affect the HEAT Score of other houses and (e) HEAT Scores can be compared within and across different cities. We also describe how HEAT Scores are incorporated within the HEAT Geoweb architecture. It is envisioned that HEAT Scores will promote energy efficiency among homeowners and urban city planners, as they will quantify and visualize invisible waste heat, and provide a public comparison of urban energy efficiency at the scale of homes, communities and cities. Analysis is conducted on 9279 houses in 12 communities over the SW quadrant of The City of Calgary and their results are publically available for comparison at www.saveheat.co.

Mother-child memory conversations and self-construal in Eastern Turkey, Western Turkey and the USA.

PubMed

Sahin-Acar, Basak; Leichtman, Michelle D

2015-01-01

Eighty-seven mothers and their four-year-old children from Eastern Turkey (N = 32 pairs), Western Turkey (N = 30 pairs) and the USA (N = 25 pairs) participated in a study of mother-child memory talk as a reflection of mothers' self construal, in view of differences in the function of memory talk across cultures. Mother-child pairs were audio-recorded while talking about shared past and anticipated future events. Mothers completed the Balanced Integration-Differentiation questionnaire measure of self-construal and were scored as high or low on individuation and relatedness orientations. Mothers' memory and future talk showed similar patterns of cultural differences: American mothers provided the most voluminous, descriptive and elaborative talk, while Eastern Turkish mothers showed the highest level of repetitiveness, and Western Turkish mothers' talk fell in between. Children's memory talk was similar across cultures. In all cultures, mothers who scored high on both individuation and relatedness (balanced self-construal subtype) engaged in more voluminous and contexted memory talk, and individuation was associated with more elaborative talk about future events. Results are discussed in light of literature on cultural differences in self-construal and memory function.

Contribution of integrated teaching in the improvement of an undergraduate ophthalmology curriculum

PubMed Central

Tsinopoulos, Ioannis T; Symeonidis, Chrysanthos; Tsaousis, Konstantinos T; Mataftsi, Asimina; Chalvatzis, Nikolaos; Tzamalis, Argyrios; Lamprogiannis, Lampros P; Dimitrakos, Stavros A

2014-01-01

Purpose Conventional medical curriculum is the rule of medical teaching in Greek Medical Schools. Medical students are often taught irrelevant details with little or no reference to their potential clinical significance. Alternatively, integrated teaching warrants that the complete teaching material is covered by each faculty member not considering areas of personal expertise. The aim of this study was to evaluate the implementation of integrated teaching in ophthalmic training. Methods The main outcome measures of this retrospective study were a) comments and recommendations made anonymously by the fifth-year medical students in the evaluation questionnaires filled in at the end of their training, and b) scores obtained by students in their final examination at the end of their training in the 2nd Department of Ophthalmology as part of the core Curriculum of the Medical School of the Aristotle University of Thessaloniki. The latter outcome was analyzed with respect to the implementation of integrated teaching. Results The score obtained by students in the final examination, which is an objective outcome measure, increased significantly after the implementation of integrated teaching. The final grade (scores out of 10) of students who were trained with the integrated system (6.17±1.67, mean ± standard deviation) was significantly higher compared to those (5.52±2.20) trained with the conventional system (P<0.001). The positive outcome of this process was evident as there was a significant increase in the number of students satisfied with the teaching process compared to previous academic years. Conclusion Based on the experience of eight academic years and as a result of interactive assessment process our department has modified its medical student teaching process from conventional to integrated; all teaching staff members are involved in the teaching process, while students are divided in small groups. In conclusion, integrated teaching in small student groups appears to be an efficient teaching method (for both theoretical and clinical skills) of ophthalmic training for medical students. PMID:25429248

Evaluating temporal changes in stream condition in three New Jersey rive basins by using an index of biotic integrity

USGS Publications Warehouse

Chang, Ming; Kennen, Jonathan G.; Del Corso, Ellyn

2000-01-01

An index of biotic integrity (!B!) modified for New Jersey streams was used to compare changes in stream condition from the 1970s to the 1990s in Delaware, Passaic, and Raritan River Basins. Stream condition was assessed at 88 sampling locations. Mean IBI scores for all basins increased from the 1970s to the 1990s, but the stream-condition category improved (from fair to good) only for the Delaware River Basin. The number of benthic insectivores and the proportion of insectivorous cyprinds increased in all three basins; however, the number of white suckers decreased significantly only in the Delaware River Basin. Results of linear-regression analysis indicate a significant correlation between the percentage of altered land in the basin and change in IBI score (1970s to 1990s) for Delaware River sites. Results of analysis of variance of the rank-transformed IBI scores for the 1970s and 1990s indicate that the three basins was equal in the 1970s. Results of a multiple-comparison test demonstrated that the 1990s IBI values for the Delaware River Basin differed significantly from those for the Passaic and Raritan River Basins. Many factors, such as the imposition of the more stringent standards on water-water and industrial discharges during the 1980s and changes in land-use practices, likely contributed to the change in the Delaware River Basin. A general increase in IBI values for the Passaic, Raritan, and Delaware River Basins over the past 25 years appears to reflect overall improvements in water quality.

Structural Integrity of Normal Appearing White Matter and Sex-Specific Outcomes After Acute Ischemic Stroke.

PubMed

Etherton, Mark R; Wu, Ona; Cougo, Pedro; Giese, Anne-Katrin; Cloonan, Lisa; Fitzpatrick, Kaitlin M; Kanakis, Allison S; Boulouis, Gregoire; Karadeli, Hasan H; Lauer, Arne; Rosand, Jonathan; Furie, Karen L; Rost, Natalia S

2017-12-01

Women have worse poststroke outcomes than men. We evaluated sex-specific clinical and neuroimaging characteristics of white matter in association with functional recovery after acute ischemic stroke. We performed a retrospective analysis of acute ischemic stroke patients with admission brain MRI and 3- to 6-month modified Rankin Scale score. White matter hyperintensity and acute infarct volume were quantified on fluid-attenuated inversion recovery and diffusion tensor imaging MRI, respectively. Diffusivity anisotropy metrics were calculated in normal appearing white matter contralateral to the acute ischemia. Among 319 patients with acute ischemic stroke, women were older (68.0 versus 62.7 years; P =0.004), had increased incidence of atrial fibrillation (21.4% versus 12.2%; P =0.04), and lower rate of tobacco use (21.1% versus 35.9%; P =0.03). There was no sex-specific difference in white matter hyperintensity volume, acute infarct volume, National Institutes of Health Stroke Scale, prestroke modified Rankin Scale score, or normal appearing white matter diffusivity anisotropy metrics. However, women were less likely to have an excellent outcome (modified Rankin Scale score <2: 49.6% versus 67.0%; P =0.005). In logistic regression analysis, female sex and the interaction of sex with fractional anisotropy, radial diffusivity, and axial diffusivity were independent predictors of functional outcome. Female sex is associated with decreased likelihood of excellent outcome after acute ischemic stroke. The correlation between markers of white matter integrity and functional outcomes in women, but not men, suggests a potential sex-specific mechanism. © 2017 American Heart Association, Inc.

An investigation of the psychometric properties of the Chinese (Cantonese) version of Subjective Index of Physical and Social Outcome (SIPSO).

PubMed

Kwong, Patrick Wh; Ng, Shamay Sm; Ng, Gabriel Yf

2017-11-01

The objectives of this study were 1) to translate and make cultural adaptations to the English version of the SIPSO questionnaire to create a Chinese (Cantonese) version, 2) evaluate the internal consistency, test-retest reliability the C-SIPSO questionnaire, and 3) compare the SIPSO-C scores of stroke survivors with different demographic characteristics to establish the discriminant validity of the questionnaire Design: Translation of questionnaire, cross sectional study. University-based clinical research laboratory. Subjects Community-dwelling chronic stroke survivors. Not applicable. Subjective Index of Physical and Social Outcome, Geriatric Depression Scale, 10-metre Walk test. Two bilingual professional translators translated the SIPSO questionnaire independently. An expert panel comprising five registered physiotherapists verified the content validity of the final version (C-SIPSO). C-SIPSO demonstrated good internal consistency (Cronbach's α = 0.83) and excellent test-retest reliability (ICC 3,1 = 0.866) in ninety-two community dwelling chronic stroke survivors. Stroke survivors scored higher than 10 in the Geriatric Depression Scale ( U = 555.0, P < 0.001) and with the comfortable walking speed lower than 0.8ms -1 ( U = 726.5; P = 0.012) scored significantly lower on SIPSO-C. SIPSO-C is a reliable instrument that can be used to measure the level of community integration in community-dwelling stroke survivors in Hong Kong and southern China. Stroke survivors who were at high risk of minor depression and with limited community ambulation ability demonstrated a lower level of community integration as measured with SIPSO-C.

