Can Placement Test Score Predict Success for a First-Semester Community College Student in Their First Online Course?

ERIC Educational Resources Information Center

MacGregor, Philip C.; O'Reilly, Frances L.; Matt, John

2017-01-01

This study examined the following question: What is the relationship, if any, between COMPASS placement scores and the student success in the first online course during the students first semester? Discriminant function analysis was used to examine the relationship. This study used existing data from new students, who took the COMPASS placement…

The Impact of Advanced Placement Courses on High School Students Taking the Scholastic Aptitude Test.

ERIC Educational Resources Information Center

Thomas, L. M.; Thomas, Suzanne G.

This obtrusive post-hoc quasi-experimental study investigated Scholastic Assessment Test (SAT) scores of 111 high school students in grades 10 through 12. Fifty-three students were enrolled in at least one Advanced Placement (AP) course at the time of the study. General factorial analysis of variance (ANOVA) tested for significant differences…

Graduate Students' Administration and Scoring Errors on the Woodcock-Johnson III Tests of Cognitive Abilities

ERIC Educational Resources Information Center

Ramos, Erica; Alfonso, Vincent C.; Schermerhorn, Susan M.

2009-01-01

The interpretation of cognitive test scores often leads to decisions concerning the diagnosis, educational placement, and types of interventions used for children. Therefore, it is important that practitioners administer and score cognitive tests without error. This study assesses the frequency and types of examiner errors that occur during the…

Measurement Characteristics of the MAA Math Placement Tests.

ERIC Educational Resources Information Center

Melancon, Janet G.; Thompson, Bruce

This paper presents analyses of score reliability for a mathematics placement test developed by the Mathematical Association of America in 1984 for use with undergraduate college students. Subjects included all 589 students seeking admission to the college mathematics curricula at a private university in the South during the course of the study.…

Placing Texts, Placing Writers: Sources of Readers' Judgments in University Placement-Testing.

ERIC Educational Resources Information Center

Sullivan, Francis J.

A study examined how pragmatic form influences evaluation of student essays in university placement testing. Specifically, the study documented how patterns in students' use of information (assumed to be either old, inferable, or new for readers) affected the holistic scores for quality given to the essays. Subjects, 99 randomly selected entering…

The Re-Placement Test: Using TOEFL for Purposes of Placement

ERIC Educational Resources Information Center

Moglen, Daniel

2015-01-01

This article will consider using TOEFL scores for purposes of placement and advising for international graduate students at a northern California research university. As the number of international students is on the rise and the funds for the graduate ESL program are diminishing, the way in which the university is handling the influx of…

The relationship between selected standardized test scores and performance in advanced placement math and science exams: Analyzing the differential effectiveness of scores for course identification and placement

NASA Astrophysics Data System (ADS)

Urbina, Josue N.

There is a national need to increase the STEM-related workforce. Among factors leading towards STEM careers include the number of advanced high school mathematics and science courses students complete. Florida's enrollment patterns in STEM-related Advanced Placement (AP) courses, however, reveal that only a small percentage of students enroll into these classes. Therefore, screening tools are needed to find more students for these courses, who are academically ready, yet have not been identified. The purpose of this study was to investigate the extent to which scores from a national standardized test, Preliminary Scholastic Assessment Test/ National Merit Qualifying Test (PSAT/NMSQT), in conjunction with and compared to a state-mandated standardized test, Florida Comprehensive Assessment Test (FCAT), are related to selected AP exam performance in Seminole County Public Schools. An ex post facto correlational study was conducted using 6,189 student records from the 2010 - 2012 academic years. Multiple regression analyses using simultaneous Full Model testing showed differential moderate to strong relationships between scores in eight of the nine AP courses (i.e., Biology, Environmental Science, Chemistry, Physics B, Physics C Electrical, Physics C Mechanical, Statistics, Calculus AB and BC) examined. For example, the significant unique contribution to overall variance in AP scores was a linear combination of PSAT Math (M), Critical Reading (CR) and FCAT Reading (R) for Biology and Environmental Science. Moderate relationships for Chemistry included a linear combination of PSAT M, W (Writing) and FCAT M; a combination of FCAT M and PSAT M was most significantly associated with Calculus AB performance. These findings have implications for both research and practice. FCAT scores, in conjunction with PSAT scores, can potentially be used for specific STEM-related AP courses, as part of a systematic approach towards AP course identification and placement. For courses with moderate to strong relationships, validation studies and development of expectancy tables, which estimate the probability of successful performance on these AP exams, are recommended. Also, findings established a need to examine other related research issues including, but not limited to, extensive longitudinal studies and analyses of other available or prospective standardized test scores.

Estimating Achievement Gaps from Test Scores Reported in Ordinal "Proficiency" Categories

ERIC Educational Resources Information Center

Ho, Andrew D.; Reardon, Sean F.

2012-01-01

Test scores are commonly reported in a small number of ordered categories. Examples of such reporting include state accountability testing, Advanced Placement tests, and English proficiency tests. This paper introduces and evaluates methods for estimating achievement gaps on a familiar standard-deviation-unit metric using data from these ordered…

Her physics, his physics: gender issues in Israeli advanced placement physics classes

NASA Astrophysics Data System (ADS)

Zohar, Anat

2003-02-01

Gender gaps in physics in favour of boys are more prominent in Israel than in other countries. The main research question is to find out what gender issues are at play in Israeli advanced placement physics classes. Matriculation exam scores from approximately 400 high schools were analysed across 12 years. In addition, semi-constructed interviews were conducted with 50 advanced placement physics students (25 girls and 25 boys). In terms of participation, it was found that the ratio of girls to boys has been unchanged from 1988 to 2000 and is roughly 1:3. In terms of performance, it was found that the final matriculation scores of boys and girls are similar. However, breaking up the final scores into its two components - teachers' given grades and matriculation test scores - showed that boy's test scores are usually higher than girls' test scores, while girls' teachers' given grades are usually higher than boys'. Results from semi-constructed interviews pointed to two factors that are especially unfavourable to many girls: excessive competitiveness and lack of teaching for understanding. Girls' yearning for deep understanding is seen as a form of questing for connected knowledge. It is suggested that instructional methods that foster students' understanding while decreasing competitiveness in physics classes might contribute to girls' participation and performance in advanced physics classes while also supporting the learning of many boys.

Effects of a Developmental Boot Camp: Improving Student Performance on a College Placement Test

ERIC Educational Resources Information Center

Hill, Heather H.

2012-01-01

Nationwide, students are entering college unprepared for college-level work. Recent high school graduates are placing into developmental courses at an alarming rate. The purpose of this research study is to examine the effect of a developmental boot camp on standardized placement test scores of students enrolling at a community college in North…

Interpreting Mathematics Scores on the New Jersey College Basic Skills Placement Test.

ERIC Educational Resources Information Center

Dass, Jane; Pine, Charles

The New Jersey College Basic Skills Placement Test (NJCBSPT) is designed to measure certain basic language and mathematics skills of students entering New Jersey colleges. The primary purpose of the two mathematics sections is to determine whether students are prepared to begin certain college-level work without a handicap in computation or…

Accuracy of Course Placement Validity Statistics under Various Soft Truncation Conditions. ACT Research Report Series 99-2.

ERIC Educational Resources Information Center

Schiel, Jeff L.; King, Jason E.

Analyses of data from operational course placement systems are subject to the effects of truncation; students with low placement test scores may enroll in a remedial course, rather than a standard-level course, and therefore will not have outcome data from the standard course. In "soft" truncation, some (but not all) students who score…

Relationships of Declining Test Scores and Grade Inflation.

ERIC Educational Resources Information Center

Bellott, Fred K.

The relationship between declining scores on national standardized tests and grade inflation is explored. Grade inflation refers to the indicated measure of evaluation of student performance having higher placement than is usual based on the performances. Data for this study were taken from the American College Testing (ACT) Program Class Profile…

High-Stakes and Non-Stakes Testing States and the Transfer of Knowledge to Students' Advanced Placement Test, Advanced Placement U.S. History Test, and SAT Exam Scores

ERIC Educational Resources Information Center

Lessler, Karen Jean

2010-01-01

The Federal education policy No Child Left Behind Act (NCLB) has initiated high-stakes testing among U.S. public schools. The premise of the NCLB initiative is that all students reach proficiency in reading and math by 2014. Under NCLB, individual state education departments were required to implement annual assessments in grades two through eight…

AP Trends: Tests Soar, Scores Slip--Gaps between Groups Spur Equity Concerns

ERIC Educational Resources Information Center

Cech, Scott J.

2008-01-01

More students are taking Advanced Placement tests, but the proportion of tests receiving what is deemed a passing score has dipped, and the mean score is down for the fourth year in a row. Data released here this week by the New York City-based nonprofit organization that owns the AP brand shows that a greater-than-ever proportion of students…

Investigating the Possibility of Using TOEFL Scores for University ESL Decision-Making: Placement Trends and Effect of Time Lag

ERIC Educational Resources Information Center

Kokhan, Kateryna

2012-01-01

The English Placement Test (EPT) at the University of Illinois at Urbana-Champaign (UIUC) is designed to provide an accurate placement (or exemption) of international students into the ESL writing and pronunciation classes. Over the last five years, UIUC has experienced an increase in the number of international students taking the EPT. Because of…

The Relationship between Academic Averages of Primary School Science and Technology Class and Test Sub-Test Scores of Placement Test of Science

ERIC Educational Resources Information Center

Guzeller, Cem Oktay

2012-01-01

In this research, the relationship between written exam scores of science and technology class of 6th, 7th, and 8th grades, project, participation in class activities and performance work, year-end academic success point averages and sub-test raw scores of LDT science of 6th, 7th and 8th grades. Academic success point averages were used as…

Automated Essay Scoring versus Human Scoring: A Correlational Study

ERIC Educational Resources Information Center

Wang, Jinhao; Brown, Michelle Stallone

2008-01-01

The purpose of the current study was to analyze the relationship between automated essay scoring (AES) and human scoring in order to determine the validity and usefulness of AES for large-scale placement tests. Specifically, a correlational research design was used to examine the correlations between AES performance and human raters' performance.…

Questionnaire design: carry-over effects of overall acceptance question placement and pre-evaluation instructions on overall acceptance scores in central location tests.

PubMed

Bastian, Mauresa; Eggett, Dennis L; Jefferies, Laura K

2015-02-01

Question placement and usage of pre-evaluation instructions (PEI) in questionnaires for food sensory analysis may bias consumers' scores via carry-over effects. Data from consumer sensory panels previously conducted at a central location, spanning 11 years and covering a broad range of food product categories, were compiled. Overall acceptance (OA) question placement was studied with categories designated as first (the first evaluation question following demographic questions), after nongustation questions (immediately following questions that do not require panelists to taste the product), and later (following all other hedonic and just-about-right [JAR] questions, but occasionally before ranking, open-ended comments, and/or intent to purchase questions). Each panel was categorized as having or not having PEI in the questionnaire; PEI are instructions that appear immediately before the first evaluation question and show panelists all attributes they will evaluate before receiving test samples. Postpanel surveys were administered regarding the self-reported effect of PEI on panelists' evaluation experience. OA scores were analyzed and compared (1) between OA question placement categories and (2) between panels with and without PEI. For most product categories, OA scores tended to be lower when asked later in the questionnaire, suggesting evidence of a carry-over effect. Usage of PEI increased OA scores by 0.10 of a 9-point hedonic scale point, which is not practically significant. Postpanel survey data showed that presence of PEI typically improved the panelists' experience. Using PEI does not appear to introduce a meaningful carry-over effect. © 2015 Institute of Food Technologists®

College Planning: The Savvy Parent's Guide

ERIC Educational Resources Information Center

Berger, Sandra

2008-01-01

Because college admission has become much more competitive, parents and students need to know that excellent grades and test scores may not be enough to gain placement, especially in highly selective schools. Keep in mind that there are more than 25,000 class valedictorians every year, most with nearly perfect standardized test scores. Also, the…

The Relationship of Expert-System Scored Constrained Free-Response Items to Multiple-Choice and Open-Ended Items.

ERIC Educational Resources Information Center

Bennett, Randy Elliot; And Others

1990-01-01

The relationship of an expert-system-scored constrained free-response item type to multiple-choice and free-response items was studied using data for 614 students on the College Board's Advanced Placement Computer Science (APCS) Examination. Implications for testing and the APCS test are discussed. (SLD)

Using College Admission Test Scores to Clarify High School Placement. Leading Indicator Spotlight

ERIC Educational Resources Information Center

Flug, Susanna

2010-01-01

In "Beyond Test Scores: Leading Indicators for Education," Foley and colleagues (2008) define leading indicators as those that "provide early signals of progress toward academic achievement" (p. 1) and stress that educators "need leading indicators to help them see the direction their efforts are going in and to take…

The Community College Student: Preparation for the Math Placement Test

ERIC Educational Resources Information Center

Dudley, Jennifer

2010-01-01

The purpose of this action research case study was to explore attitudes and beliefs regarding strategies to improve math placement scores for low-socioeconomic community college students at an urban campus. Using a pragmatic worldview, qualitative techniques were used to gather data to explore this problem at a single community college located in…

Payment of Advanced Placement Exam Fees by Virginia Public School Divisions and Its Impact on Advanced Placement Enrollment and Scores

ERIC Educational Resources Information Center

Cirillo, Mary Grupe

2010-01-01

The purpose of this study was to determine the impact of Virginia school divisions' policy of paying the fee for students to take Advanced Placement exams on Advanced Placement course enrollment, the number of Advanced Placement exams taken by students, the average scores earned and the percent of students earning qualifying scores of 3, 4, or 5…

Assessment Test Scores of Incoming Students, Fall 2001.

ERIC Educational Resources Information Center

Negron, Maggie; Breindel, Matthew

This assessment of placement test scores in reading, math, and sentence skills from incoming students at College of the Desert (California) shows that students are overwhelmingly underprepared for study at the college. Only 15% of students were prepared in sentence skills, 27% in reading skills, 7% in math skills; only 3% were prepared in all 3…

Creating and Analyzing the Effectiveness of a Mathematics Placement Policy for New Freshmen

ERIC Educational Resources Information Center

Denny, Jeffrey K.; Nelson, David G.; Zhao, Martin Q.

2012-01-01

In the mid-1990s, Mercer University's undergraduate schools placed incoming freshmen in their first mathematics course, using only their scores on the mathematics portion of the SAT (SATM). This placement policy was strongly supported by the admissions office because it did not require additional testing of the freshmen in their on-campus summer…

Information Technology and Literacy Assessment.

ERIC Educational Resources Information Center

Balajthy, Ernest

2002-01-01

Compares technology predictions from around 1989 with the technology of 2002. Discusses the place of computer-based assessment today, computer-scored testing, computer-administered formal assessment, Internet-based formal assessment, computerized adaptive tests, placement tests, informal assessment, electronic portfolios, information management,…

Academic Attributes of College Freshmen that Lead to Success in Actuarial Studies in a Business College

ERIC Educational Resources Information Center

Smith, Richard Manning; Schumacher, Phyllis

2006-01-01

The authors studied beginning undergraduate actuarial concentrators in a business college. They identified four variables (math Scholastic Aptitude Test [SAT] score, verbal SAT score, percentile rank in high school graduating class, and percentage score on a college mathematics placement exam) that were available for entering college students that…

Validity Evidence for ACT Compass® Placement Tests. ACT Research Report Series 2014 (2)

ERIC Educational Resources Information Center

Westrick, Paul A.; Allen, Jeff

2014-01-01

We examined the validity of using Compass® test scores and high school grade point average (GPA) for placing students in first-year college courses and for identifying students at risk of not succeeding. Consistent with other research, the combination of high school GPA and Compass scores performed better than either measure used alone. Results…

[Assessment.

ERIC Educational Resources Information Center

Boylan, Hunter R., Ed.; Kerstiens, Gene, Ed.

1989-01-01

These four serial issues examine the effectiveness and appropriateness of a variety of assessment tests as well as their relationship to developmental education. Included are reviews of the following tests: (1) the Comparative Guidance and Placement Program, a self-scoring test of English and mathematics; (2) the Stanford Achievement Test, an…

Vocational Guidance for the Deaf; A Classified Guide to the Basic Requirements for Occupations Open to the Profoundly Deaf.

ERIC Educational Resources Information Center

Montgomery, G.W.G.

Published in Britain for use by counselors and placement officials, the book offers a systematic attack on occupational placement problems of the prelingually deaf. The system is based on a vocational guidance profile, which is developed from intelligence and achievement test scores. The vocational guidance profile is explained, and occupational…

Catch-up growth assessment in long-term physically neglected and emotionally abused preschool age male children.

PubMed

Oliván, Gonzalo

2003-01-01

To assess the catch-up growth of long-term physically neglected and emotionally abused preschool male children who have entered foster residential care and remained 1 year after initial placement. Longitudinal study over a 7-year period (1994-2001). So that a child was eligible for the study, three selection criteria were included: (1) aged between 24 and 48 months at the time of entry into residential facility, (2) having suffered both long-term (more than 6 months) physically neglected and emotionally abused, and (3) having stayed in foster care for 1 year after initial placement. Weight, height, and head circumference were established upon entry and re-assessed 1 year after initial placement, calculating the annual growth velocity. Results were compared with normal regional longitudinal standards of reference (Z score). Student's t test was used to assess statistically significant differences. During the study period, 87 children aged between 24 and 48 months (54 male/33 female) were admitted to residential facility after having suffered both long-term physical neglect and emotional abuse. Nevertheless, only 20 children (23% of the total admissions) met the third selection criteria (having remained 1 year after initial placement). Of these children, all were males and at placement they were between the ages of 30 and 42 months, with an average age of 36 months (1.9 SD). At placement, the analyzed parameters were below the normal standards, showing a statistically significant difference for height (Z score = -1.29; p = .008) and weight (Z score = -.75; p = .038). The annual growth velocity for all parameters was above the normal standards showing a statistically significant difference for height (Z score = +1.43; p = .009). One year after initial placement, the significant differences for height (Z score = -.68; p = .102) and weight (Z score = -.31; p = .435) with respect to the normal standards disappeared, though still remained below, showing a significant catch-up growth for height (improvement height Z = +.61 SD). At placement, the both long-term physically neglected and emotionally abused preschool age male children showed a mild form of chronic malnutrition with growth failure. Growth failure was reversible after the first year of stay, which demonstrates that this delay in growth was secondary to nutritional and psychosocial factors. Placement in foster residential care was beneficial for the catch-up growth of these patients. Copyright 2002 Elsevier Science Ltd.

Simulated lumbar minimally invasive surgery educational model with didactic and technical components.

PubMed

Chitale, Rohan; Ghobrial, George M; Lobel, Darlene; Harrop, James

2013-10-01

The learning and development of technical skills are paramount for neurosurgical trainees. External influences and a need for maximizing efficiency and proficiency have encouraged advancements in simulator-based learning models. To confirm the importance of establishing an educational curriculum for teaching minimally invasive techniques of pedicle screw placement using a computer-enhanced physical model of percutaneous pedicle screw placement with simultaneous didactic and technical components. A 2-hour educational curriculum was created to educate neurosurgical residents on anatomy, pathophysiology, and technical aspects associated with image-guided pedicle screw placement. Predidactic and postdidactic practical and written scores were analyzed and compared. Scores were calculated for each participant on the basis of the optimal pedicle screw starting point and trajectory for both fluoroscopy and computed tomographic navigation. Eight trainees participated in this module. Average mean scores on the written didactic test improved from 78% to 100%. The technical component scores for fluoroscopic guidance improved from 58.8 to 52.9. Technical score for computed tomography-navigated guidance also improved from 28.3 to 26.6. Didactic and technical quantitative scores with a simulator-based educational curriculum improved objectively measured resident performance. A minimally invasive spine simulation model and curriculum may serve a valuable function in the education of neurosurgical residents and outcomes for patients.

A Study of the Relationship between Student Placement Test Scores and Final Grades in Physics 121 at Pima College.

ERIC Educational Resources Information Center

Iadevaia, David G.

A study was conducted at Pima Community College to determine the relationship between the final grade received by students in an introductory, algebra-based physics course (PHY 121) and their scores on the reading, writing, and mathematics portions of the college's nonmandatory assessment test. Between 1983 and 1988, 639 students obtained a final…

The Effects of Math Anxiety

ERIC Educational Resources Information Center

Andrews, Amanda; Brown, Jennifer

2015-01-01

Math anxiety is a reoccurring problem for many students, and the effects of this anxiety on college students are increasing. The purpose of this study was to examine the association between pre-enrollment math anxiety, standardized test scores, math placement scores, and academic success during freshman math coursework (i.e., pre-algebra, college…

A Survey of School Psychologists' Practices for Identifying Mentally Retarded Students.

ERIC Educational Resources Information Center

Wodrich, David L.; Barry, Christine T.

1991-01-01

Surveyed school psychologists regarding identification of mentally retarded students. The Wechsler scales were the most frequently used tests for deriving intelligence quotient scores, which together with adaptive behavior scale scores were rated as most influential in identification-placement decisions. The Vineland Adaptive Behavior Scales were…

Advanced Placement Results, 2013-14. Measuring Up. D&A Report No.15.01

ERIC Educational Resources Information Center

Gilleland, Kevin; Muli, Juliana

2015-01-01

Advanced Placement (AP) outcomes for Wake County Public School System (WCPSS) students have continued an upward trend for over 18 years, out-performing the state and the nation in all measures. In 2013-14 there were 13,757 exams taken by 6,955 WCPSS test-takers with almost 76% of the exams resulting in scores at or above 3, outperforming Guilford…

Equating in Small-Scale Language Testing Programs

ERIC Educational Resources Information Center

LaFlair, Geoffrey T.; Isbell, Daniel; May, L. D. Nicolas; Gutierrez Arvizu, Maria Nelly; Jamieson, Joan

2017-01-01

Language programs need multiple test forms for secure administrations and effective placement decisions, but can they have confidence that scores on alternate test forms have the same meaning? In large-scale testing programs, various equating methods are available to ensure the comparability of forms. The choice of equating method is informed by…

Influence of Client Intelligence Quotient Scores on Placement Recommendations: An Analogue Study.

ERIC Educational Resources Information Center

Ursprung, Alex William

1987-01-01

Examined influence of client intelligence quotient (IQ) scores on placement recommendations by rehabilitation students (N=59). Clients' IQ scores were found to influence significantly number of placement options generated by the participants, but had no significant impact on prediction of vocational success or willingness to work with the client.…

The Association Between Premedical Curricular and Admission Requirements and Medical School Performance and Residency Placement: A Study of Two Admission Routes.

PubMed

George, Paul; Park, Yoon Soo; Ip, Julianne; Gruppuso, Philip A; Adashi, Eli Y

2016-03-01

The curricular elements of undergraduate premedical education are the subject of an ongoing debate. The Warren Alpert Medical School of Brown University (AMS) matriculates students via the traditional premedical route (TPM) and an eight-year baccalaureate/MD program-the Program in Liberal Medical Education (PLME)-which provides students with a broad and liberal education. Using the juxtaposition of these two admission routes, the authors aimed to determine whether there is an association between highly distinct premedical curricular and admission requirements and medical school performance and residency placement. The cohorts studied included all of the PLME (n = 295) and TPM (n = 215) students who graduated from the AMS between 2010 and 2015. Outcome variables consisted of multiple measures of medical school performance, including standardized multiple-choice examination scores and honors grades, and residency placement. The authors employed unadjusted tests of averages and proportions (independent t tests and chi-square tests) to compare variables. The TPM students attained marginally, but statistically significantly, higher average scores on standardized multiple-choice examinations than their PLME counterparts. The number of undergraduate premedical science courses completed by PLME students accounted for less than 4% of the variance in key metrics of medical school performance. The residency placement record of the PLME and TPM cohorts proved comparable. These findings suggest that the association between medical school performance and residency placement and undergraduate premedical curricular and admission requirements is weak. Further study is needed to determine the optimal premedical preparation of students.

Relationships between Visual and Auditory Perceptual Skills and Comprehension in Students with Learning Disabilities.

ERIC Educational Resources Information Center

Weaver, Phyllis A.; Rosner, Jerome

1979-01-01

Scores of 25 learning disabled students (aged 9 to 13) were compared on five tests: a visual-perceptual test (Coloured Progressive Matrices); an auditory-perceptual test (Auditory Motor Placement); a listening and reading comprehension test (Durrell Listening-Reading Series); and a word recognition test (Word Recognition subtest, Diagnostic…

Tests for Adult Basic Education Teachers. "28 Suggestions for Classroom Teachers".

ERIC Educational Resources Information Center

Vonderhaar, Kathleen; And Others

An updated and improved listing of test and measurement items useful in Adult Basic Education Classrooms is provided. Diagnostic, placement, achievement, and group and individual intelligence tests are reviewed. Information on test type and purpose, appropriate grade level, test time, number of forms, the manual, scoring, and format is included.…

Predictors of placement for children who initially remained in their homes after an investigation for abuse or neglect

PubMed Central

Horwitz, Sarah McCue; Hurlburt, Michael S.; Cohen, Steven D.; Zhang, Jinjin; Landsverk, John

2011-01-01

Objective To examine the frequency and predictors of out-of-home placement in a 30 month follow-up for a nationally representative sample of children investigated for a report of maltreatment who remained in their homes following the index child welfare report. Methods Data came from the National Survey of Child and Adolescent Well-being (NSCAW), a 3-year longitudinal study of 5,501 youth 0-14 years old referred to child welfare agencies for potential maltreatment between 10/1999 and 12/2000. These analyses focused on the children who had not been placed out-of-home at the baseline interview and examined child, family and case characteristics as predictors of subsequent out-of-home placement. Weighted logistic regression models were used to determine which baseline characteristics were related to out-of-home placement in the follow-up. Results For the total study sample, predictors of placement in the 30 month follow-up period included elevated Conflict Tactics Scale scores, prior history of child welfare involvement, high family risk scores and caseworkers’ assessment of likelihood of re-report without receipt of services. Higher family income was protective. For children without any prior child welfare history (incident cases), younger children, low family income and a high family risk score were strongly related to subsequent placement but receipt of services and case workers’ assessments were not. Conclusions/Practice implications Family risk variables are strongly related to out-of-home placement in a 30 month follow-up, but receipt of child welfare services is not related to further placements. Considering family risk factors and income, 25% of the children who lived in poor families, with high family risk scores, were subsequently placed out-of-home, even among children in families who received child welfare services. Given that relevant evidence-based interventions are available for these families, more widespread tests of their use should be explored to understand whether their use could make a substantial difference in the lives of vulnerable children. PMID:21489626

Student and Faculty Evaluation of Placement Results. Results of In-Class Surveys of Faculty and Students Regarding SDCCD Placement Practices and Results.

ERIC Educational Resources Information Center

Armstrong, Bill; Takahata, Gail

In the fall of 1988, a stratified sample of courses at City, Mesa, and Miramar colleges in the San Diego Community College District (California) were surveyed as part of a skills assessment research project. For classes into which students were placed on the basis of assessment test scores (in English writing and reading, and mathematics), student…

Exploring Equity Properties in Equating Using AP® Examinations. Research Report No. 2012-4

ERIC Educational Resources Information Center

Lee, Eunjung; Lee, Won-Chan; Brennan, Robert L.

2012-01-01

In almost all high-stakes testing programs, test equating is necessary to ensure that test scores across multiple test administrations are equivalent and can be used interchangeably. Test equating becomes even more challenging in mixed-format tests, such as Advanced Placement Program® (AP®) Exams, that contain both multiple-choice and constructed…

The Association Between Premedical Curricular and Admission Requirements and Medical School Performance and Residency Placement: A Study of Two Admission Routes at The Warren Alpert Medical School of Brown University

PubMed Central

George, Paul; Park, Yoon Soo; Ip, Julianne; Gruppuso, Philip A.; Adashi, Eli Y.

2015-01-01

Purpose The curricular elements of undergraduate premedical education are the subject of an ongoing debate. The Warren Alpert Medical School of Brown University (AMS) matriculates students via the traditional premedical route (TPM) and an eight-year baccalaureate/MD program—the Program in Liberal Medical Education (PLME)—which provides students with a broad and liberal education. Using the juxtaposition of these two admission routes, the authors aimed to determine whether there is an association between highly distinct premedical curricular and admission requirements and medical school performance and residency placement. Method The cohorts studied included all of the PLME (n = 295) and TPM (n = 215) students who graduated from the AMS between 2010 and 2015. Outcome variables consisted of multiple measures of medical school performance, including standardized multiple-choice examination scores and honors grades, and residency placement. The authors employed unadjusted tests of averages and proportions (independent t tests and chi-squared tests) to compare variables. Results The TPM students attained marginally, but statistically significantly, higher average scores on standardized multiple-choice examinations than their PLME counterparts. The number of undergraduate premedical science courses completed by PLME students accounted for less than 4% of the variance in key metrics of medical school performance. The residency placement record of the PLME and TPM cohorts proved comparable. Conclusions These findings suggest that the association between medical school performance and residency placement and undergraduate premedical curricular and admission requirements is weak. Further study is needed to determine the optimal premedical preparation of students. PMID:26422591

Assessing Student Preparation through Placement Tests

NASA Astrophysics Data System (ADS)

McFate, Craig; Olmsted, John, III

1999-04-01

The chemistry department at California State University, Fullerton, uses a placement test of its own design to assess student readiness to enroll in General Chemistry. This test contains items designed to test cognitive skills more than factual knowledge. We have analyzed the ability of this test to predict student success (defined as passing the first-semester course with a C or better) using data for 845 students from four consecutive semesters. In common with other placement tests, we find a weak but statistically significant correlation between test performance and course grades. More meaningfully, there is a strong correlation (R2 = 0.82) between test score and course success, sufficient to use for counseling purposes. An item analysis was conducted to determine what types of questions provide the best predictability. Six questions from the full set of 25 were identified as strong predictors, on the basis of discrimination indices and coefficients of determination that were more than one standard deviation above the mean values for test items. These questions had little in common except for requiring multistep mathematical operations and formal reasoning.

Effect of different mixing and placement methods on the quality of MTA apical plug in simulated apexification model.

PubMed

Ghasemi, Negin; Janani, Maryam; Razi, Tahmineh; Atharmoghaddam, Faezeh

2017-03-01

It is necessary apical plug material to exhibit proper adaptation with the root canal walls. Presence of voids at the interface between the root canal wall and this material result in micro leakage, which might have a relationship with post treatment disease. The aim of the present study was to evaluate the effect of different mixing (manual and ultrasonic) and placement (manual and manual in association with indirect ultrasonic) method of Mineral Trioxide Aggregate (MTA) on the void count and dimension in the apical plug in natural teeth with simulated open apices. Eighty human maxillary central incisors were selected. After simulation of the open apex model, the teeth were assigned to 4 groups based on the mixing and placement techniques of MTA: group 1, manual mixing and manual placement; group 2, manual mixing and manual placement in association with indirect ultrasonic; group 3, ultrasonic mixing and and manual placement; and group 4, ultrasonic mixing and manual placement in association with indirect ultrasonic. The prepared samples were placed within gypsum sockets in which the periodontal ligament was reconstructed with polyether impression material. In group 1, after mixing, the material was condensed with a hand plugger. In group 2, after mixing, the ultrasonic tip was contacted with the hand plugger for 2 seconds. In groups 3 and 4, mixing was carried out with the ultrasonic tip for 5 seconds and in groups 3 and 4, similar to groups 1 and 2, respectively, the materials were placed as apical plugs, measuring 3 mm in length. A wet cotton pellet was placed at canal orifices and dressed with Cavit. After one week, the cone beam computed tomography (CBCT) technique was used to count the number of voids between the material and root canal walls. The void dimensions were determined using the following scoring system: score 1, absence of voids; score 2, the void size less than half of the dimensions of the evaluated cross-section; score 3, the void size larger than half of the dimensions of the evaluated cross-section. Chi-squared and Fisher's exact tests were used for statistical analyses. Statistical significance was set at P <0.05. The maximum (13) and minimum (3) number of voids were detected in groups 2 and 3, respectively. There were no significant differences between groups 1 and 3 in the number of voids ( p >0.05). Evaluation of void dimensions showed no score 3 in any of the study groups and the dimensions of all the voids conformed to score 2. Under the limitations of the present study, use of ultrasonic mixing and manual placement techniques resulted in a decrease in the number of voids in the apical plug. Key words: Apical plug, MTA, ultrasonic, void.

Does the Test Work? Evaluating a Web-Based Language Placement Test

ERIC Educational Resources Information Center

Long, Avizia Y.; Shin, Sun-Young; Geeslin, Kimberly; Willis, Erik W.

2018-01-01

In response to the need for examples of test validation from which everyday language programs can benefit, this paper reports on a study that used Bachman's (2005) assessment use argument (AUA) framework to examine evidence to support claims made about the intended interpretations and uses of scores based on a new web-based Spanish language…

A model-based reasoning approach to sensor placement for monitorability

NASA Technical Reports Server (NTRS)

Chien, Steve; Doyle, Richard; Homemdemello, Luiz

1992-01-01

An approach is presented to evaluating sensor placements to maximize monitorability of the target system while minimizing the number of sensors. The approach uses a model of the monitored system to score potential sensor placements on the basis of four monitorability criteria. The scores can then be analyzed to produce a recommended sensor set. An example from our NASA application domain is used to illustrate our model-based approach to sensor placement.

Standard and modified administrations of the Iowa Tests of Basic Skills with learning disabled students.

PubMed

Estes, R E; Baum, D L; Bray, N M

1986-04-01

The purpose of this study was to investigate the performance of junior high school learning disabled students on standard and modified administrations of selected subtests from the Iowa Tests of Basic Skills. No significant differences were noted for correlations between types of administration and teachers' ratings on any of the subtest comparisons. Grade placements for Vocabulary and Reading Comprehension using the modified administration were significantly higher than those using the standard administration and more closely aligned with teachers' ratings. Math Concept and Math Problem-solving grade-placement scores did not differ by type of administration; teachers' ratings were higher than those produced by either testing format.

The Validity of College Grade Prediction Equations Over Time.

ERIC Educational Resources Information Center

Sawyer, Richard L.; Maxey, James

A sample of 260 colleges was surveyed during the years 1972-1976 to determine the validity of predicting college freshmen grades from standardized test scores and high school grades using the American College Testing (ACT) Assessment Program, an evaluative and placement service for students and educators involved in the transition from high school…

Statewide Mandatory Remediation Policies: National, State, and Institutional Perspectives

ERIC Educational Resources Information Center

Peak, Charity S.

2012-01-01

Despite uncertainty related to student outcomes resulting from remediation (Bettinger & Long, 2009), eleven states mandate remedial education through common placement testing and standardized cutoff scores rather than permitting individual postsecondary institutions to establish remediation guidelines. Colorado, in particular, offers an…

Validating the Use of AP® Exam Scores for College Course Placement. Research Report 2013-2

ERIC Educational Resources Information Center

Patterson, Brian F.; Ewing, Maureen

2013-01-01

The Advanced Placement Program® (AP®) was created to provide access to rigorous, college-level curricula to motivated and prepared high school students. This study evaluated whether the AP Exam scores from the summative exams associated with 10 courses were valid for the placement of students into higher-level college courses in the subject area…

Relationship between out-of-home care placement history characteristics and educational achievement: A population level linked data study.

PubMed

Maclean, Miriam J; Taylor, Catherine L; O'Donnell, Melissa

2017-08-01

Studies generally show children who have entered out-of-home care have worse educational outcomes than the general population, although recent research suggests maltreatment and other adversities are major contributing factors. Children's out-of-home care experiences vary and may affect their outcomes. This study examined the influence of placement stability, reunification, type of care, time in care and age at entry to care on children's educational outcomes. We conducted a population-based record-linkage study of children born in Western Australia between 1990 and 2010 who sat State or national Year 3 reading achievement tests (N=235,045 children, including 2160 children with a history of out-of-home care). Children's educational outcomes varied with many aspects of their care experience. Children placed in residential care were particularly likely to have low scores, with an unadjusted OR 6.81, 95% CI[4.94, 9.39] for low reading scores, which was partially attenuated after adjusting for background risk factors but remained significant (OR=1.50, 95% CIs [1.08, 2.08]). Reading scores were also lower for children who had experienced changes in care arrangements in the year of the test. A dose-response effect for multiple placements was expected but not found. Older age at entering care was also associated with worse reading scores. Different characteristics of a child's care history were interwoven with each other as well as child, family and neighbourhood characteristics, highlighting a need for caution in attributing causality. Although the level of educational difficulties varied, the findings suggest a widespread need for additional educational support for children who have entered care, including after reunification. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of the Florida College and Career Readiness Initiative: Year 2 Report

ERIC Educational Resources Information Center

Mokher, Christine; Jacobson, Lou

2014-01-01

The Florida College and Career Readiness Initiative is a statewide policy that mandates college placement testing of 11th-graders who meet high school graduation criteria but are unlikely to meet college readiness criteria. Students who score below college-ready on the Postsecondary Education Readiness Test (PERT) are required to take math and…

Concurrent Validity of the Woodcock-Johnson Tests of Cognitive Ability with the WISC-R: EMR Children.

ERIC Educational Resources Information Center

Cummings, Jack A.; Sanville, David

1983-01-01

Administered the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Woodcock-Johnson Tests of Cognitive Ability (WJTCA) to educable mentally retarded children (N=30). Results showed significant mean differences between WISC-R and WJTCA full-scale standard scores, providing implications for placement of children in classes for the…

The Flynn effect and U.S. policies: the impact of rising IQ scores on American society via mental retardation diagnoses.

PubMed

Kanaya, Tomoe; Scullin, Matthew H; Ceci, Stephen J

2003-10-01

Over the last century, IQ scores have been steadily rising, a phenomenon dubbed the Flynn effect. Because of the Flynn effect, IQ tests are periodically renormed, making them harder. Given that eligibility for mental retardation (MR) services relies heavily on IQ scores, renormed tests could have a significant impact on MR placements. In longitudinal IQ records from 9 sites around the country, students in the borderline and mild MR range lost an average of 5.6 points when retested on a renormed test and were more likely to be classified MR compared with peers retested on the same test. The magnitude of the effect is large and affects national policies on education, social security, the death penalty, and the military. This paper reports the perceptions of professionals as they relate to IQ score fluctuations in normal, borderline, and/or MR populations.

Nursing students' perceptions of their clinical learning environment in placements outside traditional hospital settings.

PubMed

Bjørk, Ida T; Berntsen, Karin; Brynildsen, Grethe; Hestetun, Margrete

2014-10-01

To explore students' opinions of the learning environment during clinical placement in settings outside traditional hospital settings. Clinical placement experiences may influence positively on nursing students attitudes towards the clinical setting in question. Most studies exploring the quality of clinical placements have targeted students' experience in hospital settings. The number of studies exploring students' experiences of the learning environment in healthcare settings outside of the hospital venue does not match the growing importance of such settings in the delivery of health care, nor the growing number of nurses needed in these venues. A survey design was used. The Clinical Learning Environment Inventory was administered to two cohorts of undergraduate nursing students (n = 184) after clinical placement in mental health care, home care and nursing home care. Nursing students' overall contentment with the learning environment was quite similar across all three placement areas. Students in mental health care had significantly higher scores on the subscale individualisation, and older students had significantly higher scores on the total scale. Compared with other studies where the Clinical Learning Environment Inventory has been used, the students' total scores in this study are similar or higher than scores in studies including students from hospital settings. Results from this study negate the negative views on clinical placements outside the hospital setting, especially those related to placements in nursing homes and mental healthcare settings. Students' experience of the learning environment during placements in mental health care, home care and nursing homes indicates the relevance of clinical education in settings outside the hospital setting. © 2014 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

Nursing students' perceptions of their clinical learning environment in placements outside traditional hospital settings

PubMed Central

Bjørk, Ida T; Berntsen, Karin; Brynildsen, Grethe; Hestetun, Margrete

2014-01-01

Aims and objectives To explore students' opinions of the learning environment during clinical placement in settings outside traditional hospital settings. Background Clinical placement experiences may influence positively on nursing students attitudes towards the clinical setting in question. Most studies exploring the quality of clinical placements have targeted students' experience in hospital settings. The number of studies exploring students' experiences of the learning environment in healthcare settings outside of the hospital venue does not match the growing importance of such settings in the delivery of health care, nor the growing number of nurses needed in these venues. Design A survey design was used. Method The Clinical Learning Environment Inventory was administered to two cohorts of undergraduate nursing students (n = 184) after clinical placement in mental health care, home care and nursing home care. Results Nursing students' overall contentment with the learning environment was quite similar across all three placement areas. Students in mental health care had significantly higher scores on the subscale individualisation, and older students had significantly higher scores on the total scale. Compared with other studies where the Clinical Learning Environment Inventory has been used, the students' total scores in this study are similar or higher than scores in studies including students from hospital settings. Conclusion Results from this study negate the negative views on clinical placements outside the hospital setting, especially those related to placements in nursing homes and mental healthcare settings. Relevance to clinical practice Students' experience of the learning environment during placements in mental health care, home care and nursing homes indicates the relevance of clinical education in settings outside the hospital setting. PMID:24460862

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?

Stakeholders' Beliefs about the "TOEFL iBT"® Test as a Measure of Academic Language Ability. "TOEFL iBT"® Research Report. TOEFL iBT-22. ETS Research Report. RR-14-42

ERIC Educational Resources Information Center

Malone, Margaret E.; Montee, Megan

2014-01-01

The "TOEFL iBT"® test presents test takers with tasks meant to simulate the tasks required of students in English-medium universities. Research establishing the validity argument for the test provides evidence for score interpretation and the use of the test for university admissions and placement. Now that the test has been operational…

Percutaneous spinal fixation simulation with virtual reality and haptics.

PubMed

Luciano, Cristian J; Banerjee, P Pat; Sorenson, Jeffery M; Foley, Kevin T; Ansari, Sameer A; Rizzi, Silvio; Germanwala, Anand V; Kranzler, Leonard; Chittiboina, Prashant; Roitberg, Ben Z

2013-01-01

In this study, we evaluated the use of a part-task simulator with 3-dimensional and haptic feedback as a training tool for percutaneous spinal needle placement. To evaluate the learning effectiveness in terms of entry point/target point accuracy of percutaneous spinal needle placement on a high-performance augmented-reality and haptic technology workstation with the ability to control the duration of computer-simulated fluoroscopic exposure, thereby simulating an actual situation. Sixty-three fellows and residents performed needle placement on the simulator. A virtual needle was percutaneously inserted into a virtual patient's thoracic spine derived from an actual patient computed tomography data set. Ten of 126 needle placement attempts by 63 participants ended in failure for a failure rate of 7.93%. From all 126 needle insertions, the average error (15.69 vs 13.91), average fluoroscopy exposure (4.6 vs 3.92), and average individual performance score (32.39 vs 30.71) improved from the first to the second attempt. Performance accuracy yielded P = .04 from a 2-sample t test in which the rejected null hypothesis assumes no improvement in performance accuracy from the first to second attempt in the test session. The experiments showed evidence (P = .04) of performance accuracy improvement from the first to the second percutaneous needle placement attempt. This result, combined with previous learning retention and/or face validity results of using the simulator for open thoracic pedicle screw placement and ventriculostomy catheter placement, supports the efficacy of augmented reality and haptics simulation as a learning tool.

Ketorolac for Pain Control With Intrauterine Device Placement: A Randomized Controlled Trial

PubMed Central

Ngo, Lynn L.; Ward, Kristy K.; Mody, Sheila K.

2015-01-01

Objective To evaluate intramuscular ketorolac compared to placebo saline injection for pain control with intrauterine device (IUD) placement. Methods We conducted a randomized, double-blind, placebo controlled trial between July 2012 and March 2014. Patients received ketorolac 30mg or placebo saline intramuscular injection 30 minutes prior to IUD placement. The primary outcome was pain with IUD placement on a 10cm visual analog scale (VAS). Sample size was calculated to provide 80% power to show a 2.0cm difference (α=0.05) in the primary outcome. Secondary outcomes included pain with study drug injection, speculum insertion, tenaculum placement, uterine sounding, and at 5 and 15 minutes after IUD placement. Results A total of 67 women participated in the study, 33 in the ketorolac arm and 34 in the placebo arm. There were no differences in baseline demographics including age, BMI, and race. There were no differences in median pain scores for IUD placement in the placebo versus ketorolac groups (5.2cm vs 3.6cm, p=0.99). There was a decrease in median pain scores at 5 minutes (2.2cm vs 0.3cm, p=<0.001) and 15 minutes (1.6cm vs 0.1cm, p=<0.001) after IUD placement but no difference for all other time points. Nulliparous participants (n=16, 8 per arm) had a decrease in pain scores with IUD placement (8.1cm vs 5.4cm, p=0.02). In this study, 22% of participants in the placebo group and 18% in the ketorolac group reported injection pain was as painful as IUD placement. Conclusions Ketorolac does not reduce pain with IUD placement but does reduce pain at 5 and 15 minutes after placement. PMID:26241253

Ketorolac for Pain Control With Intrauterine Device Placement: A Randomized Controlled Trial.

PubMed

Ngo, Lynn L; Ward, Kristy K; Mody, Sheila K

2015-07-01

To evaluate intramuscular ketorolac compared with placebo saline injection for pain control with intrauterine device (IUD) placement. We conducted a randomized, double-blind, placebo-controlled trial between July 2012 and March 2014. Patients received 30 mg ketorolac or placebo saline intramuscular injection 30 minutes before IUD placement. The primary outcome was pain with IUD placement on a 10-cm visual analog scale. Sample size was calculated to provide 80% power to show a 2.0-cm difference (α=0.05) in the primary outcome. Secondary outcomes included pain with study drug injection, speculum insertion, tenaculum placement, uterine sounding, and at 5 and 15 minutes after IUD placement. A total of 67 women participated in the study, 33 in the ketorolac arm and 34 in the placebo arm. There were no differences in baseline demographics including age, body mass index, and race. There were no differences in median pain scores for IUD placement in the placebo compared with ketorolac groups (5.2 compared with 3.6 cm, P=.99). There was a decrease in median pain scores at 5 minutes (2.2 compared with 0.3 cm, P≤.001) and 15 minutes (1.6 compared with 0.1 cm, P≤.001) after IUD placement but no difference for all other time points. Nulliparous participants (n=16, eight per arm) had a decrease in pain scores with IUD placement (8.1 compared with 5.4 cm, P=.02). In this study, 22% of participants in the placebo group and 18% in the ketorolac group reported injection pain was as painful as IUD placement. Ketorolac does not reduce pain with IUD placement but does reduce pain at 5 and 15 minutes after placement. ClinicalTrials.gov; www.clinicaltrials.gov, NCT01664559. I.

An Investigation of the Longitudinal Validity of WISC and Bender Scores for Primary School Special Education Students.

ERIC Educational Resources Information Center

Froman, Robin D.; Owen, Steven V.

The long term predictive validity of the Wechsler Intelligence Scale for Children (WISC) and the Bender Visual Motor Gestalt Test for Children, when used for the educational placement of exceptional students, was investigated. In 1971, 225 learning disabled elementary school students were tested on the WISC and the Bender. The students were…

Does Prior Knowledge Affect College Students' Performance on a State Developed Reading Competency Test?

ERIC Educational Resources Information Center

Feeley, Joan T.; Wepner, Shelley B.

Using 33 college freshmen enrolled in a basic reading skills course as subjects, a study was conducted for two purposes: (1) to determine the effects of direct exposure to the topics of the selections in the New Jersey College Basic Skills Placement Test (NJCBSPT) on their posttest scores, and (2) to investigate whether students exposed to the…

What Happened to the "Superior Abilities" in Adults with Dyslexia and High IQs? A Behavioral and Neurological Illustration

ERIC Educational Resources Information Center

Gilger, Jeffrey W.; Olulade, Olumide A.

2013-01-01

Observable behavior, such as test scores, is the gold standard by which we make judgments about levels of function, grade placements, and the presence/absence of pathology. Individual differences in test performance have long intrigued researchers and clinicians, and some have noted how people can come up with essentially the same answers using…

The Frog Pond Revisited: High School Academic Context, Class Rank, and Elite College Admission

ERIC Educational Resources Information Center

Espenshade, Thomas J.; Hale, Lauren E.; Chung, Chang Y.

2005-01-01

In this article, the authors test a "frog-pond" model of elite college admission proposed by Attewell, operationalizing high school academic context as the secondary school-average SAT score and number of Advanced Placement tests per high school senior. Data on more than 45,000 applications to three elite universities show that a high…

Does High School Performance Predict College Math Placement?

ERIC Educational Resources Information Center

Kowski, Lynne E.

2013-01-01

Predicting student success has long been a question of interest for postsecondary admission counselors throughout the United States. Past research has examined the validity of several methods designed for predicting undergraduate success. High school record, standardized test scores, extracurricular activities, and combinations of all three have…

Statistical Summary of Missouri Higher Education, 1999-2000.

ERIC Educational Resources Information Center

Missouri State Coordinating Board for Higher Education, Jefferson City.

This report provides a statistical summary of higher education in Missouri for the 1999-2000 academic year. More than 74 tables provide data on: advanced placement enrollment in secondary schools, American College Testing program scores by institutional sector, high school rankings by institutional sector, the Missouri Coordinating Board for…

Validating Automated Essay Scoring for Online Writing Placement

ERIC Educational Resources Information Center

Ramineni, Chaitanya

2013-01-01

In this paper, I describe the design and evaluation of automated essay scoring (AES) models for an institution's writing placement program. Information was gathered on admitted student writing performance at a science and technology research university in the northeastern United States. Under timed conditions, first-year students (N = 879) were…

Assessing the writing of deaf college students: reevaluating a direct assessment of writing.

PubMed

Schley, Sara; Albertini, John

2005-01-01

The NTID Writing Test was developed to assess the writing ability of postsecondary deaf students entering the National Technical Institute for the Deaf and to determine their appropriate placement into developmental writing courses. While previous research (Albertini et al., 1986; Albertini et al., 1996; Bochner, Albertini, Samar, & Metz, 1992) has shown the test to be reliable between multiple test raters and as a valid measure of writing ability for placement into these courses, changes in curriculum and the rater pool necessitated a new look at interrater reliability and concurrent validity. We evaluated the rating scores for 236 samples from students who entered the college during the fall 2001. Using a multiprong approach, we confirmed the interrater reliability and the validity of this direct measure of assessment. The implications of continued use of this and similar tests in light of definitions of validity, local control, and the nature of writing are discussed.

Medical school clinical placements - the optimal method for assessing the clinical educational environment from a graduate entry perspective.

PubMed

Hyde, Sarah; Hannigan, Ailish; Dornan, Tim; McGrath, Deirdre

2018-01-05

Educational environment is a strong determinant of student satisfaction and achievement. The learning environments of medical students on clinical placements are busy workplaces, composed of many variables. There is no universally accepted method of evaluating the clinical learning environment, nor is there consensus on what concepts or aspects should be measured. The aims of this study were to compare the Dundee ready educational environment measure (DREEM - the current de facto standard) and the more recently developed Manchester clinical placement index (MCPI) for the assessment of the clinical learning environment in a graduate entry medical student cohort by correlating the scores of each and analysing free text comments. This study also explored student perceptionof how the clinical educational environment is assessed. An online, anonymous survey comprising of both the DREEM and MCPI instruments was delivered to students on clinical placement in a graduate entry medical school. Additional questions explored students' perceptions of instruments for giving feedback. Numeric variables (DREEM score, MCPI score, ratings) were tested for normality and summarised. Pearson's correlation coefficient was used to measure the strength of the association between total DREEM score and total MCPI scores. Thematic analysis was used to analyse the free text comments. The overall response rate to the questionnaire was 67% (n = 180), with a completed response rate for the MCPI of 60% (n = 161) and for the DREEM of 58% (n = 154). There was a strong, positive correlation between total DREEM and MCPI scores (r = 0.71, p < 0.001). On a scale of 0 to 7, the mean rating for how worthwhile students found completing the DREEM was 3.27 (SD 1.41) and for the MCPI was 3.49 (SD 1.57). 'Finding balance' and 'learning at work' were among the themes to emerge from analysis of free text comments. The present study confirms that DREEM and MCPI total scores are strongly correlated. Graduate entry students tended to favour this method of evaluation over the DREEM with the MCPI prompting rich description of the clinical learning environment. Further study is warranted to determine if this finding is transferable to all clinical medical student cohorts.

Learning curve of hysteroscopic placement of tubal sterilization microinserts in 15 gynecologists in the Netherlands.

PubMed

Janse, Juliënne A; Pattij, Thyrza O S; Eijkemans, Marinus J C; Broekmans, Frank J; Veersema, Sebastiaan; Schreuder, Henk W R

2013-09-01

To evaluate the learning curve of hysteroscopic placement of tubal sterilization microinserts by gynecologists in the Netherlands. Prospective multicenter study (Canadian Task Force II-2). Ten community (teaching) hospitals in the Netherlands. A total of 631 women who underwent permanent sterilization by tubal microinserts. Hysteroscopic placement of tubal sterilization microinserts performed by 15 gynecologists experienced in performing operative hysteroscopy, starting from their very first placement. Effect of increasing experience in time on procedure time, pain score, successful bilateral placement, and complications. Bilateral successful placement with confirmation of adequate positioning at follow-up evaluation was achieved in 480 (76.1%) patients at first attempt and in 44 (7.0%) at second attempt. Median procedure time was 8.0 minutes (range: 3-40), and 31 (4.9%) patients were lost to follow-up evaluation. Gravidity showed to be a confounding factor and was consequently adjusted for. A learning curve was seen in a statistically significant decrease of procedure time with increasing experience. The decrease in procedure time extended to 11 to 15 cases and was followed by a plateau phase of the subsequent 60 cases. In contrast, pain scores, successful placement, and complication rate appeared not to improve with increasing experience. A learning curve for hysteroscopic tubal sterilization was seen for procedure time, but successful placement, pain score, and complication rate were not clearly influenced by increasing experience. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Mathematics Boot Camps: A Strategy for Helping Students to Bypass Remedial Courses

NASA Astrophysics Data System (ADS)

Hamilton, Marilyn A. L.

Many community colleges struggle to find the best strategy to help incoming at-risk students prepare for the placement test. The purpose of this quantitative quasi-experimental study, was to answer the question as to which of 2 programs, a 2-week, face-to-face mathematics refresher program, Math Boost-Up, or an online-only program, might increase the ACCUPLACER posttest scores of incoming community college students. The study used archival data for 136 students who self-selected to either participate in the Math Boost-Up program (the experiment group), or in the online-only program (the comparison group). Knowles's theory of adult learning, andragogy, served as the theoretical framework. Spearman, Kruskal-Wallis, Mann-Whitney, and chi-square tests were used to measure the effect of 4 moderator variables (age, high school GPA, number of minutes spent in MyFoundationsLab, and number of days spent in face-to-face sessions) on the pre- and posttest scores of students in each group. The results indicated that students in the Math Boost-Up program experienced statistically significant gains in arithmetic and elementary algebra than did those students in the online-only program. The results also indicated that the 4 moderator variables affected gains in posttest scores. Additionally, the results disproved the andragogical premise that students would be self-directed and would self-select to participate in the intervention. A recommendation was that participation in the face-to-face refresher program should be mandatory. The study contributes to social change by providing evidence that short-term refresher programs could increase the scores of students on placement tests.

Questioning the Use of Outcome Measures to Evaluate Principal Preparation Programs

ERIC Educational Resources Information Center

Fuller, Ed; Hollingworth, Liz

2018-01-01

Policymakers are proposing the use of outcome measures as indicators of effective principal preparation programs. The three most common metrics recommended are: (1) graduates' effectiveness in improving student achievement test scores, (2) graduate job placement rates, and (3) principal job retention once employed. This article explores the use of…

What's Wrong with Architecture?

ERIC Educational Resources Information Center

Gorrell, Donna

A study examined factors related to the high failure rate of architectural students at the University of Wisconsin-Milwaukee on an essay writing task designed to show proficiency in writing before gaining junior standing. Students become eligible to write the essay by getting a score of 65 or better on the Wisconsin English Placement Test (WEPT)…

Do Work Placements Improve Final Year Academic Performance or Do High-Calibre Students Choose to Do Work Placements?

ERIC Educational Resources Information Center

Jones, C. M.; Green, J. P.; Higson, H. E.

2017-01-01

This study investigates whether the completion of an optional sandwich work placement enhances student performance in final year examinations. Using Propensity Score Matching, our analysis departs from the literature by controlling for self-selection. Previous studies may have overestimated the impact of sandwich work placements on performance…

The difference in learning culture and learning performance between a traditional clinical placement, a dedicated education unit and work-based learning.

PubMed

Claeys, Maureen; Deplaecie, Monique; Vanderplancke, Tine; Delbaere, Ilse; Myny, Dries; Beeckman, Dimitri; Verhaeghe, Sofie

2015-09-01

An experiment was carried out on the bachelor's degree course in nursing with two new clinical placement concepts: workplace learning and the dedicated education centre. The aim was to establish a learning culture that creates a sufficiently high learning performance for students. The objectives of this study are threefold: (1) to look for a difference in the "learning culture" and "learning performance" in traditional clinical placement departments and the new clinical placement concepts, the "dedicated education centre" and "workplace learning"; (2) to assess factors influencing the learning culture and learning performance; and (3) to investigate whether there is a link between the learning culture and the learning performance. A non-randomised control study was carried out. The experimental group consisted of 33 final-year nursing undergraduates who were following clinical placements at dedicated education centres and 70 nursing undergraduates who undertook workplace learning. The control group consisted of 106 students who followed a traditional clinical placement. The "learning culture" outcome was measured using the Clinical Learning Environment, Supervision and Nurse Teacher scale. The "learning performance" outcome consisting of three competencies was measured using the Nursing Competence Questionnaire. The traditional clinical placement concept achieved the highest score for learning culture (p<0.001). The new concepts scored higher for learning performance of which the dedicated education centres achieved the highest scores. The 3 clinical placement concepts showed marked differences in learning performance for the "assessment" competency (p<0.05) and for the "interventions" competency (p<0.05). Traditional clinical placement, a dedicated education centre and workplace learning can be seen as complementary clinical placement concepts. The organisation of clinical placements under the dedicated education centre concept and workplace learning is recommended for final-year undergraduate nursing students. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact of Online Summer Mathematics Bridge Program on Placement Scores and Pass Rates

ERIC Educational Resources Information Center

Frost, Jodi L.; Dreher, J. P.

2017-01-01

An online four-week summer mathematics bridge program was implemented at a Midwest university with historically low pass rates in College Algebra and Remedial Mathematics. Students who completed the four week program significantly increased their mathematics placement exam scores. These students also had a higher pass rate in their initial college…

Tubeless percutaneous nephrolithotomy with non-absorbable hemostatic sealant (Quikclot®) versus nephrostomy tube placement: a propensity score-matched analysis.

PubMed

Koo, Kyo Chul; Park, Sang Un; Jang, Ho Sung; Hong, Chang-Hee

2015-11-01

The purpose of this study was to determine the efficacy and safety of tubeless percutaneous nephrolithotomy (PNL) using a non-absorbable hemostatic sealant (Quikclot(®)) as an adjunct compared to nephrostomy tube placement in patients exhibiting significant parenchymal bleeding following PNL. We identified 113 PNL cases performed between May 2011 and October 2014. For patients with insignificant parenchymal bleeding following stone removal, defined as a clear visualization of the surgical field at full irrigation of the nephroscope, tubeless PNL was performed. For patients with significant parenchymal bleeding, we introduced the tubeless Quikclot(®) technique as of September 2013 and have performed it ever since. Formerly, nephrostomy placement PNL was performed. In this study, 40 Quikclot(®) applied PNL cases were matched with an equal number of nephrostomy placement cases by propensity scoring based on body mass index, stone size, and Guy's stone score. The mean postoperative drop in hematocrit was comparative between the Quikclot(®) group and the nephrostomy group on both postoperative days 1 (p = 0.459) and 2 (p = 0.325). Quikclot(®) application was associated with lower VAS scores throughout the postoperative period, lower cumulative analgesic requirement (p = 0.025), and with shorter hospitalization (p = 0.002). Complication rates were comparable with no need for blood transfusions in any patients. Tubeless Quikclot(®) PNL was safe and provided effective hemostasis of significant parenchymal bleeding. By avoiding nephrostomy placement, we were able to reduce postoperative pain, analgesic requirements, and hospitalization. Application of Quikclot(®) may be considered prior to nephrostomy placement in patients with significant parenchymal bleeding.

Strategies Employed by Iranian EFL Freshman University Students in Extensive Listening: A Qualitative Research

ERIC Educational Resources Information Center

Bidabadi, Farinaz Shirani; Yamat, Hamidah

2014-01-01

This paper discusses the findings of a qualitative study on the strategies employed by Iranian freshmen in extensive listening. A group of 12 freshman university students were purposefully selected based on their scores in the Oxford Placement Test administered. Four learners were identified as advanced, four as intermediate, and four as lower…

A Compensatory Approach to Optimal Selection with Mastery Scores. Research Report 94-2.

ERIC Educational Resources Information Center

van der Linden, Wim J.; Vos, Hans J.

This paper presents some Bayesian theories of simultaneous optimization of decision rules for test-based decisions. Simultaneous decision making arises when an institution has to make a series of selection, placement, or mastery decisions with respect to subjects from a population. An obvious example is the use of individualized instruction in…

Advanced Coursework Rates by Ethnicity: An 11-Year, Statewide Analysis

ERIC Educational Resources Information Center

Fowler, Janis C.

2013-01-01

Purpose: The purpose of this study was to examine advanced coursework completion rates, Advanced Placement (AP)/International Baccalaureate (IB) testing rates, AP/IB exam passage rates, and the percentage of AP/IB exam scores at or above the criterion that may exist among Texas public high school students from 2001 to 2012 to ascertain (a) the…

Pharmacodynamics of transdermal granisetron in women with nausea and vomiting of pregnancy.

PubMed

Caritis, Steve; Zhao, Yang; Chen, Hui-Jun; Venkataramanan, Raman

2016-07-01

Limited options exist for women with nausea and vomiting of pregnancy (NVP) who cannot tolerate oral intake. Transdermal delivery of granisetron, a 5-hydroxytryptamine-3 receptor antagonist, provides an effective alternative for such patients. The objective of this study was to evaluate the pharmacodynamics of granisetron administered intravenously (IV) and as a sustained release transdermal patch in women with NVP. We recruited 16 women with singleton gestation between 12 0/7-18 6/7 weeks who were receiving treatment for NVP and had a Pregnancy Unique Quantification of Emesis and Nausea (PUQE) score of ≥6. All consenting subjects received 1 mg of granisetron as an IV infusion over 5 minutes and blood was obtained prior to the infusion and at 10, 20, 30, and 60 minutes and at 2, 4, 6, 8, 12, and 24 hours after the start of the infusion. After a minimum washout of 48 hours after initiation of IV granisetron, a 52-cm(2) granisetron patch (34.3 mg) was placed on the upper arm of all subjects for 7 days. Blood was drawn prior to patch placement and daily thereafter for 9 days. The subjects were evaluated daily. The PUQE score was obtained from these subjects prior to the IV infusion and daily for 2 days after and again prior to and daily for 9 days after patch placement. Complete data were available in 15 women after IV administration and 13 women after patch placement. One woman stopped participation during the IV infusion while data were not available in 2 additional women after patch placement due to noncompliance. Peak plasma granisetron concentrations after IV and transdermal administration were similar (∼10 ng/mL). Prior to IV administration of granisetron, the PUQE score was 8.6 ± 1.8 (mean ± SD). The PUQE scores were significantly reduced for the ensuing 2 days (P < .01). The PUQE score prior to patch placement was 7.6 ± 2.4. Scores were significantly (P < .001) reduced within 1 day of patch placement and stayed significantly reduced during the ensuing 6 days of patch placement. The patch was removed on the seventh day and PUQE scores increased significantly on the third day after patch removal. No serious side effects were reported either during IV administration or patch placement. Granisetron significantly improved symptoms of nausea and vomiting as gauged by the PUQE score. After IV infusion the reduction in PUQE score was observed within 1 day. When granisetron was administered as a patch, benefit likewise was seen within 1 day suggesting rapid absorption of the medication transdermally. The beneficial effect of transdermal granisetron on the PUQE score persisted for the entire 7 days during which the patch was in place. In this small cohort, the granisetron patch appeared to be efficacious in reducing the symptoms of nausea and vomiting. The patch provides another option for treating this disorder and may be particularly useful in women who cannot tolerate oral medications. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of posterior crown margin placement on gingival health.

PubMed

Reitemeier, Bernd; Hänsel, Kristina; Walter, Michael H; Kastner, Christian; Toutenburg, Helge

2002-02-01

The clinical impact of posterior crown margin placement on gingival health has not been thoroughly quantified. This study evaluated the effect of posterior crown margin placement with multivariate analysis. Ten general dentists reviewed 240 patients with 480 metal-ceramic crowns in a prospective clinical trial. The alloy was randomly selected from 2 high gold, 1 low gold, and 1 palladium alloy. Variables were the alloy used, oral hygiene index score before treatment, location of crown margins at baseline, and plaque index and sulcus bleeding index scores recorded for restored and control teeth after 1 year. The effect of crown margin placement on sulcular bleeding and plaque accumulation was analyzed with regression models (P<.05). The probability of plaque at 1 year increased with increasing oral hygiene index score before treatment. The lingual surfaces demonstrated the highest probability of plaque. The risk of bleeding at intrasulcular posterior crown margins was approximately twice that at supragingival margins. Poor oral hygiene before treatment and plaque also were associated with sulcular bleeding. Facial sites exhibited a lower probability of sulcular bleeding than lingual surfaces. Type of alloy did not influence sulcular bleeding. In this study, placement of crown margins was one of several parameters that affected gingival health.

Foot placement control and gait instability among people with stroke

PubMed Central

Dean, Jesse C.; Kautz, Steven A.

2016-01-01

Gait instability is a common problem following stroke, as evidenced by increases in fall risk and fear of falling. However, the mechanism underlying gait instability is currently unclear. We recently found that young, healthy humans use a consistent gait stabilization strategy of actively controlling their mediolateral foot placement based on the concurrent mechanical state of the stance limb. In the present work, we tested whether people with stroke (n = 16) and age-matched controls (n = 19) used this neuromechanical strategy. Specifically, we used multiple linear regressions to test whether (1) swing phase gluteus medius (GM) activity was influenced by the simultaneous state of the stance limb and (2) mediolateral foot placement location was influenced by swing phase GM activity and the mechanical state of the swing limb at the start of the step. We found that both age-matched controls and people with stroke classified as having a low fall risk (Dynamic Gait Index [DGI] score >19) essentially used the stabilization strategy previously described in young controls. In contrast, this strategy was disrupted for people with stroke classified as higher fall risk (DGI

School Placement and Perceived Quality of Life in Youth Who Are Deaf or Hard of Hearing

PubMed Central

Schick, Brenda

2013-01-01

In the education of students who are deaf and hard of hearing (DHH), there is much debate about how placement affects educational outcomes and quality of life. This study examined the relationship between quality of life and educational placement that include and do not include other DHH youth. Participants included 221 DHH youth, ages 11–18 with bilateral hearing loss. Results showed that there were few differences in quality of life related to school placement (with age, gender, depression symptoms, and hearing level as covariates). For both participation and perceived stigma, there was an interaction between school placement and parent hearing status, with no single school placement showing the best results. DHH youth with hearing parents in schools specifically for DHH students scored lower than DHH with deaf parents in some domains (Participation and Perceived Stigma). When the DHH youth were compared with the general population, those in schools that included DHH students scored lower in some aspects of quality of life, particularly Self and Relationships. This study demonstrates that DHH students may not differ much in terms of quality of life across schools placements, but that there may be differences in subsets of DHH youth. PMID:23184867

Robot-assisted laparoscopic skills development: formal versus informal training.