The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis.

PubMed

Hashim, Peter W; Patel, Anup; Yang, Jenny F; Travieso, Roberto; Terner, Jordan; Losee, Joseph E; Pollack, Ian; Jane, John; Jane, John; Kanev, Paul; Mayes, Linda; Duncan, Charles; Bridgett, David J; Persing, John A

2014-09-01

The optimal type of surgical management for isolated sagittal synostosis remains a source of significant debate. There is a paucity of data regarding possible differences in long-term neuropsychological outcomes following treatment with whole-vault cranioplasty or endoscopic strip craniectomy. This study provides the first comparative analysis examining the effects of the two techniques related to long-term intellectual functioning. A total of 70 patients were enrolled in this multicenter study, 29 of whom had previously undergone endoscopic strip craniectomy and 41 of whom had previously undergone whole-vault cranioplasty. All patients completed a battery of neurodevelopmental tests (Beery-Buktenica Developmental Test of Visual-Motor Integration, Wechsler Abbreviated Scale of Intelligence, and Wechsler Fundamentals) to evaluate various domains of neuropsychological function. In a group comparison of those treated before 6 months of age, whole-vault patients obtained higher scores relative to endoscopic strip craniectomy patients on visuomotor integration, full-scale intelligence quotient, verbal intelligence quotient, word reading, and reading comprehension (p < 0.05 for all). When compared against strip craniectomy performed before 3 months of age, the whole-vault group still showed significantly higher scores in verbal intelligence quotient, reading comprehension, and word reading (p < 0.05 for all). The type of surgical intervention for isolated sagittal synostosis impacts long-term neuropsychological outcomes. Patients undergoing early whole-vault cranioplasty attained higher intelligence quotient and achievement scores relative to those undergoing strip craniectomy. Surgical management with whole-vault cranioplasty performed before 6 months of age provides the most favorable long-term intellectual outcomes in patients with isolated sagittal synostosis. Therapeutic, II.

The efficacy of adult christian support groups in coping with the death of a significant loved one.

PubMed

Goodman, Herbert; Stone, Mark H

2009-09-01

Psychologists sometimes minimize important resources such as religion and spiritual beliefs for coping with bereavement. Alienation of therapeutic psychology from religious values contrasts to professional and public interest in religious experience and commitment. A supportive viewpoint has come about partially as a result of recognizing important values which clinicians have found absent in many of their clients. Until spiritual belief systems become integrated into the work of clinicians, clients may not be fully integrative in coping with loss. The key finding of this study was that individuals who participated in Christian and secular support groups showed no statistically significant difference in their mean endorsement of negative criteria on the BHS, and no statistically significant difference for their mean score endorsement of positive criteria on the RCOPE. However, a Christian-oriented approach was no less effective than a psychological-oriented one. In both groups, a spiritual connection to a specific or generalized higher power was frequently identified which clients ascribed to facilitating the management of their coping.

Feasibility of integrating mental health screening and services into routine elder abuse practice to improve client outcomes.

PubMed

Sirey, Jo Anne; Berman, Jacquelin; Salamone, Aurora; DePasquale, Alyssa; Halkett, Ashley; Raeifar, Elmira; Banerjee, Samprit; Bruce, Martha L; Raue, Patrick J

2015-01-01

The goal of this pilot program was to test the feasibility of mental health screening among elder abuse victims and of offering those victims a brief psychotherapy for depression and anxiety. Elder abuse victims who sought assistance from a large, urban elder abuse service were screened for depression and anxiety using standardized measures. Clients with clinically significant depression (PHQ-9) or anxiety (GAD-7) were randomized to receive one of three different interventions concurrent with abuse resolution services. Staff were able to screen 315 individuals, with 34% of clients scoring positive for depression or anxiety. Of those with mental health needs, only 15% refused all services. The mental health intervention (PROTECT) was successfully implemented in two different formats with collaboration between staff workers. These findings support both the need for mental health care among elder abuse victims and the feasibility of integrating mental health screening and treatment into routine elder abuse practice.

Who is prone to wander and when? Examining an integrative effect of working memory capacity and mindfulness trait on mind wandering under different task loads.

PubMed

Ju, Yu-Jeng; Lien, Yunn-Wen

2018-06-13

We proposed an integration hypothesis of mind wandering in which the tendency of mind wandering is only related to working memory capacity (WMC) when a self-regulation process is required (i.e., under a high task load); however, this tendency is related to mindfulness regardless of task load. A within-group experiment with 160 participants was conducted. Task load was manipulated as high or low using modified 0-back and 2-back tasks, during which participants' self-caught mind wanderings and the types of mind wandering (aware vs. unaware; intentional vs. unintentional) were measured. The results supported our hypothesis that WMC was negatively associated with mind wandering only in demanding tasks, and mindfulness scores were negatively associated with mind wandering across tasks. Furthermore, we also determined how WMC and the mindfulness trait were related to different types of mind wandering. Theoretical implications were discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

Measurement of the Ecological Integrity of Cerrado Streams Using Biological Metrics and the Index of Habitat Integrity

PubMed Central

dos Reis, Deusiano Florêncio; Salazar, Ayala Eduardo; Machado, Mayana Mendes Dias; Couceiro, Sheyla Regina Marques; de Morais, Paula Benevides

2017-01-01

Generally, aquatic communities reflect the effects of anthropogenic changes such as deforestation or organic pollution. The Cerrado stands among the most threatened ecosystems by human activities in Brazil. In order to evaluate the ecological integrity of the streams in a preserved watershed in the Northern Cerrado biome corresponding to a mosaic of ecosystems in transition to the Amazonia biome in Brazil, biological metrics related to diversity, structure, and sensitivity of aquatic macroinvertebrates were calculated. Sampling included collections along stretches of 200 m of nine streams and measurements of abiotic variables (temperature, electrical conductivity, pH, total dissolved solids, dissolved oxygen, and discharge) and the Index of Habitat Integrity (HII). The values of the abiotic variables and the HII indicated that most of the streams have good ecological integrity, due to high oxygen levels and low concentrations of dissolved solids and electric conductivity. Two streams showed altered HII scores mainly related to small dams for recreational and domestic use, use of Cerrado natural pasture for cattle raising, and spot deforestation in bathing areas. However, this finding is not reflected in the biological metrics that were used. Considering all nine streams, only two showed satisfactory ecological quality (measured by Biological Monitoring Working Party (BMWP), total richness, and EPT (Ephemeroptera, Plecoptera, and Trichoptera) richness), only one of which had a low HII score. These results indicate that punctual measures of abiotic parameters do not reveal the long-term impacts of anthropic activities in these streams, including related fire management of pasture that annually alters the vegetation matrix and may act as a disturbance for the macroinvertebrate communities. Due to this, biomonitoring of low order streams in Cerrado ecosystems of the Northern Central Brazil by different biotic metrics and also physical attributes of the riparian zone such as HII is recommended for the monitoring and control of anthropic impacts on aquatic communities. PMID:28085090

Measurement of the Ecological Integrity of Cerrado Streams Using Biological Metrics and the Index of Habitat Integrity.

PubMed

Reis, Deusiano Florêncio Dos; Salazar, Ayala Eduardo; Machado, Mayana Mendes Dias; Couceiro, Sheyla Regina Marques; Morais, Paula Benevides de

2017-01-12

Generally, aquatic communities reflect the effects of anthropogenic changes such as deforestation or organic pollution. The Cerrado stands among the most threatened ecosystems by human activities in Brazil. In order to evaluate the ecological integrity of the streams in a preserved watershed in the Northern Cerrado biome corresponding to a mosaic of ecosystems in transition to the Amazonia biome in Brazil, biological metrics related to diversity, structure, and sensitivity of aquatic macroinvertebrates were calculated. Sampling included collections along stretches of 200 m of nine streams and measurements of abiotic variables (temperature, electrical conductivity, pH, total dissolved solids, dissolved oxygen, and discharge) and the Index of Habitat Integrity (HII). The values of the abiotic variables and the HII indicated that most of the streams have good ecological integrity, due to high oxygen levels and low concentrations of dissolved solids and electric conductivity. Two streams showed altered HII scores mainly related to small dams for recreational and domestic use, use of Cerrado natural pasture for cattle raising, and spot deforestation in bathing areas. However, this finding is not reflected in the biological metrics that were used. Considering all nine streams, only two showed satisfactory ecological quality (measured by Biological Monitoring Working Party (BMWP), total richness, and EPT (Ephemeroptera, Plecoptera, and Trichoptera) richness), only one of which had a low HII score. These results indicate that punctual measures of abiotic parameters do not reveal the long-term impacts of anthropic activities in these streams, including related fire management of pasture that annually alters the vegetation matrix and may act as a disturbance for the macroinvertebrate communities. Due to this, biomonitoring of low order streams in Cerrado ecosystems of the Northern Central Brazil by different biotic metrics and also physical attributes of the riparian zone such as HII is recommended for the monitoring and control of anthropic impacts on aquatic communities.