PubMed

Benson, Aaron D; Kramer, Brandan A; Boehler, Margaret; Schwind, Cathy J; Schwartz, Bradley F

2010-08-01

The learning curve for robotic surgery is not completely defined, and ideal training components have not yet been identified. We attempted to determine whether skill development would be accelerated with formal, organized instruction in robotic surgical techniques versus informal practice alone. Forty-three medical students naive to robotic surgery were randomized into two groups and tested on three tasks using the robotic platform. Between the testing sessions, the students were given equally timed practice sessions. The formal training group participated in an organized, formal training session with instruction from an attending robotic surgeon, whereas the informal training group participated in an equally timed unstructured practice session with the robot. The results were compared based on technical score and time to completion of each task. There was no difference between groups in prepractice testing for any task. In postpractice testing, there was no difference between groups for the ring transfer tasks. However, for the suture placement and knot-tying task, the technical score of the formal training group was significantly better than that of the informal training group (p < 0.001), yet time to completion was not different. Although formal training may not be necessary for basic skills, formal instruction for more advanced skills, such as suture placement and knot tying, is important in developing skills needed for effective robotic surgery. These findings may be important in formulating potential skills labs or training courses for robotic surgery.

Does Preequating Work? An Investigation into a Preequated Testlet-Based College Placement Exam Using Postadministration Data. Research Report. ETS RR-12-12

ERIC Educational Resources Information Center

Gao, Rui; He, Wei; Ruan, Chunyi

2012-01-01

In this study, we investigated whether preequating results agree with equating results that are based on observed operational data (postequating) for a college placement program. Specifically, we examined the degree to which item response theory (IRT) true score preequating results agreed with those from IRT true score postequating and from…

Objective assessment of operator performance during ultrasound-guided procedures.

PubMed

Tabriz, David M; Street, Mandie; Pilgram, Thomas K; Duncan, James R

2011-09-01

Simulation permits objective assessment of operator performance in a controlled and safe environment. Image-guided procedures often require accurate needle placement, and we designed a system to monitor how ultrasound guidance is used to monitor needle advancement toward a target. The results were correlated with other estimates of operator skill. The simulator consisted of a tissue phantom, ultrasound unit, and electromagnetic tracking system. Operators were asked to guide a needle toward a visible point target. Performance was video-recorded and synchronized with the electromagnetic tracking data. A series of algorithms based on motor control theory and human information processing were used to convert raw tracking data into different performance indices. Scoring algorithms converted the tracking data into efficiency, quality, task difficulty, and targeting scores that were aggregated to create performance indices. After initial feasibility testing, a standardized assessment was developed. Operators (N = 12) with a broad spectrum of skill and experience were enrolled and tested. Overall scores were based on performance during ten simulated procedures. Prior clinical experience was used to independently estimate operator skill. When summed, the performance indices correlated well with estimated skill. Operators with minimal or no prior experience scored markedly lower than experienced operators. The overall score tended to increase according to operator's clinical experience. Operator experience was linked to decreased variation in multiple aspects of performance. The aggregated results of multiple trials provided the best correlation between estimated skill and performance. A metric for the operator's ability to maintain the needle aimed at the target discriminated between operators with different levels of experience. This study used a highly focused task model, standardized assessment, and objective data analysis to assess performance during simulated ultrasound-guided needle placement. The performance indices were closely related to operator experience.

A Look at the Impact of Raising Standards in Developmental Mathematics

ERIC Educational Resources Information Center

Guy, G. Michael; Puri, Karan; Cornick, Jonathan

2016-01-01

In this paper, we assess the effect of higher entry and exit standards at a community college in New York City. A complex set of university and college-wide policy modifications led to an increase in placement test cut-scores as well as increased requirements to complete remediation. The implementation of this policy change allows us to utilize…

Correlation of Social Science Students' Grade Outcome with Reading and Writing Scores.

ERIC Educational Resources Information Center

Parrott, Marietta

A study was conducted at College of the Sequoias (COS) to examine the entry-level reading and writing skills of students and their grade outcomes in the social science courses for which they were enrolled. The study sought to identify any predictors of students' eventual success/non-success in class. The study focused on the placement test scores…

Grades in Selected First-Year Courses by ELT Status.

ERIC Educational Resources Information Center

Windham, Patricia

This report presents tables of grades in selected first-year courses by entry-level placement test (ELT) status in Florida community colleges. The cohort used in this analysis consisted of the fall 1993 students with ELT scores as reported in the 1993-94 Student Data Base (SDB). Students who took an ELT were divided into those who passed and those…

Quality of life improvement after pressure equalization tube placement in Down syndrome: A prospective study.

PubMed

Labby, Alex; Mace, Jess C; Buncke, Michelle; MacArthur, Carol J

2016-09-01

To evaluate quality-of-life changes after bilateral pressure equalization tube placement with or without adenoidectomy for the treatment of chronic otitis media with effusion or recurrent acute otitis media in a pediatric Down syndrome population compared to controls. Prospective case-control observational study. The OM Outcome Survey (OMO-22) was administered to both patients with Down syndrome and controls before bilateral tube placement with or without adenoidectomy and at an average of 6-7 months postoperatively. Thirty-one patients with Down syndrome and 34 controls were recruited. Both pre-operative and post-operative between-group and within-group score comparisons were conducted for the Physical, Hearing/Balance, Speech, Emotional, and Social domains of the OMO-22. Both groups experienced improvement of mean symptom scores post-operatively. Patients with Down syndrome reported significant post-operative improvement in mean Physical and Hearing domain item scores while control patients reported significant improvement in Physical, Hearing, and Emotional domain item scores. All four symptom scores in the Speech domain, both pre-operatively and post-operatively, were significantly worse for Down syndrome patients compared to controls (p ≤ 0.008). Surgical placement of pressure equalizing tubes results in significant quality of life improvements in patients with Down syndrome and controls. Problems related to speech and balance are reported at a higher rate and persist despite intervention in the Down syndrome population. It is possible that longer follow up periods and/or more sensitive tools are required to measure speech improvements in the Down syndrome population after pressure equalizing tube placement ± adenoidectomy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Carotid Artery Stent Placement and Carotid Endarterectomy: A Challenge for Urgent Treatment after Stroke-Early and 12-Month Outcomes in a Comprehensive Stroke Center.

PubMed

Rocco, Alessandro; Sallustio, Fabrizio; Toschi, Nicola; Rizzato, Barbara; Legramante, Jacopo; Ippoliti, Arnaldo; Marchetti, Andrea Ascoli; Pampana, Enrico; Gandini, Roberto; Diomedi, Marina

2018-06-20

To compare feasibility, 12-month outcome, and periprocedural and postprocedural risks between carotid artery stent (CAS) placement and carotid endarterectomy (CEA) performed within 1 week after transient ischemic attack (TIA) or mild to severe stroke onset in a single comprehensive stroke center. Retrospective analysis of prospective data collected from 1,148 patients with ischemic stroke admitted to a single stroke unit between January 2013 and July 2015 was conducted. Among 130 consecutive patients with symptomatic carotid stenosis, 110 (10 with TIA, 100 with stroke) with a National Institutes of Health Stroke Scale (NIHSS) score < 20 and a prestroke modified Rankin Scale (mRS) score < 2 were eligible for CAS placement or CEA and treated according to the preference of the patient or a surrogate. Periprocedural (< 48 h) and postprocedural complications, functional outcome, stroke, and death rate up to 12 months were analyzed. Sixty-two patients were treated with CAS placement and 48 were treated with CEA. Several patients presented with moderate or major stroke (45.8% CEA, 64.5% CAS). NIHSS scores indicated slightly greater severity at onset in patients treated with a CAS vs CEA (6.6 ± 5.7 vs 4.2 ± 3.4; P = .08). Complication rates were similar between groups. mRS scores showed a significant improvement over time and a significant interaction with age in both groups. Similar incidences of death or stroke were shown on survival analysis. A subanalysis in patients with NIHSS scores ≥ 4 showed no differences in complication rate and outcome. CAS placement and CEA seem to offer early safe and feasible secondary stroke prevention treatments in experienced centers, even after major atherosclerotic stroke. Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

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.

Thoracic irrigation prevents retained hemothorax: A prospective propensity scored analysis.

PubMed

Kugler, Nathan W; Carver, Thomas W; Milia, David; Paul, Jasmeet S

2017-12-01

Thoracic trauma resulting in hemothorax (HTx) is typically managed with thoracostomy tube (TT) placement; however, up to 20% of patients develop retained HTx which may necessitate further intervention for definitive management. Although optimal management of retained HTx has been extensively researched, little is known about prevention of this complication. We hypothesized that thoracic irrigation at the time of TT placement would significantly decrease the rate of retained HTx necessitating secondary intervention. A prospective, comparative study of patients with traumatic HTx who underwent bedside TT placement was conducted. The control group consisted of patients who underwent standard TT placement, whereas the irrigation group underwent standard TT placement with immediate irrigation using 1 L of warmed sterile 0.9% saline. Patients who underwent emergency thoracotomy, those with TTs removed within 24 hours, or those who died within 30 days of discharge were excluded. The primary end point was secondary intervention defined by additional TT placement or operative management for retained HTx. A propensity-matched analysis was performed with scores estimated using a logistic regression model based on age, sex, mechanism of injury, Abbreviated Injury Scale chest score, and TT size. In over a 30-month period, a total of 296 patients underwent TT placement for the management of traumatic HTx. Patients were predominantly male (79.6%) at a median age of 40 years and were evenly split between blunt (48.8%) and penetrating (51.2%) mechanisms. Sixty (20%) patients underwent thoracic irrigation at time of initial TT placement. The secondary intervention rate was significantly lower within the study group (5.6% vs. 21.8%; OR, 0.16; p < 0.001). No significant differences in TT duration, ventilator days, or length of stay were noted between the irrigation and control cohort. Thoracic irrigation at the time of initial TT placement for traumatic HTx significantly reduced the need for secondary intervention for retained HTx. Therapeutic Study, Level III.

Effects of microRNA-21 on Nerve Cell Regeneration and Neural Function Recovery in Diabetes Mellitus Combined with Cerebral Infarction Rats by Targeting PDCD4.

PubMed

Guo, Yun-Bao; Ji, Tie-Feng; Zhou, Hong-Wei; Yu, Jin-Lu

2018-03-01

We aimed to determine the effect and mechanism of microRNA-21 (miR-21) on nerve cell regeneration and nerve functional recovery in diabetes mellitus combined with cerebral infarction (DM + CI) rats by targeting PDCD4. A total of 125 male Wistar rats were selected for DM + CI rat model construction and assigned into the blank, miR-21 mimics, mimics control, miR-21 inhibitor, inhibitor control, miR-21 inhibitor + si-PDCD4 and si-PDCD4 groups. And, 20 healthy rats were selected for the normal group. Triphenylterazolium chloride (TTC) staining and HE staining were used for determination of the area of CI and pathological changes, respectively. Behaviors of rats in the eight groups were determined by forelimb placement test and balance beam walking test. Immunohistochemical staining, double immunofluorescence staining assay, Western blotting, and qRT-PCR were used to detect expressions of miR-21, PDCD4, HNA, Nestin, NeuN, β-III-Tub, PTEN, FasL, and GFAP. DNA laddering and TUNEL staining was used for cell apoptosis. TTC and HE staining confirmed that 87.5% rats were induced into CI + DM models successfully. Results of forelimb placement test and balance beam walking test showed that miR-21 mimics, and si-PCDC4 improved the nerve defect of model rats. Comparing with the blank group at the same time, rats in the miR-21 inhibitor group displayed significant decrease in the forelimb placement test score, significant increase in the balance beam walking test score, and exacerbation of nerve defect, while rats in the miR-21 mimics and si-PCDC4 groups displayed significant increase in forelimb placement test score and significant decrease in the balance beam walking test score and improvement of nerve defect situation. The HNA, Nestin, and PDCD4 expressions were decreased and the NeuN, β-III-Tub, and GFAP expressions were increased in the miR-21 mimics and si-PDCD4 groups comparing with the blank group. The results of miR-21 inhibitor group were on the contrary. In comparison to the blank group, the miR-21 mimics group and the si-PDCD4 had lower miR-21 expressions and higher expressions of PDCD4, PTEN, and FasL, while the miR-21 inhibitor group was in the opposite trend. The results of qRT-PCR were the same with Western blotting. The expressions of fluorescence in other groups were higher than the normal group; compared with the blank group, the miR-21 mimics group and the si-PDCD4 group had lower fluorescence expression and DNA ladder. However, the fluorescence expressions and DNA ladder of miR-21 inhibitor group increased markedly in contrast with the blank group. Comparing with the blank group, BrdU + /DEX + fluorescence intensity significantly enhanced in the miR-21 mimics and si-PDCD4 groups and significantly reduced in the miR-21 inhibitor group. And, comparing with the blank group, in the miR-21 mimics group, the signal strength of luciferase carrying the wild-type PDCD4 was reduced by 25%. The present studies demonstrated that miR-21 could promote the nerve cell regeneration, suppress apoptosis of nerve cells in DM + CI rats and improves the nerve defect situation of DM + CI rats by inhibiting PDCD4.

Functional and morphological differences following Monarc and TVT-O procedures.

PubMed

Huang, W-C; Yang, S-H; Yang, J-M; Tzeng, C-R

2012-12-01

To explore function of the lower urinary tract and morphology of tape and urethra following Monarc or TVT-O suburethral tape placement for urodynamic stress incontinence (USI). We recruited prospectively women undergoing either Monarc or TVT-O placement for USI. Before and 3 months after the procedure, participants were evaluated by a question-directed interview, the measures of Sandvik Incontinence Severity Index (SISI), Incontinence Bother Scale (IBS), Ingelman-Sundberg Score (ISS) and short forms of Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), physical examination, a cough stress test and 4D ultrasound investigation. The primary outcome was participants' responses to clinical assessments and the secondary outcome was ultrasound findings. A total of 67 women with Monarc procedures and 60 women with TVT-O procedures completed the survey both preoperatively and 3 months postoperatively. There were significant improvements in scores of SISI, IBS, ISS, UDI-6 and IIQ-7 after both Monarc and TVT-O procedures. At the 3-month follow-up, both procedures had similar success rates, SISI scores, IBS scores, ISS scores, UDI-6 scores and IIQ-7 scores, and similar incidences of postoperative voiding difficulty and overactive bladder symptoms. After Bonferroni correction, all ultrasound parameters representing tape location, tape tension and urethral mobility were similar between the two procedures. At short-term follow-up, Monarc and TVT-O procedures are comparable in both functional outcome of the lower urinary tract and morphology on ultrasound as assessed by parameters representing tape location, tape tension and urethral mobility. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Optimization of Ultrasound Transducer Positioning for Endotracheal Tube Placement Confirmation in Cadaveric Model.

PubMed

Lonchena, Tiffany; So, Sokpoleak; Ibinson, James; Roolf, Peter; Orebaugh, Steven L

2017-02-01

Sonography has been suggested as a possible means of endotracheal tube (ETT) placement confirmation. However, optimum ultrasound transducer placement has not been established. Using a cadaveric model, ETT placement by the sonographic appearance at the thyroid cartilage, cricoid cartilage, and suprasternal notch in the upper airway was assessed to determine which ultrasound transducer placement offered the most optimal images for ETT confirmation in the airway. One provider intubated 5 cadavers, with the ultrasound transducer at each of the 3 levels, for a total of 30 intubations per specimen, while 2 providers assigned a visual score of 1 (subtle), 2 (clear), or 3 (pronounced) to each sonogram of the ETT in the airway. At the level of the thyroid cartilage, tracheal intubation was detected at a rate of 40%, with a median visualization scale of 1 (subtle movement). At the level of the cricoid cartilage, the visualization scale improved to a median of 2 (clear movement), with a 70% intubation detection rate. At the level of the suprasternal notch, 100% of the tracheal intubations were visualized on sonography, with a median score of 3 (pronounced movement). In comparing sonographic detection of ETT placement at 3 levels of the upper airway in a cadaveric model, our results clearly indicate that visualization was superior at the level of the suprasternal notch, with 100% of intubations detected with the best visualization scores. © 2017 by the American Institute of Ultrasound in Medicine.

Evaluation of an Assessment and Placement System for Entry-Level Courses.

ERIC Educational Resources Information Center

Astroth, Jonathan; Weber, Jerry

In fall 1987, a study was conducted at Lincoln Land Community College (LLCC) to examine the college's system of basic skills assessment for course placement. The study investigated the adequacy of established cut scores; placement evasion (i.e., the disregarding of a recommendation to take a developmental course) and its consequences; the use of…

A Correlation of Community College Math Readiness and Student Success

NASA Astrophysics Data System (ADS)

Brown, Jayna Nicole

Although traditional college students are more prepared for college-level math based on college admissions tests, little data have been collected on nontraditional adult learners. The purpose of this study was to investigate relationships between math placement tests and community college students' success in math courses and persistence to degree or certificate completion. Guided by Tinto's theory of departure and student retention, the research questions addressed relationships and predictability of math Computer-adaptive Placement Assessment and Support System (COMPASS) test scores and students' performance in math courses, persistence in college, and degree completion. After conducting correlation and regression analyses, no significant relationships were identified between COMPASS Math test scores and students' performance (n = 234) in math courses, persistence in college, or degree completion. However, independent t test and chi-squared analyses of the achievements of college students who tested into Basic Math (n = 138) vs. Introduction to Algebra (n = 96) yielded statistically significant differences in persistence (p = .039), degree completion (p < .001), performance (p = .008), and progress ( p = .001), indicating students who tested into Introduction to Algebra were more successful and persisted more often to degree completion. In order to improve instructional methods for Basic Math courses, a 3-day professional development workshop was developed for math faculty focusing on current, best practices in remedial math instruction. Implications for social change include providing math faculty with the knowledge and skills to develop new instructional methods for remedial math courses. A change in instructional methods may improve community college students' math competencies and degree achievement.

Defining surgical criteria for empty nose syndrome: Validation of the office-based cotton test and clinical interpretability of the validated Empty Nose Syndrome 6-Item Questionnaire.

PubMed

Thamboo, Andrew; Velasquez, Nathalia; Habib, Al-Rahim R; Zarabanda, David; Paknezhad, Hassan; Nayak, Jayakar V

2017-08-01

The validated Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) identifies empty nose syndrome (ENS) patients. The unvalidated cotton test assesses improvement in ENS-related symptoms. By first validating the cotton test using the ENS6Q, we define the minimal clinically important difference (MCID) score for the ENS6Q. Individual case-control study. Fifteen patients diagnosed with ENS and 18 controls with non-ENS sinonasal conditions underwent office cotton placement. Both groups completed ENS6Q testing in three conditions-precotton, cotton in situ, and postcotton-to measure the reproducibility of ENS6Q scoring. Participants also completed a five-item transition scale ranging from "much better" to "much worse" to rate subjective changes in nasal breathing with and without cotton placement. Mean changes for each transition point, and the ENS6Q MCID, were then calculated. In the precotton condition, significant differences (P < .001) in all ENS6Q questions between ENS and controls were noted. With cotton in situ, nearly all prior ENS6Q differences normalized between ENS and control patients. For ENS patients, the changes in the mean differences between the precotton and cotton in situ conditions compared to postcotton versus cotton in situ conditions were insignificant among individuals. Including all 33 participants, the mean change in the ENS6Q between the parameters "a little better" and "about the same" was 4.25 (standard deviation [SD] = 5.79) and -2.00 (SD = 3.70), giving an MCID of 6.25. Cotton testing is a validated office test to assess for ENS patients. Cotton testing also helped to determine the MCID of the ENS6Q, which is a 7-point change from the baseline ENS6Q score. 3b. Laryngoscope, 127:1746-1752, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Do specialty courts achieve better outcomes for children in foster care than general courts?

PubMed

Sloan, Frank A; Gifford, Elizabeth J; Eldred, Lindsey M; Acquah, Kofi F; Blevins, Claire E

2013-02-01

This study assessed the effects of unified family and drug treatment courts (DTCs) on the resolution of cases involving foster care children and the resulting effects on school performance. The first analytic step was to assess the impacts of presence of unified and DTCs in North Carolina counties on time children spent in foster care and the type of placement at exit from foster care. In the second step, the same data on foster care placements were merged with school records for youth in Grades 3-8 in public schools. The effect of children's time in foster care and placement outcomes on school performance as measured by math and reading tests, grade retention, and attendance was assessed using child fixed-effects regression. Children in counties with unified family courts experienced shorter foster care spells and higher rates of reunification with parents or primary caregivers. Shorter foster care spells translated into improved school performance measured by end-of-grade reading and math test scores. Adult DTCs were associated with lower probability of reunification with parents/primary caregivers. The shortened time in foster care implies an efficiency gain attributable to unified family courts, which translate into savings for the court system through the use of fewer resources. Children also benefit through shortened stays in temporary placements, which are related to some improved educational outcomes.

The Power of Positioning: The Stories of National Hispanic Scholars' Lives and Their Mothers' Careful Placement to Enhance the Likelihood of Academic Success

ERIC Educational Resources Information Center

Ulibarri-Nasio, Crystal S.

2010-01-01

Established in 1983 by the College Board, the National Hispanic Recognition Program annually recognizes approximately 3,300 Hispanic students who scored the highest on the Preliminary SAT/National Merit Scholarship Qualifying Test (PSAT/NMSQT). These top-performing high school students are recruited by U.S. universities as National Hispanic…

Deaf college students' mathematical skills relative to morphological knowledge, reading level, and language proficiency.

PubMed

Kelly, Ronald R; Gaustad, Martha G

2007-01-01

This study of deaf college students examined specific relationships between their mathematics performance and their assessed skills in reading, language, and English morphology. Simple regression analyses showed that deaf college students' language proficiency scores, reading grade level, and morphological knowledge regarding word segmentation and meaning were all significantly correlated with both the ACT Mathematics Subtest and National Technical Institute for the Deaf (NTID) Mathematics Placement Test scores. Multiple regression analyses identified the best combination from among these potential independent predictors of students' performance on both the ACT and NTID mathematics tests. Additionally, the participating deaf students' grades in their college mathematics courses were significantly and positively associated with their reading grade level and their knowledge of morphological components of words.

Awake craniotomy for assisting placement of auditory brainstem implant in NF2 patients.

PubMed

Zhou, Qiangyi; Yang, Zhijun; Wang, Zhenmin; Wang, Bo; Wang, Xingchao; Zhao, Chi; Zhang, Shun; Wu, Tao; Li, Peng; Li, Shiwei; Zhao, Fu; Liu, Pinan

2018-06-01

Auditory brainstem implants (ABIs) may be the only opportunity for patients with NF2 to regain some sense of hearing sensation. However, only a very small number of individuals achieved open-set speech understanding and high sentence scores. Suboptimal placement of the ABI electrode array over the cochlear nucleus may be one of main factors for poor auditory performance. In the current study, we present a method of awake craniotomy to assist with ABI placement. Awake surgery and hearing test via the retrosigmoid approach were performed for vestibular schwannoma resections and auditory brainstem implantations in four patients with NF2. Auditory outcomes and complications were assessed postoperatively. Three of 4 patients who underwent awake craniotomy during ABI surgery received reproducible auditory sensations intraoperatively. Satisfactory numbers of effective electrodes, threshold levels and distinct pitches were achieved in the wake-up hearing test. In addition, relatively few electrodes produced non-auditory percepts. There was no serious complication attributable to the ABI or awake craniotomy. It is safe and well tolerated for neurofibromatosis type 2 (NF2) patients using awake craniotomy during auditory brainstem implantation. This method can potentially improve the localization accuracy of the cochlear nucleus during surgery.

The effects of a test-taking strategy intervention for high school students with test anxiety in advanced placement science courses

NASA Astrophysics Data System (ADS)

Markus, Doron J.

Test anxiety is one of the most debilitating and disruptive factors associated with underachievement and failure in schools (Birenbaum, Menucha, Nasser, & Fadia, 1994; Tobias, 1985). Researchers have suggested that interventions that combine multiple test-anxiety reduction techniques are most effective at reducing test anxiety levels (Ergene, 2003). For the current study, involving 62 public high school students enrolled in advanced placement science courses, the researcher designed a multimodal intervention designed to reduce test anxiety. Analyses were conducted to assess the relationships among test anxiety levels, unit examination scores, and irregular multiple-choice error patterns (error clumping), as well as changes in these measures after the intervention. Results indicate significant, positive relationships between some measures of test anxiety and error clumping, as well as significant, negative relationships between test anxiety levels and student achievement. In addition, results show significant decreases in holistic measures of test anxiety among students with low anxiety levels, as well as decreases in Emotionality subscores of test anxiety among students with high levels of test anxiety. There were no significant changes over time in the Worry subscores of test anxiety. Suggestions for further research include further confirmation of the existence of error clumping, and its causal relationship with test anxiety.

A Comparative Study of High School Advanced Placement and Dual Enrollment Programs Using a Mixed Methods Analysis

ERIC Educational Resources Information Center

Haley, Katrina A.

2013-01-01

This study provides an in-depth analysis of whether students who take dual enrollment and/or AP classes have higher ACT test scores compared to a group of their peers that did not take dual enrollment or AP courses. The study also identified the demographic characteristics (ethnicity, gender, and socio-economic status) of students with a 3.0 or…

Admission interview scores are associated with clinical performance in an undergraduate physiotherapy course: an observational study.

PubMed

Edgar, Susan; Mercer, Annette; Hamer, Peter

2014-12-01

The purpose of this study was to determine if there is an association between admission interview score and subsequent academic and clinical performance, in a four-year undergraduate physiotherapy course. Retrospective observational study. 141 physiotherapy students enrolled in two entry year groups. Individual student performance in all course units, practical examinations, clinical placements as well as year level and overall Grade Point Average. Predictor variables included admission interview scores, admission academic scores and demographic data (gender, age and entry level). Interview score demonstrated a significant association with performance in three of six clinical placements through the course. This association was stronger than for any other admission criterion although effect sizes were small to moderate. Further, it was the only admission score to have a significant association with overall Clinical Grade Point Average for the two year groups analysed (r=0.322). By contrast, academic scores on entry showed significant associations with all year level Grade Point Averages except Year 4, the clinical year. This is the first study to review the predictive validity of an admission interview for entry into a physiotherapy course in Australia. The results show that performance in this admission interview is associated with overall performance in clinical placements through the course, while academic admission scoring is not. These findings suggest that there is a role for both academic and non-academic selection processes for entry into physiotherapy. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

The effect of the Advanced Placement Training and Incentive Program on increasing enrollment and performance on Advanced Placement science exams

NASA Astrophysics Data System (ADS)

Ramsey, Susan Brady

The purpose of this study is to examine the effectiveness of the National Math and Science Initiative's Advanced Placement Training and Incentive Program (APTIP) on the number of students taking AP science courses and their performance. The study evaluated 39 schools over a six-year period in six states that participate in the APTIP. The National Math and Science Initiative provided data for cohort I. A general linear model for repeated measures was used to evaluate the data. Data was evaluated three years prior to the intervention and three years during the intervention, which will actually continue for two more years (2012 and 2013) since cohort I schools were awarded five years of support. Students in APTIP schools enrolled in more AP science exams (AP Biology, AP Chemistry, AP Environmental Science, and AP Physics-B) over the course of the intervention. The quantity of students earning qualifying scores increased during the intervention years. APTIP is a multi-tiered program that includes seven days of teacher training, three six-hour student prep sessions, school equipment, reduced exam fees, and monetary incentives for students and teachers. This program positively impacted the quantity of enrollment and qualifying scores during the three years evaluated in this study. Increases in the number of female and African American students' test takers their and qualifying scores were seen in all three years of the APTIP intervention. This study supports the premise that the first step to increasing the Science, technology, engineering, and math (STEM) pipeline is giving access to advanced courses to more students in high schools.

The influence of caregiver depression on children in non-relative foster care versus kinship care placements.

PubMed

Garcia, Antonio; O'Reilly, Amanda; Matone, Meredith; Kim, Minseop; Long, Jin; Rubin, David M

2015-03-01

Little is known about how the challenges faced by caregivers influence the variation in social, emotional, and behavioral (SEB) outcomes of youth placed in kinship versus non-relative foster care. This study examined SEB symptoms among youth in kinship and non-relative foster care settings, hypothesizing that changes in caregiver depression would modify children's change in behavior over time. Child Behavior Checklist (CBCL) assessments of 199 children placed with kinship and non-relative foster care providers in a Mid-Atlantic city were conducted at time of placement and 6-12 months post-placement. Linear regression estimated CBCL change scores for youth across placement type and caregiver depression trajectories. Kinship caregivers were more likely to become depressed or remained depressed than non-relative foster caregivers. Youth in kinship care always exhibited better change in SEB outcomes than youth in non-relative foster care, but these positive outcomes were principally observed among families where caregivers demonstrated a reduction in depression over time or were never depressed. Adjusted change scores for non-relative foster care youth were always negative, with the most negative scores among youth whose caregivers became depressed over time. Caregiver well-being may modify the influence of placement setting on SEB outcomes for youth placed into out-of-home care. Findings lend to policy relevance for child welfare systems that seek kinship settings as a panacea to the challenges faced by youth, without allocating resources to address caregiver needs.

Premedical special master’s programs increase USMLE STEP1 scores and improve residency placements

PubMed Central

Khuder, Sadik

2017-01-01

The effectiveness of Special Master’s Programs (SMPs) in benefiting a potential medical student’s career beyond admission into an MD-program is largely unknown. This study aims to evaluate the role of SMPs, if any, in affecting the performance and outcomes of students during their medical school career. This study analyzed anonymous surveys of students and residents from the University of Toledo. The data analysis is used to evaluate a student’s academic performance before, during and after medical school. Measured metrics included: MCAT Scores, undergraduate GPA, USMLE STEP 1 scores, participation in research, number of research publications, and residency placement. Of 500 people surveyed 164 medical students or residents responded. Based on their responses, the respondents were divided into traditional (non-SMP) and SMP groups. As anticipated, MCAT scores (SMP: 29.82 vs. traditional 31.10) are significantly (p<0.05) different between the two groups. Interestingly, there is no significant difference in USMLE STEP 1 scores (SMP: 232.7 vs. traditional: 233.8) and when normalized relative to MCAT scores, USMLE STEP 1 scores for SMP-students are significantly (p<0.05) higher than their traditional counterparts (p<0.05). Additionally, SMP-students did not outperform the traditional students with regards to research publications. But, they did demonstrate a significant (p<0.05) proclivity towards surgical residencies when compared to the traditional students. Overall, our results highlight that SMPs potentiate USMLE STEP 1 performance and competitive residency-placements for its students. PMID:29190691

Can a clinical placement influence stigma? An analysis of measures of social distance.

PubMed

Moxham, Lorna; Taylor, Ellie; Patterson, Christopher; Perlman, Dana; Brighton, Renee; Sumskis, Susan; Keough, Emily; Heffernan, Tim

2016-09-01

The way people who experience mental illness are perceived by health care professionals, which often includes stigmatising attitudes, can have a significant impact on treatment outcomes and on their quality of life. To determine whether stigma towards people with mental illness varied for undergraduate nursing students who attended a non-traditional clinical placement called Recovery Camp compared to students who attended a 'typical' mental health clinical placement. Quasi-experimental. Seventy-nine third-year nursing students were surveyed; n=40 attended Recovery Camp (intervention), n=39 (comparison group) attended a 'typical' mental health clinical placement. All students completed the Social Distance Scale (SDS) pre- and post-placement and at three-month follow-up. Data analysis consisted of a one-way repeated measures analysis of variance (ANOVA) exploring parameter estimates between group scores across three time points. Two secondary repeated measures ANOVAs were performed to demonstrate the differences in SDS scores for each group across time. Pairwise comparisons demonstrated the differences between time intervals. A statistically significant difference in ratings of stigma between the intervention group and the comparison group existed. Parameter estimates revealed that stigma ratings for the intervention group were significantly reduced post-placement and remained consistently low at three-month follow-up. There was no significant difference in ratings of stigma for the comparison group over time. Students who attended Recovery Camp reported significant decreases in stigma towards people with a mental illness over time, compared to the typical placement group. Findings suggest that a therapeutic recreation based clinical placement was more successful in reducing stigma regarding mental illness in undergraduate nursing students compared to those who attended typical mental health clinical placements. Copyright © 2016 Elsevier Ltd. All rights reserved.

The CHESS score: a simple tool for early prediction of shunt dependency after aneurysmal subarachnoid hemorrhage.

PubMed

Jabbarli, R; Bohrer, A-M; Pierscianek, D; Müller, D; Wrede, K H; Dammann, P; El Hindy, N; Özkan, N; Sure, U; Müller, O

2016-05-01

Acute hydrocephalus is an early and common complication of aneurysmal subarachnoid hemorrhage (SAH). However, considerably fewer patients develop chronic hydrocephalus requiring shunt placement. Our aim was to develop a risk score for early identification of patients with shunt dependency after SAH. Two hundred and forty-two SAH individuals who were treated in our institution between January 2008 and December 2013 and survived the initial impact were retrospectively analyzed. Clinical parameters within 72 h after the ictus were correlated with shunt dependency. Independent predictors were summarized into a new risk score which was validated in a subsequent SAH cohort treated between January and December 2014. Seventy-five patients (31%) underwent shunt placement. Of 23 evaluated variables, only the following five showed independent associations with shunt dependency and were subsequently used to establish the Chronic Hydrocephalus Ensuing from SAH Score (CHESS, 0-8 points): Hunt and Hess grade ≥IV (1 point), location of the ruptured aneurysm in the posterior circulation (1 point), acute hydrocephalus (4 points), the presence of intraventricular hemorrhage (1 point) and early cerebral infarction on follow-up computed tomography scan (1 point). The CHESS showed strong correlation with shunt dependency (P = 0.0007) and could be successfully validated in both internal SAH cohorts tested. Patients scoring ≥6 CHESS points had significantly higher risk of shunt dependency (P < 0.0001) than other patients. The CHESS may become a valuable diagnostic tool for early estimation of shunt dependency after SAH. Further evaluation and external validation will be required in prospective studies. © 2016 EAN.

Shifts in nursing and medical student's attitudes, beliefs and behaviours about interprofessional work: An interprofessional placement in ambulatory care.

PubMed

Seaman, Karla; Saunders, Rosemary; Dugmore, Helen; Tobin, Claire; Singer, Rachel; Lake, Fiona

2018-05-12

To examine students' beliefs, behaviours and attitudes in relation to interprofessional socialisation, and their expectations and experience, before and after a two-week clinical placement in ambulatory care. Interprofessional clinical placements for students are important for developing an understanding of interprofessional collaboration and identity, for the benefit of patient care. Ambulatory care environment involves collaborative management of complex chronic problems. This educator supported placement enabled final year nursing and medical students to work together. A descriptive matched pre-post study was conducted. Students' completed an online questionnaire pre and post their clinical placement. The questionnaire comprised of three sections; demographic information, the Interprofessional Socialisation and Valuing Scale and open-ended questions. Descriptive analysis and paired t-tests were conducted for the three subscales and thematic analysis of qualitative responses was conducted. Sixty-two of the 151 students between 2011-2014 completed both surveys. There was a significant increase post placement in the overall Interprofessional Socialisation and Valuing Scale scores. The change was greater for nursing students compared with medical students, although for both groups the change was small. The majority had a good to very good experience learning each other's and their own professions, and identified the Nurse Educator and Teaching Registrar as key to success. A clinical placement in an ambulatory setting for nursing and medical students resulted in an increase in self-perceived ability to work with others and in valuing working with others. Interprofessional clinical placements are essential for students to understand interprofessional practice for better patient outcomes and developing their own perspective of future work within an interprofessional team. Ambulatory care is an ideal environment for nursing and other health professional students to engage in interprofessional clinical placements. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Can a Rescuer or Simulated Patient Accurately Assess Motion During Cervical Spine Stabilization Practice Sessions?

PubMed Central

Shrier, Ian; Boissy, Patrick; Brière, Simon; Mellette, Jay; Fecteau, Luc; Matheson, Gordon O.; Garza, Daniel; Meeuwisse, Willem H.; Segal, Eli; Boulay, John; Steele, Russell J.

2012-01-01

Context: Health care providers must be prepared to manage all potential spine injuries as if they are unstable. Therefore, most sport teams devote resources to training for sideline cervical spine (C-spine) emergencies. Objective: To determine (1) how accurately rescuers and simulated patients can assess motion during C-spine stabilization practice and (2) whether providing performance feedback to rescuers influences their choice of stabilization technique. Design: Crossover study. Setting: Training studio. Patients or Other Participants: Athletic trainers, athletic therapists, and physiotherapists experienced at managing suspected C-spine injuries. Intervention(s): Twelve lead rescuers (at the patient's head) performed both the head-squeeze and trap-squeeze C-spine stabilization maneuvers during 4 test scenarios: lift-and-slide and log-roll placement on a spine board and confused patient trying to sit up or rotate the head. Main Outcome Measure(s): Interrater reliability between rescuer and simulated patient quality scores for subjective evaluation of C-spine stabilization during trials (0 = best, 10 = worst), correlation between rescuers' quality scores and objective measures of motion with inertial measurement units, and frequency of change in preference for the head-squeeze versus trap-squeeze maneuver. Results: Although the weighted κ value for interrater reliability was acceptable (0.71–0.74), scores varied by 2 points or more between rescuers and simulated patients for approximately 10% to 15% of trials. Rescuers' scores correlated with objective measures, but variability was large: 38% of trials scored as 0 or 1 by the rescuer involved more than 10° of motion in at least 1 direction. Feedback did not affect the preference for the lift-and-slide placement. For the log-roll placement, 6 of 8 participants who preferred the head squeeze at baseline preferred the trap squeeze after feedback. For the confused patient, 5 of 5 participants initially preferred the head squeeze but preferred the trap squeeze after feedback. Conclusions: Rescuers and simulated patients could not adequately assess performance during C-spine stabilization maneuvers without objective measures. Providing immediate feedback in this context is a promising tool for changing behavior preferences and improving training. PMID:22488229

Mathematics Placement Test: Typical Results with Unexpected Outcomes

ERIC Educational Resources Information Center

Ingalls, Victoria

2011-01-01

Based on the results of a prior case-study analysis of mathematics placement at one university, the mathematics department developed and piloted a mathematics placement test. This article describes the implementation process for a mathematics placement test and further analyzes the test results for the pilot group. As an unexpected result, the…

Evaluation of the influence of implant placement timing on the esthetic outcomes of single tooth implant treatment in the anterior maxilla: A retrospective study.

PubMed

Arora, Himanshu; Ivanovski, Saso

2018-05-15

The purpose of this retrospective study was to investigate the influence of implant placement timing on the esthetic outcomes for single implants in the anterior maxilla. One hundred and ten patients (48 males; 62 females) who received a single-tooth implant after extraction either immediately (Type 1); after 4-8 weeks (Type 2); after 8-16 weeks (Type 3); or more than 16 weeks (Type 4) were evaluated in terms of esthetic outcomes after a mean post-placement interval of 26.3 months (range 12-116). Esthetic outcomes were measured using the Pink and White Esthetic Score (PES; WES). Stepwise regression analysis was performed to analyze the effect of timing of placement, as well as patient demographics and other clinical parameters on the esthetic outcomes. No statistically significantly differences in PES were found between the various treatment modalities with Type 1 implants (n = 33) scoring 10.58 ± 1.65 (median: 11), followed by 10.36 ± 2.09 (median: 10.5), 9.68 ± 2.43 (median: 10), and 9.63 ± 2.21 (median: 10) for Type 2 (n = 14), Type 3 (n = 19), and Type 4 (n = 44), respectively. For immediate implants, a trend towards better esthetic outcomes was observed when implant placement was done flaplessly in cases with intact buccal bone (Type 1A, median PES 11) as compared to cases with partial/complete missing buccal plates where a flap was raised (Type 1B, median PES 10). Overall, the only parameter that influenced esthetic outcomes (as measured by PES) was gender, with females having significantly superior results. The median WES was 8 and 96% of the crowns were deemed esthetically acceptable, with crowns placed by specialist prosthodontists yielding higher scores than those placed by general practitioners. Single tooth implants in the anterior maxilla showed satisfactory outcomes when measured with objective esthetic criteria. Timing of implant placement did not significantly influence the esthetic outcomes, although a trend towards better outcomes was seen with immediate implant placement as observed by higher median PES values. Single tooth implant placement in the anterior maxilla is a predictable treatment modality for achieving acceptable esthetic outcomes regardless of the timing of placement. © 2018 Wiley Periodicals, Inc.

Mathematics Course Placement Using Holistic Measures: Possibilities for Community College Students

ERIC Educational Resources Information Center

Ngo, Federick; Chi, W. Edward; Park, Elizabeth So Yun

2018-01-01

Background/Context: Most community colleges across the country use a placement test to determine students' readiness for college-level coursework, yet these tests are admittedly imperfect instruments. Researchers have documented significant problems stemming from overreliance on placement testing, including placement error and misdiagnosis of…

The Effects of Advanced Placement and International Baccalaureate Programs on Student Achievement

ERIC Educational Resources Information Center

Luo, Samia Merza

2013-01-01

This study compared student academic achievement in two college readiness programs, Advanced Placement (AP) and International Baccalaureate (IB) and attempted to determine how well program participation predict student performance compared to variables such as SES, parent education level, GPA, gender, and SAT II scores. Finally, the research…

Longitudinal Course of Risk for Parental Post-Adoption Depression

PubMed Central

Foli, Karen J.; South, Susan C.; Lim, Eunjung; Hebdon, Megan

2016-01-01

Objective To determine whether the Postpartum Depression Predictors Inventory-Revised (PDPI-R) could be used to reveal distinct classes of adoptive parents across time. Design Longitudinal data were collected via online surveys at 4-6 weeks pre-placement, 4-6 weeks post-placement, and 5-6 months post-placement. Setting Participants were primarily clients of the largest adoption agency in the United States. Participants Participants included 127 adoptive parents (68 mothers and 59 fathers). Methods We applied a latent class growth analysis to the PDPI-R and conducted mixed effects modeling of class, time, and class×time interaction for the following categories of explanatory variables: parental expectations; interpersonal variables; psychological symptoms; and life orientation. Results Four latent trajectory classes were found. Class 1 (55% of sample) showed a stably low level of PDPI-R scores over time. Class 2 (32%) reported mean scores below the cut-off points at all three time points. Class 3 (8%) started at an intermediate level and increased after post-placement, but decreased at 5-6 months post-placement. Class 4 (5%) had high mean scores at all three time points. Significant main effects were found for almost all explanatory variables for class and for several variables for time. Significant interactions between class and time were found for expectations about the child and amount of love and ambivalence in parent's intimate relationship. Conclusion Findings may assist nurses to be alert to trajectories of risk for post-adoption depression. Additional factors, not included in the PDPI-R, to determine risk for post-adoption depression may be needed for adoptive parents. PMID:26874267

Changes in the oral environment after placement of lingual and labial orthodontic appliances.

PubMed

Lombardo, Luca; Ortan, Yildiz Öztürk; Gorgun, Özge; Panza, Chiara; Scuzzo, Giuseppe; Siciliani, Giuseppe

2013-09-11

This study compared the oral hygiene and caries risk of patients treated with labial and lingual orthodontic appliances throughout a prospective evaluation of the status of the oral environment before and after bracket placement. A total of 20 orthodontic patients aged 19 to 23 years were included in the study and were divided into two groups: 10 patients wore Roth labial appliance (American Orthodontics, Sheboygan, WI, USA) and 10 patients wore STb lingual appliance (Ormco Corporation, Glendora, CA, USA). Plaque index (PI), gingival bleeding index (GBI), salivary flow rate, saliva buffer capacity, salivary pH, and Streptococcus mutans and Lactobacillus counts in saliva were determined at three time points: before orthodontic appliance placement (T0), 4 weeks after bonding (T1), and 8 weeks after bonding (T2). After appliance placement, all patients were periodically educated to the oral hygiene procedures. Wilcoxon rank and Mann-Whitney U tests were used to determine intragroup and intergroup differences as regards qualitative data. To compare quantitative data between the groups, chi-square and Fisher's exact tests were undertaken, while intragroup differences were tested with McNemar test. The level of statistical significance was set at p<0.05. Statistical analysis of the data obtained revealed a statistically significant difference between the data of T0 and T1 and the data of T0 and T2 of the PI scores and between T0 and T2 of the GBI scores in the group treated with the lingual appliance. The GBI value increased significantly between T0 and T1 but decreased significantly between T1 and T2 (p<0.01) in the group treated with labial appliance. S. mutans counts increased significantly between T0 and T2 in the saliva samples of patients treated with lingual appliance. No statistically significant differences were found between S. mutans and Lactobacillus counts at the three terms of saliva collection in patients treated with labial appliance. No statistically significant differences were found between the two groups at the three time points as regards the salivary flow rate and saliva buffer capacity. Lingual and labial orthodontic appliances showed a different potential in modifying the investigated clinical parameters: patients wearing STb lingual orthodontic appliance had more plaque retention 4 and 8 weeks after bonding, while there were more gingival inflammation and more S. mutans counts 8 weeks after bonding. No differences were found between the two groups as regards the Lactobacillus counts, the salivary flow rate, and saliva buffer capacity.

Chronological grey scale changes in supporting alveolar bone by removable partial denture placement on patients with periodontal disease: A 6-month follow-up study using digital subtraction analysis.

PubMed

Watanabe, Chie; Wada, Junichiro; Mizutani, Koji; Watanabe, Hiroshi; Wakabayashi, Noriyuki

2017-08-01

The purpose was to assess the early effects of removable partial denture (RPD) placement on abutment teeth in patients with periodontal disease. Fifteen distal-extension RPDs and 19 abutment teeth were evaluated in 13 patients with moderate-to-severe periodontal diseases. Clinical periodontal records and grey level (GL) score based on digital subtraction radiography were measured on the day of denture placement (baseline) and at 1day, 1 week, 1 month, 3 months, and 6 months after the placement. Occlusal force on total dentition (Ft) and abutment tooth (Fa) were recorded with (baseline) and without denture on the day of the placement, and with denture in the follow-up examinations. No statistically significant difference between a follow-up period and the baseline was found in the clinical periodontal and occlusal force records, except for Ft with denture on the day of the placement, which was significantly lower than the baseline (p<0.05). The GL at distal crestal of the abutment was significantly higher at 1 week after the placement than at the baseline (p<0.05), while the scores of following examinations returned to the baseline level. The distal crestal bone of the abutment tooth transitorily reacts to mechanical stress due to the denture placement, while this does not suggest a detrimental effect within the limitation of the study design with a short-term observation period. The RPDs can be safely used for patients with periodontal diseases for at least 6 months if they are properly placed and maintained by professional care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Chance performance and floor effects: threats to the validity of the Wechsler Memory Scale--fourth edition designs subtest.

PubMed

Martin, Phillip K; Schroeder, Ryan W

2014-06-01

The Designs subtest allows for accumulation of raw score points by chance alone, creating the potential for artificially inflated performances, especially in older patients. A random number generator was used to simulate the random selection and placement of cards by 100 test naive participants, resulting in a mean raw score of 36.26 (SD = 3.86). This resulted in relatively high-scaled scores in the 45-54, 55-64, and 65-69 age groups on Designs II. In the latter age group, in particular, the mean simulated performance resulted in a scaled score of 7, with scores 1 SD below and above the performance mean translating to scaled scores of 5 and 8, respectively. The findings indicate that clinicians should use caution when interpreting Designs II performance in these age groups, as our simulations demonstrated that low average to average range scores occur frequently when patients are relying solely on chance performance. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Long-term Stability of Soft Tissue Esthetic Outcomes Following Conventional Single Implant Treatment in the Anterior Maxilla: 10-12 Year Results.

PubMed

Rokn, A; Bassir, S H; Rasouli Ghahroudi, A A; Kharazifard, M J; Manesheof, R

2016-01-01

The present study aimed to evaluate the long-term stability of esthetic outcomes of soft tissue around maxillary anterior single-tooth implants after 10-to-12 years of loading. Patients who had been treated for single-tooth implants in the anterior maxilla between February 2000 and July 2002 were invited to participate in the study. All implants had been placed according to delayed implant placement and conventional loading protocols without any connective tissue graft or papilla preservation flaps. Pink Esthetic Score (PES) was rated using standardized clinical photographs to assess the esthetic outcomes of the implant treatment at the time of crown placement and at time of follow-up examination which was at least 10 years after the crown placement. A total of 19 patients were included. The mean score of PES was 11.63 (SD 1.61; range 7-14) at baseline. After 10-to-12 years of function, a mean PES score of 11.05 (SD 2.09; range 6-14) was recorded. No significant differences were found in the esthetic outcomes, categorized based on clinically relevant levels, between the baseline and follow-up session (p>0.05). Within limitation of the present study, it can be concluded that the esthetic outcomes of soft tissue around the maxillary anterior single-tooth implants placed using conventional implant placement technique remained stable in the long-term.

Raising Rigor, Getting Results: Lessons Learned from AP Expansion

ERIC Educational Resources Information Center

Wakelyn, David

2009-01-01

Advanced Placement (AP), which enables high school students to take introductory college-level courses, is the nation's oldest example of a rigorous, common curriculum. Students who score well on AP exams are more likely to persist in college and earn a degree. The Advanced Placement Expansion project of the National Governors Association Center…

Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: A prospective Japanese multicenter study

PubMed Central

Sasaki, Reina; Sakai, Yuji; Tsuyuguchi, Toshio; Nishikawa, Takao; Fujimoto, Tatsuya; Mikami, Shigeru; Sugiyama, Harutoshi; Yokosuka, Osamu

2016-01-01

AIM: To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet obstruction. METHODS: This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, self-expandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the baseline. RESULTS: Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients (10.3%) in the form of mild pneumonitis. No other morbidities or mortalities were observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients (7.7%) on account of tumor growth. CONCLUSION: Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients’ quality of life. PMID:27076769

Parametric study of sensor placement for vision-based relative navigation system of multiple spacecraft

NASA Astrophysics Data System (ADS)

Jeong, Junho; Kim, Seungkeun; Suk, Jinyoung

2017-12-01

In order to overcome the limited range of GPS-based techniques, vision-based relative navigation methods have recently emerged as alternative approaches for a high Earth orbit (HEO) or deep space missions. Therefore, various vision-based relative navigation systems use for proximity operations between two spacecraft. For the implementation of these systems, a sensor placement problem can occur on the exterior of spacecraft due to its limited space. To deal with the sensor placement, this paper proposes a novel methodology for a vision-based relative navigation based on multiple position sensitive diode (PSD) sensors and multiple infrared beacon modules. For the proposed method, an iterated parametric study is used based on the farthest point optimization (FPO) and a constrained extended Kalman filter (CEKF). Each algorithm is applied to set the location of the sensors and to estimate relative positions and attitudes according to each combination by the PSDs and beacons. After that, scores for the sensor placement are calculated with respect to parameters: the number of the PSDs, number of the beacons, and accuracy of relative estimates. Then, the best scoring candidate is determined for the sensor placement. Moreover, the results of the iterated estimation show that the accuracy improves dramatically, as the number of the PSDs increases from one to three.

FUNCTIONAL HOP TESTS AND TUCK JUMP ASSESSMENT SCORES BETWEEN FEMALE DIVISION I COLLEGIATE ATHLETES PARTICIPATING IN HIGH VERSUS LOW ACL INJURY PRONE SPORTS: A CROSS SECTIONAL ANALYSIS

PubMed Central

Hoog, Philipp; Warren, Meghan; Smith, Craig A.

2016-01-01

Background Although functional tests including the single leg hop (SLH), triple hop (TH), cross over hop (COH) for distance, and the tuck jump assessment (TJA) are used for return to play (RTP) criteria for post anterior cruciate ligament (ACL) injury, sport-specific baseline measurements are limited. Purpose The purpose of this study was to examine differences in SLH, TH, and COH distance and limb symmetry index (LSI), as well as total scores, number of jumps, and individual flaws of the TJA in 97 injury-free Division I (DI) collegiate female student athletes participating in ACL injury prone vs. non ACL injury prone sports. The hypothesis was that significant mean differences and asymmetries (LSI) would exist between the two groups in SLH, TH, COH and TJA. Study Design Cross sectional. Methods Due to research suggesting inherent ACL injury risk associated with specific sport involvement, participants were grouped into high (HR, n=57) and low (LR, n=40) ACL injury risk based on participating in a sport with high or low ACL injury rates. The HR group was composed of athletes participating in soccer, basketball, and volleyball, while the LR group athletes participated in diving, cross country, and track and field. Participants performed all standard functional tests (SFT) and side-to-side differences for each participant as well as between group differences were assessed for the hop tests. The LSI, a ratio frequently used to gauge athletes’ readiness for RTP post injury, was also assessed for between group differences. The TJA was compared between the groups on individual flaws, overall scores, and number of jumps performed. Results No between group differences for hop distances were found, with medium to large effect sizes for SLH, TH, and COH. The HR group had a higher TJA score, number of jumps, and higher proportion of the flaw of ‘foot placement not shoulder width apart’. Conclusion Although most SFT's showed no significant differences between athlete groups, some differences were seen in the TJA; the HR group showed an increase in ‘foot placement not shoulder width apart’ flaw, higher overall flaw scores, and overall jumped more times compared to the LR group. These results may warrant caution in relying solely on SFT for RTP decisions, due to potential asymmetries seen in an uninjured population with baseline testing. Level of Evidence 4 PMID:27904796

Academic achievement and course taking among language minority youth in U.S. schools: Effects of ESL placement

PubMed Central

Callahan, Rebecca; Wilkinson, Lindsey; Muller, Chandra

2014-01-01

The 1974 Lau decision requires that U.S. public schools ensure a meaningful education for students learning English. English as a Second Language (ESL) placement is an institutional response to the linguistic needs of these students; however, its academic implications remain largely unexplored. Using nationally representative data from the Educational Longitudinal Study (ELS), the effects of ESL placement on college preparatory course enrollment and academic achievement of language minority students are estimated, first with fixed effects regression models and then with multi-level propensity score matching techniques. While numerous school and individual level factors beyond language proficiency predict ESL placement, a significant negative estimated effect of ESL placement on science enrollment and cumulative GPA is consistently found. Perhaps more important, however, no positive effects of ESL placement on the achievement of language minority youth are found when accounting for English proficiency and other potential covariates. PMID:25431506

Academic achievement and course taking among language minority youth in U.S. schools: Effects of ESL placement.

PubMed

Callahan, Rebecca; Wilkinson, Lindsey; Muller, Chandra

2010-03-01

The 1974 Lau decision requires that U.S. public schools ensure a meaningful education for students learning English. English as a Second Language (ESL) placement is an institutional response to the linguistic needs of these students; however, its academic implications remain largely unexplored. Using nationally representative data from the Educational Longitudinal Study (ELS), the effects of ESL placement on college preparatory course enrollment and academic achievement of language minority students are estimated, first with fixed effects regression models and then with multi-level propensity score matching techniques. While numerous school and individual level factors beyond language proficiency predict ESL placement, a significant negative estimated effect of ESL placement on science enrollment and cumulative GPA is consistently found. Perhaps more important, however, no positive effects of ESL placement on the achievement of language minority youth are found when accounting for English proficiency and other potential covariates.

English Placement Testing, Multiple Measures, and Disproportionate Impact: An Analysis of the Criterion- and Content-Related Validity Evidence for the Reading & Writing Placement Tests in the San Diego Community College District.

ERIC Educational Resources Information Center

Armstrong, William B.

As part of an effort to statistically validate the placement tests used in California's San Diego Community College District (SDCCD) a study was undertaken to review the criteria- and content-related validity of the Assessment and Placement Services (APS) reading and writing tests. Evidence of criteria and content validity was gathered from…

Collaborative learning and testing in introductory general chemistry

NASA Astrophysics Data System (ADS)

Amaral, Katie Elizabeth

Students taking General chemistry at the University of Florida are either well-prepared or under-prepared. To meet the needs of the under-prepared students, an introductory course (CHM 1025) was developed. An accurate method of placement into CHM 1025 or the mainstream course (CHM 2045) was needed. The Chemistry Readiness Assessment Exam was written and tested and students are advised to take either course based upon their scores. The accuracy of the cutoff scores was examined, with the minimum passing chemistry score lowered to six correct out of 18, and the math score raised to six correct out of eight. Collaborative problem-solving sessions were held during every CHM 1025 class. These sessions were shown to increase student achievement in CHM 1025. Group placement was also shown to have an effect on student achievement in the course. Students placed randomly into collaborative groups had the highest average GPA, while students placed by achievement had the lowest average GPA. The efficacy of CHM 1025 was examined to determine if the students who required the course do as well in CHM 2045 as those students who did not need it. Students who had taken CHM 1025 had a higher GPA in CHM 2045 than the students who went directly into CHM 2045. Students in the spring semester of 2004 took collaborative exams. Achievement levels of students who had collaborative exams were compared to students who took traditional exams to determine if collaborative testing had an effect on student achievement and retention in CHM 1025. There was no significant difference in achievement although the collaborative exams were harder. Percentages of students taking each exam were also compared, with more students taking the collaborative exams. Finally, undergraduate students called peer mentors, who had taken CHM 1025, were recruited to assist with the course. Mentors helped CHM 1025 students with the collaborative problems. The mentors' presence helped lower students' withdrawal rates in the class. The mentors also benefited from the program, as evidenced by their higher GPA in CHM 2045.

Is it possible to enhance the confidence of student dietitians prior to professional placements? A design-based research model.

PubMed

Ross, L J; Mitchell, L J; Williams, L T

2017-10-01

Student confidence is an important contributor to a successful professional placement experience. The present study aimed to evaluate a placement preparation program for student dietitians and to assess the impact on self-rated confidence with respect to commencing placements. The present study is part of a design-based research approach that involves students in a cyclic enquiry to evaluate and improve curricula. Nutrition and Dietetics students at an Australian university participated in a 1-week mandatory workshop - Pre-Placement week (PrePW), N = 98 students: in 2015 (n = 54) and 2016 (n = 44). An online survey was conducted before and after PrePW using a five-point Likert scale (1 = not confident; 5 = very confident) to assess self-rated confidence to commence placements. Mean (SD) scores were calculated. Paired and independent t-tests evaluated within- and between-group differences, respectively. Before PrePW, the mean (SD) for student confidence to commence placements overall (in all areas of practise) was 'somewhat confident' [2.9 (0.6) in 2015 and 3.0 (0.7) in 2016]. Students were least confident to commence Clinical Practice [2015: 2.5 (0.6); 2016: 2.8 (0.6)] compared to Food Service Management (FSM) [2015: 3.2 (0.9); 2016: 3.1 (0.9)] and Community and Public Health Nutrition (CPHN) [2015: 3.3 (0.9); 2016: 3.2 (0.8)]. Student feedback from PrePW 2015 was used to change the curriculum and PrePW program. The 2016 students reported significantly greater confidence within all areas of practice: Clinical Practice [3.4 (0.6)], FSM [3.7 (0.6)] and CPHN [3.8 (0.6)], including confidence to commence placements overall [3.6 (0.6)] (P < 0.05). Design-based research provides a useful framework for improvement to curricula and, in this case, was successful in enhancing student confidence in preparation for professional placement. © 2017 Commonwealth of Australia. Journal of Human Nutrition and Dietetics © 2017 The British Dietetic Association Ltd.

Predicting Success for Actuarial Students in Undergraduate Mathematics Courses

ERIC Educational Resources Information Center

Smith, Richard Manning; Schumacher, Phyllis A.

2005-01-01

A study of undergraduate actuarial graduates found that math SAT scores, verbal SAT scores, percentile rank in high school graduating class, and percentage score on a college mathematics placement exam had some relevance to forecasting the students' grade point averages in their major. For both males and females, percentile rank in high school…

A low dose of subperiosteal anaesthesia injection versus a high dose of infiltration anaesthesia to minimise the risk of nerve damage at implant placement: A randomised controlled trial.

PubMed

Sánchez-Siles, Mariano; Camacho-Alonso, Fabio; Salazar-Sánchez, Noemi; Aguinaga-Ontoso, Enrique; Muñoz, Javier Guardia; Calvo-Guirado, Jose Luis

2016-01-01

To evaluate whether a low-dose subperiosteal anaesthesia is effective in minimising risks of inferior alveolar nerve damage at implant placement when compared to high-dose infiltration anaesthesia. One hundred and twenty patients requiring the placement of a single implant in order to replace a missing first mandibular were randomly allocated to two groups: group A (awake hemilip) subperiosteal crestal injection equal to 0.9 ml of articaine with 0.5% epinephrine and group B (numb hemilip) infiltration equal to 7.2 ml of articaine with 0.5% epinephrine in the vestibular fundus. Intraoperative sensory control using sensory tests was carried out in all patients. Outcome measures were neurological complications, intraoperative and postoperative visual analogue scale (VAS) scores for pain and swelling, and a questionnaire evaluating patient satisfaction. Patients were followed for 1 week postoperatively. There were no cases of nerve injury. Seven days after surgery the postoperative VAS score for pain and swelling was lower in group A in a statistically significant manner (difference = -3.41%; 95% CI: -5.57, -1.26; P = 0.002 and difference = -3.33%; 95% CI: -5.41, -1.25; P = 0.002, respectively). No nerve damage occurred using either anaesthesia types, therefore the choice of type of anaesthesia is a subjective clinical decision, however it may be preferable to use a low dose (0.9 ml) of subperiosteal anaesthesia, since it is unnecessary to deliver 7.2 ml of articaine to anaesthetise a single mandibular molar implant site.

Effects of Desktop Virtual Reality Environment Training on State Anxiety and Vocational Identity Scores among Persons with Disabilities during Job Placement

ERIC Educational Resources Information Center

Washington, Andre Lamont

2013-01-01

This study examined how desktop virtual reality environment training (DVRET) affected state anxiety and vocational identity of vocational rehabilitation services consumers during job placement/job readiness activities. It utilized a quantitative research model with a quasi-experimental pretest-posttest design plus some qualitative descriptive…

Ethnic and Gender Differences in Advanced Placement Exam Performance: A Multiyear National Analysis

ERIC Educational Resources Information Center

Holmes, Maria Alexander

2013-01-01

Purpose: The purpose of this study was to analyze ethnic and gender differences in Advanced Placement (AP) exam performance of U.S. high school students. Specifically, the extent to which differences exist in overall AP exam performance scores within and between four ethnic groups (i.e., Asian, Black, Hispanic, and White) was investigated. Within…

Teacher Scaffolding of Academic Language in an Advanced Placement U.S. History Class

ERIC Educational Resources Information Center

Gritter, Kristine; Beers, Scott; Knaus, Robert W.

2013-01-01

This article examines teacher scaffolding of academic language in an Advanced Placement United States History (APUSH) course throughout a school year for one student who received a perfect score on the end of year APUSH exam. Data includes four months of observation of teacher instructional strategies to scaffold student writing and vignettes of…

Validating College Course Placement Decisions Based on CLEP Exam Scores: CLEP Placement Validity Study Results. Statistical Report

ERIC Educational Resources Information Center

Godfrey, Kelly E.; Jagesic, Sanja

2016-01-01

The College-Level Examination Program® (CLEP®) is a computer-based prior-learning assessment that allows examinees the opportunity to demonstrate mastery of knowledge and skills necessary to earn postsecondary course credit in higher education. Currently, there are 33 exams in five subject areas: composition and literature, world languages,…

The Effect of Advanced Placement or International Baccalaureate Exam Scores upon College GPA and College Choice

ERIC Educational Resources Information Center

Farmer, Daniel Raymond

2017-01-01

This quantitative, causal-comparative and correlational study analyzed students' academic performance in college based on whether the student was classified as an International Baccalaureate student, an Advanced Placement student, or a non-accelerated student (those who did not participate in IB or AP) and how that choice of academic program…

Outcomes of a proficiency-based skills curriculum at the beginning of the fourth year for senior medical students entering surgery.

PubMed

Wade, Thomas J; Lorbeer, Karly; Awad, Michael M; Woodhouse, Julie; DeClue, Angela; Brunt, L Michael

2015-10-01

We hypothesized that a proficiency-based curriculum administered early in the fourth year to senior medical students (MS4) would achieve outcomes comparable to a similar program administered during surgical internship. MS4 (n = 18) entering any surgical specialty enrolled in a proficiency-based skills curriculum at the beginning of the fourth year that included suturing/knot-tying, on-call problems, laparoscopic, and other skills (urinary catheter, sterile prep/drape, IV placement, informed consent, electrosurgical use). Assessment was at 4-12 weeks after training by a modified Objective Structured Assessment of Technical Skills (OSATS). Suturing and knot tying tasks were assessed by time and OSATS technical proficiency (TP) scores (1 [novice], 3 [proficient], 5 [expert]). Outcomes were compared with PGY-1 residents who received similar training at the beginning of internship and assessment 4-12 weeks later. Data are presented as mean values ± standard deviation; statistical significance was assessed by Student's t test. Fifteen of 18 MS4 (83%) reached proficiency on all 15 tasks, and 2 others were proficient on all but 1 laparoscopic task. Compared with PGY-1s, MS4 were significantly faster for 3 of 5 suturing and tying tasks and total task time (547 ± 63 vs 637 ± 127 s; P < .05). Mean TP scores were similar for both groups (MS4, 3.4 ± 0.5 vs PGY-1, 3.1 ± .57; P = NS). MS4 OSATS scores were higher for IV placement, informed consent, and urinary catheter placement, but lower for prep and drape and for management of on-call problems. MS4 who participate in a proficiency-based curriculum taught early in the fourth year are able to meet proficiency targets in a high percentage of cases. This approach should better prepare MS4 for surgical internship. Copyright © 2015 Elsevier Inc. All rights reserved.

78 FR 19691 - Applications for New Awards; Advanced Placement (AP) Test Fee Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... DEPARTMENT OF EDUCATION Applications for New Awards; Advanced Placement (AP) Test Fee Program... Information Advanced Placement Test Fee Program. Notice inviting applications for new awards for fiscal year... Program: The AP Test Fee program awards grants to eligible State educational agencies (SEAs) to enable...

77 FR 8848 - Application for New Awards; Advanced Placement (AP) Test Fee Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-15

... DEPARTMENT OF EDUCATION Application for New Awards; Advanced Placement (AP) Test Fee Program... Information: Advanced Placement Test Fee Program. Notice inviting applications for new awards for fiscal year... Description Purpose of Program: The AP Test Fee program awards grants to eligible State educational agencies...

Clinical outcome after intrahepatic venous stent placement for malignant inferior vena cava syndrome.

PubMed

Brountzos, Elias N; Binkert, Christoph A; Panagiotou, Irene E; Petersen, Bryan D; Timmermans, Hans; Lakin, Paul C

2004-01-01

We evaluated the clinical outcome of malignant inferior vena cava (IVC) syndrome after intrahepatic IVC stent placement by retrospective analysis of 50 consecutive patients (25 men, 25 women, age 32-83 years) with malignant IVC syndrome who were treated with intrahepatic stent placement. Gianturco-Rosch-Z (GRZ) stents (n = 45), and Wallstents (n = 5) were inserted. Clinical outcome was assessed from patients' records using a score based on leg swelling, scrotal/vulvar edema, ascites and anasarca before and after stent placement, as well as at last follow-up visit before death. Clinical follow-up was supplemented by duplex sonography in 36 patients. Inferior venocavography was performed in 5 patients prior to re- intervention. Follow-up time ranged from 1 to 932 days (mean 62 days). Mean pressure gradient in the IVC was reduced from 14 +/- 4.1 mmHg before to 2.9 +/- 3.2 mmHg after stent placement (p < 0.001). Four patients had stent occlusion, 2 of whom were successfully re-stented. Primary and secondary patency was 59% and 100%, respectively at 540 days. Immediate clinical data were available in 44 patients: 38 improved; 6 did not respond. Last follow-up visit data were available in 36 patients: 24 showed persistent symptom relief till death. All symptom scores were significantly improved after stent placement (p < 0.001) and with the exception of ascites, remained significantly improved (p < 0.05) until the last follow-up. Increased serum bilirubin was a common characteristic of clinical failures and recurrences. Intrahepatic IVC stent placement resulted in significant symptomatic relief in patients with malignant IVC syndrome. Palliation was effective even in patients with a very short life expectancy.