Towards an integrative soil health assessment strategy: a three tier (integrative biomarker response) approach with Eisenia fetida applied to soils subjected to chronic metal pollution.

PubMed

Asensio, Vega; Rodríguez-Ruiz, Amaia; Garmendia, Larraitz; Andre, Jane; Kille, Peter; Morgan, Andrew John; Soto, Manu; Marigómez, Ionan

2013-01-01

This is a pilot study for assessing soil ecosystem health in chronically polluted sites on the basis of a 3-tier approach (screening+scoring+understanding) designed to be cost-effective and scientifically based, and to provide straightforward advice and support to managers and stakeholders involved in environmental protection. For the initial screening (Tier 1), the use of a highly sensitive, low-cost biomarker such as neutral red uptake (NRU) in earthworm coelomocytes is proposed. In sites where an alteration in NRU has been established, the stress level may be further assessed by utilising a suite of low-cost and rapid biomarkers of effect integrated in an integrative biological response (IBR) index to obtain an objective (scored) assessment of the induced stress syndrome (Tier 2). The IBR/n index is based on the integration of biomarkers at different levels of biological organisation. Acyl-CoA oxidase activity (AOX), catalase activity (CAT), lipofuscin optical density (LOD%), NRU and the mean epithelial thickness (MET) have been used to calculate the IBR/n index. Biomarkers are determined in earthworms, Eisenia fetida, exposed ex situ to real soils (three mining sites and a reference) for 3, 10 and 17d. The 3d NRU (Tier 1) provided signal of stress. After 3d, PCA, based on the suite of biomarkers (Tier 2), discriminated reference and polluted sites according to toxicity profiles and at 17d, the most polluted site is segregated from less polluted and reference sites. Soils were classified as harmful, unhealthy (not apparently toxic) or healthy. Soils were investigated by microarray transcriptomics (Tier 3), to understand the causes (aetiology) and consequences (prognosis) of health impairment. Tier 3 discriminates, according to stress syndrome traits, soils that did not fall into the category of highly stressed and revealed the main agent causing toxicity at each site by identifying the toxicity mechanisms and biological responses. Copyright © 2012 Elsevier B.V. All rights reserved.

VISUALIZATION FROM INTRAOPERATIVE SWEPT-SOURCE MICROSCOPE-INTEGRATED OPTICAL COHERENCE TOMOGRAPHY IN VITRECTOMY FOR COMPLICATIONS OF PROLIFERATIVE DIABETIC RETINOPATHY.

PubMed

Gabr, Hesham; Chen, Xi; Zevallos-Carrasco, Oscar M; Viehland, Christian; Dandrige, Alexandria; Sarin, Neeru; Mahmoud, Tamer H; Vajzovic, Lejla; Izatt, Joseph A; Toth, Cynthia A

2018-01-10

To evaluate the use of live volumetric (4D) intraoperative swept-source microscope-integrated optical coherence tomography in vitrectomy for proliferative diabetic retinopathy complications. In this prospective study, we analyzed a subgroup of patients with proliferative diabetic retinopathy complications who required vitrectomy and who were imaged by the research swept-source microscope-integrated optical coherence tomography system. In near real time, images were displayed in stereo heads-up display facilitating intraoperative surgeon feedback. Postoperative review included scoring image quality, identifying different diabetic retinopathy-associated pathologies and reviewing the intraoperatively documented surgeon feedback. Twenty eyes were included. Indications for vitrectomy were tractional retinal detachment (16 eyes), combined tractional-rhegmatogenous retinal detachment (2 eyes), and vitreous hemorrhage (2 eyes). Useful, good-quality 2D (B-scans) and 4D images were obtained in 16/20 eyes (80%). In these eyes, multiple diabetic retinopathy complications could be imaged. Swept-source microscope-integrated optical coherence tomography provided surgical guidance, e.g., in identifying dissection planes under fibrovascular membranes, and in determining residual membranes and traction that would benefit from additional peeling. In 4/20 eyes (20%), acceptable images were captured, but they were not useful due to high tractional retinal detachment elevation which was challenging for imaging. Swept-source microscope-integrated optical coherence tomography can provide important guidance during surgery for proliferative diabetic retinopathy complications through intraoperative identification of different complications and facilitation of intraoperative decision making.

Performance of two different digital evaluation systems used for assessing pre-clinical dental students' prosthodontic technical skills.

PubMed

Gratton, D G; Kwon, S R; Blanchette, D R; Aquilino, S A

2017-11-01

Proper integration of newly emerging digital assessment tools is a central issue in dental education in an effort to provide more accurate and objective feedback to students. The study examined how the outcomes of students' tooth preparation were correlated when evaluated using traditional faculty assessment and two types of digital assessment approaches. Specifically, incorporation of the Romexis Compare 2.0 (Compare) and Sirona prepCheck 1.1 (prepCheck) systems was evaluated. Additionally, satisfaction of students based on the type of software was evaluated through a survey. Students in a second-year pre-clinical prosthodontics course were allocated to either Compare (n = 42) or prepCheck (n = 37) systems. All students received conventional instruction and used their assigned digital system as an additional evaluation tool to aid in assessing their work. Examinations assessed crown preparations of the maxillary right central incisor (#8) and the mandibular left first molar (#19). All submissions were graded by faculty, Compare and prepCheck. Technical scores did not differ between student groups for any of the assessment approaches. Compare and prepCheck had modest, statistically significant correlations with faculty scores with a minimum correlation of 0.3944 (P = 0.0011) and strong, statistically significant correlations with each other with a minimum correlation of 0.8203 (P < 0.0001). A post-course student survey found that 55.26% of the students felt unfavourably about learning the digital evaluation protocols. A total of 62.31% felt favourably about the integration of these digital tools into the curriculum. Comparison of Compare and prepCheck showed no evidence of significant difference in students' prosthodontics technical performance and perception. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Substrain and light regime effects on integrated anxiety-related behavioral z-scores in male C57BL/6 mice-Hypomagnesaemia has only a small effect on avoidance behavior.

PubMed

Labots, M; Zheng, X; Moattari, G; Lozeman-Van't Klooster, J G; Baars, J M; Hesseling, P; Lavrijsen, M; Kirchhoff, S; Ohl, F; van Lith, H A

2016-06-01

Magnesium (Mg) has been described to possess an anxiolytic function, but a number of studies present inconsistent results on this matter. In this study the effect of Mg deficiency on anxiety-related behavior, brain and blood plasma Mg in young adult male C57BL/6JOlaHsd and C57BL/6NCrl mice was studied. The animals were put on a control or Mg deficient diet from day 0 and significant hypomagnesaemia was evident from day 12 onwards in the test animals. Housing and test conditions were under either conventional light regime (white light behavioral test conditions) or reverse light regime (red light behavioral test conditions). The animals were tested in three tests for unconditioned anxiety: the modified Hole Board (day 14), the light-dark test (day 21) and the elevated plus maze (day 28). Overall integrated behavioral z-scores were calculated over these three behavioral tests. Mg showed a structure dependent distribution at the level of the brain, that differed between C57BL/6 substrain and light regime (conventional versus reverse), respectively. Likewise, total brain Mg did differ between substrain and light regime, but was not affected by the diet. Animals on the Mg deficient diet housed under conventional light regime had a higher final (day 28) blood plasma corticosterone level as compared to controls. Animals housed under reverse light regime exhibited no diet effect of plasma corticosterone levels. The significant hypomagnesaemia at blood plasma level resulted in an effect of Mg deficiency on avoidance, but not overall anxiety-related behavior. Significant differences regarding avoidance behavior were found between the two substrains and light regimes, respectively. Copyright © 2016 Elsevier B.V. All rights reserved.

Advantages of Arthroscopic Rotator Cuff Repair With a Transosseous Suture Technique: A Prospective Randomized Controlled Trial.

PubMed

Randelli, Pietro; Stoppani, Carlo Alberto; Zaolino, Carlo; Menon, Alessandra; Randelli, Filippo; Cabitza, Paolo

2017-07-01

Rotator cuff tear is a common finding in patients with painful, poorly functioning shoulders. The surgical management of this disorder has improved greatly and can now be fully arthroscopic. To evaluate clinical and radiological results of arthroscopic rotator cuff repair using 2 different techniques: single-row anchor fixation versus transosseous hardware-free suture repair. Randomized controlled trial; Level of evidence, 1. Sixty-nine patients with rotator cuff tears were enrolled: 35 patients were operated with metal anchors and 34 with standardized transosseous repair. The patients were clinically evaluated before surgery, during the 28 days after surgery, and at least 1 year after the operation by the use of validated rating scores (Constant score, QuickDASH, and numerical rating scale [NRS]). Final follow-up was obtained at more than 3 years by a QuickDASH evaluation to detect any difference from the previous follow-up. During the follow-up, rotator cuff integrity was determined through magnetic resonance imaging and was classified according to the 5 Sugaya categories. Patients operated with the transosseous technique had significantly less pain, especially from the 15th postoperative day: In the third week, the mean NRS value for the anchor group was 3.00 while that for transosseous group was 2.46 ( P = .02); in the fourth week, the values were 2.44 and 1.76, respectively ( P < .01). No differences in functional outcome were noted between the 2 groups at the final evaluation. In the evaluation of rotator cuff repair integrity, based on Sugaya magnetic resonance imaging classification, no significant difference was found between the 2 techniques in terms of retear rate ( P = .81). No significant differences were found between the 2 arthroscopic repair techniques in terms of functional and radiological results. However, postoperative pain decreased more quickly after the transosseous procedure, which therefore emerges as a possible improvement in the surgical repair of the rotator cuff. Registration: NCT01815177 ( ClinicalTrials.gov identifier).

Assessing Top-Down and Bottom-Up Contributions to Auditory Stream Segregation and Integration With Polyphonic Music

PubMed Central

Disbergen, Niels R.; Valente, Giancarlo; Formisano, Elia; Zatorre, Robert J.

2018-01-01

Polyphonic music listening well exemplifies processes typically involved in daily auditory scene analysis situations, relying on an interactive interplay between bottom-up and top-down processes. Most studies investigating scene analysis have used elementary auditory scenes, however real-world scene analysis is far more complex. In particular, music, contrary to most other natural auditory scenes, can be perceived by either integrating or, under attentive control, segregating sound streams, often carried by different instruments. One of the prominent bottom-up cues contributing to multi-instrument music perception is their timbre difference. In this work, we introduce and validate a novel paradigm designed to investigate, within naturalistic musical auditory scenes, attentive modulation as well as its interaction with bottom-up processes. Two psychophysical experiments are described, employing custom-composed two-voice polyphonic music pieces within a framework implementing a behavioral performance metric to validate listener instructions requiring either integration or segregation of scene elements. In Experiment 1, the listeners' locus of attention was switched between individual instruments or the aggregate (i.e., both instruments together), via a task requiring the detection of temporal modulations (i.e., triplets) incorporated within or across instruments. Subjects responded post-stimulus whether triplets were present in the to-be-attended instrument(s). Experiment 2 introduced the bottom-up manipulation by adding a three-level morphing of instrument timbre distance to the attentional framework. The task was designed to be used within neuroimaging paradigms; Experiment 2 was additionally validated behaviorally in the functional Magnetic Resonance Imaging (fMRI) environment. Experiment 1 subjects (N = 29, non-musicians) completed the task at high levels of accuracy, showing no group differences between any experimental conditions. Nineteen listeners also participated in Experiment 2, showing a main effect of instrument timbre distance, even though within attention-condition timbre-distance contrasts did not demonstrate any timbre effect. Correlation of overall scores with morph-distance effects, computed by subtracting the largest from the smallest timbre distance scores, showed an influence of general task difficulty on the timbre distance effect. Comparison of laboratory and fMRI data showed scanner noise had no adverse effect on task performance. These Experimental paradigms enable to study both bottom-up and top-down contributions to auditory stream segregation and integration within psychophysical and neuroimaging experiments. PMID:29563861

Elements of integrated care approaches for older people: a review of reviews.

PubMed

Briggs, Andrew M; Valentijn, Pim P; Thiyagarajan, Jotheeswaran A; Araujo de Carvalho, Islene

2018-04-07

The World Health Organization (WHO) recently proposed an Integrated Care for Older People approach to guide health systems and services in better supporting functional ability of older people. A knowledge gap remains in the key elements of integrated care approaches used in health and social care delivery systems for older populations. The objective of this review was to identify and describe the key elements of integrated care models for elderly people reported in the literature. Review of reviews using a systematic search method. A systematic search was performed in MEDLINE and the Cochrane database in June 2017. Reviews of interventions aimed at care integration at the clinical (micro), organisational/service (meso) or health system (macro) levels for people aged ≥60 years were included. Non-Cochrane reviews published before 2015 were excluded. Reviews were assessed for quality using the Assessment of Multiple Systematic Reviews (AMSTAR) 1 tool. Fifteen reviews (11 systematic reviews, of which six were Cochrane reviews) were included, representing 219 primary studies. Three reviews (20%) included only randomised controlled trials (RCT), while 10 reviews (65%) included both RCTs and non-RCTs. The region where the largest number of primary studies originated was North America (n=89, 47.6%), followed by Europe (n=60, 32.1%) and Oceania (n=31, 16.6%). Eleven (73%) reviews focused on clinical 'micro' and organisational 'meso' care integration strategies. The most commonly reported elements of integrated care models were multidisciplinary teams, comprehensive assessment and case management. Nurses, physiotherapists, general practitioners and social workers were the most commonly reported service providers. Methodological quality was variable (AMSTAR scores: 1-11). Seven (47%) reviews were scored as high quality (AMSTAR score ≥8). Evidence of elements of integrated care for older people focuses particularly on micro clinical care integration processes, while there is a relative lack of information regarding the meso organisational and macro system-level care integration strategies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Sexual function in young women with type 1 diabetes: the METRO study.

PubMed

Maiorino, M I; Bellastella, G; Castaldo, F; Petrizzo, M; Giugliano, D; Esposito, K

2017-02-01

The aim of this study was to evaluate the prevalence and risk factors associated with female sexual dysfunction (FSD) in young women with type 1 diabetes treated with different intensive insulin regimens. Type 1 diabetic women aged 18-35 years were included in this study if they had stable couple relationship and no oral contraceptive use. All women were asked to complete the Female Sexual Function Index (FSFI) and other validated multiple-choice questionnaires assessing sexual-related distress (Female Sexual Distress Scale, FSDS), quality of life (SF-36 Health Survey), physical activity (International Physical Activity Questionnaire), depressive symptoms (Zung Self-Rating Depression Scale, SRDS) and diabetes-related problems (Diabetes Integration Scale ATT-19). FSD was diagnosed according to a FSFI score higher than 26.55 and a FSDS score lower than 15. The overall prevalence of FSD in diabetic and control women was 20 and 15 %, respectively (P = 0.446). Compared with the continuous subcutaneous insulin infusion group and control women, diabetic women on multiple daily injections (MDI) had lower global FSFI score (P = 0.007), FSDS score (P = 0.045) and domains such as arousal (P = 0.006), lubrication and satisfaction scores (P < 0.001 for both). In the multiple regression analysis, only the mental component summary (P = 0.047) and the SRDS score (P = 0.042) were independent predictors of FSFI score in the overall diabetic women. Young women with type 1 diabetes wearing an insulin pump show a prevalence of sexual dysfunction similar to that of healthy age-matched women, but sexual function was significantly impaired in diabetic women on MDI therapy. Depression and the mental health status were independent predictors for FSD in diabetic women.

Correlation between standardized assessment of concussion scores and small-world brain network in mild traumatic brain injury.

PubMed

Yan, Yan; Song, Jian; Xu, Guozheng; Yao, Shun; Cao, Chenglong; Li, Chang; Peng, Guibao; Du, Hao

2017-10-01

This study investigated the characteristics of the small-world brain network architecture of patients with mild traumatic brain injury (MTBI), and a correlation between brain functional connectivity network properties in the resting-state fMRI and Standardized Assessment of Concussion (SAC) parameters. The neurological conditions of 22 MTBI patients and 17 normal control individuals were evaluated according to the SAC. Resting-state fMRI was performed in all subjects 3 and 7days after injury respectively. After preprocessing the fMRI data, cortex functional regions were marked using AAL90 and Dosenbach160 templates. The small-world network parameters and areas under the integral curves were computed in the range of sparsity from 0.01 to 0.5. Independent-sample t-tests were used to compare these parameters between the MTBI and control group. Significantly different parameters were investigated for correlations with SAC scores; those that correlated were chosen for further curve fitting. The clustering coefficient, the communication efficiency across in local networks, and the strength of connectivity were all higher in MTBI patients relative to control individuals. Parameters in 160 brain regions of the MTBI group significantly correlated with total SAC score and score for attention; the network parameters may be a quadratic function of attention scores of SAC and a cubic function of SAC scores. MTBI patients were characterized by elevated communication efficiency across global brain regions, and in local networks, and strength of mean connectivity. These features may be associated with brain function compensation. The network parameters significantly correlated with SAC total and attention scores. Copyright © 2017 Elsevier Ltd. All rights reserved.