First impressions count: does FAIRness affect adaptation of clinical clerks in their first clinical placement?

PubMed

Edafe, Ovie; Mistry, Natasha; Chan, Philip

2013-09-01

FAIRness (Feedback, Activity, Individualisation, Relevance) teaching is a structured program, comprising series of classes in which student work is anonymised and reviewed by the whole class, as well as students receiving private feedback on their written work. The class work emphasises logic, structure and order in history and examination, with a diagnostic and management focus. The effect of FAIRness teaching methods on the adaptation of medical students entering their first clinical rotations was studied. 18 students in FAIRness placements and 72 students in conventional placements, all in medical/surgical units in the same University teaching hospital were studied. They completed questionnaires relating to effectiveness and quality of clinical teaching. Some students additionally attended focus groups, at the start of placement to discuss their expectations, and after 3 weeks, to discuss their adaptation to the clinical learning environment. All students entering clinical placements had low expectations of their future teaching. Students in standard placements still expressed negative attitudes after 3 weeks, while students on FAIRness placements felt positive. Students in FAIRness placements scored significantly higher on questions related to feedback and review of student work. FAIRness teaching practices help students to adapt to their first clinical placements.

Long-term Stability of Soft Tissue Esthetic Outcomes Following Conventional Single Implant Treatment in the Anterior Maxilla: 10-12 Year Results

PubMed Central

Rokn, A; Bassir, SH; Rasouli Ghahroudi, AA; Kharazifard, MJ; Manesheof, R

2016-01-01

Purpose: The present study aimed to evaluate the long-term stability of esthetic outcomes of soft tissue around maxillary anterior single-tooth implants after 10-to-12 years of loading. Methods: Patients who had been treated for single-tooth implants in the anterior maxilla between February 2000 and July 2002 were invited to participate in the study. All implants had been placed according to delayed implant placement and conventional loading protocols without any connective tissue graft or papilla preservation flaps. Pink Esthetic Score (PES) was rated using standardized clinical photographs to assess the esthetic outcomes of the implant treatment at the time of crown placement and at time of follow-up examination which was at least 10 years after the crown placement. Results: A total of 19 patients were included. The mean score of PES was 11.63 (SD 1.61; range 7-14) at baseline. After 10-to-12 years of function, a mean PES score of 11.05 (SD 2.09; range 6–14) was recorded. No significant differences were found in the esthetic outcomes, categorized based on clinically relevant levels, between the baseline and follow-up session (p>0.05). Conclusion: Within limitation of the present study, it can be concluded that the esthetic outcomes of soft tissue around the maxillary anterior single-tooth implants placed using conventional implant placement technique remained stable in the long-term. PMID:27990185

Acetaminophen Versus Liquefied Ibuprofen for Control of Pain During Separation in Orthodontic Patients: A Randomized Triple Blinded Clinical Trial.

PubMed

Hosseinzadeh Nik, Tahereh; Shahsavari, Negin; Ghadirian, Hannaneh; Ostad, Seyed Nasser

2016-07-01

The aim of this randomized clinical study was to investigate the effectiveness of acetaminophen 650 mg or liquefied ibuprofen 400 mg in pain control of orthodontic patients during separation with an elastic separator. A total of 101 patients with specific inclusion criteria were divided randomly into three groups (acetaminophen, liquefied ibuprofen, and placebo). They were instructed to take their drugs one hour before separator placement and every six hours afterward (five doses in total). They recorded their discomfort on visual analog scales immediately after separator placement, 2 hours later, 6 hours later, at bedtime, and 24 hours after separator placement. Repeated measure analysis of variance (ANOVA) was used to compare the mean pain scores between the three groups. Data were collected from 89 patients. The pain increased with time in all groups. Pain scores were statistically lower in the analgesic groups compared with the placebo group (P.value<0.001), but no statistically significant difference was found in mean pain scores between the two drug groups (acetaminophen and liquefied ibuprofen) (P.value=1). Acetaminophen and liquefied ibuprofen have similar potential in pain reduction during separation.

ESL Placement and Schools

PubMed Central

Callahan, Rebecca; Wilkinson, Lindsey; Muller, Chandra; Frisco, Michelle

2010-01-01

In this study, the authors explore English as a Second Language (ESL) placement as a measure of how schools label and process immigrant students. Using propensity score matching and data from the Adolescent Health and Academic Achievement Study and the National Longitudinal Study of Adolescent Health, the authors estimate the effect of ESL placement on immigrant achievement. In schools with more immigrant students, the authors find that ESL placement results in higher levels of academic performance; in schools with few immigrant students, the effect reverses. This is not to suggest a one-size-fits-all policy; many immigrant students, regardless of school composition, generational status, or ESL placement, struggle to achieve at levels sufficient for acceptance to a 4-year university. This study offers several factors to be taken into consideration as schools develop policies and practices to provide immigrant students opportunities to learn. PMID:20617111

Active Learning in the Physics Classroom

NASA Astrophysics Data System (ADS)

Naron, Carol

Many students enter physics classes filled with misconceptions about physics concepts. Students tend to retain these misconceptions into their adult lives, even after physics instruction. Constructivist researchers have found that students gain understanding through their experiences. Researchers have also found that active learning practices increase conceptual understanding of introductory physics students. This project study sought to examine whether incorporating active learning practices in an advanced placement physics classroom increased conceptual understanding as measured by the force concept inventory (FCI). Physics students at the study site were given the FCI as both a pre- and posttest. Test data were analyzed using two different methods---a repeated-measures t test and the Hake gain method. The results of this research project showed that test score gains were statistically significant, as measured by the t test. The Hake gain results indicated a low (22.5%) gain for the class. The resulting project was a curriculum plan for teaching the mechanics portion of Advanced Placement (AP) physics B as well as several active learning classroom practices supported by the research. This project will allow AP physics teachers an opportunity to improve their curricular practices. Locally, the results of this project study showed that research participants gained understanding of physics concepts. Social change may occur as teachers implement active learning strategies, thus creating improved student understanding of physics concepts.

Test-retest reliability of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale.

PubMed

Gustafsson, Margareta; Blomberg, Karin; Holmefur, Marie

2015-07-01

The Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale evaluates the student nurses' perception of the learning environment and supervision within the clinical placement. It has never been tested in a replication study. The aim of the present study was to evaluate the test-retest reliability of the CLES + T scale. The CLES + T scale was administered twice to a group of 42 student nurses, with a one-week interval. Test-retest reliability was determined by calculations of Intraclass Correlation Coefficients (ICCs) and weighted Kappa coefficients. Standard Error of Measurements (SEM) and Smallest Detectable Difference (SDD) determined the precision of individual scores. Bland-Altman plots were created for analyses of systematic differences between the test occasions. The results of the study showed that the stability over time was good to excellent (ICC 0.88-0.96) in the sub-dimensions "Supervisory relationship", "Pedagogical atmosphere on the ward" and "Role of the nurse teacher". Measurements of "Premises of nursing on the ward" and "Leadership style of the manager" had lower but still acceptable stability (ICC 0.70-0.75). No systematic differences occurred between the test occasions. This study supports the usefulness of the CLES + T scale as a reliable measure of the student nurses' perception of the learning environment within the clinical placement at a hospital. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Predictive Validity of the University Student Selection Examination

ERIC Educational Resources Information Center

Karakaya, Ismail; Tavsancil, Ezel

2008-01-01

The main purpose of this study is to investigate the predictive validity of the 2003 University Student Selection Examination (OSS). For this purpose, freshman grade point average (FGPA) in higher education was predicted by raw scores, standard scores, and placement scores (YEP). This study has been conducted on a research group. In this study,…

Demographic, Clinical, and Geographic Predictors of Placement Disruption among Foster Care Youth Receiving Wraparound Services

ERIC Educational Resources Information Center

Weiner, Dana A.; Leon, Scott C.; Stiehl, Michael J.

2011-01-01

The effective delivery of wraparound depends upon the availability of a wide range of community-based services. This study seeks to determine the impact of proximity to resources on the effectiveness of a wraparound program for stabilizing foster care placements among a sample of youth. We present a methodology for deriving proximity scores for…

Kinship and Nonrelative Foster Care: The Effect of Placement Type on Child Well-Being

ERIC Educational Resources Information Center

Font, Sarah A.

2014-01-01

This study uses a national sample of 1,215 children, ages 6-17, who spent some time in formal kinship or nonrelative foster care to identify the effect of placement type on academic achievement, behavior, and health. Several identification strategies are used to reduce selection bias, including ordinary least squares, change score models,…

What Does a Student Know Who Earns a Top Score on the Advanced Placement Chemistry Exam?

ERIC Educational Resources Information Center

Claesgens, Jennifer; Daubenmire, Paul L.; Scalise, Kathleen M.; Balicki, Scott; Gochyyev, Perman; Stacy, Angelica M.

2014-01-01

This paper compares the performance of students at a high-performing U.S. public school (n = 64) on the advanced placement (AP) chemistry exam to their performance on the ChemQuery assessment system. The AP chemistry exam was chosen because, as the National Research Council acknowledges, it is the "perceived standard of excellence and school…

An Investigation of College Students' Perceptions of Advanced Placement® Courses. Research Note 2013-2

ERIC Educational Resources Information Center

Cooney, Siobhan M.; McKillip, Mary E. M.; Smith, Kara

2013-01-01

The present study investigates how current college students perceive their experiences in high school Advanced Placement Program (AP) courses. The goal of this research was twofold: We wanted to not only add to the existing literature on outcomes for AP students but also investigate possible benefits for students without success (i.e., a score of…

Class of 2014 Advanced Placement and International Baccalaureate Exam Participation and Performance. Memorandum

ERIC Educational Resources Information Center

Sanderson, Geoffrey T.

2015-01-01

Beginning in 2006, Maryland has led the nation as the state with the highest percentage of graduates who earned one or more Advanced Placement (AP) exam scores of 3 or higher. Students in the Montgomery County (Maryland) Public Schools (MCPS) Class of 2014 continued to outperform students in the state of Maryland on AP examinations based on AP…

Vaginoscopy compared to traditional hysteroscopy for hysteroscopic sterilization. A randomized trial.

PubMed

Chapa, Hector O; Venegas, Gonzalo

2015-01-01

To compare vaginoscopic hysteroscopic sterilization with traditional hysteroscopic approach for differences in pain, bilateral microinsert placement rates, and procedure time. We performed a prospective, randomized, single-blinded study of hysteroscopic sterilization using the Essure System. The study setting was an inner city ObGyn clinic. Ninety patients were randomized to either vaginoscopy or traditional approach. The traditional approach was speculum insertion, paracervical analgesia, and tenaculum. All procedures were done with a 5 mm, 30 degree rigid hysteroscope. Main outcome measures were pain scores (10-point visual analog scale), bilateral placement rates, and procedure times. Vaginoscopy was successful in 42/45 patients (93%). There was no statistically significant difference in pain-scores for microinsert placement between the groups (p = 0.71). First attempt, bilateral microinsert placement rate was 95% (40/42) with vaginoscopy and 95% (43/45) with traditional (p = 0.89). Time for treatment completion was 16 minutes (mean) (range, 13-21) in the traditional group versus vaginoscopy time of 9 minutes (mean) (range, 7-11) (p = 0.03). Hysteroscopic sterilization via vaginoscopy is feasible with bilateral microinsert rates comparable to those of traditional hysteroscopy. Vaginoscopy is associated with less overall discomfort and is faster to perform.

A Hybrid of a CBT- and a CAT-based New English Placement Test Online (NEPTON)

ERIC Educational Resources Information Center

Papadima-Sophocleous, Salomi

2008-01-01

In recent years, many tertiary institutions have been changing their pen-and-paper English placement test practices into computer based ones. In the process of constructing the University of Nicosia (Intercollege) New English Placement Test Online (NEPTON), we discovered how to redesign our test to include the use of technology. The present…

Visual-Constructional Ability in Individuals with Severe Obesity: Rey Complex Figure Test Accuracy and the Q-Score.

PubMed

Sargénius, Hanna L; Bylsma, Frederick W; Lydersen, Stian; Hestad, Knut

2017-01-01

The aims of this study were to investigate visual-construction and organizational strategy among individuals with severe obesity, as measured by the Rey Complex Figure Test (RCFT), and to examine the validity of the Q-score as a measure for the quality of performance on the RCFT. Ninety-six non-demented morbidly obese (MO) patients and 100 healthy controls (HC) completed the RCFT. Their performance was calculated by applying the standard scoring criteria. The quality of the copying process was evaluated per the directions of the Q-score scoring system. Results revealed that the MO did not perform significantly lower than the HC on Copy accuracy (mean difference -0.302, CI -1.374 to 0.769, p = 0.579). In contrast, the groups did statistically differ from each other, with MO performing poorer than the HC on the Q-score (mean -1.784, CI -3.237 to -0.331, p = 0.016) and the Unit points (mean -1.409, CI -2.291 to -0.528, p = 0.002), but not on the Order points score (mean -0.351, CI -0.994 to 0.293, p = 0.284). Differences on the Unit score and the Q-score were slightly reduced when adjusting for gender, age, and education. This study presents evidence supporting the presence of inefficiency in visuospatial constructional ability among MO patients. We believe we have found an indication that the Q-score captures a wider range of cognitive processes that are not described by traditional scoring methods. Rather than considering accuracy and placement of the different elements only, the Q-score focuses more on how the subject has approached the task.

Zum Problem des Tests, insbesondere des Einstufungstests, im Deutschunterricht fuer Auslaender (On the Problem of Tests, Particularly Placement Tests, in Teaching German to Foreigners)

ERIC Educational Resources Information Center

Breitung, H. A.; And Others

1974-01-01

New placement procedure at Humboldt University includes interviews and placement tests. Interviews reveal response ability, tempo, pronunciation, comprehension, etc. The 60-minute test that follows is described and results discussed, as well as difficulty level and grading. Results: better grouping of students, less shifting, better work. (Text is…

Hepatocellular Carcinoma Complicated by Gastroduodenal Obstruction: Palliative Treatment with Metallic Stent Placement

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

Lee, Ye Jin; Kim, Jin Hyoung, E-mail: m1fenew@daum.net; Song, Ho-Young

Purpose: To evaluate the clinical effectiveness of self-expandable metallic stents in seven patients with malignant gastroduodenal obstruction caused by inoperable hepatocellular carcinoma (HCC). Methods: Seven patients with gastroduodenal obstruction caused by advanced HCC underwent metallic stent placement from 2003 to 2010. These patients had total dysphagia (n = 5) or were able to eat only liquids (n = 2) before stent placement. Patients had Eastern Cooperative Oncology Group performance scores of 2 or 3, and Child-Pugh classification B or C. Results: Stent placement was technically successful in all seven patients (100%) and clinically successful in six (86%). Five patients couldmore » eat a soft diet, and one patient tolerated regular diet after stent placement. Stent-related obstructive jaundice occurred in one patient. One patient had hematemesis 11 days after stent placement. Overall mean survival was 51 days (range, 10-119 days). Stent patency was preserved in six patients with clinical success until death. Conclusion: Placement of a covered self-expandable metallic stent may offer good palliation in patients with gastroduodenal obstruction due to advanced HCC.« less

A prospective assessment of pelvic infection risk following same-day sexually transmitted infection testing and levonorgestrel intrauterine system placement.

PubMed

Turok, David K; Eisenberg, David L; Teal, Stephanie B; Keder, Lisa M; Creinin, Mitchell D

2016-11-01

Misperceptions persist that intrauterine device placement is related to pelvic infections and Chlamydia and gonorrhea testing results are needed prior to placement. We sought to evaluate the relationship of Chlamydia and gonorrhea screening to pelvic infection for up to 2 years following placement of the levonorgestrel 52-mg intrauterine system. A total of 1751 nulliparous and multiparous females 16 to 45 years old enrolled in a multicenter trial designed to evaluate the efficacy and safety of a new levonorgestrel intrauterine system for up to 7 years. Participants had Chlamydia screening at study entry and yearly if they were age ≤25 years. Women also had baseline gonorrhea screening if testing had not been performed since starting their current sexual relationship. Those who changed sexual partners during the trial had repeated Chlamydia and gonorrhea testing. Intrauterine system insertion could occur on the same day as screening. Participants did not receive prophylactic antibiotics for intrauterine system placement. Investigators performed pelvic examinations after 12 and 24 months and when clinically indicated during visits at 3, 6, and 18 months after placement and unscheduled visits. Pelvic infection included any clinical diagnosis of pelvic inflammatory disease or endometritis. Most participants (n = 1364, 79.6%) did not have sexually transmitted infection test results available prior to intrauterine system placement. In all, 29 (1.7%) participants had positive baseline testing for a sexually transmitted infection (Chlamydia, n = 25; gonorrhea, n = 3; both, n = 1); 6 of these participants had known results (all with Chlamydia infection) prior to intrauterine system placement and received treatment before enrollment. The 23 participants whose results were not known at the time of intrauterine system placement received treatment without intrauterine system removal and none developed pelvic infection. The incidence of positive Chlamydia testing was similar among those with and without known test results at the time of intrauterine system placement (1.9% vs 1.5%, respectively, P = .6). Nine (0.5%) participants had a diagnosis of pelvic infection over 2 years after placement, all of whom had negative Chlamydia screening on the day of or within 1 month after intrauterine system placement. Infections were diagnosed in 3 participants within 7 days, 1 at 39 days, and 5 at ≥6 months. Seven participants received outpatient antibiotic treatment and 2 (diagnoses between 6-12 months after placement) received inpatient treatment. Two (0.1%) participants had intrauterine system removal related to infection (at 6 days and at 7 months after placement), both of whom only required outpatient treatment. Conducting Chlamydia and gonorrhea testing on the same day as intrauterine system placement is associated with a low risk of pelvic infection (0.2%). Over the first 2 years of intrauterine system use, infections are infrequent and not temporally related to intrauterine system placement. Pelvic infection can be successfully treated in most women with outpatient antibiotics and typically does not require intrauterine system removal. Women without clinical evidence of active infection can have intrauterine system placement and sexually transmitted infection screening, if indicated, on the same day. Copyright © 2016 Elsevier Inc. All rights reserved.

ESL Placement and Schools: Effects on Immigrant Achievement.

PubMed

Callahan, Rebecca; Wilkinson, Lindsey; Muller, Chandra; Frisco, Michelle

2009-05-01

In this study, the authors explore English as a Second Language (ESL) placement as a measure of how schools label and process immigrant students. Using propensity score matching and data from the Adolescent Health and Academic Achievement Study and the National Longitudinal Study of Adolescent Health, the authors estimate the effect of ESL placement on immigrant achievement. In schools with more immigrant students, the authors find that ESL placement results in higher levels of academic performance; in schools with few immigrant students, the effect reverses. This is not to suggest a one-size-fits-all policy; many immigrant students, regardless of school composition, generational status, or ESL placement, struggle to achieve at levels sufficient for acceptance to a 4-year university. This study offers several factors to be taken into consideration as schools develop policies and practices to provide immigrant students opportunities to learn.

Class of 2013 Advanced Placement and International Baccalaureate Exam Participation and Performance. Memorandum

ERIC Educational Resources Information Center

Sanderson, Geoffrey T.

2014-01-01

Beginning in 2006, Maryland has led the nation as the state with the highest percentage of graduates who earned one or more Advanced Placement (AP) exam scores of 3 or higher. Students in the Montgomery County Public Schools (MCPS) Class of 2013 continued to outperform students in the state of Maryland and the nation on AP examinations, based on…

A Randomized Controlled Trial of Music Use During Epidural Catheter Placement on Laboring Parturient Anxiety, Pain, and Satisfaction.

PubMed

Drzymalski, Dan M; Tsen, Lawrence C; Palanisamy, Arvind; Zhou, Jie; Huang, Chuan-Chin; Kodali, Bhavani S

2017-02-01

Although music is frequently used to promote a relaxing environment during labor and delivery, the effect of its use during the placement of neuraxial techniques is unknown. Our study sought to determine the effects of music use on laboring parturients during epidural catheter placement, with the hypothesis that music use would result in lower anxiety, lower pain, and greater patient satisfaction. We conducted a prospective, randomized, controlled trial of laboring parturients undergoing epidural catheter placement with or without music. The music group listened to the patient's preferred music on a Pandora® station broadcast through an external amplified speaker; the control group listened to no music. All women received a standardized epidural technique and local anesthetic dose. The primary outcomes were 3 measures of anxiety. Secondary outcomes included pain, patient satisfaction, hemodynamic parameters, obstetric parameters, neonatal outcomes, and anesthesia provider anxiety. Intention-to-treat analysis with Bonferroni correction was used for the primary outcomes. For secondary outcomes, a P value of <.001 was considered statistically significant. A total of 100 parturients were randomly assigned, with 99 included in the intention-to-treat analysis. Patient characteristics were similar in both groups; in the music group, the duration of music use was 31.1 ± 7.7 minutes (mean ± SD). The music group experienced higher anxiety as measured by Numeric Rating Scale scores immediately after epidural catheter placement (2.9 ± 3.3 vs 1.4 ± 1.7, mean difference 1.5 [95% confidence interval {CI} 0.2-2.7], P = .02), and as measured by fewer parturients being "very much relaxed" 1 hour after epidural catheter placement (51% vs 78%, odds ratio {OR} 0.3 [95% CI 0.1-0.9], P = .02). No differences in mean pain scores immediately after placement or patient satisfaction with the overall epidural placement experience were observed; however, the desire for music use with future epidural catheter placements was higher in the music group (84% vs 45%, OR 6.4 [95% CI 2.5-16.5], P < .0001). No differences in the difficulty with the epidural catheter placement or in the rate of cesarean delivery were observed. Music use during epidural catheter placement in laboring parturients is associated with higher postprocedure anxiety and no improvement in pain or satisfaction; however, a stronger desire for music with future epidural catheter placements was observed. Further investigation is needed to determine the effect of music use in parturients requesting and using epidural labor analgesia.

A change to pass/fail grading in the first two years at one medical school results in improved psychological well-being.

PubMed

Bloodgood, Robert A; Short, Jerry G; Jackson, John M; Martindale, James R

2009-05-01

To measure the impact of a change in grading system in the first two years of medical school, from graded (A, B, C, D, F) to pass/fail, on medical students' academic performance, attendance, residency match, satisfaction, and psychological well-being. For both the graded and pass/fail classes, objective data were collected on academic performance in the first- and second-year courses, the clerkships, United States Medical Licensing Examination (USMLE) Steps 1 and 2 Clinical Knowledge (CK), and residency placement. Self-report data were collected using a Web survey (which included the Dupuy General Well-Being Schedule) administered each of the first four semesters of medical school. The study was conducted from 2002 to 2007 at the University of Virginia School of Medicine. The pass/fail class exhibited a significant increase in well-being during each of the first three semesters of medical school relative to the graded class, greater satisfaction with the quality of their medical education during the first four semesters of medical school, and greater satisfaction with their personal lives during the first three semesters of medical school. The graded and pass/fail classes showed no significant differences in performance in first- and second-year courses, grades in clerkships, scores on USMLE Step 1 and Step 2CK, success in residency placement, and attendance at academic activities. A change in grading from letter grades to pass/fail in the first two years of medical school conferred distinct advantages to medical students, in terms of improved psychological well-being and satisfaction, without any reduction in performance in courses or clerkships, USMLE test scores, success in residency placement, or level of attendance.

Can Patients Comprehend the Educational Materials that Hospitals Provide about Common IR Procedures?

PubMed

Sadigh, Gelareh; Hawkins, C Matthew; O'Keefe, John J; Khan, Ramsha; Duszak, Richard

2015-08-01

To assess the readability of online education materials offered by hospitals describing commonly performed interventional radiology (IR) procedures. Online patient education materials from 402 hospitals selected from the Medicare Hospital Compare database were assessed. The presence of an IR service was determined by representation in the Society of Interventional Radiology physician finder directory. Patient online education materials about (i) uterine artery embolization for fibroid tumors, (ii) liver cancer embolization, (iii) varicose vein treatment, (iv) central venous access, (v) inferior vena cava (IVC) filter placement, (vi) nephrostomy tube insertion, (vii) gastrostomy tube placement, and (viii) vertebral augmentation were targeted and assessed by using six validated readability scoring systems. Of 402 hospitals sampled, 156 (39%) were presumed to offer IR services. Of these, 119 (76%) offered online patient education material for one or more of the eight service lines. The average readability scores corresponding to grade varied between the ninth- and 12th-grade levels. All were higher than the recommended seventh-grade level (P < .05) except for nephrostomy and gastrostomy tube placement. Average Flesch-Kincaid Reading Ease scores ranged from 42 to 69, corresponding with fairly difficult to difficult readability for all service lines except IVC filter and gastrostomy tube placement, which corresponded with standard readability. A majority of hospitals offering IR services provide at least some online patient education material. Most, however, are written significantly above the reading comprehension level of most Americans. More attention to health literacy by hospitals and IR physicians is warranted. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Using a Math Pre-Test in a Large General Education Geoscience Course: How Effective?

NASA Astrophysics Data System (ADS)

Richardson, R. M.

2006-12-01

Teaching large (150 or more students) General Education Geoscience courses presents many challenges, but one of the most important is how to effectively incorporate quantitative literacy. Many students are math phobic, and will run to General Education courses that minimize quantitative aspects. I will present results from one approach that we have used successfully for at least two years: a math pre-test. Our General Education Geoscience course has no prerequisites other than admission to the University, and is designed for first and second year non-science students. Fortunately, with limited exceptions, all entering students at the University of Arizona take a Math Readiness Test (MRT) for math placement. With the cooperation of the Mathematics Department, we have used old MRT exams to selectively use questions that are of the highest utility for the course material `understanding graphs, linear equations and extrapolations, scientific notation and large numbers, word problems, and scaling/unit conversions. We administer the exam in the first discussion section. Students receive full credit for a `serious effort', and we score the exam. In recent semesters the percentage of correct answers has varied from just under 50% to nearly 90% on individual questions. The pre-test has several important benefits. First, it lets students know clearly up front that there will be mathematics in the class. Second, it lets students know the range of skills expected to be successful. Third, because the average score is between 70-80% it gives students confidence that they can do the math in the course. Fourth, we contact all students who score less than 50%, and offer help, including referral to tutoring service in Mathematics. Feedback from students has been positive. Unfortunately, when we compared scores on the math pre-test to final grades in the course, we found essentially no correlation. We are exploring a number of possible explanations. We are also seeing if our math pre-test scores correlate with the initial MRT score, and overall student success.

Sarcopenia Is Risk Factor for Development of Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt Placement.

PubMed

Nardelli, Silvia; Lattanzi, Barbara; Torrisi, Sabrina; Greco, Francesca; Farcomeni, Alessio; Gioia, Stefania; Merli, Manuela; Riggio, Oliviero

2017-06-01

Hepatic encephalopathy (HE) is an important complication in patients with cirrhosis who received transjugular intrahepatic portosystemic shunts (TIPS). We investigated whether a decrease in muscle mass was associated independently with the occurrence of HE after TIPS. We performed a prospective study of 46 consecutive patients with cirrhosis (mean age, 58.6 ± 9.1 y; mean model for end-stage liver disease score, 11.3 ± 3.3; mean Child-Pugh score, 7.6 ± 1.5) who received TIPS from January 2013 through December 2014 at a tertiary center in Rome, Italy. All patients underwent computed tomography analysis at the level of the third lumbar vertebrae to determine the skeletal muscle index; sarcopenia was defined by sex-specific cut-off values. We estimated the incidence of the first episode of HE after TIPS, taking into account the competing risk nature of the data (death or liver transplantation). Twenty-six patients (57%) were found to have sarcopenia. Twenty-one patients (46%) developed overt HE in the 7 ± 9 months after TIPS placement; all of these patients were sarcopenic, according to the skeletal muscle index. Of the 25 patients without HE after TIPS, only 5 had sarcopenia. In multivariate analysis, model for end-stage liver disease score (subdistribution hazard ratio, 1.16; 95% confidence interval, 1.01-1.34; P = .043) and sarcopenia (subdistribution hazard ratio, 31.3; 95% confidence interval, 4.5-218.07; P < .001) were associated independently with the development of HE after TIPS placement. In a prospective study of 46 patients with cirrhosis, we found muscle wasting, probably owing to reduced processing of ammonia, to be associated with the development of HE after TIPS placement. Sarcopenia should be considered in selecting patients for TIPS therapy. Nutritional status should be evaluated in patients with sarcopenia before TIPS placement, which might reduce the incidence of HE. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

The English Placement Test at the University of Illinois at Urbana-Champaign

ERIC Educational Resources Information Center

Chung, Sun Joo; Haider, Iftikhar; Boyd, Ryan

2015-01-01

At the University of Illinois at Urbana-Champaign (UIUC), the English Placement Test (EPT) is the institutional placement test that is used to place students into appropriate English as a second language (ESL) writing and/or pronunciation service courses. The EPT is used to assess the English ability of newly admitted international undergraduate…

The effects of academic grouping on student performance in science

NASA Astrophysics Data System (ADS)

Scoggins, Sally Smykla

The current action research study explored how student placement in heterogeneous or homogeneous classes in seventh-grade science affected students' eighth-grade Science State of Texas Assessment of Academic Readiness (STAAR) scores, and how ability grouping affected students' scores based on race and socioeconomic status. The population included all eighth-grade students in the target district who took the regular eighth-grade science STAAR over four academic school years. The researcher ran three statistical tests: a t-test for independent samples, a one-way between subjects analysis of variance (ANOVA) and a two-way between subjects ANOVA. The results showed no statistically significant difference between eighth-grade Pre-AP students from seventh-grade Pre-AP classes and eighth-grade Pre-AP students from heterogeneous seventh-grade classes and no statistically significant difference between Pre-AP students' scores based on socioeconomic status. There was no statistically significant interaction between socioeconomic status and the seventh-grade science classes. The scores between regular eighth-grade students who were in heterogeneous seventh-grade classes were statistically significantly higher than the scores of regular eighth-grade students who were in regular seventh-grade classes. The results also revealed that the scores of students who were White were statistically significantly higher than the scores of students who were Black and Hispanic. Black and Hispanic scores did not differ significantly. Further results indicated that the STAAR Level II and Level III scores were statistically significantly higher for the Pre-AP eighth-grade students who were in heterogeneous seventh-grade classes than the STAAR Level II and Level III scores of Pre-AP eighth-grade students who were in Pre-AP seventh-grade classes.

Assessing Competing Demands and Charting a Course: A Phenomenological Study of Advanced Placement U.S. History Teachers' Decision Making and Course Planning

ERIC Educational Resources Information Center

Poole, Kerry D.

2014-01-01

Florida has experienced some of the greatest growth of Advanced Placement (AP) programs in recent years and student scores on the AP exams have evolved into a highly significant metric in evaluating student proficiency and teacher and school effectiveness. Despite this growth, it is not well known how AP teachers make decisions about the content…

Are Advanced Placement English and First-Year College Composition Equivalent? A Comparison of Outcomes in the Writing of Three Groups of Sophomore College Students

ERIC Educational Resources Information Center

Hansen, Kristine; Reeve, Suzanne; Gonzalez, Jennifer; Sudweeks, Richard R.; Hatch, Gary L.; Esplin, Patricia; Bradshaw, William S.

2006-01-01

This study was conducted to obtain empirical data to inform policy decisions about exempting incoming students from a first-year composition (FYC) course on the basis of Advanced Placement (AP) English exam scores. It examined the effect of avoiding first-year writing on the writing abilities of sophomore undergraduates. Two three-page writing…

Students' perception of the psycho-social clinical learning environment: an evaluation of placement models.

PubMed

Henderson, Amanda; Twentyman, Michelle; Heel, Alison; Lloyd, Belinda

2006-10-01

Nursing is a practice based discipline. A supportive environment has been identified as important for the transfer of learning in the clinical context. The aim of the paper was to assess undergraduate nurses' perceptions of the psychosocial characteristics of clinical learning environments within three different clinical placement models. Three hundred and eight-nine undergraduate nursing students rated their perceptions of the psycho-social learning environment using a Clinical Learning Environment Inventory. There were 16 respondents in the Preceptor model category, 269 respondents in the Facilitation model category and 114 respondents in the clinical education unit model across 25 different clinical areas in one tertiary facility. The most positive social climate was associated with the preceptor model. On all subscales the median score was rated higher than the two other models. When clinical education units were compared with the standard facilitation model the median score was rated higher in all of the subscales in the Clinical Learning Environment Inventory. These results suggest that while preceptoring is an effective clinical placement strategy that provides psycho-social support for students, clinical education units that are more sustainable through their placement of greater numbers of students, can provide greater psycho-social support for students than traditional models.

The impact of undergraduate occupational therapy students' interpersonal skills on their practice education performance: A pilot study.

PubMed

Yu, Mong-Lin; Brown, Ted; White, Carolynne; Marston, Celia; Thyer, Laura

2018-04-01

Interpersonal skills such as active listening, verbal communication and body language are essential competencies for occupational therapists, and students are expected to demonstrate these skills when completing practice placements. To investigate whether interpersonal skills are predictive of occupational therapy students' practice performance. A cross-sectional study was conducted involving third and fourth year occupational therapy undergraduate students (n = 70). Students' interpersonal skills were measured using the Interpersonal Communication Competence Scale (ICCS), Listening Styles Profile (LSP-R) and Active-Empathic Listening Scale (AELS). Students' practice performances at the mid-way and final points of their placements were measured using the Student Practice Evaluation Form-Revised (SPEF-R). The relationships between students' interpersonal skills and practice performance were examined using univariate and multi-variate regressions. Higher ICCS Interaction Management subscale scores predicted better SPEF-R Self-Management Skills at the mid-way point through practice placements (β = 1.93, SE = 0.76), and better Professional Behaviours (β = 1.28, SE = 0.64) and better Service Evaluation Skills (β = 2.84, SE = 0.95) at the final SPEF-R completion point. Higher ICCS Empathy subscale scores predicted lower SPEF-R Documentation scores at the mid-way point (β = -0.81, SE = 0.38), while higher ICCS Supportiveness subscale scores predicted lower mid-way SPEF-R Service Provision scores (β = -2.84, SE = 1.77). No ICCS subscale scores were predictive of the SPEF-R communication, co-worker communication and information gathering subscale scores. As well, LSP-R and AELS subscale scores were not predictive of the SPEF-R subscale scores. While predictive relationships were not found between occupational therapy students' communication, co-worker communication and information gathering skills, this preliminary evidence indicates that students' interpersonal skills (including interaction management and empathetic supportiveness) were predictive of some notable SPEF-R competencies (including Professional Behaviours, Self-Management, Documentation, Service Provision and Service Evaluation). Therefore, students' exposure to professional interpersonal skills should be incorporated into the curriculum of academic education programs with the aim of better preparing them for practice education. © 2018 Occupational Therapy Australia.

Low-level hydrogen sulfide and central nervous system dysfunction.

PubMed

Kilburn, Kaye H; Thrasher, Jack D; Gray, Michael R

2010-08-01

Forty-nine adults living in Lovington, Tatum, and Artesia, the sour gas/oil sector of Southeastern New Mexico, were tested for neurobehavioral impairment. Contributing hydrogen sulfide were (1) an anaerobic sewage plant; (2) two oil refineries; (3) natural gas/oil wells and (4) a cheese-manufacturing plant and its waste lagoons. Comparisons were to unexposed Wickenburg, Arizona, adults. Neurobehavioral functions were measured in 26 Lovington adults including 23 people from Tatum and Artesia, New Mexico, and 42 unexposed Arizona people. Participants completed questionnaires including chemical exposures, symptom frequencies and the Profile of Mood States. Measurements included balance, reaction time, color discrimination, blink reflex, visual fields, grip strength, hearing, vibration, problem solving, verbal recall, long-term memory, peg placement, trail making and fingertip number writing errors (FTNWE). Average numbers of abnormalities and test scores were adjusted for age, gender, educational level, height and weight, expressed as percent predicted (% pred) and compared by analysis of variance (ANOVA). Ages and educational attainment of the three groups were not statistically significantly different (ssd). Mean values of Lovington residents were ssd from the unexposed Arizona people for simple and choice reaction times, balance with eyes open and closed, visual field score, hearing and grip strength. Culture Fair, digit symbol substitution, vocabulary, verbal recall, peg placement, trail making A and B, FTNWE, information, picture completion and similarities were also ssd. The Lovington adults who averaged 11.8 abnormalities were ssd from, Tatum-Artesia adults who had 3.6 and from unexposed subjects with 2.0. Multiple source community hydrogen sulfide exposures impaired neurobehavioral functions.

Transcorporal artificial urinary sphincter in radiated and non - radiated compromised urethra. Assessment with a minimum 2 year follow-up.

PubMed

Le Long, Erwann; Rebibo, John David; Nouhaud, Francois Xavier; Grise, Philippe

2016-01-01

to assess the efficacy of transcorporal artificial urinary sphincter (AUS) implantation on continence for male stress urinary incontinence in cases of prior surgical treatment or/and radiation failure, and as a first option in radiation patients. From March 2007 to August 2012, 37 male patients were treated with transcorporal AUS AMS™ 800. Twelve patients had primary placement of transcorporal cuff, a surgical option due to a previous history of radiation and 25 patients had secondary procedure after failure of AUS or urinary incontinence surgery. Functional urinary outcomes were assessed by daily pad use, 24-hour Pad-test and ICIQ-SF questionnaire. Quality of life and satisfaction were assessed based on I-QoL and PGI-I questionnaires. After a median of 32 months, the continence rate (0 to 1 pad) was 69.7%. Median pad test was 17.5g (0-159), mean ICIQ-SF score was 7.3/21 (±5.4) and mean I-QoL score was 93.9/110. A total of 88% of the patients reported satisfaction with the AUS. The 5-year actuarial revision-free for AUS total device was 51%. Patients for primary implant for radiation were not more likely to experience revision than non-radiation patients. Preservation of erections was reported in half of the potent patients. Transcorporal AUS cuff placement is a useful alternative procedure option for severe male UI treatment, especially in patients with a compromised urethra after prior surgery or radiation. A high continence rate was reported and implantation as first option in radiation patients should be considered.

Predictors of professional placement outcome: cultural background, English speaking and international student status.

PubMed

Attrill, Stacie; McAllister, Sue; Lincoln, Michelle

2016-08-01

Placements provide opportunities for students to develop practice skills in professional settings. Learning in placements may be challenging for culturally and linguistically diverse (CALD) students, international students, or those without sufficient English proficiency for professional practice. This study investigated whether these factors, which are hypothesized to influence acculturation, predict poor placement outcome. Placement outcome data were collected for 854 students who completed 2747 placements. Placement outcome was categorized into 'Pass' or 'At risk' categories. Multilevel binomial regression analysis was used to determine whether being CALD, an international student, speaking 'English as an additional language', or a 'Language other than English at home' predicted placement outcome. In multiple multilevel analysis speaking English as an additional language and being an international student were significant predictors of 'at risk' placements, but other variables tested were not. Effect sizes were small indicating untested factors also influenced placement outcome. These results suggest that students' English as an additional language or international student status influences success in placements. The extent of acculturation may explain the differences in placement outcome for the groups tested. This suggests that learning needs for placement may differ for students undertaking more acculturative adjustments. Further research is needed to understand this and to identify placement support strategies.

Benign tracheobronchial stenoses: changes in short-term and long-term pulmonary function testing after expandable metallic stent placement.

PubMed

Gotway, Michael B; Golden, Jeffrey A; LaBerge, Jeanne M; Webb, W Richard; Reddy, Gautham P; Wilson, Mark W; Kerlan, Robert K; Gordon, Roy L

2002-01-01

To determine the short- and long-term improvement in airflow dynamics in patients undergoing tracheobronchial stent placement for benign airway stenoses. Twenty-two patients underwent 34 tracheal and/or bronchial stent placement procedures for benign airway stenoses and had the results of pulmonary function tests available. Stent placement indications included bronchomalacia after lung transplantation (n = 11), postintubation stenoses (n = 6), relapsing polychondritis (n = 2), and 1 each of tracheomalacia, tracheal compression, and histoplasmosis. Six patients underwent more than one stent placement procedure (range: 2-7 procedures). The mean forced expiratory volume in one second (FEV(1) ), forced expiratory flow rate in the midportion of the forced vital capacity curve (FEF(25-75) ), forced vital capacity, and peak flow (PF) rate obtained before stent placement were compared with those immediately after stent placement and with those measurements most remote from stent placement using the paired two-tailed test. All patients reported improved respiratory function immediately after stent placement. The mean FEV(1), FEF(25-75), and PF rate improved significantly (p < 0.001, p = 0.002, and p = 0.009, respectively) after stent placement. On long-term follow-up averaging 15 months after stent placement, these parameters declined despite patients' subjective sense of improvement. Segregating the population into transplant and nontransplant airway stenosis etiologies, however, FEF(25-75) and PF rate remained significantly improved (p = 0.045, p = 0.027, respectively), over the long term for the latter. FEV increased after subsequent stent placements for patients receiving multiple stents. Stent placement for benign tracheobronchial stenoses provides significant immediate improvement in airflow dynamics. Long-term improvement in airflow obstruction may be expected, and additional stent placements may further improve pulmonary function.

Restrictive educational placements increase adolescent risks for students with early-starting conduct problems.

PubMed

Powers, Christopher J; Bierman, Karen L; Coffman, Donna L

2016-08-01

Students with early-starting conduct problems often do poorly in school; they are disproportionately placed in restrictive educational placements outside of mainstream classrooms. Although intended to benefit students, research suggests that restrictive placements may exacerbate the maladjustment of youth with conduct problems. Mixed findings, small samples, and flawed designs limit the utility of existing research. This study examined the impact of restrictive educational placements on three adolescent outcomes (high school noncompletion, conduct disorder, depressive symptoms) in a sample of 861 students with early-starting conduct problems followed longitudinally from kindergarten (age 5-6). Causal modeling with propensity scores was used to adjust for confounding factors associated with restrictive placements. Analyses explored the timing of placement (elementary vs. secondary school) and moderation of impact by initial problem severity. Restrictive educational placement in secondary school (but not in elementary school) was iatrogenic, increasing the risk of high school noncompletion and the severity of adolescent conduct disorder. Negative effects were amplified for students with conduct problem behavior with less cognitive impairment. To avoid harm to students and to society, schools must find alternatives to restrictive placements for students with conduct problems in secondary school, particularly when these students do not have cognitive impairments that might warrant specialized educational supports. © 2015 Association for Child and Adolescent Mental Health.

Spinal Anesthesia and Minimal Invasive Laminotomy for Paddle Electrode Placement in Spinal Cord Stimulation: Technical Report and Clinical Results at Long-Term Followup

PubMed Central

Sarubbo, S.; Latini, F.; Tugnoli, V.; Quatrale, R.; Granieri, E.; Cavallo, M. A.

2012-01-01

Object. We arranged a mini-invasive surgical approach for implantation of paddle electrodes for SCS under spinal anesthesia obtaining the best paddle electrode placement and minimizing patients' discomfort. We describe our technique supported by neurophysiological intraoperative monitoring and clinical results. Methods. 16 patients, affected by neuropathic pain underwent the implantation of paddle electrodes for spinal cord stimulation in lateral decubitus under spinal anesthesia. The paddle was introduced after flavectomy and each patient confirmed the correct distribution of paresthesias induced by intraoperative test stimulation. VAS and patients' satisfaction rate were recorded during the followup and compared to preoperative values. Results. No patients reported discomfort during the procedure. In all cases, paresthesias coverage of the total painful region was achieved, allowing the best final electrode positioning. At the last followup (mean 36.7 months), 87.5% of the implanted patients had a good rate of satisfaction with a mean VAS score improvement of 70.5%. Conclusions. Spinal cord stimulation under spinal anesthesia allows an optimal positioning of the paddle electrodes without any discomfort for patients or neurosurgeons. The best intraoperative positioning allows a better postoperative control of pain, avoiding the risk of blind placements of the paddle or further surgery for their replacement. PMID:22566761

The UK Clinical Aptitude Test and clinical course performance at Nottingham: a prospective cohort study.

PubMed

Yates, Janet; James, David

2013-02-26

The UK Clinical Aptitude Test (UKCAT) was introduced in 2006 as an additional tool for the selection of medical students. It tests mental ability in four distinct domains (Verbal Reasoning, Quantitative Reasoning, Abstract Reasoning, and Decision Analysis), and the results are available to students and admission panels in advance of the selection process. Our first study showed little evidence of any predictive validity for performance in the first two years of the Nottingham undergraduate course.The study objective was to determine whether the UKCAT scores had any predictive value for the later parts of the course, largely delivered via clinical placements. Students entering the course in 2007 and who had taken the UKCAT were asked for permission to use their anonymised data in research. The UKCAT scores were incorporated into a database with routine pre-admission socio-demographics and subsequent course performance data. Correlation analysis was followed by hierarchical multivariate linear regression. The original study group comprised 204/254 (80%) of the full entry cohort. With attrition over the five years of the course this fell to 185 (73%) by Year 5. The Verbal Reasoning score and the UKCAT Total score both demonstrated some univariate correlations with clinical knowledge marks, and slightly less with clinical skills. No parts of the UKCAT proved to be an independent predictor of clinical course marks, whereas prior attainment was a highly significant predictor (p <0.001). This study of one cohort of Nottingham medical students showed that UKCAT scores at admission did not independently predict subsequent performance on the course. Whilst the test adds another dimension to the selection process, its fairness and validity in selecting promising students remains unproven, and requires wider investigation and debate by other schools.

Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement: a review.

PubMed

Scotti, Roberto; Pellegrino, Gerardo; Marchetti, Claudio; Corinaldesi, Guiseppe; Ciocca, Leonardo

2010-01-01

To test if using a CAD/CAM system might reduce the necessity of bone augmentation in patients with atrophic maxillary arches before implant therapy. Twenty male and female patients consecutively scheduled for bone augmentation of the jaw before implant surgery were included in this study, with a total of 29 jaws (maxillary and mandibular) to analyze for the implant-supported fixed prosthesis group and 19 maxillary arches for the implant-supported removable prosthesis group. NobelGuide System (Nobel Biocare), Autocad System (Autodesk), and routine manual CT measurements of available bone were used in this study. The total results of the mean values of the fixed prosthesis group plus the mean values of the removable prosthesis group showed a statistically significant difference between the NobelGuide intervention score and both manual (P = .004) and Autocad (P = .001) measurements. The NobelGuide System represents a viable diagnostic device to reduce the entity or avoid bone reconstructive surgery before implant placements in the atrophic maxilla and mandible.

7 CFR 15b.24 - Evaluation and placement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Education § 15b.24 Evaluation and placement. (a) Placement evaluation. A recipient that operates a public... speaking skills, the test results accurately reflect the student's aptitude or achievement level or..., manual or speaking skills (except where those skills are the factors that the test purports to measure...

7 CFR 15b.24 - Evaluation and placement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Education § 15b.24 Evaluation and placement. (a) Placement evaluation. A recipient that operates a public... speaking skills, the test results accurately reflect the student's aptitude or achievement level or..., manual or speaking skills (except where those skills are the factors that the test purports to measure...

7 CFR 15b.24 - Evaluation and placement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Education § 15b.24 Evaluation and placement. (a) Placement evaluation. A recipient that operates a public... speaking skills, the test results accurately reflect the student's aptitude or achievement level or..., manual or speaking skills (except where those skills are the factors that the test purports to measure...

7 CFR 15b.24 - Evaluation and placement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Education § 15b.24 Evaluation and placement. (a) Placement evaluation. A recipient that operates a public... speaking skills, the test results accurately reflect the student's aptitude or achievement level or..., manual or speaking skills (except where those skills are the factors that the test purports to measure...

Impact of a Child Life and Music Therapy Procedural Support Intervention on Parental Perception of Their Child's Distress During Intravenous Placement.

PubMed

Ortiz, Gabriela S; OʼConnor, Todd; Carey, Jessa; Vella, Adam; Paul, Audrey; Rode, Diane; Weinberg, Alan

2017-02-21

Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department. The aim of this study was to investigate the efficacy of this collaborative intervention by evaluating parental perception of their child's distress. This study was a prospective analysis investigating the impact of a child life and music therapy intervention on children aged 4 to 11 years old receiving an IV placement in the pediatric emergency department. Efficacy was evaluated by comparing scores between a 4-question pretest and subsequent 4-question posttest that asked the child's parent to evaluate how they anticipated their child would respond to the procedure, and then to evaluate how they perceived their child to have responded after the procedure. Qualitative data were collected in the form of open-ended comments, which were accommodated at the end of the posttest. Data were analyzed by the Cochran-Mantel-Haenszel method for testing repeated ordinal responses and the PROC GENMOD procedure in the SAS system software. A total of 41 participants were enrolled in this study. Results of the statistical analysis revealed significant differences between all pre- and posttest scores (P < 0.05), and significant likelihood that the patient would improve relative to the 4 questions, as a result of the child life and music therapy intervention. Improvement was demonstrated across all 4 questions, suggesting that the child life and music therapy intervention supported healthy, adaptive coping and helped to minimize distress experienced by patients during IV placement. These results underscore the importance and potential clinical impact of child life psychological preparation and psychotherapy-based music therapy interventions in reducing distress in pediatric patients during common medical procedures.

Standard Transistor Array (STAR). Volume 1: Placement technique

NASA Technical Reports Server (NTRS)

Cox, G. W.; Caroll, B. D.

1979-01-01

A large scale integration (LSI) technology, the standard transistor array uses a prefabricated understructure of transistors and a comprehensive library of digital logic cells to allow efficient fabrication of semicustom digital LSI circuits. The cell placement technique for this technology involves formation of a one dimensional cell layout and "folding" of the one dimensional placement onto the chip. It was found that, by use of various folding methods, high quality chip layouts can be achieved. Methods developed to measure of the "goodness" of the generated placements include efficient means for estimating channel usage requirements and for via counting. The placement and rating techniques were incorporated into a placement program (CAPSTAR). By means of repetitive use of the folding methods and simple placement improvement strategies, this program provides near optimum placements in a reasonable amount of time. The program was tested on several typical LSI circuits to provide performance comparisons both with respect to input parameters and with respect to the performance of other placement techniques. The results of this testing indicate that near optimum placements can be achieved by use of the procedures incurring severe time penalties.

Children's Communication Checklist (CCC) Scores in 11-Year-Old Children with Communication Impairments

ERIC Educational Resources Information Center

Botting, Nicola

2004-01-01

Background: The pragmatic skills of children with communication disorders and their assessment are currently an issue for speech and language therapy and educational placement. Aims: To explore whether different subgroups of children with communication disorders score differently on the Children's Communication Checklist (CCC) and to study how…

[Therapeutic observation of subcutaneous pedicle screw-rod system with modified placement for Tile B pelvic fractures].

PubMed

Wu, Xiao-Tian; Chen, Nong; Pan, Fu-Gen; Liu, Zuo-Qing; He, Xiao-Jian

2017-03-25

To investigate the feasibility and therapeutic effect of subcutaneous pedicle screw-rod system with modified placement in treatment of Tile B pelvic fractures. From June 2014 to August 2015, 14 patients with Tile B pelvic fractures were treated by subcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle. There were 8 males and 6 females, aged from 23 to 65 years with an average of 42 years. Operative time, intraoperative blood loss, fracture healing and postoperative complication were observed and clinical effects were evaluated by Matta reduction standard and Majeed score. All patients were followed up from 8 to 15 months with an average of 10.5 months. Operative time was 25 to 45 min with an average of 32 min;intraoperative blood loss was 10 to 35 ml with an average of 18 ml. All fractures got primary healing and healed time was 9 to 14 weeks with an average of 12.5 weeks. No postoperative incision infection, internal fixation failure and ectopic ossification were found, 4 cases occurred unilateral lateral femoral cutaneous nerve injury and 1 case occurred unilateral femoral nerve paralysis, but all restored finally. According to Matta criteria, reduction was excellent in 7 cases, good in 5 cases, fair in 2 case. According to Majeed score system, the functional evaluation at last follow-up was excellent in 5 cases, good in 7 cases, fair in 2 cases with the average score of 81.50±8.05. Subcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle have advantages of strong reduction, less trauma and complications, and is a promising surgical method in the treatment of Tile B pelvic fractures.

Estimating the "impact" of out-of-home placement on child well-being: approaching the problem of selection bias.

PubMed

Berger, Lawrence M; Bruch, Sarah K; Johnson, Elizabeth I; James, Sigrid; Rubin, David

2009-01-01

This study used data on 2,453 children aged 4-17 from the National Survey of Child and Adolescent Well-Being and 5 analytic methods that adjust for selection factors to estimate the impact of out-of-home placement on children's cognitive skills and behavior problems. Methods included ordinary least squares (OLS) regressions and residualized change, simple change, difference-in-difference, and fixed effects models. Models were estimated using the full sample and a matched sample generated by propensity scoring. Although results from the unmatched OLS and residualized change models suggested that out-of-home placement is associated with increased child behavior problems, estimates from models that more rigorously adjust for selection bias indicated that placement has little effect on children's cognitive skills or behavior problems.

An analysis of the impact of three high school schedules on student achievement in advanced placement biology classes

NASA Astrophysics Data System (ADS)

Arons-Polan, Bonnie

This study examined the effect of three schedule types on student achievement in Advanced Placement Biology classes. AP Biology test scores from students on three types of full-year schedules were analyzed to assess the impact schedule type had on student achievement. The three schedules included the block and traditional schedules, and the rotating/hybrid, a blend of the former two schedules. The results indicated the variable most closely associated with success on the AP Biology exam was the length of experience the teachers had teaching the course, regardless of schedule type. Although significant differences were seen in mean AP Biology test scores among the three schedule types, this could be explained by the relationship between instructors' experience and schedule type. Regression analysis determined the two strongest predictors of successful performance on the AP Biology exam were instructors' experience and perceived teaching style, regardless of schedule type. It appears that the economically developed suburbs, had teachers with the largest amount of experience teaching AP Biology, and these teachers reported using a direct approach to teaching, using lecture greater than 50% of the time. The results of this study also suggest when restructuring to improve student achievement, educators should examine other variables in addition to the high school schedule. Restructuring the day to allow for longer classes must be accompanied by professional staff development to allow teachers to develop new teaching methods. Most of the teachers in the survey reported using lecture a great deal of the time, regardless of schedule type. Comments from the teachers from the various schedules revealed that the ability to add student centered, inquiry based activities and labs were dependent on adequate class time. No information on whether or not the teachers were given professional development to expand their repertoire of teaching methods when the school adopted a block or rotating hybrid schedule was obtained. Limitations to this study include the fact that there was no independent verification of teaching style as reported by the teachers in this study. This study involved only Advanced Placement Biology classes, so no generalizations can be made to other science classes.

Evaluating a technical university's placement test using the Rasch measurement model

NASA Astrophysics Data System (ADS)

Salleh, Tuan Salwani; Bakri, Norhayati; Zin, Zalhan Mohd

2016-10-01

This study discusses the process of validating a mathematics placement test at a technical university. The main objective is to produce a valid and reliable test to measure students' prerequisite knowledge to learn engineering technology mathematics. It is crucial to have a valid and reliable test as the results will be used in a critical decision making to assign students into different groups of Technical Mathematics 1. The placement test which consists of 50 mathematics questions were tested on 82 new diplomas in engineering technology students at a technical university. This study employed rasch measurement model to analyze the data through the Winsteps software. The results revealed that there are ten test questions lower than less able students' ability. Nevertheless, all the ten questions satisfied infit and outfit standard values. Thus, all the questions can be reused in the future placement test at the technical university.

Every team needs a coach: Training for interprofessional clinical placements.

PubMed

Grymonpre, Ruby; Bowman, Susan; Rippin-Sisler, Cathy; Klaasen, Kathleen; Bapuji, Sunita B; Norrie, Ola; Metge, Colleen

2016-09-01

Despite growing awareness of the benefits of interprofessional education and interprofessional collaboration (IPC), understanding how teams successfully transition to IPC is limited. Student exposure to interprofessional teams fosters the learners' integration and application of classroom-based interprofessional theory to practice. A further benefit might be reinforcing the value of IPC to members of the mentoring team and strengthening their IPC. The research question for this study was: Does training in IPC and clinical team facilitation and mentorship of pre-licensure learners during interprofessional clinical placements improve the mentoring teams' collaborative working relationships compared to control teams? Statistical analyses included repeated time analysis multivariate analysis of variance (MANOVA). Teams on four clinical units participated in the project. Impact on intervention teams pre- versus post-interprofessional clinical placement was modest with only the Cost of Team score of the Attitudes Towards Healthcare Team Scale improving relative to controls (p = 0.059) although reflective evaluations by intervention team members noted many perceived benefits of interprofessional clinical placements. The significantly higher group scores for control teams (geriatric and palliative care) on three of four subscales of the Assessment of Interprofessional Team Collaboration Scale underscore our need to better understand the unique features within geriatric and palliative care settings that foster superior IPC and to recognise that the transition to IPC likely requires a more diverse intervention than the interprofessional clinical placement experience implemented in this study. More recently, it is encouraging to see the development of innovative tools that use an evidence-based, multi-dimensional approach to support teams in their transition to IPC.

An investigation into non-invasive physical activity recognition using smartphones.

PubMed

Kelly, Daniel; Caulfield, Brian

2012-01-01

Technology utilized to automatically monitor Activities of Daily Living (ADL) could be a key component in identifying deviations from normal functional profiles and providing feedback on interventions aimed at improving health. However, if activity recognition systems are to be implemented in real world scenarios such as health and wellness monitoring, the activity sensing modality must unobtrusively fit the human environment rather than forcing humans to adhere to sensor specific conditions. Modern smart phones represent a ubiquitous computing device which has already undergone mainstream adoption. In this paper, we investigate the feasibility of using a modern smartphone, with limited placement constraints, as the sensing modality for an activity recognition system. A dataset of 4 subjects performing 7 activities, using varying sensor placement conditions, is utilized to investigate this. Initial experiments show that a decision tree classifier performs activity classification with precision and recall scores of 0.75 and 0.73 respectively. More importantly, as part of this initial experiment, 3 main problems, and subsequently 3 solutions, relating to unconstrained sensor placement were identified. Using our proposed solutions, classification precision and recall scores were improved by +13% and +14.6% respectively.

Etiology and Treatment of Delayed-Onset Medial Malleolar Pain Following Total Ankle Arthroplasty.

PubMed

Lundeen, Gregory A; Dunaway, Linda J

2016-08-01

Total ankle arthroplasty (TAA) has become a successful treatment for end-stage ankle arthritis. Some patients may still have pain or may present with new pain. Suggested sources of medial pain include tibialis posterior tendonitis, impingement, or medial malleolar stress fracture. Etiology and treatment remain unclear. The objective of our study was to evaluate patients with delayed-onset medial malleolar pain following TAA who underwent treatment with percutaneous medial malleolar screw placement and propose an etiology. Patients who had undergone TAA at our institution were reviewed and those with medial malleolar pain were identified. Clinical and radiographic examinations were performed pre- and postoperatively. Radiographs were compared with those from a cohort of controls without a history of medial pain. All affected patients failed conservative therapy and were treated with percutaneous placement of medial malleolar screws positioned from the malleolar tip and extending proximally beyond the tibial component. Postoperatively, patients were placed in an ace wrap and allowed to be weightbearing to tolerance, except for 1 patient initially restricted to partial weightbearing. Visual analog scale (VAS) scores were recorded. Seventy-four (74) patients underwent TAA by the corresponding author. All (100%) were female with an average age of 66 (range, 57-73) years. Average follow-up since screw placement was 21.4 (range, 10-41) months. Six (8.1%) underwent placement of 2 percutaneous medial malleolar screws. Patients presented with pain an average of 12 (range, 4-24) months postoperatively and underwent screw placement an average of 2.8 (range, 1-6) months after presentation. At the time of TAA, none had a coronal plane deformity and none underwent a deltoid ligament release as part of balancing. All (100%) patients had pain and swelling directly over the medial malleolus prior to screw placement. Postoperatively, 1 (17%) had mild pain clinically at this site and 2 (33%) had occasional pain medially with activity. Average VAS scores improved from 5.7 (range, 4-6) preoperatively to 1.3 (range, 0-3) postoperatively (P < .05). Three (50%) patients had a bone density test and all were normal. Prior to screw placement, radiographs demonstrated no signs of stress fracture or misalignment. Average minimum width of the medial malleolus at the level of the tibial component was 10.2 mm (range, 9.2-11.0), which was significantly less (P < .05) than the control group of 19 patients whose distance measured 12.2 mm (range, 8.5-14.8). Patients who present with new-onset medial malleolar pain with normal radiographs following TAA may have medial malleolar insufficiency fracture. These patients can be treated successfully with minimal morbidity by placement of percutaneous medial malleolar screws. Etiology may be related to deltoid traction, subacute stress fracture, and/or impingement of the talus component on the medial malleolus. Medial malleolar pain may be misdiagnosed as tibialis posterior tendonitis, impingement, or implant failure. This diagnosis should be considered in patients who have pain at the medial malleolus, particularly if they are female or have medial malleolus thickness less than 11 mm at the level of the tibial implant. Placement of prophylactic medial malleolar screws may be considered at the time of TAA when these conditions exist. Level IV, case series. © The Author(s) 2016.

Antegrade continence enemas improve quality of life in patients with medically-refractory encopresis.

PubMed

Church, Joseph T; Simha, Sidd; Wild, Laurie C; Teitelbaum, Daniel H; Ehrlich, Peter F

2017-05-01

Fecal incontinence is a socially debilitating problem for many children. We hypothesized that in selected patients with medically-refractory encopresis, placement of an appendicostomy or cecostomy tube for administration of antegrade continence enemas (ACE) would improve quality of life (QOL). We reviewed all patients with encopresis who underwent appendicostomy or cecostomy placement from 2003 to 2014 at our institution. We contacted subjects' parents by phone and administered 3 surveys: a survey reflecting current stooling habits, a disease-specific QOL survey, and the PedsQL™ QOL survey. QOL surveys were completed twice by parents, once reflecting pre-operative QOL, then again reflecting current QOL. Pre-procedure and post-procedure scores were compared by paired t-test. Ten patients underwent appendicostomy/cecostomy for encopresis. Eight completed phone surveys. All procedures were performed laparoscopically. All patients experienced fecal soiling pre-operatively, whereas 5/8 surveyed patients (63%) noted complete resolution of soiling post-procedure (p<0.01). General and disease-specific QOL improved from pre-procedure to post-procedure in the following domains: social habits, physical activity, ability to spend the night elsewhere, feeling, and overall QOL (p<0.05). PedsQL™ scores improved significantly in physical functioning, social functioning, and overall functioning (p<0.05). Antegrade continence enemas significantly improve quality of life in patients with medically-refractory encopresis, likely related to resolution of soiling. 4. Copyright © 2017. Published by Elsevier Inc.

A feasibility study of dementia communication training based on the VERA framework for pre-registration nurses: Part II impact on student experience.

PubMed

Naughton, Corina; Beard, Chloe; Tzouvara, Vasiliki; Pegram, Anne; Verity, Rebecca; Eley, Rhiannon; Hingley, David

2018-04-01

People living with dementia have complex communication needs, especially during acute hospital admissions. The VERA framework (validation, emotion, reassurance, activity) was designed to promote person centred communication between student nurses and people living with dementia, but there is limited evaluation of its impact. To measure the impact of dementia communication training (based on VERA) plus older adult unit (OAU) placement on students' ability to recognise opportunities for person centred (PC) communication compared to OAU placement alone. A control pre-post-study design was used. Dementia communication training plus follow-up during OAU placement was delivered to 51 students (5 OAU, two hospitals) while 66 students (7 OAUs, five hospitals) acted as controls. The primary outcome was students' ability to recognise PC communication assessed using case vignettes. Data were collected using electronic survey and focus group interviews. Data analysis used independent non-parametric Mann-Whitney U test and thematic analysis. In total 52 students (response rate 40%) completed surveys at the end of placements (38 intervention, 14 control group students). In the intervention group, participants were significantly more likely to identify PC responses with a mean score of 10.5 (SD 3.0) compared with 7.5 (SD 3.0) in the control group (p = 0.006). In focus group interviews (n = 19 students), the main themes were connecting with patients, VERA in practice, communication challenges, and learning environment. VERA was described as a flexible approach that added to participants' communication toolkit. The learning environment, complexity of patients and organisational resources were important contextual factors. The VERA framework has potential as a foundation level dementia communication training intervention, but it requires more rigorous testing. Nursing can lead the way in developing and embedding evidence-based, interdisciplinary dementia communication training in preregistration curricula. Copyright © 2018 Elsevier Ltd. All rights reserved.

Late intellectual and academic outcomes following traumatic brain injury sustained during early childhood.

PubMed

Ewing-Cobbs, Linda; Prasad, Mary R; Kramer, Larry; Cox, Charles S; Baumgartner, James; Fletcher, Stephen; Mendez, Donna; Barnes, Marcia; Zhang, Xiaoling; Swank, Paul

2006-10-01

Although long-term neurological outcomes after traumatic brain injury (TBI) sustained early in life are generally unfavorable, the effect of TBI on the development of academic competencies is unknown. The present study characterizes intelligence quotient (IQ) and academic outcomes an average of 5.7 years after injury in children who sustained moderate to severe TBI prior to 6 years of age. Twenty-three children who suffered inflicted or noninflicted TBI between the ages of 4 and 71 months were enrolled in a prospective, longitudinal cohort study. Their mean age at injury was 21 months; their mean age at assessment was 89 months. The authors used general linear modeling approaches to compare IQ and standardized academic achievement test scores from the TBI group and a community comparison group (21 children). Children who sustained early TBI scored significantly lower than children in the comparison group on intelligence tests and in the reading, mathematical, and language domains of achievement tests. Forty-eight percent of the TBI group had IQs below the 10th percentile. During the approximately 5-year follow-up period, longitudinal IQ testing revealed continuing deficits and no recovery of function. Both IQ and academic achievement test scores were significantly related to the number of intracranial lesions and the lowest postresuscitation Glasgow Coma Scale score but not to age at the time of injury. Nearly 50% of the TBI group failed a school grade and/or required placement in self-contained special education classrooms; the odds of unfavorable academic performance were 18 times higher for the TBI group than the comparison group. Traumatic brain injury sustained early in life has significant and persistent consequences for the development of intellectual and academic functions and deleterious effects on academic performance.

2014 Advanced Placement Exam Participation and Performance for Students in Montgomery County Public Schools and Public School Students in the State of Maryland and the Nation. Memorandum

ERIC Educational Resources Information Center

Sanderson, Geoffrey T.