A magnetic resonance spectroscopy study of antisocial behaviour disorder, psychopathy and violent crime among military conscripts.

PubMed

Basoglu, Cengiz; Semiz, Umit; Oner, Ozgur; Gunay, Huseyin; Ebrinc, Servet; Cetin, Mesut; Sildiroglu, Onur; Algul, Ayhan; Ates, Alpay; Sonmez, Guner

2008-04-01

Prefrontal and/or temporo-limbic abnormalities associated with antisocial personality disorder (APD), high psychopathy scores and violent behaviours can readily be evaluated by neuroimaging methods. In this study, we compared the brain metabolites in adult male military conscripts with APD, high psychopathy scores and serious violent crimes (n = 15) with age- and educational-level-matched healthy controls (n = 15) by means of magnetic resonance spectroscopy. All cases were diagnosed by means of the Diagnostic Statistical Manual-IV APD module of the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II) semistructured questionnaire in Turkish. The psychopathy scores were evaluated by means of the Hare Psychopathy Checklist-Revised translated into Turkish (PCL-R). PCL-R is a 20-item, reliable and valid instrument for assessment of psychopathy, both in categorical and dimensional natures. All patients had a total score of 29 (of possible 40) or higher from PCL-R, indicating a high degree of psychopathy. Our results showed no significant differences in ratio of N-acetyl aspartate (NAA), creatine (Cr) and choline-related compounds in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC) and amygdala-hippocampus regions of cases compared with controls. ACC NAA/Cr was significantly negatively correlated with both the PCL-R total score and the PCL-R factor I score (interpersonal/affective problems) among the cases. As ACC plays an important role in decision-making and emotional information processing, we postulate that the lower NAA/Cr ratio, suggesting impaired neural integrity, may increase the severity of interpersonal/affective problems of the psychopathy factor in male subjects exhibiting APD, high psychopathy overall scores and violent crimes.

Integrated healthcare networks' performance: a growth curve modeling approach.

PubMed

Wan, Thomas T H; Wang, Bill B L

2003-05-01

This study examines the effects of integration on the performance ratings of the top 100 integrated healthcare networks (IHNs) in the United States. A strategic-contingency theory is used to identify the relationship of IHNs' performance to their structural and operational characteristics and integration strategies. To create a database for the panel study, the top 100 IHNs selected by the SMG Marketing Group in 1998 were followed up in 1999 and 2000. The data were merged with the Dorenfest data on information system integration. A growth curve model was developed and validated by the Mplus statistical program. Factors influencing the top 100 IHNs' performance in 1998 and their subsequent rankings in the consecutive years were analyzed. IHNs' initial performance scores were positively influenced by network size, number of affiliated physicians and profit margin, and were negatively associated with average length of stay and technical efficiency. The continuing high performance, judged by maintaining higher performance scores, tended to be enhanced by the use of more managerial or executive decision-support systems. Future studies should include time-varying operational indicators to serve as predictors of network performance.

From All Walks of Life: New Hope for School Integration

ERIC Educational Resources Information Center

Kahlenberg, Richard D.

2013-01-01

Integrating our schools is a goal that many of us share. But some seem to have given up on the idea, as plans to boost racial diversity have come under attack, and as the fixation on test scores has narrowed some people's concept of a good education. There is, however, new hope: integration by socioeconomic status. It's a cost-effective, legally…

Spatial ability mediates the gender difference in middle school students' science performance.

PubMed

Ganley, Colleen M; Vasilyeva, Marina; Dulaney, Alana

2014-01-01

Prior research has demonstrated a male advantage in spatial skills and science achievement. The present research integrated these findings by testing the potential role of spatial skills in gender differences in the science performance of eighth-grade students (13-15 years old). In (N = 113), the findings showed that mental rotation ability mediated gender differences in physical science and technology/engineering test scores. In (N = 73,245), science performance was examined in a state population of eighth-grade students. As in , the results revealed larger gender differences on items that showed higher correlations with mental rotation. These findings underscore the importance of considering spatial training interventions aimed at reducing gender differences in the science performance of school-aged children. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.

Attention and Visual Motor Integration in Young Children with Uncorrected Hyperopia.

PubMed

Kulp, Marjean Taylor; Ciner, Elise; Maguire, Maureen; Pistilli, Maxwell; Candy, T Rowan; Ying, Gui-Shuang; Quinn, Graham; Cyert, Lynn; Moore, Bruce

2017-10-01

Among 4- and 5-year-old children, deficits in measures of attention, visual-motor integration (VMI) and visual perception (VP) are associated with moderate, uncorrected hyperopia (3 to 6 diopters [D]) accompanied by reduced near visual function (near visual acuity worse than 20/40 or stereoacuity worse than 240 seconds of arc). To compare attention, visual motor, and visual perceptual skills in uncorrected hyperopes and emmetropes attending preschool or kindergarten and evaluate their associations with visual function. Participants were 4 and 5 years of age with either hyperopia (≥3 to ≤6 D, astigmatism ≤1.5 D, anisometropia ≤1 D) or emmetropia (hyperopia ≤1 D; astigmatism, anisometropia, and myopia each <1 D), without amblyopia or strabismus. Examiners masked to refractive status administered tests of attention (sustained, receptive, and expressive), VMI, and VP. Binocular visual acuity, stereoacuity, and accommodative accuracy were also assessed at near. Analyses were adjusted for age, sex, race/ethnicity, and parent's/caregiver's education. Two hundred forty-four hyperopes (mean, +3.8 ± [SD] 0.8 D) and 248 emmetropes (+0.5 ± 0.5 D) completed testing. Mean sustained attention score was worse in hyperopes compared with emmetropes (mean difference, -4.1; P < .001 for 3 to 6 D). Mean Receptive Attention score was worse in 4 to 6 D hyperopes compared with emmetropes (by -2.6, P = .01). Hyperopes with reduced near visual acuity (20/40 or worse) had worse scores than emmetropes (-6.4, P < .001 for sustained attention; -3.0, P = .004 for Receptive Attention; -0.7, P = .006 for VMI; -1.3, P = .008 for VP). Hyperopes with stereoacuity of 240 seconds of arc or worse scored significantly worse than emmetropes (-6.7, P < .001 for sustained attention; -3.4, P = .03 for Expressive Attention; -2.2, P = .03 for Receptive Attention; -0.7, P = .01 for VMI; -1.7, P < .001 for VP). Overall, hyperopes with better near visual function generally performed similarly to emmetropes. Moderately hyperopic children were found to have deficits in measures of attention. Hyperopic children with reduced near visual function also had lower scores on VMI and VP than emmetropic children.

Supportive Care: Time to Change Our Prognostic Tools and Their Use in CKD

PubMed Central

Hemmelgarn, Brenda; Kotanko, Peter; Germain, Michael J.; Moranne, Olivier; Davison, Sara N.

2016-01-01

In using a patient-centered approach, neither a clinician nor a prognostic score can predict with absolute certainty how well a patient will do or how long he will live; however, validated prognostic scores may improve accuracy of prognostic estimates, thereby enhancing the ability of the clinicians to appreciate the individual burden of disease and the prognosis of their patients and inform them accordingly. They may also facilitate nephrologist’s recommendation of dialysis services to those who may benefit and proposal of alternative care pathways that might better respect patients’ values and goals to those who are unlikely to benefit. The purpose of this article is to discuss the use as well as the limits and deficiencies of currently available prognostic tools. It will describe new predictors that could be integrated in future scores and the role of patients’ priorities in development of new scores. Delivering patient-centered care requires an understanding of patients’ priorities that are important and relevant to them. Because of limits of available scores, the contribution of new prognostic tools with specific markers of the trajectories for patients with CKD and patients’ health reports should be evaluated in relation to their transportability to different clinical and cultural contexts and their potential for integration into the decision-making processes. The benefit of their use then needs to be quantified in clinical practice by outcome studies including health–related quality of life, patient and caregiver satisfaction, or utility for improving clinical management pathways and tailoring individualized patient–centered strategies of care. Future research also needs to incorporate qualitative methods involving patients and their caregivers to better understand the barriers and facilitators to use of these tools in the clinical setting. Information given to patients should be supported by a more realistic approach to what dialysis is likely to entail for the individual patient in terms of likely quality and quantity of life according to the patient’s values and goals and not just the possibility of life prolongation. PMID:27510452

Benefits and risks of emerging technologies: integrating life cycle assessment and decision analysis to assess lumber treatment alternatives.

PubMed

Tsang, Michael P; Bates, Matthew E; Madison, Marcus; Linkov, Igor

2014-10-07

Assessing the best options among emerging technologies (e.g., new chemicals, nanotechnologies) is complicated because of trade-offs across benefits and risks that are difficult to quantify given limited and fragmented availability of information. This study demonstrates the integration of multicriteria decision analysis (MCDA) and life cycle assessment (LCA) to address technology alternative selection decisions. As a case study, prioritization of six lumber treatment alternatives [micronized copper quaternary (MCQ); alkaline copper quaternary (ACQ); water-borne copper naphthenate (CN); oil-borne copper naphthenate (CNo); water-borne copper quinolate (CQ); and water-borne zinc naphthenate (ZN)] for military use are considered. Multiattribute value theory (MAVT) is used to derive risk and benefit scores. Risk scores are calculated using a cradle-to-gate LCA. Benefit scores are calculated by scoring of cost, durability, and corrosiveness criteria. Three weighting schemes are used, representing Environmental, Military and Balanced stakeholder perspectives. Aggregated scores from all three perspectives show CQ to be the least favorable alterative. MCQ is identified as the most favorable alternative from the Environmental stakeholder perspective. From the Military stakeholder perspective, ZN is determined to be the most favorable alternative, followed closely by MCQ. This type of scoring and ranking of multiple heterogeneous criteria in a systematic and transparent way facilitates better justification of technology selection and regulation.

Scoring and staging systems using cox linear regression modeling and recursive partitioning.

PubMed

Lee, J W; Um, S H; Lee, J B; Mun, J; Cho, H

2006-01-01

Scoring and staging systems are used to determine the order and class of data according to predictors. Systems used for medical data, such as the Child-Turcotte-Pugh scoring and staging systems for ordering and classifying patients with liver disease, are often derived strictly from physicians' experience and intuition. We construct objective and data-based scoring/staging systems using statistical methods. We consider Cox linear regression modeling and recursive partitioning techniques for censored survival data. In particular, to obtain a target number of stages we propose cross-validation and amalgamation algorithms. We also propose an algorithm for constructing scoring and staging systems by integrating local Cox linear regression models into recursive partitioning, so that we can retain the merits of both methods such as superior predictive accuracy, ease of use, and detection of interactions between predictors. The staging system construction algorithms are compared by cross-validation evaluation of real data. The data-based cross-validation comparison shows that Cox linear regression modeling is somewhat better than recursive partitioning when there are only continuous predictors, while recursive partitioning is better when there are significant categorical predictors. The proposed local Cox linear recursive partitioning has better predictive accuracy than Cox linear modeling and simple recursive partitioning. This study indicates that integrating local linear modeling into recursive partitioning can significantly improve prediction accuracy in constructing scoring and staging systems.

White matter integrity and cognition in Parkinson's disease: a cross-sectional study

PubMed Central

Auning, Eirik; Kjærvik, Veslemøy Krohn; Selnes, Per; Aarsland, Dag; Haram, Astrid; Bjørnerud, Atle; Hessen, Erik; Esnaashari, Abdolreza; Fladby, Tormod

2014-01-01

Objective We used diffusion tensor imaging (DTI) to test the following hypotheses: (1) there is decreased white matter (WM) integrity in non-demented Parkinson’s disease (PD), (2) WM integrity is differentially reduced in PD and early Alzheimer’s disease (AD) and (3) DTI changes in non-demented PD are specifically associated with cognitive performance. Methods This study included 18 non-demented patients with PD, 18 patients with mild cognitive impairment due to incipient AD and 19 healthy elderly normal control (NC) participants in a cross-sectional design. The participants underwent DTI, and tract-based spatial statistics was used to analyse and extract radial diffusivity and fractional anisotropy. Correlations between scores from a battery of neuropsychological tests and DTI were performed in the PD group. Results Patients with PD had significant differences in DTI in WM underlying the temporal, parietal and occipital cortex as compared with NC. There were no significant differences between the PD and AD groups in the primary region of interest analyses, but compared with NC there was a tendency for more anterior changes in AD in contrast to more posterior changes in PD. In a secondary whole-brain analysis there were frontoparietal areas with significant differences between AD and PD. In patients with PD, there were significant correlations between DTI parameters in WM underlying the prefrontal cortex and executive and visuospatial abilities. Conclusions In early, non-demented PD we found reduced WM integrity underlying the temporal, parietal and occipital cortices. In addition, WM integrity changes in prefrontal areas were associated with executive and visuospatial ability. These findings support that DTI may be an important biomarker in early PD, and that WM changes are related to cognitive impairment in PD. PMID:24448846

White Matter Abnormalities Correlating with Memory and Depression in Heroin Users under Methadone Maintenance Treatment

PubMed Central

Lin, Wei-Che; Chou, Kun-Hsien; Chen, Chien-Chih; Huang, Chu-Chung; Chen, Hsiu-Ling; Lu, Cheng-Hsien; Li, Shau-Hsuan; Wang, Ya-Ling; Cheng, Yu-Fan; Lin, Ching-Po

2012-01-01

Methadone maintenance treatment (MMT) has elevated rates of co-morbid memory deficit and depression that are associated with higher relapse rates for substance abuse. White matter (WM) disruption in MMT patients have been reported but their impact on these co-morbidities is unknown. This study aimed to investigate changes in WM integrity of MMT subjects using diffusion tensor image (DTI), and their relationship with history of heroin and methadone use in treated opiate-dependent individuals. The association between WM integrity changes from direct group comparisons and the severity of memory deficit and depression was also investigated. Differences in WM integrity between 35 MMT patients and 23 healthy controls were evaluated using DTI with tract-based spatial statistical analysis. Differences in DTI indices correlated with diminished memory function, Beck Depression Inventory, duration of heroin use and MMT, and dose of heroin and methadone administration. Changes in WM integrity were found in several WM regions, including the temporal and frontal lobes, pons, cerebellum, and cingulum bundles. The duration of MMT was associated with declining DTI indices in the superior longitudinal fasciculus and para-hippocampus. MMT patients had more memory and emotional deficits than healthy subjects. Worse scores in both depression and memory functions were associated with altered WM integrity in the superior longitudinal fasciculus, para-hippocampus, and middle cerebellar peduncle in MMT. Patients on MMT also had significant WM differences in the reward circuit and in depression- and memory-associated regions. Correlations among decreased DTI indices, disease severity, and accumulation effects of methadone suggest that WM alterations may be involved in the psychopathology and pathophysiology of co-morbidities in MMT. PMID:22496768

A Hybrid Computational Method for the Discovery of Novel Reproduction-Related Genes

PubMed Central

Chen, Lei; Chu, Chen; Kong, Xiangyin; Huang, Guohua; Huang, Tao; Cai, Yu-Dong

2015-01-01

Uncovering the molecular mechanisms underlying reproduction is of great importance to infertility treatment and to the generation of healthy offspring. In this study, we discovered novel reproduction-related genes with a hybrid computational method, integrating three different types of method, which offered new clues for further reproduction research. This method was first executed on a weighted graph, constructed based on known protein-protein interactions, to search the shortest paths connecting any two known reproduction-related genes. Genes occurring in these paths were deemed to have a special relationship with reproduction. These newly discovered genes were filtered with a randomization test. Then, the remaining genes were further selected according to their associations with known reproduction-related genes measured by protein-protein interaction score and alignment score obtained by BLAST. The in-depth analysis of the high confidence novel reproduction genes revealed hidden mechanisms of reproduction and provided guidelines for further experimental validations. PMID:25768094

A hybrid computational method for the discovery of novel reproduction-related genes.