2014-01-01

The continuing emphasis by Montgomery County (Maryland) Public Schools (MCPS) on rigorous course taking resulted in MCPS students taking a record-setting 33,662 Advanced Placement (AP) exams in 2014. Additionally, the percentage of AP exams taken by MCPS students who attained scores of 3 or higher (73.9 percent) was 13.0 and 16.7 percentage points…

WCPSS Advanced Placement (AP) Results, 2011-12 and 2012-13. Measuring Up. D&A Report No. 13.17

ERIC Educational Resources Information Center

Muli, Juliana; McMillen, Brad

2014-01-01

Students in Wake County Public Schools (WCPSS) continue to score well on AP exams with an increased percentage of students enrolling in the courses. As in past years, in 2013 the district had higher average AP exam scores compared to the state and the nation. WCPSS had 76.6% of scores 3 or higher in 2013 (qualified and above). Again in both 2012…

The Impact of Structured Inter-professional Education on Health Care Professional Students' Perceptions of Collaboration in a Clinical Setting

PubMed Central

Lee, Sam; Lombardo, Samantha; Salama, Mariam; Ellis, Sandi; Kay, Theresa; Davies, Robyn; Landry, Michel D.

2012-01-01

ABSTRACT Purpose: To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. Methods: This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE clinical placement to examine changes in their perceptions of IPC. Students in a traditional clinical placement (n=28) were used as a control group. Focus groups were then conducted with seven students who took part in the structured IPE clinical placement. A coding framework was devised a priori, and the qualitative results were used to explain the quantitative findings. Results: There were no statistically significant differences between groups after the structured IPE clinical placement, but the intervention group showed a greater positive trend in total IEPS scores from baseline to follow-up. Qualitative data suggest that students valued the knowledge and skills gained through the structured IPE clinical placement. Conclusions: Findings suggest that structured IPE clinical placements may provide students with valuable collaborative learning opportunities, enhanced respect for other professionals, and insight into the value of IPC in healthcare delivery. More research is needed to explore other factors that influence specific perceptions among physical therapy students. PMID:23450044

Traditional and cyberbullying co-occurrence and its relationship to psychiatric symptoms.

PubMed

Tural Hesapcioglu, Selma; Ercan, Filiz

2017-01-01

The effect of cyberbullying accompanied by traditional bullying on mental health has been less studied. In this study, the frequency, co-occurrence, and the relationship to psychiatric symptoms of traditional bullying and cyberbullying among bullies and victims are examined. All of the high schools in the province of Mus, Turkey were stratified according to Placement Test for High Schools admission points for 2014-2015. By choosing schools using simple random sampling, 1276 students were reached. Students were given the Brief Symptom Inventory and three separate scale assessments: peer bullying rating, cybervictimization, and cyberbullying scales. High scores in all subscale scores of bullying and victimization were significantly related to higher depression, anxiety, low self-esteem, somatization, and hostility scores. For people who were exposed to cyberbullying in addition to traditional bullying, the severity of the psychiatric symptoms was significantly higher. For all psychiatric symptoms, major predictors were gender, total victimization score, and total cybervictimization score. Moreover, the bullying total score was among the predictors of low self-esteem and hostility. Cybervictimization and cyberbullying occur less often than traditional bullying and victimization, but people who were exposed to or performed cyberbullying were also exposed to or performed traditional bullying. The addition of cyberbullying to traditional bullying is associated with more intense psychiatric symptoms. © 2016 Japan Pediatric Society.

The Effect of Microphone Placement on Interaural Level Differences and Sound Localization Across the Horizontal Plane in Bilateral Cochlear Implant Users.

PubMed

Jones, Heath G; Kan, Alan; Litovsky, Ruth Y

2016-01-01

This study examined the effect of microphone placement on the interaural level differences (ILDs) available to bilateral cochlear implant (BiCI) users, and the subsequent effects on horizontal-plane sound localization. Virtual acoustic stimuli for sound localization testing were created individually for eight BiCI users by making acoustic transfer function measurements for microphones placed in the ear (ITE), behind the ear (BTE), and on the shoulders (SHD). The ILDs across source locations were calculated for each placement to analyze their effect on sound localization performance. Sound localization was tested using a repeated-measures, within-participant design for the three microphone placements. The ITE microphone placement provided significantly larger ILDs compared to BTE and SHD placements, which correlated with overall localization errors. However, differences in localization errors across the microphone conditions were small. The BTE microphones worn by many BiCI users in everyday life do not capture the full range of acoustic ILDs available, and also reduce the change in cue magnitudes for sound sources across the horizontal plane. Acute testing with an ITE placement reduced sound localization errors along the horizontal plane compared to the other placements in some patients. Larger improvements may be observed if patients had more experience with the new ILD cues provided by an ITE placement.

Effect of a geriatric curriculum on emergency medicine resident attitudes, knowledge, and decision-making.

PubMed

Biese, Kevin J; Roberts, Ellen; LaMantia, Michael; Zamora, Zeke; Shofer, Frances S; Snyder, Graham; Patel, Amar; Hollar, David; Kizer, John Steve; Busby-Whitehead, Jan

2011-10-01

Despite an increasing number of elderly emergency department (ED) patients, emergency medicine (EM) residency training lacks geriatric-specific curricula. The objective was to determine if a 1-year geriatric curriculum, designed for residents, would affect residents' attitudes, knowledge, and decision-making for older patients seen in the ED. The authors created a geriatric curriculum for EM residents composed of six lectures on the following topics: trauma, abdominal pain, transitions of care, medication management, iatrogenic injuries, and confusional states. A second component of the curriculum included seven high-fidelity simulation skills training sessions on aortic aneurysm, salicylate toxicity, drugs of abuse, infection from a posterior pressure ulcer, medication-induced elevated prothrombin time resulting in gastrointestinal bleeding, mesenteric ischemia, and myocardial infarction. Before and after completion of the curriculum, residents were assessed on attitudes toward caring for geriatric patients using a validated survey and knowledge of geriatric principals of care using a 35-question multiple choice test. To determine differences before and after the new curriculum was implemented, the paired t-test was performed on knowledge and attitude scores. ED records were also reviewed for frequency of chemical sedation and urinary catheter placement in patients aged 65 and over, both before and after the educational intervention, as a measure of appropriate decision-making. Appropriateness of urinary catheter placement was determined by two physician reviewers using criteria adapted from the Centers for Disease Control and Prevention indications for appropriate urinary catheter use. Reviewers met to adjudicate any disagreements about appropriateness. Fisher's exact test was used to examine differences in frequency of chemical sedation and urinary catheter placement. Twenty-nine EM residents underwent the training. There was no measured change in attitudes. Knowledge improved from the pre- to posttest with average scores of 58.5 and 68.0%, respectively (p < 0.0001), among the 25 residents who completed both tests. There was no change in the percentage of elderly patients receiving chemical sedation and urinary catheters before and after the curriculum (5.4% vs. 4.5%, p = 0.47; and 7.4% vs. 5.9%, p = 0.3, respectively). The number of inappropriate urinary catheters placed significantly decreased after the curriculum, from 8 of 49 to 1 of 47 (16.3% vs. 2.1%, p = 0.03). Geriatric educational curricula for EM residents may positively affect knowledge base and appropriate decision-making when working with older adults in the ED. These educational enhancements may place elderly patients at less risk of adverse outcomes. © 2011 by the Society for Academic Emergency Medicine.

The University of Illinois Placement and Proficiency System: Description and Results.

ERIC Educational Resources Information Center

Stallings, William M.; And Others

This report begins with an overview of placement and proficiency testing, with emphasis on the benefits to students and instructors of such testing. Various ways in which proficiency credit may be earned at the University of Illinois are discussed. In particular, the freshmen Placement and Proficiency System is described in detail. Some data are…

Youth Residing in Out-of-Home Placements: Examination of Behavior and Academic Achievement

ERIC Educational Resources Information Center

Lewis, Calli G.; Bullock, Lyndal M.

2016-01-01

A data set from the National Survey of Child and Adolescent Well-Being II was analyzed to determine if significant relationships existed between participants' internalizing and externalizing scores on the Child Behavior Checklist (CBCL) and their (a) scores on assessments of academic achievement and (b) behavior problems leading to suspension or…

A Comparison of Advanced Placement Scores for Hispanic Students from California, Texas, and Arizona

ERIC Educational Resources Information Center

Koch, Bevan M.

2012-01-01

Purpose: One purpose of this study was to analyze the overall AP exam performance of Hispanic students of Mexican origin from California, Texas, and Arizona. A second purpose was to conduct a comparison of Hispanic student exam scores from California, Texas, and Arizona on mathematics and English exams. Specifically, the performance of Hispanic…

Electromyography tests in patients with implanted cardiac devices are safe regardless of magnet placement.

PubMed

Ohira, Masayuki; Silcox, Jade; Haygood, Deavin; Harper-King, Valerie; Alsharabati, Mohammad; Lu, Liang; Morgan, Marla B; Young, Angela M; Claussen, Gwen C; King, Peter H; Oh, Shin J

2013-01-01

We compared the problems or complications associated with electrodiagnostic testing in 77 patients with implanted cardiac devices. Thirty tests were performed after magnet placement, and 47 were performed without magnet application. All electrodiagnostic tests were performed safely in all patients without any serious effect on the implanted cardiac devices with or without magnet placement. A significantly higher number of patient symptoms and procedure changes were reported in the magnet group (P < 0.013). No statistical difference was found in the testing difficulty or ECG changes. The magnet group patients had an approximately 11-fold greater risk of symptoms than those in the control group. Our data do not support a recommendation that magnet placement is necessary for routine electrodiagnostic testing in patients with implanted cardiac devices, as long as our general and specific guidelines are followed. Copyright © 2012 Wiley Periodicals, Inc.

Selective local anesthetic placement using ultrasound guidance and neurostimulation for infraclavicular brachial plexus block.

PubMed

Bowens, Clifford; Gupta, Rajnish K; O'Byrne, William T; Schildcrout, Jonathan S; Shi, Yaping; Hawkins, Jermel J; Michaels, Damon R; Berry, James M

2010-05-01

In this study, we performed the infraclavicular block with combined ultrasound guidance and neurostimulation to selectively target cords to compare the success rates of placing a single injection of local anesthetic either in a central or peripheral location. Two hundred eighteen patients were enrolled in a consecutive, prospective study. Patients were randomized to injection of local anesthetic either centrally (posterior cord) or peripherally (medial or lateral cord) using ultrasound guidance and neurostimulation. Supervised senior anesthesiology residents or attending anesthesiologists performed the blocks. Both intent-to-treat and treatment-received analyses were used to compare central and peripheral placement efficacy. The overall success rate was significantly higher for the central placements than peripheral placements (96% vs 85%, P = 0.004). Individual cord success rates were as follows: posterior 99%, lateral 92%, and medial 84% (P = 0.001). The central group required attending physician intervention more frequently (27% vs 6%, P < 0.001). Postoperative pain scores of < or =3 were more likely with central placement (100% vs 94%, P = 0.012). Central placement of a single injection of local anesthetic targeted at the posterior cord resulted in a higher success rate for infraclavicular block.

Transcorporal artificial urinary sphincter in radiated and non - radiated compromised urethra. Assessment with a minimum 2 year follow-up

PubMed Central

Long, Erwann Le; Rebibo, John David; Nouhaud, Francois Xavier; Grise, Philippe

2016-01-01

ABSTRACT Purpose to assess the efficacy of transcorporal artificial urinary sphincter (AUS) implantation on continence for male stress urinary incontinence in cases of prior surgical treatment or/and radiation failure, and as a first option in radiation patients. Materials and Methods From March 2007 to August 2012, 37 male patients were treated with transcorporal AUS AMS™ 800. Twelve patients had primary placement of transcorporal cuff, a surgical option due to a previous history of radiation and 25 patients had secondary procedure after failure of AUS or urinary incontinence surgery. Functional urinary outcomes were assessed by daily pad use, 24-hour Pad-test and ICIQ-SF questionnaire. Quality of life and satisfaction were assessed based on I-QoL and PGI-I questionnaires. Results After a median of 32 months, the continence rate (0 to 1 pad) was 69.7%. Median pad test was 17.5g (0-159), mean ICIQ-SF score was 7.3/21 (±5.4) and mean I-QoL score was 93.9/110. A total of 88% of the patients reported satisfaction with the AUS. The 5-year actuarial revision-free for AUS total device was 51%. Patients for primary implant for radiation were not more likely to experience revision than non-radiation patients. Preservation of erections was reported in half of the potent patients. Conclusions Transcorporal AUS cuff placement is a useful alternative procedure option for severe male UI treatment, especially in patients with a compromised urethra after prior surgery or radiation. A high continence rate was reported and implantation as first option in radiation patients should be considered. PMID:27286112

Minimally invasive percutaneous pericardial ICD placement in an infant piglet model: Head-to-head comparison with an open surgical thoracotomy approach.

PubMed

Clark, Bradley C; Davis, Tanya D; El-Sayed Ahmed, Magdy M; McCarter, Robert; Ishibashi, Nobuyuki; Jordan, Christopher P; Kane, Timothy D; Kim, Peter C W; Krieger, Axel; Nath, Dilip S; Opfermann, Justin D; Berul, Charles I

2016-05-01

Epicardial implantable cardioverter-defibrillator (ICD) placement in infants, children, and patients with complex cardiac anatomy requires an open surgical thoracotomy and is associated with increased pain, longer length of stay, and higher cost. The purpose of this study was to compare an open surgical epicardial placement approach with percutaneous pericardial placement of an ICD lead system in an infant piglet model. Animals underwent either epicardial placement by direct suture fixation through a left thoracotomy or minimally invasive pericardial placement with thoracoscopic visualization. Initial lead testing and defibrillation threshold testing (DFT) were performed. After the 2-week survival period, repeat lead testing and DFT were performed before euthanasia. Minimally invasive placement was performed in 8 piglets and open surgical placement in 7 piglets without procedural morbidity or mortality. The mean initial DFT value was 10.5 J (range 3-28 J) in the minimally invasive group and 10.0 J (range 5-35 J) in the open surgical group (P = .90). After the survival period, the mean DFT value was 12.0 J (range 3-20 J) in the minimally invasive group and 12.3 J (range 3-35 J) in the open surgical group (P = .95). All lead and shock impedances, R-wave amplitudes, and ventricular pacing thresholds remained stable throughout the survival period. Compared with open surgical epicardial ICD lead placement, minimally invasive pericardial placement demonstrates an equivalent ability to effectively defibrillate the heart and has demonstrated similar lead stability. With continued technical development and operator experience, the minimally invasive method may provide a viable alternative to epicardial ICD lead placement in infants, children, and adults at risk of sudden cardiac death. Copyright © 2016 Heart Rhythm Society. All rights reserved.

Comparison of patient-reported outcomes between immediately and conventionally loaded mandibular two-implant overdentures: A preliminary study.

PubMed

Omura, Yuri; Kanazawa, Manabu; Sato, Daisuke; Kasugai, Shohei; Minakuchi, Shunsuke

2016-07-01

The aim of this preliminary study is to compare patient-reported outcomes between immediately and conventionally loaded mandibular two-implant overdentures retained by magnetic attachments. Nineteen participants with edentulous mandibles were randomly assigned into either an immediate loading group (immediate group) or a conventional loading group (conventional group). Each participant received 2 implants in the inter-foraminal region by means of flapless surgery. Prostheses in the immediate and conventional groups were loaded using magnetic attachments on the same day as implant placement or 3 months after surgery, respectively. All participants completed questionnaires (the Japanese version of the Oral Health Impact Profile for edentulous [OHIP-EDENT-J], the patient's denture assessment [PDA], and general satisfaction) before implant placement (baseline) and 1, 2, 3, 4, 5, 6, and 12 months after surgery. The median differences between baseline and each monthly score were compared using the Mann-Whitney U test. The differences in median and 95% confidence interval between two groups were analyzed. The immediate group showed slightly lower OHIP-EDENT-J summary score at 1 and 3 months than the conventional group (P=0.09). In the lower denture domain of PDA, the immediate group showed a statistically higher score at 3 months (P=0.04). There was no statistically significant difference in general satisfaction between the two groups. Based on this preliminary study, immediate loading of mandibular two-implant overdentures with magnetic attachments tends to improve oral health-related quality of life and patient assessment earlier than observed with a conventional loading protocol. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Comparative effectiveness of liver transplant strategies for end-stage liver disease patients on renal replacement therapy.

PubMed

Chang, Yaojen; Gallon, Lorenzo; Jay, Colleen; Shetty, Kirti; Ho, Bing; Levitsky, Josh; Baker, Talia; Ladner, Daniela; Friedewald, John; Abecassis, Michael; Hazen, Gordon; Skaro, Anton I

2014-09-01

There are complex risk-benefit tradeoffs with different transplantation strategies for end-stage liver disease patients on renal support. Using a Markov discrete-time state transition model, we compared survival for this group with 3 strategies: simultaneous liver-kidney (SLK) transplantation, liver transplantation alone (LTA) followed by immediate kidney transplantation if renal function did not recover, and LTA followed by placement on the kidney transplant wait list. Patients were followed for 30 years from the age of 50 years. The probabilities of events were synthesized from population data and clinical trials according to Model for End-Stage Liver Disease (MELD) scores (21-30 and >30) to estimate input parameters. Sensitivity analyses tested the impact of uncertainty on survival. Overall, the highest survival rates were seen with SLK transplantation for both MELD score groups (82.8% for MELD scores of 21-30 and 82.5% for MELD scores > 30 at 1 year), albeit at the cost of using kidneys that might not be needed. Liver transplantation followed by kidney transplantation led to higher survival rates (77.3% and 76.4%, respectively, at 1 year) than placement on the kidney transplant wait list (75.1% and 74.3%, respectively, at 1 year). When uncertainty was considered, the results indicated that the waiting time and renal recovery affected conclusions about survival after SLK transplantation and liver transplantation, respectively. The subgroups with the longest durations of pretransplant renal replacement therapy and highest MELD scores had the largest absolute increases in survival with SLK transplantation versus sequential transplantation. In conclusion, the findings demonstrate the inherent tension in choices about the use of available kidneys and suggest that performing liver transplantation and using renal transplantation only for those who fail to recover their native renal function could free up available donor kidneys. These results could inform discussions about transplantation policy. © 2014 American Association for the Study of Liver Diseases.

Long term use of hydraulic artificial urethral sphincters in nine dogs from New Zealand with urethral sphincter mechanism incompetence.

PubMed

Morgan, Krs; Milner, H R; Tikekar, A; Smith, H L; Coomer, A R

2018-07-01

To report on the long-term outcomes of hydraulic artificial urethral sphincter (HAUS) placement for the correction of urethral sphincter mechanism incompetence (USMI) in New Zealand dogs. Retrospective data were obtained from cases of dogs which had a HAUS placed after failed medical and/or surgical management of USMI between August 2012 and November 2016. Owner assessment of urinary incontinence was evaluated by an online survey in May 2017 using a visual analogue scale (0 being normal, 100 being severely affected) for the frequency, volume and severity of any straining to urinate, immediately prior to the placement of the HAUS and at the time of the survey. The number of days between surgery and the completion of survey were recorded. Seven females and two male dogs, which were all desexed except for one female, were eligible for inclusion in the study. The period of follow-up following HAUS placement ranged from 206-1,685 days. Following HAUS placement, frequency and volume of urinary incontinence decreased for six dogs and were practically unchanged for three dogs. The median frequency score decreased from 70 to 13 and the volume score decreased from 73 to 12. There was no consistent change in the perceived degree of straining to urinate. Complications occurred in three dogs; one required repositioning of a dislodged injection port, one required management for haematuria and a hypoplastic bladder, and one required surgical removal of fibrous tissue around the HAUS cuff. HAUS placement was an effective method for the treatment of persistent USMI in most dogs and provided good clinical results based on owner assessment. The technique was associated with few complications and allowed successful long-term control of urinary incontinence without the need for medical management.

AP® Potential Predicted by PSAT/NMSQT® Scores Using Logistic Regression. Statistical Report 2014-1

ERIC Educational Resources Information Center

Zhang, Xiuyuan; Patel, Priyank; Ewing, Maureen

2014-01-01

AP Potential™ is an educational guidance tool that uses PSAT/NMSQT® scores to identify students who have the potential to do well on one or more Advanced Placement® (AP®) Exams. Students identified as having AP potential, perhaps students who would not have been otherwise identified, should consider enrolling in the corresponding AP course if they…

Exploring approaches to dietetic assessment of a common task across different universities through assessment moderation.

PubMed

Palermo, C; Volders, E; Gibson, S; Kennedy, M; Wray, A; Thomas, J; Hannan-Jones, M; Gallegos, D; Beck, E

2018-02-01

Assessment presents one of the greatest challenges to evaluating health professional trainee performance, as a result of the subjectivity of judgements and variability in assessor standards. The present study aimed to test a moderation procedure for assessment across four independent universities and explore approaches to assessment and the factors that influence assessment decisions. Assessment tasks designed independently by each of the four universities to assess student readiness for placement were chosen for the present study. Each university provided four student performance recordings for moderation. Eight different academic assessors viewed the student performances and assessed them using the corresponding university assessment instrument. Assessment results were collated and presented back to the assessors, together with the original university assessment results. Results were discussed with assessors to explore variations. The discussion was recorded, transcribed, thematically analysed and presented back to all assessors to achieve consensus on the emerging major learnings. Although there were differences in absolute scores, there was consistency (12 out of 16 performances) in overall judgement decisions regarding placement readiness. Proficient communication skills were considered a key factor when determining placement readiness. The discussion revealed: (i) assessment instruments; (ii) assessor factors; and (iii) the subjectivity of judgement as the major factors influencing assessment. Assessment moderation is a useful method for improving the quality of assessment decisions by sharing understanding and aligning standards of performance. © 2017 The British Dietetic Association Ltd.

Guided implant surgery with modification of the technique involving the raising of a semicircular miniflap: A preliminary study

PubMed Central

Viña, José; Maestre, Laura; Peñarrocha, David; Balaguer, José

2012-01-01

Objective: An evaluation is made of pain, swelling and peri-implant attached mucosal width after implant-based rehabilitation involving guided surgery and a modification of the technique with the raising of a semicircular miniflap, in single and partial replacements. Study design: A case-control study was carried out. The study group consisted of 12 patients with the placement of 19 implants using a guided surgery and miniflap technique. The control group consisted of 12 patients with the placement of 22 implants using the conventional technique. Each patient scored postoperative swelling and pain by means of a visual analog scale (VAS). Attached vestibular mucosa width was evaluated 12 weeks after implant placement. Results: Twelve operations were carried out in each group. Immediate aesthetics were established for all implants of the study group. One implant failed in each group. Maximum pain was recorded after 6 hours in both groups (mean VAS score 4 and 4.9 in the study and control group, respectively). Maximum swelling was recorded after 24 hours (mean VAS score 2.5) in the study group and on the second day (mean VAS score 3.4) in the control group. The mean attached vestibular mucosa width was 2.9 mm in the study group and 3.2 mm in the control group. Conclusion: In this preliminary study, guided implant surgery with a semicircular miniflap in single and partial replacements resulted in slightly less postoperative pain and swelling than with the conventional implant technique. The attached vestibular mucosa width was greater in the control group, though the differences were very small. Key words:Guided surgery, flapless surgery, miniflap, peri-implant mucosa. PMID:22549666

Emergency reconstructive endovascular management of intraoperative complications involving the internal carotid artery from trans-sphenoidal surgery.

PubMed

Griauzde, Julius; Gemmete, Joseph J; Pandey, Aditya S; McKean, Erin L; Sullivan, Stephen E; Chaudhary, Neeraj

2015-01-01

To report our experience with intraoperative complications involving the internal carotid artery (ICA) during trans-sphenoidal surgery and their outcome with reconstructive endovascular management. A retrospective review was conducted of patients with an ICA injury related to trans-sphenoidal surgery from 2000 to 2012. Demographic data, clinical charts, indications for treatment, radiographic images, lesion characteristics, operative notes, endovascular procedure notes and post-procedure hospital course were reviewed. Three men and one woman of mean age of 52 years (range 33-74) were identified. The lesions included two macroadenomas, one meningioma and one chondrosarcoma. Risk factors for ICA rupture included two patients with carotid dehiscence, one with sphenoid septal attachment to the ICA, two with revision surgery, one with prior radiation to the tumor, one with bromocriptine treatment and two with acromegaly. In three patients, covered stent placement achieved hemostasis at the site of injury within the ICA. One patient developed delayed bleeding 6 h after covered stent placement and underwent successful endovascular occlusion of the ICA but died 6 days after the injury. The fourth patient had an intraoperative ICA stroke requiring suction thrombectomy, thrombolysis, stent placement and evacuation of an epidural hematoma. At 1-year follow-up, two patients had a modified Rankin score (mRS) and National Institute of Health Stroke Scale (NIHSS) score of 0; in the patient who had a stroke the mRS score was 1 and the NIHSS score 2. Endovascular management with arterial reconstruction is helpful in the treatment of ICA injuries during trans-sphenoidal surgery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

77 FR 24480 - Application for New Awards; Advanced Placement (AP) Test Fee Program-Reopening the AP Test Fee...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... DEPARTMENT OF EDUCATION Application for New Awards; Advanced Placement (AP) Test Fee Program--Reopening the AP Test Fee Fiscal Year 2012 Competition AGENCY: Office of Elementary and Secondary Education (OESE), Department of Education. ACTION: Notice reopening the AP Test Fee fiscal year 2012 competition...

Educating registered nursing and healthcare assistant students in community-based supportive care of older adults: A mixed methods study.

PubMed

Pesut, Barbara; McLean, Tammy; Reimer-Kirkham, Sheryl; Hartrick-Doane, Gweneth; Hutchings, Deanna; Russell, Lara B

2015-09-01

Collaborative education that prepares nursing and healthcare assistant students in supportive care for older adults living at home with advanced chronic illness is an important innovation to prepare the nursing workforce to meet the needs of this growing population. To explore whether a collaborative educational intervention could develop registered nursing and healthcare assistant students' capabilities in supportive care while enhancing care of clients with advanced chronic illness in the community. Mixed method study design. A rural college in Canada. Twenty-one registered nursing and 21 healthcare assistant students completed the collaborative workshop. Eight registered nursing students and 13 healthcare assistant students completed an innovative clinical experience with fifteen clients living with advanced chronic illness. Pre and post-test measures of self-perceived competence and knowledge in supportive care were collected at three time points. Semi-structured interviews were conducted to evaluate the innovative clinical placement. Application of Friedman's test indicated statistically significant changes on all self-perceived competence scores for RN and HCA students with two exceptions: the ethical and legal as well as personal and professional issues domains for HCA students. Application of Friedman's test to self-perceived knowledge scores showed statistically significant changes in all but one domain (interprofessional collaboration and communication) for RN students and all but three domains for HCA students (spiritual needs, ethical and legal issues, and inter-professional collaboration and communication). Not all gains were sustained until T-3. The innovative community placement was evaluated positively by clients and students. Collaborative education for nursing and healthcare assistant students can enhance self-perceived knowledge and competence in supportive care of adults with advanced chronic illness. An innovative clinical experience can maximize reciprocal learning while providing nursing services to a population that is not receiving home-based care. Copyright © 2015. Published by Elsevier Ltd.

Unravelling the complexities of nursing students' feedback on the clinical learning environment: a mixed methods approach.

PubMed

Salamonson, Yenna; Everett, Bronwyn; Halcomb, Elizabeth; Hutchinson, Marie; Jackson, Debra; Mannix, Judy; Peters, Kath; Weaver, Roslyn

2015-01-01

Clinical placement is an essential part of nursing education, and students' experiences on clinical placement can affect the quality of their learning. Understanding nursing students' positive and negative perceptions of clinical placement experience is therefore important. To describe nursing students' satisfaction with their clinical placement experiences and identify any variations in satisfaction based on demographic characteristics. Mixed methods - online survey with qualitative items. Four universities in Australia. Students (n=213) enrolled in an undergraduate nursing degree. Between 2010 and 2012, students completed online surveys following their clinical placement experiences. The surveys included demographic questions and the Clinical Learning Environment Inventory (CLEI-19), a 19-item tool measuring students' satisfaction with clinical placement. The surveys included two open-ended questions asking students to share their most satisfying and challenging experiences whilst on placement. Descriptive statistics and thematic analyses were undertaken. Of the 213 participants, those in health-related employment and those with English as an additional language (EAL) were less satisfied with the clinical facility and with clinical facilitator support respectively, as indicated by the CLEI-19 subscale scores. Qualitative findings showed students were positive about the opportunity to make a difference and be involved in nursing, and negative about clinical facilitator support. Nevertheless, those who were most critical in their written comments about their placement were those who only spoke English at home. Although the study found overall satisfaction with clinical placement, the lower satisfaction reported by students in health-related employment, and the mixed findings regarding language spoken and satisfaction, warrant further attention. Copyright © 2014 Elsevier Ltd. All rights reserved.

75 FR 75666 - Advanced Placement (AP) Test Fee Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-06

... DEPARTMENT OF EDUCATION [CFDA No. 84.330B] Advanced Placement (AP) Test Fee Program AGENCY: Office... AP Test Fee fiscal year (FY) 2011 competition. SUMMARY: On September 1, 2010, we published in the Federal Register (75 FR 53681) a notice inviting applications for the AP Test Fee FY 2011 competition...

Pain and chewing sensitivity during fixed orthodontic treatment in extraction and non-extraction patients.

PubMed

Sayar, Gulsilay

2017-01-01

The aim of this study was to evaluate the differences in pain perception and chewing sensitivity between extraction and non-extraction patients. Thirty orthodontic patients (11 males, 19 females) were included in this study who were classified as extraction (n=15; 6 males, 9 females) and non-extraction patients (n=15; 7 males, 8 females). The mean age of patients were 15.10±1.83 years in non-extraction group and 15.44±0.75 years in extraction group. The patients were asked to complete the Visual Analogue Scale (VAS) questionnaire and they were asked to mark the presence or absence of sensitivity during 7 days after the first arch wire placement. Pain intensity comparison between groups was performed using the Mann-Whitney U test. The Friedman test was used to analyze within-group differences over time. There were no significant differences in pain scores between the groups. Pain levels significantly decreased between day 1 and day 3 in both the groups. No differences were found in the chewing sensitivity between the non-extraction and extraction groups. No difference in the pain perception was observed between the extraction and non-extraction patients during the 7 days after arch wire placement.

Bilateral deficits in fine motor control and pinch grip force are not associated with electrodiagnostic findings in women with carpal tunnel syndrome.

PubMed

de la Llave-Rincón, Ana Isabel; Fernández-de-Las-Peñas, César; Pérez-de-Heredia-Torres, Marta; Martínez-Perez, Almudena; Valenza, Marie Carmen; Pareja, Juan A

2011-06-01

: The aim of this study was to analyze the differences in deficits in fine motor control and pinch grip force between patients with minimal, moderate/mild, or severe carpal tunnel syndrome (CTS) and healthy age- and hand dominance-matched controls. : A case-control study was conducted. The subtests of the Purdue Pegboard Test (one-hand and bilateral pin placements and assemblies) and pinch grip force between the thumb and the remaining four fingers of the hand were bilaterally evaluated in 66 women with minimal (n = 16), moderate (n = 16), or severe (n = 34) CTS and in 20 age- and hand-matched healthy women. The differences among the groups were analyzed using different mixed models of analysis of variance. : A two-way mixed analysis of variance revealed significant differences between groups, not depending on the presence of unilateral or bilateral symptoms (side), for the one-hand pin placement subtest: patients showed bilateral lower scores compared with controls (P < 0.001), without differences among those with minimal, moderate, or severe CTS (P = 0.946). The patients also exhibited lower scores in bilateral pin placement (P < 0.001) and assembly (P < 0.001) subtests, without differences among them. The three-way analysis of variance revealed significant differences among groups (P < 0.001) and fingers (P < 0.001), not depending on the presence of unilateral/bilateral symptoms (P = 0.684), for pinch grip force: patients showed bilateral lower pinch grip force in all fingers compared with healthy controls, without differences among those with minimal, moderate, or severe CTS. : The current study revealed similar bilateral deficits in fine motor control and pinch grip force in patients with minimal, moderate, or severe CTS, supporting that fine motor control deficits are a common feature of CTS not associated with electrodiagnostic findings.

The Aftermath of Hip Fracture: Discharge Placement, Functional Status Change, and Mortality

PubMed Central

Bentler, Suzanne E.; Liu, Li; Obrizan, Maksym; Cook, Elizabeth A.; Wright, Kara B.; Geweke, John F.; Chrischilles, Elizabeth A.; Pavlik, Claire E.; Wallace, Robert B.; Ohsfeldt, Robert L.; Jones, Michael P.; Rosenthal, Gary E.; Wolinsky, Fredric D.

2009-01-01

The authors prospectively explored the consequences of hip fracture with regard to discharge placement, functional status, and mortality using the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD). Data from baseline (1993) AHEAD interviews and biennial follow-up interviews were linked to Medicare claims data from 1993–2005. There were 495 postbaseline hip fractures among 5,511 respondents aged ≥69 years. Mean age at hip fracture was 85 years; 73% of fracture patients were white women, 45% had pertrochanteric fractures, and 55% underwent surgical pinning. Most patients (58%) were discharged to a nursing facility, with 14% being discharged to their homes. In-hospital, 6-month, and 1-year mortality were 2.7%, 19%, and 26%, respectively. Declines in functional-status-scale scores ranged from 29% on the fine motor skills scale to 56% on the mobility index. Mean scale score declines were 1.9 for activities of daily living, 1.7 for instrumental activities of daily living, and 2.2 for depressive symptoms; scores on mobility, large muscle, gross motor, and cognitive status scales worsened by 2.3, 1.6, 2.2, and 2.5 points, respectively. Hip fracture characteristics, socioeconomic status, and year of fracture were significantly associated with discharge placement. Sex, age, dementia, and frailty were significantly associated with mortality. This is one of the few studies to prospectively capture these declines in functional status after hip fracture. PMID:19808632

Development of a clinical practice guideline for testing nasogastric tube placement.

PubMed

Peter, Sue; Gill, Fenella

2009-01-01

A Perth metropolitan hospital group standardized changes to nasogastric tube placement, including removal of the "whoosh test" and litmus paper, and introduction of pH testing. Two audits were conducted: bedside data collection at a pediatric hospital and a point-prevalence audit across seven hospitals. Aspirate was obtained for 97% of all tests and pH was < or = 5.5 for 84%, validating the practice changes. However, patients on continuous feeds and/or receiving acid-inhibiting medications had multiple pH testing fails. Nasogastric tube placement continues to present a challenge for those high-risk patients on continuous feeds and/or receiving acid-inhibiting medications.

Using Multiple Measures to Make Math Placement Decisions: Implications for Access and Success in Community Colleges

ERIC Educational Resources Information Center

Ngo, Federick; Kwon, William W.

2015-01-01

Community college students are often placed in developmental math courses based on the results of a single placement test. However, concerns about accurate placement have recently led states and colleges across the country to consider using other measures to inform placement decisions. While the relationships between college outcomes and such…

The 2007 AASM Recommendations for EEG Electrode Placement in Polysomnography: Impact on Sleep and Cortical Arousal Scoring

PubMed Central

Ruehland, Warren R.; O'Donoghue, Fergal J.; Pierce, Robert J.; Thornton, Andrew T.; Singh, Parmjit; Copland, Janet M.; Stevens, Bronwyn; Rochford, Peter D.

2011-01-01

Study Objective: To examine the impact of using American Academy of Sleep Medicine (AASM) recommended EEG derivations (F4/M1, C4/M1, O2/M1) vs. a single derivation (C4/M1) in polysomnography (PSG) on the measurement of sleep and cortical arousals, including inter- and intra-observer variability. Design: Prospective, non-blinded, randomized comparison. Setting: Three Australian tertiary-care hospital clinical sleep laboratories. Patients or Participants: 30 PSGs from consecutive patients investigated for obstructive sleep apnea (OSA) during December 2007 and January 2008. Interventions: N/A Measurements and Results: To examine the impact of EEG derivations on PSG summary statistics, 3 scorers from different Australian clinical sleep laboratories each scored separate sets of 10 PSGs twice, once using 3 EEG derivations and once using 1 EEG derivation. To examine the impact on inter- and intra-scorer reliability, all 3 scorers scored a subset of 10 PSGs 4 times, twice using each method. All PSGs were de-identified and scored in random order according to the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Using 3 referential EEG derivations during PSG, as recommended in the AASM manual, instead of a single central EEG derivation, as originally suggested by Rechtschaffen and Kales (1968), resulted in a mean ± SE decrease in N1 sleep of 9.6 ± 3.9 min (P = 0.018) and an increase in N3 sleep of 10.6 ± 2.8 min (P = 0.001). No significant differences were observed for any other sleep or arousal scoring summary statistics; nor were any differences observed in inter-scorer or intra-scorer reliability for scoring sleep or cortical arousals. Conclusion: This study provides information for those changing practice to comply with the 2007 AASM recommendations for EEG placement in PSG, for those using portable devices that are unable to comply with the recommendations due to limited channel options, and for the development of future standards for PSG scoring and recording. As the use of multiple EEG derivations only led to small changes in the distribution of derived sleep stages and no significant differences in scoring reliability, this study calls into question the need to use multiple EEG derivations in clinical PSG as suggested in the AASM manual. Citation: Ruehland WR; O'Donoghue FJ; Pierce RJ; Thornton AT; Singh P; Copland JM; Stevens B; Rochford PD. The 2007 AASM recommendations for EEG electrode placement in polysomnography: impact on sleep and cortical arousal scoring. SLEEP 2011;34(1):73-81. PMID:21203376

Preadolescent's oral health-related quality of life during the first month of fixed orthodontic appliance therapy.

PubMed

Abreu, Lucas G; Lages, Elizabeth M B; Abreu, Mauro H N G; Pereira, Luciano J; Paiva, Saul M

2013-09-01

To evaluate preadolescent oral health related quality of life (OHRQoL) during the first month of fixed orthodontic appliance therapy. Descriptive study. The Department of Pediatric Dentistry and Orthodontics at Federal University of Minas Gerais, Belo Horizonte, Brazil. This study included a sample of 96 preadolescent children aged between 11 and 12 years undergoing orthodontic treatment with a fixed appliance. Preadolescent children were required to answer the short form of the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14) before treatment (T0) and 1 month after placement of the fixed appliance (T1). Statistical analysis was performed using the Wilcoxon signed rank test and the Bonferroni correction for the domains of CPQ11-14. Out of the 96 patients originally admitted, one gave up the treatment before the placement of bands and one failed to return the second questionnaire (T1). So, a sample of 94 preadolescents participated in this study, with a response rate of 97·9%. Among the 94 participants, 49 were females (52·1 %) and 45 were males (47·9 %). The mean age was 11·5 years (SD = 0·502). There was a statistically significant improvement in emotional well-being domain (P<0·001) as well as in the overall score (P = 0·032). However, there were no significant changes in oral symptoms, functional limitations and social well-being domains (P>0·013) before treatment and 1 month after the placement of fixed appliance. One month after the placement of fixed orthodontic appliance, the preadolescents had positive alterations in their OHRQoL mainly in the emotional well-being domain.

Are overreferrals on developmental screening tests really a problem?

PubMed

Glascoe, F P

2001-01-01

Developmental screening tests, even those meeting standards for screening test accuracy, produce numerous false-positive results for 15% to 30% of children. This is thought to produce unnecessary referrals for diagnostic testing or special services and increase the cost of screening programs. To explore whether children who pass screening tests differ in important ways from those who do not and to determine whether children overreferred for testing benefit from the scrutiny of diagnostic testing and treatment planning. Subjects were a national sample of 512 parents and their children (age range of the children, 7 months to 8 years) who participated in validation studies of various screening tests. Psychological examiners adhering to standardized directions obtained informed consent and administered at least 2 developmental screening measures (the Brigance Screens, the Battelle Developmental Inventory Screening Test, the Denver-II, and the Parents' Evaluations of Developmental Status) and a concurrent battery of diagnostic measures, including tests of intelligence, language, and academic achievement (for children aged 2(1/2) years and older). The performance on diagnostic measures of children who failed screening but were not found to have a disability (false positives) was compared with that of children who passed screening and did not have a disability on diagnostic testing (true negatives). Children with false-positive scores performed significantly (P<.001) lower on diagnostic measures than did children with true-negative scores. The false-positive group had scores in adaptive behavior, language, intelligence, and academic achievement that were 9 to 14 points lower than the scores of those in the true-negative group. When viewing the likelihood of scoring below the 25th percentile on diagnostic measures, children with false-positive scores had a relative risk of 2.6 in adaptive behavior (95% confidence interval [CI], 1.67-4.21), 3.1 in language skills (95% CI, 1.90-5.20), 6.7 on intelligence tests (95% CI, 3.28-13.50), and 4.9 on academic measures (95% CI, 2.61-9.28). Overall, 151 (70%) of the children with false-positive results scored below the 25th percentile on 1 or more diagnostic measures (the point at which most children have difficulty benefiting from typical classroom instruction) in contrast with 64 (29%) of the children with true-negative scores (odds ratio, 5.6; 95% CI, 3.73-8.49). Children with false-positive scores were also more likely to be nonwhite and to have parents who had not graduated from high school. Performance differences between children with true-negative scores and children with false-positive scores continued to be significant (P<.001) even after adjusting for sociodemographic differences between groups. Children overreferred for diagnostic testing by developmental screens perform substantially lower than children with true-negative scores on measures of intelligence, language, and academic achievement-the 3 best predictors of school success. These children also carry more psychosocial risk factors, such as limited parental education and minority status. Thus, children with false-positive screening results are an at-risk group for whom diagnostic testing may not be an unnecessary expense but rather a beneficial and needed service that can help focus intervention efforts. Although such testing will not indicate a need for special education placement, it can be useful in identifying children's needs for other programs known to improve language, cognitive, and academic skills, such as Head Start, Title I services, tutoring, private speech-language therapy, and quality day care.

College Readiness Policy Implementation in the Massachusetts Public Higher Education System from Policy to Practice: An Analysis of the Implementation of the State College Placement Testing (CPT) Policies at the Four Year Public Institutions

ERIC Educational Resources Information Center

Solomon, Jibril

2013-01-01

In 1998, the Massachusetts Board of Higher Education, with assistance from the Developmental Assessment and Placement Advisory Committee, adopted an assessment policy that set standards for college placement testing at Massachusetts public colleges and universities. The purposes of the policy were to place students more adequately suited for…

Predictors of scoring at least 600 on COMLEX-USA Level 1: successful preparation strategies.

PubMed

Vora, Aditya; Maltezos, Nathan; Alfonzo, Lauren; Hernandez, Nilda; Calix, Erica; Fernandez, M Isabel

2013-02-01

Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 scores are an important criterion used by residency directors to make residency placement decisions. To explore the association between scoring at least 600 on COMLEX-USA Level 1 and grade point average (GPA), scores on the Medical College Admission Test (MCAT), and different test preparation strategies. Third-year osteopathic medical students at Nova Southeastern University were invited to complete a self-administered survey regarding their COMLEX-USA preparation strategies and to provide consent for the researchers to access their preclinical GPA and their MCAT and COMLEX-USA scores. Descriptive analyses were conducted to understand examination preparation procedures and resources used, and bivariate analyses were conducted to identify the statisically significant predictors of scoring 600 or higher. Two separate logistic regressions were also run. The first included all of the statisically significant factors that emerged from the bivariate analyses, and the second examined which candidate predictors remained statistically significant once the effects of GPA and MCAT scores were removed. One hundred twenty-two students completed the survey, and 113 (93%) provided informed consent to access their preclinical GPA and their MCAT and COMLEX-USA scores. In the first regression, scoring 600 or higher was associated with a higher GPA (P<.02), a higher MCAT score (P<.05), earlier preparation initiation (P<.05), and not ranking the Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) as the most helpful practice examination (P<.04). In the second regression, scoring 600 or higher was associated with earlier initiation of examination preparation (P<.01) and not ranking COMBANK (question bank for COMLEX-USA) as the most helpful question bank (P<.03). Among the different examination preparation methods, the specific resources ranked as most helpful were First Aid for the USMLE (United States Medical Licensing Examination) (review book), the COMSAE (practice examination); COMBANK (question bank); and Kaplan USMLE (lecture videos). Preclinical GPA and MCAT scores continue to be important predictors of scoring at least 600 on COMLEX-USA Level 1. However, the findings underscore the importance of maintaining a high GPA during the first 2 years of medical school and initiating COMLEX-USA preparation early.

Discriminant Analysis of Gross and Fine Motor Proficiency Data.

ERIC Educational Resources Information Center

Broadhead, Geoffrey D.; Church, Gabie E.

1982-01-01

Handicapped and nonhandicapped students were administered the Bruininks-Oseretsky Test of Motor Proficiency to determine regular or specially designed physical education placement. Two of the three functions on the test were significant, indicating usefulness in placement. Fewer than half the test items for each function contributed discriminatory…

National Assessments. Research Brief

ERIC Educational Resources Information Center

Education Partnerships, Inc., 2012

2012-01-01

This paper answers a question about national diagnostic and placement tests that measure students' strengths and weaknesses so that they can recognize their strengths and improve their weaknesses. Some schools and districts described using placement tests, however, for the most part, the names of the specific tests were not given. In states such…

Local Norms and Test Characteristics for Selected Forms of the M.A.A. Placement Test.

ERIC Educational Resources Information Center

Melancon, Janet G.; Thompson, Bruce

The psychometric integrity of selected items from the Mathematics Association of America (MAA) placement tests for college students was investigated. Two alternative and parallel versions of the test were developed (Form A and Form B) for this study. Data for 539 students seeking admission into an undergraduate mathematics curriculum at a private…

Post-adoption Depression: Parental Classes of Depressive Symptoms Across Time

PubMed Central

Foli, Karen J.; South, Susan C.; Lim, Eunjung; Jarnecke, Amber

2016-01-01

Background Approximately 10%-15% of birth mothers and fathers experience postpartum depression, but reports of depressive symptoms in adoptive parents are more variable. Findings from investigators range from 10%-32%, which may mask the experiences of distinct groups of adoptive parents from pre-to post-placement of a child. Methods We performed latent class growth analysis using the Center for Epidemiologic Studies-Depression scores of 129 primarily heterosexual, adoptive parents (50% females) for three time points: 4-6 weeks pre-placement of the child, 4-6 weeks post-placement, and 5-6 months post-placement. Mixed effects models by parent depressive trajectories were also conducted for three types of variables: interpersonal, psychological symptoms, and life orientation. Results Five classes of depressive symptom trajectories were found. The majority of parents (71%) belonged to a class with low levels of depressive symptoms across time. However, two classes of parents were above the threshold for depressive symptoms at placement, and three classes of parents were above the threshold at 6 months post-placement. The majority of interpersonal, psychological symptom, and life orientation variables were significant across classes and by time. Limitations The homogeneity of the sample calls for replication of study findings. Conclusions An explanation for inconsistencies in the range of adoptive parent depressive symptoms may be explained by different subgroups of parents who vary by their trajectory of depressive symptoms before and after placement of the child. Adoption and mental health professionals should be aware that select adoptive parents may struggle pre-and post-placement of a child. PMID:27155072

Post-adoption depression: Parental classes of depressive symptoms across time.

PubMed

Foli, Karen J; South, Susan C; Lim, Eunjung; Jarnecke, Amber M

2016-08-01

Approximately 10-15% of birth mothers and fathers experience postpartum depression, but reports of depressive symptoms in adoptive parents are more variable. Findings from investigators range from 10% to 32%, which may mask the experiences of distinct groups of adoptive parents from pre-to post-placement of a child. We performed latent class growth analysis using the Center for Epidemiologic Studies-Depression scores of 129 primarily heterosexual, adoptive parents (50% females) for three time points: 4-6 weeks pre-placement of the child, 4-6 weeks post-placement, and 5-6 months post-placement. Mixed effects models by parent depressive trajectories were also conducted for three types of variables: interpersonal, psychological symptoms, and life orientation. Five classes of depressive symptom trajectories were found. The majority of parents (71%) belonged to a class with low levels of depressive symptoms across time. However, two classes of parents were above the threshold for depressive symptoms at placement, and three classes of parents were above the threshold at 6 months post-placement. The majority of interpersonal, psychological symptom, and life orientation variables were significant across classes and by time. The homogeneity of the sample calls for replication of study findings. An explanation for inconsistencies in the range of adoptive parent depressive symptoms may be explained by different subgroups of parents who vary by their trajectory of depressive symptoms before and after placement of the child. Adoption and mental health professionals should be aware that select adoptive parents may struggle pre-and post-placement of a child. Copyright © 2016 Elsevier B.V. All rights reserved.

A comparative study of internally and externally capped balloons using small scale test balloons

NASA Technical Reports Server (NTRS)

Bell, Douglas P.

1994-01-01

Caps have been used to structurally reinforce scientific research balloons since the late 1950's. The scientific research balloons used by the National Aeronautics and Space Administration (NASA) use internal caps. A NASA cap placement specification does not exist since no empirical information exisits concerning cap placement. To develop a cap placement specification, NASA has completed two in-hangar inflation tests comparing the structural contributions of internal caps and external caps. The tests used small scale test balloons designed to develop the highest possible stresses within the constraints of the hangar and balloon materials. An externally capped test balloon and an internally capped test balloon were designed, built, inflated and simulated to determine the structural contributions and benefits of each. The results of the tests and simulations are presented.

The effectiveness of four-cavity treatment systems in sealing amalgam restorations.

PubMed

Morrow, Leean A; Wilson, Nairn H F

2002-01-01

Amalgam does not bond to tooth tissue; therefore, restorations using such material are prone to leakage despite the deposition of corrosion products. This study evaluated the effectiveness of four cavity treatment systems placed in vivo in sealing restorations of amalgam. Four cavity treatment systems were investigated in this study: Cervitec, Gluma One Bond, Panavia 21 and Copaliner Dentin Varnish and Sealant. No cavity treatment was placed in an additional group to serve as a control. The teeth were extracted within 15 minutes of restoration placement. The specimens were thermocycled (5-55 +/- 2 degrees C, 500 cycles), immersed in a dye solution, sectioned and scored for leakage. Scanning electron microscopy also examined features of the tooth/restoration interfaces. There were statistically significant differences among the groups regarding leakage scores (p = 0.00). None of the materials tested consistently prevented leakage; however, use of Copaliner Dentin Varnish and Sealant resulted in less overall, occlusal and cervical microleakage than any other systems tested. Significantly more leakage was observed in relation to the cervical portions of the cavities (p = 0.00). No significant differences were identified between the leakage scores obtained for the buccal and palatal (lingual) cavities and the different tooth types (p = 0.52 and 0.83, respectively). A level of significance of 0.05 was selected in all cases. The benefits of the materials tested in this study need to be evaluated using robust, long-term clinical studies. Further work should continue to develop laboratory tests that predict the behavior and performance of cavity sealants in clinical service.

Test build from Robotic Fiber Placement Machine

NASA Image and Video Library

2015-10-01

MAJID BABAI, LEFT, CHIEF OF THE NONMETALLIC MANUFACTURING BRANCH AT MARSHALL, AND STEPHEN RICHARDSON, LEAD FOR THE STRUCTURAL DEVELOPMENT TEAM, TAKE A CLOSER LOOK AT ONE OF THE FIRST TEST BUILDS MADE BY THE NEW ROBOTIC FIBER PLACEMENT MACHINE BEHIND THEM.

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.

Efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturient.

PubMed

Anwari, Jamil S; Khalil, Laith; Terkawi, Abdullah S

2015-01-01

Establishing an epidural in an agitated laboring woman can be challenging. The ideal pain control technique in such a situation should be effective, fast acting, and short lived. We assessed the efficacy of inhalational methoxyflurane (Penthrox™) analgesia as bridging analgesia for epidural placement. Sixty-four laboring women who requested epidural analgesia with pain score of ≥7 enrolled in an observational study, 56 of which completed the study. The parturients were instructed to use the device prior to the onset of uterine contraction pain and to stop at the peak of uterine contraction, repeatedly until epidural has been successfully placed. After each (methoxyflurane inhalation-uterine contraction) cycle, pain, Richmond Agitation Sedation Scale (RASS), nausea and vomiting were evaluated. Maternal and fetal hemodynamics and parturient satisfaction were recorded. The mean baseline pain score was 8.2 ± 1.5 which was reduced to 6.2 ± 2.0 after the first inhalation with a mean difference of 2.0 ± 1.1 (95% confidence interval 1.7-2.3, P < 0.0001), and continued to decrease significantly over the study period (P < 0.0001). The RASS scores continuously improved after each cycle (P < 0.0001). Only 1 parturient from the cohort became lightly sedated (RASS = -1). Two parturients vomited, and no significant changes in maternal hemodynamics or fetal heart rate changes were identified during treatment. 67% of the parturients reported very good or excellent satisfaction with treatment. Penthrox™ provides rapid, robust, and satisfactory therapy to control pain and restlessness during epidural placement in laboring parturient.

Where Should We Go With Advanced Placement?

NASA Astrophysics Data System (ADS)

Lichten, William

2001-04-01

This is a review of the Advanced Placement (AP)Program. In disagreement with claims of the College Board, there is firm evidence that the average test performance level has dropped. The College Board's scale and claims for AP qualification disagree seriously with college standards. A majority of tests taken do not qualify. It appears that "advanced placement" is coming closer to "placement." This paper recommends that the College Board's policy, which previously has concentrated on the numbers of participants, should include an emphasis on student performance and program quality. AP could accomplish its goal of reaching a wider range of students by changing along the lines followed in college introductory physics courses: multiple tracks.

The effect of a lidocaine/prilocaine topical anesthetic on pain and discomfort associated with orthodontic elastomeric separator placement.

PubMed

Al-Melh, M Abu; Andersson, L

2017-12-01

The initial placement of orthodontic elastomeric separators can be uncomfortable and painful. Therefore, it is important to relieve this disturbing sensation to create a discomfort or pain-free orthodontic visit. The purpose of this study was to investigate the effect of a lidocaine/prilocaine topical anesthetic on pain and discomfort associated with the placement of orthodontic elastomeric separators. Fifty subjects aging between 20-35 years were included in this study. In the maxillary arch, a lidocaine/prilocaine topical anesthetic was placed around the ginigval margins of the premolar and molar on side. On the other side, a placebo agent was placed around the ginigval margins of the premolar and molar. After two minutes, an elastomeric separator was placed between the premolar and molar on both sides. The subjects were then asked to report their findings on a Verbal Scale and a Visual Analogue Scale every second minute for a period of 10 min. The subjects were also given a questionnaire to evaluate the overall impression on the topical anesthetic use. The overall mean discomfort/pain score was found to be significantly lower (p < 0.001) with the topical anesthetic than with the placebo. Repeated measures ANOVA with a Greenhouse-Geisser correction determined that mean pain scores were statistically significantly low with the 10-min time duration (F (1.54,42.2)  = 40.7, p = 0.001), with an estimated grand mean (8.37, 95% CI 6.75-9.98). The questionnaire responses revealed that 87% of the subjects reported an overall satisfaction and agreement with the topical anesthetic than with the placebo or no difference (13%) after the initial separator placement. The discomfort and pain resulting from the initial placement of orthodontic elastomeric separators can be significantly reduced with the lidocaine/prilocaine topical anesthetic.

The effects of TV unhealthy food brand placement on children. Its separate and joint effect with advertising.

PubMed

Uribe, Rodrigo; Fuentes-García, Alejandra

2015-08-01

This paper examines the effect of unhealthy food brand placement on children across different age groups (9, 12 and 15 year-old children). Results show that both brand awareness, and the behavioral disposition (toward junk food and McDonald's) increased when children were exposed to this marketing technique (in comparison with the control group). In the case of age, older groups (12-15) performed better in brand awareness, but scored lower in behavioral disposition than the 9-year-old group. Moreover, the joint use of advertising and placement (synergy) increased the effect of these communication tactics on children. Results are discussed in terms of previous results of the studies providing evidence of the influence of promotional tools of junk food on children. Copyright © 2015. Published by Elsevier Ltd.

Establishing a field epidemiology elective for medical students in Kenya: a strategy for increasing public health awareness and workforce capacity.

PubMed

Arvelo, Wences; Gura, Zeinab; Amwayi, Samuel; Wiersma, Petra; Omolo, Jared; Becknell, Steven; Jones, Donna; Ongore, Dismas; Dicker, Richard

2015-03-01

Medical students have limited exposure to field epidemiology, even though will assume public health roles after graduation. We established a 10-week elective in field epidemiology during medical school. Students attended one-week didactic sessions on epidemiology, and nine weeks in field placement sites. We administered pre- and post-tests to evaluate the training. We enrolled 34 students in 2011 and 2012. In 2011, we enrolled five of 24 applicants from a class of 280 medical students. In 2012, we enrolled 18 of 81 applicants from a class of 360 students; plus 11 who participated in the didactic sessions only. Among the 34 students who completed the didactic sessions, 74% were male, and their median age was 24 years (range: 22-26). The median pre-test score was 64% (range: 47-88%) and the median post-test score was 82% (range: 72-100%). Successful completion of the field projects was 100%. Six (30%) students were not aware of public health as a career option before this elective, 56% rated the field experience as outstanding, and 100% reported it increased their understanding of epidemiology. Implementing an elective in field epidemiology within the medical training is a highly acceptable strategy to increase awareness for public health among medical students. Published by Elsevier Ltd.

Predicting procedural pain after ureteroscopy: does hydrodistention play a role?

PubMed Central

Gul, Zeynep; Alazem, Kareem; Li, Ina; Monga, Manoj

2016-01-01

ABSTRACT Purpose: To identify perioperative predictors of immediate pain after ureteroscopy, specifically evaluating the impact of hydrodistention from irrigation on pain. Materials and Methods: We retrospectively identified patients who underwent ureteroscopy for the treatment of calculi. Data recorded for these patients included their maximum pain score in the post-anesthesia care unit (PACU), average flow rate of irrigant used during the procedure, patient and stone characteristics, operative procedure, and details of patients' immediate, post-operative course. Spearman's rho was used to determine the relationship between non-parametric, continuous variables. Then, a linear regression was performed to assess which variables could predict the peak pain score. Results: A total of 131 patients were included in the study. A non-parametric correlation analysis revealed that maximum pain score was negatively correlated with being male (r = −0.18, p=0.04), age (r = −0.34, p<0.001), and post-op foley placement (r = −0.20, p=0.02) but positively correlated with the preoperative pain score (r = 0.41, p<0.001), time in the PACU (r = 0.19, p = 0.03), and the morphine equivalent dose (MED) of narcotics administered in the PACU (r = 0.67, p<0.001). On linear regression, the significant variables were age, preoperative pain score, and stent placement. For every ten-year increase in age post-operative pain score decreased by 4/10 of a point (p = 0.03). For every 1 point increase in preoperative pain score there was a 3/10 of a point increase in the maximum pain score (p = 0.01), and leaving a stent in place post-operatively was associated with a 1.6 point increase in the maximum pain score. Conclusions: Hydrodistention does not play a role in post-ureteroscopy pain. Patients who are younger, have higher preoperative pain scores, or who are stented will experience more post-operative pain after ureteroscopy. PMID:27564284

Factors influencing decision regret regarding placement of a PEG among substitute decision-makers of older persons in Japan: a prospective study.

PubMed

Kuraoka, Yumiko; Nakayama, Kazuhiro

2017-06-28

A tube feeding decision aid designed at the Ottawa Health Research Institute was specifically created for substitute decision-makers who must decide whether to allow placement of a percutaneous endoscopic gastrostomy (PEG) tube in a cognitively impaired older person. We developed a Japanese version and found that the decision aid promoted the decision-making process of substitute decision-makers to decrease decisional conflict and increase knowledge. However, the factors that influence decision regret among substitute decision-makers were not measured after the decision was made. The objective of this study was to explore the factors that influence decision regret among substitute decision-makers 6 months after using a decision aid for PEG placement. In this prospective study, participants comprised substitute decision-makers for 45 inpatients aged 65 years and older who were being considered for placement of a PEG tube in hospitals, nursing homes and patients' homes in Japan. The Decisional Conflict Scale (DCS) was used to evaluate decisional conflict among substitute decision-makers immediately after deciding whether to introduce tube feeding and the Decision Regret Scale (DRS) was used to evaluate decisional regret among substitute decision-makers 6 months after they made their decision. Normalized scores were evaluated and analysis of variance was used to compare groups. The results of the multiple regression analysis suggest that PEG placement (P < .01) and decision conflict (P < .001) are explanatory factors of decision regret regarding placement of a PEG among substitute decision-makers. PEG placement and decision conflict immediately after deciding whether to allow PEG placement have an influence on decision regret among substitute decision-makers after 6 months.

Twelve-year retrospective review of unintended pregnancies after Essure sterilization in the Netherlands.

PubMed

Hitzerd, Emilie; Schreuder, Henk W R; Vleugels, Michel P H; Veersema, Sebastiaan

2016-04-01

To identify factors contributing to the occurrence of unintended pregnancies after Essure sterilization in the Netherlands. Even though Essure is a permanent method of contraception, unintended pregnancies have been reported. Retrospective case series analysis. Not applicable. Thirty-five pregnancies were reported in the Netherlands after Essure sterilization from 2002 through 2014 out of 27,346 placements. Data regarding Essure placement procedure, confirmation tests, and pregnancy outcome of the reported cases were obtained and analyzed to identify a possible cause of failure. Four causes of failure were identified: perforation (n = 10), expulsion (n = 7), unilateral placement (n = 7), and luteal pregnancy (n = 2). The occurrence of most pregnancies was related to physician noncompliance (n = 14). The other cases were associated with patient noncompliance (n = 5) or misinterpretation of the confirmation test (n = 9). Most pregnancies occurred within the first 24 months after the 3-month confirmation test (n = 23). The results of this study show that the incidence of pregnancies after Essure sterilization is low. Most pregnancies were related to incorrect positioning of a device or unilateral placement, and seem therefore preventable. Unilateral placement without prior history of salpingectomy should always be considered as unsuccessful sterilization. Furthermore, interpretation of the confirmation tests should be done by trained physicians, and with caution. We want to emphasize the importance of strictly adhering to placement and follow-up protocols. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis

PubMed Central

Doosti-Irani, Amin; Mansournia, Mohammad Ali; Rahimi-Foroushani, Abbas; Haddad, Peiman

2017-01-01

Background Palliative treatments and stents are necessary for relieving dysphagia in patients with esophageal cancer. The aim of this study was to simultaneously compare available treatments in terms of complications. Methods Web of Science, Medline, Scopus, Cochrane Library and Embase were searched. Statistical heterogeneity was assessed using the Chi2 test and was quantified by I2. The results of this study were summarized in terms of Risk Ratio (RR). The random effects model was used to report the results. The rank probability for each treatment was calculated using the p-score. Results Out of 17855 references, 24 RCTs reported complications including treatment related death (TRD), bleeding, stent migration, aspiration, severe pain and fistula formation. In the ranking of treatments, thermal ablative therapy (p-score = 0.82), covered Evolution® stent (p-score = 0.70), brachytherapy (p-score = 0.72) and antireflux stent (p-score = 0.74) were better treatments in the network of TRD. Thermal ablative therapy (p-score = 0.86), the conventional stent (p-score = 0.62), covered Evolution® stent (p-score = 0.96) and brachytherapy (p-score = 0.82) were better treatments in the network of bleeding complications. Covered Evolution® (p-score = 0.78), uncovered (p-score = 0.88) and irradiation stents (p-score = 0.65) were better treatments in network of stent migration complications. In the network of severe pain, Conventional self-expandable nitinol alloy covered stent (p-score = 0.73), polyflex (p-score = 0.79), latex prosthesis (p-score = 0.96) and brachytherapy (p-score = 0.65) were better treatments. Conclusion According to our results, thermal ablative therapy, covered Evolution® stents, brachytherapy, and antireflux stents are associated with a lower risk of TRD. Moreover, thermal ablative therapy, conventional, covered Evolution® and brachytherapy had lower risks of bleeding. Overall, fewer complications were associated with covered Evolution® stent and brachytherapy. PMID:28968416

Study of Bias in 2012-Placement Test through Rasch Model in Terms of Gender Variable

ERIC Educational Resources Information Center

Turkan, Azmi; Cetin, Bayram

2017-01-01

Validity and reliability are among the most crucial characteristics of a test. One of the steps to make sure that a test is valid and reliable is to examine the bias in test items. The purpose of this study was to examine the bias in 2012 Placement Test items in terms of gender variable using Rasch Model in Turkey. The sample of this study was…

Performance of advanced resuscitation skills by pediatric housestaff.

PubMed

White, J R; Shugerman, R; Brownlee, C; Quan, L

1998-12-01

To describe pediatric housestaff resuscitation experience and their ability to perform key resuscitation skills. Cohort study of 63 pediatric residents in a university-based training program. Investigators observed, scored, and timed resident performance on 4 key resuscitation skills. Cognitive ability was tested with 4 written scenarios. Housestaff provided self-reports of the number of months since their last American Heart Association Pediatric Advanced Life Support course, number of mock and actual codes attended, number of times skills were performed, and self-confidence with respect to resuscitation. A total of 45 pediatric residents (71%) participated. Median cognitive score was 5 (range, 1-5). Of all residents, 44 (97%) successfully bag mask-ventilated the mannequin; 24 (53%) and 36 (80%) used the correct bag and mask size, respectively. Thirty-nine residents (87%) placed a tube in the mannequin trachea, 12 (27%) checked that suction was working prior to intubation, and 30 (67%) chose the correct endotracheal tube size. Forty residents (89%) discharged the defibrillator, and 25 (56%) and 32 (71%) correctly chose asynchronous mode and infant paddles, respectively. Thirty-eight residents (84%) inserted an intraosseous line; 35 (78%) had correct placement. Median times for successful skill completion were 83 seconds for bag mask ventilation, 136 seconds for intubation, 149 seconds for defibrillation, and 68 seconds for intraosseous line placement. Pediatric housestaff previously trained in pediatric advanced life support were generally able to reach the end point of 4 key resuscitation skills but less frequently performed the specific subcomponents of each skill. This poor performance and the prolonged time to skill completion suggest the need for greater attention to detail during training.

MAA Placement Test Newsletter. 1978-87.

ERIC Educational Resources Information Center

Harvey, John G., Ed.

1987-01-01

This document consists of volumes 1-9 of the Mathematics Association of America's (MAA) Placement Test Program Newsletter. The MAA is the professional association primarily concerned with undergraduate education in mathematics. It has responded to the increasingly difficult problem of placing freshmen students in mathematics courses by developing…

Aspiration, Performance, Reward: The Advanced Placement Program at 40.

ERIC Educational Resources Information Center

Rothschild, Eric

1995-01-01

The history of the College Entrance Examination Board's Advanced Placement Program is chronicled from its conception in 1951 through early developmental stages and 40 years of implementation. Issues discussed include test development, funding, administration at the institutional level, expansion of curriculum areas and testing options, teacher…

Effects of ankle-foot orthoses on mediolateral foot-placement ability during post-stroke gait.