PubMed

Chen, Lei; Chu, Chen; Kong, Xiangyin; Huang, Guohua; Huang, Tao; Cai, Yu-Dong

2015-01-01

Uncovering the molecular mechanisms underlying reproduction is of great importance to infertility treatment and to the generation of healthy offspring. In this study, we discovered novel reproduction-related genes with a hybrid computational method, integrating three different types of method, which offered new clues for further reproduction research. This method was first executed on a weighted graph, constructed based on known protein-protein interactions, to search the shortest paths connecting any two known reproduction-related genes. Genes occurring in these paths were deemed to have a special relationship with reproduction. These newly discovered genes were filtered with a randomization test. Then, the remaining genes were further selected according to their associations with known reproduction-related genes measured by protein-protein interaction score and alignment score obtained by BLAST. The in-depth analysis of the high confidence novel reproduction genes revealed hidden mechanisms of reproduction and provided guidelines for further experimental validations.

The Effect of Cartilage Fragments on Femoral Tunnel Widening After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Study.

PubMed

Zhang, Chi; Pan, Jun; Chen, Jian-De; Zhang, Yi-Jun; Gu, Peng-Cheng; Lin, Xiang-Jin; Cai, You-Zhi

2018-05-03

To analyze the effect of cartilage fragments on tunnel widening and tendon-bone integration at 2 years' follow-up after anterior cruciate ligament reconstruction (ACLR). A prospective randomized controlled study was performed in 116 patients who underwent ACLR with autologous hamstring tendons augmented with cartilage fragments (study group, n = 56) or without any augmentation (control group, n = 60). All patients were followed up for 25.6 months (range, 24-28 months), and the International Knee Documentation Committee score, Lysholm score, and visual analog scale score were determined. Computed tomography scans of all patients were obtained 2 years after surgery to evaluate the diameter of the femoral tunnel and thereby assess the amount of tunnel widening. Magnetic resonance imaging evaluation was performed 2 years postoperatively to evaluate the status of the graft in the femoral tunnel. In addition, 5 patients underwent biopsy of the tendon-bone interface at 24 months postoperatively with histologic assessment and transmission electron microscopy. A total of 107 patients completed the follow-up. There were no significant differences between the 2 groups in terms of International Knee Documentation Committee score (P = .07), Lysholm score (P = .10), and visual analog scale score (P = .57) at 24 months' follow-up. The femoral tunnel diameter and the tunnel widening percentage in the study group were significantly smaller than those in the control group (P < .001). The signal-noise quotient value of the graft in the femoral tunnel was 10.4 ± 7.0 in the study group, which was significantly lower than that in the control group (19.5 ± 9.2, P < .001). Histologic studies of the tendon-bone interface showed that there were more bone formations containing chondroid cells with aligned connective tissue in the study group compared with the control group; in addition, the diameter of the collagen fibrils in the study group was considerably thicker than that in the control group (P < .05). The use of cartilage fragments was effective in preventing femoral tunnel widening and seemed to promote the tendon-bone integration process after ACLR. Level II, prospective randomized controlled study. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Factor Scores, Structure and Communality Coefficients: A Primer

ERIC Educational Resources Information Center

Odum, Mary

2011-01-01

(Purpose) The purpose of this paper is to present an easy-to-understand primer on three important concepts of factor analysis: Factor scores, structure coefficients, and communality coefficients. Given that statistical analyses are a part of a global general linear model (GLM), and utilize weights as an integral part of analyses (Thompson, 2006;…

Integration of Computers into a Course on Biostatistics

ERIC Educational Resources Information Center

Gjerde, Craig L.

1977-01-01

The biostatistics course for undergraduate medical and dental students at the University of Connecticut Health Center is taught by the Keller Plan, and students can use computers to analyze data sets and to score their unit tests. The computer is an essential tool for data analysis and an attractive option for test scoring. (LBH)

Efficiency in the Community College Sector: Stochastic Frontier Analysis

ERIC Educational Resources Information Center

Agasisti, Tommaso; Belfield, Clive

2017-01-01

This paper estimates technical efficiency scores across the community college sector in the United States. Using stochastic frontier analysis and data from the Integrated Postsecondary Education Data System for 2003-2010, we estimate efficiency scores for 950 community colleges and perform a series of sensitivity tests to check for robustness. We…

Within-Semester Stability and Adjustment Correlates of the Multidimensional Perfectionism Scale.

ERIC Educational Resources Information Center

Rice, Kenneth G.; Dellwo, Jacqueline P.

2001-01-01

Subscale scores from R.O. Frost, P. Marten, C. Lahart, and R. Rosenblate's (1990) Mulitdimensional Perfectionism Scale were found to be moderately stable over a 10-week period. Associations between perfectionism and self-esteem, depression, and academic integration yielded mixed support for the criterion-related validity of the scores from this…

THE IMPACT OF THE MELD SCORE ON LIVER TRANSPLANT ALLOCATION AND RESULTS: AN INTEGRATIVE REVIEW

PubMed Central

de MORAES, Ana Claudia Oliveira; de OLIVEIRA, Priscilla Caroliny; da FONSECA-NETO, Olival Cirilo Lucena

2017-01-01

ABSTRACT Introduction: Liver transplantation is intended to increase the survival of patients with chronic liver disease in terminal phase, as well as improved quality of life. Since the first transplant until today many changes have occurred in the organ allocation system. Objective: To review the literature on the Model for End-stage Liver Disease (MELD) and analyze its correlation with survival after liver transplantation. Method: An integrative literature review in Lilacs, SciELO, and Pubmed in October 2015, was realized. Were included eight studies related to the MELD score and its impact on liver transplant. Results: There was predominance of transplants in male between 45-55 y. The main indications were hepatitis C, hepatocellular carcinoma and alcoholic cirrhosis. The most important factors post-surgery were related to the MELD score, the recipient age, expanded donor criteria and hemotransfusion. Conclusion: The MELD system reduced the death rate in patients waiting for a liver transplant. However, this score by itself is not a good predictor of survival after liver transplantation. PMID:28489174

Experienced job autonomy among maternity care professionals in The Netherlands.

PubMed

Perdok, Hilde; Cronie, Doug; van der Speld, Cecile; van Dillen, Jeroen; de Jonge, Ank; Rijnders, Marlies; de Graaf, Irene; Schellevis, François G; Verhoeven, Corine J

2017-11-01

High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care system and whether they expect a new system of integrated maternity care to affect their experienced job autonomy. A cross-sectional survey. The Leiden Quality of Work Life Questionnaire was used to assess experienced job autonomy among maternity care professionals. Data were collected in the Netherlands in 2015. 799 professionals participated of whom 362 were primary care midwives, 240 obstetricians, 93 clinical midwives and 104 obstetric nurses. The mean score for experienced job autonomy was highest for primary care midwives, followed by obstetricians, clinical midwives and obstetric nurses. Primary care midwives scored highest in expecting to lose their job autonomy in an integrated care system. There are significant differences in experienced job autonomy between maternity care professionals. When changing the maternity care system it will be a challenge to maintain a high level of experienced job autonomy for professionals. A decrease in job autonomy could lead to a reduction in job related wellbeing and in satisfaction with care among pregnant women. Copyright © 2017. Published by Elsevier Ltd.

Neural mechanisms of discourse comprehension: a human lesion study

PubMed Central

Colom, Roberto; Grafman, Jordan

2014-01-01

Discourse comprehension is a hallmark of human social behaviour and refers to the act of interpreting a written or spoken message by constructing mental representations that integrate incoming language with prior knowledge and experience. Here, we report a human lesion study (n = 145) that investigates the neural mechanisms underlying discourse comprehension (measured by the Discourse Comprehension Test) and systematically examine its relation to a broad range of psychological factors, including psychometric intelligence (measured by the Wechsler Adult Intelligence Scale), emotional intelligence (measured by the Mayer, Salovey, Caruso Emotional Intelligence Test), and personality traits (measured by the Neuroticism-Extraversion-Openness Personality Inventory). Scores obtained from these factors were submitted to voxel-based lesion-symptom mapping to elucidate their neural substrates. Stepwise regression analyses revealed that working memory and extraversion reliably predict individual differences in discourse comprehension: higher working memory scores and lower extraversion levels predict better discourse comprehension performance. Lesion mapping results indicated that these convergent variables depend on a shared network of frontal and parietal regions, including white matter association tracts that bind these areas into a coordinated system. The observed findings motivate an integrative framework for understanding the neural foundations of discourse comprehension, suggesting that core elements of discourse processing emerge from a distributed network of brain regions that support specific competencies for executive and social function. PMID:24293267

Personnel attitudes toward people with mental illness at a psychiatric hospital in Taiwan.