PubMed

Zissimopoulos, Angelika; Fatone, Stefania; Gard, Steven

2015-10-01

Accurate and precise mediolateral foot placement is important for balance during gait, but is impaired post stroke. Mediolateral foot placement may be improved with ankle-foot orthosis use. The purpose of this study was to determine whether an ankle-foot orthosis improves mediolateral foot-placement ability during post-stroke ambulation. Crossover trial with randomized order of conditions tested. The accuracy and precision of mediolateral foot placement was quantified while subjects targeted four different randomized step widths. Subjects were tested with and without their regular non-rigid ankle-foot orthosis in two separate visits (order randomized). While ankle-foot orthosis use corrected foot and ankle alignment (i.e. significantly decreased mid-swing plantar flexion, p = 0.000), effects of ankle-foot orthosis use on hip hiking (p = 0.545), circumduction (p = 0.179), coronal plane hip range of motion (p = 0.06), and mediolateral foot-placement ability (p = 0.537) were not significant. While ankle-foot orthosis-mediated equinovarus correction of the affected foot and ankle was not associated with improved biomechanics of walking (i.e. proximal ipsilateral hip kinematics or mediolateral foot-placement ability), it may affect other aspects of balance that were not tested in this study (e.g. proprioception, cerebellar, vestibular, and cognitive mechanisms). Studies that investigate the effect of ankle-foot orthosis on gait can help advance stroke rehabilitation by documenting the specific gait benefits of ankle-foot orthosis use. In this study, we investigated the effect of ankle-foot orthosis use on mediolateral foot-placement ability, an aspect of gait important for maintaining balance. © The International Society for Prosthetics and Orthotics 2014.

Educational late effects in long-term survivors of childhood acute lymphocytic leukemia.

PubMed

Peckham, V C; Meadows, A T; Bartel, N; Marrero, O

1988-01-01

Records of levels of school achievement in long-term survivors of childhood acute lymphocytic leukemia were obtained for 23 children who had received 2,400-rad cranial irradiation and intrathecal methotrexate and standard chemotherapeutic agents 8 to 10 years previously. The children had been evaluated with standardized tests of intelligence at the time of diagnosis and periodically thereafter. Declines in IQ and cognitive dysfunctions have been previously described. School placements, educational histories, attendance records, learning strengths and weaknesses, social/emotional adjustments, and grade level achievements in reading and mathematics as measured by standardized achievement tests are reported here. Children achieved less than the expected levels in both reading and mathematics given both pretreatment and most recent IQ scores. Neither sex nor initial IQ were related to achievement scores. Children experienced difficulty with attention/concentration, memory, sequencing, and comprehension when performing school tasks. Individual children showed different degrees of dysfunction, but results of this study suggest that there are patterns of specific learning disabilities rather than global retardation. A small number of children achieved greater than expected levels, indicating that individualized instruction, tutoring, and parental support may reduce some learning deficits. Early educational intervention is recommended for similarly treated patients.

Evaluation of the Safety and Tolerability of Conjunctival Ring for Posterior Segment of the Eye.

PubMed

Kinoshita, Satoshi; Ohguchi, Takeshi; Noda, Kousuke; Murata, Miyuki; Yasueda, Shin-Ichi; Obata, Haruka; Matsunaga, Toru; Fukushima, Tsutomu; Kanda, Atsuhiro; Ishida, Susumu

2017-08-01

To evaluate the safety and tolerability of conjunctival rings (CRs), a novel device for drug delivery to the posterior segment of the eye. In animal studies, CRs containing 5% dexamethasone sodium phosphate (DSP) or vehicle solution were placed on the right and left eyes of C57BL/6J mice, respectively. Contact lenses (CLs) containing vehicle solution were used as a control. Twenty-four hours after placement of the CRs, corneal fluorescein staining was graded based on the McDonald-Shadduck scoring system, ranging from 0 to 4. In humans, CRs containing vehicle solution were placed on the right eye of healthy volunteers for 9 hours. The corneal curvature, corneal thickness, intraocular pressure, visual acuity, tear production (Schirmer I test), tear film break-up time and fluorescein staining scores of the cornea (scores ranging from 0 to 3) and conjunctiva (scores ranging from 0 to 6) were assessed before and after wearing the CRs. The release characteristics of DSP from CRs were also evaluated. In animal experiments, corneal fluorescein staining scores were 1 or less in all the groups, and there was no significant difference between the CR group and the CL group. In the preclinical safety evaluation of CR for humans, ophthalmic examination revealed that CR caused no significant changes in all the parameters investigated including corneal curvature (p = 0.77), corneal thickness (p = 0.96), intraocular pressure (p = 0.59), visual acuity (p = 0.14), Schirmer I test results (p = 0.76), tear film break-up time (p = 0.68), corneal fluorescein staining scores (p = 0.64), and conjunctival fluorescein staining scores (p = 0.52). The DSP release from CRs occurs within a few hours, which is similar to the drug-release property of medicated CL, as reported previously. The current data showed the safety and tolerability of CR as a drug delivery device for the treatment of posterior segment diseases.

Infant Placement in Canadian Child Maltreatment-Related Investigations

ERIC Educational Resources Information Center

Tonmyr, Lil; Williams, Gabriela; Jack, Susan M.; MacMillan, Harriet L.

2011-01-01

This study examined factors associated with decisions in favour of out-of-home placement following investigations involving infants at risk of maltreatment. We used data from a sample of children less than 1 year of age (n = 763) investigated by child welfare services across Canada in 2003. We tested unadjusted relationships with placement using…

A Case for Faculty Involvement in EAP Placement Testing

ERIC Educational Resources Information Center

James, Cindy; Templeman, Elizabeth

2009-01-01

The EAP placement procedure at Thompson Rivers University (TRU) involves multiple measures to assess the language skills of incoming students, some of which are facilitated and all of which are assessed by ESL faculty. In order to determine the effectiveness of this comprehensive EAP placement process and the effect of the faculty factor, a…

Placement Assistance Services: Procedures Manual. S.P.A.C.E. Student Placement and Counseling Effort.

ERIC Educational Resources Information Center

Irvin, Donald E.; Galey, Stephen B.

This manual represents an attempt to develop a model and procedures for implementing career planning and placement assistance services in Minnesota high schools. The procedures described were developed for and tested in four participating high schools of different sizes, administrative structures, and geographic locations. Divided into seven…

Video-augmented feedback for procedural performance.

PubMed

Wittler, Mary; Hartman, Nicholas; Manthey, David; Hiestand, Brian; Askew, Kim

2016-06-01

Resident programs must assess residents' achievement of core competencies for clinical and procedural skills. Video-augmented feedback may facilitate procedural skill acquisition and promote more accurate self-assessment. A randomized controlled study to investigate whether video-augmented verbal feedback leads to increased procedural skill and improved accuracy of self-assessment compared to verbal only feedback. Participants were evaluated during procedural training for ultrasound guided internal jugular central venous catheter (US IJ CVC) placement. All participants received feedback based on a validated 30-point checklist for US IJ CVC placement and validated 6-point procedural global rating scale. Scores in both groups improved by a mean of 9.6 points (95% CI: 7.8-11.4) on the 30-point checklist, with no difference between groups in mean score improvement on the global rating scale. In regards to self-assessment, participant self-rating diverged from faculty scoring, increasingly so after receiving feedback. Residents rated highly by faculty underestimated their skill, while those rated more poorly demonstrated increasing overestimation. Accuracy of self-assessment was not improved by addition of video. While feedback advanced the skill of the resident, video-augmented feedback did not enhance skill acquisition or improve accuracy of resident self-assessment compared to standard feedback.

Predictive Validity Study of the APS Writing and Reading Tests [and] Validating Placement Rules for the APS Writing Test.

ERIC Educational Resources Information Center

College of the Canyons, Valencia, CA. Office of Institutional Development.

California's College of the Canyons has used the College Board Assessment and Placement Services (APS) test to assess students' abilities in basic and college English since spring 1993. These two reports summarize data from a May 1994 study of the predictive validity of the APS writing and reading tests and a June 1994 effort to validate the cut…

Predictive Validity of a Multiple-Choice Test for Placement in a Community College

ERIC Educational Resources Information Center

Verbout, Mary F.

2013-01-01

Multiple-choice tests of punctuation and usage are used throughout the United States to assess the writing skills of new community college students in order to place them in either a basic writing course or first-year composition. To determine whether using the COMPASS Writing Test (CWT) is a valid placement at a community college, student test…

Optimal sensor placement for leak location in water distribution networks using genetic algorithms.

PubMed

Casillas, Myrna V; Puig, Vicenç; Garza-Castañón, Luis E; Rosich, Albert

2013-11-04

This paper proposes a new sensor placement approach for leak location in water distribution networks (WDNs). The sensor placement problem is formulated as an integer optimization problem. The optimization criterion consists in minimizing the number of non-isolable leaks according to the isolability criteria introduced. Because of the large size and non-linear integer nature of the resulting optimization problem, genetic algorithms (GAs) are used as the solution approach. The obtained results are compared with a semi-exhaustive search method with higher computational effort, proving that GA allows one to find near-optimal solutions with less computational load. Moreover, three ways of increasing the robustness of the GA-based sensor placement method have been proposed using a time horizon analysis, a distance-based scoring and considering different leaks sizes. A great advantage of the proposed methodology is that it does not depend on the isolation method chosen by the user, as long as it is based on leak sensitivity analysis. Experiments in two networks allow us to evaluate the performance of the proposed approach.

Optimal Sensor Placement for Leak Location in Water Distribution Networks Using Genetic Algorithms

PubMed Central

Casillas, Myrna V.; Puig, Vicenç; Garza-Castañón, Luis E.; Rosich, Albert

2013-01-01

This paper proposes a new sensor placement approach for leak location in water distribution networks (WDNs). The sensor placement problem is formulated as an integer optimization problem. The optimization criterion consists in minimizing the number of non-isolable leaks according to the isolability criteria introduced. Because of the large size and non-linear integer nature of the resulting optimization problem, genetic algorithms (GAs) are used as the solution approach. The obtained results are compared with a semi-exhaustive search method with higher computational effort, proving that GA allows one to find near-optimal solutions with less computational load. Moreover, three ways of increasing the robustness of the GA-based sensor placement method have been proposed using a time horizon analysis, a distance-based scoring and considering different leaks sizes. A great advantage of the proposed methodology is that it does not depend on the isolation method chosen by the user, as long as it is based on leak sensitivity analysis. Experiments in two networks allow us to evaluate the performance of the proposed approach. PMID:24193099

Comparative evaluation of different periods of enamel microabrasion on the microleakage of class V resin-modified glass ionomer and compomer restorations: An In vitro study.

PubMed

Bansal, Disha; Mahajan, Mrinalini

2017-01-01

The design of the class V cavity presents a clinical challenge in the field of adhesive dentistry as the margin placement is partially in enamel and partly in dentin, and the trouble associated with this design is the microleakage at the dentinal margin. When these restorations undergo microabrasion due to cosmetic reasons, this trouble aggravates to the significant levels. The aim of this study was the measurement of microleakage of class V glass ionomer restorations over two different periods of enamel microabrasion. This in vitro experimental study was conducted on 120 class V cavities which had been prepared on the buccal and lingual surfaces of 60 sound human premolars. One-half of the cavities were restored with the resin-modified glass ionomer cement (GIC) (60 cavities) and another half with the compomer (60 cavities). Finishing and polishing were performed. Then, the teeth were classified into six groups (n = 20). Microabrasion treatment was performed with Opaluster (Ultradent Product Inc., South Jordan, UT, USA) for 0 (control no treatment), 60 and 120 s. Then, teeth were thermocycled between 5°C and 55°C, immersed in rhodamine B solution (24 h), and sectioned longitudinally in buccolingual direction. Dye penetration was examined with stereomicroscope (×10). Microleakage scores were statistically analyzed. The mean occlusal margin scores and gingival margin scores were compared between all the groups using the Kruskal-Wallis test, Mann-Whitney U-test, Wilcoxon signed-rank test, and post hoc comparison. There was a significant difference between Group 1a, Group 2a, Group 1b, Group 2b, Group 1c, and Group 2c. Statistical analysis used in this study was Kruskal-Wallis test, Mann-Whitney U-test, Wilcoxon signed-rank test, and post hoc comparison. The least microleakage scores were observed in occlusal margins of control groups (without microabrasion). Moreover, in both restorations, the microleakage scores in occlusal margins were higher than gingival margins, and compoglass had less microleakage in occlusal and occlusal plus axial walls of class V cavities compared with resin-modified GIC. Whereas, the light-cured glass ionomer had less microleakage in the gingival and gingival plus axial walls of class V cavities when compared with compoglass. The least microleakage scores were observed in occlusal margins of control groups (without microabrasion). Moreover, in both restorations, the microleakage scores in occlusal margins were higher than gingival margins.

Effect of organizational strategy on visual memory in patients with schizophrenia.

PubMed

Kim, Myung-Sun; Namgoong, Yoon; Youn, Tak

2008-08-01

The aim of the present study was to examine how copy organization mediated immediate recall among patients with schizophrenia using the Rey-Osterrieth Complex Figure Test (ROCF). The Boston Qualitative Scoring System (BQSS) was applied for qualitative and quantitative analyses of ROCF performances. Subjects included 20 patients with schizophrenia and 20 age- and gender-matched healthy controls. During the copy condition, the schizophrenia group and the control group differed in fragmentation; during the immediate recall condition, the two groups differed in configural presence and planning; and during the delayed recall condition, they differed in several qualitative measurements, including configural presence, cluster presence/placement, detail presence/placement, fragmentation, planning, and neatness. The two groups also differed in several quantitative measurements, including immediate presence and accuracy, immediate retention, delayed retention, and organization. Although organizational strategies used during the copy condition mediated the difference between the two groups during the immediate recall condition, group also had a significant direct effect on immediate recall. Schizophrenia patients are deficient in visual memory, and a piecemeal approach to the figure and organizational deficit seem to be related to the visual memory deficit. But schizophrenia patients also appeared to have some memory problems, including retention and/or retrieval deficits.

Developing a Multimedia, Computer-Based Spanish Placement Test

ERIC Educational Resources Information Center

Zabaleta, Francisco

2007-01-01

Placing students of a foreign language within a basic language program constitutes an ongoing problem, particularly for large university departments when they have many incoming freshmen and transfer students. This article outlines the author's experience designing and piloting a language placement test for a university level Spanish program. The…

Diabetes knowledge and perceptions among nursing students, and curriculum differences in Japan and Australia: A cross-sectional study.

PubMed

Ramjan, Lucie M; Watanabe, Hiroko; Salamonson, Yenna

2017-06-01

To investigate the associations between knowledge and perceptions of diabetes mellitus (DM) among nursing students from Japan and Australia; and to compare curriculum differences. Cross-sectional study. Convenience sample of students from Japan (N=78) and Australia (N=85) in their final year were surveyed. Students reported demographic details, and perceptions towards caring for patients with DM. The 23-item Michigan Diabetes Knowledge Test (MDKT) was used to assess general knowledge, and seven additional questions were used to assess DM-related clinical knowledge (CDKT). Multivariate logistic regression models were used to determine the associations between knowledge and perceptions. The curricula of the two universities were compared through a review of teaching hours on DM, teaching methods, class sizes and self-reported number of DM patients cared for during clinical placement. Australian students were more likely to be aware of DM and identified caring for more patients on clinical placement during the course. They also performed better on the CDKT in comparison to the Japanese students (71.43% versus 65.02%). When teaching models were compared, the Japanese curriculum dedicated more hours to didactic classroom teaching on DM and had a smaller teacher to student ratio. While both groups felt they received enough classroom education on DM, the Japanese students self-reported lower perceived competency, self-confidence, and felt less prepared to care for DM patients. However Japanese students performed slightly better on the MDKT than Australian students (74.25% versus 70.03%). Being from Japan was a predictor for high MDKT score (>73.91%), while perceived preparedness was a predictor for high CDKT score (>71.43%). Statistically significant differences in DM knowledge (CDKT score) between students were found. There remains room for improvement, particularly a need for increased teaching hours at University and greater clinical practice time caring for patients with DM, to further improve knowledge and skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of Lecture-Based Learning vs Discussion-Based Learning in Undergraduate Medical Students.

PubMed

Zhao, Beiqun; Potter, Donald D

2016-01-01

To compare lecture-based learning (LBL) and discussion-based learning (DBL) by assessing immediate and long-term knowledge retention and application of practical knowledge in third- and fourth-year medical students. A prospective, randomized control trial was designed to study the effects of DBL. Medical students were randomly assigned to intervention (DBL) or control (LBL) groups. Both the groups were instructed regarding the management of gastroschisis. The control group received a PowerPoint presentation, whereas the intervention group was guided only by an objectives list and a gastroschisis model. Students were evaluated using a multiple-choice pretest (Pre-Test MC) immediately before the teaching session, a posttest (Post-Test MC) following the session, and a follow-up test (Follow-Up MC) at 3 months. A practical examination (PE), which tested simple skills and management decisions, was administered at the end of the clerkship (Initial PE) and at 3 months after clerkship (Follow-Up PE). Students were also given a self-evaluation immediately following the Post-Test MC to gauge satisfaction and comfort level in the management of gastroschisis. University of Iowa Hospitals and Clinics and the Carver College of Medicine, Iowa City, IA. A total of 49 third- and fourth-year medical students who were enrolled in the general surgery clerkship were eligible for this study. Enrollment into the study was completely voluntary. Of the 49 eligible students, 36 students agreed to participate in the study, and 27 completed the study. Mean scores for the Pre-Test MC, Post-Test MC, and Follow-Up MC were similar between the control and intervention groups. In the control group, the Post-Test MC scores were significantly greater than Pre-Test MC scores (8.92 ± 0.79 vs 4.00 ± 1.04, p < 0.0001), whereas the Follow-Up MC scores were significantly lower than Post-Test MC scores (7.17 ± 1.75 vs 8.92 ± 0.79, p = 0.005). In the control group, the Follow-Up MC scores were significantly greater than Pre-Test MC scores (7.17 ± 1.75 vs 4.00 ± 1.04, p < 0.0001). Analysis of variance for all control group MC examinations had a p < 0.0001. In the intervention group, the Post-Test MC scores were significantly greater than Pre-Test MC scores (8.33 ± 1.23 vs 4.60 ± 1.55, p < 0.0001), whereas the Follow-Up MC scores were significantly lower than Post-Test MC scores (7.13 ± 1.77 vs 8.33 ± 1.23, p = 0.04). In the intervention group, the Follow-Up MC scores were significantly greater than Pre-Test MC scores (7.13 ± 1.77 vs 4.60 ± 1.55, p = 0.0002). Analysis of variance for all intervention group MC examinations had a p < 0.0001. Mean scores for the Initial PE were significantly higher for the intervention group compared with the control group's score (7.47 ± 1.68 vs 5.25 ± 2.34, p = 0.008). Mean scores for the Follow-Up PE were significantly higher for the intervention group compared with the control group's score (7.87 ± 1.77 vs 5.83 ± 2.04, p = 0.005). A comparison of Initial PE vs Follow-Up PE was not significant in either group. Students in the intervention group were more comfortable in the immediate management of gastroschisis and placement of a silo and felt that the educational experience was more worthwhile than students in the control group did. After a single instructional session, there was a significant difference in the students' scores between the control and the intervention groups on both administrations of the PEs. There were no significant differences between the 2 groups in any administration of the MC examinations. This seems to suggest that DBL may lead to better practical knowledge and potentially improved long-term knowledge retention when compared with LBL. Students in the DBL group also felt more comfortable with the management of gastroschisis and were more satisfied with the educational session. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Effects of the temporary placement of a self-expandable metallic stent in benign pyloric stenosis.

PubMed

Choi, Won Jae; Park, Jong-Jae; Park, Jain; Lim, Eun-Hye; Joo, Moon Kyung; Yun, Jae-Won; Noh, Hyejin; Kim, Sung Ho; Choi, Woo Seok; Lee, Beom Jae; Kim, Ji Hoon; Yeon, Jong Eun; Kim, Jae Seon; Byun, Kwan Soo; Bak, Young-Tae

2013-07-01

The use of self-expandable metallic stents (SEMS) is an established palliative treatment for malignant stenosis in the gastrointestinal tract; therefore, its application to benign stenosis is expected to be beneficial because of the more gradual and sustained dilatation in the stenotic portion. We aimed in this prospective observational study to evaluate the efficacy and safety of temporary SEMS placement in benign pyloric stenosis. Twenty-two patients with benign stenosis of the prepylorus, pylorus, and duodenal bulb were enrolled and underwent SEMS placement. We assessed symptom improvement, defined as an increase of at least 1 degree in the gastric-outlet-obstruction scoring system after stent insertion. No major complications were observed during the procedures. After stent placement, early symptom improvement was achieved in 18 of 22 patients (81.8%). During the follow-up period (mean 10.2 months), the stents remained in place successfully for 6 to 8 weeks in seven patients (31.8%). Among the 15 patients (62.5%) with stent migration, seven (46.6%) showed continued symptomatic improvement without recurrence of obstructive symptoms. Despite the symptomatic improvement, temporary SEMS placement is premature as an effective therapeutic tool for benign pyloric stenosis unless a novel stent is developed to prevent migration.

Effects of the Temporary Placement of a Self-Expandable Metallic Stent in Benign Pyloric Stenosis

PubMed Central

Choi, Won Jae; Park, Jain; Lim, Eun-Hye; Joo, Moon Kyung; Yun, Jae-Won; Noh, Hyejin; Kim, Sung Ho; Choi, Woo Seok; Lee, Beom Jae; Kim, Ji Hoon; Yeon, Jong Eun; Kim, Jae Seon; Byun, Kwan Soo; Bak, Young-Tae

2013-01-01

Background/Aims The use of self-expandable metallic stents (SEMS) is an established palliative treatment for malignant stenosis in the gastrointestinal tract; therefore, its application to benign stenosis is expected to be beneficial because of the more gradual and sustained dilatation in the stenotic portion. We aimed in this prospective observational study to evaluate the efficacy and safety of temporary SEMS placement in benign pyloric stenosis. Methods Twenty-two patients with benign stenosis of the prepylorus, pylorus, and duodenal bulb were enrolled and underwent SEMS placement. We assessed symptom improvement, defined as an increase of at least 1 degree in the gastric-outlet-obstruction scoring system after stent insertion. Results No major complications were observed during the procedures. After stent placement, early symptom improvement was achieved in 18 of 22 patients (81.8%). During the follow-up period (mean 10.2 months), the stents remained in place successfully for 6 to 8 weeks in seven patients (31.8%). Among the 15 patients (62.5%) with stent migration, seven (46.6%) showed continued symptomatic improvement without recurrence of obstructive symptoms. Conclusions Despite the symptomatic improvement, temporary SEMS placement is premature as an effective therapeutic tool for benign pyloric stenosis unless a novel stent is developed to prevent migration. PMID:23898381

Japanese nursing students' sense of belonging: A story of Uchi (insider) and Soto (outsider).

PubMed

Honda, Kazuma; Levett-Jones, Tracy; Stone, Teresa; Maguire, Jane

2016-09-01

Clinical placement experiences are the cornerstone of nursing education and a body of literature indicates that belongingness is fundamental to students' learning when undertaking placements. However, little is known about Japanese nursing students' sense of belonging and how it is influenced by their cultural values. The aim of this paper is to profile a study that: measured the extent to which Japanese nursing students' experience a sense of belonging in clinical placements, and explored the factors that impact on and are consequences of that experience. A mixed methods design was used with quantitative data collected using the Belongingness Scale-Clinical Placement Experience and qualitative data collected using semi-structured interviews. Ninety-two third and fourth year students from a large regional university in Japan completed the questionnaire; of these six also participated in interviews. The results identified similarities and differences between this and other studies of belongingness. Supportive and welcoming clinical environments facilitated participants' belongingness and motivation to learn. However, the belongingness scores of this sample were lower than those in all other studies. This may be explained, in part, by the Japanese cultural values of "Uchi (insider) and Soto" (outsider), which pervaded the participants' placement experiences and led to feelings of exclusion and alienation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Malignant esophageal-tracheobronchial strictures: parallel placement of covered retrievable expandable nitinol stents.

PubMed

Nam, D H; Shin, J H; Song, H Y; Jung, G S; Han, Y M

2006-02-01

To assess the safety and clinical effectiveness of the parallel placement of covered retrievable expandable metallic stents in the palliative treatment of malignant esophageal and tracheobronchial strictures. Under fluoroscopic guidance, parallel stents were placed in 12 symptomatic patients with both malignant esophageal and tracheobronchial strictures. Seven of these 12 patients also had an esophagorespiratory fistula (ERF) and one patient had an esophagocutaneous fistula. Technical success, clinical improvement, complications, and survival rates were evaluated. A total of 28 esophageal and airway stents were successfully placed. The grade of dysphagia and dyspnea score significantly decreased after stent placement (P=0.002 and 0.003, respectively). ERF and esophagocutaneous fistula were sealed off in all eight patients after esophageal stent placement; however, the esophagocutaneous fistula reopened 1 month later. Complications included stent migration or expectoration (n=3), tracheal compression by the esophageal stent (n=3), new fistula development due to covering membrane degradation of the esophageal stent (n=1), and symptomatic sputum retention (n=1). Stent removal was easily performed for two stents; one migrated stent and the other with covering membrane degradation. All 12 patients died within the mean survival period of 72.50 days (range 7-375 days). Parallel placement of covered retrievable expandable metallic stents is safe and effective for the palliative treatment of malignant esophageal and tracheobronchial strictures.

FACTORS ASSOCIATED WITH ODONTOGENIC BACTERAEMIA IN ORTHODONTIC PATIENTS.

PubMed

Umeh, O D; Sanu, O O; Utomi, I L; Nwaokorie, F O

2016-01-01

Various researches have investigated factors associated with the prevalence and intensity of bacteraemia following oral procedures including orthodontic procedures. The aim of this study was to determine the effect of age, gender, plaque and gingival indices on the occurrence of odontogenic bacteraemia following orthodontic treatment procedures. Orthodontic Clinic, Lagos University Teaching Hospital (LUTH), Lagos , Nigeria. Using the consecutive, convenience sampling method, a total of 100 subjects who met the inclusion criteria were recruited for the study and peripheral blood was collected before and again within 2 minutes of completion of orthodontic procedures for microbiologic analysis using the BACTEC automated blood culture system and the lysis filtration methods of blood culturing. The subjects were randomly placed in one of four orthodontic procedures investigated: alginate impression making (Group I), separator placement (Group II), band cementation (Group III) and arch wire change (Group IV). Plaque and gingival indices were assessed using the plaque component of the Simplified Oral Hygiene Index (OHI-S) (Greene & Vermillion) and Modified gingival index (Lobene) respectively before blood collection. Spearman Point bi-serial correlations and logistic regression statistics were used for statistical evaluations at p < 0.05 level. An overall baseline prevalence of bacteraemia of 3% and 17% were observed using the BACCTEC and lysis filtration methods respectively. Similarly, overall prevalence of bacteraemia following orthodontic treatment procedures of 16% and 28% were observed respectively using the BACTEC and lysis filtration methods. A statistically significant increase in the prevalence of bateraemia was observed following separator placement (p=0.016). An increase in age, plaque index scores and modified gingival index scores of the subjects were found to be associated with an increase in the prevalence of bacteraemia following orthodontic treatment procedures, with plaque index score showing the strongest correlation. Separator placement was found to induce significantly highest level of bacteraemia. Meticulous oral hygiene practice and the use of 0.2% chlorhexidine mouth rinse prior to separator placement may be considered an effective measure in reducing oral bacteria load and consequent reduction of the occurrence of bacteraemia following orthodontic treatment procedures.

Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.

PubMed

Branzetti, Jeremy B; Adedipe, Adeyinka A; Gittinger, Matthew J; Rosenman, Elizabeth D; Brolliar, Sarah; Chipman, Anne K; Grand, James A; Fernandez, Rosemarie

2017-11-01

A subset of high-risk procedures present significant safety threats due to their (1) infrequent occurrence, (2) execution under time constraints and (3) immediate necessity for patient survival. A Just-in-Time (JIT) intervention could provide real-time bedside guidance to improve high-risk procedural performance and address procedural deficits associated with skill decay. To evaluate the impact of a novel JIT intervention on transvenous pacemaker (TVP) placement during a simulated patient event. This was a prospective, randomised controlled study to determine the effect of a JIT intervention on performance of TVP placement. Subjects included board-certified emergency medicine physicians from two hospitals. The JIT intervention consisted of a portable, bedside computer-based procedural adjunct. The primary outcome was performance during a simulated patient encounter requiring TVP placement, as assessed by trained raters using a technical skills checklist. Secondary outcomes included global performance ratings, time to TVP placement, number of critical omissions and System Usability Scale scores (intervention only). Groups were similar at baseline across all outcomes. Compared with the control group, the intervention group demonstrated statistically significant improvement in the technical checklist score (11.45 vs 23.44, p<0.001, Cohen's d effect size 4.64), the global rating scale (2.27 vs 4.54, p<0.001, Cohen's d effect size 3.76), and a statistically significant reduction in critical omissions (2.23 vs 0.68, p<0.001, Cohen's d effect size -1.86). The difference in time to procedural completion was not statistically significant between conditions (11.15 min vs 12.80 min, p=0.12, Cohen's d effect size 0.65). System Usability Scale scores demonstrated excellent usability. A JIT intervention improved procedure perfromance, suggesting a role for JIT interventions in rarely performed procedures. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The old man and the C-spine fracture: Impact of halo vest stabilization in patients with blunt cervical spine fractures.

PubMed

Sharpe, John P; Magnotti, Louis J; Weinberg, Jordan A; Schroeppel, Thomas J; Fabian, Timothy C; Croce, Martin A

2016-01-01

Placement of a halo vest for cervical spine fractures is presumed to be less morbid than operative fixation. However, restrictions imposed by the halo vest can be detrimental, especially in older patients. The purpose of this study was to evaluate the impact of halo vest placement on outcomes by age in patients with cervical spine fractures without spinal cord injury. All patients with blunt cervical spine fractures managed over an 18-year period were identified. Those with spinal cord injury and severe traumatic brain injury were excluded. Patients were stratified by age, sex, halo vest, injury severity, and severity of shock. Outcomes included intensive care unit length of stay, ventilator days, ventilator-associated pneumonia, functional status, and mortality. Multivariable logistic regression was performed to determine whether halo vest was an independent predictor of mortality in older patients. A total of 3,457 patients were identified: 69% were male, with a mean Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) score of 19 and 13, respectively. Overall mortality was 5.3%. One hundred seventy-nine patients were managed with a halo vest, 133 of those 54 years and older and 46 of those younger than 54 years. Both mortality (13% vs. 0%, p < 0.001) and intensive care unit length of stay (4 days vs. 2 days, p = 0.02) were significantly increased in older patients despite less severe injury (admission GCS score of 15 vs. 14 and ISS of 14 vs. 17, p = 0.03). Multivariable logistic regression identified halo vest as an independent predictor of mortality after adjusting for injury severity and severity of shock (odds ratio, 2.629; 95% confidence interval, 1.056-6.543) in older patients. The potential risk of operative stabilization must be weighed against that of halo vest placement for older patients with cervical spine fractures following blunt trauma. Patient age should be strongly considered before placement of a halo vest for cervical spine stabilization. Therapeutic study, level IV.

Lidocaine patches reduce pain in trauma patients with rib fractures.

PubMed

Zink, Karen A; Mayberry, John C; Peck, Ellen G; Schreiber, Martin A

2011-04-01

Rib fracture pain is notoriously difficult to manage. The lidocaine patch is effective in other pain scenarios with an excellent safety profile. This study assesses the efficacy of lidocaine patches for treating rib fracture pain. A prospectively gathered cohort of patients with rib fracture was retrospectively analyzed for use of lidocaine patches. Patients treated with lidocaine patches were matched to control subjects treated without patches. Subjective pain reports and narcotic use before and after patch placement, or equivalent time points for control subjects, were gathered from the chart. All patients underwent long-term follow-up, including a McGill Pain Questionnaire (MPQ). Twenty-nine patients with lidocaine patches (LP) and 29 matched control subjects (C) were analyzed. During the 24 hours before patch placement, pain scores and narcotic use were similar (LP 5.3, C 4.6, P = 0.19 and LP 51, C 32 mg morphine, P = 0.17). In the 24 hours after patch placement, LP patients had a greater decrease in pain scores (LP 1.2, C 0.0, P = 0.01) with no change in narcotic use (LP -8.4, C 0.5-mg change in morphine, P = 0.25). At 60 days, LP patients had a lower MPQ pain score (LP 7.7, C 12.2, P < 0.01), although only one patient was still using a patch. There was no difference in time to return to baseline activity (LP 73, C 105 days, P = 0.16) and no adverse events. Lidocaine patches are a safe, effective adjunct for rib fracture pain. Lidocaine patches resulted in a sustained reduction in pain, outlasting the duration of therapy.

Accuracy and Safety of External Ventricular Drain Placement by Physician Assistants and Nurse Practitioners in Aneurysmal Acute Subarachnoid Hemorrhage.

PubMed

Enriquez-Marulanda, Alejandro; Ascanio, Luis C; Salem, Mohamed M; Maragkos, Georgios A; Jhun, Ray; Alturki, Abdulrahman Y; Moore, Justin M; Ogilvy, Christopher S; Thomas, Ajith J

2018-06-11

In the current dynamic health environment, increasing number of procedures are being completed by advanced practitioners (nurse practitioners and physician assistants). This is the first study to assess the clinical outcomes and safety of external ventricular drain (EVD) placements by specially trained advanced practitioners. Compare the safety and outcomes of EVD placement by advanced practitioners in patients with subarachnoid hemorrhage (SAH). A cohort comparison study was performed from an aneurysmal SAH database selecting patients treated with EVD from a single major academic institution in the USA between June 2007 and June 2017. Safety, accuracy, and complications of EVD placement were compared between advanced practitioners and neurosurgical physicians (attending neurosurgeon and subspecialty clinical fellow). Statistical analysis was performed using the Mann-Whitney test for continuous variables and χ 2 test for categorical variables, with p values set at < 0.05 for significance. We identified 203 patients for this cohort with 238 EVD placements; eighty-seven (36.6%) placements were performed by advanced practitioners and 151 (63.4%) by neurosurgeons. Most of the ventriculostomies were placed in the emergency room (n = 114; 47.9%). Additional procedures performed concurrently with the EVD placements were significantly higher among the physicians' group (21.8 vs. 4.6%; p < 0.001). Bedside placement and usage of Ghajar guide were significantly higher among advanced practitioner's (58.3 vs. 98.9 and 9.9 vs. 64.4%, respectively, with a p < 0.001 for both). There were, however, no significant differences in terms of the number of attempts for insertion, intraprocedural complications, tract hemorrhages, accuracy, infection rates, catheter dislodgments, and need for repositioning/replacement of EVD. After appropriate training, EVD placement can be safely performed by advanced practitioners with an adequate accuracy of placement.

Film Processing Module for Automated Fiber Placement

NASA Technical Reports Server (NTRS)

Hulcher, A. Bruce

2004-01-01

This viewgraph presentation describes fiber placement technology which was originally developed by Marshall Space Flight Center (MSFC) for the fabrication of fiber composite propellant tanks. The presentation includes an image of the MSFC Fiber Placement Machine, which is a prototype test bed, and images of some of the machine's parts. Some possible applications for the machines are listed.

Large state-level fluctuations in mental retardation classifications related to introduction of renormed intelligence test.

PubMed

Scullin, Matthew H

2006-09-01

Oppositely valenced forces may be at work to influence rates of placement of children into mental retardation programs. On one hand, educational policies regarding intellectual disability and concerns about overrepresentation of minorities in special education may contribute to lower placement rates; on the other hand, more difficult intelligence test norms may be a countervailing force, increasing placement rates. An analysis of longitudinal data on state and national level placement rates reveals that a lengthy and steep 12-year decline in students receiving mental retardation services reversed shortly after the introduction of the WISC-III in 1991. This phenomenon has relevance for death-penalty cases, because this historical pattern may affect the ability to establish whether an adult meets the developmental period onset criterion for mental retardation.

75 FR 53681 - Office of Elementary and Secondary Education Overview Information; Advanced Placement (AP) Test...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-01

... DEPARTMENT OF EDUCATION Office of Elementary and Secondary Education Overview Information; Advanced Placement (AP) Test Fee Program; Notice Inviting Applications for New Awards for Fiscal Year (FY) 2011 Catalog of Federal Domestic Assistance (CFDA) Number: 84.330B. Dates: Applications Available: September 1, 2010. Deadline for Transmittal of...

Screw Placement Accuracy for Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery: A Study on 3-D Neuronavigation-Guided Surgery

PubMed Central

Torres, Jorge; James, Andrew R.; Alimi, Marjan; Tsiouris, Apostolos John; Geannette, Christian; Härtl, Roger

2012-01-01

Purpose The aim of this study was to assess the impact of 3-D navigation for pedicle screw placement accuracy in minimally invasive transverse lumbar interbody fusion (MIS-TLIF). Methods A retrospective review of 52 patients who had MIS-TLIF assisted with 3D navigation is presented. Clinical outcomes were assessed with the Oswestry Disability Index (ODI), Visual Analog Scales (VAS), and MacNab scores. Radiographic outcomes were assessed using X-rays and thin-slice computed tomography. Result The mean age was 56.5 years, and 172 screws were implanted with 16 pedicle breaches (91.0% accuracy rate). Radiographic fusion rate at a mean follow-up of 15.6 months was 87.23%. No revision surgeries were required. The mean improvement in the VAS back pain, VAS leg pain, and ODI at 11.3 months follow-up was 4.3, 4.5, and 26.8 points, respectively. At last follow-up the mean postoperative disc height gain was 4.92 mm and the mean postoperative disc angle gain was 2.79 degrees. At L5–S1 level, there was a significant correlation between a greater disc space height gain and a lower VAS leg score. Conclusion Our data support that application of 3-D navigation in MIS-TLIF is associated with a high level of accuracy in the pedicle screw placement. PMID:24353961

Evaluating the effect placement capacitor and distributed photovoltaic generation for power system losses minimization in radial distribution system

NASA Astrophysics Data System (ADS)

Rahman, Yuli Asmi; Manjang, Salama; Yusran, Ilham, Amil Ahmad

2018-03-01

Power loss minimization have many advantagess to the distribution system radial among others reduction of power flow in feeder lines, freeing stress on feeder loading, deterrence of power procurement from the grid and also the cost of loss compensating instruments. This paper, presents capacitor and photovoltaic (PV) placement as alternative means to decrease power system losses. The paper aims to evaluate the best alternative for decreasing power system losses and improving voltage profile in the radial distribution system. To achieve the objectives of paper, they are used three cases tested by Electric Transient and Analysis Program (ETAP) simulation. Firstly, it performs simulation of placement capacitor. Secondly, simulated placement of PV. Lastly, it runs simulation of placement capacitor and PV simultaneously. The simulations were validated using the IEEE 34-bus test system. As a result, they proved that the installation of capacitor and PV integration simultaneously leading to voltage profile correction and power losses minimization significantly.

Comparison of CT Fluoroscopy-Guided Manual and CT-Guided Robotic Positioning System for In Vivo Needle Placements in Swine Liver

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

Cornelis, F.; Takaki, H.; Laskhmanan, M.

PurposeTo compare CT fluoroscopy-guided manual and CT-guided robotic positioning system (RPS)-assisted needle placement by experienced IR physicians to targets in swine liver.Materials and MethodsManual and RPS-assisted needle placement was performed by six experienced IR physicians to four 5 mm fiducial seeds placed in swine liver (n = 6). Placement performance was assessed for placement accuracy, procedure time, number of confirmatory scans, needle manipulations, and procedure radiation dose. Intra-modality difference in performance for each physician was assessed using paired t test. Inter-physician performance variation for each modality was analyzed using Kruskal–Wallis test.ResultsPaired comparison of manual and RPS-assisted placements to a target by the samemore » physician indicated accuracy outcomes was not statistically different (manual: 4.53 mm; RPS: 4.66 mm; p = 0.41), but manual placement resulted in higher total radiation dose (manual: 1075.77 mGy/cm; RPS: 636.4 mGy/cm; p = 0.03), required more confirmation scans (manual: 6.6; RPS: 1.6; p < 0.0001) and needle manipulations (manual: 4.6; RPS: 0.4; p < 0.0001). Procedure time for RPS was longer than manual placement (manual: 6.12 min; RPS: 9.7 min; p = 0.0003). Comparison of inter-physician performance during manual placement indicated significant differences in the time taken to complete placements (p = 0.008) and number of repositions (p = 0.04) but not in other study measures (p > 0.05). Comparison of inter-physician performance during RPS-assisted placement suggested statistically significant differences in procedure time (p = 0.02) and not in other study measures (p > 0.05).ConclusionsCT-guided RPS-assisted needle placement reduced radiation dose, number of confirmatory scans, and needle manipulations when compared to manual needle placement by experienced IR physicians, with equivalent accuracy.« less

Transanal drainage tube reduces rate and severity of anastomotic leakage in patients with colorectal anastomosis: A case controlled study.

PubMed

Brandl, A; Czipin, S; Mittermair, R; Weiss, S; Pratschke, J; Kafka-Ritsch, R

2016-03-01

The aim of this study was to investigate the clinical usefulness of the placement of a transanal drainage tube to prevent anastomotic leakage in colorectal anastomoses. This single-center retrospective trial included all patients treated with surgery for benign or malign colorectal disease between January 2009 and December 2012. The transanal drainage tube was immediately placed after colorectal anastomosis until day five and was routinely used since 2010. Patients treated with a transanal drainage tube were compared with the control group. Statistical analysis was performed using Fisher's exact or Chi-square tests for group comparison and a linear regression model for multivariate analysis. This study included 242 patients (46% female; median age 63 years; range 18-93); 34% of the patients underwent a laparoscopic procedure, and 57% of the patients received a placement of a transanal drainage tube. Anastomotic leakage occurred in 19 patients (7.9%). Univariate analysis showed a higher rate of anastomotic leakage in patients with an ASA score 4 (p = 0.02) and a lower rate in patients with transanal drainage placement (3.6% vs. 13.6%; p = 0.007). The grading of the complication of anastomotic leakage was reduced with transanal drainage (e.g., Dindo ≧ 3b: 20.0% vs. 92.9%; p = 0.006), and the hospital stay was shortened (17.6 ± 12.5 vs. 22.1 ± 17.6 days; p = 0.02). Multivariate analysis revealed that transanal drainage was the only significant factor (HR = -2.90; -0.168 to -0.032; p = 0.007) affecting anastomotic leakage. Placement of a transanal drainage tube in patients with colorectal anastomoses is a safe and simple technique to perform and reduces anastomotic leakage, the severity of the complication and hospital stay.

Selection of patients with idiopathic normal-pressure hydrocephalus for shunt placement: a single-institution experience.

PubMed

Anile, Carmelo; De Bonis, Pasquale; Albanese, Alessio; Di Chirico, Alessandro; Mangiola, Annunziato; Petrella, Gianpaolo; Santini, Pietro

2010-07-01

The ability to predict outcome after shunt placement in patients with idiopathic normal-pressure hydrocephalus (NPH) represents a challenge. To date, no single diagnostic tool or combination of tools has proved capable of reliably predicting whether the condition of a patient with suspected NPH will improve after a shunting procedure. In this paper, the authors report their experience with 120 patients with the goal of identifying CSF hydrodynamics criteria capable of selecting patients with idiopathic NPH. Specifically, they focused on the comparison between CSF-outflow resistance (R-out) and intracranial elastance (IE). Between January 1977 and December 2005, 120 patients in whom idiopathic NPH had been diagnosed (on the basis of clinical findings and imaging) underwent CSF hydrodynamics evaluation based on an intraventricular infusion test. Ninety-six patients underwent CSF shunt placement: 32 between 1977 and 1989 (Group I) on the basis of purely clinical and radiological criteria; 44 between 1990 and 2002 (Group II) on the basis of the same criteria as Group I and because they had an IE slope > 0.25; and 20 between 2003 and 2005 (Group III) on the basis of the same criteria as Group II but with an IE slope > or = 0.30. Outcomes were evaluated by means of both Stein-Langfitt and Larsson scores. Patients' conditions were considered improved when there was a stable decrease (at 6- and 12-month follow-up) of at least 1 point in the Stein-Langfitt score and 2 points in the Larsson score. Group I: while no statistically significant difference in mean R-out value between improved and unimproved cases was observed, a clear-cut IE slope value of 0.25 differentiated very sharply between unimproved and improved cases. Group II: R-out values in the 2 unimproved cases were 20 and 47 mm Hg/ml/min, respectively. The mean IE slope in the improved cases was 0.56 (range 0.30-1.4), while the IE slopes in the 2 unimproved cases were 0.26 and 0.27. Group III: the mean IE slope was 0.51 (range 0.31-0.7). The conditions of all patients improved after shunting. A significant reduction of the Evans ratio was observed in 34 (40.5%) of the 84 improved cases and in none of the unimproved cases. Our strategy based on the analysis of CSF pulse pressure parameters seems to have a great accuracy in predicting surgical outcome in clinical practice.

Decreased urinary glycosaminoglycan excretion following alfuzosin treatment on ureteral stent-related symptoms: a prospective, randomized, placebo-controlled study.

PubMed

Liu, Shucheng; Yu, Ying; Gao, Yang; Yang, Xiong; Pang, Zili

2016-04-01

The objectives of the study were to evaluate changes in ureteral stent-related symptoms and urinary glycosaminoglycan (GAG) excretion after alfuzosin treatment, and to further investigate the relationship between stent-related symptoms and loss of urinary GAGs. Seventy consecutive patients scheduled for unilateral retrograde ureteroscopy with stent placement were recruited. Patients were randomly assigned to treatment with alfuzosin 10 mg/day or placebo for 3 weeks starting on the third postoperative day. The ureteral stent was removed when treatment stopped. International Prostate Symptom Score (IPSS), visual analog scale (VAS) score, and urinary GAG excretion were determined before treatment at 1, 2, and 3 weeks after treatment, and at 3 weeks after stent removal. Fifty-nine patients completed the study. IPSS, VAS score, and urinary GAG excretion were significantly lower in the alfuzosin group, compared with the placebo group, at 1, 2, and 3 weeks after treatment (P < 0.01). In both groups, IPSS, VAS score, and urinary GAG excretion were significantly lower at 3 weeks after stent removal compared with those before stent removal. No significant differences in IPSS, VAS score, or urinary GAG excretion were observed between the two groups at baseline and 3 weeks after stent removal (P > 0.05). Positive correlations were found between urinary GAG excretion (R(2) = 0.65, P < 0.001) and IPSS and between urinary GAG excretion and VAS score (R(2) = 0.33, P < 0.001). Stent placement contributes to loss of urinary GAGs. However, alfuzosin effectively reduces such loss and improves ureteral stent-related symptoms. Loss of urinary GAGs plays a role in these symptoms.

Assessing residents' operative skills for external ventricular drain placement and shunt surgery in pediatric neurosurgery.

PubMed

Aldave, Guillermo; Hansen, Daniel; Briceño, Valentina; Luerssen, Thomas G; Jea, Andrew

2017-04-01

OBJECTIVE The authors previously demonstrated the use of a validated Objective Structured Assessment of Technical Skills (OSATS) tool for evaluating residents' operative skills in pediatric neurosurgery. However, no benchmarks have been established for specific pediatric procedures despite an increased need for meaningful assessments that can either allow for early intervention for underperforming trainees or allow for proficient residents to progress to conducting operations independently with more passive supervision. This validated methodology and tool for assessment of operative skills for common pediatric neurosurgical procedures-external ventricular drain (EVD) placement and shunt surgery- was applied to establish its procedure-based feasibility and reliability, and to document the effect of repetition on achieving surgical skill proficiency in pediatric EVD placement and shunt surgery. METHODS A procedure-based technical skills assessment for EVD placements and shunt surgeries in pediatric neurosurgery was established through the use of task analysis. The authors enrolled all residents from 3 training programs (Baylor College of Medicine, Houston Methodist Hospital, and University of Texas-Medical Branch) who rotated through pediatric neurosurgery at Texas Children's Hospital over a 26-month period. For each EVD placement or shunt procedure performed with a resident, the faculty and resident (for self-assessment) completed an evaluation form (OSATS) based on a 5-point Likert scale with 7 categories. Data forms were then grouped according to faculty versus resident (self) assessment, length of pediatric neurosurgery rotation, postgraduate year level, and date of evaluation ("beginning of rotation," within 1 month of start date; "end of rotation," within 1 month of completion date; or "middle of rotation"). Descriptive statistical analyses were performed with the commercially available SPSS statistical software package. A p value < 0.05 was considered statistically significant. RESULTS Five attending evaluators (including 2 fellows who acted as attending surgeons) completed 260 evaluations. Twenty house staff completed 269 evaluations for self-assessment. Evaluations were completed in 562 EVD and shunt procedures before the surgeons left the operating room. There were statistically significant differences (p < 0.05) between overall attending (mean 4.3) and junior resident (self; mean 3.6) assessments, and between overall attending (mean 4.8) and senior resident (self; mean 4.6) assessment scores on general performance and technical skills. The learning curves produced for the residents demonstrate a stereotypical U- or V-shaped curve for acquiring skills, with a significant improvement in overall scores at the end of the rotation compared with the beginning. The improvement for junior residents (Δ score = 0.5; p = 0.002) was larger than for senior residents (Δ score = 0.2; p = 0.018). CONCLUSIONS The OSATS is an effective assessment tool as part of a comprehensive evaluation of neurosurgery residents' performance for specific pediatric procedures. The authors observed a U-shaped learning curve, contradicting the idea that developing one's surgical technique and learning a procedure represents a monotonic, cumulative process of repetitions and improvement.

Outcomes of Temporary Partially Covered Stent Placement for Benign Tracheobronchial Stenosis.

PubMed

Ma, Ji; Han, Xinwei; Wu, Gang; Jiao, Dechao; Ren, Kewei; Bi, Yonghua

2016-08-01

To evaluate the intermediate outcomes of temporary partially covered tracheobronchial stenting in patients with benign tracheobronchial stenosis. We conducted a retrospective study of patients with benign tracheobronchial stenosis who underwent stent placement. All stents were removed approximately 3 months after placement. Respiratory function was assessed using the visual analogue scale (VAS) and Karnofsky performance status scale (KPS) before and after stent placement. The lumen diameters of the stenotic lesions were measured using chest computed tomography (CT) and compared between before stent placement and after stent removal. A total of 51 stents were successfully placed in consecutive 51 patients with benign tracheobronchial stenosis. No serious complications occurred. The mean VAS and KPS scores significantly improved after stent removal (6.291 ± 0.495 and 25.352 ± 10.533, respectively) compared with those before stent placement (1.493 ± 0.504 and 60.140 ± 16.344, respectively; P < 0.05). The mean lumen transverse diameters of the stenotic site in trachea and main bronchus after stent removal (17.235 ± 3.457 and 8.993 ± 0.961 mm; 1 month post-removal; 16.353 ± 4.132 and 8.357 ± 1.082 mm; 6 months post-removal) were significantly larger than those before stent placement (7.876 ± 2.351 and 2.143 ± 0.770 mm, respectively; P < 0.05). However, the mean lumen diameters between 1 and 6 months after stent removal had no significant difference (P > 0.05). Temporary partially covered stenting may be a safe and effective treatment for benign tracheobronchial stenosis.

Comparative Validity of the Descriptive Tests of Mathematical Skills (DTMS) and SAT-Mathematics (SAT-M) for Predicting Performance in Freshman College Mathematics Courses: Prefatory Report

ERIC Educational Resources Information Center

McLoughlin, M. Padraig M. M.; Bluford, Dontrell A.

2004-01-01

This study investigated the predictive validity of the Descriptive Tests of Mathematical Skills (DTMS) and the SAT-Mathematics (SAT-M) tests as placement tools for entering students in a small, liberal arts, historically black institution (HBI) using regression analysis. The placement schema is four-tiered: for a remedial algebra course, college…

The Effects of Essay Placement and Prompt Type on Performance on the New SAT®. Research Report No. 2006-7. ETS RR-06-34

ERIC Educational Resources Information Center

Oh, Hyeon-Joo; Walker, Michael E.

2007-01-01

This study evaluated (1) whether essay placement (either at the beginning or at the end of the test battery) impacts test-takers' performance on the critical reading, mathematics, and writing multiple choice measures; and (2) whether essay prompt type (either a simple one-line prompt or a prompt including a short passage) affects test-takers'…

Math Placement Validation Study: A Summary of the Criterion-Related Validity Evidence and Multiple Measures Data for the San Diego Community College District.

ERIC Educational Resources Information Center

Armstrong, William B.

In Fall 1994, the San Diego Community College District (SDCCD), in California, conducted a study to determine the validity of the Mathematics Diagnostic Testing Project (MDTP) placement test. The MDTP provides tests at four levels (i.e., algebra readiness, elementary algebra, intermediate algebra, and pre-calculus) and is used in the District for…

Evaluating Different Standard-Setting Methods in an ESL Placement Testing Context

ERIC Educational Resources Information Center

Shin, Sun-Young; Lidster, Ryan

2017-01-01

In language programs, it is crucial to place incoming students into appropriate levels to ensure that course curriculum and materials are well targeted to their learning needs. Deciding how and where to set cutscores on placement tests is thus of central importance to programs, but previous studies in educational measurement disagree as to which…

The Effect of Learner-Generated Illustrations on the Immediate and Delayed Recall of English Idioms

ERIC Educational Resources Information Center

Aeineh, Afrouz; Moeeni, Saeed; Merati, Hamideh

2014-01-01

The present study investigated the effect of learner generated illustrations on the immediate and delayed idiom recall of Iranian EFL (English as a foreign language) learners. To accomplish this end, 40 female students participated in this study. A placement test (Quick Placement Test, Version 2) was administered to the participants to ascertain…

A National Survey of Spanish Language Testing for Placement of Outcome Assessment at B.A. -Granting Institutions in the United States.

ERIC Educational Resources Information Center

Wherritt, Irene; Cleary, T. Anne

1990-01-01

Describes the results of a national survey that was conducted to determine the current state of Spanish-language testing for placement and outcome assessments. The survey was undertaken in the United States in the departments of Spanish in B.A.-granting institutions. (Author/VWL)

A Study of Placement and Grade Prediction in First College Mathematics Courses

ERIC Educational Resources Information Center

Madison, Bernard L.; Linde, Cassandra S.; Decker, Blake R.; Rigsby, E. Myron; Dingman, Shannon W.; Stegman, Charles E.

2015-01-01

A college mathematics placement test with 25 basic algebra items and 15 calculus readiness items was administered to 1572 high school seniors, and first college mathematics course grades were obtained for 319 of these students. Test results indicated that more than two thirds of the high school graduates were not college ready, and the test…

Approach and Instrument Placement Validation

NASA Technical Reports Server (NTRS)

Ator, Danielle

2005-01-01

The Mars Exploration Rovers (MER) from the 2003 flight mission represents the state of the art technology for target approach and instrument placement on Mars. It currently takes 3 sols (Martian days) for the rover to place an instrument on a designated rock target that is about 10 to 20 m away. The objective of this project is to provide an experimentally validated single-sol instrument placement capability to future Mars missions. After completing numerous test runs on the Rocky8 rover under various test conditions, it has been observed that lighting conditions, shadow effects, target features and the initial target distance have an effect on the performance and reliability of the tracking software. Additional software validation testing will be conducted in the months to come.

Validation of Foot Placement Locations from Ankle Data of a Kinect v2 Sensor

PubMed Central

Geerse, Daphne; Coolen, Bert; Kolijn, Detmar; Roerdink, Melvyn

2017-01-01

The Kinect v2 sensor may be a cheap and easy to use sensor to quantify gait in clinical settings, especially when applied in set-ups integrating multiple Kinect sensors to increase the measurement volume. Reliable estimates of foot placement locations are required to quantify spatial gait parameters. This study aimed to systematically evaluate the effects of distance from the sensor, side and step length on estimates of foot placement locations based on Kinect’s ankle body points. Subjects (n = 12) performed stepping trials at imposed foot placement locations distanced 2 m or 3 m from the Kinect sensor (distance), for left and right foot placement locations (side), and for five imposed step lengths. Body points’ time series of the lower extremities were recorded with a Kinect v2 sensor, placed frontoparallelly on the left side, and a gold-standard motion-registration system. Foot placement locations, step lengths, and stepping accuracies were compared between systems using repeated-measures ANOVAs, agreement statistics and two one-sided t-tests to test equivalence. For the right side at the 2 m distance from the sensor we found significant between-systems differences in foot placement locations and step lengths, and evidence for nonequivalence. This distance by side effect was likely caused by differences in body orientation relative to the Kinect sensor. It can be reduced by using Kinect’s higher-dimensional depth data to estimate foot placement locations directly from the foot’s point cloud and/or by using smaller inter-sensor distances in the case of a multi-Kinect v2 set-up to estimate foot placement locations at greater distances from the sensor. PMID:28994731

Validation of Foot Placement Locations from Ankle Data of a Kinect v2 Sensor.

PubMed

Geerse, Daphne; Coolen, Bert; Kolijn, Detmar; Roerdink, Melvyn

2017-10-10

The Kinect v2 sensor may be a cheap and easy to use sensor to quantify gait in clinical settings, especially when applied in set-ups integrating multiple Kinect sensors to increase the measurement volume. Reliable estimates of foot placement locations are required to quantify spatial gait parameters. This study aimed to systematically evaluate the effects of distance from the sensor, side and step length on estimates of foot placement locations based on Kinect's ankle body points. Subjects (n = 12) performed stepping trials at imposed foot placement locations distanced 2 m or 3 m from the Kinect sensor (distance), for left and right foot placement locations (side), and for five imposed step lengths. Body points' time series of the lower extremities were recorded with a Kinect v2 sensor, placed frontoparallelly on the left side, and a gold-standard motion-registration system. Foot placement locations, step lengths, and stepping accuracies were compared between systems using repeated-measures ANOVAs, agreement statistics and two one-sided t -tests to test equivalence. For the right side at the 2 m distance from the sensor we found significant between-systems differences in foot placement locations and step lengths, and evidence for nonequivalence. This distance by side effect was likely caused by differences in body orientation relative to the Kinect sensor. It can be reduced by using Kinect's higher-dimensional depth data to estimate foot placement locations directly from the foot's point cloud and/or by using smaller inter-sensor distances in the case of a multi-Kinect v2 set-up to estimate foot placement locations at greater distances from the sensor.

Neurophysiological changes associated with implant-associated augmentation procedures in the lower jaw.

PubMed

Hartmann, Amely; Welte-Jzyk, Claudia; Seiler, Marcus; Daubländer, Monika

2017-08-01

Neurophysiological changes after oral and maxillofacial surgery remain one of the topics of current research. This study evaluated if implant placement associated with augmentation procedures increases the possibility of sensory disturbances or result in impaired quality of life during the healing period. Patients who had obtained an implant placement in the lower jaw in combination with augmentation procedures were examined by implementing a comprehensive Quantitative Sensory Testing (QST) protocol for extra- and intraoral use. As augmentation procedures, we used Guided Bone Regeneration (Group A) and Customized Bone Regeneration (Group B) techniques. Patients were tested bilaterally at the chin and mucosal lower lip. Results were compared to a group without augmentation procedures (Group C). Patients' quality of life and psychological comorbidity after the surgical procedures was assessed with the Oral Health Impact Profile and the Hospital Anxiety and Depression Scale. For groups A (n = 20) and B (n = 8), mechanical QST parameters showed no significant differences in all qualities of the inferior alveolar nerve compared to the contralateral side and compared to the nonaugmentation control group (n = 32) as well. Evaluation of quality of life and psychological factors showed no statistical differences. Augmentation procedures did not increase sensory disturbances, indicating no changes in the neurophysiological pathways. Extended augmentation procedures did not lead to sensory changes either or result in an impaired quality of life or modified anxiety and depression scores. © 2017 Wiley Periodicals, Inc.

Characterization of the Mineral Trioxide Aggregate–Resin Modified Glass Ionomer Cement Interface in Different Setting Conditions

PubMed Central

Eid, Ashraf A.; Komabayashi, Takashi; Watanabe, Etsuko; Shiraishi, Takanobu; Watanabe, Ikuya

2012-01-01

Introduction Mineral trioxide aggregate (MTA) has been used successfully for perforation repair, vital pulpotomies, and direct pulp capping. However, little is known about the interactions between MTA and glass ionomer cement (GIC) in final restorations. In this study, 2 null hypotheses were tested: (1) GIC placement time does not affect the MTA-GIC structural interface and hardness and (2) moisture does not affect the MTA-GIC structural interface and hardness. Methods Fifty cylinders were half filled with MTA and divided into 5 groups. The other half was filled with resin-modified GIC either immediately after MTA placement or after 1 or 7 days of temporization in the presence or absence of a wet cotton pellet. The specimens were then sectioned, carbon coated, and examined using a scanning electron microscope and an electron probe micro-analyzer (SEM-EPMA) for interfacial adaptation, gap formation, and elemental analysis. The Vickers hardness numbers of the interfacial MTA were recorded 24 hours after GIC placement and 8 days after MTA placement and analyzed using the analysis of variance test. Results Hardness testing 24 hours after GIC placement revealed a significant increase in hardness with an increase of temporization time but not with a change of moisture conditions (P < .05). Hardness testing 8 days after MTA placement indicated no significant differences among groups. SEM-EPMA showed interfacial adaptation to improve with temporization time and moisture. Observed changes were limited to the outermost layer of MTA. The 2 null hypotheses were not rejected. Conclusions GIC can be applied over freshly mixed MTA with minimal effects on the MTA, which seemed to decrease with time. PMID:22794220

Establishing a field epidemiology elective for medical students in Kenya: A strategy for increasing public health awareness and workforce capacity

PubMed Central

Arvelo, Wences; Gura, Zeinab; Amwayi, Samuel; Wiersma, Petra; Omolo, Jared; Becknell, Steven; Jones, Donna; Ongore, Dismas; Dicker, Richard

2017-01-01

Medical students have limited exposure to field epidemiology, even though will assume public health roles after graduation. We established a 10-week elective in field epidemiology during medical school. Students attended one-week didactic sessions on epidemiology, and nine weeks in field placement sites. We administered pre-and post-tests to evaluate the training. We enrolled 34 students in 2011 and 2012. In 2011, we enrolled five of 24 applicants from a class of 280 medical students. In 2012, we enrolled 18 of 81 applicants from a class of 360 students; plus 11 who participated in the didactic sessions only. Among the 34 students who completed the didactic sessions, 74% were male, and their median age was 24 years (range: 22–26). The median pre-test score was 64% (range: 47–88%) and the median post-test score was 82% (range: 72–100%). Successful completion of the field projects was 100%. Six (30%) students were not aware of public health as a career option before this elective, 56% rated the field experience as outstanding, and 100% reported it increased their understanding of epidemiology. Implementing an elective in field epidemiology within the medical training is a highly acceptable strategy to increase awareness for public health among medical students. PMID:25700921

Investigating the impact of a research-based integrated curriculum on self-perceived research experiences of medical students in community placements: a pre- and post-test analysis of three student cohorts.

PubMed

Mullan, Judy R; Weston, Kathryn M; Rich, Warren C; McLennan, Peter L

2014-08-05

To build research capacity among graduating medical students, the teaching of research and critical analysis was integrated into the University of Wollongong (UoW) new, graduate-entry medical curriculum. This study examined whether the self-perceived research experiences of medical students, and consequent research capability, were influenced by exposure to this innovative research and critical analysis curriculum, which incorporated a 12-month community-based research project, and associated assessment tasks. The first three medical students cohorts (N = 221) completed a self-assessment of their research experiences in ten areas of research activity. Their responses were collected: before and after they undertook an individual community-based research project within a 12-month regional/rural clinical placement. The research areas investigated by the self-assessment tool were: (i) defining a research question/idea; (ii) writing a research protocol; (iii) finding relevant literature; (iv) critically reviewing the literature; (v) using quantitative research methods; (vi) using qualitative research methods; (vii) analysing and interpreting results; (viii) writing and presenting a research report; (ix) publishing results; and (x) applying for research funding. Participation rates of 94% (207/221) pre-placement and 99% (219/221) post-placement were achieved from the three student cohorts. Following the successful completion of the research projects and their assessment tasks, the median responses were significantly higher (p < 0.05) in nine of the ten research areas. The only area of research for which there was no increase recorded for any one of the three cohorts, or overall, was (x) applying for research funding. This activity was not a component of the UoW research and critical analysis curriculum and the item was included as a test of internal validity. Significant gains were also seen between cohorts in some key research areas. Improved research capability among medical students was evidenced by increased scores in various areas of research experience in the context of successful completion of relevant assessment tasks. The results suggest that research capability of medical students can be positively influenced by the provision of a research-based integrated medical curriculum and further consolidated by authentic learning experiences, gained through conducting 'hands-on' research projects, under the supervision and mentoring of research-qualified academics.

Investigating the impact of a research-based integrated curriculum on self-perceived research experiences of medical students in community placements: a pre- and post-test analysis of three student cohorts

PubMed Central

2014-01-01

Background To build research capacity among graduating medical students, the teaching of research and critical analysis was integrated into the University of Wollongong (UoW) new, graduate-entry medical curriculum. This study examined whether the self-perceived research experiences of medical students, and consequent research capability, were influenced by exposure to this innovative research and critical analysis curriculum, which incorporated a 12-month community-based research project, and associated assessment tasks. Methods The first three medical students cohorts (N = 221) completed a self-assessment of their research experiences in ten areas of research activity. Their responses were collected: before and after they undertook an individual community-based research project within a 12-month regional/rural clinical placement. The research areas investigated by the self-assessment tool were: (i) defining a research question/idea; (ii) writing a research protocol; (iii) finding relevant literature; (iv) critically reviewing the literature; (v) using quantitative research methods; (vi) using qualitative research methods; (vii) analysing and interpreting results; (viii) writing and presenting a research report; (ix) publishing results; and (x) applying for research funding. Results Participation rates of 94% (207/221) pre-placement and 99% (219/221) post-placement were achieved from the three student cohorts. Following the successful completion of the research projects and their assessment tasks, the median responses were significantly higher (p < 0.05) in nine of the ten research areas. The only area of research for which there was no increase recorded for any one of the three cohorts, or overall, was (x) applying for research funding. This activity was not a component of the UoW research and critical analysis curriculum and the item was included as a test of internal validity. Significant gains were also seen between cohorts in some key research areas. Conclusions Improved research capability among medical students was evidenced by increased scores in various areas of research experience in the context of successful completion of relevant assessment tasks. The results suggest that research capability of medical students can be positively influenced by the provision of a research-based integrated medical curriculum and further consolidated by authentic learning experiences, gained through conducting ‘hands-on’ research projects, under the supervision and mentoring of research-qualified academics. PMID:25096817

True incidence and clinical significance of pneumoperitoneum after PEG placement: a prospective study.

PubMed

Wiesen, Ari J; Sideridis, Kostas; Fernandes, Angelo; Hines, Jonathan; Indaram, Anant; Weinstein, Lenny; Davidoff, Samuel; Bank, Simmy

2006-12-01

PEG is a widely used method for providing nutritional support. Although pneumoperitoneum is a known finding after PEG placement, its true incidence is subject to debate. Small retrospective studies have found varied rates of free air after PEG placement. There were a total of 65 patients. To assess the true incidence of pneumoperitoneum and its clinical significance. Prospective study. Long Island Jewish Medical Center. We obtained upright and anterior-posterior chest radiographs of 65 patients within 3 hours after PEG placement. Type of PEG tube, gauge of the needle used, number of sticks, and indications were recorded. The presence of pneumoperitoneum on the initial chest film was considered to be a positive finding. After a positive result, a repeat chest film was obtained 72 hours later to determine whether there was progression or resolution of the free air. Patients enrolled in the study were also monitored clinically for evidence of peritonitis. Of the 65 patients who underwent PEG placement, 13 developed a pneumoperitoneum on the initial chest radiograph; there was complete resolution of pneumoperitoneum at 72 hours in 10 of the 13 patients. In 3 patients, the free air persisted but was of no clinical significance. The free air was quantified by measuring the height of the air column under the diaphragm and was graded with a scoring system (0, no air; 1, small; 2, moderate; 3, large). Eleven patients who underwent PEG died during the hospitalization; none of the deaths were related to the PEG placement or pneumoperitoneum. The other 54 patients were discharged to a skilled nursing facility. No patients in the study had clinical evidence of peritonitis. There were no adverse events, ie, infection or bleeding, associated with the PEG placement in any of the patients. Our data suggest that pneumoperitoneum after PEG placement is common and, in the absence of clinical symptoms, is of no clinical significance and does not warrant any further intervention.

Factors associated to clinical learning in nursing students in primary health care: an analytical cross-sectional study

PubMed Central

Serrano-Gallardo, Pilar; Martínez-Marcos, Mercedes; Espejo-Matorrales, Flora; Arakawa, Tiemi; Magnabosco, Gabriela Tavares; Pinto, Ione Carvalho

2016-01-01

ABSTRACT Objective: to identify the students' perception about the quality of clinical placements and asses the influence of the different tutoring processes in clinical learning. Methods: analytical cross-sectional study on second and third year nursing students (n=122) about clinical learning in primary health care. The Clinical Placement Evaluation Tool and a synthetic index of attitudes and skills were computed to give scores to the clinical learning (scale 0-10). Univariate, bivariate and multivariate (multiple linear regression) analyses were performed. Results: the response rate was 91.8%. The most commonly identified tutoring process was "preceptor-professor" (45.2%). The clinical placement was assessed as "optimal" by 55.1%, relationship with team-preceptor was considered good by 80.4% of the cases and the average grade for clinical learning was 7.89. The multiple linear regression model with more explanatory capacity included the variables "Academic year" (beta coefficient = 1.042 for third-year students), "Primary Health Care Area (PHC)" (beta coefficient = 0.308 for Area B) and "Clinical placement perception" (beta coefficient = - 0.204 for a suboptimal perception). Conclusions: timeframe within the academic program, location and clinical placement perception were associated with students' clinical learning. Students' perceptions of setting quality were positive and a good team-preceptor relationship is a matter of relevance. PMID:27627124

Bedside ultrasound curriculum for medical students: report of a blended learning curriculum implementation and validation.

PubMed

Blackstock, Uché; Munson, Jaclyn; Szyld, Demian

2015-03-01

Medical students on clinical rotations rarely receive formal bedside ultrasound (BUS) training. We designed, implemented, and evaluated a standardized BUS curriculum for medical students on their Emergency Medicine (EM) rotation. Teaching was aimed toward influencing four cognitive and psychomotor learning domains: BUS instrumentation knowledge, image interpretation, image acquisition, and procedural guidance. Participants viewed three instructional Web-based tutorials on BUS instrumentation, the Focused Assessment for Sonography in Trauma (FAST) examination and ultrasound-guided central venous catheter (CVC) placement. Subsequently, participants attended a 3-hour hands-on training session to discuss the same content area and practice with faculty coaches. A Web-based, multiple-choice questionnaire was administered before and after the session. During the final week of the rotation, students returned for skills assessments on FAST image acquisition and CVC placement. Forty-five medical students on an EM rotation were enrolled. Sonographic knowledge overall mean score improved significantly from 66.6% (SD ±11.2) to 85.7% (SD ±10.0), corresponding to a mean difference of 19.1% (95% CI 15.5-22.7; p < 0.001). There were high pass rates for FAST (89.0%, 40/45) and CVC (96.0%, 43/45) skills assessments. There was no significant difference between medical student posttest and EM resident test scores 85.7% (SD ±10.0) and 88.1% (SD ± 7.6) (p = 0.40), respectively. A formal BUS curriculum for medical students on EM rotation positively influenced performance in several key learning domains. As BUS competency is required for residency in EM and other specialties, medical schools could consider routinely incorporating BUS teaching into their clinical rotation curricula. © 2014 Wiley Periodicals, Inc.

Outcomes of Stent Placement for Chronic Occlusion of a Filter-bearing Inferior Vena Cava in Patients with Severe Post-thrombotic Syndrome.

PubMed

Ye, K; Lu, X; Li, W; Yin, M; Liu, X; Qin, J; Liu, G; Jiang, M

2016-12-01

To evaluate the technical aspects and short-term clinical results of stent placement for chronic occlusion of a filter-bearing inferior vena cava (IVC) in patients with severe post-thrombotic syndrome (PTS). A retrospective analysis of 24 patients with severe PTS associated with occlusion of a filter-bearing IVC treated by stent placement was conducted at a single institution from January 2010 to December 2014. Patient-reported quality of life and limb Villalta scores were evaluated before and after treatment by questionnaire and clinical examination, respectively. Stent patency was evaluated by duplex Doppler ultrasound, venography, or venous computed tomographic (CT) angiography. All patients tolerated the procedure well. Nineteen patients with filter-bearing IVC and bilateral iliofemoral occlusions were treated with "double-barrel" stents, two were treated with fenestrated stents, and the remaining three patients were treated by unilateral stent placement of the iliofemoral vein and filter-bearing IVC. Quality of life and Villalta scores were significantly improved (p < .001) after the procedure. The 1-year, and 2-year cumulative primary and secondary stent patency rates were 67% and 91%, and 45% and 77%, respectively. During a median follow-up period of 27 months (range 3-55 months), the cumulative rates of complete relief of pain (visual analog scale >5) and swelling (grade 3) were 77% (13 of 17 limbs at risk) and 75% (24 of 32 limbs at risk), respectively. There were 23 limbs with active ulcers and the cumulative rate of ulcer healing at 2 years was 73%. There were no cases of clinical bleeding, symptomatic pulmonary embolism, or mortality. Recanalization of an occluded IVC filter and stent placement through the filter is a feasible and safe method for management of PTS associated with filter-bearing IVC occlusions, with acceptable short-term stent patency and clinical results. However, close follow-up after procedure is necessary because of a relatively high re-occlusion rate. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Safety and Efficacy of Percutaneous Biliary Covered Stent Placement in Patients with Malignant Biliary Hilar Obstruction; Correlation with Liver Function.

PubMed

Hyun, Hyeran; Choi, Sun Young; Kim, Kyung Ah; Ko, Soo Bin

2016-09-01

To estimate the safety and efficacy of percutaneous ePTFE-covered biliary stent placement and the relationship between underlying liver function and stent patency in patients with malignant hilar obstruction. From March 2012 to June 2015, 41 patients [22 females, 19 males; mean age 69.8 (range 34-94) years] with malignant biliary obstruction underwent percutaneous biliary stent placement (31 patients with unilateral, 10 patients with bilateral side-by-side). Cumulative patient survival and stent patency rate curves were derived using the Kaplan-Meier method. A Cox model was used to explore the relationship between liver function and patient survival, and also biliary stent patency. Pearson correlation coefficient was used to analyze the relationship between patient survival and stent patency. Technical success rate was 100 % and clinical success rate was 95 %. During follow-up, four complications occurred (two bilomas and two cases of acute cholecystitis) and were treated successfully with percutaneous drainage. No other complication occurred. Mean serum bilirubin level was 11.34 ± 7.35 mg/dL before drainage and 5.00 ± 4.83 mg/dL 2 weeks after stent placement. The median patent survival duration was 147 days (95 % CI, 69.6-224.4 days). The median stent patency duration was 101 days (95 % CI, 70.0-132.0 days). The cumulative stent patency rates at 1, 3, 6, and 12 months were 97, 57.6, 30.3, and 17.0 %, respectively. Child-Pugh score was correlated significantly with patient survival (P = 0.011) and stent patency (P = 0.007). MELD score was correlated significantly with stent patency (P = 0.044). There was a correlation between patient survival and stent patency (r = 0.778, P < 0.001). Percutaneous placement of ePTFE-covered biliary stent was a safe and an effective method for malignant biliary obstruction. Underlying liver function seemed to be one of the important factors affecting patient survival and stent patency, and stent patency showed statistically significant correlation with patient survival.

[The placement courses and the subjective quality of life of 6- to 11-year-old children living in child welfare institutions].

PubMed

Bacro, F; Rambaud, A; Humbert, C; Sellenet, C

2015-10-01

Besides diseases, the concept of quality of life is increasingly used to account for the consequences of other vulnerability situations that may be encountered by individuals, including young children. However, very few studies have examined children's perception of their quality of life in the context of child welfare and protection, and they yielded mixed results. The objectives of this study were (1) to compare the subjective quality of life of children placed in institution with that of children living in their families, by controlling for child sex, age, socioeconomic and familial status, and (2) to examine its relations with their placement course in the child welfare system. The sample of this study was composed of 56 children aged 6 to 11, 28 of which were placed in a child welfare institution. Information about the placement course of institutionalized children was given by their social workers and the quality of life of all participants was assessed with the AUQUEI questionnaire. This self-report, which is based on children's conception of their quality of life, allows assessment of four distinct dimensions in addition to the overall score: leisure, performances, relations and family life, and separation. According to the results, the quality of life of children placed in institutions did not differ from that of children living in their families. However, its perception was closely related to the placement course of institutionalized children in the child welfare system. Whereas maltreated children obtained lower overall and performance scores than their neglected peers, children placed in foster families before institution had a poorer perception of their quality of life in the domains of family life and separations. These results are interpreted in light of attachment research and theory. Indeed, the relations between children's quality of life and their placement course could be explained by their high level of attachment disorganization. Finally, the results of this study suggested that children were well aware of their difficulties and that they can easily be identified by directly assessing the children's quality of life. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Children's Attitudes toward Physical Activity and Self-Esteem.

ERIC Educational Resources Information Center

Ewy, Stan R.

This study was conducted to investigate attitudes toward physical activity and self-esteem of students (N=82) in grades three through five. The independent variables were gender, grade placement, and physical fitness. The dependent variables were scores from the Grade 3 Children's Attitudes Toward Physical Activity, the Revised Children's…

Investigating the Syllabus as a Defining Document

ERIC Educational Resources Information Center

Bowers-Campbell, Joy

2015-01-01

The following study is part of a larger study exploring reading identity in students who were placed into a mandatory developmental reading class because of low scores on college placement exams. Sociocultural theories of learning framed the qualitative study. Although the larger study addressed two overarching questions related to reading…

Spoken language skills and educational placement in Finnish children with cochlear implants.

PubMed

Lonka, Eila; Hasan, Marja; Komulainen, Erkki

2011-01-01

This study reports the demographics, and the auditory and spoken language development as well as educational settings, for a total of 164 Finnish children with cochlear implants. Two questionnaires were employed: the first, concerning day care and educational placement, was filled in by professionals for rehabilitation guidance, and the second, evaluating language development (categories of auditory performance, spoken language skills, and main mode of communication), by speech and language therapists in audiology departments. Nearly half of the children were enrolled in normal kindergartens and 43% of school-aged children in mainstream schools. Categories of auditory performance were observed to grow in relation to age at cochlear implantation (p < 0.001) as well as in relation to proportional hearing age (p < 0.001). The composite scores for language development moved to more diversified ones in relation to increasing age at cochlear implantation and proportional hearing age (p < 0.001). Children without additional disorders outperformed those with additional disorders. The results indicate that the most favorable age for cochlear implantation could be earlier than 2. Compared to other children, spoken language evaluation scores of those with additional disabilities were significantly lower; however, these children showed gradual improvements in their auditory perception and language scores. Copyright © 2011 S. Karger AG, Basel.

Predictors of the patency of self-expandable metallic stents in malignant gastroduodenal obstruction.

PubMed

Kim, Seung Han; Chun, Hoon Jai; Yoo, In Kyung; Lee, Jae Min; Nam, Seung Joo; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck

2015-08-14

To investigate the predictive factors of self-expandable metallic stent patency after stent placement in patients with inoperable malignant gastroduodenal obstruction. A total of 116 patients underwent stent placements for inoperable malignant gastroduodenal obstruction at a tertiary academic center. Clinical success was defined as acceptable decompression of the obstructive lesion within the malignant gastroduodenal neoplasm. We evaluated patient comorbidities and clinical statuses using the World Health Organization's scoring system and categorized patient responses to chemotherapy using the Response Evaluation Criteria in Solid Tumors criteria. We analyzed the relationships between possible predictive factors and stent patency. Self-expandable metallic stent placement was technically successful in all patients (100%), and the clinical success rate was 84.2%. In a multivariate Cox proportional hazards model, carcinoembryonic antigen (CEA) levels were correlated with a reduction in stent patency [P = 0.006; adjusted hazard ratio (aHR) = 2.92, 95%CI: 1.36-6.25]. Palliative chemotherapy was statistically associated with an increase in stent patency (P = 0.009; aHR = 0.27, 95%CI: 0.10-0.72). CEA levels can easily be measured at the time of stent placement and may help clinicians to predict stent patency and determine the appropriate stent procedure.

The impact of length of placement on self-reported mental health problems in detained Jordanian youth.

PubMed

Schwalbe, Craig S; Gearing, Robin E; Mackenzie, Michael J; Brewer, Kathryne B; Ibrahim, Rawan W

2013-01-01

This study reports the prevalence of emotional and behavioral problems among youths placed in juvenile correctional facilities in Jordan and describes the effect of length of stay on mental health outcomes. The Youth Self Report (YSR) was administered to 187 adolescent males (mean age=16.4, SD=1.0) in all five juvenile detention facilities in Jordan in 2011. Descriptive statistics were calculated to estimate the prevalence of emotional and behavioral problems. Logistic regression models were estimated to evaluate the impact of placement length on mental health. Statistical models were weighted by the youth propensity to be 'long-stay' youths (>23 weeks) based on preplacement case characteristics. The prevalence of clinically significant emotional and behavioral problems was 84%. 46% had YSR scores above the clinical cutpoint in both the internalizing and externalizing subscales. 24% of youths reported suicidal ideation. The high prevalence of emotional and behavioral disorders was stable across placement for most YSR subscales. The prevalence of emotional and behavioral disorders among detained and incarcerated youth in Jordan mirrors the literature worldwide. These findings suggest that serious mental health problems for many youths persist throughout placement. Copyright © 2013 Elsevier Ltd. All rights reserved.

Quality clinical placements for undergraduate nursing students: a cross-sectional survey of undergraduates and supervising nurses.

PubMed

Courtney-Pratt, Helen; FitzGerald, Mary; Ford, Karen; Marsden, Kathryn; Marlow, Annette

2012-06-01

  This article is a report of a mixed method study of the quality of clinical placements for second year undergraduate nursing students in an acute care hospital.   In response to the current and predicted workforce shortages, greater numbers of nursing undergraduate places are being offered at tertiary institutions. This means that requests for clinical places in hospitals to support undergraduate students has risen. Little is known about the impact of increased numbers on the quality of clinical placement as a learning experience and this is of concern as demand grows and the means of assessing capacity is still unknown.   A 5-point Likert Scale questionnaire, including free text fields, was administered to undergraduates (n = 178), clinical facilitators (n = 22) and supervising ward nurses (n = 163) at two time points in 2009. The survey targeted the quality of the clinical placement in four domains: welcoming and belongingness; teaching and learning; feedback; confidence and competence. Findings.  The findings demonstrated consistently high scoring of the clinical placement experience by both undergraduates and registered nurses. There were higher ratings of levels of support from clinical facilitators compared to supervising ward nurses evident in data associated with the items on the questionnaire relating to teaching and learning.   The results are indicative of the professional commitment of nursing staff to support the next generation of nurses. The findings also give a mechanism to communicate outcomes of undergraduate support to nurses in practice, and highlight steps which can be taken to ensure high quality clinical placement continues. © 2011 Blackwell Publishing Ltd.

A Study of Gender and Performance on Advanced Placement History Examinations. College Board Report No. 91-4.

ERIC Educational Resources Information Center

Breland, Hunter M.; And Others

Several studies have shown that, on average, women perform slightly better than men on free-response tests, while men perform slightly better on multiple-choice tests. Two advanced placement examinations, United States History (USH) and European History (EH), were chosen for study because previous studies have shown that sex differences on the…

College Readiness: A Compendium of M-DCPS Results from the Florida College Placement Test, 2007 to 2010

ERIC Educational Resources Information Center

Romanik, Dale; Rembowski, Mary

2012-01-01

Section 1008.30 (formerly 240.117), Florida Statutes, requires the State Board of Education to develop and implement a common placement testing program to assess the basic computation and communication skills of students who intend to enter a degree program at any public community college or state university. Every year the State provides reports…

College Readiness: A Compendium of M-DCPS Results from the Florida College Placement Test, 2006 to 2009

ERIC Educational Resources Information Center

Romanik, Dale; Rembowski, Mary

2011-01-01

Section 1008.30 (formerly 240.117), Florida Statutes, requires the State Board of Education to develop and implement a common placement testing program to assess the basic computation and communication skills of students who intend to enter a degree program at any public community college or state university. Every year the State provides reports…

Automated Tow Placement Processing and Characterization of Composites

NASA Technical Reports Server (NTRS)

Prabhakaran, R.

2004-01-01

The project had one of the initial objectives as automated tow placement (ATP), in which a robot was used to place a collimated band of pre-impregnated ribbons or a wide preconsolidated tape onto a tool surface. It was proposed to utilize the Automated Tow Placement machine that was already available and to fabricate carbon fiber reinforced PEEK (polyether-ether-ketone) matrix composites. After initial experiments with the fabrication of flat plates, composite cylinders were to be fabricated. Specimens from the fabricated parts were to be tested for mechanical characterization. A second objective was to conduct various types of tests for characterizing composite specimens cured by different fabrication processes.

Correlation of Objective Assessment Data With General Surgery Resident In-Training Evaluation Reports and Operative Volumes.

PubMed

Abdelsattar, Jad M; AlJamal, Yazan N; Ruparel, Raaj K; Rowse, Phillip G; Heller, Stephanie F; Farley, David R

2018-05-14

Faculty evaluations, ABSITE scores, and operative case volumes often tell little about true resident performance. We developed an objective structured clinical examination called the Surgical X-Games (5 rooms, 15 minutes each, 12-15 tests total, different for each postgraduate [PGY] level). We hypothesized that performance in X-Games will prove more useful in identifying areas of strength or weakness among general surgery (GS) residents than faculty evaluations, ABSITE scores, or operative cases volumes. PGY 2 to 5 GS residents (n = 35) were tested in a semiannual X-Games assessment using multiple simulation tasks: laparoscopic skills, bowel anastomosis, CT/CXR analysis, chest tube placement, etc. over 1 academic year. Resident scores were compared to their ABSITE, in-training evaluation reports, and operating room case numbers. Academic medical center. PGY-2, 3, 4, and 5 GS residents at Mayo Clinic in Rochester, MN. Results varied greatly within each class except for staff evaluations: in-training evaluation reports medians for PGY-2s were 5.3 (range: 5.0-6.0), PGY-3s 5.9 (5.5-6.3), PGY-4s 5.6 (5.0-6.0), and PGY-5s were 6.1 (5.6-6.9). Although ABSITE and operating room case volumes fluctated greatly with each PGY class, only X-Games scores (median: PGY-2 = 82, PGY-3 = 61, PGY-4 = 76, and PGY-5 = 60) correlated positively (p < 0.05) with operative case volume and negatively (p < 0.05) with staff evaluations. X-Games assessment generated wide differentiation of resident performance quickly, inexpensively, and objectively. Although "Minnesota-nice" surgical staff may feel all GS trainees are "above average," objective assessment tells us otherwise. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A Study of the Significant Factors That Affect the Job Placement Rates of Students Who Have Completed a HERO Program.

ERIC Educational Resources Information Center

Instructional Development and Evaluation Associates, Inc., Berkeley, MI.

A three-year study examined the significant factors that affect the job placement rates of students completing a Home Economics Related Occupations (HERO) program. Other purposes of the study were to develop and pilot test a model that could be used to determine factors related to student placement in a variety of vocational education programs and…

A Study of the Significant Factors That Affect the Job Placement Rates of Students Who Have Completed a HERO Program. Year Summary Report.

ERIC Educational Resources Information Center

Instructional Development and Evaluation Associates, Inc., Berkeley, MI.

A three-year study examined the significant factors that affect the job placement rates of students completing a Home Economics Related Occupations (HERO) program. Other purposes of the study were to develop and pilot test a model that could be used to determine factors related to student placement in a variety of vocational education programs and…

A Study of the Significant Factors That Affect the Job Placement Rates of Students Who Have Completed a HERO Program. Year 2 Report.

ERIC Educational Resources Information Center

Instructional Development and Evaluation Associates, Inc., Berkeley, MI.

A three-year study examined the significant factors that affect the job placement rates of students completing a Home Economics Related Occupations (HERO) program. Other purposes of the study were to develop and pilot test a model that could be used to determine factors related to student placement in a variety of vocational education programs and…

Spatial Placement of Human Figure Drawings as an Indicator of Cognitive and Personality Characteristics Among Normal Young Adolescents

ERIC Educational Resources Information Center

Swartz, Jon D.; And Others

1976-01-01

The present study investigated the relationship between spatial placement of human figure drawings and measures of test anxiety, time estimation, and conceptual maturity. Results are discussed. (Author)

Feasibility of Carbon Fiber/PEEK Composites for Cryogenic Fuel Tank Applications

NASA Astrophysics Data System (ADS)

Doyle, K.; Doyle, A.; O Bradaigh, C. M.; Jaredson, D.

2012-07-01

This paper investigates the feasibility of CF/PEEK composites for manufacture of cryogenic fuel tanks for Next Generation Space Launchers. The material considered is CF/PEEK tape from Suprem SA and the proposed manufacturing process for the fuel tank is Automated Tape Placement. Material characterization was carried out on test laminates manufactured in an autoclave and also by Automated Tape Placement with in-situ consolidation. The results of the two processes were compared to establish if there is any knock down in properties for the automated tape placement process. A permeability test rig was setup with a helium leak detector and the effect of thermal cycling on the permeability properties of CF/PEEK was measured. A 1/10th scale demonstrator was designed and manufactured consisting of a cylinder manufactured by automated tape placement and an upper dome manufactured by autoclave processing. The assembly was achieved by Amorphous Interlayer Bonding with PEI.

More Home Schoolers Taking Advanced Placement Tests: Students Seek Outside Validation of Work and Leg Up on College-Admissions Process

ERIC Educational Resources Information Center

Zehr, Mary Ann

2006-01-01

When Susan Richman called the College Board in 1992 to ask if her son Jesse could take Advanced Placement tests as a home schooler, a staff member responded that no one had ever asked him that question, but then assured her that home schoolers were welcome to take the tests. Ms. Richman went on to coach Jesse for so many AP exams that he started…

Summary of Available Guidance and Best Practices for Determining Suitability of Dredged Material for Beneficial Uses

DTIC Science & Technology

2007-11-01

sediment, exposure to effluent from sediments during placement of material at reuse site, and exposure to leachate after material placement. This...Brannon et al. (1994) describe additional leachate quality tests. ERDC/EL TR-07-27 15 Table 3. Appropriate characterization tests for chemical...33. Dioxins EPA-SW846-8290 and 1630 34. Leachate Quality Test Myers and Brannon 1988 35. Surface Runoff Quality Skogerboe et al. 1987 Notes

An eight-year clinic experience with clozapine use in a Parkinson's disease clinic setting.

PubMed

Hack, Nawaz; Fayad, Sarah M; Monari, Erin H; Akbar, Umer; Hardwick, Angela; Rodriguez, Ramon L; Malaty, Irene A; Romrell, Janet; Shukla, Aparna A Wagle; McFarland, Nikolaus; Ward, Herbert E; Okun, Michael S

2014-01-01

To examine our eight year clinic-based experience in a Parkinson's disease expert clinical care center using clozapine as a treatment for refractory psychosis in Parkinson's disease (PD). The study was a retrospective chart review which covered eight years of clozapine registry use. Statistical T-tests, chi-square, correlations and regression analysis were used to analyze treatment response for potential associations of age, disease duration, and Hoehn & Yahr (H&Y) score, and degree of response to clozapine therapy. There were 36 participants included in the analysis (32 PD, 4 parkinsonism-plus). The characteristics included 30.6% female, age 45-87 years (mean 68.3±10.15), disease duration of 17-240 months (mean 108.14±51.13) and H&Y score of 2 to 4 (mean 2.51±0.51). The overall retention rate on clozapine was 41% and the most common reasons for discontinuation were frequent blood testing (28%), nursing home (NH) placement (11%) and leucopenia (8%). Responses to clozapine across the cohort were: complete (33%), partial (33%), absent (16%), and unknown (16%). Age (r = -0.36, p<0.01) and H&Y score (r = -0.41, p<0.01) were shown to be related to response to clozapine therapy, but disease duration was not an associated factor (r = 0.21, p>0.05). This single-center experience highlights the challenges associated with clozapine therapy in PD psychosis. Frequent blood testing remains a significant barrier for clozapine, even in patients with therapeutic benefit. Surprisingly, all patients admitted to a NH discontinued clozapine due to logistical issues of administration and monitoring within that setting. Consideration of the barriers to clozapine therapy will be important to its use and to its continued success in an outpatient setting.

Immediate loading of unsplinted implants in the anterior mandible for overdentures: 3-year results.

PubMed

Roe, Phillip; Kan, Joseph Y K; Rungcharassaeng, Kitichai; Lozada, Jaime L

2011-01-01

This 3-year study evaluated the implant survival rate, peri-implant tissue response, prosthetic maintenance, and prosthetic complications in a series of patients who received two immediately loaded unsplinted threaded implants to retain a mandibular overdenture. Eight completely edentulous patients were evaluated clinically and radiographically immediately after implant placement, at 3 months, and at 1, 2, and 3 years after implant placement. Data were analyzed using repeated-measures one-way analysis of variance and the Wilcoxon signed rank test at a significance level of α = .05. At 3 years, all implants remained osseointegrated (16/16), with an overall mean marginal bone change of -0.58 ± 0.39 mm and a mean Periotest value of -7.19 ± 0.54. The modified Plaque Index scores showed marked improvement in oral hygiene during the first year, but some relapse was observed thereafter. Prosthetic maintenance and complications included replacement of the attachment inserts, abutment loosening, dislodgement of the attachment housing, overdenture reline, denture tooth fracture, and overdenture base fracture. This 3-year study suggests that, despite less than ideal oral hygiene and a high incidence of complete/partial fracture of overdentures, favorable implant survival rate and peri-implant tissue responses can be achieved in mandibular overdentures retained with two immediately loaded unsplinted threaded implants.

School Context and the Effect ESL Placement on Mexican-Origin Adolescents’ Achievement*

PubMed Central

Callahan, Rebecca; Wilkinson, Lindsey; Muller, Chandra

2010-01-01

Objectives Immigrant adolescents’ academic achievement is crucial to our future economic stability, and Mexican-origin linguistic minority youth in U.S. schools generally demonstrate lower levels of achievement. English as a Second Language (ESL) programs provide an institutional response to these students’ needs, the effect of which may vary by the proportion of immigrant students in the school. Measures Using propensity score matching and data from the Adolescent Health and Academic Achievement Study (AHAA) and the National Longitudinal Study of Adolescent Health (Add Health), we estimate the effect of ESL placement on Mexican-origin achievement for first-, second-, and third-generation adolescents separately in schools with many and few immigrant students. Results The estimated effect of ESL placement varies by both immigrant concentration in the school and by students’ generational status. Conclusions We find that ESL enrollment may be protective for second-generation Mexican-origin adolescents in high immigrant concentration schools, and may prove detrimental for first-generation adolescents in contexts with few other immigrant students. PMID:20354570

School Context and the Effect ESL Placement on Mexican-Origin Adolescents' Achievement.

PubMed

Callahan, Rebecca; Wilkinson, Lindsey; Muller, Chandra

2008-01-01

OBJECTIVES: Immigrant adolescents' academic achievement is crucial to our future economic stability, and Mexican-origin linguistic minority youth in U.S. schools generally demonstrate lower levels of achievement. English as a Second Language (ESL) programs provide an institutional response to these students' needs, the effect of which may vary by the proportion of immigrant students in the school. MEASURES: Using propensity score matching and data from the Adolescent Health and Academic Achievement Study (AHAA) and the National Longitudinal Study of Adolescent Health (Add Health), we estimate the effect of ESL placement on Mexican-origin achievement for first-, second-, and third-generation adolescents separately in schools with many and few immigrant students. RESULTS: The estimated effect of ESL placement varies by both immigrant concentration in the school and by students' generational status. CONCLUSIONS: We find that ESL enrollment may be protective for second-generation Mexican-origin adolescents in high immigrant concentration schools, and may prove detrimental for first-generation adolescents in contexts with few other immigrant students.

Simulating video-assisted thoracoscopic lobectomy: a virtual reality cognitive task simulation.

PubMed

Solomon, Brian; Bizekis, Costas; Dellis, Sophia L; Donington, Jessica S; Oliker, Aaron; Balsam, Leora B; Zervos, Michael; Galloway, Aubrey C; Pass, Harvey; Grossi, Eugene A

2011-01-01

Current video-assisted thoracoscopic surgery training models rely on animals or mannequins to teach procedural skills. These approaches lack inherent teaching/testing capability and are limited by cost, anatomic variations, and single use. In response, we hypothesized that video-assisted thoracoscopic surgery right upper lobe resection could be simulated in a virtual reality environment with commercial software. An anatomy explorer (Maya [Autodesk Inc, San Rafael, Calif] models of the chest and hilar structures) and simulation engine were adapted. Design goals included freedom of port placement, incorporation of well-known anatomic variants, teaching and testing modes, haptic feedback for the dissection, ability to perform the anatomic divisions, and a portable platform. Preexisting commercial models did not provide sufficient surgical detail, and extensive modeling modifications were required. Video-assisted thoracoscopic surgery right upper lobe resection simulation is initiated with a random vein and artery variation. The trainee proceeds in a teaching or testing mode. A knowledge database currently includes 13 anatomic identifications and 20 high-yield lung cancer learning points. The "patient" is presented in the left lateral decubitus position. After initial camera port placement, the endoscopic view is displayed and the thoracoscope is manipulated via the haptic device. The thoracoscope port can be relocated; additional ports are placed using an external "operating room" view. Unrestricted endoscopic exploration of the thorax is allowed. An endo-dissector tool allows for hilar dissection, and a virtual stapling device divides structures. The trainee's performance is reported. A virtual reality cognitive task simulation can overcome the deficiencies of existing training models. Performance scoring is being validated as we assess this simulator for cognitive and technical surgical education. Copyright © 2011. Published by Mosby, Inc.

Predicting academic success among deaf college students.

PubMed

Convertino, Carol M; Marschark, Marc; Sapere, Patricia; Sarchet, Thomastine; Zupan, Megan

2009-01-01

For both practical and theoretical reasons, educators and educational researchers seek to determine predictors of academic success for students at different levels and from different populations. Studies involving hearing students at the postsecondary level have documented significant predictors of success relating to various demographic factors, school experience, and prior academic attainment. Studies involving deaf and hard-of-hearing students have focused primarily on younger students and variables such as degree of hearing loss, use of cochlear implants, educational placement, and communication factors-although these typically are considered only one or two at a time. The present investigation utilizes data from 10 previous experiments, all using the same paradigm, in an attempt to discern significant predictors of readiness for college (utilizing college entrance examination scores) and classroom learning at the college level (utilizing scores from tests in simulated classrooms). Academic preparation was a clear and consistent predictor in both domains, but the audiological and communication variables examined were not. Communication variables that were significant reflected benefits of language flexibility over skills in either spoken language or American Sign Language.

The Effectiveness of the North Carolina Early Mathematics Placement Test in Preparing High School Students for College-Level Introductory Mathematics Courses

ERIC Educational Resources Information Center

Hilgoe, Ellen; Brinkley, Jason; Hattingh, Johannes; Bernhardt, Robert

2016-01-01

Since its establishment in 1996, the North Carolina Early Mathematics Placement Testing (NC EMPT) Program has provided a low stakes reality check of readiness for college-level mathematics to more than 600,000 high school students statewide. The program strives to help reduce the percentage of incoming college freshmen requiring mathematics…

First-line endoscopic treatment with over-the-scope clips significantly improves the primary failure and rebleeding rates in high-risk gastrointestinal bleeding: A single-center experience with 100 cases.

PubMed

Richter-Schrag, Hans-Jürgen; Glatz, Torben; Walker, Christine; Fischer, Andreas; Thimme, Robert

2016-11-07

To evaluate rebleeding, primary failure (PF) and mortality of patients in whom over-the-scope clips (OTSCs) were used as first-line and second-line endoscopic treatment (FLET, SLET) of upper and lower gastrointestinal bleeding (UGIB, LGIB). A retrospective analysis of a prospectively collected database identified all patients with UGIB and LGIB in a tertiary endoscopic referral center of the University of Freiburg, Germany, from 04-2012 to 05-2016 ( n = 93) who underwent FLET and SLET with OTSCs. The complete Rockall risk scores were calculated from patients with UGIB. The scores were categorized as < or ≥ 7 and were compared with the original Rockall data. Differences between FLET and SLET were calculated. Univariate and multivariate analysis were performed to evaluate the factors that influenced rebleeding after OTSC placement. Primary hemostasis and clinical success of bleeding lesions (without rebleeding) was achieved in 88/100 (88%) and 78/100 (78%), respectively. PF was significantly lower when OTSCs were applied as FLET compared to SLET (4.9% vs 23%, P = 0.008). In multivariate analysis, patients who had OTSC placement as SLET had a significantly higher rebleeding risk compared to those who had FLET (OR 5.3; P = 0.008). Patients with Rockall risk scores ≥ 7 had a significantly higher in-hospital mortality compared to those with scores < 7 (35% vs 10%, P = 0.034). No significant differences were observed in patients with scores < or ≥ 7 in rebleeding and rebleeding-associated mortality. Our data show for the first time that FLET with OTSC might be the best predictor to successfully prevent rebleeding of gastrointestinal bleeding compared to SLET. The type of treatment determines the success of primary hemostasis or primary failure.

Factors Associated with Success in College Calculus II

ERIC Educational Resources Information Center

Rosasco, Margaret E.

2013-01-01

Students are entering college having earned credit for college Calculus 1 based on their scores on the College Board's Advanced Placement (AP) Calculus AB exam. Despite being granted credit for college Calculus 1, it is unclear whether these students are adequately prepared for college Calculus 2. College calculus classes are often taught from a…

The Quality of IEP Objectives Associated with Placement on Integrated versus Segregated School Sites.

ERIC Educational Resources Information Center

Hunt, Pam; And Others

1986-01-01

Individualized education programs (IEPs) written for 18 severely disabled students (ages 4-19) who attended integrated school sites scored higher on selected indicators of best practices when compared with IEPs written for students attending segregated sites. IEPs were examined for age-appropriateness, functionality, and potential for…

The Risks and Opportunities Associated with Weak Arithmatic Skills of Accounting Students

ERIC Educational Resources Information Center

Kerr, Stephen; Krull, George

2017-01-01

This paper explored the authors' concerns about students enrolled in their introductory accounting course. Anecdotal evidence suggested that students struggle with basic arithmetic concepts that underlie basic business transactions even though their math placement and ACT scores are high. A survey of 125 students in a first accounting course was…

Seoul Searching: Transitioning Basic Writers within the Global Frontiers Project

ERIC Educational Resources Information Center

Adkins, Tabetha; Meyer, Connie

2014-01-01

The course described here was designed especially for students enrolled in a collaborative program between Texas A&M University-Commerce and Konkuk University in South Korea. This course was created specifically for students who did not earn a qualifying score on a standardized placement exam required of all first-year students for enrollment…

Examination of the Classification Accuracy of Music Education Special Aptitude Exams

ERIC Educational Resources Information Center

Atar, Hakan Yavuz; Sayin, Ayfer; Atar, Burcu

2013-01-01

It is critical both for candidates who apply for programs that require special aptitude and the professors who teach in these programs whether those students' scores on placement exams are correctly calculated. Because student's ability profile and the quality of education in these programs may be directly affected by how candidates placement…

The Futility of Propensity Score Methods in a Statewide Study of International Baccalaureate (IB)

ERIC Educational Resources Information Center

May, Henry; Rodriguez, Awilda; Sirinides, Philip M.; Perna, Laura W.; Yee, April; Ransom, Tafaya

2014-01-01

With the goal of increasing students' academic readiness for college, high schools in the United States are increasingly offering "credit-based transition programs," including International Baccalaureate (IB), Advanced Placement (AP), and dual enrollment. Existing research points to the promise of IB, AP, and other credit-based…

Factor validity and norms for the aberrant behavior checklist in a community sample of children with mental retardation.

PubMed

Marshburn, E C; Aman, M G

1992-09-01

The Aberrant Behavior Checklist (ABC) is a 58-item rating scale that was developed primarily to measure the effects of pharmacological intervention in individuals living in residential facilities. This study investigated the use of the ABC in a sample of community children with mental retardation. Teacher ratings on the ABC were collected on 666 students attending special classes. The data were factor analyzed and compared with other studies using the ABC. In addition, subscales were analyzed as a function of age, sex, and classroom placement, and preliminary norms were derived. A four-factor solution of the ABC was obtained. Congruence between the four derived factors and corresponding factors from the original ABC was high (congruence coefficients ranged between .87 and .96). Classroom placement and age had significant effects on subscale scores, whereas sex failed to affect ratings. The current results are sufficiently close to the original factor solution that the original scoring method can be used with community samples, although further studies are needed to look at this in more detail.

Safety, feasibility, and efficacy of placement of steroid-eluting bioabsorbable sinus implants in the office setting: a prospective case series.

PubMed

Matheny, Keith E; Carter, Kenny B; Tseng, Ewen Y; Fong, Karen J

2014-10-01

The outcomes of endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) can be compromised by postoperative inflammation, recurrent polyposis, middle turbinate lateralization, and synechiae, often requiring subsequent interventions. A bioabsorbable steroid-eluting sinus implant placed in the operating room following ESS has been proven safe and effective in 2 randomized controlled trials and a subsequent meta-analysis, for its ability to preserve sinus patency, and reduce medical and surgical interventions. This trial sought to evaluate the safety, feasibility, and outcomes of implants placed in the office after achieving hemostasis. Twenty patients with CRS underwent ESS including bilateral ethmoidectomy. A steroid-eluting bioabsorbable implant was deployed into each ethmoid cavity in the office within 7 days after ESS. Endoscopic appearance of the ethmoid cavities was evaluated at 1 week, 2 weeks, and 4 weeks postoperatively by the operating surgeon and an independent blinded evaluator. Procedural tolerance was assessed at week 2 using a patient preference questionnaire. The 20-item Sino-Nasal Outcome Test (SNOT-20) questionnaire was completed at baseline, week 2, and week 4. In-office placement of steroid-eluting bioabsorbable implants was well tolerated, with 90% of patients very satisfied with the overall experience, and 80% very satisfied with the recovery process. At 1 month, there were no significant adhesions or frank polyposis, and middle turbinate lateralization was only 5%. Compared to baseline, ethmoid sinus inflammation was significantly reduced (p = 0.03), and the mean SNOT-20 score was significantly improved (p < 0.001). In-office placement of steroid-eluting bioabsorbable implants after achieving hemostasis was well tolerated and might improve local drug diffusion and surgical outcomes. © 2014 ARS-AAOA, LLC.

Selecting Students for Pre-Algebra: Examination of the Relative Utility of the Anchorage Pre-Algebra Screening Tests and the State of Alaska Standards Based Benchmark 2 Mathematics Study. An Examination of Consequential Validity and Recommendation.

ERIC Educational Resources Information Center

Fenton, Ray

This study examined the relative efficacy of the Anchorage (Alaska) Pre-Algebra Test and the State of Alaska Benchmark in 2 Math examination as tools used in the process of recommending grade 6 students for grade 7 Pre-Algebra placement. The consequential validity of the tests is explored in the context of class placements and grades earned. The…

Ability Of Optical Coherence Tomography To Detect Caries Beneath Commonly Used Dental Sealants

PubMed Central

Osann, Kathryn; Pharar, Jessica; Lee, Kenneth; Ahn, Yeh-chan; Tucker, Travis; Sabet, Sharareh; Chen, Zhongping; Gukasyan, Ripsik; Wilder-Smith, Petra

2010-01-01

Background and Objective The onset and progression of early tooth decay is often preventable with dental sealants. However, occasionally decay progresses underneath the sealant. Current technology does not permit monitoring of potential lesion progression or arrest. Dental sealants themselves mask the visual cues that identify early tooth decay, and radiographs are not sufficiently sensitive. Therefore clinicians can be reluctant to use dental sealant. The objective of this ex vivo study was to evaluate the ability of dentists to detect decay beneath commonly used dental sealants using Optical Coherence Tomography (OCT) imaging. Study Designs/Materials/Methods Forty extracted teeth were divided into equal groups of carious and non-carious teeth, as determined by visual inspection. After radiographs and OCT imaging, teeth were randomly assigned for sealant placement with one of four commonly purchased dental sealants: Clinpro™, Fuji Triage™, Embrace Wet Bond™, and Delton™. Following sealant placement, teeth were radiographed, imaged with OCT, sectioned, examined histologically, and scored as healthy/not healthy. OCT and radiographic images were scored separately. The gold standard was histopathological diagnosis from the serial sections. Cohen’s Kappa, sensitivity, negative predictive value and positive predictive value were computed for all measures. Results After 90 mins training, pre-standardized dentists were able to detect tooth decay more accurately using OCT than with visual or radiographic examination. Detection using OCT was somewhat better prior to sealant placement than afterwards. This effect varied in size depending on the type of sealant used. Radiographic diagnosis was also less accurate after sealant placement. Of the four dental sealants, Delton provided excellent positive predictive value and the best post-sealant negative predictive values. Conclusion In this ex vivo study, dentists were able to detect tooth decay beneath four commonly used dental sealants based on OCT images. Clinical investigations are now underway to determine the usefulness of this approach in vivo. PMID:20848554

Suction evacuation of hemothorax: A prospective study.

PubMed

Savage, Stephanie A; Cibulas, George A; Ward, Tyler A; Davis, Corinne A; Croce, Martin A; Zarzaur, Ben L

2016-07-01

Although tube thoracostomy is a common procedure after thoracic trauma, incomplete evacuation of fluid places the patient at risk for retained hemothorax. As little as 300 to 500 cm of blood may result in the need for an additional thoracostomy tube or, in more severe cases, lung entrapment and empyema. We hypothesized that suction evacuation of the thoracic cavity before tube placement would decrease the incidence of late complications. Patients requiring tube thoracostomy within 96 hours of admission were prospectively identified and underwent suction evacuation of the pleural space (SEPS) before tube placement. These patients were compared to historical controls without suction evacuation. Demographics, admission vital signs, laboratory values, details of chest tube placement, and outcomes were collected on all patients. Multivariable logistic regression was used to compare outcomes between groups. A total of 199 patients were identified, consisting of 100 retrospective controls and 99 SEPS patients. There were no differences in age, sex, admission injury severity score or chest abbreviated injury score, admission laboratory values or vital signs, or hospital length of stay. Mean (SD) volume of hemothorax in SEPS patients was 220 (297) cm; with only 48% having a volume greater than 100 cm at the time of tube placement. Three patients developed empyema, and 19 demonstrated retained blood; there was no difference between SEPS and control patients. Suction evacuation of the pleural space was significantly protective against recurrent pneumothorax after chest tube removal (odds ratio, 0.332; 95% confidence interval, 0.148-0.745). Preemptive suction evacuation of the thoracic cavity did not have a significant impact on subsequent development of retained hemothorax or empyema. Suction evacuation of the pleural space significantly decreased incidence of recurrent pneumothorax after thoracostomy removal. Although the mechanism is unclear, such a benefit may make this simple procedure worthwhile. A larger sample size is required for validation and to determine if preemptive thoracic evacuation has a clinical benefit. Therapeutic/care management study, level IV.

Novel ex vivo model for hands-on teaching of and training in EUS-guided biliary drainage: creation of "Mumbai EUS" stereolithography/3D printing bile duct prototype (with videos).

PubMed

Dhir, Vinay; Itoi, Takao; Fockens, Paul; Perez-Miranda, Manuel; Khashab, Mouen A; Seo, Dong Wan; Yang, Ai Ming; Lawrence, Khek Yu; Maydeo, Amit

2015-02-01

EUS-guided biliary drainage (EUS-BD) has emerged as an alternative rescue method in patients with failed ERCP. Opportunities for teaching and training are limited because of a low case volume at most centers. To evaluate a stereolithography/3-dimensional (3D) printing bile duct prototype for teaching and training in EUS-BD. Prospective observational feasibility study. Tertiary referral center. Twenty endosonographers attending an interventional EUS workshop. A prototype of a dilated biliary system was prepared by computer-aided design and 3D printing. The study participants performed guidewire manipulation and EUS-BD procedures (antegrade procedure and/or choledochoduodenostomy) on the prototype. Participants were scored with the device on a scale of 1 to 5 via a questionnaire. Participants' success rate for various steps of the EUS-BD procedure was noted. Subjective and objective evaluation of the prototype regarding its overall applicability, quality of radiographic and EUS images, and 4 steps of EUS-BD procedure (needle puncture, guidewire manipulation, tract dilation, stent placement). Fifteen participants returned the questionnaire, and 10 completed all 4 steps of EUS-BD. The median score for overall utility was 4, whereas that for EUS and US views was 5. Participants with experience in performing more than 20 EUS-BD procedures scored the prototype significantly lower for stent placement (P = .013) and equivalent for needle puncture, tract dilation, and wire manipulation. The success rate of various steps was 100% for needle puncture and tract dilation, 82.35% for wire manipulation, and 80% for stent placement. The mean overall procedure time was 18 minutes. Small number of participants. The 3D printing bile duct prototype appears suitable for teaching of and training in the various steps of EUS-BD. Further studies are required to elucidate its role. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Changes in Hyolaryngeal Movement and Swallowing Function After Neuromuscular Electrical Stimulation in Patients With Dysphagia

PubMed Central

Lee, Hoo Young; Hong, Ji Seong; Lee, Kil Chan; Shin, Yoon-Kyum

2015-01-01

Objective To investigate immediate changes in hyolaryngeal movement and swallowing function after a cycle of neuromuscular electrical stimulation (NMES) on both submental and throat regions and submental placement alone in patients with dysphagia. Methods Fifteen patients with dysphagia were recruited. First, videofluoroscopic swallowing study (VFSS) was performed before NMES. All patients thereafter received a cycle of NMES by 2 methods of electrode placement: 1) both submental and throat regions and 2) submental placement alone concomitant with VFSS. The Penetration-Aspiration Score (PAS) and the NIH-Swallowing Safety Scale (NIH-SSS) were measured for swallowing function. Results During swallowing, hyolaryngeal descent significantly occurred by NMES on both submental and throat regions, and anterior displacement of hyolaryngeal complex was significant on submental placement alone. NMES on submental placement alone did not change the PAS and NIH-SSS. However, NMES on both submental and throat regions significantly reduced the NIH-SSS, although it did not change the PAS. Patients with no brainstem lesion and with dysphagia duration of <3 months showed significantly improved the NIH-SSS. Conclusion Immediate hyolaryngeal movement was paradoxically depressed after NMES on both submental and throat regions with significant reductions in the NIH-SSS but not the PAS, suggesting improvement in pharyngeal peristalsis and cricopharyngeal functions at the esophageal entry rather than decreased aspiration and penetration. The results also suggested that patients with dysphagia should be carefully screened when determining motor-level NMES. PMID:25932416

Comparison of intraoperative versus delayed enteral feeding tube placement in patients undergoing a Whipple procedure.

PubMed

Scaife, Courtney L; Hewitt, Kelly C; Mone, Mary C; Hansen, Heidi J; Nelson, Edward T; Mulvihill, Sean J

2014-01-01

The intraoperative placement of an enteral feeding tube (FT) during pancreaticoduodenectomy (PD) is based on the surgeon's perception of need for postoperative nutrition. Published preoperative risk factors predicting postoperative morbidity may be used to predict FT need and associated intraoperative placement. A retrospective review of patients who underwent PD during 2005-2011 was performed by querying the National Surgical Quality Improvement Program (NSQIP) database with specific procedure codes. Patients were categorized based on how many of 10 possible preoperative risk factors they demonstrated. Groups of patients with scores of ≤ 1 (low) and ≥ 2 (high), respectively, were compared for FT need, length of stay (LoS) and organ space surgical site infections (SSIs). Of 138 PD patients, 82 did not have an FT placed intraoperatively, and, of those, 16 (19.5%) required delayed FT placement. High-risk patients were more likely to require a delayed FT (29.3%) compared with low-risk patients (9.8%) (P = 0.026). The 16 patients who required a delayed FT had a median LoS of 15.5 days, whereas the 66 patients who did not require an FT had a median LoS of 8 days (P < 0.001). In this analysis, subjects considered as high-risk patients were more likely to require an FT than low-risk patients. Assessment of preoperative risk factors may improve decision making for selective intraoperative FT placement. © 2013 International Hepato-Pancreato-Biliary Association.

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

Ma, Ji; Han, Xinwei, E-mail: hanxinwei2006@163.com; Wu, Gang

PurposeTo evaluate the intermediate outcomes of temporary partially covered tracheobronchial stenting in patients with benign tracheobronchial stenosis.Materials and MethodsWe conducted a retrospective study of patients with benign tracheobronchial stenosis who underwent stent placement. All stents were removed approximately 3 months after placement. Respiratory function was assessed using the visual analogue scale (VAS) and Karnofsky performance status scale (KPS) before and after stent placement. The lumen diameters of the stenotic lesions were measured using chest computed tomography (CT) and compared between before stent placement and after stent removal.ResultsA total of 51 stents were successfully placed in consecutive 51 patients with benign tracheobronchialmore » stenosis. No serious complications occurred. The mean VAS and KPS scores significantly improved after stent removal (6.291 ± 0.495 and 25.352 ± 10.533, respectively) compared with those before stent placement (1.493 ± 0.504 and 60.140 ± 16.344, respectively; P < 0.05). The mean lumen transverse diameters of the stenotic site in trachea and main bronchus after stent removal (17.235 ± 3.457 and 8.993 ± 0.961 mm; 1 month post-removal; 16.353 ± 4.132 and 8.357 ± 1.082 mm; 6 months post-removal) were significantly larger than those before stent placement (7.876 ± 2.351 and 2.143 ± 0.770 mm, respectively; P < 0.05). However, the mean lumen diameters between 1 and 6 months after stent removal had no significant difference (P > 0.05).ConclusionTemporary partially covered stenting may be a safe and effective treatment for benign tracheobronchial stenosis.« less

Ultrathin endoscope-assisted self-expandable metallic stent placement following initial unsuccessful attempt in malignant upper gastrointestinal obstruction.

PubMed

Park, Se Woo; Lee, Hyuk; Park, Jun Chul; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan

2014-03-01

Conventional endoscopy for self-expandable metallic stent (SEMS) placement may be technically limited in long and tortuous strictures. Therefore, we analyzed the feasibility, safety and usefulness of ultrathin endoscopy (UTE)-guided SEMS placement. This study involved 24 patients with upper gastrointestinal obstruction and unsuccessful initial attempts to place SEMS using conventional endoscopy. After completely passing a UTE across the stricture, the UTE was withdrawn, leaving a guidewire placed via the working channel. Through-the-scope SEMS placement was done using a conventional endoscope inserted along the guidewire. The primary endpoints were assessed by technical/clinical success and stent patency duration. Stents were successfully placed at target locations in all but one case with a long tortuous stricture, with 95.8% (23/24) technical success. One week after stent placement, mean gastricoutlet obstruction score improved significantly from baseline (1.74 ± 0.62 and 0.33 ± 0.48, respectively; P < 0.001). Stent migration, restenosis, and fracture occurred in four (17.4%), six (26.1%), and one (4.3%) of 23 stents, respectively. Median stent patency duration was 79 days. Mean stent patency was significantly longer in patients who received palliative chemotherapy than in those who did not (122.9 ± 11.0 and 38.3 ± 4.6, respectively; P < 0.001). UTE guidance SEMS delivery can be a feasible and safe rescue treatment method for malignant upper gastrointestinal obstruction in cases of failed attempts to place SEMS using conventional endoscopy. Our result warrants a further study to define the efficacy of this method in difficult SEMS placement cases. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

Foster care placement change: The role of family dynamics and household composition

PubMed Central

Waid, Jeffrey; Kothari, Brianne H.; Bank, Lew; McBeath, Bowen

2016-01-01

Sibling co-placement and kinship care have each been shown to protect against the occurrence of placement change for youth in substitute care. However, little is known about the effects of different combinations of sibling placement and relative caregiver status on placement change. Nor does the field fully understand how family dynamics may differ in these households. Utilizing data from the Supporting Siblings in Foster Care study, this paper examines family dynamics across four typologies of living composition, and tests the effects of living composition membership on the odds of experiencing a placement change over an 18-month period of time. Findings suggest that across living composition typologies, children who were placed separately from their siblings in non-relative care were more likely to be older, have more extensive placement histories, and experience more placement changes both prior to and during the study than were children in other living composition groups. Family living composition was found to influence the occurrence of placement change. Specifically, children co-placed in kinship care were least likely to experience movement; however, sibling co-placement in non-relative care was also protective. Results reveal the need to conduct additional research into the experiences of children in different family living arrangements, and tailor case management services and supports to children in substitute care accordingly. Implications and future directions are discussed. PMID:27990039

The Effect of Recreational Activities on the Elimination of State-Trait Anxiety of the Students Who Will Take the SBS Placement Test

ERIC Educational Resources Information Center

Birtürk, Atilay; Karagün, Elif

2015-01-01

The purpose of this study is to examine whether recreational activities have an effect on the elimination of state-trait anxiety of the students who will take the "SBS Placement Test" which is an exam for transition from secondary school to high school. For this purpose, as well as an information survey which determined the…

Comparison of V50 Shot Placement on Final Outcome

DTIC Science & Technology

2014-11-01

molecular- weight polyethylene (UHMWPE). In V50 testing of those types of materials, large delaminations may occur that influence the results. This...placement, a proper evaluation of materials may not be possible. 15. SUBJECT TERMS ballistics, V50 test, logistic regression , statistical inference...from an impact. While this may work with ceramics or metal armor, it is inappropriate for use on composite armors like ultra-high-molecular- weight

Effectiveness of Cognitive-behavioral Program on Pain and Fear in School-aged Children Undergoing Intravenous Placement.

PubMed

Hsieh, Yi-Chuan; Cheng, Su-Fen; Tsay, Pei-Kwei; Su, Wen-Jen; Cho, Yen-Hua; Chen, Chi-Wen

2017-12-01

This study aimed to evaluate the effects of cognitive-behavioral program on pain and medical fear in hospitalized school-aged children receiving intravenous (IV) placement. This study used an quasi-experimental design. Thirty-five participants were assigned to the experimental group and 33 to the control group in the acute internal medicine ward of a children's hospital. The cognitive-behavioral program entailed having the patients read an educational photo book about IV placement before the procedure and having them watch their favorite music video during the procedure. The outcome measures were numeric rating scales for pain intensity and fear during the procedure. After applying the cognitive-behavioral program, the mean scores on pain and fear decreased in the experimental group. However, the difference in pain intensity between these two groups was nonsignificant. The intensity of fear in the experimental group was significantly lower than that in the control group. In this study, the cognitive-behavioral program used with school-aged hospitalized children promoted less fear during IV placement. The results of this study can serve as a reference for empirical nursing care and as care guidance for clinical IV injections involving children. Copyright © 2017. Published by Elsevier B.V.

Predictors of the patency of self-expandable metallic stents in malignant gastroduodenal obstruction

PubMed Central

Kim, Seung Han; Chun, Hoon Jai; Yoo, In Kyung; Lee, Jae Min; Nam, Seung Joo; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck

2015-01-01

AIM: To investigate the predictive factors of self-expandable metallic stent patency after stent placement in patients with inoperable malignant gastroduodenal obstruction. METHODS: A total of 116 patients underwent stent placements for inoperable malignant gastroduodenal obstruction at a tertiary academic center. Clinical success was defined as acceptable decompression of the obstructive lesion within the malignant gastroduodenal neoplasm. We evaluated patient comorbidities and clinical statuses using the World Health Organization’s scoring system and categorized patient responses to chemotherapy using the Response Evaluation Criteria in Solid Tumors criteria. We analyzed the relationships between possible predictive factors and stent patency. RESULTS: Self-expandable metallic stent placement was technically successful in all patients (100%), and the clinical success rate was 84.2%. In a multivariate Cox proportional hazards model, carcinoembryonic antigen (CEA) levels were correlated with a reduction in stent patency [P = 0.006; adjusted hazard ratio (aHR) = 2.92, 95%CI: 1.36-6.25]. Palliative chemotherapy was statistically associated with an increase in stent patency (P = 0.009; aHR = 0.27, 95%CI: 0.10-0.72). CONCLUSION: CEA levels can easily be measured at the time of stent placement and may help clinicians to predict stent patency and determine the appropriate stent procedure. PMID:26290640

Use of occlusal sealant in a community program and caries incidence in high- and low-risk children.

PubMed

Baldini, Vânia; Tagliaferro, Elaine Pereira da Silva; Ambrosano, Gláucia Maria Bovi; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos

2011-08-01

The aims of this study were to investigate the effectiveness of sealant placement under the guidelines of the Oral Health Promotion Program for Children and Adolescents (Portugal), and to test the influence of clinical and socioeconomic variables on the DMFT increment in 277 children, born in 1997. A dental hygienist performed the initial examinations and sealant placement (Helioseal, Vivadent) on the permanent first molars in 2005. These activities were registered in dental records that were assessed in 2007. Children were classified according to caries risk at baseline [high (HR: DMFT+dmft>0); low (LR: DMFT+dmft=0) risk] and sealant placement as follows: HR-S and LR-S Groups (with sealant placement); HR-NS and LR-NS Groups (without sealant placement). A calibrated dentist performed the final examination in 2007 at school, based on the World Health Organization recommendations. The variables collected were: dental caries, visible dental plaque, malocclusions, and socioeconomic level (questionnaire sent to children's parents). For univariate (Chi-square or Fisher tests) and multivariate (Multiple logistic regression) analyses the DMFT increment >0 was selected as dependent variable. Approximately 17.0% of the children showed DMFT increment>0 (mean=0.25). High-risk children presented a significant increase in the number of decayed and/or filled teeth. These children had 7.94 more chance of developing caries. Children who did not receive sealant were 1.8 more prone to have DMFT increment >0. It appears that sealant placement was effective in preventing dental caries development. Moreover, the variables "risk" and "sealant placement" were predictors for DMFT increment in the studied children.

Histopathological comparative analysis of peri-implant soft tissue response after dental implant placement with flap and flapless surgical technique. Experimental study in pigs.

PubMed

Vlahovic, Zoran; Markovic, Aleksa; Golubovic, Mileta; Scepanovic, Miodrag; Kalanovic, Milena; Djinic, Ana

2015-11-01

The aim of this study was comparing the effect of flapless vs. flap technique of implant placement on inflammation degree of peri-implant soft tissue, through histopathological analysis. The experiment was conducted on five domestic pigs. Nine weeks after tooth extraction, implants were installed. Each animal received six implants in mandible. According to split-mouth design, randomly one side was used for flapless technique using mini-incision, while on the other side, flap was raised. After 7, 14, 21, 28, and 90 days, the experimental animals were sacrificed. Samples for histopathological analyzes were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The degree of inflammatory response in the peri-implant soft tissue was estimated through ordinal scores from 0 to 3. In the flap group Score 3 indicating high degree of inflammation was present from day 7 to day 21, in contrast to flapless group where Score 3 was not recorded during the entire follow-up. Three months after implantation, there were no signs of inflammation neither around flap nor around flapless implants. Flapless surgical implantation technique using mini-incision decreases peri-implant soft tissue inflammatory reaction compared with flap surgery. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Percutaneous endoscopic gastrostomy placement in paediatric Crohn's disease patients contributes to both improved nutrition and growth.

PubMed

Duncan, H; Painesi, A; Buchanan, E; McGrogan, P; Gerasimidis, K; Walker, G; Haddock, G; Russell, R K

2018-06-01

This paper describes the outcomes of gastrostomy feeding in patients with Crohn's disease (CD). Patients with CD who attended the Royal Hospital for Children, Glasgow and received gastrostomy feeding for at least two years between 2003 and 2010 were identified from the clinical database. The data recorded included the anthropometric data, CD phenotype, the surgical technique that was used, complications, medication, feed type, median feed, calories, volume and clinical outcomes. The study identified 16 patients (14 male) who had a gastrostomy inserted using a pull technique at a median age of 12.6 years. Of these two required laparoscopic placement. Short-term complications lasting less than one month were experienced by nine (56%) patients and one (6%) experienced long-term complications. Anthropometry significantly improved at follow-up compared to baseline: at 12 months, the body mass index z-score was 1.11 (p = 0.005) and the weight z-score was 0.19 (p < 0.05). At 24 months, the height z-score was -1.03 (p = 0.04). The daily median volume and calories from feeds increased significantly from baseline to post-PEG insertion, from 400 to 738 mL and 705 to 860 kcal/day (p ≤ 0.01). Gastrostomy feeding for paediatric patients with CD was associated with improved nutrition, weight gain and growth outcomes. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Standardized, Interdepartmental, Simulation-Based Central Line Insertion Course Closes an Educational Gap and Improves Intern Comfort with the Procedure.

PubMed

Grudziak, Joanna; Herndon, Blair; Dancel, Ria D; Arora, Harendra; Tignanelli, Christopher J; Phillips, Michael R; Crowner, Jason R; True, Nicholas A; Kiser, Andy C; Brown, Rebecca F; Goodell, Harry P; Murty, Neil; Meyers, Michael O; Montgomery, Sean P

2017-06-01

Central line placement is a common procedure, routinely performed by junior residents in medical and surgical departments. Before this project, no standardized instructional course on the insertion of central lines existed at our institution, and few interns had received formal ultrasound training. Interns from five departments participated in a simulation-based central line insertion course. Intern familiarity with the procedure and with ultrasound, as well as their prior experience with line placement and their level of comfort, was assessed. Of the 99 interns in participating departments, 45 per cent had been trained as of October 2015. Forty-one per cent were female. The majority (59.5%) had no prior formal ultrasound training, and 46.0 per cent had never placed a line as primary operator. Scores increased significantly, from a precourse score mean of 13.7 to a postcourse score mean of 16.1, P < 0.001. All three of the self-reported measures of comfort with ultrasound also improved significantly. All interns reported the course was "very much" helpful, and 100 per cent reported they felt "somewhat" or "much" more comfortable with the procedure after attendance. To our knowledge, this is the first hospital-wide, standardized, simulation-based central line insertion course in the United States. Preliminary results indicate overwhelming satisfaction with the course, better ultrasound preparedness, and improved comfort with central line insertion.

Sexual Function and Quality of Life Before and After Penile Prosthesis Implantation Following Radial Forearm Flap Phalloplasty.

PubMed

Young, Ezekiel E; Friedlander, Daniel; Lue, Kathy; Anele, Uzoma A; Khurgin, Jacob L; Bivalacqua, Trinity J; Burnett, Arthur L; Redett, Richard J; Gearhart, John P

2017-06-01

To provide sexual function and quality of life outcomes in patients with severe penile deficiency who underwent radial forearm flap phalloplasty with and without penile prosthesis implantation. Patients with history of severe penile deficiency who underwent microsurgical radial forearm flap phalloplasty with and without penile prosthesis implantation between 2007 and 2014 were identified. They completed a set of web-based validated questionnaires including the International Index of Erectile Function, the Pediatric Penile Perception Score, the Sexual Quality of Life for Men, and several items addressing general quality of life. Outcomes were compared between groups. Nine of the 12 identified patients who had prosthesis after phalloplasty and 4 out of the 7 phalloplasty-only patients completed the survey, resulting in an overall response rate of 68%. Among the phalloplasty-prosthesis patients, 66% reported current sexual activity and 78% reported regular masturbation, whereas 1 of the 4 phalloplasty-only patients reported both. Prosthesis patients scored notably higher in all domains of the International Index of Erectile Function except for sexual desire. In contrast, they demonstrated similar scores of penile perception, as well as general and sexual quality of life. Among patients who have undergone flap phalloplasty, the subsequent placement of penile prosthesis appears to effectively allow for both intercourse and masturbation, resulting in measurable improvements in orgasmic function, intercourse satisfaction, and overall sexual satisfaction. Despite these important benefits, prosthesis placement does not appear to result in improvements in penile perception scores, or general or sexual quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

Naproxen Sodium for Pain Control With Intrauterine Device Insertion: A Randomized Controlled Trial.

PubMed

Ngo, Lynn L; Braaten, Kari P; Eichen, Eva; Fortin, Jennifer; Maurer, Rie; Goldberg, Alisa B

2016-12-01

To evaluate whether 550 mg oral naproxen sodium given 1 hour before intrauterine device (IUD) insertion is effective for pain relief as compared with placebo. This was a randomized, double-blind, placebo-controlled trial. The primary outcome was pain with IUD insertion measured on a 100-mm visual analog scale (VAS). Our sample size was calculated to detect a 15-mm difference in VAS scores with 80% power (α=0.05). Secondary outcomes included pain with tenaculum placement, uterine sounding, and 5 and 15 minutes postinsertion. A total of 118 women were enrolled and analyzed (58 in the naproxen sodium arm, 60 in the placebo arm, 97% nulliparous) between May 11, 2015, and March 25, 2016. There were no differences in baseline demographics or reproductive characteristics between arms. There were no differences in median VAS pain scores for the primary outcome of pain with IUD insertion between the naproxen sodium arm compared with the placebo arm (69 compared with 66 mm, P=.89). There were no differences in the secondary outcomes of median VAS pain scores with tenaculum placement (37 compared with 32 mm, P=.97) or uterine sounding (60 compared with 58 mm, P=.66). However, median pain scores postprocedure were lower in the naproxen arm as compared with the placebo arm: 17 compared with 26 mm (P=.01) at 5 minutes and 13 compared with 24 mm (P=.01) at 15 minutes postinsertion. Oral naproxen sodium does not reduce pain with IUD insertion but does reduce pain after insertion and should be considered as a premedication. ClinicalTrials.gov, http://clinicaltrials.gov, NCT02388191.

Interest in mathematics and science among students having high mathematics aptitude

NASA Astrophysics Data System (ADS)

Ely, Jane Alice

The study investigates why men and women differ in their interest in mathematics and science and in the pursuit of careers in mathematics and science. The most persistent gender differential in educational standard testing is the scores in mathematics achievement. The mean Scholastic Aptitude Test (Mathematics) scores for women are consistently below that of men by about 40 points. One result of this gender differential in mathematics is that few women entertain a career requiring a robust knowledge of higher mathematics (i.e. engineering, computing, or the physical sciences). A large body of literature has been written attempting to explain why this is happening. Biological, cultural, structural and psychological explanations have been suggested and empirically examined. Controlling for mathematical ability is one method of sorting out these explanations. Eliminating mathematical ability as a factor, this dissertation reports the results of a study of men and women college students who all had high mathematics ability. Thus, any differences we found among them would have to be a result of other variables. Using a Mathematics Placement Exam and the SAT-M, forty-two students (12 males and 30 females) with high scores in both were interviewed. Student were asked about their experiences in high school and college mathematics, their career choices, and their attitudes toward mathematics. The findings, that there were no gender differences in the course selection, attitudes towards mathematics, and career choice, differed from my initial expectations. This negative finding suggests that women with high ability in mathematics are just as likely as men to pursue interests in mathematics and related courses in college and in selecting careers.