PubMed

Chen, Ming-De; Chang, Yen-Ching

2016-06-01

The attitudes of psychiatric hospital personnel are critically related to the quality of mental health care, but few studies have investigated this issue. This study is aimed at an exploration of the attitudes of psychiatric hospital personnel toward people with mental illness and at an examination of the associated factors. A self-report questionnaire, the Mental Illness Attitude Scale (MIAS), was used to collect data from psychiatric hospital personnel in Taiwan (n = 290). The MIAS included 46 items and 4 dimensions: acceptance, rehabilitation and prognosis, social distance and recommendations for interventions. Rehabilitation and prognosis had the highest item average scores (4.03) and social distance had the lowest item average scores (3.22). Stigmatization and the number of different types of contacted clients were two significantly associated attitude factors. Psychiatric hospital personnel in Taiwan tend to have positive attitudes toward people with mental illness in general situations but hold less positive attitudes in terms of community integration-related issues and intimate relationships. More evidence-based community services should be conducted to decrease personnel concerns about the successful community integration of those who are mentally ill. Future studies can investigate the concept and impact of stigmatization more deeply. © The Author(s) 2016.

Computational and informatics strategies for identification of specific protein interaction partners in affinity purification mass spectrometry experiments

PubMed Central

Nesvizhskii, Alexey I.

2013-01-01

Analysis of protein interaction networks and protein complexes using affinity purification and mass spectrometry (AP/MS) is among most commonly used and successful applications of proteomics technologies. One of the foremost challenges of AP/MS data is a large number of false positive protein interactions present in unfiltered datasets. Here we review computational and informatics strategies for detecting specific protein interaction partners in AP/MS experiments, with a focus on incomplete (as opposite to genome-wide) interactome mapping studies. These strategies range from standard statistical approaches, to empirical scoring schemes optimized for a particular type of data, to advanced computational frameworks. The common denominator among these methods is the use of label-free quantitative information such as spectral counts or integrated peptide intensities that can be extracted from AP/MS data. We also discuss related issues such as combining multiple biological or technical replicates, and dealing with data generated using different tagging strategies. Computational approaches for benchmarking of scoring methods are discussed, and the need for generation of reference AP/MS datasets is highlighted. Finally, we discuss the possibility of more extended modeling of experimental AP/MS data, including integration with external information such as protein interaction predictions based on functional genomics data. PMID:22611043

Disturbance metrics predict a wetland Vegetation Index of Biotic Integrity

USGS Publications Warehouse

Stapanian, Martin A.; Mack, John; Adams, Jean V.; Gara, Brian; Micacchion, Mick

2013-01-01

Indices of biological integrity of wetlands based on vascular plants (VIBIs) have been developed in many areas in the USA. Knowledge of the best predictors of VIBIs would enable management agencies to make better decisions regarding mitigation site selection and performance monitoring criteria. We use a novel statistical technique to develop predictive models for an established index of wetland vegetation integrity (Ohio VIBI), using as independent variables 20 indices and metrics of habitat quality, wetland disturbance, and buffer area land use from 149 wetlands in Ohio, USA. For emergent and forest wetlands, predictive models explained 61% and 54% of the variability, respectively, in Ohio VIBI scores. In both cases the most important predictor of Ohio VIBI score was a metric that assessed habitat alteration and development in the wetland. Of secondary importance as a predictor was a metric that assessed microtopography, interspersion, and quality of vegetation communities in the wetland. Metrics and indices assessing disturbance and land use of the buffer area were generally poor predictors of Ohio VIBI scores. Our results suggest that vegetation integrity of emergent and forest wetlands could be most directly enhanced by minimizing substrate and habitat disturbance within the wetland. Such efforts could include reducing or eliminating any practices that disturb the soil profile, such as nutrient enrichment from adjacent farm land, mowing, grazing, or cutting or removing woody plants.

The effects of computer-assisted instruction and locus of control upon preservice elementary teachers' acquisition of the integrated science process skills

NASA Astrophysics Data System (ADS)

Wesley, Beth Eddinger; Krockover, Gerald H.; Devito, Alfred

The purpose of this study was to determine the effects of computer-assisted instruction (CAI) versus a text mode of programmed instruction (PI), and the cognitive style of locus of control, on preservice elementary teachers' achievement of the integrated science process skills. Eighty-one preservice elementary teachers in six sections of a science methods class were classified as internally or externally controlled. The sections were randomly assigned to receive instruction in the integrated science process skills via a microcomputer or printed text. The study used a pretest-posttest control group design. Before assessing main and interaction effects, analysis of covariance was used to adjust posttest scores using the pretest scores. Statistical analysis revealed that main effects were not significant. Additionally, no interaction effects between treatments and loci of control were demonstrated. The results suggest that printed PI and tutorial CAI are equally effective modes of instruction for teaching internally and externally oriented preservice elementary teachers the integrated science process skills.

Effect of Integrated Yoga Module on Selected Psychological Variables among Women with Anxiety Problem.

PubMed

Parthasarathy, S; Jaiganesh, K; Duraisamy

2014-01-01

The implementation of yogic practices has proven benefits in both organic and psychological diseases. Forty-five women with anxiety selected by a random sampling method were divided into three groups. Experimental group I was subjected to asanas, relaxation and pranayama while Experimental group II was subjected to an integrated yoga module. The control group did not receive any intervention. Anxiety was measured by Taylor's Manifest Anxiety Scale before and after treatment. Frustration was measured through Reaction to Frustration Scale. All data were spread in an Excel sheet to be analysed with SPSS 16 software using analysis of covariance (ANCOVA). Selected yoga and asanas decreased anxiety and frustration scores but treatment with an integrated yoga module resulted in significant reduction of anxiety and frustration. To conclude, the practice of asanas and yoga decreased anxiety in women, and yoga as an integrated module significantly improved anxiety scores in young women with proven anxiety without any ill effects.

Psychiatry in the Harvard Medical School-Cambridge Integrated Clerkship: an innovative, year-long program.

PubMed

Griswold, Todd; Bullock, Christopher; Gaufberg, Elizabeth; Albanese, Mark; Bonilla, Pedro; Dvorak, Ramona; Epelbaum, Claudia; Givon, Lior; Kueppenbender, Karsten; Joseph, Robert; Boyd, J Wesley; Shtasel, Derri

2012-09-01

The authors present what is to their knowledge the first description of a model for longitudinal third-year medical student psychiatry education. A longitudinal, integrated psychiatric curriculum was developed, implemented, and sustained within the Harvard Medical School-Cambridge Integrated Clerkship. Curriculum elements include longitudinal mentoring by attending physicians in an outpatient psychiatry clinic, exposure to the major psychotherapies, psychopharmacology training, acute psychiatry "immersion" experiences, and a variety of clinical and didactic teaching sessions. The longitudinal psychiatry curriculum has been sustained for 8 years to-date, providing effective learning as demonstrated by OSCE scores, NBME shelf exam scores, written work, and observed clinical work. The percentage of students in this clerkship choosing psychiatry as a residency specialty is significantly greater than those in traditional clerkships at Harvard Medical School and greater than the U.S. average. Longitudinal integrated clerkship experiences are effective and sustainable; they offer particular strengths and opportunities for psychiatry education, and may influence student choice of specialty.

An evaluation of the use of microcomputer-based laboratory instruction on middle school students' concept attainment and attitudes towards computer-based instruction

NASA Astrophysics Data System (ADS)

Osio, Sergio Albina

The advent of instructional technology has become an integral part of the learning process, thought by many to be a vital component in the reform of science instruction. Microcomputer-Based Laboratory (MBL) is an instructional technology environment in which a computer is connected through its Universal Serial Box (USB) port or an interface (for older models) with sensors to control the experiment, collect data, and generate and interpret graphs. In this study, MBL tools and instructions were used to design an instructional program that integrated ideas in teaching thinking skills so that middle school students from varying levels of differentiated achievement could categorize and create concepts grounded on the Concept Attainment Model of teaching. Data were collected and analyzed based on the procedures of a one-group pretest-posttest experimental design and two research questions. The study provided a quantitative correlation of variables such as MBL to students' pretest-posttest total scores; pretest-posttest total scores to the levels of differentiated achievement and treatment groups. Likewise, a modified student-computer-attitude survey was administered to evaluate students' attitude toward the use of computer technologies. The research findings revealed a 9.1% increase in test scores in the three concepts of investigation; multiple increases in test scores in the three levels of differentiated achievement (22.2% for regular science group, 6.2% for accelerated science group students, and 1% for sheltered science group); and 11.1% mean difference between the MHL group and traditional laboratory group. Simultaneously, participants showed a positive significance of 77% feeling of comfort and confidence towards the use of computer technologies. Eventually, the great potential of MBL technology could play an important role in the reform of science education in the schools of the second largest Unified School District in the country today.