Effect of Dental Chair Light on Enamel Bonding of Orthodontic Brackets Using Light Cure Based Adhesive System: An In-Vitro Study

PubMed Central

Tiwari, Anil; Shyagali, Tarulatha; Kohli, Sarvraj; Joshi, Rishi; Gupta, Abhishek; Tiwari, Rana

2016-01-01

Aim: The aim of this in vitro study was to evaluate the influence of the Dental chair light on the bond strength of light cured composite resin. Materials and Methods: Sixty therapeutically extracted human premolar teeth were randomly allocated to two groups of 30 specimens each. In both groups light cured composite resin (Transbond XT) and MBT premolar metal brackets (3M Unitek) was used to bond brackets. In group I and II light curing was done using Light-emitting diode light curing units without and with the dental chair light respectively. After bonding, all samples were stored in distilled water at room temperature for 24 hours and subsequently tested for shear bond strength and Adhesive Remnant Index (ARI) scores. Data was subjected to Mann Whitney U statistical test. Results: Results indicated that there was significantly higher shear bond strength (7.71 ± 1.90) for the Group II (composite cured with LED and dental chair light) compared with Group I (composite cured with LED LCU only) (5.74 ± 1.13).the obtained difference was statistically significant. There was no statistical significant difference between ARI scores in between the groups. Conclusions: light cure bonding with dental chair light switched on will produce greater bond strength than the conventional bonding. However, the ARI score were similar to both the groups. It is advised that the inexperienced orthodontist should always switch off the dental chair light while bonding for enough working time during the bracket placement. PMID:28077886

Spinal cord stimulation: Subjective pain intensity and presurgical correlates in chronic pain patients.

PubMed

Sumner, Lekeisha A; Lofland, Kenneth

2014-09-01

This study determined the changes in pain intensity prior to and after permanent placement of spinal cord stimulation (SCS), as measured by the Visual Analog Scale (VAS) and, examined associations of presurgical characteristics to both pre- and post-SCS VAS scores. Demographic, disease, and psychological data were extracted from the medical charts of chronic pain patients (N = 58) being treated at a Hospital in IL, USA. Most patients were diagnosed with complex regional pain syndrome (51.9%) and low back pain (33.3%). The majority were White (72.5%), male (60%), married (72%), and temporary disabled or receiving worker's compensation (40%). Study objectives were tested with correlational and univariate analysis. A significant reduction between pre (M = 6.87; SD = 1.38) and Post-(M = 4.11; SD = 1.54) SCS pain intensity scores was observed (p < .000). Pre-SCS pain intensity scores were associated with medical diagnosis (p < .01), marital status (p < .05), and catastrophizing (p < .05). Post-SCS pain intensity scores were associated with body mass index (p < .05), medical diagnosis (p < .05), employment status (p < .05), bodily concern (p < .05), marital status (p < .05), and race (p < .05). Results strengthen support for the short-term effectiveness of SCS and demonstrate the differential associations of presurgical factors on pain intensity. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Comparison of instructor-led versus peer-led debriefing in nursing students.

PubMed

Roh, Young Sook; Kelly, Michelle; Ha, Eun Ho

2016-06-01

Despite its widespread support, the most effective simulation-based debriefing method has little evidence to support its efficacy. In this study, we compared the effect of peer-led and instructor-led debriefing among nursing students. The study was conducted with a non-equivalent control group using a pretest-post-test design. A convenience sample of third-year nursing students was used for the study, where 65 students enrolled in a 2-week clinical placement rotation were randomly assigned to the instructor-led group or peer-led group. The quality of cardiopulmonary resuscitation skills, satisfaction with simulation, and quality of debriefing in the peer-led group were compared to those in the instructor-led group. Group differences at each testing interval were analyzed using independent t-test. Nursing students in the instructor-led debriefing group showed better subsequent cardiopulmonary resuscitation performance, more satisfaction with simulation experience, and higher debriefing scores compared to the peer-led group. From our study, instructor-led debriefing is an effective method in improving skills performance, inducing favorable satisfaction, and providing better quality of debriefing among nursing students. © 2016 John Wiley & Sons Australia, Ltd.

Translating theory into practice: results of a 2-year trial for the LEAD programme.

PubMed

Shelton, D

2008-05-01

This paper presents data for 2 years of a continuing study aimed to reduce the risk of first-time involvement by minority youth with the juvenile justice system. A quasi-experimental design was used to test a 14-week expressive art curriculum (LEAD: leadership, education, achievement and development) implemented in two rural communities. A total of 70 African American youth participated in the programme over a 2-year period. Pre- and post-test differences were examined for protective factors, behavioural self-control, self-esteem and resilience measures. When compared with the after-school programme (control group), youth in the LEAD programme in both communities had more dramatic increases in post-test scores following the intervention. The combined data from year 1 and year 2 provide positive findings in support of LEAD as a prevention programme for young offenders. The placement of the programme within an African American church in year 2 improved the processes of the LEAD programme and seemed to provide a better fit with the original design of the programme, highlighting the importance of the context, in which the programme was provided.

Structural acoustic control of plates with variable boundary conditions: design methodology.

PubMed

Sprofera, Joseph D; Cabell, Randolph H; Gibbs, Gary P; Clark, Robert L

2007-07-01

A method for optimizing a structural acoustic control system subject to variations in plate boundary conditions is provided. The assumed modes method is used to build a plate model with varying levels of rotational boundary stiffness to simulate the dynamics of a plate with uncertain edge conditions. A transducer placement scoring process, involving Hankel singular values, is combined with a genetic optimization routine to find spatial locations robust to boundary condition variation. Predicted frequency response characteristics are examined, and theoretically optimized results are discussed in relation to the range of boundary conditions investigated. Modeled results indicate that it is possible to minimize the impact of uncertain boundary conditions in active structural acoustic control by optimizing the placement of transducers with respect to those uncertainties.

Do We Need Remedial College Math Courses?

NASA Astrophysics Data System (ADS)

Hughes, Anne O.; Khatri, D.

2006-12-01

Entering college freshmen, in increasing numbers, in practically every public institution of higher learning are in need of one or two remedial math courses. This is particularly a big problem at the Historically Black Colleges and Universities where a large number of remedial math course sections are offered to meet the growing demand for such courses. For most of these students, graduation is delayed by at least a year. In addition, these students continue to be taught by teaching methodologies that did not work for them even in high schools resulting in disgust and hatred for math. This situation makes entry for these students into STEM areas difficult and is the perfect recipe for failure in STEM disciplines if they enroll in college level courses. The University of the District of Columbia (UDC) is no exception. A first attempt was made in summer 2006 to remedy this situation. The problem for this exploratory research study was to ascertain if a short, intensive six-week project in basic math and introductory algebra would produce a recognizable improvement in the math performance of entering UDC freshmen students as measured by the UDC math placement test. The results are eye opening. On the pre-test for basic math (005), the mean score for the group (N=10) was 35.6, with the passing score being 70. On the post-test, the mean increased to 63.4 showing an improvement of 78 percent. The authors will present the results of this research study at the conference

Esophageal stent fixation with endoscopic suturing device improves clinical outcomes and reduces complications in patients with locally advanced esophageal cancer prior to neoadjuvant therapy: a large multicenter experience.

PubMed

Yang, Juliana; Siddiqui, Ali A; Kowalski, Thomas E; Loren, David E; Khalid, Ammara; Soomro, Ayesha; Mazhar, Syed M; Rosé, Julian; Isby, Laura; Kahaleh, Michel; Kalra, Ankush; Sarkisian, Alex M; Kumta, Nikhil A; Nieto, Jose; Sharaiha, Reem Z

2017-03-01

Endoscopic placement of fully covered self-expanding metal stents (FCSEMS) to treat malignant dysphagia in patients with esophageal cancer significantly improves dysphagia; however, these stents have a high migration rate. To determine whether FCSEMS fixation using an endoscopic suturing device treated malignant dysphagia and prevented stent migration in patients with locally advanced esophageal cancer receiving neoadjuvant therapy when compared to patients with FCSEMS placement alone. A review of patients with locally advanced esophageal cancer who underwent FCSEMS placement at 3 centers was performed. Patients were divided into two groups: Group A (n = 26) was composed of patients who underwent FCSEMS placement with suture placement, and Group B (n = 67) was composed of patients with FCSEMS placement alone. There were no significant differences between Groups A and B in demographics, and tumor characteristics. The technical success rate for stent placement was 100 %. There was no difference between Groups A and B in the median stent diameter and stent lengths. Mean dysphagia score obtained at 1 week after stent placement had improved significantly from baseline (2.4 and 1, respectively, p < 0.001). Patients had a median follow-up of 4 months. Immediate adverse events were mild chest discomfort in 4 patients in Group A and 2 patients in Group B (p = 0.05), and significant acid reflux in 3 patient in Group A compared to 2 patients in Group B (p = 0.1). The stent migration rate was significantly lower in Group A compared to compared to Group B (7.7 vs 26.9 %, respectively, p = 0.004). There was a delayed perforation in 1 patient and 1 death due to aspiration pneumonia in Group B. Fixation of esophageal FCSEMSs by using an endoscopic suturing device in patients receiving neoadjuvant therapy was shown to be feasible, safe, and relatively effective at preventing stent migration compared to those who had stent placed alone.

Planning Image-Based Measurements in Wind Tunnels by Virtual Imaging

NASA Technical Reports Server (NTRS)

Kushner, Laura Kathryn; Schairer, Edward T.

2011-01-01

Virtual imaging is routinely used at NASA Ames Research Center to plan the placement of cameras and light sources for image-based measurements in production wind tunnel tests. Virtual imaging allows users to quickly and comprehensively model a given test situation, well before the test occurs, in order to verify that all optical testing requirements will be met. It allows optimization of the placement of cameras and light sources and leads to faster set-up times, thereby decreasing tunnel occupancy costs. This paper describes how virtual imaging was used to plan optical measurements for three tests in production wind tunnels at NASA Ames.

Effect of the College Placement Process on Occupational Stereotype

ERIC Educational Resources Information Center

Roe, Robert G.

1974-01-01

Graduating seniors in engineering and business were tested before and ater a placement process to measure perceptions of their chosen occupation's stereotype. Business and engineering students and professional engineers and businessmen could individually identify occupational stereotypes. Only the business students experienced significant change…

Prediction of pain in orthodontic patients based on preoperative pain assessment

PubMed Central

Zheng, Baoyu; Ren, Manman; Lin, Feiou; Yao, Linjie

2016-01-01

Aim To investigate whether pretreatment assessment of experimental pain can predict the level of pain after archwire placement. Methods One hundred and twenty-one general university students seeking orthodontic treatment were enrolled in this study. A cold pressor test was performed to estimate the pain tolerance of subjects before treatment. Self-reported pain intensity was calculated using a 10 cm visual analog scale during the 7 days after treatment. The relationship between pain tolerance and orthodontic pain was analyzed using Spearman’s correlation analysis. Results The maximum mean level of pain intensity occurred at 24 hours after bonding (53.31±16.13) and fell to normal levels at day 7. Spearman’s correlation analysis found a moderate positive association between preoperative pain tolerance and self-reported pain after archwire placement (P<0.01). There was no significant difference in pain intensity between male and female patients at any time point (P>0.05). Conclusion A simple and noninvasive preoperative sensory test (the cold pressor test) was useful in predicting the risk of developing unbearable pain in patients after archwire placement. Self-reported pain after archwire placement decreased as individual pain tolerance increased. PMID:27042019

Academic Success of At-Risk African American Male Students Who Receive Culturally Relevant Teaching, College Readiness Preparation, and Mentorship

ERIC Educational Resources Information Center

Taylor, Timothy L.

2016-01-01

This quantitative study analyzed archival data to determine whether a significant difference existed in the reading comprehension scores and student success (enrollment in honors and or advanced placement classes and college after graduation) of at-risk African American male students who received Advancement via Individual Determination/African…

PSAT Component Scores as a Predictor of Success on AP Exam Performance for Diverse Students

ERIC Educational Resources Information Center

Richardson, Cristianne C.; Gonzalez, Alejandro; Leal, Lonnie; Castillo, Mary Z.; Carman, Carol A.

2016-01-01

While studies have shown the positive effect of the Advanced Placement (AP) program on college readiness, there are still barriers preventing minority and low socioeconomic status (SES) students who possess high academic potential from participating in the opportunity that AP courses offer. One tool that could help identify students for…

Students' Concept-Building Approaches: A Novel Predictor of Success in Chemistry Courses

ERIC Educational Resources Information Center

Frey, Regina F.; Cahill, Michael J.; McDaniel, Mark A.

2017-01-01

One primary goal of many science courses is for students to learn creative problem-solving skills; that is, integrating concepts, explaining concepts in a problem context, and using concepts to solve problems. However, what science instructors see is that many students, even those having excellent SAT/ACT and Advanced Placement scores, struggle in…

Armed Service Vocational Aptitude Battery Scores and Aviation Electrician's Mate Class "A" School Attrition Rate.

ERIC Educational Resources Information Center

Miller, Hershel M.

A study investigated the use of the Armed Services Vocational Aptitude Battery (ASVAB) subtests and combinations of subtest composites as placement qualifiers for the Aviation Electrician's Mate AEA(A1) school. It examined the relationship of the independent variables Arithmetic Reasoning; Math Knowledge; General Science; and Composite ASVAB score…

Getting Developmental Education Up to Speed: A Look at MDRC's Research. Issue Focus

ERIC Educational Resources Information Center

Malbin, Joshua

2016-01-01

When they arrive at community colleges or open-enrollment universities, most students take placement exams in English and mathematics to determine whether they are ready for college-level courses. Students with low scores are referred to developmental--remedial--courses. Forty percent of all entering college students and over half of entering…

[Changes of brain function and cognitive function after carotid artery stenting].

PubMed

Lu, Z X; Deng, G; Wei, H L; Zhao, G F; Wen, L Z; Chen, X

2017-10-24

Objective: To investigate the effect of carotid artery stenting(CAS) on cognitive function and brain function based on changes of a battery of neuropsychological tests and magnetic resonance imaging. Methods: Thirty-three patients were included with 17 in the stent-placement group and 16 in the control group (receiving medical treatment), among whom, the unilateral or bilateral severe internal carotid artery stenosis was confirmed by cerebral vascular angiography in the department of Interventional Radiology and Vascular Surgery of Zhongda Hospital Southeast University from June 2015 to September 2016.Neuropsychological tests and rest-state blood oxygenation level dependent fMRI were performed at the baseline and six months follow-up.The baseline characteristics and follow-up changes were compared in each group. Results: The overall cognitive function of the stent-placement group was statistically significantly improved ( P <0.05) compared with control group, mainly in the executive function, memory, attention and other aspects.The value of amplitude of low-frequency fluctuation(ALFF) showed statistically significant increase ( P <0.05, Alphasim correction) in left prefrontal cortex ( t =5.861 3, P <0.05), the somatosensory association cortex in left superior parietal lobe( t =5.601 2, P <0.05) and bilateral motor cortical area in posterior frontal lobe ( t =5.288 5, P <0.05). The ALFF showed statistically significant decrease ( P <0.05, Alphasim correction) in left retrosplenial cingulate cortex( t =-5.590 4, P <0.05), left insular cortex ( t =-6.340 8, P <0.05), right insular cortex ( t =-8.129 9, P <0.05) and left dorsal anterior cingulate cortex ( t =-5.584 8, P <0.05). There was no statistically significant difference ( P >0.05, Alphasim correction)between baseline and follow-up results in control group.Besides, the ALFF changes of the left insular cortex ( r =-0.591, P =0.033) and bilateral motor cortical area ( r =-0.659, P =0.014) were negatively correlated with auditory verb learning test (AVLT) score changes.The ALFF change of bilateral motor cortical area was negatively correlated with the AVLT-delay score change ( r =-0.588, P =0.034). And the ALFF change on right insular cortex and the frontal assessment battery (FAB) score change was positively correlated ( r =0.638, P =0.025). Conclusions: The overall cognitive function of patients with carotid artery stenosis significantly improve after CAS compared with medical treatment.The change of ALFF value in related brain area is also statistically significant.ALFF Change most in area of Default Mode Network may suggest a mechanism of postoperative neurological recovery in patients with carotid artery stenosis.

Optimization Strategies for Sensor and Actuator Placement

NASA Technical Reports Server (NTRS)

Padula, Sharon L.; Kincaid, Rex K.

1999-01-01

This paper provides a survey of actuator and sensor placement problems from a wide range of engineering disciplines and a variety of applications. Combinatorial optimization methods are recommended as a means for identifying sets of actuators and sensors that maximize performance. Several sample applications from NASA Langley Research Center, such as active structural acoustic control, are covered in detail. Laboratory and flight tests of these applications indicate that actuator and sensor placement methods are effective and important. Lessons learned in solving these optimization problems can guide future research.

Artificial Intelligence based technique for BTS placement

NASA Astrophysics Data System (ADS)

Alenoghena, C. O.; Emagbetere, J. O.; Aibinu, A. M.

2013-12-01

The increase of the base transceiver station (BTS) in most urban areas can be traced to the drive by network providers to meet demand for coverage and capacity. In traditional network planning, the final decision of BTS placement is taken by a team of radio planners, this decision is not fool proof against regulatory requirements. In this paper, an intelligent based algorithm for optimal BTS site placement has been proposed. The proposed technique takes into consideration neighbour and regulation considerations objectively while determining cell site. The application will lead to a quantitatively unbiased evaluated decision making process in BTS placement. An experimental data of a 2km by 3km territory was simulated for testing the new algorithm, results obtained show a 100% performance of the neighbour constrained algorithm in BTS placement optimization. Results on the application of GA with neighbourhood constraint indicate that the choices of location can be unbiased and optimization of facility placement for network design can be carried out.

Lower rates of symptom recurrence and surgical revision after primary compared with secondary endoscopic third ventriculostomy for obstructive hydrocephalus secondary to aqueductal stenosis in adults.

PubMed

Sankey, Eric W; Goodwin, C Rory; Jusué-Torres, Ignacio; Elder, Benjamin D; Hoffberger, Jamie; Lu, Jennifer; Blitz, Ari M; Rigamonti, Daniele

2016-05-01

OBJECT Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus; however, the success of ETV in patients who have previously undergone shunt placement remains unclear. The present study analyzed 103 adult patients with aqueductal stenosis who underwent ETV for obstructive hydrocephalus and evaluated the effect of previous shunt placement on post-ETV outcomes. METHODS This study was a retrospective review of 151 consecutive patients who were treated between 2007 and 2013 with ETV for hydrocephalus. One hundred three (68.2%) patients with aqueductal stenosis causing obstructive hydrocephalus were included in the analysis. Postoperative ETV patency and aqueductal and cisternal flow were assessed by high-resolution, gradient-echo MRI. Post-ETV Mini-Mental State Examination, Timed Up and Go, and Tinetti scores were compared with preoperative values. Univariate and multivariate analyses were performed comparing the post-ETV outcomes in patients who underwent a primary (no previous shunt) ETV (n = 64) versus secondary (previous shunt) ETV (n = 39). RESULTS The majority of patients showed significant improvement in symptoms after ETV; however, no significant differences were seen in any of the quantitative tests performed during follow-up. Symptom recurrence occurred in 29 (28.2%) patients after ETV, after a median of 3.0 (interquartile range 0.8-8.0) months post-ETV failure. Twenty-seven (26.2%) patients required surgical revision after their initial ETV. Patients who received a secondary ETV had higher rates of symptom recurrence (p = 0.003) and surgical revision (p = 0.003), particularly in regard to additional shunt placement/revision post-ETV (p = 0.005). These differences remained significant after multivariate analysis for both symptom recurrence (p = 0.030) and surgical revision (p = 0.043). CONCLUSIONS Patients with obstructive hydrocephalus due to aqueductal stenosis exhibit symptomatic improvement after ETV, with a relatively low failure rate. Patients with a primary history of shunt placement who undergo ETV as a secondary intervention are at increased risk of symptom recurrence and need for surgical revision post-ETV.

Safety and Efficacy of Percutaneous Biliary Covered Stent Placement in Patients with Malignant Biliary Hilar Obstruction; Correlation with Liver Function

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

Hyun, Hyeran; Choi, Sun Young, E-mail: medmath@hanmail.net; Kim, Kyung Ah

PurposeTo estimate the safety and efficacy of percutaneous ePTFE-covered biliary stent placement and the relationship between underlying liver function and stent patency in patients with malignant hilar obstruction.Materials and MethodsFrom March 2012 to June 2015, 41 patients [22 females, 19 males; mean age 69.8 (range 34–94) years] with malignant biliary obstruction underwent percutaneous biliary stent placement (31 patients with unilateral, 10 patients with bilateral side-by-side). Cumulative patient survival and stent patency rate curves were derived using the Kaplan–Meier method. A Cox model was used to explore the relationship between liver function and patient survival, and also biliary stent patency. Pearsonmore » correlation coefficient was used to analyze the relationship between patient survival and stent patency.ResultsTechnical success rate was 100 % and clinical success rate was 95 %. During follow-up, four complications occurred (two bilomas and two cases of acute cholecystitis) and were treated successfully with percutaneous drainage. No other complication occurred. Mean serum bilirubin level was 11.34 ± 7.35 mg/dL before drainage and 5.00 ± 4.83 mg/dL 2 weeks after stent placement. The median patent survival duration was 147 days (95 % CI, 69.6–224.4 days). The median stent patency duration was 101 days (95 % CI, 70.0–132.0 days). The cumulative stent patency rates at 1, 3, 6, and 12 months were 97, 57.6, 30.3, and 17.0 %, respectively. Child–Pugh score was correlated significantly with patient survival (P = 0.011) and stent patency (P = 0.007). MELD score was correlated significantly with stent patency (P = 0.044). There was a correlation between patient survival and stent patency (r = 0.778, P < 0.001).ConclusionPercutaneous placement of ePTFE-covered biliary stent was a safe and an effective method for malignant biliary obstruction. Underlying liver function seemed to be one of the important factors affecting patient survival and stent patency, and stent patency showed statistically significant correlation with patient survival.« less

Behavior problems and placement change in a national child welfare sample: a prospective study.

PubMed

Aarons, Gregory A; James, Sigrid; Monn, Amy R; Raghavan, Ramesh; Wells, Rebecca S; Leslie, Laurel K

2010-01-01

There is ongoing debate regarding the impact of youth behavior problems on placement change in child welfare compared to the impact of placement change on behavior problems. Existing studies provide support for both perspectives. The purpose of this study was to prospectively examine the relations of behavior problems and placement change in a nationally representative sample of youths in the National Survey of Child and Adolescent Well-Being. The sample consisted of 500 youths in the child welfare system with out-of-home placements over the course of the National Survey of Child and Adolescent Well-Being study. We used a prospective cross-lag design and path analysis to examine reciprocal effects of behavior problems and placement change, testing an overall model and models examining effects of age and gender. In the overall model, out of a total of eight path coefficients, behavior problems significantly predicted placement changes for three paths and placement change predicted behavior problems for one path. Internalizing and externalizing behavior problems at baseline predicted placement change between baseline and 18 months. Behavior problems at an older age and externalizing behavior at 18 months appear to confer an increased risk of placement change. Of note, among female subjects, placement changes later in the study predicted subsequent internalizing and externalizing behavior problems. In keeping with recommendations from a number of professional bodies, we suggest that initial and ongoing screening for internalizing and externalizing behavior problems be instituted as part of standard practice for youths entering or transitioning in the child welfare system.

Falloposcopy.

PubMed

Milad, M P; Corfman, R S

1992-06-01

This review discusses advances in falloposcopy over the past 10 years. Refinements in instrumentation, including fiberoptics, have allowed visualization of the endosalpinx, a portion of the reproductive tract that has evaded endoscopic evaluation. A coaxial system of falloposcopic placement may give way to a linear everting catheter that does not require hysteroscopic guidance. Tubal endoscopic applications are discussed, including correlating hysterosalpingogram findings with those findings at salpingoscopy. Endosalpingeal changes can be quantitated in the presence of hydrosalpinges, and possibly with endometriosis. A scoring system to measure changes has been described. Using this scoring system, endosalpingeal findings at salpingoscopy have been compared with histologic and electron microscopic findings.

Optimal Multi-Type Sensor Placement for Structural Identification by Static-Load Testing

PubMed Central

Papadopoulou, Maria; Vernay, Didier; Smith, Ian F. C.

2017-01-01

Assessing ageing infrastructure is a critical challenge for civil engineers due to the difficulty in the estimation and integration of uncertainties in structural models. Field measurements are increasingly used to improve knowledge of the real behavior of a structure; this activity is called structural identification. Error-domain model falsification (EDMF) is an easy-to-use model-based structural-identification methodology which robustly accommodates systematic uncertainties originating from sources such as boundary conditions, numerical modelling and model fidelity, as well as aleatory uncertainties from sources such as measurement error and material parameter-value estimations. In most practical applications of structural identification, sensors are placed using engineering judgment and experience. However, since sensor placement is fundamental to the success of structural identification, a more rational and systematic method is justified. This study presents a measurement system design methodology to identify the best sensor locations and sensor types using information from static-load tests. More specifically, three static-load tests were studied for the sensor system design using three types of sensors for a performance evaluation of a full-scale bridge in Singapore. Several sensor placement strategies are compared using joint entropy as an information-gain metric. A modified version of the hierarchical algorithm for sensor placement is proposed to take into account mutual information between load tests. It is shown that a carefully-configured measurement strategy that includes multiple sensor types and several load tests maximizes information gain. PMID:29240684

Structures, Design and Test: Materials

NASA Technical Reports Server (NTRS)

2004-01-01

NASA Marshall has developed a technology that combines a film/adhesive laydown module with fiber placement technology to enable the processing of composite prepreg tow/tape and films, foils, or adhesives on the same placement machine. The deve!opment of this technology grew out of NASA's need for lightweight, permeation-resistant cryogenic propellant tanks.

How High School Coursework Predicts Introductory College-Level Course Success

ERIC Educational Resources Information Center

Woods, Chenoa S.; Park, Toby; Hu, Shouping; Betrand Jones, Tamara

2018-01-01

Objective: In recent years, developmental education (DE) reform has led to a restructuring of the placement process, redesigning of course instructional modalities, or implementing student support services to supplement developmental coursework. In Florida, recent legislative changes allowed students to opt out of placement testing and enroll…

Creating a Strain Relief Loop during S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: A Technical Note.

PubMed

van Velsen, Valery; van Helmond, Noud; Chapman, Kenneth B

2018-04-01

Chronic neuropathic pain is often refractory to conventional medical treatments and leads to significant disability and socio-economic burden. Dorsal root ganglion (DRG) stimulation has recently emerged as a treatment for persistent neuropathic pain, but creating a strain relief loop at the S1 level has thus far been a challenging technical component of DRG lead placement. We describe a refined technique for strain relief loop formation at the S1 level using a transforaminal approach that we employed in a 45-year-old patient with intractable foot pain. We successfully placed a strain relief loop in the sacral space in a predictable and easily reproducible manner using a transforaminal anchorless approach. The patient experienced a decrease in visual analog pain score (85%), and improvement in function during the trial period, and proceeded with permanent implantation. The described sacral transforaminal strain relief loop formation technique appears to be a more reliable and predictable technique of DRG lead placement in the sacrum than those previously documented. © 2017 World Institute of Pain.

Implementation of the evidence review on best practice for confirming the correct placement of nasogastric tube in patients in an acute care hospital.

PubMed

Tho, Poh Chi; Mordiffi, Siti; Ang, Emily; Chen, Helen

2011-03-01

Nasogastric (NG) tube is a device passed through the gastrointestinal tract of patients for the purpose of feeding, gastric decompression and medication administration. However, a small risk involved in the process is that the tube may be misplaced into the trachea during insertion or may get displaced at a later stage, leading to disastrous results. Recent adverse incidences arising out of the misplacement of NG tube raised concerns among the nursing and medical community and the Patient Safety Officer of the hospital. The Evidence Based Nursing Unit, in collaboration with some of the key nursing leaders in nursing administration, was tasked to explore and institute the current best practice in confirming the correct placement of NG tube. The aim of this project was to institute the best practice to confirm the correct placement of NG tube in patients in an acute care hospital setting. The project comprised of a few stages. The first stage involved reviewing the existing recommendations and guidelines on the methods for checking correct NG tube placement. The second stage involved incorporation of the change of practice into the clinical setting. The final stage was to monitor and evaluate the impact of the new practice on the patients, nurses and other healthcare professionals. Evidence search from guidelines and journals supported the test that used pH indicator instead of the litmus test. There is no evidence that supports the method of auscultation and bubbling to confirm correct NG tube placement in the absence of aspirate. Radiology remains the 'gold standard' for checking correct NG tube placement. The revised method of NG tube placement and workflow was incorporated in the revised Standard Operating Procedures. A total of 17 roadshows were conducted to create awareness regarding the new method amongst the nurses, and the implementation of the revised method and workflow was commenced on 3 November 2008. The initial audit conducted 1 month after the practice change was implemented reported 26 (50%) observations of NG tube feeding in 26 audit wards. The key areas of practice change in feeding when tube placement was confirmed (84.6%) and proper testing of aspirate (76.9%) showed good compliance. The implementation of the change in the practice of confirming the correct placement of the NG tube in patients requires good coordination and a multidisciplinary team approach. © 2011 The Authors. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

Umbilical venous catheters placement evaluation on frontal radiogram: application of a simplified flow-chart for radiology residents.

PubMed

Salerno, Sergio; Tudisca, Chiara; Murmura, Elena; Matranga, Domenica; La Tona, Giuseppe; Lo Re, Giuseppe; Lo Casto, Antonio

2017-05-01

Umbilical Venous Catheter (UVC) are commonly used in neonatal period; they can be not correctly positioned and could be associated with complications. The purpose of this article is to suggest a flow-chart to evaluate the placement of UVC, testing it in young radiologists-in-training. We developed a simple flow-chart to asses, steps by step, UVC placement considering its course and tip location (ideally placed in the atriocaval junction). We tested the flow-chart impact asking to 20 residents to evaluate the placement of 10 UVC before and after they familiarized with the flow-chart and the anatomical findings of a newborn. The agreement among the 20 students was evaluated too. The number of correct characterizations was different due to the administration of the flow-chart. One hundred and six correct UVC assessments at the beginning switched to 196 after the administration of the flow-chart (p = 0.0001). The observed agreement among the twenty radiology residents was statistically significant, both before (kappa = 0.41, p < 0.001) and after (kappa = 0.37, p < 0.001) the flow-chart administration. The developed flow-chart demonstrated to be useful in increasing residents performance in UVC placement assessment.

Validation of EncephalApp, Smartphone-Based Stroop Test, for the Diagnosis of Covert Hepatic Encephalopathy.

PubMed

Bajaj, Jasmohan S; Heuman, Douglas M; Sterling, Richard K; Sanyal, Arun J; Siddiqui, Muhammad; Matherly, Scott; Luketic, Velimir; Stravitz, R Todd; Fuchs, Michael; Thacker, Leroy R; Gilles, HoChong; White, Melanie B; Unser, Ariel; Hovermale, James; Gavis, Edith; Noble, Nicole A; Wade, James B

2015-10-01

Detection of covert hepatic encephalopathy (CHE) is difficult, but point-of-care testing could increase rates of diagnosis. We aimed to validate the ability of the smartphone app EncephalApp, a streamlined version of Stroop App, to detect CHE. We evaluated face validity, test-retest reliability, and external validity. Patients with cirrhosis (n = 167; 38% with overt HE [OHE]; mean age, 55 years; mean Model for End-Stage Liver Disease score, 12) and controls (n = 114) were each given a paper and pencil cognitive battery (standard) along with EncephalApp. EncephalApp has Off and On states; results measured were OffTime, OnTime, OffTime+OnTime, and number of runs required to complete 5 off and on runs. Thirty-six patients with cirrhosis underwent driving simulation tests, and EncephalApp results were correlated with results. Test-retest reliability was analyzed in a subgroup of patients. The test was performed before and after transjugular intrahepatic portosystemic shunt placement, and before and after correction for hyponatremia, to determine external validity. All patients with cirrhosis performed worse on paper and pencil and EncephalApp tests than controls. Patients with cirrhosis and OHE performed worse than those without OHE. Age-dependent EncephalApp cutoffs (younger or older than 45 years) were set. An OffTime+OnTime value of >190 seconds identified all patients with CHE with an area under the receiver operator characteristic value of 0.91; the area under the receiver operator characteristic value was 0.88 for diagnosis of CHE in those without OHE. EncephalApp times correlated with crashes and illegal turns in driving simulation tests. Test-retest reliability was high (intraclass coefficient, 0.83) among 30 patients retested 1-3 months apart. OffTime+OnTime increased significantly (206 vs 255 seconds, P = .007) among 10 patients retested 33 ± 7 days after transjugular intrahepatic portosystemic shunt placement. OffTime+OnTime decreased significantly (242 vs 225 seconds, P = .03) in 7 patients tested before and after correction for hyponatremia (126 ± 3 to 132 ± 4 meq/L, P = .01) 10 ± 5 days apart. A smartphone app called EncephalApp has good face validity, test-retest reliability, and external validity for the diagnosis of CHE. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

The 2007 AASM recommendations for EEG electrode placement in polysomnography: impact on sleep and cortical arousal scoring.

PubMed

Ruehland, Warren R; O'Donoghue, Fergal J; Pierce, Robert J; Thornton, Andrew T; Singh, Parmjit; Copland, Janet M; Stevens, Bronwyn; Rochford, Peter D

2011-01-01

To examine the impact of using American Academy of Sleep Medicine (AASM) recommended EEG derivations (F4/M1, C4/M1, O2/M1) vs. a single derivation (C4/M1) in polysomnography (PSG) on the measurement of sleep and cortical arousals, including inter- and intra-observer variability. Prospective, non-blinded, randomized comparison. Three Australian tertiary-care hospital clinical sleep laboratories. 30 PSGs from consecutive patients investigated for obstructive sleep apnea (OSA) during December 2007 and January 2008. N/A. To examine the impact of EEG derivations on PSG summary statistics, 3 scorers from different Australian clinical sleep laboratories each scored separate sets of 10 PSGs twice, once using 3 EEG derivations and once using 1 EEG derivation. To examine the impact on inter- and intra-scorer reliability, all 3 scorers scored a subset of 10 PSGs 4 times, twice using each method. All PSGs were de-identified and scored in random order according to the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Using 3 referential EEG derivations during PSG, as recommended in the AASM manual, instead of a single central EEG derivation, as originally suggested by Rechtschaffen and Kales (1968), resulted in a mean ± SE decrease in N1 sleep of 9.6 ± 3.9 min (P = 0.018) and an increase in N3 sleep of 10.6 ± 2.8 min (P = 0.001). No significant differences were observed for any other sleep or arousal scoring summary statistics; nor were any differences observed in inter-scorer or intra-scorer reliability for scoring sleep or cortical arousals. This study provides information for those changing practice to comply with the 2007 AASM recommendations for EEG placement in PSG, for those using portable devices that are unable to comply with the recommendations due to limited channel options, and for the development of future standards for PSG scoring and recording. As the use of multiple EEG derivations only led to small changes in the distribution of derived sleep stages and no significant differences in scoring reliability, this study calls into question the need to use multiple EEG derivations in clinical PSG as suggested in the AASM manual.

Inmate Prerelease Assessment (IPASS) Aftercare Placement Recommendation as a Predictor of Rural Inmate's 12-Step Attendance and Treatment Entry Postrelease

ERIC Educational Resources Information Center

Oser, Carrie B.; Biebel, Elizabeth P.; Havens, Jennifer R.; Staton-Tindall, Michele; Knudsen, Hannah K.; Mooney, Jenny L.; Leukefeld, Carl G.

2009-01-01

The purpose of this study is to use the Criminal Justice Drug Abuse Treatment Studies' (CJ-DATS) Inmate Prerelease Assessment (IPASS), which recommends either intensive or nonintensive treatment after release, to predict rural offenders' 12-step attendance and treatment entry within six months of release from prison. IPASS scores indicated that…

The Short- and Long-Term Effectiveness of Reading Recovery in a Rural School Setting

ERIC Educational Resources Information Center

Choi, Hee-sook; Bieber, Gregg

2011-01-01

Five years of emergent literacy and literacy data from 2002 to 2007 were reviewed for first through third graders in a small, rural school in the Midwest. Forty first graders had received Reading Recovery services over that time span. Their scores on DIBELS were compared to 41 low average to average students. Subsequent placement in special…

The Evolution of Foreign Language AP Exam Candidates: A 36-Year Descriptive Study

ERIC Educational Resources Information Center

Brown, Alan V.; Thompson, Gregory L.

2016-01-01

Using a data set exclusively prepared for and licensed to them by the College Board, the authors examined the growth of the Advanced Placement program in foreign languages and overall trends in regard to the number of candidates who sat for the foreign language exams, their gender, their scores, and their ethnicity over the 36-year period covering…

Reforming Developmental Education to Better Support Students' Postsecondary Success in the Common Core Era. Core to College Evaluation. Policy Brief

ERIC Educational Resources Information Center

Bracco, Kathy Reeves; Austin, Kim; Bugler, Daniel; Finkelstein, Neal

2015-01-01

When students first enroll in college, they are required to demonstrate readiness for college-level work. Course placement depends on standardized assessments, and students who do not attain a satisfactory score are typically assigned to developmental (e.g. remedial) education courses. The theory behind this approach has been that remedial…

The Effectiveness of the National Board Certification as It Relates to the Advanced Placement Calculus AB Exam

ERIC Educational Resources Information Center

Antunez, Fernando

2015-01-01

This study compared data related to National Board Certification (NBC) of mathematics teachers in a South Florida school district. Data included 1,162 student scores on the 2014 AP Calculus AB exam, student gender, student grade level, and eligibility for free or reduced price lunch (FRL) status. Teachers completed the Standards' Beliefs…

An Examination of Advanced Placement Scores for Black Male Students from Connecticut, Florida, Maryland, Massachusetts, and Texas

ERIC Educational Resources Information Center

Wilson, Jeanine L.

2013-01-01

Purpose: The purpose of this study was to analyze the extent to which differences in student performance were present between Black males in Connecticut, Florida, Maryland, Massachusetts, and Texas on selected AP examinations from the 2001 through the 2012 exam years. Specific AP exams included in this study were the English Language and…

Using the First Exam for Student Placement in Beginning Chemistry Courses

ERIC Educational Resources Information Center

Mills, Pamela; Sweeney, William; Bonner, Sarah M.

2009-01-01

The first exam in a typical first-semester general chemistry course is used to identify students at risk of failing the course. The performance at Hunter College of 667 students on the first exam in general chemistry in seven different classes between fall 2000 and fall 2005 was correlated with the students' final score in the course. The…

The anterolateral acromial approach for fractures of the proximal humerus.

PubMed

Gardner, Michael J; Boraiah, Sreevathsa; Helfet, David L; Lorich, Dean G

2008-02-01

Displaced and unstable fractures of the proximal humerus are notoriously difficult to manage. Successful surgical treatment requires finding the appropriate balance between adequate exposure for reduction and rigid fixation and minimizing soft tissue dissection. The anterolateral acromial approach was developed to allow less invasive treatment of proximal humerus fractures. The plane of the avascular anterior deltoid raphe is utilized, and the axillary nerve is identified and protected. Anterior dissection near the critical blood supply is avoided, substantial muscle retraction is minimized, and the lateral plating zone is directly accessed. Over a 4-year period, 52 patients with acute displaced fractures of the proximal humerus were treated with the anterolateral acromial approach and either a locking plate or an intramedullary nail. Twenty-three patients were evaluated clinically at a minimum follow-up of 1 year (average, 28 months) by clinical examination for range of motion and nerve function and a QuickDASH score. There were no axillary nerve deficits postoperatively related to the approach, and the average QuickDASH score was 25.2 (0, best; 100, worst). This approach allowed direct access to the lateral fracture planes for fracture reduction and plate placement or safe nail and interlocking screw placement.

The Clinical and Service Outcomes of Unilateral and Bilateral ECT Electrode Placements in Australian Aged Psychiatry Services.

PubMed

D'Cunha, Craig; Plakiotis, Christos; Macfarlane, Stephen; Moss, Francine; Reddy, Murali; Singh, Dhiren; Tofler, David; White, Erica; O'Connor, Daniel W

2016-03-01

The aim of the study was to determine whether depressed aged inpatients treated with brief pulse unilateral electroconvulsive therapy (ECT) differed from those treated with bilateral (bitemporal or bifrontal) ECT with respect to numbers of treatments, length of hospital admission, changes in scores on depression and cognitive scales, and serious adverse effects. An audit of routinely collected data regarding 221 acute ECT courses in 7 public aged psychiatry services in Victoria, Australia. Patients given unilateral, bifrontal, and bitemporal treatments were similar with respect to personal, clinical, and treatment characteristics. Most treatments were administered in line with local clinical guidelines and were rated as effective. Psychiatrists preferred unilateral ECT in the first instance with stimulus dosing based on patients' seizure thresholds. Approximately a quarter of unilateral courses were switched later to bitemporal placement, most probably because of insufficient progress. Bilateral treatments were associated with a larger number of treatments, less improvement in scores on mood and cognitive scales, and more refusals to continue treatment than unilateral-only ECT. Brief pulse unilateral ECT proved more effective than bitemporal and bifrontal ECT for most aged patients, especially when coupled with stimulus dosing based on seizure threshold.

Test Scheduling for Core-Based SOCs Using Genetic Algorithm Based Heuristic Approach

NASA Astrophysics Data System (ADS)

Giri, Chandan; Sarkar, Soumojit; Chattopadhyay, Santanu

This paper presents a Genetic algorithm (GA) based solution to co-optimize test scheduling and wrapper design for core based SOCs. Core testing solutions are generated as a set of wrapper configurations, represented as rectangles with width equal to the number of TAM (Test Access Mechanism) channels and height equal to the corresponding testing time. A locally optimal best-fit heuristic based bin packing algorithm has been used to determine placement of rectangles minimizing the overall test times, whereas, GA has been utilized to generate the sequence of rectangles to be considered for placement. Experimental result on ITC'02 benchmark SOCs shows that the proposed method provides better solutions compared to the recent works reported in the literature.

An analysis of predictors of enrollment and successful achievement for girls in high school Advanced Placement physics

NASA Astrophysics Data System (ADS)

Depalma, Darlene M.

A problem within science education in the United States persists. U.S students rank lower in science than most other students from participating countries on international tests of achievement (National Center for Education Statistics, 2003). In addition, U.S. students overall enrollment rate in high school Advanced Placement (AP) physics is still low compared to other academic domains, especially for females. This problem is the background for the purpose of this study. This investigation examined cognitive and motivational variables thought to play a part in the under-representation of females in AP physics. Cognitive variables consisted of mathematics, reading, and science knowledge, as measured by scores on the 10th and 11th grade Florida Comprehensive Assessment Tests (FCAT). The motivational factors of attitude, stereotypical views toward science, self-efficacy, and epistemological beliefs were measured by a questionnaire developed with questions taken from previously proven reliable and valid instruments. A general survey regarding participation in extracurricular activities was also included. The sample included 12th grade students from two high schools located in Seminole County, Florida. Of the 106 participants, 20 girls and 27 boys were enrolled in AP physics, and 39 girls and 20 boys were enrolled in other elective science courses. Differences between males and females enrolled in AP physics were examined, as well as differences between females enrolled in AP physics and females that chose not to participate in AP physics, in order to determine predictors that apply exclusively to female enrollment in high school AP physics and predictors of an anticipated science related college major. Data were first analyzed by Exploratory Factor Analysis, followed by Analysis of Variance (ANOVA), independent t-tests, univariate analysis, and logistic regression analysis. One overall theme that emerged from this research was findings that refute the ideas that females have lower achievement scores, lower attitude, lower self-efficacy, and more stereotypical views regarding science than males. Secondly, the only significant differences found between males and females enrolled in AP physics were for stereotypical views toward science and one factor from the epistemological views questions, both of which favored females. Although the non AP boys significantly outscored non AP girls on science FCAT scores, the only other significant differences found between these groups of students were related to attitude, with the girls scoring higher than the boys on both counts. There were significant differences found for numerous variables between AP and non AP females, however, most of the same differences were found between the two ability groups of male students as well. This leads to the conclusion that these factors certainly play an important role in AP physics enrollment for both genders. But the few significant differences found exclusively between the two female ability groups; reading ability, stereotypical views toward science, and the epistemological beliefs regarding branches of physics being related by common principles and aspects of physics need to be inferred instead of directly measured, may play a more important role in increasing enrollment numbers of females.

Efficacy of a Self-expanding Tract Sealant Device in the Reduction of Pneumothorax and Chest Tube Placement Rates After Percutaneous Lung Biopsy: A Matched Controlled Study Using Propensity Score Analysis.

PubMed

Ahrar, Judy U; Gupta, Sanjay; Ensor, Joe E; Mahvash, Armeen; Sabir, Sharjeel H; Steele, Joseph R; McRae, Stephen E; Avritscher, Rony; Huang, Steven Y; Odisio, Bruno C; Murthy, Ravi; Ahrar, Kamran; Wallace, Michael J; Tam, Alda L

2017-02-01

To evaluate the use of a self-expanding tract sealant device (BioSentry™) on the rates of pneumothorax and chest tube insertion after percutaneous lung biopsy. In this retrospective study, we compared 318 patients who received BioSentry™ during percutaneous lung biopsy (treated group) with 1956 patients who did not (control group). Patient-, lesion-, and procedure-specific variables, and pneumothorax and chest tube insertion rates were recorded. To adjust for potential selection bias, patients in the treated group were matched 1:1 to patients in the control group using propensity score matching based on the above-mentioned variables. Patients were considered a match if the absolute difference in their propensity scores was ≤equal to 0.02. Before matching, the pneumothorax and chest tube rates were 24.5 and 13.1% in the control group, and 21.1 and 8.5% in the treated group, respectively. Using propensity scores, a match was found for 317 patients in the treatment group. Chi-square contingency matched pair analysis showed the treated group had significantly lower pneumothorax (20.8 vs. 32.8%; p = 0.001) and chest tube (8.2 vs. 20.8%; p < 0.0001) rates compared to the control group. Sub-analysis including only faculty who had >30 cases of both treatment and control cases demonstrated similar findings: the treated group had significantly lower pneumothorax (17.6 vs. 30.2%; p = 0.002) and chest tube (7.2 vs. 18%; p = 0.001) rates. The self-expanding tract sealant device significantly reduced the pneumothorax rate, and more importantly, the chest tube placement rate after percutaneous lung biopsy.

Block versus longitudinal integrated clerkships: students' views of rural clinical supervision.

PubMed

Witney, Martin; Isaac, Vivian; Playford, Denese; Walker, Leesa; Garne, David; Walters, Lucie

2018-07-01

Medical students undertaking longitudinal integrated clerkships (LICs) train in multiple disciplines concurrently, compared with students in block rotations who typically address one medical discipline at a time. Current research suggests that LICs afford students increased access to patients and continuity of clinical supervision. However, these factors are less of an issue in rural placements where there are fewer learners. The aim of this study was to compare rural LIC and rural block rotation students' reported experiences of clinical supervision. De-identified data from the 2015 version of the Australian national rural clinical schools (RCSs) exit survey was used to compare students in LICs with those in block rotations in relation to how they evaluate their clinical supervisors and how they rate their own clinical competence. Multivariate general linear modelling showed no association between placement type (LIC versus Block) and reported clinical supervision. The single independent predictor of positive perception of clinical supervisors was choosing an RCS as a first preference. There was also no association between placement type (LIC versus Block) and self-rated clinical competence. Instead, the clinical supervision score and male gender predicted more positive self-ratings of clinical competence. The quality of clinical supervision in block placements and LIC programmes in rural Australian settings was reported by students as equivalent. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Assessment of readability, quality and popularity of online information on ureteral stents.

PubMed

Mozafarpour, Sarah; Norris, Briony; Borin, James; Eisner, Brian H

2018-02-12

To evaluate the quality and readability of online information on ureteral stents. Google.com was queried using the search terms "ureteric stent", "ureteral stent", "double J stent" and, "Kidney stent" derived from Google AdWords. Website popularity was determined using Google Rank and the Alexa tool. Website quality assessment was performed using the following criteria: Journal of the American Medical Association (JAMA) benchmarks, Health on the Net (HON) criteria, and a customized DISCERN questionnaire. The customized DISCERN questionnaire was developed by combining the short validated DISCERN questionnaire with additional stent-specific items including definition, placement, complications, limitations, removal and "when to seek help". Scores related to stent items were considered as the "stent score" (SS). Readability was evaluated using five readability tests. Thirty-two websites were included. The mean customized DISCERN score and "stent score" were 27.1 ± 7.1 (maximum possible score = 59) and 14.6 ± 3.8 (maximum possible score = 24), respectively. A minority of websites adequately addressed "stent removal" and "when to seek medical attention". Only two websites (6.3%) had HON certification (drugs.com, radiologyinfo.org) and only one website (3.3%) met all JAMA criteria (bradyurology.blogspot.com). Readability level was higher than the American Medical Association recommendation of sixth-grade level for more than 75% of the websites. There was no correlation between Google rank, Alexa rank, and the quality scores (P > 0.05). Among the 32 most popular websites on the topic of ureteral stents, online information was highly variable. The readability of many of the websites was far higher than standard recommendations and the online information was questionable in many cases. These findings suggest a need for improved online resources in order to better educate patients about ureteral stents and also should inform physicians that popular websites may have incomplete information.

A Quantitative Comparative Study of Blended and Traditional Models in the Secondary Advanced Placement Statistics Classroom

ERIC Educational Resources Information Center

Owens, Susan T.

2017-01-01

Technology is becoming an integral tool in the classroom and can make a positive impact on how the students learn. This quantitative comparative research study examined gender-based differences among secondary Advanced Placement (AP) Statistic students comparing Educational Testing Service (ETS) College Board AP Statistic examination scores…

Surviving a Midlife Crisis: Advanced Placement Turns Fifty

ERIC Educational Resources Information Center

Mollison, Andrew

2006-01-01

In 1956, 1,220 college-bound juniors and seniors in 104 American high schools took the first Advanced Placement (AP) exams conducted by the Educational Testing Service for the College Board. The AP program was unabashedly elitist and designed to fortify the education of the nation's future leaders in anticipation of Cold War national security…

Large State-Level Fluctuations in Mental Retardation Classifications Related to Introduction of Renormed Intelligence Test

ERIC Educational Resources Information Center

Scullin, Matthew H.

2006-01-01

Oppositely valenced forces may be at work to influence rates of placement of children into mental retardation programs. On one hand, educational policies regarding intellectual disability and concerns about overrepresentation of minorities in special education may contribute to lower placement rates; on the other hand, more difficult intelligence…

Use of sulfur hexafluoride airflow studies to determine the appropriate number and placement of air monitors in an alpha inhalation exposure laboratory

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

Newton, G.J.; Hoover, M.D.

1995-12-01

Determination of the appropriate number and placement of air monitors in the workplace is quite subjective and is generally one of the more difficult tasks in radiation protection. General guidance for determining the number and placement of air sampling and monitoring instruments has been provided by technical reports such as Mishima, J. These two documents and other published guidelines suggest that some insight into sampler placement can be obtained by conducting airflow studies involving the dilution and clearance of the relatively inert tracer gas sulfur hexafluoride (SF{sub 6}) in sampler placement studies and describes the results of a study donemore » within the ITRI alpha inhalation exposure laboratories. The objectives of the study were to document an appropriate method for conducting SF{sub 6} dispersion studies, and to confirm the appropriate number and placement of air monitors and air samplers within a typical ITRI inhalation exposure laboratory. The results of this study have become part of the technical bases for air sampling and monitoring in the test room.« less

Malignant Gastroduodenal Obstruction: Treatment with Self-Expanding Uncovered Wallstent

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

Gutzeit, Andreas, E-mail: Andreas.Gutzeit@ksw.ch; Binkert, Christoph A.; Schoch, Eric

2009-01-15

Purpose: To retrospectively evaluate the clinical effectiveness of a self-expanding uncovered Wallstent in patients with malignant gastroduodenal obstruction. Materials and Methods: Under combined endoscopic and fluoroscopic guidance, 29 patients with a malignant gastroduodenal stenosis were treated with a self-expanding uncovered metallic Wallstent. A dysphagia score was assessed before and after the intervention to measure the success of this palliative therapy. The dysphagia score ranged between grade 0 to grade 4: grade 0 = able to tolerate solid food, grade 1 = able to tolerate soft food, grade 2 = able to tolerate thick liquids, grade 3 = able to toleratemore » water or clear fluids, and grade 4 = unable to tolerate anything perorally. Stent patency and patients survival rates were calculated. Results: The insertion of the gastroduodenal stent was technically successful in 28 patients (96.5%). After stenting, 25 patients (86.2%) showed clinical improvement by at least one score point. During follow-up, 22 (78.5%) of 28 patients showed no stent occlusion until death and did not have to undergo any further intervention. In six patients (20.6%), all of whom were treated with secondary stent insertions, occlusion with tumor ingrowth and/or overgrowth was observed after the intervention. The median period of primary stent patency in our study was 240 days. Conclusion: Placement of an uncovered Wallstent is clinically effective in patients with malignant gastroduodenal obstruction. Stent placement is associated with high technical success, good palliation effect, and high durability of stent function.« less

Enhanced cephalomedullary nail lag screw placement and intraoperative tip-apex distance measurement with a novel computer assisted surgery system.

PubMed

Kuhl, Mitchell; Beimel, Claudia

2016-10-01

The goal of this study was to evaluate the ability of a novel computer assisted surgery system to guide ideal placement of a lag screw during cephalomedullary nailing and then accurately measure the tip-apex distance (TAD) measurement intraoperatively. Retrospective case review. Level II trauma hospital. The initial 98 consecutive clinical cases treated with a cephalomedullary nail in conjunction with a novel computer assisted surgery system were retrospectively reviewed. A novel computer assisted surgery system was utilized to enhance lag screw placement during cephalomedullary nailing procedures. The computer assisted surgery system calculates the TAD intraoperatively after final lag screw placement. The ideal TAD was considered to be within a range of 5mm-20mm. The ability of the computer assisted surgery system (CASS) to assist in placement of a lag screw within the ideal TAD was evaluated. Intraoperative TAD measurements provided by the computer assisted surgery system were then compared to standard postoperative TAD measurements on PACS (picture archiving and communication system) images to determine whether these measurements are equivalent. 79 cases (80.6%) were available with complete information for a retrospective review. All cases had CASS TAD and PACS TAD measurements >5mm and<20mm. In addition, no significant difference could be detected between the intraoperative CASS TAD and the postoperative PACS TAD (p=0.374, Wilcoxon Test; p=0.174, paired T-Test). A cut-out rate of 0% was observed in all patients who were treated with CASS in this case series (95% CI: 0 - 3.01%). The novel computer assisted surgery system tested here is an effective and reliable adjunct that can be utilized for optimal lag screw placement in cephalomedullary nailing procedures. The computer assisted surgery system provides an accurate intraoperative TAD measurement that is equivalent to the standard postoperative measurement utilizing PACS images. Therapeutic Level IV. Copyright © 2016 Elsevier Ltd. All rights reserved.

Auditory development after placement of bone-anchored hearing aids Softband among Chinese Mandarin-speaking children with bilateral aural atresia.

PubMed

Fan, Yue; Zhang, Ying; Wang, Suju; Chen, Xiaowei

2014-01-01

To evaluate auditory developments of Chinese Mandarin-speaking children with congenital bilateral aural atresia after using Bone-anchored hearing aids (Baha) Softband and to compare them with matched peers with normal hearing. Sixteen patients (age ranging from 3 months to 6 years) with bilateral aural atresia and 29 children with normal hearing (age ranging from 8 months to 6 years) were studied. Auditory development was assessed at three time intervals: baseline, 6 months and 12 months. Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) was conducted for children under 4 years old; Meaningful Auditory Integration Scale (MAIS), Chinese Mandarin lexical neighborhood test (MLNT) and sound field pure tone audiometry (PTA) were used for children of 4-6 years old. Mean IT-MAIS scores were 41 ± 24%, 60 ± 22% and 73 ± 7%, respectively at three time intervals. Mean MAIS scores were 66 ± 7%, 90 ± 5%, and 99 ± 2%. Mean speech discrimination scores at the three time intervals were 74 ± 19%, 86 ± 16%, and 95 ± 4% with the easy disyllabic (D-E) list; 48 ± 18%, 73 ± 15%, and 81 ± 7% with the hard disyllabic (D-H) list; 55 ± 17%, 74 ± 22%, and 83 ± 14% with the easy monosyllabic(M-E) list; and 31 ± 14%, 61 ± 15%, and 71 ± 13% with the hard monosyllabic (M-H) list. Baha Softband is suitable for infants and young children with bilateral atresia. Results from these auditory development testing are encouraging. Baha Softband should be used as a bridge for surgical implantations when the temporal bone is thick enough. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Measuring the healthfulness of food retail stores: variations by store type and neighbourhood deprivation

PubMed Central

2014-01-01

Background The consumer nutrition environment has been conceptualised as in-store environmental factors that influence food shopping habits. More healthful in-store environments could be characterised as those which promote healthful food choices such as selling good quality healthy foods or placing them in prominent locations to prompt purchasing. Research measuring the full-range of in-store environmental factors concurrently is limited. Purpose To develop a summary score of ‘healthfulness’ composed of nine in-store factors that influence food shopping behaviour, and to assess this score by store type and neighbourhood deprivation. Methods A cross-sectional survey of 601 retail food stores, including supermarkets, grocery stores and convenience stores, was completed in Hampshire, United Kingdom between July 2010 and June 2011. The survey measured nine variables (variety, price, quality, promotions, shelf placement, store placement, nutrition information, healthier alternatives and single fruit sale) to assess the healthfulness of retail food stores on seven healthy and five less healthy foods that are markers of diet quality. Four steps were completed to create nine individual variable scores and another three to create an overall score of healthfulness for each store. Results Analysis of variance showed strong evidence of a difference in overall healthfulness by store type (p < 0.001). Large and premium supermarkets offered the most healthful shopping environments for consumers. Discount supermarkets, ‘world’, convenience and petrol stores offered less healthful environments to consumers however there was variation across the healthfulness spectrum. No relationship between overall healthfulness and neighbourhood deprivation was observed (p = 0.1). Conclusions A new composite measure of nine variables that can influence food choices was developed to provide an overall assessment of the healthfulness of retail food stores. This composite score could be useful in future research to measure the relationship between main food store and quality of diet, and to evaluate the effects of multi-component food environment interventions. PMID:24884529

Measuring the healthfulness of food retail stores: variations by store type and neighbourhood deprivation.

PubMed

Black, Christina; Ntani, Georgia; Inskip, Hazel; Cooper, Cyrus; Cummins, Steven; Moon, Graham; Baird, Janis

2014-05-23

The consumer nutrition environment has been conceptualised as in-store environmental factors that influence food shopping habits. More healthful in-store environments could be characterised as those which promote healthful food choices such as selling good quality healthy foods or placing them in prominent locations to prompt purchasing. Research measuring the full-range of in-store environmental factors concurrently is limited. To develop a summary score of 'healthfulness' composed of nine in-store factors that influence food shopping behaviour, and to assess this score by store type and neighbourhood deprivation. A cross-sectional survey of 601 retail food stores, including supermarkets, grocery stores and convenience stores, was completed in Hampshire, United Kingdom between July 2010 and June 2011. The survey measured nine variables (variety, price, quality, promotions, shelf placement, store placement, nutrition information, healthier alternatives and single fruit sale) to assess the healthfulness of retail food stores on seven healthy and five less healthy foods that are markers of diet quality. Four steps were completed to create nine individual variable scores and another three to create an overall score of healthfulness for each store. Analysis of variance showed strong evidence of a difference in overall healthfulness by store type (p < 0.001). Large and premium supermarkets offered the most healthful shopping environments for consumers. Discount supermarkets, 'world', convenience and petrol stores offered less healthful environments to consumers however there was variation across the healthfulness spectrum. No relationship between overall healthfulness and neighbourhood deprivation was observed (p = 0.1). A new composite measure of nine variables that can influence food choices was developed to provide an overall assessment of the healthfulness of retail food stores. This composite score could be useful in future research to measure the relationship between main food store and quality of diet, and to evaluate the effects of multi-component food environment interventions.

First-line endoscopic treatment with over-the-scope clips significantly improves the primary failure and rebleeding rates in high-risk gastrointestinal bleeding: A single-center experience with 100 cases

PubMed Central

Richter-Schrag, Hans-Jürgen; Glatz, Torben; Walker, Christine; Fischer, Andreas; Thimme, Robert

2016-01-01

AIM To evaluate rebleeding, primary failure (PF) and mortality of patients in whom over-the-scope clips (OTSCs) were used as first-line and second-line endoscopic treatment (FLET, SLET) of upper and lower gastrointestinal bleeding (UGIB, LGIB). METHODS A retrospective analysis of a prospectively collected database identified all patients with UGIB and LGIB in a tertiary endoscopic referral center of the University of Freiburg, Germany, from 04-2012 to 05-2016 (n = 93) who underwent FLET and SLET with OTSCs. The complete Rockall risk scores were calculated from patients with UGIB. The scores were categorized as < or ≥ 7 and were compared with the original Rockall data. Differences between FLET and SLET were calculated. Univariate and multivariate analysis were performed to evaluate the factors that influenced rebleeding after OTSC placement. RESULTS Primary hemostasis and clinical success of bleeding lesions (without rebleeding) was achieved in 88/100 (88%) and 78/100 (78%), respectively. PF was significantly lower when OTSCs were applied as FLET compared to SLET (4.9% vs 23%, P = 0.008). In multivariate analysis, patients who had OTSC placement as SLET had a significantly higher rebleeding risk compared to those who had FLET (OR 5.3; P = 0.008). Patients with Rockall risk scores ≥ 7 had a significantly higher in-hospital mortality compared to those with scores < 7 (35% vs 10%, P = 0.034). No significant differences were observed in patients with scores < or ≥ 7 in rebleeding and rebleeding-associated mortality. CONCLUSION Our data show for the first time that FLET with OTSC might be the best predictor to successfully prevent rebleeding of gastrointestinal bleeding compared to SLET. The type of treatment determines the success of primary hemostasis or primary failure. PMID:27895403

Placement and Delinquency Outcomes Among System-Involved Youth Referred to Multisystemic Therapy: A Propensity Score Matching Analysis.

PubMed

Vidal, Sarah; Steeger, Christine M; Caron, Colleen; Lasher, Leanne; Connell, Christian M

2017-11-01

Multisystemic therapy (MST) was developed to help youth with serious social, emotional, and behavioral problems. Research on the efficacy and effectiveness of MST has shown positive outcomes in different domains of development and functioning among various populations of youth. Nonetheless, even with a large body of literature investigating the treatment effects of MST, few studies have focused on the effectiveness of MST through large-scale dissemination efforts. Utilizing a large sample of youth involved in a statewide dissemination of MST (n = 740; 43% females; 14% Black; 29% Hispanic; 49% White; M age  = 14.9 years), propensity score matching was employed to account for baseline differences between the treatment (n = 577) and comparison (n = 163) groups. Treatment effects were examined based on three outcomes: out-of-home placement, adjudication, and placement in a juvenile training school over a 6-year period. Significant group differences remained after adjusting for baseline differences, with youth who received MST experiencing better outcomes in offending rates than youth who did not have an opportunity to complete MST due to non-clinical or administrative reasons. Survival analyses revealed rates of all three outcomes were approximately 40% lower among the treatment group. Overall, this study adds to the body of literature supporting the long-term effectiveness of MST in reducing offending among high-risk youth. The findings underscore the potential benefits of taking evidence-based programs such as MST to scale to improve the well-being and functioning of high-risk youth. However, strategies to effectively deliver the program in mental health service settings, and to address the specific needs of high-risk youth are necessary.

Residual hemothorax after chest tube placement correlates with increased risk of empyema following traumatic injury

PubMed Central

Karmy-Jones, Riyad; Holevar, Michele; Sullivan, Ryan J; Fleisig, Ani; Jurkovich, Gregory J

2008-01-01

BACKGROUND: Empyema complicates tube thoracostomy following trauma in up to 10% of cases. Studies of potential risk factors of empyema have included use of antibiotics, site of injury and technique of chest tube placement. Residual fluid has also been cited as a risk factor for empyema, although the imaging technique to identify this varies. OBJECTIVE: To determine whether residual hemothorax detected by chest x-ray (CXR) after one or more initial chest tubes predicts an increased risk of empyema. METHODS: A study of patients admitted to two level I trauma centres between January 7, 2004, and December 31, 2004, was conducted. All patients who received a chest tube in the emergency department, did not undergo thoracotomy within 24 h, and survived more than two days were followed. Empyema was defined as a pleural effusion with positive cultures, and a ratio of pleural fluid lactate dehydrogenase to serum lactate dehydrogenase greater than 0.6 in the setting of elevated leukocyte count and fever. Factors analyzed included the presence of retained hemothorax on CXR after the most recent tube placement in the emergency room, age, mechanism of injury and injury severity score. RESULTS: A total of 102 patients met the criteria. Nine patients (9%) developed empyema: seven of 21 patients (33%) with residual hemothorax developed empyema versus two of 81 patients (2%) without residual hemothorax developed empyema (P=0.001). Injury severity score was significantly higher in those who developed empyema (31.4±26) versus those who did not (22.6±13; P=0.03). CONCLUSIONS: The presence of residual hemothorax detected by CXR after tube thoracostomy should prompt further efforts, including thoracoscopy, to drain it. With increasing injury severity, there may be increased benefit in terms of reducing empyema with this approach. PMID:18716687

The Effect of Listening to Music During Percutaneous Nephrostomy Tube Placement on Pain, Anxiety, and Success Rate of Procedure: A Randomized Prospective Study.

PubMed

Hamidi, Nurullah; Ozturk, Erdem

2017-05-01

To evaluate the effect of listening to music on pain, anxiety, and success of procedure during office-based percutaneous nephrostomy tube placement (PNTP). One hundred consecutive patients (age >18 years) with hydronephrosis were prospectively enrolled in this study. All patients were prospectively randomized to undergo office-based PNTP with (Group I, n = 50) or without music (Group II, n = 50). Anxiety levels were evaluated with State Trait Anxiety Inventory. A visual analog scale was used to evaluate pain levels, patient's satisfaction, and willingness to undergo the procedure. We also compared success rates of procedures. The mean age, duration of procedure, and gender distribution were statistically similar between the two groups. The mean postprocedural heart rates and systolic blood pressures in Group I patients were significantly lower than Group II patients (p = 0.01 and p = 0.028, respectively), whereas preprocedural pulse rate and systolic blood pressure were similar. The mean anxiety level and mean pain score of Group I were significantly lower than those of Group II (p = 0.008 and p < 0.001, respectively). Group I also carried a significant greater mean satisfaction score and willingness to undergo repeat procedure compared with Group II (p < 0.001 for both). Success rate of nephrostomy tube placement in Group I was significantly higher compared with Group II (92% vs 66%, p = 0.04). The present randomized prospective study demonstrates that listening to music during office-based PNTP decreases anxiety or pain and increases success rate of procedure. As an alternative to sedation or general anesthesia, music is easily accessible without side effect and cost.

A Novel Minimally Invasive Wireless Technology for Neuromodulation via Percutaneous Intercostal Nerve Stimulation for Post-Herpetic Neuralgia: A Case Report with Short-Term Follow-up.

PubMed

Billet, Bart; Wynendaele, Roel; Vanquathem, Niek E

2018-03-01

Peripheral nerve stimulation of primary afferent neurons provides control of localized chronic pain. This technique applies permanent electrical stimulation at the target area via a minimally invasive, subcutaneous placement of an electrode. To assess the analgesic effects of minimally invasive wireless neuromodulation in the treatment of chronic intractable pain secondary to post-herpetic neuralgia. A 78-year-old man presented with severe intractable post-herpetic neuralgic pain. He was known to have non-Hodgkin's lymphoma under remission following treatment with chemotherapy and stem cell transplantation, twice. He also developed steroid-induced diabetes mellitus during this treatment. In view of his compromised immune status, he was deemed a suitable candidate for our minimally invasive neuromodulation technology. Two subcutaneous electrodes were placed on the right-hand side of the trunk, 10 cm medial and parallel to the spinous process at the level of T7-T8 under fluoroscopic guidance along the T7 intercostal nerve. The external transmitter was worn with a belt over a single layer of clothing and used to transmit power to the stimulator. The entire procedure required only a small incision for the introduction of the electrode placement. After an uneventful procedure, the pain score decreased from 8 to 3, with a reduction in pain medication. The EuroQol Five Dimensions Questionnaire scores were 0.102 before the trial, 0.630 at 1 month, and 0.576 at 3 months. Subcutaneous placement of electrodes with our minimally invasive technique and wireless neuromodulation technology was safe and effective. Significant improvements in pain relief ensued, and no further adverse events had been reported at the end of 3 months' follow-up. © 2017 World Institute of Pain.

Predictors of outcomes in patients undergoing covered and uncovered self-expandable metal stent placement for malignant gastric outlet obstruction: a multicenter study.

PubMed

Hori, Yasuki; Naitoh, Itaru; Hayashi, Kazuki; Ban, Tesshin; Natsume, Makoto; Okumura, Fumihiro; Nakazawa, Takahiro; Takada, Hiroki; Hirano, Atsuyuki; Jinno, Naruomi; Togawa, Shozo; Ando, Tomoaki; Kataoka, Hiromi; Joh, Takashi

2017-02-01

Uncovered self-expandable metal stents (U-SEMSs) and covered self-expandable metal stents (C-SEMSs) are available for palliative therapy for malignant gastric outlet obstruction (GOO). However, clinical differences and indications between the 2 types of SEMSs have not been elucidated. We retrospectively compared 126 patients with U-SEMS and 126 patients with C-SEMSs with regard to clinical outcome and factors predictive of clinical improvement after SEMSs placement. No significant difference was observed between the U-SEMS and C-SEMS groups with respect to technical success, clinical success, GOO score, or time to stent dysfunction. Stent migration was significantly more frequent in patients with C-SEMSs (U-SEMSs, .79%; C-SEMSs, 8.73%; P = .005). Karnofsky performance status, chemotherapy, peritoneal dissemination, and stent expansion ≤ 30% were associated significantly with poor GOO score improvement in multivariable analyses, but stent type was not (P = .213). In subgroup analyses, insufficient (≤30%) stent expansion was an independent factor in patients with U-SEMSs (P = .041) but not C-SEMSs. In the insufficient stent expansion subgroup, C-SEMSs was associated significantly with superior clinical improvement compared with U-SEMSs (P = .01). Insufficient stent expansion was observed more frequently in patients with GI obstruction because of anastomotic sites or metastatic cancer (44.8% [13/29], P = .001). No clinical difference, apart from stent migration, was observed between patients with U-SEMSs and C-SEMSs. GI obstruction because of an anastomotic site or metastatic cancer may be an indication for C-SEMS use to improve oral intake after SEMSs placement. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Stenting versus non-stenting following uncomplicated ureteroscopic lithotripsy: Comparsion and evaluation of symptoms.

PubMed

Savić, Slaviša; Vukotić, Vinka; Lazić, Miodrag; Savić, Nataša

2016-09-01

Currently, ureterorenoscopic (URS) stone fragmentation and removal is the treatment of choice for managing ureteral stones, especially mid and distal ones and is advocated as initial management of ureteric stones. The aim of this work was to evaluate the symptoms, necessity, potential benefits and adverse effects of ureteral stent placement after uncomplicated ureteroscopic lithotripsy. This retrospective-prospective study evaluated a total of 125 patients who had underwent ureteroscopic lithotripsy (URSL). The patients were divided into two groups: stented (59 patients) and unstented (controls, 66 patients). The outcomes measured and compared between the two groups included: stone free rate, postoperative patient pain validated by scale, lower urinary tract symptoms (LUTS), the need for unplanned hospital care, stent related complications, and functional recovery in the form return to normal physical activities. A successful outcome, defined as being stonefree after 12 weeks, was achieved in all 125 (100%) patients. The stone-free rate showed no significant differences between the two groups. LUTS was frequent complaint in the stented group, with statistically significant difference in the domain of frequency/urgency (p = 0.0314). There was a statistically significant difference between the groups in the mean operative time and mean hospitalization time, mean pain visual analog scale (VAS) score and in the use of nonnarcotic analgesic. On the day of the surgery and until postoperative day 3 (POD 3) and postoperative day 5 (POD 5), the pain score was much higher among stented patients than among the controls (p = 0.0001) and non-narcotic analgesic use (p = 0.001) was frequently required in the stented group. Routine placement of ureteral stent after URSL is not mandatory and may be associated with stent side effects. Uncomplicated URSL is safe without stent placement after the treatment.

Connective tissue grafts for thickening peri-implant tissues at implant placement. One-year results from an explanatory split-mouth randomised controlled clinical trial.

PubMed

Wiesner, Günter; Esposito, Marco; Worthington, Helen; Schlee, Markus

2010-01-01

Nothing to declare. To evaluate whether connective tissue grafts performed at implant placement could be effective in augmenting peri-implant soft tissues. Ten partially edentulous patients requiring at least one single implant in the premolar or molar areas of both sides of the mandible were randomised to have one side augmented at implant placement with a connective soft tissue graft harvested from the palate or no augmentation. After 3 months of submerged healing, abutments were placed and within 1 month definitive crowns were permanently cemented. Outcome measures were implant success, any complications, peri-implant marginal bone level changes, patient satisfaction and preference, thickness of the soft tissues and aesthetics (pink aesthetic score) evaluated by an independent and blinded assessor 1 year after loading. One year after loading, no patients dropped out, no implants failed and no complications occurred. Both groups lost statistically significant amounts of peri-implant bone 1 year after loading (0.8 mm in the grafted group and 0.6 mm in the non-grafted group), but there was no statistically significant difference between groups. Soft tissues at augmented sites were 1.3 mm thicker (P < 0.001) and had a significantly better pink aesthetic score (P < 0.001). Patients were highly satisfied (no statistically significant differences between treatments) though they preferred the aesthetics of the augmented sites (P = 0.031). However, five patients would not undergo the grafting procedure again and two were uncertain. Connective tissue grafts are effective in increasing soft tissue thickness, thus improving aesthetics. Longer follow-ups are needed to evaluate the stability of peri-implant tissues over time.

Tutoring Trainees to Suture: An Alternative Method for Learning How to Suture and a Way to Compensate for a Lack of Suturing Cases.

PubMed

Wongkietkachorn, Apinut; Rhunsiri, Peera; Boonyawong, Pangpoom; Lawanprasert, Attaporn; Tantiphlachiva, Kasaya

2016-01-01

Tutoring in suturing was developed to compensate for a shortage of suturing cases. The objective of this study was to compare ideal suturing score (ISS; 9 points), suturing time (min:sec), and suture placement error (mm) between medical students completing the suturing tutoring program and medical students attending ordinary medical school training program. Participants consisted of 2 groups of medical students who had never performed suturing. The study group had the role of suturing tutor to teach interested high school students. The control group consisted of volunteers from the ordinary medical school program. Skills measurement was performed by having students from both the groups perform 3 vertical mattress sutures on a model. The study group was tested at weeks 1, 9, and 10 to assess improvement. Both the groups were tested at week 10 to compare final learning outcome. There were 41 and 40 participants in the study group and the control group, respectively. ISS was significantly improved in the study group from week 1-week 10 (7.0 ± 1.3 vs. 8.2 ± 0.9, p = 0.01). At week 10, the study group had a higher mean ISS than the control group (8.2 ± 0.9 vs. 7.8 ± 1.1, p = 0.68). Mean suturing time and mean placement error were also lower in the study group at the end of suturing training (5:1 ± 1:0 vs. 5:2 ± 1:2, p = 0.13; 7.4 ± 7.4 vs. 8.0 ± 10.8, p = 0.44). Tutoring trainees to suture can improve a student's ability to learn how to suture. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Accuracy of pedicle screw insertion in the thoracic and lumbar spine: a comparative study between percutaneous screw insertion and conventional open technique.

PubMed

Ikeuchi, Hiroko; Ikuta, Ko

2016-09-01

In the last decade, posterior instrumented fusion using percutaneous pedicle screws (PPSs) had been growing in popularity, and its safety and good clinical results have been reported. However, there have been few previous reports of the accuracy of PPS placement compared with that of conventional open screw insertion in an institution. This study aimed to evaluate the accuracy of PPS placement compared with that of conventional open technique. One hundred patients were treated with posterior instrumented fusion of the thoracic and lumbar spine from April 2008 to July 2013. Four cases of revised instrumentation surgery were excluded. In this study, the pedicle screws inserted below Th7 were investigated, therefore, a total of 455 screws were enrolled. Two hundred and ninety-three pedicle screws were conventional open-inserted screws (O-group) and 162 screws were PPSs (P-group). We conducted a comparative study about the accuracy of placement between the two groups. Postoperative computed tomography scans were carried out to all patients, and the pedicle screw position was assessed according to a scoring system described by Zdichavsky et al. (Eur J Trauma 30:241-247, 2004; Eur J Trauma 30:234-240, 2004) and a classification described by Wiesner et al. (Spine 24:1599-1603, 1999). Based on Zdichavsky's scoring system, the number of grade Ia screws was 283 (96.6 %) in the O-group and 153 (94.4 %) in the P-group, whereas 5 screws (1.7 %) in the O-group and one screw (0.6 %) in the P-group were grade IIIa/IIIb. Meanwhile, the pedicle wall penetrations based on Wiesner classification were demonstrated in 20 screws (6.8 %) in the O-group, and 12 screws (7.4 %) in the P-group. No neurologic complications were observed and no screws had to be replaced in both groups. The PPSs could be ideally inserted without complications. There were no statistically significant differences about the accuracy between the conventional open insertion and PPS placement.

Midwifery students׳ experiences of an innovative clinical placement model embedded within midwifery continuity of care in Australia.

PubMed

Carter, Amanda G; Wilkes, Elizabeth; Gamble, Jenny; Sidebotham, Mary; Creedy, Debra K

2015-08-01

midwifery continuity of care experiences can provide high quality clinical learning for students but can be challenging to implement. The Rural and Private Midwifery Education Project (RPMEP) is a strategic government funded initiative to (1) grow the midwifery workforce within private midwifery practice and rural midwifery, by (2) better preparing new graduates to work in private midwifery and rural continuity of care models. this study evaluated midwifery students׳ experience of an innovative continuity of care clinical placement model in partnership with private midwifery practice and rural midwifery group practices. a descriptive cohort design was used. All students in the RPMEP were invited to complete an online survey about their experiences of clinical placement within midwifery continuity models of care. Responses were analysed using descriptive statistics. Correlations between total scale scores were examined. Open-ended responses were analysed using content analysis. Internal reliability of the scales was assessed using Cronbach׳s alpha. sixteen out of 17 completed surveys were received (94% response rate). Scales included in the survey demonstrated good internal reliability. The majority of students felt inspired by caseload approaches to care, expressed overall satisfaction with the mentoring received and reported a positive learning environment at their placement site. Some students reported stress related to course expectations and demands in the clinical environment (e.g. skill acquisition and hours required for continuity of care). There were significant correlations between scales on perceptions of caseload care and learning culture (r=.87 p<.001) and assessment (r=.87 p<.001). Scores on the clinical learning environment scale were significantly correlated with perceptions of the caseload model (rho=.86 p<.001), learning culture (rho=.94 p<.001) and assessment (rho=.65 p<.01) scales. embedding students within midwifery continuity of care models was perceived to be highly beneficial to learning, developed partnerships with women, and provided appropriate clinical skills development required for registration, while promoting students׳ confidence and competence. The flexible academic programme enabled students to access learning at any time and prioritise continuity of care experiences. Strategies are needed to better support students achieve a satisfactory work-life balance. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Structural Assessment of Advanced Composite Tow-Steered Shells

NASA Technical Reports Server (NTRS)

Wu, K. Chauncey; Stanford, Bret K.; Hrinda, Glenn A.; Wang, Zhuosong; Martin, Robert a.; Kim, H. Alicia

2013-01-01

The structural performance of two advanced composite tow-steered shells, manufactured using a fiber placement system, is assessed using both experimental and analytical methods. The fiber orientation angles vary continuously around the shell circumference from 10 degrees on the shell crown and keel, to 45 degrees on the shell sides. The two shells differ in that one shell has the full 24-tow course applied during each pass of the fiber placement system, while the second shell uses the fiber placement system s tow drop/add capability to achieve a more uniform shell wall thickness. The shells are tested in axial compression, and estimates of their prebuckling axial stiffnesses and bifurcation buckling loads are predicted using linear finite element analyses. These preliminary predictions compare well with the test results, with an average agreement of approximately 10 percent.

The effects of departmentalized and self-contained classrooms on fifth-grade students' achievement in science on the Georgia Criterion Referenced Competency Test

NASA Astrophysics Data System (ADS)

Koch, Lisa S.

Elementary instruction of fifth grade classrooms was found to be primarily in two organizational models in a school district northwest of Atlanta, Georgia. The self-contained classroom provided a generalist teacher responsible for the instruction of all academic subjects to one group of students throughout the day, while departmentalized classrooms were structured utilizing one teacher for the instruction of one or two content areas, and students rotated throughout the day for each of the academic subjects. The majority of studies looking at the effect of instructional organization were concentrated in the content areas of mathematics and reading. This quantitative study, utilized an ex post facto methodology to determine whether fifth grade students attending departmentalized schools or self-contained classrooms had higher student achievement in science as measured by the Georgia Criterion Referenced Competency Test (CRCT). The statistical data was collected through the Georgia Department of Education and included raw mean scores of over 500 students attending departmentalized schools and 500 students attending self-contained classrooms, along with the various subgroups such as gender, ethnicity status, English language learners (ELL), and students with disability (SWD) placement. This data was analyzed to show if a significant statistical difference emerged from either instructional organization. The overall results that emerged from the archival data suggested no significant difference in student achievement existed for almost all subgroups tested of the total 1000+ participant scores used in the study. The results also did however, showed the departmentalization model of instruction had a slight advantage over self-contained classrooms for male students with disabilities.

Motivation and Study Habits of College Calculus Students: Does Studying Calculus in High School Make a Difference?

ERIC Educational Resources Information Center

Gibson, Megan

2013-01-01

Due in part to the growing popularity of the Advanced Placement program, an increasingly large percentage of entering college students are enrolling in calculus courses having already taken calculus in high school. Many students do not score high enough on the AP calculus examination to place out of Calculus I, and many do not take the…

Virtobot 2.0: the future of automated surface documentation and CT-guided needle placement in forensic medicine.

PubMed

Ebert, Lars Christian; Ptacek, Wolfgang; Breitbeck, Robert; Fürst, Martin; Kronreif, Gernot; Martinez, Rosa Maria; Thali, Michael; Flach, Patricia M

2014-06-01

In this paper we present the second prototype of a robotic system to be used in forensic medicine. The system is capable of performing automated surface documentation using photogrammetry, optical surface scanning and image-guided, post-mortem needle placement for tissue sampling, liquid sampling, or the placement of guide wires. The upgraded system includes workflow optimizations, an automatic tool-change mechanism, a new software module for trajectory planning and a fully automatic computed tomography-data-set registration algorithm. We tested the placement accuracy of the system by using a needle phantom with radiopaque markers as targets. The system is routinely used for surface documentation and resulted in 24 surface documentations over the course of 11 months. We performed accuracy tests for needle placement using a biopsy phantom, and the Virtobot placed introducer needles with an accuracy of 1.4 mm (±0.9 mm). The second prototype of the Virtobot system is an upgrade of the first prototype but mainly focuses on streamlining the workflow and increasing the level of automation and also has an easier user interface. These upgrades make the Virtobot a potentially valuable tool for case documentation in a scalpel-free setting that uses purely imaging techniques and minimally invasive procedures and is the next step toward the future of virtual autopsy.

The sensitivity of motor response to needle nerve stimulation during ultrasound guided interscalene catheter placement.

PubMed

Fredrickson, Michael J

2008-01-01

Neurostimulation during single shot interscalene block has a significant false negative motor response rate. Compared with tangential needle approaches for single shot block, interscalene catheter (ISC) placement commonly involves Tuohy needles inserted longitudinally to the brachial plexus. This study aimed to determine the sensitivity of neurostimulation during ultrasound-guided ISC needle placement, and the feasibility of an ultrasound-guided ISC needle endpoint. One hundred fifty-five consecutive nonstimulating ISCs were placed with the needle tip position confirmed by the sonographic spread of 5 mL dextrose 5%. Catheter advancement was then blind 2 to 3 cm past the needle tip. A 0.8 mA electrical stimulus at 2 Hz was applied throughout. When a satisfactory image was obtained, neurostimulation was ignored and the minimum motor response amplitude noted. If imaging was equivocal, a brief appropriate motor response at 0.8 mA was sought. A sustained response at <0.5 mA was only sought if imaging was suboptimal. Prior to surgery conducted under general anesthesia, 30 mL ropivacaine 0.5% was administered through the ISC. Catheter success was defined as a recovery room numerical rating pain score of

Dilation or biodegradable stent placement for recurrent benign esophageal strictures: a randomized controlled trial.

PubMed

Walter, Daisy; van den Berg, Maarten W; Hirdes, Meike M; Vleggaar, Frank P; Repici, Alessandro; Deprez, Pierre H; Viedma, Bartolomé L; Lovat, Laurence B; Weusten, Bas L; Bisschops, Raf; Haidry, Rehan; Ferrara, Elisa; Sanborn, Keith J; O'Leary, Erin E; van Hooft, Jeanin E; Siersema, Peter D

2018-06-08

 Dilation is the standard of care for recurrent benign esophageal strictures (BES). Biodegradable stents may prolong the effect of dilation and reduce recurrences. Efficacy and safety of dilation and biodegradable stent placement early in the treatment algorithm of recurrent BES were compared.  This multicenter, randomized study enrolled patients with BES treated with previous dilations to ≥ 16 mm. The primary end point was number of repeat endoscopic dilations for recurrent stricture within 3 and 6 months. Secondary outcomes through 12 months included safety, time to first dilation for recurrent stricture, dysphagia, and level of activity.  At 3 months, the biodegradable stent group (n = 32) underwent significantly fewer endoscopic dilations for recurrent stricture compared with the dilation group (n = 34; P  < 0.001). By 6 months, the groups were similar. The number of patients experiencing adverse events was similar between the groups. Two patients in the biodegradable stent group died after developing tracheoesophageal fistulas at 95 and 96 days post-placement; no deaths were attributed to the stent. Median time to first dilation of recurrent stricture for the biodegradable stent group was significantly longer (106 vs. 41.5 days; P  = 0.003). Dysphagia scores improved for both groups. Patients in the biodegradable stent group had a significantly higher level of activity through 12 months ( P  < 0.001).  Biodegradable stent placement is associated with temporary reduction in number of repeat dilations and prolonged time to recurrent dysphagia compared with dilation. Additional studies are needed to better define the exact role of biodegradable stent placement to treat recurrent BES. © Georg Thieme Verlag KG Stuttgart · New York.

Educational Placement after Pediatric Intracerebral Hemorrhage

PubMed Central

Hawks, Charlotte; Jordan, Lori C.; Gindville, Melissa; Ichord, Rebecca N.; Licht, Daniel J.; Beslow, Lauren A.

2016-01-01

Objectives This study describes educational placement of school-aged children after spontaneous intracerebral hemorrhage (ICH) and examines whether educational placement is associated with severity of neurological deficits. Methods Children with spontaneous ICH presenting from 2007 to 2013 were prospectively enrolled at 3 tertiary children’s hospitals. The pediatric stroke outcome measure (PSOM) and a parental questionnaire gathered information about neurological outcome, school attendance, and educational placement. Results The cohort of 92 enrolled children included 42 school-aged children (6–17 years) with ICH. Four died; 1 was excluded due to preexisting cognitive deficits. Thirty-seven completed 3-month follow-up, and 30 completed 12-month follow-up. At 12 months, 14 (46.7%) received regular age-appropriate programming, 12 (40%) attended school with in-class services, 3 (10%) were in special education programs, and one child (3.3%) received home-based services due to ICH-related deficits. Of 30 children with 3-month and 12-month follow-up, 14 children (46.7%) improved their education status, 13 (43.3%) remained at the same education level, and 3 (10%) began to receive in-class services. Increasing PSOM score predicted the need for educational modifications at 3 months (OR 3.3, 95% CI 1.4–7.9, p=0.007) and at 12 months (OR 2.1, 95% CI 1.1–3.9, p=0.025). Conclusions Most children returned to school within a year after ICH and many had a reduction in the intensity of educational support. However, a great need for educational services persisted at 12 months after ICH with fewer than half enrolled in regular age-appropriate classes. Worse deficits on the PSOM were associated with remedial educational placement. PMID:27262667

Combination of biodegradable stent placement and single-dose brachytherapy is associated with an unacceptably high complication rate in the treatment of dysphagia from esophageal cancer.

PubMed

Hirdes, Meike M C; van Hooft, Jeanin E; Wijrdeman, Harm K; Hulshof, Maarten C C M; Fockens, Paul; Reerink, Onne; van Oijen, Martijn G H; van der Tweel, Ingeborg; Vleggaar, Frank P; Siersema, Peter D

2012-08-01

For the palliative treatment of dysphagia, esophageal stent placement provides immediate improvement, whereas brachytherapy offers better long-term relief. To evaluate safety and efficacy of concurrent brachytherapy and biodegradable stent placement. Prospective, single-arm study. Two tertiary-care referral centers. Nineteen consecutive patients with significant dysphagia resulting from unresectable esophageal cancer, with a life expectancy of more than 3 months. Single-dose brachytherapy (12 Gy) on day 1 followed by biodegradable stent placement on day 2. Intervention-related major complications (determined by an expert panel) and dysphagia. Nineteen patients (13 men, median age 66 years [interquartile range (IQR) 59-71] years) were included; 7 patients (37%) also received palliative chemotherapy. After inclusion of 19 patients, the study was ended prematurely because the safety threshold was exceeded. In total, 28 major complications occurred in 17 patients (89%). In 9 patients (47%), major complications were determined intervention-related (severe retrosternal pain with or without vomiting [n = 6], hematemesis [n = 1], recurrent dysphagia [n = 2]. Dysphagia scores decreased significantly from a median of 3 (IQR 3-4) to a median of 1 (IQR 0-3) after 1 month (P < .001). Despite adequate luminal patency in 17 patients (89%), normal diet could not be tolerated in 7 patients (37%) because of retrosternal pain and vomiting. Lack of routine endoscopy or contrast esophagram to evaluate recurrent dysphagia during follow-up. Despite restoration of luminal patency, a combined treatment of brachytherapy and biodegradable stent placement cannot be recommended for the palliative treatment of esophageal cancer because of an unacceptably high intervention-related major complication rate. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Esophageal leiomyoma in a dog causing esophageal distension and treated by transcardial placement of a self-expanding, covered, nitinol esophageal stent.

PubMed

Robin, Elisabeth M; Pey, Pascaline B; de Fornel-Thibaud, Pauline; Moissonnier, Pierre H M; Freiche, Valérie

2018-02-01

CASE DESCRIPTION A 10-year-old spayed female Rottweiler was referred for evaluation because of a 2-month history of regurgitation and weight loss, despite no apparent change in appetite. The dog had received antiemetic and antacid treatment, without improvement. CLINICAL FINDINGS Physical examination revealed a low body condition score (2/5), but other findings were unremarkable. Diffuse, global esophageal dilatation was noted on plain thoracic radiographs, and normal motility was confirmed through videofluoroscopic evaluation of swallowing. Transhepatic ultrasonographic and CT examination revealed a circumferential, intraparietal lesion in the distal portion of the esophagus causing distal esophageal or cardial subobstruction and no metastases. Incisional biopsy of the lesion was performed, and findings of histologic examination supported a diagnosis of esophageal leiomyoma. TREATMENT AND OUTCOME In view of numerous possible complications associated with esophageal surgery, the decision was made to palliatively treat the dog by transcardial placement of a self-expanding, covered, nitinol esophageal stent under endoscopic guidance. Two weeks after stent placement, radiography revealed complete migration of the stent into the gastric lumen. Gastrotomy was performed, and the stent was replaced and fixed in place. Twenty-four months after initial stent placement, the dog had a healthy body condition and remained free of previous clinical signs. CLINICAL RELEVANCE Diffuse benign muscular neoplasia should be considered as a differential diagnosis for acquired esophageal dilatation in adult and elderly dogs. In the dog of this report, transcardial stent placement resulted in resolution of the clinical signs, with no apparent adverse effect on digestive function. The described procedure could be beneficial for nonsurgical treatment of benign esophageal tumors in dogs.

English Reading Placement Recommendations at College of the Canyons: An Analysis of Disproportionate Impact.

ERIC Educational Resources Information Center

Gerda, Joseph

A study was undertaken at California's College of the Canyons (CC) to determine whether evidence existed of disproportionate impact in English reading course placement based on student ethnicity, gender, or age. Data were compiled for all 4,312 students tested between spring 1993 and fall 1995, while the standard for disproportionate impact was…

Intercorrelation of the WISC-R and the Renzulli-Hartman Scale for Determination of Gifted Placement.

ERIC Educational Resources Information Center

Lowrance, Dan; Anderson, Howard N.

In order to compare the Wechsler Intelligence Scale for Children--Revised (WISC-R) and the Renzulli-Hartman Scale for Determination of Gifted Placement, 192 potentially gifted elementary students were rated on both tests. A correlation matrix indicated that one of the four subscales of the Renzulli-Hartman Scale, the Learning Characteristics…

Technology: The Silent Partner in the Advancement of Measurement and Assessment Practices (A Student Centered Assessment Model).

ERIC Educational Resources Information Center

Blanzy, James J.; Sucher, Joseph E.

Michigan's Macomb Community College's institutional assessment model involves using technology to collect and disseminate data on student learning in order to facilitate continuous improvement and adaptation. The first element of this five-part model is the mandatory testing, orientation, and placement of incoming students. Using placement test…

The Relationship between Stream Placement and Teachers' Judgements of Pupils: Evidence from the Millennium Cohort Study

ERIC Educational Resources Information Center

Campbell, Tammy

2017-01-01

This paper tests the hypothesis that stream placement influences teacher judgements of pupils, thus investigating a route through which streaming by "ability" may contribute to inequalities. Regression modelling of data for 800+ 7-year-olds taking part in the Millennium Cohort Study examines whether teachers' reported perceptions of…

Where to Begin? The Evolving Role of Placement Exams for Students Starting College

ERIC Educational Resources Information Center

Burdman, Pamela

2012-01-01

For years, colleges have used placement exams to determine whether to deem incoming students "college ready" or assign them to developmental education. But emerging information reveals the tests have little correlation to students' future success, casting doubt on their use even as the high stakes for students of taking remedial courses…

Use of the SAT in Advisement and Placement: What the Research Tells Us

ERIC Educational Resources Information Center

Shaw, Emily J.

2009-01-01

Presented at the College Board Western Regional Office (WRO) Forum in San Diego in February 2009. This presentation explores SAT test validity and how it can be used to inform both advisement and placement at the national or institution level. Institutional validity can be measured using the Admitted Class Evaluation Service (ACES) which schools…

An Eight-Year Clinic Experience with Clozapine Use in a Parkinson’s Disease Clinic Setting

PubMed Central

Hack, Nawaz; Fayad, Sarah M.; Monari, Erin H.; Akbar, Umer; Hardwick, Angela; Rodriguez, Ramon L.; Malaty, Irene A.; Romrell, Janet; Shukla, Aparna A. Wagle.; McFarland, Nikolaus; Ward, Herbert E.; Okun, Michael S.

2014-01-01

Background To examine our eight year clinic-based experience in a Parkinson’s disease expert clinical care center using clozapine as a treatment for refractory psychosis in Parkinson's disease (PD). Methods The study was a retrospective chart review which covered eight years of clozapine registry use. Statistical T-tests, chi-square, correlations and regression analysis were used to analyze treatment response for potential associations of age, disease duration, and Hoehn & Yahr (H&Y) score, and degree of response to clozapine therapy. Results There were 36 participants included in the analysis (32 PD, 4 parkinsonism-plus). The characteristics included 30.6% female, age 45–87 years (mean 68.3±10.15), disease duration of 17–240 months (mean 108.14±51.13) and H&Y score of 2 to 4 (mean 2.51±0.51). The overall retention rate on clozapine was 41% and the most common reasons for discontinuation were frequent blood testing (28%), nursing home (NH) placement (11%) and leucopenia (8%). Responses to clozapine across the cohort were: complete (33%), partial (33%), absent (16%), and unknown (16%). Age (r = −0.36, p<0.01) and H&Y score (r = −0.41, p<0.01) were shown to be related to response to clozapine therapy, but disease duration was not an associated factor (r = 0.21, p>0.05). Conclusions This single-center experience highlights the challenges associated with clozapine therapy in PD psychosis. Frequent blood testing remains a significant barrier for clozapine, even in patients with therapeutic benefit. Surprisingly, all patients admitted to a NH discontinued clozapine due to logistical issues of administration and monitoring within that setting. Consideration of the barriers to clozapine therapy will be important to its use and to its continued success in an outpatient setting. PMID:24646688

Effect of warning placement on the information processing of college students reading an OTC drug facts panel.

PubMed

Bhansali, Archita H; Sangani, Darshan S; Mhatre, Shivani K; Sansgiry, Sujit S

2018-01-01

To compare three over-the-counter (OTC) Drug Facts panel versions for information processing optimization among college students. University of Houston students (N = 210) participated in a cross-sectional survey from January to May 2010. A current FDA label was compared to two experimental labels developed using the theory of CHREST to test information processing by re-positioning the warning information within the Drug Facts panel. Congruency was defined as placing like information together. Information processing was evaluated using the OTC medication Label Evaluation Process Model (LEPM): label comprehension, ease-of-use, attitude toward the product, product evaluation, and purchase intention. Experimental label with chunked congruent information (uses-directions-other information-warnings) was rated significantly higher than the current FDA label and had the best average scores among the LEPM information processing variables. If replications uphold these findings, the FDA label design might be revised to improve information processing.

Percutaneous foot joint needle placement using a C-arm flat-panel detector CT.

PubMed

Wiewiorski, Martin; Takes, Martin Thanh Long; Valderrabano, Victor; Jacob, Augustinus Ludwig

2012-03-01

Image guidance is valuable for diagnostic injections in foot orthopaedics. Flat-detector computed tomography (FD-CT) was implemented using a C-arm, and the system was tested for needle guidance in foot joint injections. FD-CT-guided joint infiltration was performed in 6 patients referred from the orthopaedic department for diagnostic foot injections. All interventions were performed utilising a flat-panel fluoroscopy system utilising specialised image guidance and planning software. Successful infiltration was defined by localisation of contrast media depot in the targeted joint. The pre- and post-interventional numeric analogue scale (NAS) pain score was assessed. All injections were technically successful. Contrast media deposit was documented in all targeted joints. Significant relief of symptoms was noted by all 6 participants. FD-CT-guided joint infiltration is a feasible method for diagnostic infiltration of midfoot and hindfoot joints. The FD-CT approach may become an alternative to commonly used 2D-fluoroscopically guidance.

Reintervention for stent occlusion after bilateral self-expandable metallic stent placement for malignant hilar biliary obstruction.

PubMed

Inoue, Tadahisa; Naitoh, Itaru; Okumura, Fumihiro; Ozeki, Takanori; Anbe, Kaiki; Iwasaki, Hiroyasu; Nishie, Hirotada; Mizushima, Takashi; Sano, Hitoshi; Nakazawa, Takahiro; Yoneda, Masashi; Joh, Takashi

2016-11-01

Endoscopic reintervention for stent occlusions following bilateral self-expandable metallic stent (SEMS) placement for malignant hilar biliary obstruction (MHBO) is challenging, and time to recurrent biliary obstruction (RBO) of the revisionary stent remains unclear. We aimed to clarify a suitable reintervention method for stent occlusions following bilateral SEMS placement for MHBO. Between 2002 and 2014, 52 consecutive patients with MHBO who underwent endoscopic reintervention for stent occlusion after bilateral SEMS placement were enrolled at two university hospitals and one tertiary care referral center. We retrospectively evaluated the technical and functional success rates of the reinterventions, and the time to RBO of the revisionary stents. Technical and functional success rates of the reinterventions were 92% (48/52) and 90% (43/48), respectively. Univariate analysis did not determine any significant predictive factors for technical and functional failures. Median time to RBO of the revisionary stents was 68 days. Median time to RBO was significantly longer for revisionary SEMS placement than for plastic stent placement (131 days vs 47 days, respectively; log-rank test, P = 0.005). Revisionary SEMS placement was the only independent factor that was significantly associated with a longer time to RBO of the revisionary stent in the multivariate Cox proportional hazards analysis (hazard ratio 0.37; 95% confidence interval 0.14-0.95; P = 0.039). Revisionary SEMS placement is a suitable endoscopic reintervention method for stent occlusion following bilateral SEMS placement from the perspective of time to RBO of the revisionary stent. © 2016 Japan Gastroenterological Endoscopy Society.

Part I. Synthesis and characterization of donor-pi-acceptor compounds with pentadienyl-bridged indoline and tetrahydroquinoline donors and aldehyde and thiobarbituric acid acceptors Part II. Longitudinal study comparing online versus face-to-face course delivery in introductory chemistry

NASA Astrophysics Data System (ADS)

Greco, Patrick F.

Part I. The design and development of organic second-order nonlinear optical (NLO) materials have attracted much interest due to their applications in optoelectronic devices and modern communications technology. Donor-pi-acceptor compounds, D-(CH=CH)n-A, often exhibit hyperpolarizability that results in laser frequency doubling (second harmonic generation) and spectroscopic solvatochromism. To study the effect of donor amine geometry upon properties associated with second-order NLO behavior in simple donor-pi-acceptor compounds, equilibrium geometries and hyperpolarizabilities (beta) for donor-acceptor polyenes with amine donors were calculated at several levels of computational theory. Two new molecules with donors that only differ by one methylene group were chosen for comparison. Thus, 5-(N-methylindolin-5-yl)-2, 4-pentadienal (1a) and 5-(N-methyl-2, 3, 4-trihydroquinolin-6-yl)-2, 4-pentadienal (2a) were synthesized in two steps from starting materials described in the literature. These aldehydes were converted into stronger acceptors in one step to give diethylthiobarbituric acid derivatives 1c and 2c, as well as tricyanofuran derivatives 1d and 2d. Positive UV solvatochromism was observed in all three derivatives. NMR solvatochromism was most pronounced in 1c, and 2c vs. 1a and 2a as measured by changes in chemical shifts. Additionally, coupling constants showed more conjugation in 1c and 2c, where 1a and 2a showed less conjugation. Finally, differential scanning calorimetry and thermal gravimetric analysis were used to compare decomposition and melting temperatures of these compounds to determine their stability. Aldehydes, 1a and 2a had distinct melting points, while the 1c, 2c, 1d, and 2d derivatives decomposed at temperatures above 150 °C. Part II. This longitudinal study focused on an introductory chemistry course taught using two different modes of delivery: online and face-to-face (FtF). The sections of the course using the different delivery modes covered the same material at the same level, used the same textbook, and were taught by the same instructor. Student success was tracked over a period of nine consecutive years along with other important dependent variables including the number of developmental courses taken, student age, math and reading placement scores, overall GPA and full time status. Surprisingly, student success correlated negatively to their placement scores. The students who chose the online course had higher overall GPA's and better placement test scores than the FtF students. Despite these advantages, online students were less successful than their FtF counterparts. This result suggests that FtF instruction was more effective, even with better students. These findings have important implications for institutions evaluating the role online instruction will play at their institutions.

Confirming nasogastric tube placement: Is the colorimeter as sensitive and specific as X-ray? A diagnostic accuracy study.

PubMed

Mordiffi, Siti Zubaidah; Goh, Mien Li; Phua, Jason; Chan, Yiong-Huak

2016-09-01

The effect of delivering enteral nutrition or medications via a nasogastric tube that is inadvertently located in the tracheobronchial tract can cause respiratory complications. Although radiographic examination is accepted as the gold standard for confirming the position of patients' enteral tubes, it is costly, involves risks of radiation, and is not failsafe. Studies using carbon dioxide sensors to detect inadvertent nasogastric tube placements have been conducted in intensive care settings. However, none involved patients in general wards. The objective of this study was to ascertain the diagnostic measure of colorimeter, with radiographic examination as the reference standard, to confirm the location of nasogastric tubes in patients. A prospective observational study of a diagnostic test. This study was conducted in the general wards of an approximately 1100-bed acute care tertiary hospital of an Academic Medical Center in Singapore. Adult patients with nasogastric tubes admitted to the general wards were recruited into the study. The colorimeter was attached to the nasogastric tube to detect for the presence of carbon dioxide, suggestive of a tracheobronchial placement. The exact location of the nasogastric tube was subsequently confirmed by a radiographic examination. A total of 192 tests were undertaken. The colorimeter detected carbon dioxide in 29 tested nasogastric tubes, of which radiographic examination confirmed that four tubes were located in the tracheobronchial tract. The colorimeter failed to detect carbon dioxide in one nasogastric tube that was located in the tracheobronchial tract, thus, demonstrating a sensitivity of 0.80 [95% CI (0.376, 0.964)]. The colorimeter detected absence of carbon dioxide in 163 tested nasogastric tubes in which radiographic examination confirmed 160 gastrointestinal and one tracheobronchial placements, demonstrating a specificity of 0.865 [95% CI (0.808, 0.907)]. The colorimeter detected one tracheobronchial nasogastric tube placement that the radiographic examination was misinterpreted. The study found that the use of the colorimeter in the general ward setting was not 100% sensitive or specific in ascertaining the location of a nasogastric tube as previously reported by many studies undertaken in intensive care settings. This is the first study on the use of a colorimeter to confirm the placement of a nasogastric tube in adult patients in the general ward setting. More research on the use of a colorimeter in the general ward setting and its potential use in certain processes for confirming the placement of a nasogastric tube is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Use of Graphing Technology to Promote Transfer of Learning: the Interpretation of Graphs in Physics.

NASA Astrophysics Data System (ADS)

Nichols, Jeri Ann

This study examined the relationship between mathematics background and performance on graph-related problems in physics before and after instruction on the graphical analysis of motion and several microcomputer-based laboratory experiences. Students identified as either having or not having a graphing technology enhanced precalculus mathematics background were further categorized into one of four groups according to mathematics placement at the university. The performances of these groups were compared to identity differences. Pre- and Post-test data were collected from 589 students and 312 students during Autumn Quarter 1990 and Winter Quarter 1991 respectively. Background information was collected from each student. Significant differences were found between students with the technology enhanced mathematics background and those without when considering the entire populations both quarters. The students with the technology background were favored Autumn quarter and students without the technology background were favored Winter quarter. However, the entire population included an underrepresentation of students at the highest and lowest placements; hence, these were eliminated from the analyses. No significant differences were found between the technology/no technology groups after the elimination of the underrepresented groups. All categories of students increased their mean scores from pretest to post-test; the average increase was 8.23 points Autumn Quarter and 11.41 points Winter Quarter. Males consistently outperformed females on both the pretest and the post-test Autumn 1990. All students found questions involving the concept of acceleration more difficult than questions involving velocity or distance. Questions requiring students to create graphs were more difficult than questions requiring students to interpret graphs. Further research involving a qualitative component is recommended to identify the specific skills students use when solving graph-related physics problems. In addition, it is recommended that a similar study be conducted to include a control group not participating in the microcomputer -based laboratory experiments.

Fragon: rapid high-resolution structure determination from ideal protein fragments.

PubMed

Jenkins, Huw T

2018-03-01

Correctly positioning ideal protein fragments by molecular replacement presents an attractive method for obtaining preliminary phases when no template structure for molecular replacement is available. This has been exploited in several existing pipelines. This paper presents a new pipeline, named Fragon, in which fragments (ideal α-helices or β-strands) are placed using Phaser and the phases calculated from these coordinates are then improved by the density-modification methods provided by ACORN. The reliable scoring algorithm provided by ACORN identifies success. In these cases, the resulting phases are usually of sufficient quality to enable automated model building of the entire structure. Fragon was evaluated against two test sets comprising mixed α/β folds and all-β folds at resolutions between 1.0 and 1.7 Å. Success rates of 61% for the mixed α/β test set and 30% for the all-β test set were achieved. In almost 70% of successful runs, fragment placement and density modification took less than 30 min on relatively modest four-core desktop computers. In all successful runs the best set of phases enabled automated model building with ARP/wARP to complete the structure.

[Esthetic analysis on immediate single-tooth implant restoration in anterior maxilla].

PubMed

Li, Shao-wei; Wang, Guo-shi; Sha, Yan-zhi

2015-10-01

To evaluate the esthetic outcomes of immediate single-tooth implant restoration in anterior maxilla with the pink esthetic score (PES). Nine patients were treated with 9 Straumann implants by immediate single-tooth implant restoration in anterior maxilla. Assessment of PES after crown placement at 1 week (baseline) and 6 months after implantation was conducted. Statistical analysis was performed using SPSS 16.0 software package. Nine implants achieved a retention rate of 100%. PES for single-tooth implant was 10.33 ± 1.50 at 1 week and 11.44 ± 0.88 at 6 months after crown placement. The difference was significant(P=0.021). This study indicates that immediate single-tooth implant restoration in anterior maxilla is predictable. Immediate single-tooth implantation can result in good clinical esthetic results in most patients with single-tooth missing in anterior maxilla.

Liposomal bupivacaine decreases pain following retropubic sling placement: a randomized placebo-controlled trial.

PubMed

Mazloomdoost, Donna; Pauls, Rachel N; Hennen, Erin N; Yeung, Jennifer Y; Smith, Benjamin C; Kleeman, Steven D; Crisp, Catrina C

2017-11-01

Midurethral slings are commonly used to treat stress urinary incontinence. Pain control, however, may be a concern. Liposomal bupivacaine is a local anesthetic with slow release over 72 hours, demonstrated to lower pain scores and decrease narcotic use postoperatively. The purpose of this study was to examine the impact of liposomal bupivacaine on pain scores and narcotic consumption following retropubic midurethral sling placement. This randomized, placebo-controlled trial enrolled women undergoing retropubic midurethral sling procedures with or without concomitant anterior or urethrocele repair. Subjects were allocated to receive liposomal bupivacaine (intervention) or normal saline placebo injected into the trocar paths and vaginal incision at the conclusion of the procedure. At the time of drug administration, surgeons became unblinded, but did not collect outcome data. Participants remained blinded to treatment. Surgical procedures and perioperative care were standardized. The primary outcome was the visual analog scale pain score 4 hours after discharge home. Secondary outcomes included narcotic consumption, time to first bowel movement, and pain scores collected in the mornings and evenings until postoperative day 6. The morning pain item assessed "current level of pain"; the evening items queried "current level of pain," "most intense pain today," "average pain today with activity," and "average pain today with rest." Likert scales were used to measure satisfaction with pain control at 1- and 2-week postoperative intervals. Sample size calculation deemed 52 subjects per arm necessary to detect a mean difference of 10 mm on a 100-mm visual analog scale. To account for 10% drop out, 114 participants were needed. One hundred fourteen women were enrolled. After 5 exclusions, 109 cases were analyzed: 54 women received intervention, and 55 women received placebo. Mean participant age was 52 years, and mean body mass index was 30.4 kg/m 2 . Surgical and demographic characteristics were similar, except for a slightly higher body mass index in the placebo group (31.6 vs 29.2 kg/m 2 ; P=.050), and fewer placebo arm subjects received midazolam during anesthesia induction (44 vs 52; P=.015). For the primary outcome, pain score (millimeter) 4 hours after discharge home was lower in the intervention group (3.5 vs 13.0 millimeters; P=.014). Pain scores were also lower for subjects receiving liposomal bupivacaine at other time points collected during the first three postoperative days. Furthermore, fewer subjects in the intervention group consumed narcotic medication on postoperative day 2 (12 vs 27; P=.006). There was no difference in satisfaction with pain control between groups. Side-effects experienced, rate of postoperative urinary retention, and time to first bowel movement were similar between groups. Finally, no serious adverse events were noted. Liposomal bupivacaine decreased postoperative pain scores following retropubic midurethral sling placement, though pain was low in both the intervention and placebo groups. Participants who received liposomal bupivacaine were less likely to use narcotics on postoperative day 2. For this common outpatient surgery, liposomal bupivacaine may be a beneficial addition. Given the cost of this intervention, however, future cost-effective analyses may be useful. Published by Elsevier Inc.

[The Relationship Between Attachment Representations of Foster Parents and Foster Children and the Role of the Child's Sex].

PubMed

Nowacki, Katja; Kliewer-Neumann, Josephine; Bovenschen, Ina; Lang, Katrin; Zimmermann, Janin; Spangler, Gottfried

2015-01-01

Children who have been placed in foster care after having experienced difficult family situations need to experience secure relationships. The development of a secure attachment model is regarded as a key protective factor for a healthy development. The present study examines predictors of attachment representations in a sample of 37 foster children aged three to eight years. Children's attachment representations were assessed using the Attachment Story Completion Task, and foster parents' attachment representations with the Adult Attachment Interview. Female foster children scored higher in secure attachment representations than males. Attachment representations of male foster children were positively influenced by a secure attachment representation of their primary foster parent and slightly by the duration of placement in the foster family as well as their age of placement but differently than expected. These results suggest that male foster children may be more vulnerable in their development of attachment representations and that foster parents' state of mind regarding attachment as well as the duration of the placement seem to have an impact on the development of attachment patterns in their foster children. This should be considered in the choice and counseling of foster parents.

Drain placement can safely be omitted for open partial nephrectomy: Results from a prospective randomized trial.

PubMed

Kriegmair, Maximilian C; Mandel, Philipp; Krombach, Patrick; Dönmez, Hasan; John, Axel; Häcker, Axel; Michel, Maurice S

2016-05-01

To examine the benefit of drain placement during open partial nephrectomy. Overall, 106 patients treated with open partial nephrectomy were enrolled in a prospective randomized trial. Based on the randomization, a drain was placed or omitted. Complications were assessed according to the Clavien classification. Pain level and requirement for analgesics was evaluated according to a customized pattern. There was no significant difference in the two groups regarding age, body mass index, American Society of Anesthesiologists score, tumor size and nephrometry (preoperative aspects and dimensions used for an anatomical classification). In terms of overall and drain-related complications, no advantage of placing a drain could be proven (P = 0.249). Patients with a drain suffered from a significantly higher pain level (P = 0.01) and showed prolonged mobilization (P < 0.001). There was no difference in bowel movements and requirement of additional analgesics (P = 0.347 and 0.11). The results of the study suggest that drain placement during open partial nephrectomy can safely be omitted, even in cases with violation of the collecting system. © 2016 The Japanese Urological Association.

Use of colour Doppler and M-mode ultrasonography to confirm the location of an epidural catheter - a retrospective case series.

PubMed

Elsharkawy, Hesham; Sonny, Abraham; Govindarajan, Srinivasa Raghavan; Chan, Vincent

2017-05-01

Epidural anesthesia and analgesia has a reported failure rate ranging from 13% to 32%. We describe a technique using colour Doppler and M-mode ultrasonography to determine the position of the epidural catheter after placement in adults. This retrospective review included 37 adult patients who received postoperative epidural analgesia and underwent technically difficult epidural catheter placement. The demographic characteristics, type of surgery, use of ultrasonography, method of insertion, intervertebral level, and success of epidural localization using colour Doppler were noted for each patient. Pain scores on postoperative day 1 and the presence of a patchy block were also reviewed. Colour Doppler study helped to indicate the catheter's path from the skin to the epidural space during saline injection in 33 patients (89%). Saline flow within the epidural space (catheter tip confirmation) was successfully detected with colour Doppler in 25 patients (67.5%) and with M-mode ultrasonography in 28 patients (75%). Appropriate dermatomal analgesia was noted in 35 patients (94.5%) during local anesthetic infusion. Our preliminary data suggest the feasibility of using colour Doppler and M-mode ultrasonography to confirm proper epidural catheter placement.

Round window electrode insertion potentiates retention in the scala tympani.

PubMed

Connor, Stephen E J; Holland, N Julian; Agger, Andreas; Leong, Annabelle C; Varghese, Re Ajay; Jiang, Dan; Fitzgerald O'Connor, Alec

2012-09-01

The round window membrane (RWM)-intentioned approach is superior to the traditional bony cochleostomy (BC) approach in obtaining electrode placement within the scala tympani (ST). Cochlear implant outcome is influenced by several factors, including optimal placement and retention of the electrode array within the ST. The present study aimed to assess whether the RWM route is superior to a traditional BC for placement and retention of the electrode array in the ST. This was a prospective consecutive non-randomized comparison study. All patients were implanted with the Advanced Bionics 1J electrode array. The RWM approach (n = 32) was compared with a traditional BC group (n = 33). The outcome measure was the electrode position as judged within the scalar chambers at four points along the basal turn using postoperative computed tomography (CT). When the mean position scores were compared, the RWM-intentioned group had significantly more electrodes directed towards the ST compartment than the BC group (p < 0.001). The RWM electrodes achieved 94% ST retention compared with 64% for the BC group (p < 0.05). All electrodes stayed in the ST in the RWM group, whereas in the BC group 9% crossed from the ST to the scala vestibuli.

Stochastic DG Placement for Conservation Voltage Reduction Based on Multiple Replications Procedure

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

Wang, Zhaoyu; Chen, Bokan; Wang, Jianhui

2015-06-01

Conservation voltage reduction (CVR) and distributed-generation (DG) integration are popular strategies implemented by utilities to improve energy efficiency. This paper investigates the interactions between CVR and DG placement to minimize load consumption in distribution networks, while keeping the lowest voltage level within the predefined range. The optimal placement of DG units is formulated as a stochastic optimization problem considering the uncertainty of DG outputs and load consumptions. A sample average approximation algorithm-based technique is developed to solve the formulated problem effectively. A multiple replications procedure is developed to test the stability of the solution and calculate the confidence interval ofmore » the gap between the candidate solution and optimal solution. The proposed method has been applied to the IEEE 37-bus distribution test system with different scenarios. The numerical results indicate that the implementations of CVR and DG, if combined, can achieve significant energy savings.« less

English Writing Placement Recommendations at College of the Canyons: An Analysis of Disproportionate Impact.

ERIC Educational Resources Information Center

Gerda, Joseph

A study was undertaken at California's College of the Canyons (CoC) to determine whether evidence existed of disproportionate impact in English course placement based on student ethnicity, gender, or age. Data were compiled for all 4,309 students tested between spring 1993 and fall 1995, while the standard for disproportionate impact was taken…

Placement of English as a Second Language (ESL) Student Learners in Higher Education

ERIC Educational Resources Information Center

Banegas, Michael R.

2013-01-01

Immigration into the U.S. will continue to increase in the coming years, thereby increasing the postsecondary enrollment of ESL students. Yet there is still a limited amount of research designed to evaluate which ESL placement programs are most effective. This study was designed to determine if the use of correct testing instruments would ensure…

Texts of Our Institutional Lives: SATs for Writing Placement--A Critique and Counterproposal

ERIC Educational Resources Information Center

Isaacs, Emily; Molloy, Sean A.

2010-01-01

Focusing on writing placement at a particular university, the authors analyze the limits of SAT tests as a tool in this process. They then describe the writing program's adoption of a supplementary measure: a faculty committee's review of essays by students who may need to be reassigned to a different writing course. They describe how and why a…

Tracking the Success of Pre-College Algebra Workshop Students in Subsequent College Mathematics Classes

ERIC Educational Resources Information Center

Fuller, Edgar; Deshler, Jessica M.; Kuhn, Betsy; Squire, Douglas

2014-01-01

In 2007 the Department of Mathematics at our institution began developing a placement process designed to identify at-risk students entering mathematics courses at the College Algebra and Calculus levels. Major changes in our placement testing process and the resulting interventions for at-risk students were put in place in Fall of 2008. At the…

Where to Begin? The Evolving Role of Placement Exams for Students Starting College. Executive Summary

ERIC Educational Resources Information Center

Burdman, Pamela

2012-01-01

For years, colleges have used placement exams to determine whether to deem incoming students "college ready" or assign them to developmental education. Emerging information reveals the tests have little correlation to students' future success, casting doubt on their use even as the high stakes for students of taking remedial courses become clear.…

Method for Vibration Response Simulation and Sensor Placement Optimization of a Machine Tool Spindle System with a Bearing Defect

PubMed Central

Cao, Hongrui; Niu, Linkai; He, Zhengjia

2012-01-01

Bearing defects are one of the most important mechanical sources for vibration and noise generation in machine tool spindles. In this study, an integrated finite element (FE) model is proposed to predict the vibration responses of a spindle bearing system with localized bearing defects and then the sensor placement for better detection of bearing faults is optimized. A nonlinear bearing model is developed based on Jones' bearing theory, while the drawbar, shaft and housing are modeled as Timoshenko's beam. The bearing model is then integrated into the FE model of drawbar/shaft/housing by assembling equations of motion. The Newmark time integration method is used to solve the vibration responses numerically. The FE model of the spindle-bearing system was verified by conducting dynamic tests. Then, the localized bearing defects were modeled and vibration responses generated by the outer ring defect were simulated as an illustration. The optimization scheme of the sensor placement was carried out on the test spindle. The results proved that, the optimal sensor placement depends on the vibration modes under different boundary conditions and the transfer path between the excitation and the response. PMID:23012514

Thermal and Structural Performance of Woven Carbon Cloth For Adaptive Deployable Entry and Placement Technology

NASA Technical Reports Server (NTRS)

Arnold, James O.; Peterson, Keith H.; Yount, Bryan C.; Schneider, Nigel; Chavez-Garcia, Jose

2013-01-01

Arcjet testing and analysis of a three-dimensional (3D) woven carbon fabric has shown that it can be used as a thermal protection system and as a load bearing structural component for a low ballistic coefficient hypersonic decelerator called ADEPT (Adaptive Deployable Entry and Placement Technology). Results of arcjet tests proved that the 3D woven carbon fabric can withstand flight-like heating while under flight-like biaxial mechanical loads representative of those encountered during shallow entry flight path angles into the atmosphere of Venus. Importantly, the arcjet test results have been used to extend a preliminary material thermal response model based on previous testing of the same 3D woven carbon fabric under uni-axial mechanical loading.

Solving return-to-sensibility problems after electrical stunning in commercial pork slaughter plants.

PubMed

Grandin, T

2001-09-01

To determine causes and solutions for return-to-sensibility problems after electrical stunning in pigs. Case studies. 6 federally inspected pork slaughter plants. 100 to 200 pigs were scored in each plant for stunner positioning, squealing when stunner was applied, and signs of insensibility. All pigs were held in a V-shaped restrainer conveyor and stunned with a manually applied head-to-body electrical stunner. Percentage of pigs that had blinking after stunning ranged from 0.5 to 7. None of the pigs had a righting reflex or kicked in response to stimuli. All signs of possible return to sensibility disappeared before bleeding pigs reached the scalding tub. Spontaneous eye blinking was eliminated by improving bleeding practices to increase blood flow, ergonomically redesigning the stunner operator's work station to make correct placement of the stunner easier, redesigning the head electrode to facilitate correct placement, reducing line speed from 1,200 to 1,080 head/h, correcting problems with poor initial contact of the stunner, and increasing amperage of a stunner that was set too low for sows. In 1 plant, a fatigued operator was the cause of stunner placement mistakes that resulted in signs of returning to sensibility. Problems with electrical stunning can be easily corrected, but effective stunning requires monitoring of correct electrode placement, amperage, and bleeding procedures. Observation of spontaneous natural eye blinking without touching the eye is recommended for use under field conditions, because it is less prone to misinterpretation than are other methods.

A Brief Measure of Language Skills at 3 Years of Age and Special Education Use in Middle Childhood.

PubMed

McIntyre, Laura Lee; Pelham, William E; Kim, Matthew H; Dishion, Thomas J; Shaw, Daniel S; Wilson, Melvin N

2017-02-01

To test whether a language screener administered during early childhood predicts special education referrals and placement in middle childhood. A series of logistic regressions was conducted in a longitudinal study of 731 children. Predictor variables included scores on the early language screener (Fluharty Preschool Speech and Language Screening Test-Second Edition [Fluharty-2]) at ages 3 and 4 years, a standardized measure of academic achievement at age 5 years, and parent report of special education services at ages 7.5, 8.5, and 9.5 years. Results showed that higher scores on the Fluharty-2 predicted a reduced likelihood of having an individualized education program (OR 0.48), being referred for special education (OR 0.55), and being held back a grade (OR 0.37). These findings did not vary by sex, race, or ethnicity, and remained significant after controlling for male sex, behavior problems, parental education, and family income. The Fluharty-2 remained predictive of special education outcomes even after controlling for children's academic skills at age 5 years. Results suggest that structured, brief assessments of language in early childhood are robust predictors of children's future engagement in special education services and low academic achievement. Primary care physicians may use a multipronged developmental surveillance and monitoring protocol designed to identify children who may need comprehensive evaluation and intervention. Early intervention may reduce the need for costly special education services in the future and reduce comorbid conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

The Influence of Placement in an Inclusive Classroom on the Academic Performance of Non-Disabled Eleventh Grade Students in a Suburban New Jersey School District

ERIC Educational Resources Information Center

Brown, Jocelyn Easley; Babo, Gerard

2017-01-01

The purpose of this study was to determine the influence, if any; assignment to an inclusive secondary language arts classroom setting has on the academic performance of grade 11 nondisabled general education students in two suburban New Jersey High Schools. Using a sampling process known as Propensity Score Matching (PSM), a statistical technique…

Searching objective criteria for patient assignment in addiction treatment.

PubMed

López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso; Esarte, Sonia

2017-05-01

The main aim of this study was to objectify the treatment assignment criteria used in a clinical centre for addiction treatment in Spain. A sample of 162 patients (87 inpatients and 75 outpatients) who sought treatment between 2010 and 2012 was assessed. Clinical characteristics (addiction severity, psychopathological symptoms, impulsiveness and maladjustment) of the two treatment groups (inpatient and outpatient) into which patients were assigned according to the clinical criteria of therapists were analysed to identify which variables were more relevant for patient placement. Moreover, the therapeutic progression of patients who met and did not meet the assignment criteria received was studied. According to the results, a score above 4 in the family/social support area of the European Addiction Severity Index (EuropASI), or, in cases of a score between 2 and 4 in the family/social area of EuropASI, a score above 2 in the partner subscale of the Maladjustment Scale correctly classified 73.5% of cases (96.6% of inpatients and 46.7% of outpatients). Comparisons of therapeutic results depending on matching or mismatching these assignment criteria showed a larger effect size in mismatching patient assignment criteria for outpatient treatment. The results obtained in this study provide an objective criterion for addicted patient placement. Moreover, from a cost-effective perspective, they question the necessity of inpatient treatment in most cases, demonstrating that outpatient treatment is a sufficient level of care. This study addresses the approach to assigning patients to the treatment modality that best fits them, implementing the least expensive level of care needed to achieve treatment success. Copyright © 2017 Elsevier Inc. All rights reserved.

Airway stabilization with silicone stents for treating adult tracheobronchomalacia: a prospective observational study.

PubMed

Ernst, Armin; Majid, Adnan; Feller-Kopman, David; Guerrero, Jorge; Boiselle, Phillip; Loring, Stephen H; O'Donnell, Carl; Decamp, Malcolm; Herth, Felix J F; Gangadharan, Sidhu; Ashiku, Simon

2007-08-01

It is postulated that in patients with severe tracheobronchomalacia (TBM), airway stabilization with stents may relieve symptoms. To evaluate the effect of silicone stents (tracheal, mainstem bronchus, or both) on symptoms, quality of life, lung function, and exercise capacity in these patients. A prospective observational study in which baseline measurements were compared to those obtained 10 to 14 days after stent placement. Of 75 referred patients, 58 had severe disease and underwent therapeutic rigid bronchoscopy with stent placement. Mean age was 69 years (range, 39 to 91 years), 34 were men, 33 had COPD, and 13 had asthma. Almost all patients (n = 57) had dyspnea as a sole symptom or in combination with cough and recurrent infections; four patients required mechanical ventilation for respiratory failure. In 45 of 58 patients, there was reported symptomatic improvement; quality of life scores improved in 19 of 27 patients (p = 0.002); dyspnea scores improved in 22 of 24 patients (p = 0.001); functional status scores improved in 18 of 26 patients (p = 0.002); and mean exercise capacity improved from baseline, although not significantly. The 49 complications included mainly 21 partial stent obstructions, 14 infections, and 10 stent migrations. Most patients with concomitant COPD also improved on most measures. In the short term, airway stabilization with silicone stents in patients with severe TBM can improve respiratory symptoms, quality of life, and functional status. Coexisting COPD is not an absolute contraindication to a stenting trial in this population. Stenting is associated with a high number of short-term and long-term but generally reversible complications.

Validation of EncephalApp, Smartphone-based Stroop Test, for the Diagnosis of Covert Hepatic Encephalopathy

PubMed Central

Bajaj, Jasmohan S; Heuman, Douglas M; Sterling, Richard K; Sanyal, Arun J; Siddiqui, Muhammad; Matherly, Scott; Luketic, Velimir; Stravitz, R Todd; Fuchs, Michael; Thacker, Leroy R; Gilles, HoChong; White, Melanie B; Unser, Ariel; Hovermale, James; Gavis, Edith; Noble, Nicole A; Wade, James B

2014-01-01

Background & Aims Detection of covert hepatic encephalopathy (CHE) is difficult but point of care testing could increase rates of diagnosis. We aimed to validate the ability of the smartphone app EncephalApp, a streamlined version of Stroop App, to detect CHE. We evaluated face validity, test–retest reliability, and external validity. Methods Patients with cirrhosis (n=167; 38% with overt HE [OHE]; mean age, 55 years; mean model for end-stage liver disease score, 12) and controls (n=114) were each given a paper and pencil cognitive battery (standard) along with EncephalApp. EncephalApp has Off and On states; results measured were: OffTime, OnTime, OffTime+OnTime, and number of runs required to complete 5 off and on runs. Thirty-six patients with cirrhosis underwent driving simulation tests, and EncephalApp results were correlated with results. Test–retest reliability was analyzed in a subgroup of patients. The test was performed before and after transjugular intra-hepatic portosystemic shunt placement, before and after correction for hyponatremia, to determine external validity. Results All patients with cirrhosis performed worse on paper and pencil and EncephalApp tests than controls. Patients with cirrhosis and OHE performed worse than those without OHE. Age-dependent EncephalApp cut-offs (younger or older than 45 years) were set. An OffTime+OnTime value of >190 seconds identified all patients with CHE with an area under the receiver operator characteristic (AUROC) value of 0.91; the AUROC value was 0.88 for diagnosis of CHE in those without OHE. EncephalApp times correlated with crashes and illegal turns in driving simulation tests. Test–retest reliability was high (intra-class coefficient, 0.83) among 30 patients retested 1–3 months apart. OffTime+OnTime increased significantly (206 vs 255, P=.007) among 10 patients retested 33±7 days after transjugular intra-hepatic portosystemic shunt placement. OffTime+OnTime decreased significantly (242 vs 225, P=.03) in 7 patients tested before and after correction for hyponatremia (126±3 to 132±4 meq/L, P=.01), 10±5 days apart. Conclusions A smartphone app called EncephalApp has good face validity, test–retest reliability, and external validity for the diagnosis of CHE. PMID:24846278

Esthetic evaluation of single-tooth implants in the anterior mandible.

PubMed

Hof, Markus; Tepper, Gabor; Koller, Barbara; Krainhöfner, Martin; Watzek, Georg; Pommer, Bernhard

2014-09-01

Single-tooth replacement of anterior mandibular teeth is frequently complicated by insufficient bucco-lingual bone width and limited mesio-distal space available for implant placement. The aim of the present study was to assess implant esthetics in the partially edentulous anterior mandible. Esthetic evaluation of 43 anterior mandibular single-tooth implants in 15 women and 28 men was performed using esthetic indices (PES = Pink Esthetic Score, PI = Papilla Index, SES = Subjective Esthetic Score) as well as subjective patients' Visual Analogue Scale (VAS) ratings. Clinical and radiological parameters (implant and crown dimensions, pocket depth, bleeding on probing, plaque, keratinized mucosa, marginal bone level, and distance to adjacent teeth) were tested for influence. Implant esthetics were judged satisfactory (PES ≤10) in 42% of implants compared with a patient satisfaction rate of 87%. Correlation between objective indices (PES/PI: rs  = 0.62, PES/SES: rs  = -0.73, PI/SES: rs  = -0.48) was highly significant (P ≤ 0.001); however, no association to subjective patients' ratings could be observed. Type of prosthetic restoration (single crown vs. tulip-shaped double crowns), mesio-distal crown width as well as anatomic crown length significantly affected esthetic scores. Patients' judgment, by contrast, could not be associated to any prognostic factor. Subjective patient satisfaction with implant esthetics in the partially edentulous anterior mandible is high, however, remains hard to predict or objectively quantify. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Nasal Floor Augmentation for the Reconstruction of the Atrophic Maxilla: A Case Series

PubMed Central

El-Ghareeb, Moustafa; Pi-Anfruns, Joan; Khosousi, Mohammed; Aghaloo, Tara; Moy, Peter

2012-01-01

Purpose The severely atrophic edentulous maxilla imposes a challenge for dental implant rehabilitation. Nasal floor augmentation (NFA) is a method of augmenting bone height in the anterior maxilla. Autogenous bone has been commonly used as a graft material. Because of variations in results and lack of insufficient studies reporting the use of bone substitutes to graft the nasal floor, this study aims to evaluate the survival and success of dental implants placed in nasally grafted maxillae with osteoconductive bone substitutes. Materials and Methods Six patients with completely edentulous maxillae and inadequate height in the anterior to support implants underwent NFA. The nasal floor was exposed through an intraoral approach and grafted with osteoconductive bone graft substitutes. Twenty-four dental implants were placed, restored with a bar-retained implant-supported overdenture after a traditional healing period, and followed up after prosthetic loading. Patient satisfaction was evaluated with a questionnaire, and responses were expressed on a visual analog scale from 1 to 10. Bone levels were quantified radiographically based on a score ranging from 1 to 3, where 3 represented the highest bone support. Implants were evaluated for thread exposure and soft tissue health and were considered successful if the following criteria were met: absence of mobility; lack of symptoms; bone score of 3; and healthy peri-implant soft tissue without thread exposure. Results The age of patients ranged from 48 to 84 years, with a mean of 71.2 years. Three patients underwent NFA and simultaneous implant placement, whereas the other 3 had a mean healing period of 6.5 months before implant placement. Post-loading follow-up ranged from 4 to 29 months, with a mean of 14.2 months. The implant survival rate was 100%, with no complications. Ninety-three percent of the responses to the treatment satisfaction questionnaire had a score of 7 or greater. Bone scores ranged from 2 to 3, with 87.5% of implants having a score of 3 and 12.5% having a score of 2. None of the implants had a bone score of 1. Conclusions The use of osteoconductive bone substitutes for NFA, as shown in this small case series, is a reliable method for reconstruction of the anterior atrophic maxilla for implant-supported overdentures. PMID:22177805